Drug user treatment failure blindness?
Einstein, Stan
2012-01-01
An ethnographic case study of a "failed" single goal (abstinence) based individual and group therapy treatment of a New York City, Harlem-based, single, young-adult of color, IDU, mother, which ended in "death by overdose," after a period of abstinence, is presented almost 50 years later, in which complex, multidimensional structural barriers, "normed," consensualized, ideologically-driven preconceptions and an array of contextual, situational and relevant stakeholder factors, which may have resulted in intervention "failure blindness," are reviewed. The need to introduce failure analysis, blindness and management, as well as success analysis, blindness and management, as integral parts of treatment planning, implementation and assessment is raised.
The spontaneous expression of pride and shame: evidence for biologically innate nonverbal displays.
Tracy, Jessica L; Matsumoto, David
2008-08-19
The present research examined whether the recognizable nonverbal expressions associated with pride and shame may be biologically innate behavioral responses to success and failure. Specifically, we tested whether sighted, blind, and congenitally blind individuals across cultures spontaneously display pride and shame behaviors in response to the same success and failure situations--victory and defeat at the Olympic or Paralympic Games. Results showed that sighted, blind, and congenitally blind individuals from >30 nations displayed the behaviors associated with the prototypical pride expression in response to success. Sighted, blind, and congenitally blind individuals from most cultures also displayed behaviors associated with shame in response to failure. However, culture moderated the shame response among sighted athletes: it was less pronounced among individuals from highly individualistic, self-expression-valuing cultures, primarily in North America and West Eurasia. Given that congenitally blind individuals across cultures showed the shame response to failure, findings overall are consistent with the suggestion that the behavioral expressions associated with both shame and pride are likely to be innate, but the shame display may be intentionally inhibited by some sighted individuals in accordance with cultural norms.
The spontaneous expression of pride and shame: Evidence for biologically innate nonverbal displays
Tracy, Jessica L.; Matsumoto, David
2008-01-01
The present research examined whether the recognizable nonverbal expressions associated with pride and shame may be biologically innate behavioral responses to success and failure. Specifically, we tested whether sighted, blind, and congenitally blind individuals across cultures spontaneously display pride and shame behaviors in response to the same success and failure situations—victory and defeat at the Olympic or Paralympic Games. Results showed that sighted, blind, and congenitally blind individuals from >30 nations displayed the behaviors associated with the prototypical pride expression in response to success. Sighted, blind, and congenitally blind individuals from most cultures also displayed behaviors associated with shame in response to failure. However, culture moderated the shame response among sighted athletes: it was less pronounced among individuals from highly individualistic, self-expression-valuing cultures, primarily in North America and West Eurasia. Given that congenitally blind individuals across cultures showed the shame response to failure, findings overall are consistent with the suggestion that the behavioral expressions associated with both shame and pride are likely to be innate, but the shame display may be intentionally inhibited by some sighted individuals in accordance with cultural norms. PMID:18695237
Canonical failure modes of real-time control systems: insights from cognitive theory
NASA Astrophysics Data System (ADS)
Wallace, Rodrick
2016-04-01
Newly developed necessary conditions statistical models from cognitive theory are applied to generalisation of the data-rate theorem for real-time control systems. Rather than graceful degradation under stress, automatons and man/machine cockpits appear prone to characteristic sudden failure under demanding fog-of-war conditions. Critical dysfunctions span a spectrum of phase transition analogues, ranging from a ground state of 'all targets are enemies' to more standard data-rate instabilities. Insidious pathologies also appear possible, akin to inattentional blindness consequent on overfocus on an expected pattern. Via no-free-lunch constraints, different equivalence classes of systems, having structure and function determined by 'market pressures', in a large sense, will be inherently unreliable under different but characteristic canonical stress landscapes, suggesting that deliberate induction of failure may often be relatively straightforward. Focusing on two recent military case histories, these results provide a caveat emptor against blind faith in the current path-dependent evolutionary trajectory of automation for critical real-time processes.
de Wit, R; de Boer, A C; vd Linden, G H M; Stoter, G; Sparreboom, A; Verweij, J
2001-01-01
In view of the similarity in chemical structure of the available 5HT3-receptor antagonists it is assumed, whilst these agents all act at the same receptor, that failure to one agent would predict subsequent failure to all 5HT3-receptor antagonists. We conducted a randomized double blind trial of granisetron 3 mg plus dexamethasone 10 mg versus continued treatment with ondansetron 8 mg plus dexamethasone 10 mg in patients with protection failure on ondansetron 8 mg plus dexamethasone 10 mg during the first 24 hours following highly emetogenic chemotherapy. Of 40 eligible patients, 21 received ondansetron + dexamethasone and 19 received granisetron + dexamethasone. We found a significant benefit from crossing-over to granisetron after failure on ondansetron. Of the 19 patients who crossed over to granisetron, 9 patients obtained complete protection, whereas this was observed in 1 of the 21 patients continuing ondansetron, P = 0.005. These results indicate that there is no complete cross-resistance between 5HT3-receptor antagonists, and that patients who have acute protection failure on one 5HT3-receptor antagonist should be offered cross-over to another 5HT3-receptor antagonist. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11710819
Boyce, B. L.; Kramer, S. L. B.; Bosiljevac, T. R.; ...
2016-03-14
Ductile failure of structural metals is relevant to a wide range of engineering scenarios. Computational methods are employed to anticipate the critical conditions of failure, yet they sometimes provide inaccurate and misleading predictions. Challenge scenarios, such as the one presented in the current work, provide an opportunity to assess the blind, quantitative predictive ability of simulation methods against a previously unseen failure problem. Instead of evaluating the predictions of a single simulation approach, the Sandia Fracture Challenge relied on numerous volunteer teams with expertise in computational mechanics to apply a broad range of computational methods, numerical algorithms, and constitutive modelsmore » to the challenge. This exercise is intended to evaluate the state of health of technologies available for failure prediction. In the first Sandia Fracture Challenge, a wide range of issues were raised in ductile failure modeling, including a lack of consistency in failure models, the importance of shear calibration data, and difficulties in quantifying the uncertainty of prediction [see Boyce et al. (Int J Fract 186:5–68, 2014) for details of these observations]. This second Sandia Fracture Challenge investigated the ductile rupture of a Ti–6Al–4V sheet under both quasi-static and modest-rate dynamic loading (failure in ~ 0.1 s). Like the previous challenge, the sheet had an unusual arrangement of notches and holes that added geometric complexity and fostered a competition between tensile- and shear-dominated failure modes. The teams were asked to predict the fracture path and quantitative far-field failure metrics such as the peak force and displacement to cause crack initiation. Fourteen teams contributed blind predictions, and the experimental outcomes were quantified in three independent test labs. In addition, shortcomings were revealed in this second challenge such as inconsistency in the application of appropriate boundary conditions, need for a thermomechanical treatment of the heat generation in the dynamic loading condition, and further difficulties in model calibration based on limited real-world engineering data. As with the prior challenge, this work not only documents the ‘state-of-the-art’ in computational failure prediction of ductile tearing scenarios, but also provides a detailed dataset for non-blind assessment of alternative methods.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Boyce, B. L.; Kramer, S. L. B.; Bosiljevac, T. R.
Ductile failure of structural metals is relevant to a wide range of engineering scenarios. Computational methods are employed to anticipate the critical conditions of failure, yet they sometimes provide inaccurate and misleading predictions. Challenge scenarios, such as the one presented in the current work, provide an opportunity to assess the blind, quantitative predictive ability of simulation methods against a previously unseen failure problem. Instead of evaluating the predictions of a single simulation approach, the Sandia Fracture Challenge relied on numerous volunteer teams with expertise in computational mechanics to apply a broad range of computational methods, numerical algorithms, and constitutive modelsmore » to the challenge. This exercise is intended to evaluate the state of health of technologies available for failure prediction. In the first Sandia Fracture Challenge, a wide range of issues were raised in ductile failure modeling, including a lack of consistency in failure models, the importance of shear calibration data, and difficulties in quantifying the uncertainty of prediction [see Boyce et al. (Int J Fract 186:5–68, 2014) for details of these observations]. This second Sandia Fracture Challenge investigated the ductile rupture of a Ti–6Al–4V sheet under both quasi-static and modest-rate dynamic loading (failure in ~ 0.1 s). Like the previous challenge, the sheet had an unusual arrangement of notches and holes that added geometric complexity and fostered a competition between tensile- and shear-dominated failure modes. The teams were asked to predict the fracture path and quantitative far-field failure metrics such as the peak force and displacement to cause crack initiation. Fourteen teams contributed blind predictions, and the experimental outcomes were quantified in three independent test labs. In addition, shortcomings were revealed in this second challenge such as inconsistency in the application of appropriate boundary conditions, need for a thermomechanical treatment of the heat generation in the dynamic loading condition, and further difficulties in model calibration based on limited real-world engineering data. As with the prior challenge, this work not only documents the ‘state-of-the-art’ in computational failure prediction of ductile tearing scenarios, but also provides a detailed dataset for non-blind assessment of alternative methods.« less
The blind leading the blind: Mutual refinement of approximate theories
NASA Technical Reports Server (NTRS)
Kedar, Smadar T.; Bresina, John L.; Dent, C. Lisa
1991-01-01
The mutual refinement theory, a method for refining world models in a reactive system, is described. The method detects failures, explains their causes, and repairs the approximate models which cause the failures. The approach focuses on using one approximate model to refine another.
Perceptual, not memorial, disruption underlies emotion-induced blindness.
Kennedy, Briana L; Most, Steven B
2012-04-01
Emotion-induced blindness refers to impaired awareness of stimuli appearing in the temporal wake of an emotionally arousing stimulus (S. B. Most, Chun, Widders, & Zald, 2005). In previous emotion-induced blindness experiments, participants withheld target responses until the end of a rapid stream of stimuli, even though each target appeared in the middle of the stream. The resulting interval between the targets' offset and participants' initiation of a response leaves open the possibility that emotion-induced blindness reflects a failure to encode or maintain target information in memory rather than a failure of perception. In the present study, participants engaged in a typical emotion-induced blindness task but initiated a response immediately upon seeing each target. Emotion-induced blindness was nevertheless robust. This suggests that emotion-induced blindness is not attributable to the delay between awareness of a target and the initiation of a response, but rather reflects the disruptive impact of emotional distractors on mechanisms driving conscious perception. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Failure to Detect Deaf-Blindness in a Population of People with Intellectual Disability
ERIC Educational Resources Information Center
Fellinger, J.; Holzinger, D.; Dirmhirn, A.; van Dijk, J.; Goldberg, D.
2009-01-01
Background: Early identification of deaf-blindness is essential to ensure appropriate management. Previous studies indicate that deaf-blindness is often missed. We aim to discover the extent to which deaf-blindness in people with intellectual disability (ID) is undiagnosed. Method: A survey was made of the 253 residents of an institute offering…
20 CFR 416.1075 - Finding of substantial failure.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Finding of substantial failure. 416.1075... AGED, BLIND, AND DISABLED Determinations of Disability Substantial Failure § 416.1075 Finding of substantial failure. A finding of substantial failure with respect to a State may not be made unless and until...
20 CFR 416.1075 - Finding of substantial failure.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Finding of substantial failure. 416.1075... AGED, BLIND, AND DISABLED Determinations of Disability Substantial Failure § 416.1075 Finding of substantial failure. A finding of substantial failure with respect to a State may not be made unless and until...
20 CFR 416.1075 - Finding of substantial failure.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Finding of substantial failure. 416.1075... AGED, BLIND, AND DISABLED Determinations of Disability Substantial Failure § 416.1075 Finding of substantial failure. A finding of substantial failure with respect to a State may not be made unless and until...
20 CFR 416.1075 - Finding of substantial failure.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Finding of substantial failure. 416.1075... AGED, BLIND, AND DISABLED Determinations of Disability Substantial Failure § 416.1075 Finding of substantial failure. A finding of substantial failure with respect to a State may not be made unless and until...
20 CFR 416.1075 - Finding of substantial failure.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Finding of substantial failure. 416.1075... AGED, BLIND, AND DISABLED Determinations of Disability Substantial Failure § 416.1075 Finding of substantial failure. A finding of substantial failure with respect to a State may not be made unless and until...
Impact of colour blindness on recognition of haematuria in bladder cancer patients.
Katmawi-Sabbagh, Samer; Haq, Ahsanul; Jain, Sunila; Subhas, Gokul; Turnham, Helen
2009-01-01
Colour blindness might lead to failure in recognizing frank haematuria. Our aim is to investigate as to whether colour-blind males who develop bladder cancer present later with less favourable histology. Two hundred male patients with bladder cancer were assessed using Ishihara plate test for colour deficiency. Degree of haematuria, method of presentation and initial histologic findings were also determined. Colour-blind patients who develop bladder cancer present with less favourable histology compared with non-colour-blind (p = 0.01). Colour blindness was associated with presentation with more advanced bladder tumours.
Does working memory capacity predict cross-modally induced failures of awareness?
Kreitz, Carina; Furley, Philip; Simons, Daniel J; Memmert, Daniel
2016-01-01
People often fail to notice unexpected stimuli when they are focusing attention on another task. Most studies of this phenomenon address visual failures induced by visual attention tasks (inattentional blindness). Yet, such failures also occur within audition (inattentional deafness), and people can even miss unexpected events in one sensory modality when focusing attention on tasks in another modality. Such cross-modal failures are revealing because they suggest the existence of a common, central resource limitation. And, such central limits might be predicted from individual differences in cognitive capacity. We replicated earlier evidence, establishing substantial rates of inattentional deafness during a visual task and inattentional blindness during an auditory task. However, neither individual working memory capacity nor the ability to perform the primary task predicted noticing in either modality. Thus, individual differences in cognitive capacity did not predict failures of awareness even though the failures presumably resulted from central resource limitations. Copyright © 2015 Elsevier Inc. All rights reserved.
Does semantic preactivation reduce inattentional blindness?
Kreitz, Carina; Schnuerch, Robert; Furley, Philip A; Gibbons, Henning; Memmert, Daniel
2015-04-01
We are susceptible to failures of awareness if a stimulus occurs unexpectedly and our attention is focused elsewhere. Such inattentional blindness is modulated by various parameters, including stimulus attributes, the observer's cognitive resources, and the observer's attentional set regarding the primary task. In three behavioral experiments with a total of 360 participants, we investigated whether mere semantic preactivation of the color of an unexpected object can reduce inattentional blindness. Neither explicitly mentioning the color several times before the occurrence of the unexpected stimulus nor priming the color more implicitly via color-related concepts could significantly reduce the susceptibility to inattentional blindness. Even putting the specific color concept in the main focus of the primary task did not lead to reduced inattentional blindness. Thus, we have shown that the failure to consciously perceive unexpected objects was not moderated by semantic preactivation of the objects' most prominent feature: its color. We suggest that this finding reflects the rather general principle that preactivations that are not motivationally relevant for one's current selection goals do not suffice to make an unexpected object overcome the threshold of awareness.
Inadvertent Evisceration of Eyes Containing Uveal Melanoma
Eagle, Ralph C.; Grossniklaus, Hans E.; Syed, Nasreen; Hogan, R. Nick; Lloyd, William C.; Folberg, Robert
2010-01-01
Objectives To report an important complication of ocular evisceration therapy for blind, painful eyes that has been unreported in the literature, and to stress the need for careful preoperative evaluation to exclude occult neoplasms prior to therapy. Design Multicenter, retrospective, nonrandomized clinicopathological case series of patients found to have previously unsuspected uveal malignant melanoma during histopathological examination of blind, painful eyes treated by evisceration. Results Histopathological examination of evisceration specimens disclosed previously unsuspected uveal melanoma in 7 patients who were treated for blind, painful eyes. Inflammation caused by necrosis of the tumor and other ocular tissues led to misdiagnosis as endophthalmitis, orbital cellulitis, or idiopathic orbital inflammation in several cases. Preoperative imaging was not performed in 3 cases and failed to detect tumors in the remaining 4 cases. Failure of necrotic tumors to enhance contributed to misdiagnosis. Conclusions The presence of a malignant intraocular neoplasm should be excluded prior to evisceration of any blind eye or blind, painful eye, particularly with opaque media. Necrosis-related inflammation can confound the clinical diagnosis of occult lesions, as can failure of necrotic tumors to enhance on imaging studies. PMID:19204229
Accessibility of insulin pumps for blind and visually impaired people.
Uslan, Mark M; Burton, Darren M; Chertow, Bruce S; Collins, Ronda
2004-10-01
Continuous subcutaneous insulin infusion using an insulin pump (IP) more closely mimics the normal pancreas than multiple insulin injections. It is an effective, and often a preferred, means of maintaining normal blood glucose levels, but IPs were not designed to be fully accessible to blind or visually impaired people. This study will identify accessibility issues related to the design of IPs and focus on the key improvements required in the user interface to provide access for people who are blind or visually impaired. IPs that are commercially available were evaluated, and features and functions such as operating procedures, user interface design, and user manuals were tabulated and analyzed. Potential failures and design priorities were identified through a Failure Modes and Effects Analysis (FMEA). Although the IPs do provide some limited audio output, in general, it was found to be of minimal use to people who are blind or visually impaired. None of the IPs uses high-contrast displays with consistently large fonts preferred by people who are visually impaired. User manuals were also found to be of minimal use. Results of the FMEA emphasize the need to focus design improvements on communicating and verifying information so that errors and failures can be detected and corrected. The most important recommendation for future IP development is speech output capability, which, more than any other improvement, would break down accessibility barriers and allow blind and visually impaired people to take advantage of the benefits of IP technology.
Kreitz, Carina; Schnuerch, Robert; Gibbons, Henning; Memmert, Daniel
2015-01-01
Human awareness is highly limited, which is vividly demonstrated by the phenomenon that unexpected objects go unnoticed when attention is focused elsewhere (inattentional blindness). Typically, some people fail to notice unexpected objects while others detect them instantaneously. Whether this pattern reflects stable individual differences is unclear to date. In particular, hardly anything is known about the influence of personality on the likelihood of inattentional blindness. To fill this empirical gap, we examined the role of multiple personality factors, namely the Big Five, BIS/BAS, absorption, achievement motivation, and schizotypy, in these failures of awareness. In a large-scale sample (N = 554), susceptibility to inattentional blindness was associated with a low level of openness to experience and marginally with a low level of achievement motivation. However, in a multiple regression analysis, only openness emerged as an independent, negative predictor. This suggests that the general tendency to be open to experience extends to the domain of perception. Our results complement earlier work on the possible link between inattentional blindness and personality by demonstrating, for the first time, that failures to consciously perceive unexpected objects reflect individual differences on a fundamental dimension of personality. PMID:26011567
20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Suspension for failure to comply with treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Suspensions and Terminations § 416.1326 Suspension for failure to comply...
Tierney, Camlin; Collier, Ann C.; Daar, Eric S.; Mollan, Katie; Budhathoki, Chakra; Godfrey, Catherine; Jahed, Nasreen C.; Myers, Laurie; Katzenstein, David; Farajallah, Awny; Rooney, James F.; Ha, Belinda; Woodward, William C.; Feinberg, Judith; Tashima, Karen; Murphy, Robert L.; Fischl, Margaret A.
2011-01-01
(See the editorial commentary by Hull and Montaner, on pages 1154–6.) Background. AIDS Clinical Trials Group A5202 compared blinded abacavir/lamivudine (ABC/3TC) to tenofovir DF/emtricitabine (TDF/FTC) with efavirenz (EFV) or atazanavir/ritonavir (ATV/r) in human immunodeficiency virus (HIV)-infected treatment-naive patients, stratified by screening HIV RNA (< or ≥105 copies/mL). Due to higher virologic failure with ABC/3TC in the high HIV RNA stratum, blinded treatment was stopped in this group, but study follow-up continued for all patients. Methods. Primary endpoints were times to virologic failure, regimen modification, and safety event. Results. In the low HIV RNA stratum, time to virologic failure was similar for ABC/3TC vs TDF/FTC with ATV/r (hazard ratio [HR] 1.25, 95% confidence interval [CI] 0.76, 2.05) or EFV (HR 1.23, 95% CI 0.77, 1.96), with significantly shorter times to regimen modification for ABC/3TC with EFV or ATV/r and to safety events with EFV. Prior to stopping blinded treatment in the high stratum, higher virologic failure rates were seen with ABC/3TC with EFV (HR 2.46, 95% CI 1.20, 5.05) or ATV/r (HR 2.22, 95% CI 1.19, 4.14). Conclusions. In the low HIV RNA stratum, times to virologic failure for ABC/3TC or TDF/FTC were not different with EFV or ATV/r. In the high stratum, virologic failure rate was significantly higher for ABC/3TC than for TDF/FTC when given with either EFV or ATV/r. PMID:21917892
2007-01-01
The idea of quantum entanglement is borrowed from physics and developed into an algebraic argument to explain how double-blinding randomized controlled trials could lead to failure to provide unequivocal evidence for the efficacy of homeopathy, and inability to distinguish proving and placebo groups in homeopathic pathogenic trials. By analogy with the famous double-slit experiment of quantum physics, and more modern notions of quantum information processing, these failings are understood as blinding causing information loss resulting from a kind of quantum superposition between the remedy and placebo. PMID:17342236
Repetition Blindness: Out of Sight or Out of Mind?
ERIC Educational Resources Information Center
Morris, Alison L.; Harris, Catherine L.
2004-01-01
Does repetition blindness represent a failure of perception or of memory? In Experiment 1, participants viewed rapid serial visual presentation (RSVP) sentences. When critical words (C1 and C2) were orthographically similar, C2 was frequently omitted from serial report; however, repetition priming for C2 on a postsentence lexical decision task was…
Jones, Jenny; Thomson, Patricia; Lauder, William; Howie, Kate; Leslie, Stephen J
2013-08-01
This study measured the effects of reflexology in 12 reflexology-naive patients with chronic heart failure in a placebo-controlled, double blind randomised controlled study design. Outcomes included 'beat-to-beat' non-invasive continuous measurement of cardiovascular parameters and measurement of state of anxiety and pain/discomfort. There were no changes in any of the haemodynamic parameters measured (all p > 0.05). Perceived state of anxiety was significantly reduced post treatment in the control group only (p = 0.03). Reflexology applied to the feet of patients with chronic heart failure appears to have no immediate haemodynamic effects. While any long term treatment effect is uncertain, it would appear that reflexology is safe for use in this patient group. Copyright © 2013 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Needham, W. E.; And Others
1993-01-01
A 39-year-old man who was blind, diabetic, and had a double amputation with chronic renal failure and peripheral vascular disease was treated with thermal biofeedback to reduce his depression through increased self-control, to minimize pain, and to facilitate healing of a pregangrenous hand. On treatment discharge, his mental and physical states…
20 CFR 416.728 - Penalty period: Second failure to report.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Penalty period: Second failure to report. 416.728 Section 416.728 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions § 416.728 Penalty period: Second...
20 CFR 416.730 - Penalty period: Three or more failures to report.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Penalty period: Three or more failures to report. 416.730 Section 416.730 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions § 416.730 Penalty period...
20 CFR 416.730 - Penalty period: Three or more failures to report.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Penalty period: Three or more failures to report. 416.730 Section 416.730 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions § 416.730 Penalty period...
20 CFR 416.726 - Penalty period: First failure to report.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Penalty period: First failure to report. 416.726 Section 416.726 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions § 416.726 Penalty period: First...
20 CFR 416.726 - Penalty period: First failure to report.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Penalty period: First failure to report. 416.726 Section 416.726 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions § 416.726 Penalty period: First...
20 CFR 416.728 - Penalty period: Second failure to report.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Penalty period: Second failure to report. 416.728 Section 416.728 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions § 416.728 Penalty period: Second...
Wallace, Rodrick M; Fullilove, Mindy T; Fullilove, Robert E; Wallace, Deborah N
2007-01-01
We address themes of distributed cognition by extending recent formal developments in the theory of individual consciousness. While single minds appear biologically limited to one dynamic structure of linked cognitive submodules instantiating consciousness, organizations, by contrast, can support several, sometimes many, such constructs simultaneously, although these usually operate relatively slowly. System behavior remains, however, constrained not only by culture, but by a developmental path dependence generated by organizational history, in the context of market selection pressures. Such highly parallel multitasking – essentially an institutional collective consciousness – while capable of reducing inattentional blindness and the consequences of failures within individual workspaces, does not eliminate them, and introduces new characteristic malfunctions involving the distortion of information sent between workspaces and the possibility of pathological resilience – dysfunctional institutional lock-in. Consequently, organizations remain subject to canonical and idiosyncratic failures analogous to, but more complicated than, those afflicting individuals. Remediation is made difficult by the manner in which pathological externalities can write images of themselves onto both institutional function and corrective intervention. The perspective is applied to the failure of AIDS control and treatment in the United States. PMID:17324268
Dall'Orologio, Giovanni Dondi; Lorenzi, Roberta
2014-10-01
An equivalence randomized controlled trial within the subject was organized to evaluate the clinical long-term success of a new 2-step etch & rinse adhesive and a new nano-filled ormocer. 50 subjects, 21 males and 29 females aged between 21 and 65, were randomized to receive 150 restorations, 100 with the new restorative material, 50 with the composite as control, placed in non-carious cervical lesions with the same bonding system. The main outcome measure was the cause of failure at 8 years. Randomization was number table-generated, with allocation concealment by opaque sequentially numbered sealed and stapled envelopes. Subjects, examiner, and analyst were blinded to group assignment. Two interim analyses were performed. Data were analyzed by ANOVA and Cox test (P < 0.05). After 8 years, 40 subjects and 120 teeth were included in the analysis of the primary outcome. There were eight failures in the experimental group and four failures in the control group. The cumulative loss rate was 7% for both restorative materials, with the annual failure lower than 1%, without any statistically significant difference. There were two key elements of failure: the presence of sclerotic dentin and the relationship between lesion and gingival margin.
DOE Office of Scientific and Technical Information (OSTI.GOV)
English, Shawn A.; Briggs, Timothy M.; Nelson, Stacy M.
Simulations of low velocity impact with a flat cylindrical indenter upon a carbon fiber fabric reinforced polymer laminate are rigorously validated. Comparison of the impact energy absorption between the model and experiment is used as the validation metric. Additionally, non-destructive evaluation, including ultrasonic scans and three-dimensional computed tomography, provide qualitative validation of the models. The simulations include delamination, matrix cracks and fiber breaks. An orthotropic damage and failure constitutive model, capable of predicting progressive damage and failure, is developed in conjunction and described. An ensemble of simulations incorporating model parameter uncertainties is used to predict a response distribution which ismore » then compared to experimental output using appropriate statistical methods. Lastly, the model form errors are exposed and corrected for use in an additional blind validation analysis. The result is a quantifiable confidence in material characterization and model physics when simulating low velocity impact in structures of interest.« less
Estimating the R-curve from residual strength data
NASA Technical Reports Server (NTRS)
Orange, T. W.
1985-01-01
A method is presented for estimating the crack-extension resistance curve (R-curve) from residual-strength (maximum load against original crack length) data for precracked fracture specimens. The method allows additional information to be inferred from simple test results, and that information can be used to estimate the failure loads of more complicated structures of the same material and thickness. The fundamentals of the R-curve concept are reviewed first. Then the analytical basis for the estimation method is presented. The estimation method has been verified in two ways. Data from the literature (involving several materials and different types of specimens) are used to show that the estimated R-curve is in good agreement with the measured R-curve. A recent predictive blind round-robin program offers a more crucial test. When the actual failure loads are disclosed, the predictions are found to be in good agreement.
Quantitative validation of carbon-fiber laminate low velocity impact simulations
English, Shawn A.; Briggs, Timothy M.; Nelson, Stacy M.
2015-09-26
Simulations of low velocity impact with a flat cylindrical indenter upon a carbon fiber fabric reinforced polymer laminate are rigorously validated. Comparison of the impact energy absorption between the model and experiment is used as the validation metric. Additionally, non-destructive evaluation, including ultrasonic scans and three-dimensional computed tomography, provide qualitative validation of the models. The simulations include delamination, matrix cracks and fiber breaks. An orthotropic damage and failure constitutive model, capable of predicting progressive damage and failure, is developed in conjunction and described. An ensemble of simulations incorporating model parameter uncertainties is used to predict a response distribution which ismore » then compared to experimental output using appropriate statistical methods. Lastly, the model form errors are exposed and corrected for use in an additional blind validation analysis. The result is a quantifiable confidence in material characterization and model physics when simulating low velocity impact in structures of interest.« less
Repetition Blindness in Rapid Lists: Activation and Inhibition Versus Construction and Attribution
ERIC Educational Resources Information Center
Whittlesea, Bruce W. A.; Masson, Michael E. J.
2005-01-01
The authors examine the repetition blindness effect--the failure to report one of the occurrences of a word presented twice in a rapid list. This phenomenon has been ascribed to inhibitory processes that prevent immediate tokenization of the 2nd occurrence of a repeated word. The authors present several kinds of evidence against that account,…
Postpartum cortical blindness.
Faiz, Shakeel Ahmed
2008-09-01
A 30-years-old third gravida with previous normal pregnancies and an unremarkable prenatal course had an emergency lower segment caesarean section at a periphery hospital for failure of labour to progress. She developed bilateral cortical blindness immediately after recovery from anesthesia due to cerebral angiopathy shown by CT and MR scan as cortical infarct cerebral angiopathy, which is a rare complication of a normal pregnancy.
ERIC Educational Resources Information Center
Yeh, Su-Ling; Li, Jing-Ling
2004-01-01
Repetition blindness (RB) refers to the failure to detect the second occurrence of a repeated item in rapid serial visual presentation (RSVP). In two experiments using RSVP, the ability to report two critical characters was found to be impaired when these two characters were identical (Experiment 1) or similar by sharing one repeated component…
Change Deafness and the Organizational Properties of Sounds
ERIC Educational Resources Information Center
Gregg, Melissa K.; Samuel, Arthur G.
2008-01-01
Change blindness, or the failure to detect (often large) changes to visual scenes, has been demonstrated in a variety of different situations. Failures to detect auditory changes are far less studied, and thus little is known about the nature of change deafness. Five experiments were conducted to explore the processes involved in change deafness…
20 CFR 416.1322 - Suspension due to failure to comply with request for information.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Suspension due to failure to comply with request for information. 416.1322 Section 416.1322 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Suspensions and Terminations § 416.1322...
20 CFR 416.1330 - Suspension due to failure to apply for and obtain other benefits.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Suspension due to failure to apply for and obtain other benefits. 416.1330 Section 416.1330 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Suspensions and Terminations § 416.1330...
Greene, Stephen J; Epstein, Stephen E; Kim, Raymond J; Quyyumi, Arshed A; Cole, Robert T; Anderson, Allen S; Wilcox, Jane E; Skopicki, Hal A; Sikora, Sergey; Verkh, Lev; Tankovich, Nikolai I; Gheorghiade, Mihai; Butler, Javed
2017-04-01
This article describes an ongoing study investigating the safety and efficacy of ischemia-tolerant mesenchymal stem cell (MSC) therapy in patients with nonischemic heart failure and dysfunctional viable myocardium without scarring. This study will follow principles of the previously described mechanistic translational-phase concept whereby the effect of the study agent on laboratory and imaging markers of cardiac structure and function will be tested in a small homogenous cohort with the goal to enhance the understanding of the effect of interventions on cardiac remodeling and performance. This single-blind, placebo-controlled, crossover, multicenter, randomized study will assess the safety, tolerability, and preliminary efficacy of a single intravenous (i.v.) dose of allogeneic ischemia-tolerant MSCs in individuals with heart failure of nonischemic cause, ejection fraction 40% or less, and dysfunctional viable myocardium who have been receiving guideline-directed medical therapy. Eligible patients will have no evidence of baseline replacement scarring on delayed-enhancement cardiac magnetic resonance (CMR). Approximately 20 patients will be randomized in a 1 : 1 ratio to receive an i.v. infusion of ischemia-tolerant MSCs or placebo. At 90 days, the two groups will undergo crossover and received the alternative treatment. The primary endpoint is safety, as evaluated through at least 1-year post-MSC infusion. Additional efficacy endpoints will include measures of cardiac structure and function, as evaluated by serial cine-CMR and transthoracic echocardiography at 90 and 180 days post-initial infusion. This pilot study will explore the safety and effects on cardiac structure and function of i.v. injection of ischemia-tolerant MSCs in a small homogenous cohort of nonischemic heart failure patients with reduced ejection fraction and absent replacement scarring on CMR. This study also represents a prospective mechanistic translational-phase study using baseline and serial CMR imaging in heart failure patients and serves as a potential model for design of future heart failure trials (ClinicalTrials.gov identifier: NCT02467387).
The fate of object memory traces under change detection and change blindness.
Busch, Niko A
2013-07-03
Observers often fail to detect substantial changes in a visual scene. This so-called change blindness is often taken as evidence that visual representations are sparse and volatile. This notion rests on the assumption that the failure to detect a change implies that representations of the changing objects are lost all together. However, recent evidence suggests that under change blindness, object memory representations may be formed and stored, but not retrieved. This study investigated the fate of object memory representations when changes go unnoticed. Participants were presented with scenes consisting of real world objects, one of which changed on each trial, while recording event-related potentials (ERPs). Participants were first asked to localize where the change had occurred. In an additional recognition task, participants then discriminated old objects, either from the pre-change or the post-change scene, from entirely new objects. Neural traces of object memories were studied by comparing ERPs for old and novel objects. Participants performed poorly in the detection task and often failed to recognize objects from the scene, especially pre-change objects. However, a robust old/novel effect was observed in the ERP, even when participants were change blind and did not recognize the old object. This implicit memory trace was found both for pre-change and post-change objects. These findings suggest that object memories are stored even under change blindness. Thus, visual representations may not be as sparse and volatile as previously thought. Rather, change blindness may point to a failure to retrieve and use these representations for change detection. Copyright © 2013 Elsevier B.V. All rights reserved.
20 CFR 416.1080 - Notice of right to hearing on proposed finding of substantial failure.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Notice of right to hearing on proposed... ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determinations of Disability Hearings and Appeals § 416.1080 Notice of right to hearing on proposed finding of substantial failure. If...
20 CFR 416.732 - No penalty deduction if you have good cause for failure to report timely.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false No penalty deduction if you have good cause for failure to report timely. 416.732 Section 416.732 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions...
20 CFR 416.732 - No penalty deduction if you have good cause for failure to report timely.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false No penalty deduction if you have good cause for failure to report timely. 416.732 Section 416.732 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions...
Effects of Zolpidem CR on Sleep and Nocturnal Ventilation in Patients with Heart Failure.
Gatti, Rodrigo C; Burke, Patrick R; Otuyama, Leonardo J; Almeida, Dirceu R; Tufik, Sergio; Poyares, Dalva
2016-08-01
This study aimed to evaluate the effects of zolpidem CR (controlled release) on sleep and nocturnal ventilation in patients with congestive heart failure, a population at risk for insomnia and poor sleep quality. Fifteen patients with heart failure (ischemic cardiomyopathy) and ejection fraction ≤ 45% in NYHA functional class I or II were evaluated with full polysomnography in a placebo-controlled, double-blind, randomized trial. Patients underwent three tests: (1) baseline polysomnography and, after randomization, (2) a new test with zolpidem CR 12.5 mg or placebo, and after 1 week, (3) a new polysomnography, crossing the "medication" used. A 16% increase in total sleep time was found with the use of zolpidem CR and an increase in stage 3 NREM sleep (slow wave sleep). The apnea hypopnea index (AHI) did not change with zolpidem CR even after controlling for supine position; however, a slight but significant decrease was observed in lowest oxygen saturation compared with baseline and placebo conditions (83.60 ± 5.51; 84.43 ± 3.80; 80.71 ± 5.18, P = 0.002). Zolpidem CR improved sleep structure in patients with heart failure, did not change apnea hypopnea index, but slightly decreased lowest oxygen saturation. © 2016 Associated Professional Sleep Societies, LLC.
Seronegative neuromyelitis optica after cardiac transplantation.
Kim, Elecia; Van Vrancken, Michael; Shaji, Mohamed; Mir, Osman; Spak, Cedric W; Gupta, Manu; Shamim, Sadat A
2016-01-01
We report a case of a 42-year-old man who presented with progressive weakness and blindness over the course of several months and met criteria for seronegative neuromyelitis optica. This presentation was in the setting of immunosuppression following cardiac transplant. No infectious causes were found within the neuroaxis, and he ultimately died with complete blindness, quadriplegia, and respiratory failure attributed to panmyelitis and brain stem inflammation despite aggressive therapies.
Seronegative neuromyelitis optica after cardiac transplantation
Kim, Elecia; Van Vrancken, Michael; Shaji, Mohamed; Mir, Osman; Spak, Cedric W.; Gupta, Manu
2016-01-01
We report a case of a 42-year-old man who presented with progressive weakness and blindness over the course of several months and met criteria for seronegative neuromyelitis optica. This presentation was in the setting of immunosuppression following cardiac transplant. No infectious causes were found within the neuroaxis, and he ultimately died with complete blindness, quadriplegia, and respiratory failure attributed to panmyelitis and brain stem inflammation despite aggressive therapies. PMID:26722177
Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Referral of Persons Eligible for Supplemental Security...
Parris, Benjamin A; Dienes, Zoltan
2013-09-01
The present study investigated how the magnitude the word blindness suggestion effect on Stroop interference depended on hypnotic suggestibility when given as an imaginative suggestion (i.e. not post-hypnotic suggestion) and under conditions in which hypnosis was not mentioned. Hypnotic suggestibility is shown to be a significant predictor of the magnitude of the imaginative word blindness suggestion effect under these conditions. This is therefore the first study to show a linear relationship between the imaginative word blindness suggestion effect and hypnotic suggestibility across the whole hypnotizability spectrum. The results replicate previous findings showing that highs respond to the word blindness suggestion to a greater extent than lows but extend previous work by showing that the advantage for those higher on the hypnotizability spectrum occurs even in a non-hypnotic context. Negative attitudes about hypnosis may not explain the failure to observe similar effects of the word blindness suggestion in less hypnotizable individuals. Copyright © 2013 Elsevier Inc. All rights reserved.
Obtaining maximal stability with a septal extension technique in East asian rhinoplasty.
Jeong, Jae Yong
2014-01-01
Recently, in Korea, the septal extension graft from the septum or rib has become a common method of correcting a small or short nose. The success rate of this method has led to the blind faith that it provides superior tip projection and definition, and to the failure to notice its weaknesses. Even if there is a sufficient amount of cartilage, improper separation or fixation might waste the cartilage, resulting in an inefficient operation. Appropriate resection and effective fixation are essential factors for economical rhinoplasty. The septal extension graft is a remarkable procedure since it can control the nasal tip bidirectionally and three dimensionally. Nevertheless, it has a serious drawback since resection is responsible for septal weakness. Safe resection and firm reconstruction of the framework should be carried out. Operating on the basis of the principle of "safe harvest" and rebuilding the structures is important. Further, it is important to learn several techniques to manage septal weakness, insufficient cartilage quantity, and failure of the rigid frame during the surgery.
Effects of Zolpidem CR on Sleep and Nocturnal Ventilation in Patients with Heart Failure
Gatti, Rodrigo C.; Burke, Patrick R.; Otuyama, Leonardo J.; Almeida, Dirceu R.; Tufik, Sergio; Poyares, Dalva
2016-01-01
Study Objective: This study aimed to evaluate the effects of zolpidem CR (controlled release) on sleep and nocturnal ventilation in patients with congestive heart failure, a population at risk for insomnia and poor sleep quality. Methods: Fifteen patients with heart failure (ischemic cardiomyopathy) and ejection fraction ≤ 45% in NYHA functional class I or II were evaluated with full polysomnography in a placebo-controlled, double-blind, randomized trial. Patients underwent three tests: (1) baseline polysomnography and, after randomization, (2) a new test with zolpidem CR 12.5 mg or placebo, and after 1 week, (3) a new polysomnography, crossing the “medication” used. Results: A 16% increase in total sleep time was found with the use of zolpidem CR and an increase in stage 3 NREM sleep (slow wave sleep). The apnea hypopnea index (AHI) did not change with zolpidem CR even after controlling for supine position; however, a slight but significant decrease was observed in lowest oxygen saturation compared with baseline and placebo conditions (83.60 ± 5.51; 84.43 ± 3.80; 80.71 ± 5.18, P = 0.002). Conclusion: Zolpidem CR improved sleep structure in patients with heart failure, did not change apnea hypopnea index, but slightly decreased lowest oxygen saturation. Citation: Gatti RC, Burke PR, Otuyama LJ, Almeida DR, Tufik S, Poyares D. Effects of zolpidem CR on sleep and nocturnal ventilation in patients with heart failure. SLEEP 2016;39(8):1501–1505. PMID:27166233
Building Quakes: Detection of Weld Fractures in Buildings using High-Frequency Seismic Techniques
NASA Astrophysics Data System (ADS)
Heckman, V.; Kohler, M. D.; Heaton, T. H.
2009-12-01
Catastrophic fracture of welded beam-column connections in buildings was observed in the Northridge and Kobe earthquakes. Despite the structural importance of such connections, it can be difficult to locate damage in structural members underneath superficial building features. We have developed a novel technique to locate fracturing welds in buildings in real time using high-frequency information from seismograms. Numerical and experimental methods were used to investigate an approach for detecting the brittle fracture of welds of beam-column connections in instrumented steel moment-frame buildings through the use of time-reversed Green’s functions and wave propagation reciprocity. The approach makes use of a prerecorded catalogue of Green’s functions for an instrumented building to detect high-frequency failure events in the building during a later earthquake by screening continuous data for the presence of one or more of the events. This was explored experimentally by comparing structural responses of a small-scale laboratory structure under a variety of loading conditions. Experimentation was conducted on a polyvinyl chloride frame model structure with data recorded at a sample rate of 2000 Hz using piezoelectric accelerometers and a 24-bit digitizer. Green’s functions were obtained by applying impulsive force loads at various locations along the structure with a rubber-tipped force transducer hammer. We performed a blind test using cross-correlation techniques to determine if it was possible to use the catalogue of Green’s functions to pinpoint the absolute times and locations of subsequent, induced failure events in the structure. A finite-element method was used to simulate the response of the model structure to various source mechanisms in order to determine the types of elastic waves that were produced as well as to obtain a general understanding of the structural response to localized loading and fracture.
Malonza, I M; Tyndall, M W; Ndinya-Achola, J O; Maclean, I; Omar, S; MacDonald, K S; Perriens, J; Orle, K; Plummer, F A; Ronald, A R; Moses, S
1999-12-01
A randomized, double-blind, placebo-controlled clinical trial was conducted in Nairobi, Kenya, to compare single-dose ciprofloxacin with a 7-day course of erythromycin for the treatment of chancroid. In all, 208 men and 37 women presenting with genital ulcers clinically compatible with chancroid were enrolled. Ulcer etiology was determined using culture techniques for chancroid, serology for syphilis, and a multiplex polymerase chain reaction for chancroid, syphilis, and herpes simplex virus (HSV). Ulcer etiology was 31% unmixed chancroid, 23% unmixed syphilis, 16% unmixed HSV, 15% mixed etiology, and 15% unknown. For 111 participants with chancroid, cure rates were 92% with ciprofloxacin and 91% with erythromycin. For all study participants, the treatment failure rate was 15%, mostly related to ulcer etiologies of HSV infection or syphilis, and treatment failure was 3 times more frequent in human immunodeficiency virus-infected subjects than in others, mostly owing to HSV infection. Ciprofloxacin is an effective single-dose treatment for chancroid, but current recommendations for empiric therapy of genital ulcers may result in high treatment failure due to HSV infection.
Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial.
Zick, Suzanna M; Vautaw, Bonnie Motyka; Gillespie, Brenda; Aaronson, Keith D
2009-10-01
Hawthorn's efficacy when added to contemporary evidence-based heart failure therapy is unknown. We aimed to determine whether hawthorn increases submaximal exercise capacity when added to standard medical therapy. We performed a randomized, double-blind, placebo-controlled trial in 120 ambulatory patients aged > or = 18 years with New York Heart Association (NYHA) class II-III chronic heart failure. All patients received conventional medical therapy, as tolerated, and were randomized to either hawthorn 450 mg twice daily or placebo for 6 months. The primary outcome was change in 6 min walk distance at 6 months. Secondary outcomes included quality of life (QOL) measures, peak oxygen consumption, and anaerobic threshold during maximal treadmill exercise testing, NYHA classification, left ventricular ejection fraction (LVEF), neurohormones, and measures of oxidative stress and inflammation. There were no significant differences between groups in the change in 6 min walk distance (P = 0.61), or on measures of QOL, functional capacity, neurohormones, oxidative stress, or inflammation. A modest difference in LVEF favoured hawthorn (P = 0.04). There were significantly more adverse events reported in the hawthorn group (P = 0.02), although most were non-cardiac. Hawthorn provides no symptomatic or functional benefit when given with standard medical therapy to patients with heart failure. This trial is registered in ClinicalTrials.gov ID: NCT00343902.
Leem, Jungtae; Lee, Seung Min Kathy; Park, Jun Hyeong; Lee, Suji; Chung, Hyemoon; Lee, Jung Myung; Kim, Weon; Lee, Sanghoon; Woo, Jong Shin
2017-07-11
The purpose of this trial is to evaluate the effectiveness and safety of electroacupuncture in the treatment of acute decompensated heart failure compared with sham electroacupuncture. This protocol is for a randomized, sham controlled, patient- and assessor-blinded, parallel group, single center clinical trial that can overcome the limitations of previous trials examining acupuncture and heart failure. Forty-four acute decompensated heart failure patients admitted to the cardiology ward will be randomly assigned into the electroacupuncture treatment group (n = 22) or the sham electroacupuncture control group (n = 22). Participants will receive electroacupuncture treatment for 5 days of their hospital stay. The primary outcome of this study is the difference in total diuretic dose between the two groups during hospitalization. On the day of discharge, follow-up heart rate variability, routine blood tests, cardiac biomarkers, high-sensitivity C-reactive protein (hs-CRP) level, and N-terminal pro b-type natriuretic peptide (NT-pro BNP) level will be assessed. Four weeks after discharge, hs-CRP, NT-pro BNP, heart failure symptoms, quality of life, and a pattern identification questionnaire will be used for follow-up analysis. Six months after discharge, major cardiac adverse events and cardiac function measured by echocardiography will be assessed. Adverse events will be recorded during every visit. The result of this clinical trial will offer evidence of the effectiveness and safety of electroacupuncture for acute decompensated heart failure. Clinical Research Information Service: KCT0002249 .
Modi, Shilpi; Bhattacharya, Manisha; Singh, Namita; Tripathi, Rajendra Prasad; Khushu, Subash
2012-10-01
To investigate structural reorganization in the brain with differential visual experience using Voxel-Based Morphometry with Diffeomorphic Anatomic Registration Through Exponentiated Lie algebra algorithm (DARTEL) approach. High resolution structural MR images were taken in fifteen normal sighted healthy controls, thirteen totally blind subjects and six partial blind subjects. The analysis was carried out using SPM8 software on MATLAB 7.6.0 platform. VBM study revealed gray matter volume atrophy in the cerebellum and left inferior parietal cortex in total blind subjects and in left inferior parietal cortex, right caudate nucleus, and left primary visual cortex in partial blind subjects as compared to controls. White matter volume loss was found in calcarine gyrus in total blind subjects and Thlamus-somatosensory region in partially blind subjects as compared to controls. Besides, an increase in Gray Matter volume was also found in left middle occipital and middle frontal gyrus and right entorhinal cortex, and an increase in White Matter volume was found in superior frontal gyrus, left middle temporal gyrus and right Heschl's gyrus in totally blind subjects as compared to controls. Comparison between total and partial blind subjects revealed a greater Gray Matter volume in left cerebellum of partial blinds and left Brodmann area 18 of total blind subjects. Results suggest that, loss of vision at an early age can induce significant structural reorganization on account of the loss of visual input. These plastic changes are different in early onset of total blindness as compared to partial blindness. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Change detection and change blindness in pigeons (Columba livia).
Herbranson, Walter T; Trinh, Yvan T; Xi, Patricia M; Arand, Mark P; Barker, Michael S K; Pratt, Theodore H
2014-05-01
Change blindness is a phenomenon in which even obvious details in a visual scene change without being noticed. Although change blindness has been studied extensively in humans, we do not yet know if it is a phenomenon that also occurs in other animals. Thus, investigation of change blindness in a nonhuman species may prove to be valuable by beginning to provide some insight into its ultimate causes. Pigeons learned a change detection task in which pecks to the location of a change in a sequence of stimulus displays were reinforced. They were worse at detecting changes if the stimulus displays were separated by a brief interstimulus interval, during which the display was blank, and this primary result matches the general pattern seen in previous studies of change blindness in humans. A second experiment attempted to identify specific stimulus characteristics that most reliably produced a failure to detect changes. Change detection was more difficult when interstimulus intervals were longer and when the change was iterated fewer times. ©2014 APA, all rights reserved.
Jabbour, Richard J; Shun-Shin, Matthew J; Finegold, Judith A; Afzal Sohaib, S M; Cook, Christopher; Nijjer, Sukhjinder S; Whinnett, Zachary I; Manisty, Charlotte H; Brugada, Josep; Francis, Darrel P
2015-01-06
Biventricular pacing (CRT) shows clear benefits in heart failure with wide QRS, but results in narrow QRS have appeared conflicting. We tested the hypothesis that study design might have influenced findings. We identified all reports of CRT-P/D therapy in subjects with narrow QRS reporting effects on continuous physiological variables. Twelve studies (2074 patients) met these criteria. Studies were stratified by presence of bias-resistance steps: the presence of a randomized control arm over a single arm, and blinded outcome measurement. Change in each endpoint was quantified using a standardized effect size (Cohen's d). We conducted separate meta-analyses for each variable in turn, stratified by trial quality. In non-randomized, non-blinded studies, the majority of variables (10 of 12, 83%) showed significant improvement, ranging from a standardized mean effect size of +1.57 (95%CI +0.43 to +2.7) for ejection fraction to +2.87 (+1.78 to +3.95) for NYHA class. In the randomized, non-blinded study, only 3 out of 6 variables (50%) showed improvement. For the randomized blinded studies, 0 out of 9 variables (0%) showed benefit, ranging from -0.04 (-0.31 to +0.22) for ejection fraction to -0.1 (-0.73 to +0.53) for 6-minute walk test. Differences in degrees of resistance to bias, rather than choice of endpoint, explain the variation between studies of CRT in narrow-QRS heart failure addressing physiological variables. When bias-resistance features are implemented, it becomes clear that these patients do not improve in any tested physiological variable. Guidance from studies without careful planning to resist bias may be far less useful than commonly perceived. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Asmadi, Aldi; Neumann, Marcus A; Kendrick, John; Girard, Pascale; Perrin, Marc-Antoine; Leusen, Frank J J
2009-12-24
In the 2007 blind test of crystal structure prediction hosted by the Cambridge Crystallographic Data Centre (CCDC), a hybrid DFT/MM method correctly ranked each of the four experimental structures as having the lowest lattice energy of all the crystal structures predicted for each molecule. The work presented here further validates this hybrid method by optimizing the crystal structures (experimental and submitted) of the first three CCDC blind tests held in 1999, 2001, and 2004. Except for the crystal structures of compound IX, all structures were reminimized and ranked according to their lattice energies. The hybrid method computes the lattice energy of a crystal structure as the sum of the DFT total energy and a van der Waals (dispersion) energy correction. Considering all four blind tests, the crystal structure with the lowest lattice energy corresponds to the experimentally observed structure for 12 out of 14 molecules. Moreover, good geometrical agreement is observed between the structures determined by the hybrid method and those measured experimentally. In comparison with the correct submissions made by the blind test participants, all hybrid optimized crystal structures (apart from compound II) have the smallest calculated root mean squared deviations from the experimentally observed structures. It is predicted that a new polymorph of compound V exists under pressure.
Kreitz, Carina; Schnuerch, Robert; Furley, Philip A; Memmert, Daniel
2018-03-01
Inattentional blindness-the phenomenon that clearly visible, yet currently unexpected objects go unnoticed when our attention is focused elsewhere-is an ecologically valid failure of awareness. It is currently subject to debate whether previous events and experiences determine whether or not inattentional blindness occurs. Using a simple two-phase paradigm in the present study, we found that the likelihood of missing an unexpected object due to inattention did not change when its defining characteristic (its color) was perceptually preactivated (Experiment 1; N = 188). Likewise, noticing rates were not significantly reduced if the object's color was previously motivationally relevant during an unrelated detection task (Experiment 2; N = 184). These results corroborate and extend recent findings questioning the influence of previous experience on subsequent inattentional blindness. This has implications for possible countermeasures intended to thwart the potentially harmful effects of inattention. Copyright © 2018 Elsevier Inc. All rights reserved.
Working memory and inattentional blindness.
Bredemeier, Keith; Simons, Daniel J
2012-04-01
Individual differences in working memory predict many aspects of cognitive performance, especially for tasks that demand focused attention. One negative consequence of focused attention is inattentional blindness, the failure to notice unexpected objects when attention is engaged elsewhere. Yet, the relationship between individual differences in working memory and inattentional blindness is unclear; some studies have found that higher working memory capacity is associated with greater noticing, but others have found no direct association. Given the theoretical and practical significance of such individual differences, more definitive tests are needed. In two studies with large samples, we tested the relationship between multiple working memory measures and inattentional blindness. Individual differences in working memory predicted the ability to perform an attention-demanding tracking task, but did not predict the likelihood of noticing an unexpected object present during the task. We discuss the reasons why we might not expect such individual differences in noticing and why other studies may have found them.
Chabris, Christopher F; Weinberger, Adam; Fontaine, Matthew; Simons, Daniel J
2011-01-01
Inattentional blindness-the failure to see visible and otherwise salient events when one is paying attention to something else-has been proposed as an explanation for various real-world events. In one such event, a Boston police officer chasing a suspect ran past a brutal assault and was prosecuted for perjury when he claimed not to have seen it. However, there have been no experimental studies of inattentional blindness in real-world conditions. We simulated the Boston incident by having subjects run after a confederate along a route near which three other confederates staged a fight. At night only 35% of subjects noticed the fight; during the day 56% noticed. We manipulated the attentional load on the subjects and found that increasing the load significantly decreased noticing. These results provide evidence that inattentional blindness can occur during real-world situations, including the Boston case.
An accelerating precursor to predict "time-to-failure" in creep and volcanic eruptions
NASA Astrophysics Data System (ADS)
Hao, Shengwang; Yang, Hang; Elsworth, Derek
2017-09-01
Real-time prediction by monitoring of the evolution of response variables is a central goal in predicting rock failure. A linear relation Ω˙Ω¨-1 = C(tf - t) has been developed to describe the time to failure, where Ω represents a response quantity, C is a constant and tf represents the failure time. Observations from laboratory creep failure experiments and precursors to volcanic eruptions are used to test the validity of the approach. Both cumulative and simple moving window techniques are developed to perform predictions and to illustrate the effects of data selection on the results. Laboratory creep failure experiments on granites show that the linear relation works well during the final approach to failure. For blind prediction, the simple moving window technique is preferred because it always uses the most recent data and excludes effects of early data deviating significantly from the predicted trend. When the predicted results show only small fluctuations, failure is imminent.
Patterns of Individual Variation in Visual Pathway Structure and Function in the Sighted and Blind
Datta, Ritobrato; Benson, Noah C.; Prasad, Sashank; Jacobson, Samuel G.; Cideciyan, Artur V.; Bridge, Holly; Watkins, Kate E.; Butt, Omar H.; Dain, Aleksandra S.; Brandes, Lauren; Gennatas, Efstathios D.
2016-01-01
Many structural and functional brain alterations accompany blindness, with substantial individual variation in these effects. In normally sighted people, there is correlated individual variation in some visual pathway structures. Here we examined if the changes in brain anatomy produced by blindness alter the patterns of anatomical variation found in the sighted. We derived eight measures of central visual pathway anatomy from a structural image of the brain from 59 sighted and 53 blind people. These measures showed highly significant differences in mean size between the sighted and blind cohorts. When we examined the measurements across individuals within each group we found three clusters of correlated variation, with V1 surface area and pericalcarine volume linked, and independent of the thickness of V1 cortex. These two clusters were in turn relatively independent of the volumes of the optic chiasm and lateral geniculate nucleus. This same pattern of variation in visual pathway anatomy was found in the sighted and the blind. Anatomical changes within these clusters were graded by the timing of onset of blindness, with those subjects with a post-natal onset of blindness having alterations in brain anatomy that were intermediate to those seen in the sighted and congenitally blind. Many of the blind and sighted subjects also contributed functional MRI measures of cross-modal responses within visual cortex, and a diffusion tensor imaging measure of fractional anisotropy within the optic radiations and the splenium of the corpus callosum. We again found group differences between the blind and sighted in these measures. The previously identified clusters of anatomical variation were also found to be differentially related to these additional measures: across subjects, V1 cortical thickness was related to cross-modal activation, and the volume of the optic chiasm and lateral geniculate was related to fractional anisotropy in the visual pathway. Our findings show that several of the structural and functional effects of blindness may be reduced to a smaller set of dimensions. It also seems that the changes in the brain that accompany blindness are on a continuum with normal variation found in the sighted. PMID:27812129
Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) Trial
Zick, Suzanna M.; Vautaw, Bonnie Motyka; Gillespie, Brenda; Aaronson, Keith D.
2009-01-01
Aims Hawthorn's efficacy when added to contemporary evidence-based heart failure therapy is unknown. We aimed to determine whether hawthorn increases submaximal exercise capacity when added to standard medical therapy. Methods and results We performed a randomized, double-blind, placebo-controlled trial in 120 ambulatory patients aged ≥18 years with New York Heart Association (NYHA) class II-III chronic heart failure. All patients received conventional medical therapy, as tolerated, and were randomized to either hawthorn 450 mg twice daily or placebo for 6 months. The primary outcome was change in 6 min walk distance at 6 months. Secondary outcomes included quality of life (QOL) measures, peak oxygen consumption, and anaerobic threshold during maximal treadmill exercise testing, NYHA classification, left ventricular ejection fraction (LVEF), neurohormones, and measures of oxidative stress and inflammation. There were no significant differences between groups in the change in 6 min walk distance (P = 0.61), or on measures of QOL, functional capacity, neurohormones, oxidative stress, or inflammation. A modest difference in LVEF favoured hawthorn (P = 0.04). There were significantly more adverse events reported in the hawthorn group (P = 0.02), although most were non-cardiac. Conclusion Hawthorn provides no symptomatic or functional benefit when given with standard medical therapy to patients with heart failure. This trial is registered in ClinicalTrials.gov ID: NCT00343902. PMID:19789403
NASA Astrophysics Data System (ADS)
Beekman, Fred; Badsi, Madjid; van Wees, Jan-Diederik
2000-05-01
Many low-efficiency hydrocarbon reservoirs are productive largely because effective reservoir permeability is controlled by faults and natural fractures. Accurate and low-cost information on basic fault and fracture properties, orientation in particular, is critical in reducing well costs and increasing well recoveries. This paper describes how we used an advanced numerical modelling technique, the finite element method (FEM), to compute site-specific in situ stresses and rock deformation and to predict fracture attributes as a function of material properties, structural position and tectonic stress. Presented are the numerical results of two-dimensional, plane-strain end-member FEM models of a hydrocarbon-bearing fault-propagation-fold structure. Interpretation of the modelling results remains qualitative because of the intrinsic limitations of numerical modelling; however, it still allows comparisons with (the little available) geological and geophysical data. In all models, the weak mechanical strength and flow properties of a thick shale layer (the main seal) leads to a decoupling of the structural deformation of the shallower sediments from the underlying sediments and basement, and results in flexural slip across the shale layer. All models predict rock fracturing to initiate at the surface and to expand with depth under increasing horizontal tectonic compression. The stress regime for the formation of new fractures changes from compressional to shear with depth. If pre-existing fractures exist, only (sub)horizontal fractures are predicted to open, thus defining the principal orientation of effective reservoir permeability. In models that do not include a blind thrust fault in the basement, flexural amplification of the initial fold structure generates additional fracturing in the crest of the anticline controlled by the material properties of the rocks. The folding-induced fracturing expands laterally along the stratigraphic boundaries under enhanced tectonic loading. Models incorporating a blind thrust fault correctly predict the formation of secondary syn- and anti-thetic mesoscale faults in the basement and sediments of the hanging wall. Some of these faults cut reservoir and/or seal layers, and thus may influence effective reservoir permeability and affect seal integrity. The predicted faults divide the sediments across the anticline in several compartments with different stress levels and different rock failure (and proximity to failure). These numerical model outcomes can assist classic interpretation of seismic and well bore data in search of fractured and overpressured hydrocarbon reservoirs.
Tsutsui, Hiroyuki; Momomura, Shinichi; Saito, Yoshihiko; Ito, Hiroshi; Yamamoto, Kazuhiro; Ohishi, Tomomi; Okino, Naoko; Guo, Weinong
2017-09-01
The prognosis of heart failure patients with reduced ejection fraction (HFrEF) in Japan remains poor, although there is growing evidence for increasing use of evidence-based pharmacotherapies in Japanese real-world HF registries. Sacubitril/valsartan (LCZ696) is a first-in-class angiotensin receptor neprilysin inhibitor shown to reduce mortality and morbidity in the recently completed largest outcome trial in patients with HFrEF (PARADIGM-HF trial). The prospectively designed phase III PARALLEL-HF (Prospective comparison of ARNI with ACE inhibitor to determine the noveL beneficiaL trEatment vaLue in Japanese Heart Failure patients) study aims to assess the clinical efficacy and safety of LCZ696 in Japanese HFrEF patients, and show similar improvements in clinical outcomes as the PARADIGM-HF study enabling the registration of LCZ696 in Japan. This is a multicenter, randomized, double-blind, parallel-group, active controlled study of 220 Japanese HFrEF patients. Eligibility criteria include a diagnosis of chronic HF (New York Heart Association Class II-IV) and reduced ejection fraction (left ventricular ejection fraction ≤35%) and increased plasma concentrations of natriuretic peptides [N-terminal pro B-type natriuretic peptide (NT-proBNP) ≥600pg/mL, or NT-proBNP ≥400pg/mL for those who had a hospitalization for HF within the last 12 months] at the screening visit. The study consists of three phases: (i) screening, (ii) single-blind active LCZ696 run-in, and (iii) double-blind randomized treatment. Patients tolerating LCZ696 50mg bid during the treatment run-in are randomized (1:1) to receive LCZ696 100mg bid or enalapril 5mg bid for 4 weeks followed by up-titration to target doses of LCZ696 200mg bid or enalapril 10mg bid in a double-blind manner. The primary outcome is the composite of cardiovascular death or HF hospitalization and the study is an event-driven trial. The design of the PARALLEL-HF study is aligned with the PARADIGM-HF study and aims to assess the efficacy and safety of LCZ696 in Japanese HFrEF patients. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Holubarsch, C J; Colucci, W S; Meinertz, T; Gaus, W; Tendera, M
2000-12-01
SPICE is the first, international, randomized, placebo-controlled, double-blind study to investigate the influence of the herbal drug Crataegus Special Extract WS 1442 (hawthorn leaves with flowers) on mortality of patients suffering from congestive heart failure. In vitro and experimental animal studies have suggested the following pharmacological modes of action of standardized Crataegus extracts: (1) cAMP-independent positive inotropy; (2) peripheral and coronary vasodilation; (3) protection against ischemia-induced ventricular arrhythmias; (4) antioxidative properties; and (5) anti-inflammatory effects. In this randomized, placebo-controlled, double-blind, international trial (approximately 120 investigational centers in seven European countries), up to 2300 patients with congestive heart failure, New York Heart Association class II and III and markedly impaired left ventricular function, will be enrolled and treated over a period of 24 months. During this time patients receive either two film-coated tablets of 450 mg of the Special Extract WS 1442 standardized to 84.3 mg of oligomeric procyanidines or matched placebo per day in addition to standard therapy for congestive heart failure, such as diuretics, digoxin or digitoxin, beta-adrenoceptor blockers and angiotensin-converting-enzyme inhibitors. The primary outcome variable is the combined endpoint of cardiac death, non-lethal myocardial infarction, and hospitalization due to progression of heart failure. Secondary outcome variables are total mortality, exercise duration, echocardiographic parameters, quality of life as well as pharmacoeconomic parameters. The first patient was included in October 1998. The trial is expected to be completed at the end of 2002.
Inattentional blindness for ignored words: comparison of explicit and implicit memory tasks.
Butler, Beverly C; Klein, Raymond
2009-09-01
Inattentional blindness is described as the failure to perceive a supra-threshold stimulus when attention is directed away from that stimulus. Based on performance on an explicit recognition memory test and concurrent functional imaging data Rees, Russell, Frith, and Driver [Rees, G., Russell, C., Frith, C. D., & Driver, J. (1999). Inattentional blindness versus inattentional amnesia for fixated but ignored words. Science, 286, 2504-2507] reported inattentional blindness for word stimuli that were fixated but ignored. The present study examined both explicit and implicit memory for fixated but ignored words using a selective-attention task in which overlapping picture/word stimuli were presented at fixation. No explicit awareness of the unattended words was apparent on a recognition memory test. Analysis of an implicit memory task, however, indicated that unattended words were perceived at a perceptual level. Thus, the selective-attention task did not result in perfect filtering as suggested by Rees et al. While there was no evidence of conscious perception, subjects were not blind to the implicit perceptual properties of fixated but ignored words.
Repetition blindness and illusory conjunctions: errors in binding visual types with visual tokens.
Kanwisher, N
1991-05-01
Repetition blindness (Kanwisher, 1986, 1987) has been defined as the failure to detect or recall repetitions of words presented in rapid serial visual presentation (RSVP). The experiments presented here suggest that repetition blindness (RB) is a more general visual phenomenon, and examine its relationship to feature integration theory (Treisman & Gelade, 1980). Experiment 1 shows RB for letters distributed through space, time, or both. Experiment 2 demonstrates RB for repeated colors in RSVP lists. In Experiments 3 and 4, RB was found for repeated letters and colors in spatial arrays. Experiment 5 provides evidence that the mental representations of discrete objects (called "visual tokens" here) that are necessary to detect visual repetitions (Kanwisher, 1987) are the same as the "object files" (Kahneman & Treisman, 1984) in which visual features are conjoined. In Experiment 6, repetition blindness for the second occurrence of a repeated letter resulted only when the first occurrence was attended to. The overall results suggest that a general dissociation between types and tokens in visual information processing can account for both repetition blindness and illusory conjunctions.
Wu, Jia-Rong; DeWalt, Darren A; Baker, David W; Schillinger, Dean; Ruo, Bernice; Bibbins-Domingo, Kristen; Macabasco-O'Connell, Aurelia; Holmes, George M; Broucksou, Kimberly A; Erman, Brian; Hawk, Victoria; Cene, Crystal W; Jones, Christine DeLong; Pignone, Michael
2014-09-01
To determine whether a single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure. Poor medication adherence is associated with increased morbidity and mortality. Having a simple means of identifying suboptimal medication adherence could help identify at-risk patients for interventions. We performed a prospective cohort study in 592 participants with heart failure within a four-site randomised trial. Self-report medication adherence was assessed at baseline using a single-item question: 'Over the past seven days, how many times did you miss a dose of any of your heart medication?' Participants who reported no missing doses were defined as fully adherent, and those missing more than one dose were considered less than fully adherent. The primary outcome was combined all-cause hospitalisation or death over one year and the secondary endpoint was heart failure hospitalisation. Outcomes were assessed with blinded chart reviews, and heart failure outcomes were determined by a blinded adjudication committee. We used negative binomial regression to examine the relationship between medication adherence and outcomes. Fifty-two percent of participants were 52% male, mean age was 61 years, and 31% were of New York Heart Association class III/IV at enrolment; 72% of participants reported full adherence to their heart medicine at baseline. Participants with full medication adherence had a lower rate of all-cause hospitalisation and death (0·71 events/year) compared with those with any nonadherence (0·86 events/year): adjusted-for-site incidence rate ratio was 0·83, fully adjusted incidence rate ratio 0·68. Incidence rate ratios were similar for heart failure hospitalisations. A single medication adherence question at baseline predicts hospitalisation and death over one year in heart failure patients. Medication adherence is associated with all-cause and heart failure-related hospitalisation and death in heart failure. It is important for clinicians to assess patients' medication adherence on a regular basis at their clinical follow-ups. © 2013 John Wiley & Sons Ltd.
Lessons from the Failure of U.S. Electricity Restructuring
DOE Office of Scientific and Technical Information (OSTI.GOV)
Blumsack, Seth A.; Apt, Jay; Lave, Lester B.
2006-03-01
Blind faith is unlikely to produce a free market that is competitive. Substituting markets for traditional regulation is only one choice among many policy instruments to achieve a goal of lower prices; such substitution should not be in itself a goal. (author)
Driving with hemianopia: IV. Head scanning and detection at intersections in a simulator.
Bowers, Alex R; Ananyev, Egor; Mandel, Aaron J; Goldstein, Robert B; Peli, Eli
2014-03-13
Using a driving simulator, we examined the effects of homonymous hemianopia (HH) on head scanning behaviors at intersections and evaluated the role of inadequate head scanning in detection failures. Fourteen people with complete HH and without cognitive decline or visual neglect and 12 normally sighted (NV) current drivers participated. They drove in an urban environment following predetermined routes, which included multiple intersections. Head scanning behaviors were quantified at T-intersections (n = 32) with a stop or yield sign. Participants also performed a pedestrian detection task. The relationship between head scanning and detection was examined at 10 intersections. For HH drivers, the first scan was more likely to be toward the blind than the seeing hemifield. They also made a greater proportion of head scans overall to the blind side than did the NV drivers to the corresponding side (P = 0.003). However, head scan magnitudes of HH drivers were smaller than those of the NV group (P < 0.001). Drivers with HH had impaired detection of blind-side pedestrians due either to not scanning in the direction of the pedestrian or to an insufficient scan magnitude (left HH detected only 46% and right HH 8% at the extreme left and right of the intersection, respectively). Drivers with HH demonstrated compensatory head scan patterns, but not scan magnitudes. Inadequate scanning resulted in blind-side detection failures, which might place HH drivers at increased risk for collisions at intersections. Scanning training tailored to specific problem areas identified in this study might be beneficial.
Towards a Personalized Prescription Tool for Diabetic Treatment
2015-05-18
for public release and sale ; its distribution is limited. U.S.N.A. --- Trident Scholar project report; no. 432 (2015) TOWARDS A...stroke, high blood pressure, blindness, kidney failure, and nervous symptom damage. Both type I and type II diabetes are currently treated with insulin
ERIC Educational Resources Information Center
Smith, Mary Tinglof
1982-01-01
A member of the Los Angeles board of education describes her experiences in the attempt to enforce school desegregation in the district between 1962 and 1965, discusses the board's "color blind" policy and its resistance to integration efforts, and examines integrationists' limited successes and eventual failure in the desegregation…
Ward, Emily J; Scholl, Brian J
2015-06-01
Perhaps the most striking phenomenon of visual awareness is inattentional blindness (IB), in which a surprisingly salient event right in front of you may go completely unseen when unattended. Does IB reflect a failure of perception, or only of subsequent memory? Previous work has been unable to answer this question, due to a seemingly intractable dilemma: ruling out memory requires immediate perceptual reports, but soliciting such reports fuels an expectation that eliminates IB. Here we introduce a way of evoking repeated IB in the same subjects and the same session: we show that observers fail to report seeing salient events' not only when they have no expectation, but also when they have the wrong expectations about the events nature. This occurs when observers must immediately report seeing anything unexpected, even mid-event. Repeated IB thus demonstrates that IB is aptly named: it reflects a genuine deficit in moment-by-moment conscious perception, rather than a form of inattentional amnesia.
van Riet, Evelien E S; Hoes, Arno W; Limburg, Alexander; van der Hoeven, Henk; Landman, Marcel A J; Rutten, Frans H
2014-01-08
Most patients with heart failure are diagnosed and managed in primary care, however, underdiagnosis and undertreatment are common. We assessed whether implementation of a diagnostic-therapeutic strategy improves functionality, health-related quality of life, and uptake of heart failure medication in primary care. A selective screening study followed by a single-blind cluster randomized trial in primary care. The study population consists of patients aged 65 years or over who presented themselves to the general practitioner in the previous 12 months with shortness of breath on exertion. Patients already known with established heart failure, confirmed by echocardiography, are excluded. Diagnostic investigations include history taking, physical examination, electrocardiography, and serum N-terminal pro B-type natriuretic peptide levels. Only participants with an abnormal electrocardiogram or an N-terminal pro B-type natriuretic peptide level exceeding the exclusionary cutpoint for non-acute onset heart failure (> 15 pmol/L (≈ 125 pg/ml)) will undergo open-access echocardiography. The diagnosis of heart failure (with reduced or preserved ejection fraction) is established by an expert panel consisting of two cardiologists and a general practitioner, according to the criteria of the European Society of Cardiology guidelines.Patients with newly established heart failure are allocated to either the 'care as usual' group or the 'intervention' group. Randomization is at the level of the general practitioner. In the intervention group general practitioners receive a single half-day training in heart failure management and the use of a structured up-titration scheme. All participants fill out quality of life questionnaires at baseline and after six months of follow-up. A six-minute walking test will be performed in patients with heart failure. Information on medication and hospitalization rates is extracted from the electronic medical files of the general practitioners. This study will provide information on the prevalence of unrecognized heart failure in elderly with shortness of breath on exertion, and the randomized comparison will reveal whether management based on a half-day training of general practitioners in the practical application of an up-titration scheme results in improvements in functionality, health-related quality of life, and uptake of heart failure medication in heart failure patients compared to care as usual. ClinicalTrials.gov NCT01202006.
Congenital prosopagnosia: face-blind from birth.
Behrmann, Marlene; Avidan, Galia
2005-04-01
Congenital prosopagnosia refers to the deficit in face processing that is apparent from early childhood in the absence of any underlying neurological basis and in the presence of intact sensory and intellectual function. Several such cases have been described recently and elucidating the mechanisms giving rise to this impairment should aid our understanding of the psychological and neural mechanisms mediating face processing. Fundamental questions include: What is the nature and extent of the face-processing deficit in congenital prosopagnosia? Is the deficit related to a more general perceptual deficit such as the failure to process configural information? Are any neural alterations detectable using fMRI, ERP or structural analyses of the anatomy of the ventral visual cortex? We discuss these issues in relation to the existing literature and suggest directions for future research.
Lalukota, Krishna; Cleland, John G F; Ingle, Lee; Clark, Andrew L; Coletta, Alison P
2004-12-01
This article summarises key presentations relevant to the pathophysiology, prevention or treatment of heart failure, from the Heart Failure Society of America annual meeting held in Toronto, Canada. Data from the EnoxiMone in intravenous inOTropE-dependent subjects (EMOTE) study suggest that the oral PDE-3 inhibitor enoximone may be effective for weaning severe heart failure patients from intravenous inotropic therapy. Hawthorn Extract Randomised Blinded Trial in CHF (HERB-CHF) failed to show a benefit of hawthorn extract added to conventional heart failure therapy. A genetic sub-group analysis of the Blocker Evaluation of Survival Trial (BEST) study showed that bucindolol reduced mortality and hospitalisations in patients who were homozygous for the Arg389 variant of the beta(1) adrenoceptor. In the Resynchronisation Hemodynamic Treatment for Heart Failure Management (RHYTHM-ICD) study, patients randomised to cardiac resynchronisation therapy (CRT) showed an improvement in symptoms and functional capacity compared to the control group.
Blind prediction of noncanonical RNA structure at atomic accuracy.
Watkins, Andrew M; Geniesse, Caleb; Kladwang, Wipapat; Zakrevsky, Paul; Jaeger, Luc; Das, Rhiju
2018-05-01
Prediction of RNA structure from nucleotide sequence remains an unsolved grand challenge of biochemistry and requires distinct concepts from protein structure prediction. Despite extensive algorithmic development in recent years, modeling of noncanonical base pairs of new RNA structural motifs has not been achieved in blind challenges. We report a stepwise Monte Carlo (SWM) method with a unique add-and-delete move set that enables predictions of noncanonical base pairs of complex RNA structures. A benchmark of 82 diverse motifs establishes the method's general ability to recover noncanonical pairs ab initio, including multistrand motifs that have been refractory to prior approaches. In a blind challenge, SWM models predicted nucleotide-resolution chemical mapping and compensatory mutagenesis experiments for three in vitro selected tetraloop/receptors with previously unsolved structures (C7.2, C7.10, and R1). As a final test, SWM blindly and correctly predicted all noncanonical pairs of a Zika virus double pseudoknot during a recent community-wide RNA-Puzzle. Stepwise structure formation, as encoded in the SWM method, enables modeling of noncanonical RNA structure in a variety of previously intractable problems.
Falls, Roman; Seman, Michael; Braat, Sabine; Sortino, Joshua; Allen, Jason D; Neil, Christopher J
2017-08-08
Acute heart failure (AHF) is a frequent reason for hospitalization worldwide and effective treatment options are limited. It is known that AHF is a condition characterized by impaired vasorelaxation, together with reduced nitric oxide (NO) bioavailability, an endogenous vasodilatory compound. Supplementation of inorganic sodium nitrate (NaNO 3 ) is an indirect dietary source of NO, through bioconversion. It is proposed that oral sodium nitrate will favorably affect levels of circulating NO precursors (nitrate and nitrite) in AHF patients, resulting in reduced systemic vascular resistance, without significant hypotension. We propose a single center, randomized, double-blind, placebo-controlled pilot trial, evaluating the feasibility of sodium nitrate as a treatment for AHF. The primary hypothesis that sodium nitrate treatment will result in increased systemic levels of nitric oxide pre-cursors (nitrate and nitrite) in plasma, in parallel with improved vasorelaxation, as assessed by non-invasively derived systemic vascular resistance index. Additional surrogate measures relevant to the known pathophysiology of AHF will be obtained in order to assess clinical effect on dyspnea and renal function. The results of this study will provide evidence of the feasibility of this novel approach and will be of interest to the heart failure community. This trial may inform a larger study.
Nonexplicit change detection in complex dynamic settings: what eye movements reveal.
Vachon, François; Vallières, Benoît R; Jones, Dylan M; Tremblay, Sébastien
2012-12-01
We employed a computer-controlled command-and-control (C2) simulation and recorded eye movements to examine the extent and nature of the inability to detect critical changes in dynamic displays when change detection is implicit (i.e., requires no explicit report) to the operator's task. Change blindness-the failure to notice significant changes to a visual scene-may have dire consequences on performance in C2 and surveillance operations. Participants performed a radar-based risk-assessment task involving multiple subtasks. Although participants were not required to explicitly report critical changes to the operational display, change detection was critical in informing decision making. Participants' eye movements were used as an index of visual attention across the display. Nonfixated (i.e., unattended) changes were more likely to be missed than were fixated (i.e., attended) changes, supporting the idea that focused attention is necessary for conscious change detection. The finding of significant pupil dilation for changes undetected but fixated suggests that attended changes can nonetheless be missed because of a failure of attentional processes. Change blindness in complex dynamic displays takes the form of failures in establishing task-appropriate patterns of attentional allocation. These findings have implications in the design of change-detection support tools for dynamic displays and work procedure in C2 and surveillance.
Cohen, Calvin J; Molina, Jean-Michel; Cahn, Pedro; Clotet, Bonaventura; Fourie, Jan; Grinsztejn, Beatriz; Wu, Hao; Johnson, Margaret A; Saag, Michael; Supparatpinyo, Khuanchai; Crauwels, Herta; Lefebvre, Eric; Rimsky, Laurence T; Vanveggel, Simon; Williams, Peter; Boven, Katia
2012-05-01
Pooled analysis of phase 3, double-blind, double-dummy ECHO and THRIVE trials comparing rilpivirine (TMC278) and efavirenz. Treatment-naive HIV-1-infected adults were randomized 1:1 to rilpivirine 25 mg once daily or efavirenz 600 mg once daily, with background tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) (ECHO) or TDF/FTC, zidovudine/lamivudine, or abacavir/lamivudine (THRIVE). The primary endpoint was confirmed response [viral load <50 copies per milliliter; intent-to-treat time-to-loss-of-virologic-response (ITT-TLOVR) algorithm] at week 48. The pooled data set enabled analyses of subgroups and predictors of response/virologic failure. Confirmed responses were 84% (rilpivirine) and 82% (efavirenz). The difference in response rates (95% confidence interval) was 2.0% (-2.0% to 6.0%). The incidence of virologic failure was 9% (rilpivirine) versus 5% (efavirenz). Responses in ITT-TLOVR and ITT-snapshot analyses were consistent. Responses were similar for rilpivirine and efavirenz by background regimen, gender, race and clade. Suboptimal adherence and higher baseline viral load resulted in lower responses, higher virologic failure, and development of resistance in both groups; the effects on virologic failure were more apparent with rilpivirine. CD4 cell count increased over time in both groups. Rilpivirine compared with efavirenz gave smaller incidences of adverse events leading to discontinuation (3% vs. 8%, respectively), treatment-related grade 2-4 adverse events (16% vs. 31%), rash (3% vs. 14%), dizziness (8% vs. 26%), abnormal dreams/nightmares (8% vs. 13%), and grade 2-4 lipid abnormalities. At week 48, rilpivirine 25 mg once daily and efavirenz 600 mg once daily had comparable response rates. Rilpivirine had more virologic failures and improved tolerability versus efavirenz.
Oellgaard, Jens; Gæde, Peter; Rossing, Peter; Rørth, Rasmus; Køber, Lars; Parving, Hans-Henrik; Pedersen, Oluf
2018-05-30
In type 2 diabetes mellitus, heart failure is a frequent, potentially fatal and often forgotten complication. Glucose-lowering agents and adjuvant therapies modify the risk of heart failure. We recently reported that 7.8 years of intensified compared with conventional multifactorial intervention in individuals with type 2 diabetes and microalbuminuria in the Steno-2 study reduced the risk of cardiovascular disease and prolonged life over 21.2 years of follow-up. In this post hoc analysis, we examine the impact of intensified multifactorial intervention on the risk of hospitalisation for heart failure. One hundred and sixty individuals were randomised to conventional or intensified multifactorial intervention, using sealed envelopes. The trial was conducted using the Prospective, Randomised, Open, Blinded Endpoints (PROBE) design. After 7.8 years, all individuals were offered intensified therapy and the study continued as an observational follow-up study for an additional 13.4 years. Heart-failure hospitalisations were adjudicated from patient records by an external expert committee blinded for treatment allocation. Event rates were compared using a Cox regression model adjusted for age and sex. Eighty patients were assigned to each treatment group. Ten patients undergoing intensive therapy vs 24 undergoing conventional therapy were hospitalised for heart failure during follow-up. The HR (95% CI) was 0.30 (0.14, 0.64), p = 0.002 in the intensive-therapy group compared with the conventional-therapy group. Including death in the endpoint did not lead to an alternate overall outcome; HR 0.51 (0.34, 0.76), p = 0.001. In a pooled cohort analysis, an increase in plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) during the first two years of the trial was associated with incident heart failure. Intensified, multifactorial intervention for 7.8 years in type 2 diabetic individuals with microalbuminuria reduced the risk of hospitalisation for heart failure by 70% during a total of 21.2 years of observation. ClinicalTrials.gov NCT00320008.
2010-01-01
Background Change blindness refers to a failure to detect changes between consecutively presented images separated by, for example, a brief blank screen. As an explanation of change blindness, it has been suggested that our representations of the environment are sparse outside focal attention and even that changed features may not be represented at all. In order to find electrophysiological evidence of neural representations of changed features during change blindness, we recorded event-related potentials (ERPs) in adults in an oddball variant of the change blindness flicker paradigm. Methods ERPs were recorded when subjects performed a change detection task in which the modified images were infrequently interspersed (p = .2) among the frequently (p = .8) presented unmodified images. Responses to modified and unmodified images were compared in the time window of 60-100 ms after stimulus onset. Results ERPs to infrequent modified images were found to differ in amplitude from those to frequent unmodified images at the midline electrodes (Fz, Pz, Cz and Oz) at the latency of 60-100 ms even when subjects were unaware of changes (change blindness). Conclusions The results suggest that the brain registers changes very rapidly, and that changed features in images are neurally represented even without participants' ability to report them. PMID:20181126
Dietrich, Susanne; Hertrich, Ingo; Kumar, Vinod; Ackermann, Hermann
2015-01-01
Late-blind humans can learn to understand speech at ultra-fast syllable rates (ca. 20 syllables/s), a capability associated with hemodynamic activation of the central-visual system. Thus, the observed functional cross-modal recruitment of occipital cortex might facilitate ultra-fast speech processing in these individuals. To further elucidate the structural prerequisites of this skill, diffusion tensor imaging (DTI) was conducted in late-blind subjects differing in their capability of understanding ultra-fast speech. Fractional anisotropy (FA) was determined as a quantitative measure of the directionality of water diffusion, indicating fiber tract characteristics that might be influenced by blindness as well as the acquired perceptual skills. Analysis of the diffusion images revealed reduced FA in late-blind individuals relative to sighted controls at the level of the optic radiations at either side and the right-hemisphere dorsal thalamus (pulvinar). Moreover, late-blind subjects showed significant positive correlations between FA and the capacity of ultra-fast speech comprehension within right-hemisphere optic radiation and thalamus. Thus, experience-related structural alterations occurred in late-blind individuals within visual pathways that, presumably, are linked to higher order frontal language areas. PMID:25830371
Motion-Dependent Filling-In of Spatiotemporal Information at the Blind Spot
Maus, Gerrit W.; Whitney, David
2016-01-01
We usually do not notice the blind spot, a receptor-free region on the retina. Stimuli extending through the blind spot appear filled in. However, if an object does not reach through but ends in the blind spot, it is perceived as “cut off” at the boundary. Here we show that even when there is no corresponding stimulation at opposing edges of the blind spot, well known motion-induced position shifts also extend into the blind spot and elicit a dynamic filling-in process that allows spatial structure to be extrapolated into the blind spot. We presented observers with sinusoidal gratings that drifted into or out of the blind spot, or flickered in counterphase. Gratings moving into the blind spot were perceived to be longer than those moving out of the blind spot or flickering, revealing motion-dependent filling-in. Further, observers could perceive more of a grating’s spatial structure inside the blind spot than would be predicted from simple filling-in of luminance information from the blind spot edge. This is evidence for a dynamic filling-in process that uses spatiotemporal information from the motion system to extrapolate visual percepts into the scotoma of the blind spot. Our findings also provide further support for the notion that an explicit spatial shift of topographic representations contributes to motion-induced position illusions. PMID:27100795
Motion-Dependent Filling-In of Spatiotemporal Information at the Blind Spot.
Maus, Gerrit W; Whitney, David
2016-01-01
We usually do not notice the blind spot, a receptor-free region on the retina. Stimuli extending through the blind spot appear filled in. However, if an object does not reach through but ends in the blind spot, it is perceived as "cut off" at the boundary. Here we show that even when there is no corresponding stimulation at opposing edges of the blind spot, well known motion-induced position shifts also extend into the blind spot and elicit a dynamic filling-in process that allows spatial structure to be extrapolated into the blind spot. We presented observers with sinusoidal gratings that drifted into or out of the blind spot, or flickered in counterphase. Gratings moving into the blind spot were perceived to be longer than those moving out of the blind spot or flickering, revealing motion-dependent filling-in. Further, observers could perceive more of a grating's spatial structure inside the blind spot than would be predicted from simple filling-in of luminance information from the blind spot edge. This is evidence for a dynamic filling-in process that uses spatiotemporal information from the motion system to extrapolate visual percepts into the scotoma of the blind spot. Our findings also provide further support for the notion that an explicit spatial shift of topographic representations contributes to motion-induced position illusions.
Howard, K.A.
2010-01-01
The 1968 trapdoor collapse (1.5 km3) of Fernandina caldera in the Galapágos Islands developed the same kinds of structures as found in small sandbox-collapse models and in concentrically zoned sinks formed in desert alluvium by fault subsidence into underground nuclear-explosion cavities. Fernandina’s collapse developed through shear failure in which the roof above the evacuating chamber was lowered mostly intact. This coherent subsidence contrasts to chaotic piecemeal collapse at small, rocky pit craters, underscoring the role of rock strength relative to subsidence size. The zoning at Fernandina implies that the deflated magma chamber underlay a central basin and a bordering inward-dipping monocline, which separates a blind inner reverse fault from an outer zone of normal faulting. Similar concentric zoning patterns can be recognized in coherent subsidence structures ranging over 16 orders of magnitude in size, from sandbox experiments to the giant Olympus Mons caldera on Mars.
Animacy, perceptual load, and inattentional blindness.
Calvillo, Dustin P; Jackson, Russell E
2014-06-01
Inattentional blindness is the failure to notice unexpected objects in a visual scene while engaging in an attention-demanding task. We examined the effects of animacy and perceptual load on inattentional blindness. Participants searched for a category exemplar under low or high perceptual load. On the last trial, the participants were exposed to an unexpected object that was either animate or inanimate. Unexpected objects were detected more frequently when they were animate rather than inanimate, and more frequently with low than with high perceptual loads. We also measured working memory capacity and found that it predicted the detection of unexpected objects, but only with high perceptual loads. The results are consistent with the animate-monitoring hypothesis, which suggests that animate objects capture attention because of the importance of the detection of animate objects in ancestral hunter-gatherer environments.
Amin, Muhammad Nasir; Zaheer, Salman; Alazba, Abdulrahman Ali; Saleem, Muhammad Umair; Niazi, Muhammad Umar Khan; Khurram, Nauman; Amin, Muhammad Tahir
2016-01-01
Structural hollow sections are gaining worldwide importance due to their structural and architectural advantages over open steel sections. The only obstacle to their use is their connection with other structural members. To overcome the obstacle of tightening the bolt from one side has given birth to the concept of blind bolts. Blind bolts, being the practical solution to the connection hindrance for the use of hollow and concrete filled hollow sections play a vital role. Flowdrill, the Huck High Strength Blind Bolt and the Lindapter Hollobolt are the well-known commercially available blind bolts. Although the development of blind bolts has largely resolved this issue, the use of structural hollow sections remains limited to shear resistance. Therefore, a new modified version of the blind bolt, known as the “Extended Hollo-Bolt” (EHB) due to its enhanced capacity for bonding with concrete, can overcome the issue of low moment resistance capacity associated with blind-bolted connections. The load transfer mechanism of this recently developed blind bolt remains unclear, however. This study uses a parametric approach to characterising the EHB, using diameter as the variable parameter. Stiffness and load-carrying capacity were evaluated at two different bolt sizes. To investigate the load transfer mechanism, a component-based study of the bond and anchorage characteristics was performed by breaking down the EHB into its components. The results of the study provide insight into the load transfer mechanism of the blind bolt in question. The proposed component-based model was validated by a spring model, through which the stiffness of the EHB was compared to that of its components combined. The combined stiffness of the components was found to be roughly equivalent to that of the EHB as a whole, validating the use of this component-based approach. PMID:26901866
Amin, Muhammad Nasir; Zaheer, Salman; Alazba, Abdulrahman Ali; Saleem, Muhammad Umair; Niazi, Muhammad Umar Khan; Khurram, Nauman; Amin, Muhammad Tahir
2016-01-01
Structural hollow sections are gaining worldwide importance due to their structural and architectural advantages over open steel sections. The only obstacle to their use is their connection with other structural members. To overcome the obstacle of tightening the bolt from one side has given birth to the concept of blind bolts. Blind bolts, being the practical solution to the connection hindrance for the use of hollow and concrete filled hollow sections play a vital role. Flowdrill, the Huck High Strength Blind Bolt and the Lindapter Hollobolt are the well-known commercially available blind bolts. Although the development of blind bolts has largely resolved this issue, the use of structural hollow sections remains limited to shear resistance. Therefore, a new modified version of the blind bolt, known as the "Extended Hollo-Bolt" (EHB) due to its enhanced capacity for bonding with concrete, can overcome the issue of low moment resistance capacity associated with blind-bolted connections. The load transfer mechanism of this recently developed blind bolt remains unclear, however. This study uses a parametric approach to characterising the EHB, using diameter as the variable parameter. Stiffness and load-carrying capacity were evaluated at two different bolt sizes. To investigate the load transfer mechanism, a component-based study of the bond and anchorage characteristics was performed by breaking down the EHB into its components. The results of the study provide insight into the load transfer mechanism of the blind bolt in question. The proposed component-based model was validated by a spring model, through which the stiffness of the EHB was compared to that of its components combined. The combined stiffness of the components was found to be roughly equivalent to that of the EHB as a whole, validating the use of this component-based approach.
Näsholm, Erika; Rohlfing, Sarah; Sauer, James D.
2014-01-01
Closed Circuit Television (CCTV) operators are responsible for maintaining security in various applied settings. However, research has largely ignored human factors that may contribute to CCTV operator error. One important source of error is inattentional blindness – the failure to detect unexpected but clearly visible stimuli when attending to a scene. We compared inattentional blindness rates for experienced (84 infantry personnel) and naïve (87 civilians) operators in a CCTV monitoring task. The task-relevance of the unexpected stimulus and the length of the monitoring period were manipulated between participants. Inattentional blindness rates were measured using typical post-event questionnaires, and participants' real-time descriptions of the monitored event. Based on the post-event measure, 66% of the participants failed to detect salient, ongoing stimuli appearing in the spatial field of their attentional focus. The unexpected task-irrelevant stimulus was significantly more likely to go undetected (79%) than the unexpected task-relevant stimulus (55%). Prior task experience did not inoculate operators against inattentional blindness effects. Participants' real-time descriptions revealed similar patterns, ruling out inattentional amnesia accounts. PMID:24465932
Levin, Daniel T; Drivdahl, Sarah B; Momen, Nausheen; Beck, Melissa R
2002-12-01
Recently, a number of experiments have emphasized the degree to which subjects fail to detect large changes in visual scenes. This finding, referred to as "change blindness," is often considered surprising because many people have the intuition that such changes should be easy to detect. documented this intuition by showing that the majority of subjects believe they would notice changes that are actually very rarely detected. Thus subjects exhibit a metacognitive error we refer to as "change blindness blindness." Here, we test whether CBB is caused by a misestimation of the perceptual experience associated with visual changes and show that it persists even when the pre- and postchange views are separated by long delays. In addition, subjects overestimate their change detection ability both when the relevant changes are illustrated by still pictures, and when they are illustrated using videos showing the changes occurring in real time. We conclude that CBB is a robust phenomenon that cannot be accounted for by failure to understand the specific perceptual experience associated with a change. Copyright 2002 Elsevier Science (USA)
Bartunek, Jozef; Terzic, Andre; Davison, Beth A; Filippatos, Gerasimos S; Radovanovic, Slavica; Beleslin, Branko; Merkely, Bela; Musialek, Piotr; Wojakowski, Wojciech; Andreka, Peter; Horvath, Ivan G; Katz, Amos; Dolatabadi, Dariouch; El Nakadi, Badih; Arandjelovic, Aleksandra; Edes, Istvan; Seferovic, Petar M; Obradovic, Slobodan; Vanderheyden, Marc; Jagic, Nikola; Petrov, Ivo; Atar, Shaul; Halabi, Majdi; Gelev, Valeri L; Shochat, Michael K; Kasprzak, Jaroslaw D; Sanz-Ruiz, Ricardo; Heyndrickx, Guy R; Nyolczas, Noémi; Legrand, Victor; Guédès, Antoine; Heyse, Alex; Moccetti, Tiziano; Fernandez-Aviles, Francisco; Jimenez-Quevedo, Pilar; Bayes-Genis, Antoni; Hernandez-Garcia, Jose Maria; Ribichini, Flavio; Gruchala, Marcin; Waldman, Scott A; Teerlink, John R; Gersh, Bernard J; Povsic, Thomas J; Henry, Timothy D; Metra, Marco; Hajjar, Roger J; Tendera, Michal; Behfar, Atta; Alexandre, Bertrand; Seron, Aymeric; Stough, Wendy Gattis; Sherman, Warren; Cotter, Gad; Wijns, William
2017-03-01
Cardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort. This multinational, randomized, double-blind, sham-controlled study was conducted in 39 hospitals. Patients with symptomatic ischaemic heart failure on guideline-directed therapy (n = 484) were screened; n = 348 underwent bone marrow harvest and mesenchymal stem cell expansion. Those achieving > 24 million mesenchymal stem cells (n = 315) were randomized to cardiopoietic cells delivered endomyocardially with a retention-enhanced catheter (n = 157) or sham procedure (n = 158). Procedures were performed as randomized in 271 patients (n = 120 cardiopoietic cells, n = 151 sham). The primary efficacy endpoint was a Finkelstein-Schoenfeld hierarchical composite (all-cause mortality, worsening heart failure, Minnesota Living with Heart Failure Questionnaire score, 6-min walk distance, left ventricular end-systolic volume, and ejection fraction) at 39 weeks. The primary outcome was neutral (Mann-Whitney estimator 0.54, 95% confidence interval [CI] 0.47-0.61 [value > 0.5 favours cell treatment], P = 0.27). Exploratory analyses suggested a benefit of cell treatment on the primary composite in patients with baseline left ventricular end-diastolic volume 200-370 mL (60% of patients) (Mann-Whitney estimator 0.61, 95% CI 0.52-0.70, P = 0.015). No difference was observed in serious adverse events. One (0.9%) cardiopoietic cell patient and 9 (5.4%) sham patients experienced aborted or sudden cardiac death. The primary endpoint was neutral, with safety demonstrated across the cohort. Further evaluation of cardiopoietic cell therapy in patients with elevated end-diastolic volume is warranted. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.
Bartunek, Jozef; Terzic, Andre; Davison, Beth A.; Filippatos, Gerasimos S.; Radovanovic, Slavica; Beleslin, Branko; Merkely, Bela; Musialek, Piotr; Wojakowski, Wojciech; Andreka, Peter; Horvath, Ivan G.; Katz, Amos; Dolatabadi, Dariouch; El Nakadi, Badih; Arandjelovic, Aleksandra; Edes, Istvan; Seferovic, Petar M.; Obradovic, Slobodan; Vanderheyden, Marc; Jagic, Nikola; Petrov, Ivo; Atar, Shaul; Halabi, Majdi; Gelev, Valeri L.; Shochat, Michael K.; Kasprzak, Jaroslaw D.; Sanz-Ruiz, Ricardo; Heyndrickx, Guy R.; Nyolczas, Noémi; Legrand, Victor; Guédès, Antoine; Heyse, Alex; Moccetti, Tiziano; Fernandez-Aviles, Francisco; Jimenez-Quevedo, Pilar; Bayes-Genis, Antoni; Hernandez-Garcia, Jose Maria; Ribichini, Flavio; Gruchala, Marcin; Waldman, Scott A.; Teerlink, John R.; Gersh, Bernard J.; Povsic, Thomas J.; Henry, Timothy D.; Metra, Marco; Hajjar, Roger J.; Tendera, Michal; Behfar, Atta; Alexandre, Bertrand; Seron, Aymeric; Stough, Wendy Gattis; Sherman, Warren; Cotter, Gad; Wijns, William
2017-01-01
Aims Cardiopoietic cells, produced through cardiogenic conditioning of patients’ mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort. Methods and results This multinational, randomized, double-blind, sham-controlled study was conducted in 39 hospitals. Patients with symptomatic ischaemic heart failure on guideline-directed therapy (n = 484) were screened; n = 348 underwent bone marrow harvest and mesenchymal stem cell expansion. Those achieving > 24 million mesenchymal stem cells (n = 315) were randomized to cardiopoietic cells delivered endomyocardially with a retention-enhanced catheter (n = 157) or sham procedure (n = 158). Procedures were performed as randomized in 271 patients (n = 120 cardiopoietic cells, n = 151 sham). The primary efficacy endpoint was a Finkelstein–Schoenfeld hierarchical composite (all-cause mortality, worsening heart failure, Minnesota Living with Heart Failure Questionnaire score, 6-min walk distance, left ventricular end-systolic volume, and ejection fraction) at 39 weeks. The primary outcome was neutral (Mann–Whitney estimator 0.54, 95% confidence interval [CI] 0.47–0.61 [value > 0.5 favours cell treatment], P = 0.27). Exploratory analyses suggested a benefit of cell treatment on the primary composite in patients with baseline left ventricular end-diastolic volume 200–370 mL (60% of patients) (Mann–Whitney estimator 0.61, 95% CI 0.52–0.70, P = 0.015). No difference was observed in serious adverse events. One (0.9%) cardiopoietic cell patient and 9 (5.4%) sham patients experienced aborted or sudden cardiac death. Conclusion The primary endpoint was neutral, with safety demonstrated across the cohort. Further evaluation of cardiopoietic cell therapy in patients with elevated end-diastolic volume is warranted. PMID:28025189
15 CFR Supplement No. 3 to Part 732 - BIS's “Know Your Customer” Guidance and Red Flags
Code of Federal Regulations, 2010 CFR
2010-01-01
... verification steps. (3) Do not self-blind. Do not cut off the flow of information that comes to your firm in... be evaluated by responsible senior officials. Failure to do so could be regarded as a form of self...
Food experiences and eating patterns of visually impaired and blind people.
Bilyk, Marie Claire; Sontrop, Jessica M; Chapman, Gwen E; Barr, Susan I; Mamer, Linda
2009-01-01
The number of visually impaired and blind Canadians will rise dramatically as our population ages, and yet little is known about the impact of blindness on the experience of food and eating. In this qualitative study, the food experiences and eating patterns of visually impaired and blind people were examined. Influencing factors were also explored. In 2000, nine blind or severely visually impaired subjects were recruited through blindness-related organizations in British Columbia. Participants completed individual semi-structured, in-depth interviews. These were transcribed verbatim, coded, and analyzed to explicate participants' experiences. Participants experienced blindness-related obstacles when shopping for food, preparing food, and eating in restaurants. Inaccessible materials and environments left participants with a diet lacking in variety and limited access to physical activity. Seven participants were overweight or obese, a finding that may be related to limited physical activity and higher-than-average restaurant use. This is the first study in which the experience of food and eating is described from the perspective of visually impaired Canadians. Nutrition and blindness professionals must work together to reduce the food-related obstacles faced by visually impaired and blind people. Professionals must address both individual skill development and social and structural inequities.
Konstam, Marvin A; Neaton, James D; Dickstein, Kenneth; Drexler, Helmut; Komajda, Michel; Martinez, Felipe A; Riegger, Gunter A J; Malbecq, William; Smith, Ronald D; Guptha, Soneil; Poole-Wilson, Philip A
2009-11-28
Angiotensin-receptor blockers (ARBs) are effective treatments for patients with heart failure, but the relation between dose and clinical outcomes has not been explored. We compared the effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure. This double-blind trial was undertaken in 255 sites in 30 countries. 3846 patients with heart failure of New York Heart Association class II-IV, left-ventricular ejection fraction 40% or less, and intolerance to angiotensin-converting-enzyme (ACE) inhibitors were randomly assigned to losartan 150 mg (n=1927) or 50 mg daily (n=1919). Allocation was by block randomisation stratified by centre and presence or absence of beta-blocker therapy, and all patients and investigators were masked to assignment. The primary endpoint was death or admission for heart failure. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00090259. Six patients in each group were excluded because of poor data quality. With 4.7-year median follow-up in each group (IQR 3.7-5.5 for losartan 150 mg; 3.4-5.5 for losartan 50 mg), 828 (43%) patients in the 150 mg group versus 889 (46%) in the 50 mg group died or were admitted for heart failure (hazard ratio [HR] 0.90, 95% CI 0.82-0.99; p=0.027). For the two primary endpoint components, 635 patients in the 150 mg group versus 665 in the 50 mg group died (HR 0.94, 95% CI 0.84-1.04; p=0.24), and 450 versus 503 patients were admitted for heart failure (0.87, 0.76-0.98; p=0.025). Renal impairment (n=454 vs 317), hypotension (203 vs 145), and hyperkalaemia (195 vs 131) were more common in the 150 mg group than in the 50 mg group, but these adverse events did not lead to significantly more treatment discontinuations in the 150 mg group. Losartan 150 mg daily reduced the rate of death or admission for heart failure in patients with heart failure, reduced left-ventricular ejection fraction, and intolerance to ACE inhibitors compared with losartan 50 mg daily. These findings show the value of up-titrating ARB doses to confer clinical benefit. Merck (USA).
Self-delivered misinformation - Merging the choice blindness and misinformation effect paradigms.
Stille, Lotta; Norin, Emelie; Sikström, Sverker
2017-01-01
Choice blindness is the failure to detect a discrepancy between a choice and its outcome. The misinformation effect occurs when the recollection of an event changes because new, misleading information about the event is received. The purpose of this study was to merge the choice blindness and misinformation effect paradigms, and thus examine whether choice blindness can be created for individuals' recollections of a witnessed event, and whether this will affect their later recollections of the event. Thus, as a way of delivering misinformation the participants ostensibly became their own source of the misleading information. The participants watched a short film and filled out a questionnaire about events shown in the film. Some of their answers were then manipulated using reattachable stickers, which allowed alteration of their original answers. The participants gave justifications for their manipulated choices, and later their recollection of the original event was tested through another questionnaire. Choice blindness was created for a majority of the participants. A majority of the choice blind participants later changed their reported recollection of the event in line with the manipulations, whereas only a small minority of the participants in the control condition changed their recollection. This study provides new information about the misinformation effect, suggesting that this effect also can occur when misinformation is given immediately following presentation of the original stimuli, and about choice blindness and its effects on the recollections of events. The results suggest that memory blindness can be created when people inadvertently supply themselves with misleading information about an event, causing a change in their recollection.
Self-delivered misinformation - Merging the choice blindness and misinformation effect paradigms
Stille, Lotta; Norin, Emelie; Sikström, Sverker
2017-01-01
Choice blindness is the failure to detect a discrepancy between a choice and its outcome. The misinformation effect occurs when the recollection of an event changes because new, misleading information about the event is received. The purpose of this study was to merge the choice blindness and misinformation effect paradigms, and thus examine whether choice blindness can be created for individuals’ recollections of a witnessed event, and whether this will affect their later recollections of the event. Thus, as a way of delivering misinformation the participants ostensibly became their own source of the misleading information. The participants watched a short film and filled out a questionnaire about events shown in the film. Some of their answers were then manipulated using reattachable stickers, which allowed alteration of their original answers. The participants gave justifications for their manipulated choices, and later their recollection of the original event was tested through another questionnaire. Choice blindness was created for a majority of the participants. A majority of the choice blind participants later changed their reported recollection of the event in line with the manipulations, whereas only a small minority of the participants in the control condition changed their recollection. This study provides new information about the misinformation effect, suggesting that this effect also can occur when misinformation is given immediately following presentation of the original stimuli, and about choice blindness and its effects on the recollections of events. The results suggest that memory blindness can be created when people inadvertently supply themselves with misleading information about an event, causing a change in their recollection. PMID:28273151
Percutaneous fenestration of the aortic dissection membrane in malperfusion syndrome.
Reber, D; Aebert, H; Manke, M; Birnbaum, D E
1999-01-01
We present two cases of malperfusion syndrome due to aortic dissection type-B. A supra-renal blind sac phenomenon resulted in renal failure and absent femoral pulses in both patients. Additionally, one patient suffered from spinal cord ischemia, the other from severe abdominal pain. By interventional techniques, catheter perforation of the blind sac was achieved. The resulting re-entries were enlarged with a balloon catheter. Distal perfusion without pressure gradients was restored by this technique in both patients and resulted in complete relief of symptoms. Percutaneous fenestration of the aortic dissection membrane may be an alternative to operative treatment in malperfusion syndrome.
Barack Obama Blindness (BOB): Absence of Visual Awareness to a Single Object.
Persuh, Marjan; Melara, Robert D
2016-01-01
In two experiments, we evaluated whether a perceiver's prior expectations could alone obliterate his or her awareness of a salient visual stimulus. To establish expectancy, observers first made a demanding visual discrimination on each of three baseline trials. Then, on a fourth, critical trial, a single, salient and highly visible object appeared in full view at the center of the visual field and in the absence of any competing visual input. Surprisingly, fully half of the participants were unaware of the solitary object in front of their eyes. Dramatically, observers were blind even when the only stimulus on display was the face of U.S. President Barack Obama. We term this novel, counterintuitive phenomenon, Barack Obama Blindness (BOB). Employing a method that rules out putative memory effects by probing awareness immediately after presentation of the critical stimulus, we demonstrate that the BOB effect is a true failure of conscious vision.
Barack Obama Blindness (BOB): Absence of Visual Awareness to a Single Object
Persuh, Marjan; Melara, Robert D.
2016-01-01
In two experiments, we evaluated whether a perceiver’s prior expectations could alone obliterate his or her awareness of a salient visual stimulus. To establish expectancy, observers first made a demanding visual discrimination on each of three baseline trials. Then, on a fourth, critical trial, a single, salient and highly visible object appeared in full view at the center of the visual field and in the absence of any competing visual input. Surprisingly, fully half of the participants were unaware of the solitary object in front of their eyes. Dramatically, observers were blind even when the only stimulus on display was the face of U.S. President Barack Obama. We term this novel, counterintuitive phenomenon, Barack Obama Blindness (BOB). Employing a method that rules out putative memory effects by probing awareness immediately after presentation of the critical stimulus, we demonstrate that the BOB effect is a true failure of conscious vision. PMID:27047362
Keratoprostheses for corneal blindness: a review of contemporary devices
Avadhanam, Venkata S; Smith, Helen E; Liu, Christopher
2015-01-01
According to the World Health Organization, globally 4.9 million are blind due to corneal pathology. Corneal transplantation is successful and curative of the blindness for a majority of these cases. However, it is less successful in a number of diseases that produce corneal neovascularization, dry ocular surface and recurrent inflammation, or infections. A keratoprosthesis or KPro is the only alternative to restore vision when corneal graft is a doomed failure. Although a number of KPros have been proposed, only two devices, Boston type-1 KPro and osteo-odonto-KPro, have came to the fore. The former is totally synthetic and the latter is semi-biological in constitution. These two KPros have different surgical techniques and indications. Keratoprosthetic surgery is complex and should only be undertaken in specialized centers, where expertise, multidisciplinary teams, and resources are available. In this article, we briefly discuss some of the prominent historical KPros and contemporary devices. PMID:25945031
Brains studying brains: look before you think in vision
NASA Astrophysics Data System (ADS)
Zhaoping, Li
2016-06-01
Using our own brains to study our brains is extraordinary. For example, in vision this makes us naturally blind to our own blindness, since our impression of seeing our world clearly is consistent with our ignorance of what we do not see. Our brain employs its ‘conscious’ part to reason and make logical deductions using familiar rules and past experience. However, human vision employs many ‘subconscious’ brain parts that follow rules alien to our intuition. Our blindness to our unknown unknowns and our presumptive intuitions easily lead us astray in asking and formulating theoretical questions, as witnessed in many unexpected and counter-intuitive difficulties and failures encountered by generations of scientists. We should therefore pay a more than usual amount of attention and respect to experimental data when studying our brain. I show that this can be productive by reviewing two vision theories that have provided testable predictions and surprising insights.
Brains studying brains: look before you think in vision.
Zhaoping, Li
2016-05-11
Using our own brains to study our brains is extraordinary. For example, in vision this makes us naturally blind to our own blindness, since our impression of seeing our world clearly is consistent with our ignorance of what we do not see. Our brain employs its 'conscious' part to reason and make logical deductions using familiar rules and past experience. However, human vision employs many 'subconscious' brain parts that follow rules alien to our intuition. Our blindness to our unknown unknowns and our presumptive intuitions easily lead us astray in asking and formulating theoretical questions, as witnessed in many unexpected and counter-intuitive difficulties and failures encountered by generations of scientists. We should therefore pay a more than usual amount of attention and respect to experimental data when studying our brain. I show that this can be productive by reviewing two vision theories that have provided testable predictions and surprising insights.
20 CFR 416.1331 - Termination of your disability or blindness payments.
Code of Federal Regulations, 2011 CFR
2011-04-01
... due to 12 consecutive suspension months for failure to comply with treatment for drug addiction or alcoholism. If you are disabled and drug addiction or alcoholism is a contributing factor material to the... benefits terminate due to payment of 36 months of benefits based on disability when drug addiction or...
20 CFR 416.1331 - Termination of your disability or blindness payments.
Code of Federal Regulations, 2012 CFR
2012-04-01
... due to 12 consecutive suspension months for failure to comply with treatment for drug addiction or alcoholism. If you are disabled and drug addiction or alcoholism is a contributing factor material to the... benefits terminate due to payment of 36 months of benefits based on disability when drug addiction or...
20 CFR 416.1331 - Termination of your disability or blindness payments.
Code of Federal Regulations, 2013 CFR
2013-04-01
... due to 12 consecutive suspension months for failure to comply with treatment for drug addiction or alcoholism. If you are disabled and drug addiction or alcoholism is a contributing factor material to the... benefits terminate due to payment of 36 months of benefits based on disability when drug addiction or...
20 CFR 416.1331 - Termination of your disability or blindness payments.
Code of Federal Regulations, 2014 CFR
2014-04-01
... due to 12 consecutive suspension months for failure to comply with treatment for drug addiction or alcoholism. If you are disabled and drug addiction or alcoholism is a contributing factor material to the... benefits terminate due to payment of 36 months of benefits based on disability when drug addiction or...
ERIC Educational Resources Information Center
Mitchell, Stephen
1997-01-01
Raises concerns about the failure of mental health service providers to address the psycho-developmental needs of people with mental retardation, especially incarcerated individuals with severe behavior disturbances and both mental illness and mental retardation. A "flight from developmental theory" is seen in most service providers to this…
Case of penetrating orbitocranial injury caused by wood.
Mutlukan, E; Fleck, B W; Cullen, J F; Whittle, I R
1991-01-01
A case of retained intraorbital and intracerebral wooden foreign body following an orbitocranial penetrating injury through the lower lid of an adult is described. Initial failure to recognise the true nature of the injury led to intracerebral abscess formation and monocular blindness. Diagnosis and management of such cases are discussed. Images PMID:2043585
Aregu, Lemlem; Darnhofer, Ika; Tegegne, Azage; Hoekstra, Dirk; Wurzinger, Maria
2016-12-01
We studied how the failure to take into account gendered roles in the management of a communal pasture can affect the resilience of this social-ecological system. Data were collected using qualitative methods, including focus group discussions, in-depth interviews, and participant observations from one community in the highlands of Ethiopia. The results show that women are excluded from the informal institution that defines the access and use rules which guide the management of the communal pasture. Consequently, women's knowledge, preferences, and needs are not taken into account. This negatively affects the resilience of the communal pasture in two ways. Firstly, the exclusion of women's knowledge leads to future adaptation options being overlooked. Secondly, as a result of the failure to address women's needs, they start to question the legitimacy of the informal institution. The case study thus shows how excluding women, i.e., side-lining their knowledge and needs, weakens social learning and the adaptiveness of the management rules. Being blind to gender-related issues may thus undermine the resilience of a social-ecological system.
Matsuzaki, Masunori; Hori, Masatsugu; Izumi, Tohru; Fukunami, Masatake
2011-12-01
Diuretics are recommended to treat volume overload with heart failure (HF), however, they may cause serum electrolyte imbalance, limiting their use. Moreover, patients with advanced HF could poorly respond to these diuretics. In this study, we evaluated the efficacy and safety of Tolvaptan, a competitive vasopressin V2-receptor antagonist developed as a new drug to treat volume overload in HF patients. A phase III, multicenter, randomized, double-blind, placebo-controlled parallel study was performed to assess the efficacy and safety of tolvaptan in treating HF patients with volume overload despite the use of conventional diuretics. One hundred and ten patients were randomly assigned to receive either placebo or 15 mg/day tolvaptan for 7 consecutive days. Compared with placebo, tolvaptan administered for 7 days significantly reduced body weight and improved symptoms associated with volume overload. The safety profile of tolvaptan was considered acceptable for clinical use with minimal adverse effects. Tolvaptan reduced volume overload and improved congestive symptoms associated with HF by a potent water diuresis (aquaresis).
Progressive Failure Analysis Methodology for Laminated Composite Structures
NASA Technical Reports Server (NTRS)
Sleight, David W.
1999-01-01
A progressive failure analysis method has been developed for predicting the failure of laminated composite structures under geometrically nonlinear deformations. The progressive failure analysis uses C(exp 1) shell elements based on classical lamination theory to calculate the in-plane stresses. Several failure criteria, including the maximum strain criterion, Hashin's criterion, and Christensen's criterion, are used to predict the failure mechanisms and several options are available to degrade the material properties after failures. The progressive failure analysis method is implemented in the COMET finite element analysis code and can predict the damage and response of laminated composite structures from initial loading to final failure. The different failure criteria and material degradation methods are compared and assessed by performing analyses of several laminated composite structures. Results from the progressive failure method indicate good correlation with the existing test data except in structural applications where interlaminar stresses are important which may cause failure mechanisms such as debonding or delaminations.
Trullàs, Joan Carles; Morales-Rull, José Luís; Casado, Jesús; Freitas Ramírez, Adriana; Manzano, Luís; Formiga, Francesc
2016-07-01
Fluid overload refractory to loop diuretic therapy can complicate acute or chronic heart failure (HF) management. The Safety and Efficacy of the Combination of Loop with Thiazide-type Diuretics in Patients with Decompensated Heart Failure (CLOROTIC) trial (Clinicaltrials.gov identifier NCT01647932) will test the hypothesis that blocking distal tubule sodium reabsorption with hydrochlorothiazide can antagonize the renal adaptation to chronic loop diuretic therapy and improve diuretic resistance. CLOROTIC is a randomized, placebo-controlled, double-blind, multicenter study. Three hundred and four patients with decompensated HF will be randomly assigned to receive hydrochlorothiazide or placebo in addition to a furosemide regimen. The main inclusion criteria are: age ≥18 years, history of chronic HF (irrespective of etiology and/or ejection fraction), admission for acute decompensation, and previous treatment with an oral loop diuretic for at least 1 month before randomization. The 2 coprimary endpoints are changes in body weight and changes in patient-reported dyspnea during hospital admission. Morbidity, mortality, and safety aspects will also be addressed. CLOROTIC is the first large-scale trial to evaluate whether the addition of a thiazide diuretic (hydrochlorothiazide) to a loop diuretic (furosemide) is a safe and effective strategy for improving congestive symptoms resulting from HF. This trial will provide important information and will therefore have a major impact on treatment strategies and future trials in these patients. Copyright © 2015 Elsevier Inc. All rights reserved.
Repeated Induction of Inattentional Blindness in a Simulated Aviation Environment
NASA Technical Reports Server (NTRS)
Kennedy, Kellie D.; Stephens, Chad L.; Williams, Ralph A.; Schutte, Paul C.
2017-01-01
The study reported herein is a subset of a larger investigation on the role of automation in the context of the flight deck and used a fixed-based, human-in-the-loop simulator. This paper explored the relationship between automation and inattentional blindness (IB) occurrences in a repeated induction paradigm using two types of runway incursions. The critical stimuli for both runway incursions were directly relevant to primary task performance. Sixty non-pilot participants performed the final five minutes of a landing scenario twice in one of three automation conditions: full automation (FA), partial automation (PA), and no automation (NA). The first induction resulted in a 70 percent (42 of 60) detection failure rate with those in the PA condition significantly more likely to detect the incursion compared to the FA condition or the NA condition. The second induction yielded a 50 percent detection failure rate. Although detection improved (detection failure rates declined) in all conditions, those in the FA condition demonstrated the greatest improvement with doubled detection rates. The detection behavior in the first trial did not preclude a failed detection in the second induction. Group membership (IB vs. Detection) in the FA condition showed a greater improvement than those in the NA condition and rated the Mental Demand and Effort subscales of the NASA-TLX (NASA Task Load Index) significantly higher for Time 2 compared Time 1. Participants in the FA condition used the experience of IB exposure to improve task performance whereas those in the NA condition did not, indicating the availability and reallocation of attentional resources in the FA condition. These findings support the role of engagement in operational attention detriment and the consideration of attentional failure causation to determine appropriate mitigation strategies.
Aliskiren, Enalapril, or Aliskiren and Enalapril in Heart Failure.
McMurray, John J V; Krum, Henry; Abraham, William T; Dickstein, Kenneth; Køber, Lars V; Desai, Akshay S; Solomon, Scott D; Greenlaw, Nicola; Ali, M Atif; Chiang, Yanntong; Shao, Qing; Tarnesby, Georgia; Massie, Barry M
2016-04-21
Among patients with chronic heart failure, angiotensin-converting-enzyme (ACE) inhibitors reduce mortality and hospitalization, but the role of a renin inhibitor in such patients is unknown. We compared the ACE inhibitor enalapril with the renin inhibitor aliskiren (to test superiority or at least noninferiority) and with the combination of the two treatments (to test superiority) in patients with heart failure and a reduced ejection fraction. After a single-blind run-in period, we assigned patients, in a double-blind fashion, to one of three groups: 2336 patients were assigned to receive enalapril at a dose of 5 or 10 mg twice daily, 2340 to receive aliskiren at a dose of 300 mg once daily, and 2340 to receive both treatments (combination therapy). The primary composite outcome was death from cardiovascular causes or hospitalization for heart failure. After a median follow-up of 36.6 months, the primary outcome occurred in 770 patients (32.9%) in the combination-therapy group and in 808 (34.6%) in the enalapril group (hazard ratio, 0.93; 95% confidence interval [CI], 0.85 to 1.03). The primary outcome occurred in 791 patients (33.8%) in the aliskiren group (hazard ratio vs. enalapril, 0.99; 95% CI, 0.90 to 1.10); the prespecified test for noninferiority was not met. There was a higher risk of hypotensive symptoms in the combination-therapy group than in the enalapril group (13.8% vs. 11.0%, P=0.005), as well as higher risks of an elevated serum creatinine level (4.1% vs. 2.7%, P=0.009) and an elevated potassium level (17.1% vs. 12.5%, P<0.001). In patients with chronic heart failure, the addition of aliskiren to enalapril led to more adverse events without an increase in benefit. Noninferiority was not shown for aliskiren as compared with enalapril. (Funded by Novartis; ATMOSPHERE ClinicalTrials.gov number, NCT00853658.).
NASA Astrophysics Data System (ADS)
Gonzaga, S.; et al.
2011-03-01
ACS was designed to provide a deep, wide-field survey capability from the visible to near-IR using the Wide Field Camera (WFC), high resolution imaging from the near-UV to near-IR with the now-defunct High Resolution Camera (HRC), and solar-blind far-UV imaging using the Solar Blind Camera (SBC). The discovery efficiency of ACS's Wide Field Channel (i.e., the product of WFC's field of view and throughput) is 10 times greater than that of WFPC2. The failure of ACS's CCD electronics in January 2007 brought a temporary halt to CCD imaging until Servicing Mission 4 in May 2009, when WFC functionality was restored. Unfortunately, the high-resolution optical imaging capability of HRC was not recovered.
Surprise-Induced Blindness: A Stimulus-Driven Attentional Limit to Conscious Perception
ERIC Educational Resources Information Center
Asplund, Christopher L.; Todd, J. Jay; Snyder, A. P.; Gilbert, Christopher M.; Marois, Rene
2010-01-01
The cost of attending to a visual event can be the failure to consciously detect other events. This processing limitation is well illustrated by the attentional blink paradigm, in which searching for and attending to a target presented in a rapid serial visual presentation stream of distractors can impair one's ability to detect a second target…
Adaptive Instructional Aids for Teaching a Blind Student in a Nonmajors College Chemistry Course
ERIC Educational Resources Information Center
Boyd-Kimball, Debra
2012-01-01
Adaptive tools and techniques for lecture instruction were developed for a blind student in a nonmajors college chemistry course. These adaptive instructional aids assisted the student in writing and balancing chemical reactions, calculating unit conversions and concentrations, drawing Lewis dot structures, understanding structural representations…
Oyanguren, Juana; Latorre García, Pedro María; Torcal Laguna, Jesús; Lekuona Goya, Iñaki; Rubio Martín, Susana; Maull Lafuente, Elena; Grandes, Gonzalo
2016-10-01
Heart failure management programs reduce hospitalizations. Some studies also show reduced mortality. The determinants of program success are unknown. The aim of the present study was to update our understanding of the reductions in mortality and readmissions produced by these programs, elucidate their components, and identify the factors determining program success. Systematic literature review (1990-2014; PubMed, EMBASE, CINAHL, Cochrane Library) and manual search of relevant journals. The studies were selected by 3 independent reviewers. Methodological quality was evaluated in a blinded manner by an external researcher (Jadad scale). These results were pooled using random effects models. Heterogeneity was evaluated with the I 2 statistic, and its explanatory factors were determined using metaregression analysis. Of the 3914 studies identified, 66 randomized controlled clinical trials were selected (18 countries, 13 535 patients). We determined the relative risks to be 0.88 for death (95% confidence interval [95%CI], 0.81-0.96; P < .002; I 2 , 6.1%), 0.92 for all-cause readmissions (95%CI, 0.86-0.98; P < .011; I 2 , 58.7%), and 0.80 for heart failure readmissions (95%CI, 0.71-0.90; P < .0001; I 2 , 52.7%). Factors associated with program success were implementation after 2001, program location outside the United States, greater baseline use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, a higher number of intervention team members and components, specialized heart failure cardiologists and nurses, protocol-driven education and its assessment, self-monitoring of signs and symptoms, detection of deterioration, flexible diuretic regimen, early care-seeking among patients and prompt health care response, psychosocial intervention, professional coordination, and program duration. We confirm the reductions in mortality and readmissions with heart failure management programs. Their success is associated with various structural and intervention variables. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
Rostaing, Lionel; Bunnapradist, Suphamai; Grinyó, Josep M; Ciechanowski, Kazimierz; Denny, Jason E; Silva, Helio Tedesco; Budde, Klemens
2016-04-01
1-year data from this trial showed the noninferiority of a novel once-daily extended-release tacrolimus (LCPT; Envarsus XR) to immediate-release tacrolimus (IR-Tac) twice daily after kidney transplantation. Final 24-month analysis of a 2-armed, parallel-group, randomized, double-blind, double-dummy, multicenter, phase 3 trial. 543 de novo kidney recipients randomly assigned to LCPT (n=268) or IR-Tac (n=275); 507 (93.4%) completed the 24-month study. LCPT tablets once daily at 0.17 mg/kg/d or IR-Tac twice daily at 0.1 mg/kg/d; subsequent doses were adjusted to maintain target trough ranges (first 30 days, 6-11 ng/mL; thereafter, 4-11 ng/mL). The intervention was 24 months; the study was double blinded for the entirety. Treatment failure (death, transplant failure, biopsy-proven acute rejection, or loss to follow up) within 24 months. Safety end points included adverse events, serious adverse events, new-onset diabetes, kidney function, opportunistic infections, and malignancies. Pharmacokinetic measures included total daily dose (TDD) of study drugs and tacrolimus trough levels. 24-month treatment failure was LCPT, 23.1%; IR-Tac, 27.3% (treatment difference, -4.14% [95% CI, -11.38% to +3.17%], well below the +10% noninferiority criterion defined for the primary 12-month end point). Subgroup analyses showed fewer treatment failures for LCPT versus IR-Tac among black, older, and female recipients. Safety was similar between groups. From month 1, TDD was lower for LCPT; the difference increased over time. At month 24, mean TDD for LCPT was 24% lower than for the IR-Tac group (P<0.001), but troughs were similar (means at 24 months: LCPT, 5.47 ± 0.17 ng/mL; IR-Tac, 5.8 ± 0.30 ng/mL; P=0.4). Trial participant eligibility criteria may limit the generalizability of results to the global population of de novo kidney transplant recipients. Results suggest that once-daily LCPT in de novo kidney transplantation has comparable efficacy and safety profile to that of IR-Tac. Lower TDD reflects LCPT's improved bioavailability and absorption. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Audiologic features of Norrie disease.
Halpin, Chris; Owen, Grace; Gutiérrez-Espeleta, Gustavo A; Sims, Katherine; Rehm, Heidi L
2005-07-01
Norrie disease is an X-linked recessive disorder in which patients are born blind and develop sensory hearing loss in adolescence. The hearing loss associated with Norrie disease has been shown in a genetically altered knockout mouse to involve dysfunction of the stria vascularis; most other structures are preserved until the later stages of the disease. The objective of this study was to characterize the audiologic phenotype of Norrie disease for comparison with the pathophysiologic mechanism. The design combined two series of clinical audiologic evaluations, with special attention to speech intelligibility. The audiologic results for 12 affected individuals and 10 carriers show that patients with Norrie disease retain high speech intelligibility scores even when the threshold loss is severe. The cochlear mechanism-- failure of the stria vascularis-- accounts for some of the higher values in the wide distribution of speech scores in cases with similar pure tone audiograms.
Awad, I A; Katz, A; Hahn, J F; Kong, A K; Ahl, J; Lüders, H
1989-01-01
The extent of resection was assessed in 45 temporal lobectomies for medically intractable epilepsy with mapped temporal lobe foci. Postoperative magnetic resonance imaging (MRI) in the coronal plane was used to quantify the extent of resection of superior lateral, inferior lateral, basal, and medial structures, including the amygdalohippocampal complex. A new 20-compartment model of the temporal lobe was used for this assessment. Blinded interobserver variability was minimal. Intraoperative measurements and maps routinely overestimated the actual extent of resection, especially of medial structures. One year after surgery, 70% of patients remained seizure-free (except for auras). Seizure-free outcome was accomplished despite varying degrees of resection, but was more likely achieved with more extensive resections in all compartments. Among patients with mesiobasal foci, seizure-free outcome correlated significantly with extent of resection of amygdalohippocampal complex. We conclude that assessment of extent of resection by postoperative MRI provides an objective basis of evaluating outcome after temporal lobectomy. It allows a rational approach to understanding of operative failures and is potentially useful in comparing efficacy of various surgical approaches.
Ability Structure and Loss of Vision. Research Series, Number 18.
ERIC Educational Resources Information Center
Juurmaa, Jyrki
In the analysis of ability structure and loss of vision, 228 blind persons (153 male, 75 female) heterogenous in respect to chronological age, sex, degree of blindness, age at onset, and duration, were compared to sighted controls. A test battery was administered which included tests for verbal comprehension, mental arithmetic, spatial ability,…
Classification of change detection and change blindness from near-infrared spectroscopy signals
NASA Astrophysics Data System (ADS)
Tanaka, Hirokazu; Katura, Takusige
2011-08-01
Using a machine-learning classification algorithm applied to near-infrared spectroscopy (NIRS) signals, we classify a success (change detection) or a failure (change blindness) in detecting visual changes for a change-detection task. Five subjects perform a change-detection task, and their brain activities are continuously monitored. A support-vector-machine algorithm is applied to classify the change-detection and change-blindness trials, and correct classification probability of 70-90% is obtained for four subjects. Two types of temporal shapes in classification probabilities are found: one exhibiting a maximum value after the task is completed (postdictive type), and another exhibiting a maximum value during the task (predictive type). As for the postdictive type, the classification probability begins to increase immediately after the task completion and reaches its maximum in about the time scale of neuronal hemodynamic response, reflecting a subjective report of change detection. As for the predictive type, the classification probability shows an increase at the task initiation and is maximal while subjects are performing the task, predicting the task performance in detecting a change. We conclude that decoding change detection and change blindness from NIRS signal is possible and argue some future applications toward brain-machine interfaces.
Kreitz, Carina; Furley, Philip; Memmert, Daniel; Simons, Daniel J
2016-04-01
The probability of inattentional blindness, the failure to notice an unexpected object when attention is engaged on some primary task, is influenced by contextual factors like task demands, features of the unexpected object, and the observer's attention set. However, predicting who will notice an unexpected object and who will remain inattentionally blind has proven difficult, and the evidence that individual differences in cognition affect noticing remains ambiguous. We hypothesized that greater working memory capacity might modulate the effect of attention sets on noticing because working memory is associated with the ability to focus attention selectively. People with greater working memory capacity might be better able to attend selectively to target items, thereby increasing the chances of noticing unexpected objects that were similar to the attended items while decreasing the odds of noticing unexpected objects that differed from the attended items. Our study (N = 120 participants) replicated evidence that task-induced attention sets modulate noticing but found no link between noticing and working memory capacity. Our results are largely consistent with the idea that individual differences in working memory capacity do not predict noticing of unexpected objects in an inattentional blindness task. © The Author(s) 2015.
Wang, Yue; Luo, Jin; Hao, Shiying; Xu, Haihua; Shin, Andrew Young; Jin, Bo; Liu, Rui; Deng, Xiaohong; Wang, Lijuan; Zheng, Le; Zhao, Yifan; Zhu, Chunqing; Hu, Zhongkai; Fu, Changlin; Hao, Yanpeng; Zhao, Yingzhen; Jiang, Yunliang; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Todd, Rogow; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B
2015-12-01
In order to proactively manage congestive heart failure (CHF) patients, an effective CHF case finding algorithm is required to process both structured and unstructured electronic medical records (EMR) to allow complementary and cost-efficient identification of CHF patients. We set to identify CHF cases from both EMR codified and natural language processing (NLP) found cases. Using narrative clinical notes from all Maine Health Information Exchange (HIE) patients, the NLP case finding algorithm was retrospectively (July 1, 2012-June 30, 2013) developed with a random subset of HIE associated facilities, and blind-tested with the remaining facilities. The NLP based method was integrated into a live HIE population exploration system and validated prospectively (July 1, 2013-June 30, 2014). Total of 18,295 codified CHF patients were included in Maine HIE. Among the 253,803 subjects without CHF codings, our case finding algorithm prospectively identified 2411 uncodified CHF cases. The positive predictive value (PPV) is 0.914, and 70.1% of these 2411 cases were found to be with CHF histories in the clinical notes. A CHF case finding algorithm was developed, tested and prospectively validated. The successful integration of the CHF case findings algorithm into the Maine HIE live system is expected to improve the Maine CHF care. Copyright © 2015. Published by Elsevier Ireland Ltd.
Ohlmann, Andreas; Scholz, Michael; Goldwich, Andreas; Chauhan, Bharesh K; Hudl, Kristiane; Ohlmann, Anne V; Zrenner, Eberhart; Berger, Wolfgang; Cvekl, Ales; Seeliger, Mathias W; Tamm, Ernst R
2005-02-16
Norrie disease is an X-linked retinal dysplasia that presents with congenital blindness, sensorineural deafness, and mental retardation. Norrin, the protein product of the Norrie disease gene (NDP), is a secreted protein of unknown biochemical function. Norrie disease (Ndp(y/-)) mutant mice that are deficient in norrin develop blindness, show a distinct failure in retinal angiogenesis, and completely lack the deep capillary layers of the retina. We show here that the transgenic expression of ectopic norrin under control of a lens-specific promoter restores the formation of a normal retinal vascular network in Ndp(y/-) mutant mice. The improvement in structure correlates with restoration of neuronal function in the retina. In addition, lenses of transgenic mice with ectopic expression of norrin show significantly more capillaries in the hyaloid vasculature that surrounds the lens during development. In vitro, lenses of transgenic mice in coculture with microvascular endothelial cells induce proliferation of the cells. Transgenic mice with ectopic expression of norrin show more bromodeoxyuridine-labeled retinal progenitor cells at embryonic day 14.5 and thicker retinas at postnatal life than wild-type littermates, indicating a putative direct neurotrophic effect of norrin. These data provide direct evidence that norrin induces growth of ocular capillaries and that pharmacologic modulation of norrin might be used for treatment of the vascular abnormalities associated with Norrie disease or other vascular disorders of the retina.
Chabris, Christopher F; Weinberger, Adam; Fontaine, Matthew; Simons, Daniel J
2011-01-01
Inattentional blindness—the failure to see visible and otherwise salient events when one is paying attention to something else—has been proposed as an explanation for various real-world events. In one such event, a Boston police officer chasing a suspect ran past a brutal assault and was prosecuted for perjury when he claimed not to have seen it. However, there have been no experimental studies of inattentional blindness in real-world conditions. We simulated the Boston incident by having subjects run after a confederate along a route near which three other confederates staged a fight. At night only 35% of subjects noticed the fight; during the day 56% noticed. We manipulated the attentional load on the subjects and found that increasing the load significantly decreased noticing. These results provide evidence that inattentional blindness can occur during real-world situations, including the Boston case. PMID:23145232
Beauvais, Francis
2013-04-01
The randomized controlled trial (RCT) is the 'gold standard' of modern clinical pharmacology. However, for many practitioners of homeopathy, blind RCTs are an inadequate research tool for testing complex therapies such as homeopathy. Classical probabilities used in biological sciences and in medicine are only a special case of the generalized theory of probability used in quantum physics. I describe homeopathy trials using a quantum-like statistical model, a model inspired by quantum physics and taking into consideration superposition of states, non-commuting observables, probability interferences, contextuality, etc. The negative effect of blinding on success of homeopathy trials and the 'smearing effect' ('specific' effects of homeopathy medicine occurring in the placebo group) are described by quantum-like probabilities without supplementary ad hoc hypotheses. The difference of positive outcome rates between placebo and homeopathy groups frequently vanish in centralized blind trials. The model proposed here suggests a way to circumvent such problems in masked homeopathy trials by incorporating in situ randomization/unblinding. In this quantum-like model of homeopathy clinical trials, success in open-label setting and failure with centralized blind RCTs emerge logically from the formalism. This model suggests that significant differences between placebo and homeopathy in blind RCTs would be found more frequently if in situ randomization/unblinding was used. Copyright © 2013. Published by Elsevier Ltd.
Pouleur, Anne-Catherine; Anker, Stefan; Brito, Dulce; Brosteanu, Oana; Hasenclever, Dirk; Casadei, Barbara; Edelmann, Frank; Filippatos, Gerasimos; Gruson, Damien; Ikonomidis, Ignatios; Lhommel, Renaud; Mahmod, Masliza; Neubauer, Stefan; Persu, Alexandre; Gerber, Bernhard L; Piechnik, Stefan; Pieske, Burkert; Pieske-Kraigher, Elisabeth; Pinto, Fausto; Ponikowski, Piotr; Senni, Michele; Trochu, Jean-Noël; Van Overstraeten, Nancy; Wachter, Rolf; Balligand, Jean-Luc
2018-06-22
Progressive left ventricular (LV) remodelling with cardiac myocyte hypertrophy, myocardial fibrosis, and endothelial dysfunction plays a key role in the onset and progression of heart failure with preserved ejection fraction. The Beta3-LVH trial will test the hypothesis that the β 3 adrenergic receptor agonist mirabegron will improve LV hypertrophy and diastolic function in patients with hypertensive structural heart disease at high risk for developing heart failure with preserved ejection fraction. Beta3-LVH is a randomized, placebo-controlled, double-blind, two-armed, multicentre, European, parallel group study. A total of 296 patients will be randomly assigned to receive either mirabegron 50 mg daily or placebo over 12 months. The main inclusion criterion is the presence of LV hypertrophy, that is, increased LV mass index (LVMi) or increased wall thickening by echocardiography. The co-primary endpoints are a change in LVMi by cardiac magnetic resonance imaging and a change in LV diastolic function (assessed by the E/e' ratio). Secondary endpoints include mirabegron's effects on cardiac fibrosis, left atrial volume index, maximal exercise capacity, and laboratory markers. Two substudies will evaluate mirabegron's effect on endothelial function by pulse amplitude tonometry and brown fat activity by positron emission tomography using 17F-fluorodeoxyglucose. Morbidity and mortality as well as safety aspects will also be assessed. Beta3-LVH is the first large-scale clinical trial to evaluate the effects of mirabegron on LVMi and diastolic function in patients with LVH. Beta3-LVH will provide important information about the clinical course of this condition and may have significant impact on treatment strategies and future trials in these patients. © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
Evaluation of a Progressive Failure Analysis Methodology for Laminated Composite Structures
NASA Technical Reports Server (NTRS)
Sleight, David W.; Knight, Norman F., Jr.; Wang, John T.
1997-01-01
A progressive failure analysis methodology has been developed for predicting the nonlinear response and failure of laminated composite structures. The progressive failure analysis uses C plate and shell elements based on classical lamination theory to calculate the in-plane stresses. Several failure criteria, including the maximum strain criterion, Hashin's criterion, and Christensen's criterion, are used to predict the failure mechanisms. The progressive failure analysis model is implemented into a general purpose finite element code and can predict the damage and response of laminated composite structures from initial loading to final failure.
Ectopic expression of pMADS3 in transgenic petunia phenocopies the petunia blind mutant.
Tsuchimoto, S; van der Krol, A R; Chua, N H
1993-01-01
We cloned a MADS-box gene, pMADS3, from Petunia hybrida, which shows high sequence homology to the Arabidopsis AGAMOUS and Antirrhinum PLENA. pMADS3 is expressed exclusively in stamens and carpels of wild-type petunia plants. In the petunia mutant blind, which shows homeotic conversions of corolla limbs into antheroid structures with pollen grains and small parts of sepals into carpelloid tissue, pMADS3 is expressed in all floral organs as well as in leaves. Ectopic expression of pMADS3 in transgenic petunia leads to phenocopies of the blind mutant, i.e., the formation of antheroid structures on limbs and carpelloid tissue on sepals. Transgenic tobacco plants that overexpress pMADS3 exhibit an even more severe phenotype, with the sepals forming a carpel-like structure encasing the interior floral organs. Our results identify BLIND as a negative regulator of pMADS3, which specifies stamens and carpels during petunia flower development. PMID:8104573
NASA Astrophysics Data System (ADS)
Ainscoe, E. A.; Elliott, J. R.; Copley, A.; Craig, T. J.; Li, T.; Parsons, B. E.; Walker, R. T.
2017-11-01
The relationship between individual earthquakes and the longer-term growth of topography and of geological structures is not fully understood, but is key to our ability to make use of topographic and geological data sets in the contexts of seismic hazard and wider-scale tectonics. Here we investigate those relationships at an active fold-and-thrust belt in the southwest Tarim Basin, Central Asia. We use seismic waveforms and interferometric synthetic aperture radar (InSAR) to determine the fault parameters and slip distribution of the 2015 Mw6.3 Pishan earthquake—a blind, reverse-faulting event dipping toward the Tibetan Plateau. Our earthquake mechanism and location correspond closely to a fault mapped independently by seismic reflection, indicating that the earthquake was on a preexisting ramp fault over a depth range of ˜9-13 km. However, the geometry of folding in the overlying fluvial terraces cannot be fully explained by repeated coseismic slip in events such as the 2015 earthquake nor by the early postseismic motion shown in our interferograms; a key role in growth of the topography must be played by other mechanisms. The earthquake occurred at the Tarim-Tibet boundary, with the unusually low dip of 21°. We use our source models from Pishan and a 2012 event to argue that the Tarim Basin crust deforms only by brittle failure on faults whose effective coefficient of friction is ≤0.05 ± 0.025. In contrast, most of the Tibetan crust undergoes ductile deformation, with a viscosity of order 1020-1022 Pa s. This contrast in rheologies provides an explanation for the low dip of the earthquake fault plane.
Sensing Structures Inspired by Blind Cave Fish
NASA Astrophysics Data System (ADS)
McConney, Michael E.; Chen, Nannan; Lu, David; Anderson, Kyle D.; Hu, Huan; Liu, Chang; Tsukruk, Vladimir V.
2009-03-01
Blind cave fish, with degenerated non-functioning eyes, have evolved to ``see'' their hydrodynamic environment by using the flow receptors of the lateral line system. The hair-cell receptors are encapsulated in a hydrogel-like material, called a cupula, which increases the sensitivity of the hair-cell receptors by coupling their motion to the surrounding flowing media. We characterized the viscoelastic properties and of blind cave fish cupulae by using colloidal-probe spectroscopy in fluid. A photo-patternable hydrogel with similar properties was developed to mimic the fish receptor coupling structure. Flow-based measurements indicated that the hydrogels enhance drag through increased surface area, but also inherent material properties. These bio-inspired structures endowed micro-fabricated flow sensors with sensitivities rivaling that of fish.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wierzbicki, T.; Jones, N.
1989-01-01
The book discusses the fragmentation of solids under dynamic loading, the debris-impact protection of space structures, the controlled fracturing of structures by shock-wave interaction and focusing, the tearing of thin metal sheets, and the dynamic inelastic failure of beams, and dynamic rupture of shells. Consideration is also given to investigations of the failure of brittle and composite materials by numerical methods, the energy absorption of polymer matrix composite structures (frictional effects), the mechanics of deep plastic collapse of thin-walled structures, the denting and bending of tubular beams under local loads, the dynamic bending collapse of strain-softening cantilever beams, and themore » failure of bar structures under repeated loading. Other topics discussed are on the behavior of composite and metallic superstructures under blast loading, the catastrophic failure modes of marine structures, and industrial experience with structural failure.« less
Wang, Xiaoying; He, Chenxi; Peelen, Marius V; Zhong, Suyu; Gong, Gaolang; Caramazza, Alfonso; Bi, Yanchao
2017-05-03
Human ventral occipital temporal cortex contains clusters of neurons that show domain-preferring responses during visual perception. Recent studies have reported that some of these clusters show surprisingly similar domain selectivity in congenitally blind participants performing nonvisual tasks. An important open question is whether these functional similarities are driven by similar innate connections in blind and sighted groups. Here we addressed this question focusing on the parahippocampal gyrus (PHG), a region that is selective for large objects and scenes. Based on the assumption that patterns of long-range connectivity shape local computation, we examined whether domain selectivity in PHG is driven by similar structural connectivity patterns in the two populations. Multiple regression models were built to predict the selectivity of PHG voxels for large human-made objects from white matter (WM) connectivity patterns in both groups. These models were then tested using independent data from participants with similar visual experience (two sighted groups) and using data from participants with different visual experience (blind and sighted groups). Strikingly, the WM-based predictions between blind and sighted groups were as successful as predictions between two independent sighted groups. That is, the functional selectivity for large objects of a PHG voxel in a blind participant could be accurately predicted by its WM pattern using the connection-to-function model built from the sighted group data, and vice versa. Regions that significantly predicted PHG selectivity were located in temporal and frontal cortices in both sighted and blind populations. These results show that the large-scale network driving domain selectivity in PHG is independent of vision. SIGNIFICANCE STATEMENT Recent studies have reported intriguingly similar domain selectivity in sighted and congenitally blind individuals in regions within the ventral visual cortex. To examine whether these similarities originate from similar innate connectional roots, we investigated whether the domain selectivity in one population could be predicted by the structural connectivity pattern of the other. We found that the selectivity for large objects of a PHG voxel in a blind participant could be predicted by its structural connectivity pattern using the connection-to-function model built from the sighted group data, and vice versa. These results reveal that the structural connectivity underlying domain selectivity in the PHG is independent of visual experience, providing evidence for nonvisual representations in this region. Copyright © 2017 the authors 0270-6474/17/374706-12$15.00/0.
The Possibility of Learning Curved Mirrors' Structure by a Normal Blind Inborn Students
ERIC Educational Resources Information Center
Bulbul, M. Sahin
2009-01-01
To take a physics course blind students must be assisted using teaching methods and aids adapted to their own perception capabilities. Touchable objects are very important for them because they have huge difficulties to visualize the third spatial dimension. However, appropriate resources and methods for blind students are not yet available. In…
ERIC Educational Resources Information Center
Cantlon, Julie; And Others
1996-01-01
This study evaluated the use of "allegation blind" interviews (in which interviewers did not know the specific allegation involved) with children (n=1535) suspected of being victims of child sexual abuse. The "allegation blind" interview technique yielded a statistically higher disclosure rate than the "allegation informed" interviews. (Author/DB)
Congenital blindness is associated with large-scale reorganization of anatomical networks.
Hasson, Uri; Andric, Michael; Atilgan, Hicret; Collignon, Olivier
2016-03-01
Blindness is a unique model for understanding the role of experience in the development of the brain's functional and anatomical architecture. Documenting changes in the structure of anatomical networks for this population would substantiate the notion that the brain's core network-level organization may undergo neuroplasticity as a result of life-long experience. To examine this issue, we compared whole-brain networks of regional cortical-thickness covariance in early blind and matched sighted individuals. This covariance is thought to reflect signatures of integration between systems involved in similar perceptual/cognitive functions. Using graph-theoretic metrics, we identified a unique mode of anatomical reorganization in the blind that differed from that found for sighted. This was seen in that network partition structures derived from subgroups of blind were more similar to each other than they were to partitions derived from sighted. Notably, after deriving network partitions, we found that language and visual regions tended to reside within separate modules in sighted but showed a pattern of merging into shared modules in the blind. Our study demonstrates that early visual deprivation triggers a systematic large-scale reorganization of whole-brain cortical-thickness networks, suggesting changes in how occipital regions interface with other functional networks in the congenitally blind. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
Functional connectivity of visual cortex in the blind follows retinotopic organization principles
Ovadia-Caro, Smadar; Caramazza, Alfonso; Margulies, Daniel S.; Villringer, Arno
2015-01-01
Is visual input during critical periods of development crucial for the emergence of the fundamental topographical mapping of the visual cortex? And would this structure be retained throughout life-long blindness or would it fade as a result of plastic, use-based reorganization? We used functional connectivity magnetic resonance imaging based on intrinsic blood oxygen level-dependent fluctuations to investigate whether significant traces of topographical mapping of the visual scene in the form of retinotopic organization, could be found in congenitally blind adults. A group of 11 fully and congenitally blind subjects and 18 sighted controls were studied. The blind demonstrated an intact functional connectivity network structural organization of the three main retinotopic mapping axes: eccentricity (centre-periphery), laterality (left-right), and elevation (upper-lower) throughout the retinotopic cortex extending to high-level ventral and dorsal streams, including characteristic eccentricity biases in face- and house-selective areas. Functional connectivity-based topographic organization in the visual cortex was indistinguishable from the normally sighted retinotopic functional connectivity structure as indicated by clustering analysis, and was found even in participants who did not have a typical retinal development in utero (microphthalmics). While the internal structural organization of the visual cortex was strikingly similar, the blind exhibited profound differences in functional connectivity to other (non-visual) brain regions as compared to the sighted, which were specific to portions of V1. Central V1 was more connected to language areas but peripheral V1 to spatial attention and control networks. These findings suggest that current accounts of critical periods and experience-dependent development should be revisited even for primary sensory areas, in that the connectivity basis for visual cortex large-scale topographical organization can develop without any visual experience and be retained through life-long experience-dependent plasticity. Furthermore, retinotopic divisions of labour, such as that between the visual cortex regions normally representing the fovea and periphery, also form the basis for topographically-unique plastic changes in the blind. PMID:25869851
NASA Astrophysics Data System (ADS)
Song, Lu-Kai; Wen, Jie; Fei, Cheng-Wei; Bai, Guang-Chen
2018-05-01
To improve the computing efficiency and precision of probabilistic design for multi-failure structure, a distributed collaborative probabilistic design method-based fuzzy neural network of regression (FR) (called as DCFRM) is proposed with the integration of distributed collaborative response surface method and fuzzy neural network regression model. The mathematical model of DCFRM is established and the probabilistic design idea with DCFRM is introduced. The probabilistic analysis of turbine blisk involving multi-failure modes (deformation failure, stress failure and strain failure) was investigated by considering fluid-structure interaction with the proposed method. The distribution characteristics, reliability degree, and sensitivity degree of each failure mode and overall failure mode on turbine blisk are obtained, which provides a useful reference for improving the performance and reliability of aeroengine. Through the comparison of methods shows that the DCFRM reshapes the probability of probabilistic analysis for multi-failure structure and improves the computing efficiency while keeping acceptable computational precision. Moreover, the proposed method offers a useful insight for reliability-based design optimization of multi-failure structure and thereby also enriches the theory and method of mechanical reliability design.
Ståhl, Agneta; Newman, Emma; Dahlin-Ivanoff, Synneve; Almén, Mai; Iwarsson, Sussane
2010-01-01
The overall purpose was to study whether and how persons with blindness detect warning surfaces with a long white cane in a real pedestrian environment after following a natural guidance surface to the warning surfaces. Of particular interest was the importance of kerb, depth, and structure of the warning surfaces. A concurrently mixed methods approach, with a combination of observation using a structured form together with 'think aloud' and a structured interview, was used. It was done with well-defined samples and study sites in an inter-disciplinary research context. The results show that the most important design characteristic for detection of the warning surfaces with a white cane is the structure of the surface, while the depth of the surface and availability of a kerb do not have any impact on the detection. A precondition was that there is a distinct natural guidance surface leading up to the warning surface. The probability among pedestrians with blindness to detect a tactile surface is not higher if the design solution has a kerb. This study also confirms the complexity of being a blind pedestrian in the traffic environment. The results can be used for evidence-based physical planning. The study also has implications for development of more efficient vision rehabilitation.
Bauer, Corinna M.; Hirsch, Gabriella V.; Zajac, Lauren; Koo, Bang-Bon; Collignon, Olivier
2017-01-01
In the setting of profound ocular blindness, numerous lines of evidence demonstrate the existence of dramatic anatomical and functional changes within the brain. However, previous studies based on a variety of distinct measures have often provided inconsistent findings. To help reconcile this issue, we used a multimodal magnetic resonance (MR)-based imaging approach to provide complementary structural and functional information regarding this neuroplastic reorganization. This included gray matter structural morphometry, high angular resolution diffusion imaging (HARDI) of white matter connectivity and integrity, and resting state functional connectivity MRI (rsfcMRI) analysis. When comparing the brains of early blind individuals to sighted controls, we found evidence of co-occurring decreases in cortical volume and cortical thickness within visual processing areas of the occipital and temporal cortices respectively. Increases in cortical volume in the early blind were evident within regions of parietal cortex. Investigating white matter connections using HARDI revealed patterns of increased and decreased connectivity when comparing both groups. In the blind, increased white matter connectivity (indexed by increased fiber number) was predominantly left-lateralized, including between frontal and temporal areas implicated with language processing. Decreases in structural connectivity were evident involving frontal and somatosensory regions as well as between occipital and cingulate cortices. Differences in white matter integrity (as indexed by quantitative anisotropy, or QA) were also in general agreement with observed pattern changes in the number of white matter fibers. Analysis of resting state sequences showed evidence of both increased and decreased functional connectivity in the blind compared to sighted controls. Specifically, increased connectivity was evident between temporal and inferior frontal areas. Decreases in functional connectivity were observed between occipital and frontal and somatosensory-motor areas and between temporal (mainly fusiform and parahippocampus) and parietal, frontal, and other temporal areas. Correlations in white matter connectivity and functional connectivity observed between early blind and sighted controls showed an overall high degree of association. However, comparing the relative changes in white matter and functional connectivity between early blind and sighted controls did not show a significant correlation. In summary, these findings provide complimentary evidence, as well as highlight potential contradictions, regarding the nature of regional and large scale neuroplastic reorganization resulting from early onset blindness. PMID:28328939
An Experimental Study of Shear-Dominated Failure in the 2013 Sandia Fracture Challenge Specimen
DOE Office of Scientific and Technical Information (OSTI.GOV)
Corona, Edmundo; Deibler, Lisa Anne; Reedlunn, Benjamin
2015-04-01
This report presents an experimental study motivated by results obtained during the 2013 Sandia Fracture Challenge. The challenge involved A286 steel, shear-dominated compression specimens whose load-deflection response contained a load maximum fol- lowed by significant displacement under decreasing load, ending with a catastrophic fracture. Blind numerical simulations deviated from the experiments well before the maximum load and did not predict the failure displacement. A series of new tests were conducted on specimens machined from the original A286 steel stock to learn more about the deformation and failure processes in the specimen and potentially improve future numerical simulations. The study consistedmore » of several uniaxial tension tests to explore anisotropy in the material, and a set of new tests on the compression speci- men. In some compression specimen tests, stereo digital image correlation (DIC) was used to measure the surface strain fields local to the region of interest. In others, the compression specimen was loaded to a given displacement prior to failure, unloaded, sectioned, and imaged under the microscope to determine when material damage first appeared and how it spread. The experiments brought the following observations to light. The tensile tests revealed that the plastic response of the material is anisotropic. DIC during the shear- dominated compression tests showed that all three in-plane surface strain components had maxima in the order of 50% at the maximum load. Sectioning of the specimens revealed no signs of material damage at the point where simulations deviated from the experiments. Cracks and other damage did start to form approximately when the max- imum load was reached, and they grew as the load decreased, eventually culminating in catastrophic failure of the specimens. In addition to the steel specimens, a similar study was carried out for aluminum 7075-T651 specimens. These specimens achieved much lower loads and displacements, and failure occurred very close to the maximum in the load-deflection response. No material damage was observed in these specimens, even when failure was imminent. In the future, we plan to use these experimental results to improve numerical simu- lations of the A286 steel experiments, and to improve plasticity and failure models for the Al 7075 stock. The ultimate goal of our efforts is to increase our confidence in the results of numerical simulations of elastic-plastic structural behavior and failure.« less
Brain morphometry in blind and sighted subjects.
Maller, Jerome J; Thomson, Richard H; Ng, Amanda; Mann, Collette; Eager, Michael; Ackland, Helen; Fitzgerald, Paul B; Egan, Gary; Rosenfeld, Jeffrey V
2016-11-01
Previous neuroimaging studies have demonstrated structural brain alterations in blind subjects, but most have focused on primary open angle glaucoma or retinopathy of prematurity, used low-field scanners, a limited number of receive channels, or have presented uncorrected results. We recruited 10 blind and 10 age and sex-matched controls to undergo high-resolution MRI using a 3T scanner and a 32-channel receive coil. We evaluated whole-brain morphological differences between the groups as well as manual segmentation of regional hippocampal volumes. There were no hippocampal volume differences between the groups. Whole-brain morphometry showed white matter volume differences between blind and sighted groups including localised larger regions in the visual cortex (occipital gyral volume and thickness) among those with blindness early in life compared to those with blindness later in life. Hence, in our patients, blindness resulted in brain volumetric differences that depend upon duration of blindness. Copyright © 2016 Elsevier Ltd. All rights reserved.
2007-05-01
seizures , sub-arachnoid hemorrhaging, prenatal strokes , alopecia universalis (hair loss disease) husband is Active Duty, came from Ft. Hood 4...restriction, failure to thrive, a seizure disorder, cortical blindness husband is Active Duty Army 20 diagnosed with severe cerebral palsy at 3 mo old ex...linked hyper IgM); oldest son has cancer too Active Duty Army officer (wife and husband participated) 3 severe cerebral palsy, seizure disorder
Raguin, Thibaut; Dupret-Bories, Agnès; Debry, Christian
2017-01-01
Research has been fighting against organ failure and shortage of donations by supplying artificial organs for many years. With the raise of new technologies, tissue engineering and regenerative medicine, many organs can benefit of an artificial equivalent: thanks to retinal implants some blind people can visualize stimuli, an artificial heart can be proposed in case of cardiac failure while awaiting for a heart transplant, artificial larynx enables laryngectomy patients to an almost normal life, while the diabetic can get a glycemic self-regulation controlled by smartphones with an artificial device. Dialysis devices become portable, as well as the oxygenation systems for terminal respiratory failure. Bright prospects are being explored or might emerge in a near future. However, the retrospective assessment of putative side effects is not yet sufficient. Finally, the cost of these new devices is significant even if the advent of three dimensional printers may reduce it. © 2017 médecine/sciences – Inserm.
ERIC Educational Resources Information Center
Lahav, Orly; Schloerb, David W.; Srinivasan, Mandayam A.
2015-01-01
Introduction: The BlindAid, a virtual system developed for orientation and mobility (O&M) training of people who are blind or have low vision, allows interaction with different virtual components (structures and objects) via auditory and haptic feedback. This research examined if and how the BlindAid that was integrated within an O&M…
Convex blind image deconvolution with inverse filtering
NASA Astrophysics Data System (ADS)
Lv, Xiao-Guang; Li, Fang; Zeng, Tieyong
2018-03-01
Blind image deconvolution is the process of estimating both the original image and the blur kernel from the degraded image with only partial or no information about degradation and the imaging system. It is a bilinear ill-posed inverse problem corresponding to the direct problem of convolution. Regularization methods are used to handle the ill-posedness of blind deconvolution and get meaningful solutions. In this paper, we investigate a convex regularized inverse filtering method for blind deconvolution of images. We assume that the support region of the blur object is known, as has been done in a few existing works. By studying the inverse filters of signal and image restoration problems, we observe the oscillation structure of the inverse filters. Inspired by the oscillation structure of the inverse filters, we propose to use the star norm to regularize the inverse filter. Meanwhile, we use the total variation to regularize the resulting image obtained by convolving the inverse filter with the degraded image. The proposed minimization model is shown to be convex. We employ the first-order primal-dual method for the solution of the proposed minimization model. Numerical examples for blind image restoration are given to show that the proposed method outperforms some existing methods in terms of peak signal-to-noise ratio (PSNR), structural similarity (SSIM), visual quality and time consumption.
Blind Quantum Signature with Blind Quantum Computation
NASA Astrophysics Data System (ADS)
Li, Wei; Shi, Ronghua; Guo, Ying
2017-04-01
Blind quantum computation allows a client without quantum abilities to interact with a quantum server to perform a unconditional secure computing protocol, while protecting client's privacy. Motivated by confidentiality of blind quantum computation, a blind quantum signature scheme is designed with laconic structure. Different from the traditional signature schemes, the signing and verifying operations are performed through measurement-based quantum computation. Inputs of blind quantum computation are securely controlled with multi-qubit entangled states. The unique signature of the transmitted message is generated by the signer without leaking information in imperfect channels. Whereas, the receiver can verify the validity of the signature using the quantum matching algorithm. The security is guaranteed by entanglement of quantum system for blind quantum computation. It provides a potential practical application for e-commerce in the cloud computing and first-generation quantum computation.
Causes of corneal graft failure in India.
Dandona, L; Naduvilath, T J; Janarthanan, M; Rao, G N
1998-09-01
The success of corneal grafting in visual rehabilitation of the corneal blind in India depends on survival of the grafts. Understanding the causes of graft failure may help reduce the risk of failure. We studied these causes in a series of 638 graft failures at our institution. Multivariate logistic regression analysis was used to evaluate the association of particular causes of graft failure with indications for grafting, socioeconomic status, age, sex, host corneal vascularization, donor corneal quality, and experience of surgeon. The major causes of graft failure were allograft rejection (29.2%), increased intraocular pressure (16.9%), infection excluding endophthalmitis (15.4%), and surface problems (12.7%). The odds of infection causing graft failure were significantly higher in patients of lower socioeconomic status (odds ratio 2.45, 95% CI 1.45-4.15). Surface problems as a cause of graft failure was significantly associated with grafts done for corneal scarring or for regrafts (odds ratio 3.36, 95% CI 1.80-6.30). Increased intraocular pressure as a cause of graft failure had significant association with grafts done for aphakic or pseudophakic bullous keratopathy, congenital conditions or glaucoma, or regrafts (odds ratio 2.19, 95% CI 1.25-3.84). Corneal dystrophy was the indication for grafting in 12 of the 13 cases of graft failure due to recurrence of host disease. Surface problems, increased intraocular pressure, and infection are modifiable risk factors that are more likely to cause graft failure in certain categories of patients in India. Knowledge about these associations can be helpful in looking for and aggressively treating these modifiable risk factors in the at-risk categories of corneal graft patients. This can possibly reduce the chance of graft failure.
Allopurinol improves endothelial dysfunction in chronic heart failure.
Farquharson, Colin A J; Butler, Robert; Hill, Alexander; Belch, Jill J F; Struthers, Allan D
2002-07-09
Increased oxidative stress in chronic heart failure is thought to contribute to endothelial dysfunction. Xanthine oxidase produces oxidative stress and therefore we examined whether allopurinol improved endothelial dysfunction in chronic heart failure. We performed a randomized, placebo-controlled, double-blind crossover study on 11 patients with New York Heart Association class II-III chronic heart failure, comparing 300 mg allopurinol daily (1 month) versus placebo. Endothelial function was assessed by standard forearm venous occlusion plethysmography with acetylcholine, nitroprusside, and verapamil. Plasma malondialdehyde levels were also compared to assess significant changes in oxidative stress. Allopurinol significantly increased the forearm blood flow response to acetylcholine (percentage change in forearm blood flow [mean+/-SEM]: 181+/-19% versus 120+/-22% allopurinol versus placebo; P=0.003). There were no significant differences in the forearm blood flow changes between the placebo and allopurinol treatment arms with regard to sodium nitroprusside or verapamil. Plasma malondialdehyde was significantly reduced with allopurinol treatment (346+/-128 nmol/L versus 461+/-101 nmol/L, allopurinol versus placebo; P=0.03), consistent with reduced oxidative stress with allopurinol therapy. We have shown that allopurinol improves endothelial dysfunction in chronic heart failure. This raises the distinct possibility that allopurinol might reduce cardiovascular events and even improve exercise capacity in chronic heart failure.
Mozafarpour, Sarah; Kajbafzadeh, Abdol-Mohammad; Mojtahed, Ali; Mojtahed, Mohammad; Mahboubi, Hossein; Shalileh, Keivan
2015-07-01
To present the long-term outcomes of appendicovesicostomy using the Mitrofanoff principle for end-stage Wolfram bladder dysfunction as an alternative to clean intermittent self-catheterization (CIC) per urethra mainly following blindness. Twelve Wolfram patients presenting with bilateral hydroureteronephrosis and advanced bladder dysfunction were included in this study. All patients were managed initially by CIC per urethra. All of these patients became blind during follow-up and were unable to perform urethral CIC independently. Out of these patients, six patients agreed to proceed to appendicovesicostomy. Appendicovesicostomy urinary diversion using the Mitrofanoff principle was performed in these six blind patients. The rest of the patients stopped CIC or performed CIC irregularly. Severe hydroureteronephrosis and large bladders were found in all patients prior to intervention. All patients were able to conduct CIC independently through the stoma and maintained overnight bladder free drainage. In all patients with urinary diversion and CIC, the hydroureteronephrosis was reduced and renal function returned to normal. However, the non-intervention group ended with different degrees of progressive renal failure with three mortalities during the follow-up. We suggest appendicovesicostomy as a safe and lifesaving procedure for long-term management of bladder dysfunction in Wolfram syndrome particularly after progression to blindness. Copyright © 2015 Elsevier Inc. All rights reserved.
Confident failures: Lapses of working memory reveal a metacognitive blind spot.
Adam, Kirsten C S; Vogel, Edward K
2017-07-01
Working memory performance fluctuates dramatically from trial to trial. On many trials, performance is no better than chance. Here, we assessed participants' awareness of working memory failures. We used a whole-report visual working memory task to quantify both trial-by-trial performance and trial-by-trial subjective ratings of inattention to the task. In Experiment 1 (N = 41), participants were probed for task-unrelated thoughts immediately following 20% of trials. In Experiment 2 (N = 30), participants gave a rating of their attentional state following 25% of trials. Finally, in Experiments 3a (N = 44) and 3b (N = 34), participants reported confidence of every response using a simple mouse-click judgment. Attention-state ratings and off-task thoughts predicted the number of items correctly identified on each trial, replicating previous findings that subjective measures of attention state predict working memory performance. However, participants correctly identified failures on only around 28% of failure trials. Across experiments, participants' metacognitive judgments reliably predicted variation in working memory performance but consistently and severely underestimated the extent of failures. Further, individual differences in metacognitive accuracy correlated with overall working memory performance, suggesting that metacognitive monitoring may be key to working memory success.
Pang, Peter S; Butler, Javed; Collins, Sean P; Cotter, Gad; Davison, Beth A; Ezekowitz, Justin A; Filippatos, Gerasimos; Levy, Phillip D; Metra, Marco; Ponikowski, Piotr; Teerlink, John R; Voors, Adriaan A; Bharucha, David; Goin, Kathleen; Soergel, David G; Felker, G Michael
2017-08-07
Currently, no acute heart failure (AHF) therapy definitively improves outcomes. Reducing morbidity and mortality from acute heart failure (AHF) remains an unmet need. TRV027 is a novel 'biased' ligand of the angiotensin II type 1 receptor (AT1R), selectively antagonizing the negative effects of angiotensin II, while preserving the potential pro-contractility effects of AT1R stimulation. BLAST-AHF was designed to determine the safety, efficacy, and optimal dose of TRV027 to advance into future studies. BLAST-AHF was a multi-centre, international, randomized, double-blind, placebo-controlled, parallel group, phase IIb dose-ranging study, enrolling patients with AHF into 4 groups: placebo, 1, 5, or 25 mg/h of TRV027. Treatment was by IV infusion for 48-96 h. The primary composite endpoint was comprised of the following: (i) time from baseline to death through day 30, (ii) time from baseline to heart failure re-hospitalization through day 30, (iii) the first assessment time point following worsening heart failure through day 5, (iv) change in dyspnea visual analogue scale (VAS) score calculated as the area under the curve (AUC) representing the change from baseline over time from baseline through day 5, and (v) length of initial hospital stay (in days) from baseline. Analyses were by modified intention-to-treat. Overall, 621 patients were enrolled. After 254 patients, a pre-specified interim analysis resulted in several protocol changes, including a lower blood pressure inclusion criterion as well as a new allocation scheme of 2:1:2:1, overweighting both placebo, and the 5 mg/h dose. TRV027 did not confer any benefit over placebo at any dose with regards to the primary composite endpoint or any of the individual components. There were no significant safety issues with TRV027. In this phase IIb dose-ranging AHF study, TRV027 did not improve clinical status through 30-day follow-up compared with placebo. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.
Blind test of physics-based prediction of protein structures.
Shell, M Scott; Ozkan, S Banu; Voelz, Vincent; Wu, Guohong Albert; Dill, Ken A
2009-02-01
We report here a multiprotein blind test of a computer method to predict native protein structures based solely on an all-atom physics-based force field. We use the AMBER 96 potential function with an implicit (GB/SA) model of solvation, combined with replica-exchange molecular-dynamics simulations. Coarse conformational sampling is performed using the zipping and assembly method (ZAM), an approach that is designed to mimic the putative physical routes of protein folding. ZAM was applied to the folding of six proteins, from 76 to 112 monomers in length, in CASP7, a community-wide blind test of protein structure prediction. Because these predictions have about the same level of accuracy as typical bioinformatics methods, and do not utilize information from databases of known native structures, this work opens up the possibility of predicting the structures of membrane proteins, synthetic peptides, or other foldable polymers, for which there is little prior knowledge of native structures. This approach may also be useful for predicting physical protein folding routes, non-native conformations, and other physical properties from amino acid sequences.
Blind Test of Physics-Based Prediction of Protein Structures
Shell, M. Scott; Ozkan, S. Banu; Voelz, Vincent; Wu, Guohong Albert; Dill, Ken A.
2009-01-01
We report here a multiprotein blind test of a computer method to predict native protein structures based solely on an all-atom physics-based force field. We use the AMBER 96 potential function with an implicit (GB/SA) model of solvation, combined with replica-exchange molecular-dynamics simulations. Coarse conformational sampling is performed using the zipping and assembly method (ZAM), an approach that is designed to mimic the putative physical routes of protein folding. ZAM was applied to the folding of six proteins, from 76 to 112 monomers in length, in CASP7, a community-wide blind test of protein structure prediction. Because these predictions have about the same level of accuracy as typical bioinformatics methods, and do not utilize information from databases of known native structures, this work opens up the possibility of predicting the structures of membrane proteins, synthetic peptides, or other foldable polymers, for which there is little prior knowledge of native structures. This approach may also be useful for predicting physical protein folding routes, non-native conformations, and other physical properties from amino acid sequences. PMID:19186130
An easy-to-use technique to characterize cardiodynamics from first-return maps on ΔRR-intervals
NASA Astrophysics Data System (ADS)
Fresnel, Emeline; Yacoub, Emad; Freitas, Ubiratan; Kerfourn, Adrien; Messager, Valérie; Mallet, Eric; Muir, Jean-François; Letellier, Christophe
2015-08-01
Heart rate variability analysis using 24-h Holter monitoring is frequently performed to assess the cardiovascular status of a patient. The present retrospective study is based on the beat-to-beat interval variations or ΔRR, which offer a better view of the underlying structures governing the cardiodynamics than the common RR-intervals. By investigating data for three groups of adults (with normal sinus rhythm, congestive heart failure, and atrial fibrillation, respectively), we showed that the first-return maps built on ΔRR can be classified according to three structures: (i) a moderate central disk, (ii) a reduced central disk with well-defined segments, and (iii) a large triangular shape. These three very different structures can be distinguished by computing a Shannon entropy based on a symbolic dynamics and an asymmetry coefficient, here introduced to quantify the balance between accelerations and decelerations in the cardiac rhythm. The probability P111111 of successive heart beats without large beat-to-beat fluctuations allows to assess the regularity of the cardiodynamics. A characteristic time scale, corresponding to the partition inducing the largest Shannon entropy, was also introduced to quantify the ability of the heart to modulate its rhythm: it was significantly different for the three structures of first-return maps. A blind validation was performed to validate the technique.
Shi, Victor; Senni, Michele; Streefkerk, Hendrik; Modgill, Vikas; Zhou, Wenchun; Kaplan, Allen
2018-08-01
PARADIGM-HF demonstrated significant clinical benefits for sacubitril/valsartan (LCZ696, an angiotensin receptor neprilysin inhibitor) versus the angiotensin-converting enzyme inhibitor (ACEI) enalapril in patients with heart failure with reduced ejection fraction. As inhibition of ACE, and co-inhibition of ACE and neprilysin, may increase the risk of angioedema, this was an adverse event of special interest. Following sequential enalapril and sacubitril/valsartan run-ins, patients were randomized to twice-daily sacubitril/valsartan 200 mg or enalapril 10 mg. The study design incorporated two wash-out periods (~36 h each) to minimize any potential risk of angioedema due to overlapping ACE and neprilysin inhibition. Suspected cases of angioedema were reported to, and blindly adjudicated by, an independent angioedema adjudication committee (AAC). Of the 10,513 patients entering the enalapril run-in, 9419 entered the sacubitril/valsartan run-in and 8432 received double-blind treatment. Overall, 148 suspected angioedema events occurring in 144 patients were reported to AAC, with one event reported during screening period. Of the remaining 147 events, 54 were confirmed as angioedema by AAC. A confirmed event was experienced by 15 (0.14%) and 10 (0.11%) patients, during the enalapril and sacubitril/valsartan run-ins, respectively, and by 10 (0.24%) and 19 (0.45%) patients in the corresponding randomized arms during the double-blind phase. The frequency of confirmed angioedema was higher in black patients. Most events were mild. Only five patients required hospitalization and none required mechanical airway support. The number of confirmed angioedema events in PARADIGM-HF was low and there was no-marked excess risk of angioedema with sacubitril/valsartan versus enalapril. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.
Uncertainty and Intelligence in Computational Stochastic Mechanics
NASA Technical Reports Server (NTRS)
Ayyub, Bilal M.
1996-01-01
Classical structural reliability assessment techniques are based on precise and crisp (sharp) definitions of failure and non-failure (survival) of a structure in meeting a set of strength, function and serviceability criteria. These definitions are provided in the form of performance functions and limit state equations. Thus, the criteria provide a dichotomous definition of what real physical situations represent, in the form of abrupt change from structural survival to failure. However, based on observing the failure and survival of real structures according to the serviceability and strength criteria, the transition from a survival state to a failure state and from serviceability criteria to strength criteria are continuous and gradual rather than crisp and abrupt. That is, an entire spectrum of damage or failure levels (grades) is observed during the transition to total collapse. In the process, serviceability criteria are gradually violated with monotonically increasing level of violation, and progressively lead into the strength criteria violation. Classical structural reliability methods correctly and adequately include the ambiguity sources of uncertainty (physical randomness, statistical and modeling uncertainty) by varying amounts. However, they are unable to adequately incorporate the presence of a damage spectrum, and do not consider in their mathematical framework any sources of uncertainty of the vagueness type. Vagueness can be attributed to sources of fuzziness, unclearness, indistinctiveness, sharplessness and grayness; whereas ambiguity can be attributed to nonspecificity, one-to-many relations, variety, generality, diversity and divergence. Using the nomenclature of structural reliability, vagueness and ambiguity can be accounted for in the form of realistic delineation of structural damage based on subjective judgment of engineers. For situations that require decisions under uncertainty with cost/benefit objectives, the risk of failure should depend on the underlying level of damage and the uncertainties associated with its definition. A mathematical model for structural reliability assessment that includes both ambiguity and vagueness types of uncertainty was suggested to result in the likelihood of failure over a damage spectrum. The resulting structural reliability estimates properly represent the continuous transition from serviceability to strength limit states over the ultimate time exposure of the structure. In this section, a structural reliability assessment method based on a fuzzy definition of failure is suggested to meet these practical needs. A failure definition can be developed to indicate the relationship between failure level and structural response. In this fuzzy model, a subjective index is introduced to represent all levels of damage (or failure). This index can be interpreted as either a measure of failure level or a measure of a degree of belief in the occurrence of some performance condition (e.g., failure). The index allows expressing the transition state between complete survival and complete failure for some structural response based on subjective evaluation and judgment.
Lahav, Orly; Schloerb, David W.; Srinivasan, Mandayam A.
2014-01-01
This paper presents the integration of a virtual environment (BlindAid) in an orientation and mobility rehabilitation program as a training aid for people who are blind. BlindAid allows the users to interact with different virtual structures and objects through auditory and haptic feedback. This research explores if and how use of the BlindAid in conjunction with a rehabilitation program can help people who are blind train themselves in familiar and unfamiliar spaces. The study, focused on nine participants who were congenitally, adventitiously, and newly blind, during their orientation and mobility rehabilitation program at the Carroll Center for the Blind (Newton, Massachusetts, USA). The research was implemented using virtual environment (VE) exploration tasks and orientation tasks in virtual environments and real spaces. The methodology encompassed both qualitative and quantitative methods, including interviews, a questionnaire, videotape recording, and user computer logs. The results demonstrated that the BlindAid training gave participants additional time to explore the virtual environment systematically. Secondly, it helped elucidate several issues concerning the potential strengths of the BlindAid system as a training aid for orientation and mobility for both adults and teenagers who are congenitally, adventitiously, and newly blind. PMID:25284952
Balme, Kate H; Zar, Heather; Swift, Donne K; Mann, Michael D
2015-01-01
Hydrocarbons, especially kerosene (paraffin), are the most common agents causing childhood poisoning in low and middle income countries (LMICs). Aspiration of kerosene causes an inflammatory sterile chemical pneumonitis, which may increase susceptibility to secondary lower respiratory tract bacterial infection. This study aimed to assess the efficacy of prophylactic antibiotics in the management of kerosene-associated pneumonitis in children and to identify risk factors associated with severity or outcome. A double-blind placebo-controlled trial of prophylactic antibiotics in the management of kerosene-associated pneumonitis of children presenting to a referral hospital was performed from July 2010 to September 2011. Sequential children with a history of kerosene ingestion and mild respiratory illness were randomised to receive placebo or amoxicillin. Each child was followed-up at Day 3 and Day 5 post-ingestion. The primary outcome measure was the number of treatment failures in each group, defined as any child who deteriorated within this time, necessitating a change in treatment regimen. Secondary outcome measures were length of hospital stay and symptoms and signs at follow-up. Seventy-four patients were enrolled. Thirty-five (47%) received placebo and 39 (53%) active treatment. There was no significant difference in treatment failures between placebo (3/35, 9%; 95% CI, 3-22) and active (2/39, 5%; 95% CI, 1-17) groups (relative risk, 0.60; 95% CI, 0.11-3.37). The median length of hospital stay was identical (placebo 0.5 days; IQR, 0-1.0 and active 0.5 days; IQR, 0.5-1.0). Symptoms and signs at Days 3 and 5 post-ingestion were similar. The only significant risk factor for treatment failure was residence in formal housing. Clinical severity at presentation was similar for treatment successes and failures. Prophylactic antibiotics do not improve the outcome in children with mild respiratory illness after kerosene ingestion.
A blind test of nondestructive underground void detection by ground penetrating radar (GPR)
NASA Astrophysics Data System (ADS)
Lai, Wallace W. L.; Chang, Ray K. W.; Sham, Janet F. C.
2018-02-01
Blind test/experiment is widely adopted in various scientific disciplines like medicine drug testing/clinical trials/psychology, but not popular in nondestructive testing and evaluation (NDTE) nor near-surface geophysics (NSG). This paper introduces a blind test of nondestructive underground void detection in highway/pavement using ground penetrating radar (GPR). Purpose of which is to help the Highways Department (HyD) of the Hong Kong Government to evaluate the feasibility of large-scale and nationwide application, and examine the ability of appropriate service providers to carry out such works. In the past failure case of such NDTE/NSG based on lowest bid price, it is not easy to know which part(s) in SWIMS (S - service provider, i.e. people; W - work procedure; I - instrumentation; M - materials in the complex underground; S - specifications by client) fails, and how it/they fail(s). This work attempts to carry out the blind test by burying fit balls (as voids) under a site with reinforced concrete road and paving block by PolyU team A. The blind test about the void centroid, spread and cover depth was then carried out by PolyU team B without prior information given. Then with this baseline, a marking scheme, acceptance criteria and passing mark were set to test six local commercial service providers, determine their scores and evaluate the performance. A pass is a prerequisite of the award of a service contract of similar nature. In this first attempt of the blind test, results were not satisfactory and it is concluded that 'S-service provider' and 'W-work procedure' amongst SWIMS contributed to most part of the unsatisfactory performance.+
The need for randomization in animal trials: an overview of systematic reviews.
Hirst, Jennifer A; Howick, Jeremy; Aronson, Jeffrey K; Roberts, Nia; Perera, Rafael; Koshiaris, Constantinos; Heneghan, Carl
2014-01-01
Randomization, allocation concealment, and blind outcome assessment have been shown to reduce bias in human studies. Authors from the Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Studies (CAMARADES) collaboration recently found that these features protect against bias in animal stroke studies. We extended the scope the work from CAMARADES to include investigations of treatments for any condition. We conducted an overview of systematic reviews. We searched Medline and Embase for systematic reviews of animal studies testing any intervention (against any control) and we included any disease area and outcome. We included reviews comparing randomized versus not randomized (but otherwise controlled), concealed versus unconcealed treatment allocation, or blinded versus unblinded outcome assessment. Thirty-one systematic reviews met our inclusion criteria: 20 investigated treatments for experimental stroke, 4 reviews investigated treatments for spinal cord diseases, while 1 review each investigated treatments for bone cancer, intracerebral hemorrhage, glioma, multiple sclerosis, Parkinson's disease, and treatments used in emergency medicine. In our sample 29% of studies reported randomization, 15% of studies reported allocation concealment, and 35% of studies reported blinded outcome assessment. We pooled the results in a meta-analysis, and in our primary analysis found that failure to randomize significantly increased effect sizes, whereas allocation concealment and blinding did not. In our secondary analyses we found that randomization, allocation concealment, and blinding reduced effect sizes, especially where outcomes were subjective. Our study demonstrates the need for randomization, allocation concealment, and blind outcome assessment in animal research across a wide range of outcomes and disease areas. Since human studies are often justified based on results from animal studies, our results suggest that unduly biased animal studies should not be allowed to constitute part of the rationale for human trials.
Poteat, V Paul; Spanierman, Lisa B
2012-01-01
Among 342 white college students, we examined the effects of social dominance orientation (SDO), right-wing authoritarianism (RWA), and racial color-blindness on modern racism attitudes. Structural equation modeling was used to test the indirect effects of SDO and RWA on modern racism attitudes through color-blind racial attitudes. We found strong indirect effects of SDO and RWA on modern racism through racial color-blindness. We did not find support for an alternative model, in which we tested racial color-blindness as a moderator of the effects of SDO and RWA on modern racism. Findings suggest that highly dominant and authoritarian white students endorse color-blind racial attitudes, although likely for different reasons. In turn, this predicts their modern racism attitudes. These findings indicate racial color-blindness is important to address as part of anti-racism education.
Factors Influencing Progressive Failure Analysis Predictions for Laminated Composite Structure
NASA Technical Reports Server (NTRS)
Knight, Norman F., Jr.
2008-01-01
Progressive failure material modeling methods used for structural analysis including failure initiation and material degradation are presented. Different failure initiation criteria and material degradation models are described that define progressive failure formulations. These progressive failure formulations are implemented in a user-defined material model for use with a nonlinear finite element analysis tool. The failure initiation criteria include the maximum stress criteria, maximum strain criteria, the Tsai-Wu failure polynomial, and the Hashin criteria. The material degradation model is based on the ply-discounting approach where the local material constitutive coefficients are degraded. Applications and extensions of the progressive failure analysis material model address two-dimensional plate and shell finite elements and three-dimensional solid finite elements. Implementation details are described in the present paper. Parametric studies for laminated composite structures are discussed to illustrate the features of the progressive failure modeling methods that have been implemented and to demonstrate their influence on progressive failure analysis predictions.
Sacubitril/Valsartan: A Review in Chronic Heart Failure with Reduced Ejection Fraction.
McCormack, Paul L
2016-03-01
Sacubitril/valsartan (Entresto™; LCZ696) is an orally administered supramolecular sodium salt complex of the neprilysin inhibitor prodrug sacubitril and the angiotensin receptor blocker (ARB) valsartan, which was recently approved in the US and the EU for the treatment of chronic heart failure (NYHA class II-IV) with reduced ejection fraction (HFrEF). In the large, randomized, double-blind, PARADIGM-HF trial, sacubitril/valsartan reduced the incidence of death from cardiovascular causes or first hospitalization for worsening heart failure (composite primary endpoint) significantly more than the angiotensin converting enzyme (ACE) inhibitor enalapril. Sacubitril/valsartan was also superior to enalapril in reducing death from any cause and in limiting the progression of heart failure. Sacubitril/valsartan was generally well tolerated, with no increase in life-threatening adverse events. Symptomatic hypotension was significantly more common with sacubitril/valsartan than with enalapril; the incidence of angio-oedema was low. Therefore, sacubitril/valsartan is a more effective replacement for an ACE inhibitor or an ARB in the treatment of HFrEF, and is likely to influence the basic approach to treatment.
A wireless sensor network based personnel positioning scheme in coal mines with blind areas.
Liu, Zhigao; Li, Chunwen; Wu, Danchen; Dai, Wenhan; Geng, Shaobo; Ding, Qingqing
2010-01-01
This paper proposes a novel personnel positioning scheme for a tunnel network with blind areas, which compared with most existing schemes offers both low-cost and high-precision. Based on the data models of tunnel networks, measurement networks and mobile miners, the global positioning method is divided into four steps: (1) calculate the real time personnel location in local areas using a location engine, and send it to the upper computer through the gateway; (2) correct any localization errors resulting from the underground tunnel environmental interference; (3) determine the global three-dimensional position by coordinate transformation; (4) estimate the personnel locations in the blind areas. A prototype system constructed to verify the positioning performance shows that the proposed positioning system has good reliability, scalability, and positioning performance. In particular, the static localization error of the positioning system is less than 2.4 m in the underground tunnel environment and the moving estimation error is below 4.5 m in the corridor environment. The system was operated continuously over three months without any failures.
Hordinsky, Maria; Fleischer, Alan; Rivers, Jason K; Poulin, Yves; Belsito, Donald; Hultsch, Thomas
2010-08-01
Chronic hand dermatitis is common and difficult to treat. Our aim was to assess the efficacy of pimecrolimus cream 1% in mild-to-moderate chronic hand dermatitis. Adult patients (n = 652) were randomized to pimecrolimus 1% or vehicle cream twice daily with overnight occlusion for 6 weeks, followed by a 6-week open-label pimecrolimus treatment. Primary efficacy was 5-point Investigators' Global Assessment of prospectively selected 'target hand' as treatment success (Investigators' Global Assessment 0 or 1) and treatment failure. Pruritus relief was also assessed. Following double-blind phase treatment, target hand treatment success was achieved in 29.8 and 23.2% of the patients in the pimecrolimus and vehicle groups, respectively (p = 0.057). The proportion of patients experiencing pruritus relief was significantly higher in the pimecrolimus group compared to the vehicle group at all time points throughout the double-blind phase. The groups were comparable with respect to treating disease signs. Pruritus relief, however, was significantly greater in the pimecrolimus group. Copyright 2010 S. Karger AG, Basel.
[An old woman with sudden pareses and blindness].
Arntzen, Kjell Arne; Albretsen, Claus; Bajic, Radoslav
2007-03-01
We present a patient with Posterior Reversible Encephalopathy Syndrome (PRES). A 74-year-old woman was admitted with sepsis, which originated from erysipelas on her neck the following day. She developed respiratory obstruction due to oedema, septic shock, disseminated intravascular coagulation (DIC), acute renal failure and atrial fibrillation. She responded well to treatment and improved rapidly, despite of her serious condition. When she had almost fully recovered after 15 days, her general condition worsened, and she developed confusion, blindness and pareses. MRI showed vasogenic oedema in the parietooccipital regions of the brain and in the cerebellum, consistent with PRES. PRES is a clinical and radiological diagnosis consisting of headache, confusion, cortical blindness, convulsions and sometimes pareses. MRI of the cerebrum with diffusion-weighted imaging (DWI) and Apparent Diffusion Coefficient (ADC) map are decisive to the diagnosis, and usually shows a characteristic bilateral vasogenic oedema in the parietooccipital region. This can distinguish PRES from brain infarction, which shows a cytotoxic oedema on MRI. We discuss our patient in the light of different conditions leading to PRES, possible pathophysiological factors and treatment options.
A Wireless Sensor Network Based Personnel Positioning Scheme in Coal Mines with Blind Areas
Liu, Zhigao; Li, Chunwen; Wu, Danchen; Dai, Wenhan; Geng, Shaobo; Ding, Qingqing
2010-01-01
This paper proposes a novel personnel positioning scheme for a tunnel network with blind areas, which compared with most existing schemes offers both low-cost and high-precision. Based on the data models of tunnel networks, measurement networks and mobile miners, the global positioning method is divided into four steps: (1) calculate the real time personnel location in local areas using a location engine, and send it to the upper computer through the gateway; (2) correct any localization errors resulting from the underground tunnel environmental interference; (3) determine the global three-dimensional position by coordinate transformation; (4) estimate the personnel locations in the blind areas. A prototype system constructed to verify the positioning performance shows that the proposed positioning system has good reliability, scalability, and positioning performance. In particular, the static localization error of the positioning system is less than 2.4 m in the underground tunnel environment and the moving estimation error is below 4.5 m in the corridor environment. The system was operated continuously over three months without any failures. PMID:22163446
Closing the Loop on Deep Brain Stimulation for Treatment-Resistant Depression.
Widge, Alik S; Malone, Donald A; Dougherty, Darin D
2018-01-01
Major depressive episodes are the largest cause of psychiatric disability, and can often resist treatment with medication and psychotherapy. Advances in the understanding of the neural circuit basis of depression, combined with the success of deep brain stimulation (DBS) in movement disorders, spurred several groups to test DBS for treatment-resistant depression. Multiple brain sites have now been stimulated in open-label and blinded studies. Initial open-label results were dramatic, but follow-on controlled/blinded clinical trials produced inconsistent results, with both successes and failures to meet endpoints. Data from follow-on studies suggest that this is because DBS in these trials was not targeted to achieve physiologic responses. We review these results within a technology-lifecycle framework, in which these early trial "failures" are a natural consequence of over-enthusiasm for an immature technology. That framework predicts that from this "valley of disillusionment," DBS may be nearing a "slope of enlightenment." Specifically, by combining recent mechanistic insights and the maturing technology of brain-computer interfaces (BCI), the next generation of trials will be better able to target pathophysiology. Key to that will be the development of closed-loop systems that semi-autonomously alter stimulation strategies based on a patient's individual phenotype. Such next-generation DBS approaches hold great promise for improving psychiatric care.
Toller, Gianina; Adhimoolam, Babu; Grunwald, Thomas; Huppertz, Hans-Jürgen; König, Kristina; Jokeit, Hennric
2015-01-01
Nonvisual spatial navigation functional magnetic resonance imaging (fMRI) may help clinicians determine memory lateralization in blind individuals with refractory mesial temporal lobe epilepsy (MTLE). We report on an exceptional case of a congenitally blind woman with late-onset left MTLE undergoing presurgical memory fMRI. To activate mesial temporal structures despite the lack of visual memory, the patient was requested to recall familiar routes using nonvisual multisensory and verbal cues. Our findings demonstrate the diagnostic value of a nonvisual fMRI task to lateralize MTLE despite congenital blindness and may therefore contribute to the risk assessment for postsurgical amnesia in rare cases with refractory MTLE and accompanying congenital blindness.
Functional connectivity of visual cortex in the blind follows retinotopic organization principles.
Striem-Amit, Ella; Ovadia-Caro, Smadar; Caramazza, Alfonso; Margulies, Daniel S; Villringer, Arno; Amedi, Amir
2015-06-01
Is visual input during critical periods of development crucial for the emergence of the fundamental topographical mapping of the visual cortex? And would this structure be retained throughout life-long blindness or would it fade as a result of plastic, use-based reorganization? We used functional connectivity magnetic resonance imaging based on intrinsic blood oxygen level-dependent fluctuations to investigate whether significant traces of topographical mapping of the visual scene in the form of retinotopic organization, could be found in congenitally blind adults. A group of 11 fully and congenitally blind subjects and 18 sighted controls were studied. The blind demonstrated an intact functional connectivity network structural organization of the three main retinotopic mapping axes: eccentricity (centre-periphery), laterality (left-right), and elevation (upper-lower) throughout the retinotopic cortex extending to high-level ventral and dorsal streams, including characteristic eccentricity biases in face- and house-selective areas. Functional connectivity-based topographic organization in the visual cortex was indistinguishable from the normally sighted retinotopic functional connectivity structure as indicated by clustering analysis, and was found even in participants who did not have a typical retinal development in utero (microphthalmics). While the internal structural organization of the visual cortex was strikingly similar, the blind exhibited profound differences in functional connectivity to other (non-visual) brain regions as compared to the sighted, which were specific to portions of V1. Central V1 was more connected to language areas but peripheral V1 to spatial attention and control networks. These findings suggest that current accounts of critical periods and experience-dependent development should be revisited even for primary sensory areas, in that the connectivity basis for visual cortex large-scale topographical organization can develop without any visual experience and be retained through life-long experience-dependent plasticity. Furthermore, retinotopic divisions of labour, such as that between the visual cortex regions normally representing the fovea and periphery, also form the basis for topographically-unique plastic changes in the blind. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain.
Palazzuoli, Alberto; Silverberg, Donald S; Calabrò, Anna; Spinelli, Tommaso; Quatrini, Ilaria; Campagna, Maria S; Franci, Beatrice; Nuti, Ranuccio
2009-06-01
Anemia in heart failure is related to advanced New York Heart Association classes, severe systolic dysfunction, and reduced exercise tolerance. Although anemia is frequently found in congestive heart failure (CHF), little is known about the effect of its' correction with erythropoietin (EPO) on cardiac structure and function. The present study examines, in patients with advanced CHF and anemia, the effects of beta-EPO on left ventricular volumes, left ventricular ejection fraction (LVEF), left and right longitudinal function mitral anular plane systolic excursion (MAPSE), tricuspid anular plane excursion (TAPSE), and pulmonary artery pressures in 58 patients during 1-year follow-up in a double-blind controlled study of correction of anemia with subcutaneous beta-EPO. Echocardiographic evaluation, B-Type natriuretic peptide (BNP) levels, and hematological parameters are reported at 4 and 12 months. The patients in group A after 4 months of follow-up period demonstrated an increase in LVEF and MAPSE (P < 0.05 and P < 0.01, respectively) with left ventricular systolic volume reduction (P < 0.02) with respect to baseline and controls. After 12 months, results regarding left ventricular systolic volume LVEF and MAPSE persisted (P < 0.001). In addition, TAPSE increased and pulmonary artery pressures fell significantly in group A (P < 0.01). All these changes occurred together with a significant BNP reduction and significant hemoglobin increase in the treated group. Therefore, we revealed a reduced hospitalization rate in treated patients with respect to the controls (25% in treated vs. 54% in controls). In patients with anemia and CHF, correction of anemia with beta-EPO and oral iron over 1 year leads to an improvement in left and right ventricular systolic function by reducing cardiac remodeling, BNP levels, and hospitalization rate.
Martinson, Melissa; Bharmi, Rupinder; Dalal, Nirav; Abraham, William T; Adamson, Philip B
2017-05-01
Haemodynamic-guided heart failure (HF) management effectively reduces decompensation events and need for hospitalizations. The economic benefit of clinical improvement requires further study. An estimate of the cost-effectiveness of haemodynamic-guided HF management was made based on observations published in the randomized, prospective single-blinded CHAMPION trial. A comprehensive analysis was performed including healthcare utilization event rates, survival, and quality of life demonstrated in the randomized portion of the trial (18 months). Markov modelling with Monte Carlo simulation was used to approximate comprehensive costs and quality-adjusted life years (QALYs) from a payer perspective. Unit costs were estimated using the Truven Health MarketScan database from April 2008 to March 2013. Over a 5-year horizon, patients in the Treatment group had average QALYs of 2.56 with a total cost of US$56 974; patients in the Control group had QALYs of 2.16 with a total cost of US$52 149. The incremental cost-effectiveness ratio (ICER) was US$12 262 per QALY. Using comprehensive cost modelling, including all anticipated costs of HF and non-HF hospitalizations, physician visits, prescription drugs, long-term care, and outpatient hospital visits over 5 years, the Treatment group had a total cost of US$212 004 and the Control group had a total cost of US$200 360. The ICER was US$29 593 per QALY. Standard economic modelling suggests that pulmonary artery pressure-guided management of HF using the CardioMEMS™ HF System is cost-effective from the US-payer perspective. This analysis provides the background for further modelling in specific country healthcare systems and cost structures. © 2016 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
NASA Technical Reports Server (NTRS)
Shrestha, S.; Kharkovsky, S.; Zoughi, R.; Hepburn, F
2005-01-01
The Space Shuttle Columbia s catastrophic failure has been attributed to a piece of external fuel tank insulating SOFI (Spray On Foam Insulation) foam striking the leading edge of the left wing of the orbiter causing significant damage to some of the protecting heat tiles. The accident emphasizes the growing need to develop effective, robust and life-cycle oriented methods of nondestructive testing and evaluation (NDT&E) of complex conductor-backed insulating foam and protective acreage heat tiles used in the space shuttle fleet and in future multi-launch space vehicles. The insulating SOFI foam is constructed from closed-cell foam. In the microwave regime this foam is in the family of low permittivity and low loss dielectric materials. Near-field microwave and millimeter wave NDT methods were one of the techniques chosen for this purpose. To this end several flat and thick SOFI foam panels, two structurally complex panels similar to the external fuel tank and a "blind" panel were used in this investigation. Several anomalies such as voids and disbonds were embedded in these panels at various locations. The location and properties of the embedded anomalies in the "blind" panel were not disclosed to the investigating team prior to the investigation. Three frequency bands were used in this investigation covering a frequency range of 8-75 GHz. Moreover, the influence of signal polarization was also investigated. Overall the results of this investigation were very promising for detecting the presence of anomalies in different panels covered with relatively thick insulating SOFI foam. Different types of anomalies were detected in foam up to 9 in thick. Many of the anomalies in the more complex panels were also detected. When investigating the blind panel no false positives were detected. Anomalies in between and underneath bolt heads were not easily detected. This paper presents the results of this investigation along with a discussion of the capabilities of the method used.
Effect of stress concentrations in composite structures
NASA Technical Reports Server (NTRS)
Babcock, G. D.; Knauss, W. G.
1984-01-01
The goal of achieving a better understanding of the failure of complex composite structure is sought. This type of structure requires a thorough understanding of the behavior under load both on a macro and micro scale if failure mechanisms are to be understood. The two problems being studied are the failure at a panel/stiffener interface and a generic problem of failure at a stress concentration.
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.
An overview of computational simulation methods for composite structures failure and life analysis
NASA Technical Reports Server (NTRS)
Chamis, Christos C.
1993-01-01
Three parallel computational simulation methods are being developed at the LeRC Structural Mechanics Branch (SMB) for composite structures failure and life analysis: progressive fracture CODSTRAN; hierarchical methods for high-temperature composites; and probabilistic evaluation. Results to date demonstrate that these methods are effective in simulating composite structures failure/life/reliability.
Blind subjects construct conscious mental images of visual scenes encoded in musical form.
Cronly-Dillon, J; Persaud, K C; Blore, R
2000-01-01
Blind (previously sighted) subjects are able to analyse, describe and graphically represent a number of high-contrast visual images translated into musical form de novo. We presented musical transforms of a random assortment of photographic images of objects and urban scenes to such subjects, a few of which depicted architectural and other landmarks that may be useful in navigating a route to a particular destination. Our blind subjects were able to use the sound representation to construct a conscious mental image that was revealed by their ability to depict a visual target by drawing it. We noted the similarity between the way the visual system integrates information from successive fixations to form a representation that is stable across eye movements and the way a succession of image frames (encoded in sound) which depict different portions of the image are integrated to form a seamless mental image. Finally, we discuss the profound resemblance between the way a professional musician carries out a structural analysis of a musical composition in order to relate its structure to the perception of musical form and the strategies used by our blind subjects in isolating structural features that collectively reveal the identity of visual form. PMID:11413637
Wieshammer, S; Hetzel, M; Hetzel, J; Kochs, M; Hombach, V
1993-07-01
To test the hypothesis that the addition of nitrates improves exercise tolerance in patients with heart failure caused by coronary artery disease already treated with an angiotensin converting enzyme inhibitor and diuretics. Randomised, double blind, placebo controlled, 16 week treatment periods. Outpatient clinic at a university hospital. 54 patients with previous myocardial infarction, symptoms of mild to moderate heart failure, left ventricular ejection fraction below 40%, no exercise-induced angina or electrocardiographic signs of ischaemia. Four patients in the nitrate group (n = 24) and one patient of the placebo group (n = 25) were withdrawn from the study. After the patients had been on constant doses of captopril and diuretics for at least 2 weeks, they were randomised to receive a target dose of 40 mg isosorbide dinitrate twice daily or placebo in addition to the continuation of captopril and diuretics. Bicycle exercise tests with measurement of gas exchange were carried out before randomisation and after 1, 6, 12, and 16 weeks of the double blind treatment. The change in peak oxygen uptake from control to week 16 was prospectively defined as the main outcome measure. The increase in peak oxygen uptake from before randomisation tended to be greater in the placebo group (before randomisation 17.4 (3.4) ml/min/kg) than in the nitrate group (before randomisation 17.1 (3.5) ml/min/kg) after 12 weeks (mean increase 1.1 (2.7) v 0.0 (2.7) ml/min/kg, p < 0.12) and 16 weeks (1.7 (3.0) v 0.3 (2.6) ml/min/kg, p < 0.14) of treatment. The addition of nitrates to a baseline treatment consisting of captopril and diuretics did not improve exercise tolerance.
Davari-Tanha, Fatemeh; Shahrokh Tehraninejad, Ensieh; Ghazi, Mohadese; Shahraki, Zahra
2016-12-01
Recurrent implantation failure (RIF) is the absence of implantation after three consecutive In Vitro Fertilization (IVF) cycles with transferring at least four good quality embryos in a minimum of three fresh or frozen cycles in a woman under 40 years. The definition and management of RIF is under constant scrutiny. To investigate the effects of Granulocyte colony stimulating factor (G-CSF) on RIF, pregnancy rate, abortion rate and implantation rates. A double blind placebo controlled randomized trial was conducted at two tertiary university based hospitals. One hundred patients with the history of RIF from December 2011 until January 2014 were recruited in the study. G-CSF 300µg/1ml was administered at the day of oocyte puncture or day of progesterone administration of FET cycle. Forty patients were recruited at G-CSF group, 40 in saline and 20 in placebo group. The mean age for whole study group was 35.3±4.2 yrs (G-CSF 35.5±4.32, saline 35.3±3.98, placebo 35.4±4.01, respectively). Seventeen patients had a positive pregnancy test after embryo transfer [10 (25%) in G-CSF; 5 (12.5%) in saline; and 2 (10%) in placebo group]. The mean of abortion rates was 17.6% (3), two of them in G-CSF, one in saline group. The implantation rate was 12.3% in G-CSF, 6.1% in saline and 4.7% in placebo group. G-CSF may increase chemical pregnancy and implantation rate in patients with recurrent implantation failure but clinical pregnancy rate and abortion rate was unaffected.
Congenital blindness improves semantic and episodic memory.
Pasqualotto, Achille; Lam, Jade S Y; Proulx, Michael J
2013-05-01
Previous studies reported that congenitally blind people possess superior verb-generation skills. Here we tested the impact of blindness on capacity and the fidelity of semantic memory by using a false memory paradigm. In the Deese-Roediger-McDermott paradigm, participants study lists of words that are all semantically related to a lure that is not presented. Subsequently, participants frequently recall the missing lure. We found that congenitally blind participants have enhanced memory performance for recalling the presented words and reduced false memories for the lure. The dissociation of memory capacity and fidelity provides further evidence for enhanced verbal ability in the blind, supported by their broader structural and functional brain reorganisation. Copyright © 2013 Elsevier B.V. All rights reserved.
Effect of stress concentrations in composite structures
NASA Technical Reports Server (NTRS)
Babcock, C. D.; Waas, A. M.
1985-01-01
Composite structures have found wide use in many engineering fields and a sound understanding of their response under load is important to their utilization. An experimental program is being carried out to gain a fundamental understanding of the failure mechanics of multilayered composite structures at GALCIT. As a part of this continuing study, the performance of laminated composite plates in the presence of a stress gradient and the failure of composite structures at points of thickness discontinuity is assessed. In particular, the questions of initiation of failure and its subsequent growth to complete failure of the structure are addressed.
Stress Analysis of B-52B and B-52H Air-Launching Systems Failure-Critical Structural Components
NASA Technical Reports Server (NTRS)
Ko, William L.
2005-01-01
The operational life analysis of any airborne failure-critical structural component requires the stress-load equation, which relates the applied load to the maximum tangential tensile stress at the critical stress point. The failure-critical structural components identified are the B-52B Pegasus pylon adapter shackles, B-52B Pegasus pylon hooks, B-52H airplane pylon hooks, B-52H airplane front fittings, B-52H airplane rear pylon fitting, and the B-52H airplane pylon lower sway brace. Finite-element stress analysis was performed on the said structural components, and the critical stress point was located and the stress-load equation was established for each failure-critical structural component. The ultimate load, yield load, and proof load needed for operational life analysis were established for each failure-critical structural component.
Change-readiness of the blind: a hospital based study in a coastal town of South India.
Shetty, Ramya; Kulkarni, Uma D
2014-01-01
Blindness is a devastating condition with psychosocial and economic effects. The shortcomings result in a burden to the blind person, the family and society. Rehabilitation of the blind can transform their lives. The aim of this study was to assess the "change-readiness" of the blind to undergo a "change-management". The study was a semi-structured pre-tested questionnaire-based study of 50 blind subjects in a medical college hospital. The blind participants were assessed for depression using the Beck Depression Inventory II, for the perceived effect of blindness on family, social life and occupation. The participants were counseled to undergo psychiatric management, vocational training, use blind aids and learn Braille. The willingness of the participants with reasons was assessed using a verbal analogue scale. Pearson Chi-square test, ANOVA and the t-test were used for statistical analysis. Over two-thirds of the subjects were depressed. Family life, social life and occupation were perceived to be affected by 44%, 66% and 74%, respectively. Change-readiness scores were low for low vision and blind aids, vocational training, psychiatric management, change of job and learning Braille. The low score was due to the associated taboo, dependence, lack of skills, embarrassment, etc., The most valuable feature was the family cohesiveness. The results suggest that there is a need to modify health policy to include blind rehabilitation, to improve visibility of blind rehabilitation centers, to include family members and co-professionals while managing the blind so that we treat the "blind person" and not a "pair of blind eyes".
Dynamic loads during failure risk assessment of bridge crane structures
NASA Astrophysics Data System (ADS)
Gorynin, A. D.; Antsev, V. Yu; Shaforost, A. N.
2018-03-01
The paper presents the method of failure risk assessment associated with a bridge crane metal structure at the design stage. It also justifies the necessity of taking into account dynamic loads with regard to the operational cycle of a bridge crane during failure risk assessment of its metal structure.
Structure and Utility of Blind Speed Intervals Associated with Doppler Measurements of Range Rate
1993-02-01
computer programming concepts of speed, memory , and data structures that can be exploited to fabricate efficient software realizations of two phase range...to the effect that it is possible to derive a reasonable unambiguous estimate of range rate from the measurement of the pulse-to-pulse phase shift in...the properties of the blind speed intervals generated by the base speeds involved in two measurement equations. Sections 12 through 18 make up the
Brain Structure Changes Visualized in Early- and Late-Onset Blind Subjects
Leporé, Natasha; Voss, Patrice; Lepore, Franco; Chou, Yi-Yu; Fortin, Madeleine; Gougoux, Frédéric; Lee, Agatha D.; Brun, Caroline; Lassonde, Maryse; Madsen, Sarah K.; Toga, Arthur W.; Thompson, Paul M.
2009-01-01
We examine 3D patterns of volume differences in the brain associated with blindness, in subjects grouped according to early and late onset. Using tensor-based morphometry, we map volume reductions and gains in 16 early-onset (EB) and 16 late-onset (LB) blind adults (onset <5 and >14 years old, respectively) relative to 16 matched sighted controls. Each subject’s structural MRI was fluidly registered to a common template. Anatomical differences between groups were mapped based on statistical analysis of the resulting deformation fields revealing profound deficits in primary and secondary visual cortices for both blind groups. Regions outside the occipital lobe showed significant hypertrophy, suggesting widespread compensatory adaptations. EBs but not LBs showed deficits in the splenium and hypertrophy in the isthmus. Gains in the isthmus and non-occipital white matter were more widespread in the EBs. These differences may reflect regional alterations in late neurodevelopmental processes, such as myelination, that continue into adulthood. PMID:19643183
Kveiborg, Britt; Major-Petersen, Atheline; Christiansen, Buris; Torp-Pedersen, Christian
2007-01-01
Beta-blockers have been shown to improve survival in patients with chronic heart failure. The effect of different generations of beta blockers has been debated. Both metoprolol and carvedilol have demonstrated beneficial effects in placebo-controlled trials. In The Carvedilol Or Metoprolol European Trial (COMET) two beta blockers were compared in a double-blind randomized matter. This is the first direct comparison between metoprolol and carvedilol of long-term effect on survival in patients with chronic heart failure. The all-cause mortality was signif icantly reduced in the favour of carvedilol. The dose and formulation of metoprolol used in this trial has caused debate, and it has been questioned whether a similar beta1-blockade is obtained in the two intervention groups. At this time there is an unresolved debate as to whether carvedilol is a superior beta-blocker or whether differences in beta1-blockade explained the results of COMET. PMID:17583173
Subcortical functional reorganization due to early blindness
Jiang, Fang; Fine, Ione; Watkins, Kate E.; Bridge, Holly
2015-01-01
Lack of visual input early in life results in occipital cortical responses to auditory and tactile stimuli. However, it remains unclear whether cross-modal plasticity also occurs in subcortical pathways. With the use of functional magnetic resonance imaging, auditory responses were compared across individuals with congenital anophthalmia (absence of eyes), those with early onset (in the first few years of life) blindness, and normally sighted individuals. We find that the superior colliculus, a “visual” subcortical structure, is recruited by the auditory system in congenital and early onset blindness. Additionally, auditory subcortical responses to monaural stimuli were altered as a result of blindness. Specifically, responses in the auditory thalamus were equally strong to contralateral and ipsilateral stimulation in both groups of blind subjects, whereas sighted controls showed stronger responses to contralateral stimulation. These findings suggest that early blindness results in substantial reorganization of subcortical auditory responses. PMID:25673746
Subcortical functional reorganization due to early blindness.
Coullon, Gaelle S L; Jiang, Fang; Fine, Ione; Watkins, Kate E; Bridge, Holly
2015-04-01
Lack of visual input early in life results in occipital cortical responses to auditory and tactile stimuli. However, it remains unclear whether cross-modal plasticity also occurs in subcortical pathways. With the use of functional magnetic resonance imaging, auditory responses were compared across individuals with congenital anophthalmia (absence of eyes), those with early onset (in the first few years of life) blindness, and normally sighted individuals. We find that the superior colliculus, a "visual" subcortical structure, is recruited by the auditory system in congenital and early onset blindness. Additionally, auditory subcortical responses to monaural stimuli were altered as a result of blindness. Specifically, responses in the auditory thalamus were equally strong to contralateral and ipsilateral stimulation in both groups of blind subjects, whereas sighted controls showed stronger responses to contralateral stimulation. These findings suggest that early blindness results in substantial reorganization of subcortical auditory responses. Copyright © 2015 the American Physiological Society.
Combining aspirin with angiotensin converting enzyme inhibitors in heart failure: how safe is it?
Mehta, H; Mahajan, A; Bansal, N; Vaidya, S; Pathak, L
1998-11-01
The above discussion on the interaction of aspirin and ACE inhibitors seems to suggest that aspirin in high doses may have adverse interaction with ACE inhibitors in patients with heart failure but the data obtained is not sufficient or conclusive to recommended omission of aspirin in patients with heart failure. This raises a query in the mind of the physician whether to use a combination or not? The role of aspirin in the early period after myocardial infarction is well established so is the role of ACE inhibitors. Hence in patients with myocardial infarction and preserved left ventricular function it would not be wrong to administer combination of ACE inhibitors and aspirin. Albeit at a lower dose. In patients with large myocardial infarction or heart failure, warfarin may be an option but still needs to be documented in large trials. As suggested long term use of aspirin after infarction is still ambiguous and may be harmful in patients with heart failure with its anticedent side effects. But long term benefits of ACE inhibitors in heart failure are well documented. Hence if a choice has to be made whether to discontinue either of the two drugs it would be preferable to stop the aspirin. To answer the issue of use of aspirin in patients with heart failure it would be essential to conduct a double blind randomized trial comparing known anti-thrombotic treatment, aspirin and anti-coagulants on mortality in patients with heart failure, especially caused by coronary artery disease. Such a trial is underway at the present and till the results are available it should be left to clinical judgement of the physician whether to administer aspirin in patients with heart failure after weighing the benefits versus risk.
Blindness and Visual Impairment in an Urban West African Population: The Tema Eye Survey
Budenz, Donald L.; Bandi, Jagadeesh R.; Barton, Keith; Nolan, Winifred; Herndon, Leon; Whiteside-de Vos, Julia; Hay-Smith, Graham; Kim, Hanna; Tielsch, James
2012-01-01
Objective To determine the prevalence, etiologies, and risk factors of blindness and visual impairment among persons age 40 years and older residing in an urban West African location. Design Population-based cross-sectional study. Participants Five thousand six hundred and three participants residing in Tema, Ghana. Methods Proportionate random cluster sampling was used to select participants age 40 and over living in the city of Tema. Presenting distance visual acuity was measured at 4 and 1 meters using a reduced Logarithm of the Minimum Angle of Resolution (logMAR) tumbling E chart and then with trial frame based on autorefraction. A screening examination was performed in the field on all participants. Complete clinical examination by an ophthalmologist was performed on participants with best corrected visual acuity < 20/40 or failure of any screening test. Main Outcome Measures Age- and gender-specific prevalence, causes, and risk factors for blindness (visual acuity in the better eye of < 20/400, World Health Organization definition) and visual impairment (visual acuity in the better eye of < 20/40). Results Six thousand eight hundred and six eligible participants were identified of which 5603 (82.3%) participated in the study. The mean age (±standard deviation) of participants was 52.7±10.9. The prevalence of visual impairment was 17.1% and blindness was 1.2%. After refraction and spectacle correction, the prevalence of visual impairment and blindness decreased to 6.7% and 0.75% respectively, suggesting that refractive error is the major correctable etiology of visual impairment and blindness in this population. Of 65 subjects having visual acuity < 20/400, 22 (34%) were correctable with refraction, 21 to the level of visual impairment, and one to normal. The remaining 43 (66%) had underlying pathology (19 cataract, 9 glaucoma, 3 non-glaucomatous optic neuropathy, 3 corneal opacities, 3 retinal disease, 5 undetermined) that prevented refractive correction. Increased age was a significant risk factor for blindness and visual impairment. Conclusions There is a high prevalence of blindness and visual impairment among those aged ≥40 years in Tema, Ghana, West Africa. Refractive error is a major cause of blindness and visual impairment in this population, followed by cataract, glaucoma, and corneal disease. PMID:22677425
Ghali, Jalal K; Anand, Inder S; Abraham, William T; Fonarow, Gregg C; Greenberg, Barry; Krum, Henry; Massie, Barry M; Wasserman, Scott M; Trotman, Marie-Louise; Sun, Yan; Knusel, Beat; Armstrong, Paul
2008-01-29
Substantial evidence suggests that anemia is an independent risk factor for worse outcomes in patients with heart failure (HF). The Study of Anemia in Heart Failure Trial (STAMINA-HeFT) is the largest multicenter, randomized, double-blind, placebo-controlled trial to date evaluating the effect of treating anemia in HF. Patients (N=319) with symptomatic HF, left ventricular ejection fraction < or = 40%, and hemoglobin > or = 9.0 g/dL and < or = 12.5 g/dL were randomized (double-blind) to placebo (N=157) or darbepoetin alfa (N=162) subcutaneously every 2 weeks for 1 year (target hemoglobin, 14.0+/-1.0 g/dL). The primary end point was change from baseline to week 27 in treadmill exercise time. Secondary end points were change from baseline in New York Heart Association class and quality of life at week 27. An additional prespecified efficacy analysis included the time to death by any cause or first HF-related hospitalization by 1 year. At baseline, the median (interquartile range) hemoglobin was 11.4 (10.9, 12.0) g/dL. At week 27, darbepoetin alfa treatment increased median (interquartile range) hemoglobin by 1.8 (1.1, 2.5) g/dL (placebo, 0.3 [-0.2, 1.0] g/dL; P<0.001). Of the patients treated with darbepoetin alfa, 85% achieved 2 consecutive hemoglobin levels of 14.0+/-1.0 g/dL during the study and experienced a hemoglobin increase of > or = 1.0 g/dL from baseline. By intent-to-treat analysis, darbepoetin alfa treatment did not significantly improve exercise duration, New York Heart Association class, or quality of life score compared with placebo. A nonsignificant trend was observed toward a lower risk of all-cause mortality or first HF hospitalization in darbepoetin alfa-treated patients compared with placebo (hazard ratio, 0.68; 95% CI, 0.43, 1.08; P=0.10). Occurrences of adverse events were similar in both treatment groups. In this study of patients with symptomatic HF and anemia, treatment with darbepoetin alfa was not associated with significant clinical benefits. Darbepoetin alfa treatment was well tolerated and effectively raised hemoglobin. A trend of lower risk of morbidity and mortality was observed.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tian, Chunguang; Jiang, Dayong, E-mail: dayongjiangcust@126.com; Tan, Zhendong
Highlights: • Single-phase wurtzite/cubic Mg{sub x}Zn{sub 1−x}O films were grown by RF magnetron sputtering technique. • We focus on the red-shift caused by annealing the Mg{sub x}Zn{sub 1−x}O films. • MSM-structured visible-blind and solar-blind UV photodetectors were fabricated. - Abstract: A series of single-phase Mg{sub x}Zn{sub 1−x}O films with different Mg contents were prepared on quartz substrates by RF magnetron sputtering technique using different MgZnO targets, and annealed under the atmospheric environment. The absorption edges of Mg{sub x}Zn{sub 1−x}O films can cover the whole near ultraviolet and even the whole solar-blind spectra range, and the solar-blind wurtzite/cubic Mg{sub x}Zn{sub 1−x}Omore » films have been realized successfully by the same method. In addition, the absorption edges of annealed films shift to a long wavelength, which is caused by the diffusion of Zn atoms gathering at the surface during the thermal treatment process. Finally, the truly solar-blind metal-semiconductor-metal structured photodetectors based on wurtzite Mg{sub 0.445}Zn{sub 0.555}O and cubic Mg{sub 0.728}Zn{sub 0.272}O films were fabricated. The corresponding peak responsivities are 17 mA/W at 275 nm and 0.53 mA/W at 250 nm under a 120 V bias, respectively.« less
Applied Computational Chemistry for the Blind and Visually Impaired
ERIC Educational Resources Information Center
Wedler, Henry B.; Cohen, Sarah R.; Davis, Rebecca L.; Harrison, Jason G.; Siebert, Matthew R.; Willenbring, Dan; Hamann, Christian S.; Shaw, Jared T.; Tantillo, Dean J.
2012-01-01
We describe accommodations that we have made to our applied computational-theoretical chemistry laboratory to provide access for blind and visually impaired students interested in independent investigation of structure-function relationships. Our approach utilizes tactile drawings, molecular model kits, existing software, Bash and Perl scripts…
What we know now: the Evanston Illinois field lineups.
Steblay, Nancy K
2011-02-01
A Freedom of Information Act lawsuit secured 100 eyewitness identification reports from Evanston, Illinois, one of three cities of the Illinois Pilot Program. The files provide empirical evidence regarding three methodological aspects of the Program's comparison of non-blind simultaneous to double-blind sequential lineups. (1) A-priori differences existed between lineup conditions. For example, the simultaneous non-blind lineup condition was more likely to involve witnesses who had already identified the suspect in a previous lineup or who knew the offender (non-stranger identifications), and this condition also entailed shorter delays between event and lineup. (2) Verbatim eyewitness comments were recorded more often in double-blind sequential than in non-blind simultaneous lineup reports (83% vs. 39%). (3) Effective lineup structure was used equally in the two lineup conditions.
Change-Readiness of the Blind: A Hospital Based Study in a Coastal Town of South India
Shetty, Ramya; Kulkarni, Uma D.
2014-01-01
Purpose: Blindness is a devastating condition with psychosocial and economic effects. The shortcomings result in a burden to the blind person, the family and society. Rehabilitation of the blind can transform their lives. The aim of this study was to assess the “change-readiness” of the blind to undergo a “change-management”. Materials and Methods: The study was a semi-structured pre-tested questionnaire-based study of 50 blind subjects in a medical college hospital. The blind participants were assessed for depression using the Beck Depression Inventory II, for the perceived effect of blindness on family, social life and occupation. The participants were counseled to undergo psychiatric management, vocational training, use blind aids and learn Braille. The willingness of the participants with reasons was assessed using a verbal analogue scale. Pearson Chi-square test, ANOVA and the t-test were used for statistical analysis. Results: Over two-thirds of the subjects were depressed. Family life, social life and occupation were perceived to be affected by 44%, 66% and 74%, respectively. Change-readiness scores were low for low vision and blind aids, vocational training, psychiatric management, change of job and learning Braille. The low score was due to the associated taboo, dependence, lack of skills, embarrassment, etc., The most valuable feature was the family cohesiveness. Conclusion: The results suggest that there is a need to modify health policy to include blind rehabilitation, to improve visibility of blind rehabilitation centers, to include family members and co-professionals while managing the blind so that we treat the “blind person” and not a “pair of blind eyes”. PMID:24791108
Diabetic nephropathy. Is end-stage renal disease inevitable?
Bogusky, R T
1983-10-01
The appearance of proteinuria in an insulin-dependent diabetic patient is an ominous sign. Proteinuria heralds the presence of diabetic nephropathy and early death, or chronic renal failure requiring dialysis or transplantation, in 50% of patients. The pathogenesis of diabetic nephropathy is unknown. Adequate insulin administration is the most important preventive measure. Hypertension, if present, should be aggressively treated to delay progression of renal disease. Good nutrition, prompt treatment of urinary tract infections, and caution in the use of radiocontrast agents are other important preventive measures. Hemodialysis, peritoneal dialysis, and transplantation are options for patients with end-stage renal disease. No matter which is selected, the patient may still have multiple amputations, blindness, congestive heart failure, infections, and uncontrolled glycemia. Advancements are being made, however, that promise a better future for insulin-dependent diabetics.
Hawthorn extract for treating chronic heart failure.
Pittler, M H; Guo, R; Ernst, E
2008-01-23
Hawthorn extract is advocated as an oral treatment option for chronic heart failure. Also, the German Commission E approved the use of extracts of hawthorn leaf with flower in patients suffering from heart failure graded stage II according to the New York Heart Association. To assess the benefits and harms as reported in double-blind randomised clinical trials of hawthorn extract compared with placebo for treating patients with chronic heart failure. We searched CENTRAL on The Cochrane Library (issue 2, 2006), MEDLINE (1951 to June 2006), EMBASE (1974 to June 2006), CINAHL (1982 to June 2006) and AMED (1985 to June 2006). Experts and manufacturers were contacted. Language restrictions were not imposed. To be included, studies were required to state that they were randomised, double-blind, and placebo controlled, and used hawthorn leaf and flower extract monopreparations. Two reviewers independently performed the selection of studies, data extraction, and assessment of methodological quality. Data were entered into RevMan 4.2 software. Results from continuous data were reported as weighted mean difference (WMD) with 95% confidence interval (CI). Where data were suitable for combining, pooled results were calculated. Fourteen trials met all inclusion criteria and were included in this review. In most of the studies, hawthorn was used as an adjunct to conventional treatment. Ten trials including 855 patients with chronic heart failure (New York Heart Association classes I to III) provided data that were suitable for meta-analysis. For the physiologic outcome of maximal workload, treatment with hawthorn extract was more beneficial than placebo (WMD (Watt) 5.35, 95% CI 0.71 to 10.00, P < 0.02, n = 380). Exercise tolerance were significantly increased by hawthorn extract (WMD (Watt x min) 122.76, 95% CI 32.74 to 212.78, n = 98). The pressure-heart rate product, an index of cardiac oxygen consumption, also showed a beneficial decrease with hawthorn treatment (WMD (mmHg/min) -19.22, 95% CI -30.46 to -7.98, n = 264). Symptoms such as shortness of breath and fatigue improved significantly with hawthorn treatment as compared with placebo (WMD -5.47, 95% CI -8.68 to -2.26, n = 239). No data on relevant mortality and morbidity such as cardiac events were reported, apart from one trial, which reported deaths (three in active, one in control) without providing further details. Reported adverse events were infrequent, mild, and transient; they included nausea, dizziness, and cardiac and gastrointestinal complaints. These results suggest that there is a significant benefit in symptom control and physiologic outcomes from hawthorn extract as an adjunctive treatment for chronic heart failure.
[Hereditary cerebro-oculo-renal syndromes].
Sessa, Galina; Hjortshøj, Tina Duelund; Egfjord, Martin
2014-02-17
Although many congenital diseases present disturbances of the central nervous system, eyes and renal function, only few of these have a defined genetic basis. The first clinical features of cerebro-oculo-renal diseases usually develop in early childhood and deterioration of kidney function and even end-stage kidney disease may occur in a young age. The syndromes should be considered in patients with retarded growth and development, central nervous system abnormalities, impaired vision or blindness and progressive renal failure.
Aunsholt, Lise; Jeppesen, Palle Bekker; Lund, Pernille; Sangild, Per Torp; Ifaoui, Inge Bøtker Rasmussen; Qvist, Niels; Husby, Steffen
2014-01-01
Management of short bowel syndrome (SBS) aims to achieve intestinal autonomy to prevent fluid, electrolyte, and nutrient deficiencies and maintain adequate development. Remnant intestinal adaptation is required to obtain autonomy. In the newborn pig, colostrum has been shown to support intestinal development and hence adaptive processes. The efficacy of bovine colostrum to improve intestinal function in children with SBS was evaluated by metabolic balance studies. Nine children with SBS were included in a randomized, double-blind, crossover study. Twenty percent of enteral fluid intake was replaced with bovine colostrum or a mixed milk diet for 4 weeks, separated by a 4-week washout period. Intestinal absorption of energy and wet weight was used to assess intestinal function and the efficacy of colostrum. Colostrum did not improve energy or wet weight absorption compared with the mixed milk diet (P = 1.00 and P = .93, respectively). Growth as measured by weight and knemometry did not differ between diets (P = .93 and P = .28). In these patients, <150% enteral energy absorption of basal metabolic rate and 50% enteral fluid absorption of basal fluid requirement suggested intestinal failure and a need for parenteral nutrition (PN). Inclusion of bovine colostrum to the diet did not improve intestinal function. Metabolic nutrient and wet weight balance studies successfully assessed intestinal function, and this method may distinguish between intestinal insufficiency (non-PN-dependent) and intestinal failure (PN-dependent) patients.
Carvalho, Vitor Oliveira; Bocchi, Edimar Alcides; Guimarães, Guilherme Veiga
2009-10-01
The Borg Scale may be a useful tool for heart failure patients to self-monitor and self-regulate exercise on land or in water (hydrotherapy) by maintaining the heart rate (HR) between the anaerobic threshold and respiratory compensation point. Patients performed a cardiopulmonary exercise test to determine their anaerobic threshold/respiratory compensation points. The percentage of the mean HR during the exercise session in relation to the anaerobic threshold HR (%EHR-AT), in relation to the respiratory compensation point (%EHR-RCP), in relation to the peak HR by the exercise test (%EHR-Peak) and in relation to the maximum predicted HR (%EHR-Predicted) was calculated. Next, patients were randomized into the land or water exercise group. One blinded investigator instructed the patients in each group to exercise at a level between "relatively easy and slightly tiring". The mean HR throughout the 30-min exercise session was recorded. The %EHR-AT and %EHR-predicted did not differ between the land and water exercise groups, but they differed in the %EHR-RCP (95 +/-7 to 86 +/-7, P<0.001) and in the %EHR-Peak (85 +/-8 to 78 +/-9, P=0.007). Exercise guided by the Borg scale maintains the patient's HR between the anaerobic threshold and respiratory compensation point (ie, in the exercise training zone).
Register of specialized sources for information on mechanics of structural failure
NASA Technical Reports Server (NTRS)
Carpenter, J. L., Jr.; Denny, F. J.
1973-01-01
Specialized information sources that generate information relative to six problem areas in aerospace mechanics of structural failure are identified. Selection for inclusion was based upon information obtained from the individual knowledge and professional contacts of Martin Marietta Aerospace staff members and the information uncovered by the staff of technical reviewers. Activities listed perform basic or applied research related to the mechanics of structural failure and publish the results of such research. The purpose of the register is to present, in easy reference form, original sources for dependable information regarding failure modes and mechanisms of aerospace structures.
Teaching Steel Connections Using an Interactive Virtual Steel Sculpture
ERIC Educational Resources Information Center
Moaveni, Saeed; Chou, Karen C.
2015-01-01
Steel connections play important roles in the integrity of a structure, and many structural failures are attributed to connection failures. Connections are the glue that holds a structure together. The failures of the Hartford Coliseum in 1977, the Hyatt Regency Hotel in Kansas City in 1980, and the I-35W Bridge in Minneapolis in 2007 are all…
NASA Astrophysics Data System (ADS)
Ishiyama, Tatsuya; Kato, Naoko; Sato, Hiroshi; Koshiya, Shin; Toda, Shigeru; Kobayashi, Kenta
2017-10-01
Active blind thrust faults, which can be a major seismic hazard in urbanized areas, are commonly difficult to image with seismic reflection surveys. To address these challenges in coastal plains, we collected about 8 km-long onshore high-resolution two-dimensional (2D) seismic reflection data using a dense array of 800 geophones across compressionally reactivated normal faults within a failed rift system located along the southwestern extension of the Toyama trough in the Sea of Japan. The processing of the seismic reflection data illuminated their detailed subsurface structures to depths of about 3 km. The interpreted depth-converted section, correlated with nearby Neogene stratigraphy, indicated the presence of and along-strike variation of previously unrecognized complex thrust-related structures composed of active fault-bend folds coupled with pairs of flexural slip faults within the forelimb and newly identified frontal active blind thrusts beneath the alluvial plain. In addition, growth strata and fold scarps that deform lower to upper Pleistocene units record the recent history of their structural growth and fault activity. This case shows that shallow seismic reflection imaging with densely spaced seismic recorders is a useful tool in defining locations, recent fault activity, and complex geometry of otherwise inaccessible active blind thrust faults.
Caird, Jeff K; Edwards, Christopher J; Creaser, Janet I; Horrey, William J
2005-01-01
A modified version of the flicker technique to induce change blindness was used to examine the effects of time constraints on decision-making accuracy at intersections on a total of 62 young (18-25 years), middle-aged (26-64 years), young-old (65-73 years), and old-old (74+ years) drivers. Thirty-six intersection photographs were manipulated so that one object (i.e., pedestrian, vehicle, sign, or traffic control device) in the scene would change when the images were alternated for either 5 or 8 s using the modified flicker method. Young and middle-aged drivers made significantly more correct decisions than did young-old and old-old drivers. Logistic regression analysis of the data indicated that age and/or time were significant predictors of decision performance in 14 of the 36 intersections. Actual or potential applications of this research include driving assessment and crash investigation.
Leuchtgens, H
1993-07-20
In 30 patients with stage NYHA II cardiac insufficiency, a placebo-controlled randomized double-blind study was carried out to determine the efficacy of the Crataegus special extract WS 1442. Treatment duration was 8 weeks, and the substance was administered at a dose of 1 capsule taken twice a day. The main target parameters were alteration in the pressure-x-rate product (PRP) under standardised loading on a bicycle ergometer, and a score of subjective improvement of complaints elicited by a questionnaire. Secondary parameters were exercise tolerance and the change in heart rate and arterial blood pressure. The active substance group showed a statistically significant advantage over placebo in terms of changes in PRP (at a load of 50 W) and the score, but also in the secondary parameter heart rate. In both groups, systolic and diastolic blood pressure was mildly reduced. No adverse reactions occurred.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cox, James V.; Wellman, Gerald William; Emery, John M.
2011-09-01
Fracture or tearing of ductile metals is a pervasive engineering concern, yet accurate prediction of the critical conditions of fracture remains elusive. Sandia National Laboratories has been developing and implementing several new modeling methodologies to address problems in fracture, including both new physical models and new numerical schemes. The present study provides a double-blind quantitative assessment of several computational capabilities including tearing parameters embedded in a conventional finite element code, localization elements, extended finite elements (XFEM), and peridynamics. For this assessment, each of four teams reported blind predictions for three challenge problems spanning crack initiation and crack propagation. After predictionsmore » had been reported, the predictions were compared to experimentally observed behavior. The metal alloys for these three problems were aluminum alloy 2024-T3 and precipitation hardened stainless steel PH13-8Mo H950. The predictive accuracies of the various methods are demonstrated, and the potential sources of error are discussed.« less
14. Detail, crack evidencing structural failure, northeast rear, view to ...
14. Detail, crack evidencing structural failure, northeast rear, view to southwest, 90mm lens. Note failure of sandstone lintel above window. - Benicia Arsenal, Powder Magazine No. 5, Junction of Interstate Highways 680 & 780, Benicia, Solano County, CA
St. Hilaire, Melissa A.; Lockley, Steven W.
2015-01-01
Objective/Background Totally blind individuals are highly likely to suffer from Non-24-Hour Sleep-Wake Disorder due to a failure of light to reset the circadian pacemaker in the suprachiasmatic nuclei. In this outpatient case series, we investigated whether daily caffeine administration could entrain the circadian pacemaker in non-entrained blind patients to alleviate symptoms of non-24-hour sleep–wake disorder. Patients/Methods Three totally blind males (63.0 ± 7.5 years old) were studied at home over ~4 months. Urinary 6-sulphatoxymelatonin (aMT6s) rhythms were measured for 48 h every 1–2 weeks. Participants completed daily sleep–wake logs, and rated their alertness and mood using nine-point scales every ~2–4 h while awake on urine sampling days. Caffeine capsules (150 mg per os) were self-administered daily at 10 a.m. for approximately one circadian beat cycle based on each participant's endogenous circadian period τ and compared to placebo (n = 2) or no treatment (n = 1) in a single-masked manner. Results Non-24-h aMT6s rhythms were confirmed in all three participants (τ range = 24.32–24.57 h). Daily administration of 150 mg caffeine did not entrain the circadian clock. Caffeine treatment significantly improved daytime alertness at adverse circadian phases (p < 0.0001) but did not decrease the occurrence of daytime naps compared with placebo. Conclusions Although caffeine was able to improve daytime alertness acutely and may therefore provide temporary symptomatic relief, the inability of caffeine to correct the underlying circadian disorder means that an entraining agent is required to treat Non-24-Hour Sleep–Wake Disorder in the blind appropriately. PMID:25891543
St Hilaire, Melissa A; Lockley, Steven W
2015-06-01
Totally blind individuals are highly likely to suffer from Non-24-Hour Sleep-Wake Disorder due to a failure of light to reset the circadian pacemaker in the suprachiasmatic nuclei. In this outpatient case series, we investigated whether daily caffeine administration could entrain the circadian pacemaker in non-entrained blind patients to alleviate symptoms of non-24-hour sleep-wake disorder. Three totally blind males (63.0 ± 7.5 years old) were studied at home over ~4 months. Urinary 6-sulphatoxymelatonin (aMT6s) rhythms were measured for 48 h every 1-2 weeks. Participants completed daily sleep-wake logs, and rated their alertness and mood using nine-point scales every ~2-4 h while awake on urine sampling days. Caffeine capsules (150 mg per os) were self-administered daily at 10 a.m. for approximately one circadian beat cycle based on each participant's endogenous circadian period τ and compared to placebo (n = 2) or no treatment (n = 1) in a single-masked manner. Non-24-h aMT6s rhythms were confirmed in all three participants (τ range = 24.32-24.57 h). Daily administration of 150 mg caffeine did not entrain the circadian clock. Caffeine treatment significantly improved daytime alertness at adverse circadian phases (p <0.0001) but did not decrease the occurrence of daytime naps compared with placebo. Although caffeine was able to improve daytime alertness acutely and may therefore provide temporary symptomatic relief, the inability of caffeine to correct the underlying circadian disorder means that an entraining agent is required to treat Non-24-Hour Sleep-Wake Disorder in the blind appropriately. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
Oki, Kentaro; Mahato, Niladri K; Nakazawa, Masato; Amano, Shinichi; France, Christopher R; Russ, David W; Clark, Brian C
2016-08-01
Decreased cortical excitability has been proposed as a potential mechanism underlying task failure during sustained muscular contractions, and cortical excitability may decrease with old age. We tested the hypothesis that transcranial direct current stimulation, which has been reported to raise cortical excitability, would prolong the time to task failure during a sustained muscular contraction in older adults. Thirteen older adults (68.3±2.0 years; eight women and five men) performed isometric, elbow flexions to failure while receiving sham or anodal transcranial direct current stimulation. Order of stimulation was randomized, and the subjects and investigators were blinded to condition. Time to task failure was measured alongside selected psychological indices of perceived exertion and affect. Anodal transcranial direct current stimulation prolonged mean time to task failure by approximately 15% (16.9±2.2 vs 14.7±1.8 minutes) and slowed the rate of increase in rating of perceived exertion (0.29±0.03 vs 0.31±0.03) relative to the sham condition. These preliminary findings suggest that anodal transcranial direct current stimulation enhances time to task failure of a sustained, submaximal contraction in older adults by potentially increasing cortical excitability and/or influencing the perception of exertion. These results raise the question of whether interventions that acutely increase cortical excitability could enhance physical function and/or exercise-induced adaptations in older adults. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Dynamics of functional failures and recovery in complex road networks
NASA Astrophysics Data System (ADS)
Zhan, Xianyuan; Ukkusuri, Satish V.; Rao, P. Suresh C.
2017-11-01
We propose a new framework for modeling the evolution of functional failures and recoveries in complex networks, with traffic congestion on road networks as the case study. Differently from conventional approaches, we transform the evolution of functional states into an equivalent dynamic structural process: dual-vertex splitting and coalescing embedded within the original network structure. The proposed model successfully explains traffic congestion and recovery patterns at the city scale based on high-resolution data from two megacities. Numerical analysis shows that certain network structural attributes can amplify or suppress cascading functional failures. Our approach represents a new general framework to model functional failures and recoveries in flow-based networks and allows understanding of the interplay between structure and function for flow-induced failure propagation and recovery.
Packer, Milton; Fowler, Michael B; Roecker, Ellen B; Coats, Andrew J S; Katus, Hugo A; Krum, Henry; Mohacsi, Paul; Rouleau, Jean L; Tendera, Michal; Staiger, Christoph; Holcslaw, Terry L; Amann-Zalan, Ildiko; DeMets, David L
2002-10-22
Beta-blocking agents improve functional status and reduce morbidity in mild-to-moderate heart failure, but it is not known whether they produce such benefits in severe heart failure. We randomly assigned 2289 patients with symptoms of heart failure at rest or on minimal exertion and with an ejection fraction <25% (but not volume-overloaded) to double-blind treatment with either placebo (n=1133) or carvedilol (n=1156) for an average of 10.4 months. Carvedilol reduced the combined risk of death or hospitalization for a cardiovascular reason by 27% (P=0.00002) and the combined risk of death or hospitalization for heart failure by 31% (P=0.000004). Patients in the carvedilol group also spent 27% fewer days in the hospital for any reason (P=0.0005) and 40% fewer days in the hospital for heart failure (P<0.0001). These differences were as a result of both a decrease in the number of hospitalizations and a shorter duration of each admission. More patients felt improved and fewer patients felt worse in the carvedilol group than in the placebo group after 6 months of maintenance therapy (P=0.0009). Carvedilol-treated patients were also less likely than placebo-treated patients to experience a serious adverse event (P=0.002), especially worsening heart failure, sudden death, cardiogenic shock, or ventricular tachycardia. In euvolemic patients with symptoms at rest or on minimal exertion, the addition of carvedilol to conventional therapy ameliorates the severity of heart failure and reduces the risk of clinical deterioration, hospitalization, and other serious adverse clinical events.
Piller, Linda B; Davis, Barry R; Cutler, Jeffrey A; Cushman, William C; Wright, Jackson T; Williamson, Jeff D; Leenen, Frans HH; Einhorn, Paula T; Randall, Otelio S; Golden, John S; Haywood, L Julian
2002-01-01
Background The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) is a randomized, double-blind, active-controlled trial designed to compare the rate of coronary heart disease events in high-risk hypertensive participants initially randomized to a diuretic (chlorthalidone) versus each of three alternative antihypertensive drugs: alpha-adrenergic blocker (doxazosin), ACE-inhibitor (lisinopril), and calcium-channel blocker (amlodipine). Combined cardiovascular disease risk was significantly increased in the doxazosin arm compared to the chlorthalidone arm (RR 1.25; 95% CI, 1.17–1.33; P < .001), with a doubling of heart failure (fatal, hospitalized, or non-hospitalized but treated) (RR 2.04; 95% CI, 1.79–2.32; P < .001). Questions about heart failure diagnostic criteria led to steps to validate these events further. Methods and Results Baseline characteristics (age, race, sex, blood pressure) did not differ significantly between treatment groups (P < .05) for participants with heart failure events. Post-event pharmacologic management was similar in both groups and generally conformed to accepted heart failure therapy. Central review of a small sample of cases showed high adherence to ALLHAT heart failure criteria. Of 105 participants with quantitative ejection fraction measurements provided, (67% by echocardiogram, 31% by catheterization), 29/46 (63%) from the chlorthalidone group and 41/59 (70%) from the doxazosin group were at or below 40%. Two-year heart failure case-fatalities (22% and 19% in the doxazosin and chlorthalidone groups, respectively) were as expected and did not differ significantly (RR 0.96; 95% CI, 0.67–1.38; P = 0.83). Conclusion Results of the validation process supported findings of increased heart failure in the ALLHAT doxazosin treatment arm compared to the chlorthalidone treatment arm. PMID:12459039
Morbi, Abigail H M; Hamady, Mohamad S; Riga, Celia V; Kashef, Elika; Pearch, Ben J; Vincent, Charles; Moorthy, Krishna; Vats, Amit; Cheshire, Nicholas J W; Bicknell, Colin D
2012-08-01
To determine the type and frequency of errors during vascular interventional radiology (VIR) and design and implement an intervention to reduce error and improve efficiency in this setting. Ethical guidance was sought from the Research Services Department at Imperial College London. Informed consent was not obtained. Field notes were recorded during 55 VIR procedures by a single observer. Two blinded assessors identified failures from field notes and categorized them into one or more errors by using a 22-part classification system. The potential to cause harm, disruption to procedural flow, and preventability of each failure was determined. A preprocedural team rehearsal (PPTR) was then designed and implemented to target frequent preventable potential failures. Thirty-three procedures were observed subsequently to determine the efficacy of the PPTR. Nonparametric statistical analysis was used to determine the effect of intervention on potential failure rates, potential to cause harm and procedural flow disruption scores (Mann-Whitney U test), and number of preventable failures (Fisher exact test). Before intervention, 1197 potential failures were recorded, of which 54.6% were preventable. A total of 2040 errors were deemed to have occurred to produce these failures. Planning error (19.7%), staff absence (16.2%), equipment unavailability (12.2%), communication error (11.2%), and lack of safety consciousness (6.1%) were the most frequent errors, accounting for 65.4% of the total. After intervention, 352 potential failures were recorded. Classification resulted in 477 errors. Preventable failures decreased from 54.6% to 27.3% (P < .001) with implementation of PPTR. Potential failure rates per hour decreased from 18.8 to 9.2 (P < .001), with no increase in potential to cause harm or procedural flow disruption per failure. Failures during VIR procedures are largely because of ineffective planning, communication error, and equipment difficulties, rather than a result of technical or patient-related issues. Many of these potential failures are preventable. A PPTR is an effective means of targeting frequent preventable failures, reducing procedural delays and improving patient safety.
Failure Analysis and Mechanisms of Failure of Fibrous Composite Structures
NASA Technical Reports Server (NTRS)
Noor, A. K. (Compiler); Shuart, M. J. (Compiler); Starnes, J. H., Jr. (Compiler); Williams, J. G. (Compiler)
1983-01-01
The state of the art of failure analysis and current design practices, especially as applied to the use of fibrous composite materials in aircraft structures is discussed. Deficiencies in these technologies are identified, as are directions for future research.
Gallet, Romain; Meyer, Guy; Ternacle, Julien; Biendel, Caroline; Brunet, Anne; Meneveau, Nicolas; Rosario, Roger; Couturaud, Francis; Sebbane, Mustapha; Lamblin, Nicolas; Bouvaist, Helene; Coste, Pierre; Maitre, Bernard; Bastuji-Garin, Sylvie; Dubois-Rande, Jean-Luc; Lim, Pascal
2015-05-22
In acute pulmonary embolism (PE), poor outcome is usually related to right ventricular (RV) failure due to the increase in RV afterload. Treatment of PE with RV failure without shock is controversial and usually relies on fluid expansion to increase RV preload. However, several studies suggest that fluid expansion may worsen acute RV failure by increasing RV dilation and ischaemia, and increase left ventricular compression by RV dilation. By reducing RV enlargement, diuretic treatment may break this vicious circle and provide early improvement in normotensive patients referred for acute PE with RV failure. The Diuretic versus placebo in Pulmonary Embolism with Right ventricular enlargement trial (DiPER) is a prospective, multicentre, randomised (1:1), double-blind, placebo controlled study assessing the superiority of furosemide as compared with placebo in normotensive patients with confirmed acute PE and RV dilation (diagnosed on echocardiography or CT of the chest) and positive brain natriuretic peptide result. The primary end point will be a combined clinical criterion derived from simplified Pulmonary Embolism Severity Index (PESI) score and evaluated at 24 h. It will include: (1) urine output >0.5 mL/kg/min for the past 24 h; (2) heart rate <110 bpm; (3) systolic blood pressure >100 mm Hg and (4) arterial oxyhaemoglobin level >90%. Thirty-day major cardiac events defined as death, cardiac arrest, mechanical ventilation, need for catecholamine and thrombolysis, will be evaluated as a secondary end point. Assuming an increase of 30% in the primary end point with furosemide and a β risk of 10%, 270 patients will be required. Ethical approval was received from the ethical committee of Ile de France (2014-001090-14). The findings of the trial will be disseminated through peer-reviewed journals, and national and international conference presentations. NCT02268903. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Failure prediction of thin beryllium sheets used in spacecraft structures
NASA Technical Reports Server (NTRS)
Roschke, Paul N.; Mascorro, Edward; Papados, Photios; Serna, Oscar R.
1991-01-01
The primary objective of this study is to develop a method for prediction of failure of thin beryllium sheets that undergo complex states of stress. Major components of the research include experimental evaluation of strength parameters for cross-rolled beryllium sheet, application of the Tsai-Wu failure criterion to plate bending problems, development of a high order failure criterion, application of the new criterion to a variety of structures, and incorporation of both failure criteria into a finite element code. A Tsai-Wu failure model for SR-200 sheet material is developed from available tensile data, experiments carried out by NASA on two circular plates, and compression and off-axis experiments performed in this study. The failure surface obtained from the resulting criterion forms an ellipsoid. By supplementing experimental data used in the the two-dimensional criterion and modifying previously suggested failure criteria, a multi-dimensional failure surface is proposed for thin beryllium structures. The new criterion for orthotropic material is represented by a failure surface in six-dimensional stress space. In order to determine coefficients of the governing equation, a number of uniaxial, biaxial, and triaxial experiments are required. Details of these experiments and a complementary ultrasonic investigation are described in detail. Finally, validity of the criterion and newly determined mechanical properties is established through experiments on structures composed of SR200 sheet material. These experiments include a plate-plug arrangement under a complex state of stress and a series of plates with an out-of-plane central point load. Both criteria have been incorporated into a general purpose finite element analysis code. Numerical simulation incrementally applied loads to a structural component that is being designed and checks each nodal point in the model for exceedance of a failure criterion. If stresses at all locations do not exceed the failure criterion, the load is increased and the process is repeated. Failure results for the plate-plug and clamped plate tests are accurate to within 2 percent.
ERIC Educational Resources Information Center
Newcomb, Michael D.; Abbott, Robert D.; Catalano, Richard F.; Hawkins, J. David; Battin-Pearson, Sara; Hill, Karl
2002-01-01
Understanding and preventing high school failure is a national priority. Structural strain and general deviance theories attempt to explain late high school failure. The authors tested the hypotheses that general (vs. specific) deviance and academic competence mediate the relationships between structural strain factors (gender, ethnicity, and…
Chatterjee, Dattatreyo; Ghosh, Sudip Kumar; Sen, Sukanta; Sarkar, Saswati; Hazra, Avijit; De, Radharaman
2016-01-01
Objective: Epidermal dermatophyte infections most commonly manifest as tinea corporis or tinea cruris. Topical azole antifungals are commonly used in their treatment but literature suggests that most require twice-daily application and provide lower cure rates than the allylamine antifungal terbinafine. We conducted a head-to-head comparison of the effectiveness of the once-daily topical azole, sertaconazole, with terbinafine in these infections. Materials and Methods: We conducted a randomized, observer-blind, parallel group study (Clinical Trial Registry India [CTRI]/2014/09/005029) with adult patients of either sex presenting with localized lesions. The clinical diagnosis was confirmed by potassium hydroxide smear microscopy of skin scrapings. After baseline assessment of erythema, scaling, and pruritus, patients applied either of the two study drugs once daily for 2 weeks. If clinical cure was not seen at 2 weeks, but improvement was noted, application was continued for further 2 weeks. Patients deemed to be clinical failure at 2 weeks were switched to oral antifungals. Results: Overall 88 patients on sertaconazole and 91 on terbinafine were analyzed. At 2 weeks, the clinical cure rates were comparable at 77.27% (95% confidence interval [CI]: 68.52%–86.03%) for sertaconazole and 73.63% (95% CI 64.57%–82.68%) for terbinafine (P = 0.606). Fourteen patients in either group improved and on further treatment showed complete healing by another 2 weeks. The final cure rate at 4 weeks was also comparable at 93.18% (95% CI 88.75%–97.62%) and 89.01% (95% CI 82.59%–95.44%), respectively (P = 0.914). At 2 weeks, 6 (6.82%) sertaconazole and 10 (10.99%) terbinafine recipients were considered as “clinical failure.” Tolerability of both preparations was excellent. Conclusion: Despite the limitations of an observer-blind study without microbiological support, the results suggest that once-daily topical sertaconazole is as effective as terbinafine in localized tinea infections. PMID:28066103
Chatterjee, Dattatreyo; Ghosh, Sudip Kumar; Sen, Sukanta; Sarkar, Saswati; Hazra, Avijit; De, Radharaman
2016-01-01
Epidermal dermatophyte infections most commonly manifest as tinea corporis or tinea cruris. Topical azole antifungals are commonly used in their treatment but literature suggests that most require twice-daily application and provide lower cure rates than the allylamine antifungal terbinafine. We conducted a head-to-head comparison of the effectiveness of the once-daily topical azole, sertaconazole, with terbinafine in these infections. We conducted a randomized, observer-blind, parallel group study (Clinical Trial Registry India [CTRI]/2014/09/005029) with adult patients of either sex presenting with localized lesions. The clinical diagnosis was confirmed by potassium hydroxide smear microscopy of skin scrapings. After baseline assessment of erythema, scaling, and pruritus, patients applied either of the two study drugs once daily for 2 weeks. If clinical cure was not seen at 2 weeks, but improvement was noted, application was continued for further 2 weeks. Patients deemed to be clinical failure at 2 weeks were switched to oral antifungals. Overall 88 patients on sertaconazole and 91 on terbinafine were analyzed. At 2 weeks, the clinical cure rates were comparable at 77.27% (95% confidence interval [CI]: 68.52%-86.03%) for sertaconazole and 73.63% (95% CI 64.57%-82.68%) for terbinafine ( P = 0.606). Fourteen patients in either group improved and on further treatment showed complete healing by another 2 weeks. The final cure rate at 4 weeks was also comparable at 93.18% (95% CI 88.75%-97.62%) and 89.01% (95% CI 82.59%-95.44%), respectively ( P = 0.914). At 2 weeks, 6 (6.82%) sertaconazole and 10 (10.99%) terbinafine recipients were considered as "clinical failure." Tolerability of both preparations was excellent. Despite the limitations of an observer-blind study without microbiological support, the results suggest that once-daily topical sertaconazole is as effective as terbinafine in localized tinea infections.
Neurogenic orthostatic hypotension: a double-blind, placebo-controlled study with midodrine
NASA Technical Reports Server (NTRS)
Jankovic, J.; Gilden, J. L.; Hiner, B. C.; Kaufmann, H.; Brown, D. C.; Coghlan, C. H.; Rubin, M.; Fouad-Tarazi, F. M.
1993-01-01
PURPOSE: To investigate the efficacy and safety of midodrine for treatment of patients with orthostatic hypotension due to autonomic failure. PATIENTS: Ninety-seven patients with orthostatic hypotension were randomized in a 4-week, double-blinded, placebo-controlled study with a 1-week placebo run-in period. Patients ranged in age from 22 to 86 years (mean: 61 years). METHODS: After a 1-week run-in phase, either placebo or midodrine at a dose of 2.5 mg, 5 mg, or 10 mg was administered three times a day for 4 weeks. Both the placebo group and the 2.5-mg midodrine group received constant doses throughout the double-blind phase. The patients receiving 5 mg or 10 mg of midodrine were given doses that were increased at weekly intervals by 2.5-mg increments until the designated dose was reached. Efficacy evaluations were based on an improvement at 1-hour postdose in standing systolic blood pressure and in symptoms of orthostatic hypotension (syncope, dizziness/lightheadedness, weakness/fatigue, and low energy level). RESULTS: Midodrine (10 mg) increased standing systolic blood pressure by 22 mm Hg (28%, p < 0.001 versus placebo). Midodrine improved (p < 0.05) the following symptoms of orthostatic hypotension compared to placebo: dizziness/lightheadedness, weakness/fatigue, syncope, low energy level, impaired ability to stand, and feelings of depression. The overall side effects were mainly mild to moderate. One or more side effects were reported by 22% of the placebo group compared with 27% of the midodrine-treated group. Scalp pruritus/tingling, which was reported by 10 of 74 (13.5%) of the midodrine-treated patients, was most frequent. Other reported side effects included supine hypertension (8%) and feelings of urinary urgency (4%). CONCLUSION: We conclude that midodrine is an effective and well-tolerated treatment for moderate-to-severe orthostatic hypotension associated with autonomic failure.
Teaching Life Sciences to Blind and Visually Impaired Learners
ERIC Educational Resources Information Center
Fraser, William John; Maguvhe, Mbulaheni Obert
2008-01-01
This study reports on the teaching of life sciences (biology) to blind and visually impaired learners in South Africa at 11 special schools with specific reference to the development of science process skills in outcomes-based classrooms. Individual structured interviews were conducted with nine science educators teaching at the different special…
An overview of the crash dynamics failure behavior of metal and composite aircraft structures
NASA Technical Reports Server (NTRS)
Carden, Huey D.; Boitnott, Richard L.; Fasanella, Edwin L.; Jones, Lisa E.
1991-01-01
An overview of failure behavior results is presented from some of the crash dynamics research conducted with concepts of aircraft elements and substructure not necessarily designed or optimized for energy absorption or crash loading considerations. Experimental and analytical data are presented that indicate some general trends in the failure behavior of a class of composite structures that includes fuselage panels, individual fuselage sections, fuselage frames, skeleton subfloors with stringers and floor beams without skin covering, and subfloors with skin added to the frame stringer structure. Although the behavior is complex, a strong similarity in the static/dynamic failure behavior among these structures is illustrated through photographs of the experimental results and through analytical data of generic composite structural models.
[Difficult reintubation during a Fantoni's tracheostomy resolved using a laryngeal mask].
Ould-Ahmed, M; Mas, B; Paris, A; Caroff, P; Segalen, F
2001-04-01
We report the failure of a reintubation under direct laryngoscopy, during a percutaneous tracheostomy by Fantoni method. After the accidental per-procedural extubation and in front of an unpredicted difficult conventional endotracheal intubation, a laryngeal mask was used as an airway intubator conduit for the blind passage of the set's ventilation tube. This ventilation tube is a 40 cm long, 4 mm internal diameter special catheter with low pressure cuff, included into the TLT kit. The end of the procedure was uneventful.
1985-03-01
aluminum outer walls by a matrix of studs screwed into blind holes in the inner wall plates and extending through the outer walls. Thermoelectric cooling...studied. The problem of the uncooled sample ports might have been dealt with, however the failure of several sections of thermoelectric cooling...encountered with the Proto I chamber. It should be kept in mind that the basic cooled wall design consists of thermoelectric cooling modules (TEM’s
Fekete, F; Breil, P; Ronsse, H; Tossen, J C; Langonnet, F
1981-01-01
Experience with the EEA stapler device used in 30 esophagogastric resections for cancer with intrathoracic anastomosis, is reported. The mortality rate was 13.3%. The anastomotic failure rate was 3.3% (1/30) with only one death; three asymptomatic blind fistulas were found on a routine contrast examination of the anastomosis. It is felt that esophagogastric EEA stapled anastomosis associated with an omental graft is a very safe technique. Images Fig. 4. Fig. 5. Fig. 6. PMID:7247526
On-clip high frequency reliability and failure test structures
Snyder, Eric S.; Campbell, David V.
1997-01-01
Self-stressing test structures for realistic high frequency reliability characterizations. An on-chip high frequency oscillator, controlled by DC signals from off-chip, provides a range of high frequency pulses to test structures. The test structures provide information with regard to a variety of reliability failure mechanisms, including hot-carriers, electromigration, and oxide breakdown. The system is normally integrated at the wafer level to predict the failure mechanisms of the production integrated circuits on the same wafer.
Cerciello, Simone; Monk, Andrew Paul; Visonà, Enrico; Carbone, Stefano; Edwards, Thomas Bradley; Maffulli, Nicola; Walch, Gilles
2017-07-01
Secondary cuff failure after shoulder replacement is disabling and often requires additional surgery. Increased critical shoulder angle (CSA) has been found in patients with cuff tear compared to normal subjects. The interobserver reliability of the CSA and the relationship between CSA and symptomatic secondary cuff failure after shoulder replacement were investigated. Nineteen patients with symptomatic cuff failure after anatomic shoulder replacement (mean FU 45 months) were compared to a control group of 29 patients showing no signs of symptomatic cuff failure (mean FU 105.7 months). The CSA was measured by two blinded surgeons at a mean follow-up of 45 and 105.7 months, respectively. Inter-observer reliability was calculated. The mean CSA in the study group in neutral, internal and external rotations were 33°, 34° and 34°, respectively. Corresponding values in the control group were 32°, 32° and 32°. The interclass correlation coefficient for the whole population between the two examiners were 0.956 (P < 0.01), 0.964 (P < 0.01) and 0.955 (P < 0.01), respectively. There were no significant differences of CSA values between patients who had undergone shoulder replacement and experienced late cuff failure and those in whom the same procedure had been successful. A good inter-observer reliability was found for the CSA method.
Recent advances in computational structural reliability analysis methods
NASA Astrophysics Data System (ADS)
Thacker, Ben H.; Wu, Y.-T.; Millwater, Harry R.; Torng, Tony Y.; Riha, David S.
1993-10-01
The goal of structural reliability analysis is to determine the probability that the structure will adequately perform its intended function when operating under the given environmental conditions. Thus, the notion of reliability admits the possibility of failure. Given the fact that many different modes of failure are usually possible, achievement of this goal is a formidable task, especially for large, complex structural systems. The traditional (deterministic) design methodology attempts to assure reliability by the application of safety factors and conservative assumptions. However, the safety factor approach lacks a quantitative basis in that the level of reliability is never known and usually results in overly conservative designs because of compounding conservatisms. Furthermore, problem parameters that control the reliability are not identified, nor their importance evaluated. A summary of recent advances in computational structural reliability assessment is presented. A significant level of activity in the research and development community was seen recently, much of which was directed towards the prediction of failure probabilities for single mode failures. The focus is to present some early results and demonstrations of advanced reliability methods applied to structural system problems. This includes structures that can fail as a result of multiple component failures (e.g., a redundant truss), or structural components that may fail due to multiple interacting failure modes (e.g., excessive deflection, resonate vibration, or creep rupture). From these results, some observations and recommendations are made with regard to future research needs.
Recent advances in computational structural reliability analysis methods
NASA Technical Reports Server (NTRS)
Thacker, Ben H.; Wu, Y.-T.; Millwater, Harry R.; Torng, Tony Y.; Riha, David S.
1993-01-01
The goal of structural reliability analysis is to determine the probability that the structure will adequately perform its intended function when operating under the given environmental conditions. Thus, the notion of reliability admits the possibility of failure. Given the fact that many different modes of failure are usually possible, achievement of this goal is a formidable task, especially for large, complex structural systems. The traditional (deterministic) design methodology attempts to assure reliability by the application of safety factors and conservative assumptions. However, the safety factor approach lacks a quantitative basis in that the level of reliability is never known and usually results in overly conservative designs because of compounding conservatisms. Furthermore, problem parameters that control the reliability are not identified, nor their importance evaluated. A summary of recent advances in computational structural reliability assessment is presented. A significant level of activity in the research and development community was seen recently, much of which was directed towards the prediction of failure probabilities for single mode failures. The focus is to present some early results and demonstrations of advanced reliability methods applied to structural system problems. This includes structures that can fail as a result of multiple component failures (e.g., a redundant truss), or structural components that may fail due to multiple interacting failure modes (e.g., excessive deflection, resonate vibration, or creep rupture). From these results, some observations and recommendations are made with regard to future research needs.
Fault slip rates in the modern new madrid seismic zone
Mueller; Champion; Guccione; Kelson
1999-11-05
Structural and geomorphic analysis of late Holocene sediments in the Lake County region of the New Madrid seismic zone indicates that they are deformed by fault-related folding above the blind Reelfoot thrust fault. The widths of narrow kink bands exposed in trenches were used to model the Reelfoot scarp as a forelimb on a fault-bend fold; this, coupled with the age of folded sediment, yields a slip rate on the blind thrust of 6.1 +/- 0.7 mm/year for the past 2300 +/- 100 years. An alternative method used structural relief across the scarp and the estimated dip of the underlying blind thrust to calculate a slip rate of 4.8 +/- 0.2 mm/year. Geometric relations suggest that the right lateral slip rate on the New Madrid seismic zone is 1.8 to 2.0 mm/year.
NASA Astrophysics Data System (ADS)
Marhadi, Kun Saptohartyadi
Structural optimization for damage tolerance under various unforeseen damage scenarios is computationally challenging. It couples non-linear progressive failure analysis with sampling-based stochastic analysis of random damage. The goal of this research was to understand the relationship between alternate load paths available in a structure and its damage tolerance, and to use this information to develop computationally efficient methods for designing damage tolerant structures. Progressive failure of a redundant truss structure subjected to small random variability was investigated to identify features that correlate with robustness and predictability of the structure's progressive failure. The identified features were used to develop numerical surrogate measures that permit computationally efficient deterministic optimization to achieve robustness and predictability of progressive failure. Analysis of damage tolerance on designs with robust progressive failure indicated that robustness and predictability of progressive failure do not guarantee damage tolerance. Damage tolerance requires a structure to redistribute its load to alternate load paths. In order to investigate the load distribution characteristics that lead to damage tolerance in structures, designs with varying degrees of damage tolerance were generated using brute force stochastic optimization. A method based on principal component analysis was used to describe load distributions (alternate load paths) in the structures. Results indicate that a structure that can develop alternate paths is not necessarily damage tolerant. The alternate load paths must have a required minimum load capability. Robustness analysis of damage tolerant optimum designs indicates that designs are tailored to specified damage. A design Optimized under one damage specification can be sensitive to other damages not considered. Effectiveness of existing load path definitions and characterizations were investigated for continuum structures. A load path definition using a relative compliance change measure (U* field) was demonstrated to be the most useful measure of load path. This measure provides quantitative information on load path trajectories and qualitative information on the effectiveness of the load path. The use of the U* description of load paths in optimizing structures for effective load paths was investigated.
Structures and geriatrics from a failure analysis experience viewpoint
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hopper, D.M.
In a failure analysis consulting engineering practice one sees a variety of structural failures from which observations may be made concerning geriatric structures. Representative experience with power plants, refineries, offshore structures, and forensic investigations is summarized and generic observations are made regarding the maintenance of fitness for purpose of structures. Although it is important to optimize the engineering design for a range of operational and environmental variables, it is essential that fabrication and inspection controls exist along with common sense based ongoing monitoring and operations procedures. 18 figs.
Langford, R M; Mares, J; Novotna, A; Vachova, M; Novakova, I; Notcutt, W; Ratcliffe, S
2013-04-01
Central neuropathic pain (CNP) occurs in many multiple sclerosis (MS) patients. The provision of adequate pain relief to these patients can very difficult. Here we report the first phase III placebo-controlled study of the efficacy of the endocannabinoid system modulator delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) oromucosal spray (USAN name, nabiximols; Sativex, GW Pharmaceuticals, Salisbury, Wiltshire, UK), to alleviate CNP. Patients who had failed to gain adequate analgesia from existing medication were treated with THC/CBD spray or placebo as an add-on treatment, in a double-blind manner, for 14 weeks to investigate the efficacy of the medication in MS-induced neuropathic pain. This parallel-group phase of the study was then followed by an 18-week randomized-withdrawal study (14-week open-label treatment period plus a double-blind 4-week randomized-withdrawal phase) to investigate time to treatment failure and show maintenance of efficacy. A total of 339 patients were randomized to phase A (167 received THC/CBD spray and 172 received placebo). Of those who completed phase A, 58 entered the randomized-withdrawal phase. The primary endpoint of responder analysis at the 30 % level at week 14 of phase A of the study was not met, with 50 % of patients on THC/CBD spray classed as responders at the 30 % level compared to 45 % of patients on placebo (p = 0.234). However, an interim analysis at week 10 showed a statistically significant treatment difference in favor of THC/CBD spray at this time point (p = 0.046). During the randomized-withdrawal phase, the primary endpoint of time to treatment failure was statistically significant in favor of THC/CBD spray, with 57 % of patients receiving placebo failing treatment versus 24 % of patients from the THC/CBD spray group (p = 0.04). The mean change from baseline in Pain Numerical Rating Scale (NRS) (p = 0.028) and sleep quality NRS (p = 0.015) scores, both secondary endpoints in phase B, were also statistically significant compared to placebo, with estimated treatment differences of -0.79 and 0.99 points, respectively, in favor of THC/CBD spray treatment. The results of the current investigation were equivocal, with conflicting findings in the two phases of the study. While there were a large proportion of responders to THC/CBD spray treatment during the phase A double-blind period, the primary endpoint was not met due to a similarly large number of placebo responders. In contrast, there was a marked effect in phase B of the study, with an increased time to treatment failure in the THC/CBD spray group compared to placebo. These findings suggest that further studies are required to explore the full potential of THC/CBD spray in these patients.
Failure analysis of thick composite cylinders under external pressure
NASA Technical Reports Server (NTRS)
Caiazzo, A.; Rosen, B. W.
1992-01-01
Failure of thick section composites due to local compression strength and overall structural instability is treated. Effects of material nonlinearity, imperfect fiber architecture, and structural imperfections upon anticipated failure stresses are determined. Comparisons with experimental data for a series of test cylinders are described. Predicting the failure strength of composite structures requires consideration of stability and material strength modes of failure using linear and nonlinear analysis techniques. Material strength prediction requires the accurate definition of the local multiaxial stress state in the material. An elasticity solution for the linear static analysis of thick anisotropic cylinders and rings is used herein to predict the axisymmetric stress state in the cylinders. Asymmetric nonlinear behavior due to initial cylinder out of roundness and the effects of end closure structure are treated using finite element methods. It is assumed that local fiber or ply waviness is an important factor in the initiation of material failure. An analytical model for the prediction of compression failure of fiber composites, which includes the effects of fiber misalignments, matrix inelasticity, and multiaxial applied stresses is used for material strength calculations. Analytical results are compared to experimental data for a series of glass and carbon fiber reinforced epoxy cylinders subjected to external pressure. Recommendations for pretest characterization and other experimental issues are presented. Implications for material and structural design are discussed.
On-clip high frequency reliability and failure test structures
Snyder, E.S.; Campbell, D.V.
1997-04-29
Self-stressing test structures for realistic high frequency reliability characterizations. An on-chip high frequency oscillator, controlled by DC signals from off-chip, provides a range of high frequency pulses to test structures. The test structures provide information with regard to a variety of reliability failure mechanisms, including hot-carriers, electromigration, and oxide breakdown. The system is normally integrated at the wafer level to predict the failure mechanisms of the production integrated circuits on the same wafer. 22 figs.
Analysis for the Progressive Failure Response of Textile Composite Fuselage Frames
NASA Technical Reports Server (NTRS)
Johnson, Eric R.; Boitnott, Richard L. (Technical Monitor)
2002-01-01
A part of aviation accident mitigation is a crashworthy airframe structure, and an important measure of merit for a crashworthy structure is the amount of kinetic energy that can be absorbed in the crush of the structure. Prediction of the energy absorbed from finite element analyses requires modeling the progressive failure sequence. Progressive failure modes may include material degradation, fracture and crack growth, and buckling and collapse. The design of crashworthy airframe components will benefit from progressive failure analyses that have been validated by tests. The subject of this research is the development of a progressive failure analysis for a textile composite, circumferential fuselage frame subjected to a quasi-static, crash-type load. The test data for the frame are reported, and these data are used to develop and to validate methods for the progressive failure response.
Cortical thickness development of human primary visual cortex related to the age of blindness onset.
Li, Qiaojun; Song, Ming; Xu, Jiayuan; Qin, Wen; Yu, Chunshui; Jiang, Tianzi
2017-08-01
Blindness primarily induces structural alteration in the primary visual cortex (V1). Some studies have found that the early blind subjects had a thicker V1 compared to sighted controls, whereas late blind subjects showed no significant differences in the V1. This implies that the age of blindness onset may exert significant effects on the development of cortical thickness of the V1. However, no previous research used a trajectory of the age of blindness onset-related changes to investigate these effects. Here we explored this issue by mapping the cortical thickness trajectory of the V1 against the age of blindness onset using data from 99 blind individuals whose age of blindness onset ranged from birth to 34 years. We found that the cortical thickness of the V1 could be fitted well with a quadratic curve in both the left (F = 11.59, P = 3 × 10 -5 ) and right hemispheres (F = 6.54, P = 2 × 10 -3 ). Specifically, the cortical thickness of the V1 thinned rapidly during childhood and adolescence and did not change significantly thereafter. This trend was not observed in the primary auditory cortex (A1), primary motor cortex (M1), or primary somatosensory cortex (S1). These results provide evidence that an onset of blindness before adulthood significantly affects the cortical thickness of the V1 and suggest a critical period for cortical development of the human V1.
Parallelization of a blind deconvolution algorithm
NASA Astrophysics Data System (ADS)
Matson, Charles L.; Borelli, Kathy J.
2006-09-01
Often it is of interest to deblur imagery in order to obtain higher-resolution images. Deblurring requires knowledge of the blurring function - information that is often not available separately from the blurred imagery. Blind deconvolution algorithms overcome this problem by jointly estimating both the high-resolution image and the blurring function from the blurred imagery. Because blind deconvolution algorithms are iterative in nature, they can take minutes to days to deblur an image depending how many frames of data are used for the deblurring and the platforms on which the algorithms are executed. Here we present our progress in parallelizing a blind deconvolution algorithm to increase its execution speed. This progress includes sub-frame parallelization and a code structure that is not specialized to a specific computer hardware architecture.
Analysis of asteroid (216) Kleopatra using dynamical and structural constraints
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hirabayashi, Masatoshi; Scheeres, Daniel J., E-mail: masatoshi.hirabayashi@colorado.edu
This paper evaluates a dynamically and structurally stable size for Asteroid (216) Kleopatra. In particular, we investigate two different failure modes: material shedding from the surface and structural failure of the internal body. We construct zero-velocity curves in the vicinity of this asteroid to determine surface shedding, while we utilize a limit analysis to calculate the lower and upper bounds of structural failure under the zero-cohesion assumption. Surface shedding does not occur at the current spin period (5.385 hr) and cannot directly initiate the formation of the satellites. On the other hand, this body may be close to structural failure;more » in particular, the neck may be situated near a plastic state. In addition, the neck's sensitivity to structural failure changes as the body size varies. We conclude that plastic deformation has probably occurred around the neck part in the past. If the true size of this body is established through additional measurements, this method will provide strong constraints on the current friction angle for the body.« less
ERIC Educational Resources Information Center
Ercan, Hülya
2017-01-01
The aim of this study is to investigate the blind and constructive patriotism tendencies of university students in light of the demographic structure and variables. The investigation is performed by using the correlational descriptive model. The purposeful sampling technique has been used and data was collected from a total of 390 university…
Effects of Weighted Vests on Classroom Behavior for Children with Autism and Cognitive Impairments
ERIC Educational Resources Information Center
Hodgetts, Sandra; Magill-Evans, Joyce; Misiaszek, John
2011-01-01
This randomized controlled single-case study investigated the effects of weighted vests for 10 children with autism in a classroom setting. Blinded observers rated targeted behaviors through video taken during structured table-top activities typically part of the classroom routine. Blinded teachers rated each child's behavior with the Conners'…
True duplication of the vas deferens: a case report and review of literature.
Liang, Mike K; Subramanian, Anuradha; Weedin, John; Griffith, Donald P; Awad, Samir S
2012-04-01
Duplication of the vas deferens is the identification of a second vas deferens within the spermatic cord; it is a rarely reported congenital anomaly. Duplicate vas deferens should not be confused with double vas deferens that describes ipsilateral renal agenesis with a blind ureter ending in the ejaculatory system. We present a case of duplicated vas deferens, and a PubMed Medline (National Library of Medicine) search was performed using the terms "[duplicated OR double]" and "vas deferens". Nineteen papers for a total of twenty-two cases (including ours) were identified. Duplication of vas deferens is a rare finding; it is likely under-reported and underrecognized. Failure to recognize this variation can result in injury to the vas deferens or an ineffective vasectomy. Following identification of a suspected duplicated vas deferens, the structure should be tracked from the internal ring down to the epididymis and intra-operative Doppler should be performed. Post-operatively, renal and bladder imaging can be considered though there have been no reported cases of non-testicular genito-urinary anomalies associated with duplicated vas deferens.
An Update on Renal Artery Denervation and Its Clinical Impact on Hypertensive Disease
Kuang, Ye Min; Gan, Gary C. H.; Burgess, David; Denniss, Alan Robert
2015-01-01
Hypertension is a globally prevalent condition, with a heavy clinical and economic burden. It is the predominant risk factor for premature cardiovascular and cerebrovascular disease, and is associated with a variety of clinical disorders including stroke, congestive cardiac failure, ischaemic heart disease, chronic renal failure, and peripheral arterial disease. A significant subset of hypertensive patients have resistant hypertensive disease. In this group of patients, catheter-based renal artery denervation has emerged as a potential therapy, with favourable clinical efficacy and safety in early trials. Additional benefits of this therapy are also being identified and include effects on left ventricular remodeling, cardiac performance, and symptom status in congestive cardiac failure. Utility of renal denervation for the management of resistant hypertension, however, has become controversial since the release of the Symplicity HTN-3 trial, the first large-scale blinded randomised study investigating the efficacy and safety of renal artery denervation. The aim of this paper is to evaluate the history, utility, and clinical efficacy of renal artery denervation technology, including an in-depth appraisal of the current literature and principal trials. PMID:26495305
NASA Technical Reports Server (NTRS)
Lovejoy, Andrew E.; Jegley, Dawn C. (Technical Monitor)
2007-01-01
Structures often comprise smaller substructures that are connected to each other or attached to the ground by a set of finite connections. Under static loading one or more of these connections may exceed allowable limits and be deemed to fail. Of particular interest is the structural response when a connection is severed (failed) while the structure is under static load. A transient failure analysis procedure was developed by which it is possible to examine the dynamic effects that result from introducing a discrete failure while a structure is under static load. The failure is introduced by replacing a connection load history by a time-dependent load set that removes the connection load at the time of failure. The subsequent transient response is examined to determine the importance of the dynamic effects by comparing the structural response with the appropriate allowables. Additionally, this procedure utilizes a standard finite element transient analysis that is readily available in most commercial software, permitting the study of dynamic failures without the need to purchase software specifically for this purpose. The procedure is developed and explained, demonstrated on a simple cantilever box example, and finally demonstrated on a real-world example, the American Airlines Flight 587 (AA587) vertical tail plane (VTP).
14 CFR 21.3 - Reporting of failures, malfunctions, and defects.
Code of Federal Regulations, 2011 CFR
2011-01-01
... that has left its quality control system and that it determines could result in any of the occurrences... propeller control system. (5) A propeller or rotorcraft hub or blade structural failure. (6) Flammable fluid.... (11) Any structural or flight control system malfunction, defect, or failure which causes an...
Shi, Jie; Collignon, Olivier; Xu, Liang; Wang, Gang; Kang, Yue; Leporé, Franco; Lao, Yi; Joshi, Anand A; Leporé, Natasha; Wang, Yalin
2015-07-01
Blindness represents a unique model to study how visual experience may shape the development of brain organization. Exploring how the structure of the corpus callosum (CC) reorganizes ensuing visual deprivation is of particular interest due to its important functional implication in vision (e.g., via the splenium of the CC). Moreover, comparing early versus late visually deprived individuals has the potential to unravel the existence of a sensitive period for reshaping the CC structure. Here, we develop a novel framework to capture a complete set of shape differences in the CC between congenitally blind (CB), late blind (LB) and sighted control (SC) groups. The CCs were manually segmented from T1-weighted brain MRI and modeled by 3D tetrahedral meshes. We statistically compared the combination of local area and thickness at each point between subject groups. Differences in area are found using surface tensor-based morphometry; thickness is estimated by tracing the streamlines in the volumetric harmonic field. Group differences were assessed on this combined measure using Hotelling's T(2) test. Interestingly, we observed that the total callosal volume did not differ between the groups. However, our fine-grained analysis reveals significant differences mostly localized around the splenium areas between both blind groups and the sighted group (general effects of blindness) and, importantly, specific dissimilarities between the LB and CB groups, illustrating the existence of a sensitive period for reorganization. The new multivariate statistics also gave better effect sizes for detecting morphometric differences, relative to other statistics. They may boost statistical power for CC morphometric analyses.
Shi, Jie; Collignon, Olivier; Xu, Liang; Wang, Gang; Kang, Yue; Leporé, Franco; Lao, Yi; Joshi, Anand A.
2015-01-01
Blindness represents a unique model to study how visual experience may shape the development of brain organization. Exploring how the structure of the corpus callosum (CC) reorganizes ensuing visual deprivation is of particular interest due to its important functional implication in vision (e.g. via the splenium of the CC). Moreover, comparing early versus late visually deprived individuals has the potential to unravel the existence of a sensitive period for reshaping the CC structure. Here, we develop a novel framework to capture a complete set of shape differences in the CC between congenitally blind (CB), late blind (LB) and sighted control (SC) groups. The CCs were manually segmented from T1-weighted brain MRI and modeled by 3D tetrahedral meshes. We statistically compared the combination of local area and thickness at each point between subject groups. Differences in area are found using surface tensor-based morphometry; thickness is estimated by tracing the streamlines in the volumetric harmonic field. Group differences were assessed on this combined measure using Hotelling’s T2 test. Interestingly, we observed that the total callosal volume did not differ between the groups. However, our fine-grained analysis reveals significant differences mostly localized around the splenium areas between both blind groups and the sighted group (general effects of blindness) and, importantly, specific dissimilarities between the LB and CB groups, illustrating the existence of a sensitive period for reorganization. The new multivariate statistics also gave better effect sizes for detecting morphometric differences, relative to other statistics. They may boost statistical power for CC morphometric analyses. PMID:25649876
Sinha, Priya; Suneja, Amita; Guleria, Kiran; Aggarwal, Richa; Vaid, Neelam B
2018-02-01
To compare the efficacy and safety of mifepristone followed by misoprostol with misoprostol alone in the management of early pregnancy failure (EPF). A randomized double-blind placebo-controlled clinical trial. Ninety-two women with EPF ≤12 weeks were recruited and randomly allocated to receive either mifepristone 200 mg ( n = 46) or placebo ( n = 46). Forty-eight hours later, patients in both the groups were given 800 µg misoprostol per-vaginum. If no expulsion occurred within 4 h, repeat doses of 400 µg misoprostol were given orally at 3-hourly interval to a maximum of 2 doses in women ≤9 weeks by scan and 4 doses in women >9 weeks by scan. Pre-treatment of misoprostol with mifepristone significantly increased the complete abortion rate (86.7 vs. 57.8%, p = 0.009) and, hence, reduced the need for surgical evacuation (13.3 vs. 42.2%, p = 0.002), induction to expulsion interval (4.74 ± 2.24 vs. 8.03 ± 2.77 h, p = 0.000), mean number of additional doses of misoprostol required (0.68 vs. 1.91, p = 0.000), and side effects. Use of mifepristone prior to misoprostol in EPF significantly improves the efficacy and reduces the side effects of misoprostol alone.
Caremans, Jeroen; Hamans, Evert; Muylle, Ludo; Van de Heyning, Paul; Van Rompaey, Vincent
2016-06-01
Allograft tympano-ossicular systems (ATOS) have proven their use over many decades in tympanoplasty and reconstruction after resection of cholesteatoma. The transcranial bone plug technique has been used in the past 50 years to procure en bloc ATOS (tympanic membrane with malleus, incus and stapes attached). Recently, our group reported the feasibility of the endoscopic procurement technique. The aim of this study was to assess whether clinical outcome is equivalent in ATOS acquired by using the endoscopic procurement technique compared to ATOS acquired by using the transcranial technique. A double-blind randomized controlled audit was performed in a tertiary referral center in patients that underwent allograft tympanoplasty because of chronic otitis media with and without cholesteatoma. Allograft epithelialisation was evaluated at the short-term postoperative visit by microscopic examination. Failures were reported if reperforation was observed. Fifty patients underwent allograft tympanoplasty: 34 received endoscopically procured ATOS and 16 received transcranially procured ATOS. One failed case was observed, in the endoscopic procurement group. We did not observe a statistically significant difference between the two groups in failure rate. This study demonstrates equivalence of the clinical outcome of allograft tympanoplasty using either endoscopic or transcranial procured ATOS and therefore indicates that the endoscopic technique can be considered the new standard procurement technique. Especially because the endoscopic procurement technique has several advantages compared to the former transcranial procurement technique: it avoids risk of prion transmission and it is faster while lacking any noticeable incision.
Martinez, S A; Wilson, M G; Linton, D D; Newbound, G C; Freise, K J; Lin, T-L; Clark, T P
2014-01-01
A prospective, double-blinded, positive-controlled, multicenter, noninferiority study was conducted to evaluate the safety and effectiveness of transdermal fentanyl solution (TFS) compared with oxymorphone for the control of postoperative pain in dogs. Five hundred and two (502) client-owned dogs were assigned to a single dose of TFS (2.7 mg/kg) applied 2–4 h prior to surgery or oxymorphone hydrochloride (0.22 mg/kg) administered subcutaneously 2–4 h prior to surgery and q6h through 90 h. Pain was evaluated over 4 days by blinded observers using a modified Glasgow composite pain scale, and the a priori criteria for treatment failure was a pain score ≥8 or adverse event necessitating withdrawal. Four TFS- and eight oxymorphone-treated dogs were withdrawn due to lack of pain control. Eighteen oxymorphone-treated, but no TFS-treated dogs were withdrawn due to severe adverse events. The one-sided upper 95% confidence interval of the difference between TFS and oxymorphone treatment failure rates was −5.3%. Adverse events associated with oxymorphone were greater in number and severity compared with TFS. It was concluded that a single administration of TFS was safe and noninferior to repeated injections of oxymorphone for the control of postoperative pain over 4 days at the dose rates of both formulations used in this study. PMID:24344787
Raval, Amish N; Cook, Thomas D; Duckers, Henricus J; Johnston, Peter V; Traverse, Jay H; Abraham, William T; Altman, Peter A; Pepine, Carl J
2018-07-01
Heart failure following myocardial infarction is a common, disabling, and deadly condition. Direct injection of autologous bone marrow mononuclear cells into the myocardium may result in improved functional recovery, relieve symptoms, and improve other cardiovascular outcomes. CardiAMP-HF is a randomized, double-blind, sham-controlled, pivotal trial designed to investigate the safety and efficacy of autologous bone marrow mononuclear cells treatment for patients with medically refractory and symptomatic ischemic cardiomyopathy. The primary end point is change in 6-minute walk distance adjusted for major adverse cardiovascular events at 12 months following treatment. Particularly novel aspects of this trial include a cell potency assay to screen subjects who have bone marrow cell characteristics that suggest a favorable response to treatment, a point-of-care treatment method, a high target dose of 200 million cells, and an efficient transcatheter intramyocardial delivery method that is associated with high cell retention. This novel approach may lead to a new treatment for those with ischemic heart disease suffering from medically refractory heart failure. Copyright © 2018 Elsevier Inc. All rights reserved.
The cardiovascular safety trials of DPP-4 inhibitors, GLP-1 agonists, and SGLT2 inhibitors.
Secrest, Matthew H; Udell, Jacob A; Filion, Kristian B
2017-04-01
In this paper, we review the results of large, double-blind, placebo-controlled randomized trials mandated by the US Food and Drug Administration to examine the cardiovascular safety of newly-approved antihyperglycemic agents in patients with type 2 diabetes. The cardiovascular effects of dipeptidyl peptidase-4 (DPP-4) inhibitors remain controversial: while these drugs did not reduce or increase the risk of primary, pre-specified composite cardiovascular outcomes, one DPP-4 inhibitor (saxagliptin) increased the risk of hospitalization for heart failure in the overall population; another (alogliptin) demonstrated inconsistent effects on heart failure hospitalization across subgroups of patients, and a third (sitagliptin) demonstrated no effect on heart failure. Evidence for cardiovascular benefits of glucagon-like peptide-1 (GLP-1) agonists has been similarly heterogeneous, with liraglutide and semaglutide reducing the risk of composite cardiovascular outcomes, but lixisenatide having no reduction or increase in cardiovascular risk. The effect of GLP-1 agonists on retinopathy remains a potential concern. In the only completed trial to date to assess a sodium-glucose cotransporter-2 (SGLT2) inhibitor, empagliflozin reduced the risk of composite cardiovascular endpoints, predominantly through its impact on cardiovascular mortality and heart failure hospitalization. Copyright © 2017 Elsevier Inc. All rights reserved.
Mineralocorticoid Receptor Activation Contributes to the Supine Hypertension of Autonomic Failure.
Arnold, Amy C; Okamoto, Luis E; Gamboa, Alfredo; Black, Bonnie K; Raj, Satish R; Elijovich, Fernando; Robertson, David; Shibao, Cyndya A; Biaggioni, Italo
2016-02-01
Primary autonomic failure is characterized by disabling orthostatic hypotension, but at least half of these patients have paradoxical supine hypertension. Renin-angiotensin mechanisms were not initially thought to contribute to this hypertension because plasma renin activity is often undetectable in autonomic failure. Plasma aldosterone levels are normal, however, and we recently showed that plasma angiotensin II is elevated and acts at AT1 (angiotensin type 1) receptors to contribute to hypertension in these patients. Because aldosterone and angiotensin II can also bind mineralocorticoid receptors to elevate blood pressure, we hypothesized that mineralocorticoid receptor activation plays a role in the hypertension of autonomic failure. To test this hypothesis, we determined the acute effects of the mineralocorticoid receptor antagonist eplerenone (50 mg, oral) versus placebo on supine blood pressure in a randomized, double-blind, crossover study. Medications were given at 8:00 pm with blood pressure recorded every 2 hours for 12 hours. Ten primary autonomic failure patients with supine hypertension completed this study (7 pure autonomic failure, 2 multiple system atrophy, 1 parkinson's disease; 7 male; 70±2 years of age). Eplerenone maximally reduced supine systolic blood pressure by 32±6 mm Hg at 8 hours after administration (versus 8±10 mm Hg placebo, P=0.016), with no effect on nocturia (12-hour urine volume: 985±134 mL placebo versus 931±94 mL eplerenone, P=0.492; nocturnal weight loss: -1.19±0.15 kg placebo versus -1.18±0.15 kg eplerenone, P=0.766). These findings suggest that inappropriate mineralocorticoid receptor activation contributes to the hypertension of autonomic failure, likely independent of canonical mineralocorticoid effects, and provides rationale for use of eplerenone in these patients. © 2015 American Heart Association, Inc.
Left atrial function in heart failure with impaired and preserved ejection fraction.
Fang, Fang; Lee, Alex Pui-Wai; Yu, Cheuk-Man
2014-09-01
Left atrial structural and functional changes in heart failure are relatively ignored parts of cardiac assessment. This review illustrates the pathophysiological and functional changes in left atrium in heart failure as well as their prognostic value. Heart failure can be divided into those with systolic dysfunction and heart failure with preserved ejection fraction (HFPEF). Left atrial enlargement and dysfunction commonly occur in systolic heart failure, in particular, in idiopathic dilated cardiomyopathy. Atrial enlargement and dysfunction also carry important prognostic value in systolic heart failure, independently of known parameters such as left ventricular ejection fraction. In HFPEF, there is evidence of left atrial enlargement, impaired atrial compliance, and reduction of atrial pump function. This occurs not only at rest but also during exercise, indicating significant impairment of atrial contractile reserve. Furthermore, atrial dyssynchrony is common in HFPEF. These factors further contribute to the development of new onset or progression of atrial arrhythmias, in particular, atrial fibrillation. Left atrial function is an integral part of cardiac function and its structural and functional changes in heart failure are common. As changes of left atrial structure and function have different clinical implications in systolic heart failure and HFPEF, routine assessment is warranted.
Report on the sixth blind test of organic crystal structure prediction methods
Reilly, Anthony M.; Cooper, Richard I.; Adjiman, Claire S.; Bhattacharya, Saswata; Boese, A. Daniel; Brandenburg, Jan Gerit; Bygrave, Peter J.; Bylsma, Rita; Campbell, Josh E.; Car, Roberto; Case, David H.; Chadha, Renu; Cole, Jason C.; Cosburn, Katherine; Cuppen, Herma M.; Curtis, Farren; Day, Graeme M.; DiStasio Jr, Robert A.; Dzyabchenko, Alexander; van Eijck, Bouke P.; Elking, Dennis M.; van den Ende, Joost A.; Facelli, Julio C.; Ferraro, Marta B.; Fusti-Molnar, Laszlo; Gatsiou, Christina-Anna; Gee, Thomas S.; de Gelder, René; Ghiringhelli, Luca M.; Goto, Hitoshi; Grimme, Stefan; Guo, Rui; Hofmann, Detlef W. M.; Hoja, Johannes; Hylton, Rebecca K.; Iuzzolino, Luca; Jankiewicz, Wojciech; de Jong, Daniël T.; Kendrick, John; de Klerk, Niek J. J.; Ko, Hsin-Yu; Kuleshova, Liudmila N.; Li, Xiayue; Lohani, Sanjaya; Leusen, Frank J. J.; Lund, Albert M.; Lv, Jian; Ma, Yanming; Marom, Noa; Masunov, Artëm E.; McCabe, Patrick; McMahon, David P.; Meekes, Hugo; Metz, Michael P.; Misquitta, Alston J.; Mohamed, Sharmarke; Monserrat, Bartomeu; Needs, Richard J.; Neumann, Marcus A.; Nyman, Jonas; Obata, Shigeaki; Oberhofer, Harald; Oganov, Artem R.; Orendt, Anita M.; Pagola, Gabriel I.; Pantelides, Constantinos C.; Pickard, Chris J.; Podeszwa, Rafal; Price, Louise S.; Price, Sarah L.; Pulido, Angeles; Read, Murray G.; Reuter, Karsten; Schneider, Elia; Schober, Christoph; Shields, Gregory P.; Singh, Pawanpreet; Sugden, Isaac J.; Szalewicz, Krzysztof; Taylor, Christopher R.; Tkatchenko, Alexandre; Tuckerman, Mark E.; Vacarro, Francesca; Vasileiadis, Manolis; Vazquez-Mayagoitia, Alvaro; Vogt, Leslie; Wang, Yanchao; Watson, Rona E.; de Wijs, Gilles A.; Yang, Jack; Zhu, Qiang; Groom, Colin R.
2016-01-01
The sixth blind test of organic crystal structure prediction (CSP) methods has been held, with five target systems: a small nearly rigid molecule, a polymorphic former drug candidate, a chloride salt hydrate, a co-crystal and a bulky flexible molecule. This blind test has seen substantial growth in the number of participants, with the broad range of prediction methods giving a unique insight into the state of the art in the field. Significant progress has been seen in treating flexible molecules, usage of hierarchical approaches to ranking structures, the application of density-functional approximations, and the establishment of new workflows and ‘best practices’ for performing CSP calculations. All of the targets, apart from a single potentially disordered Z′ = 2 polymorph of the drug candidate, were predicted by at least one submission. Despite many remaining challenges, it is clear that CSP methods are becoming more applicable to a wider range of real systems, including salts, hydrates and larger flexible molecules. The results also highlight the potential for CSP calculations to complement and augment experimental studies of organic solid forms. PMID:27484368
Nasiri, Noushin; Bo, Renheng; Fu, Lan; Tricoli, Antonio
2017-02-02
Visible-blind ultraviolet photodetectors are a promising emerging technology for the development of wide bandgap optoelectronic devices with greatly reduced power consumption and size requirements. A standing challenge is to improve the slow response time of these nanostructured devices. Here, we present a three-dimensional nanoscale heterojunction architecture for fast-responsive visible-blind UV photodetectors. The device layout consists of p-type NiO clusters densely packed on the surface of an ultraporous network of electron-depleted n-type ZnO nanoparticles. This 3D structure can detect very low UV light densities while operating with a near-zero power consumption of ca. 4 × 10 -11 watts and a low bias of 0.2 mV. Most notably, heterojunction formation decreases the device rise and decay times by 26 and 20 times, respectively. These drastic enhancements in photoresponse dynamics are attributed to the stronger surface band bending and improved electron-hole separation of the nanoscale NiO/ZnO interface. These findings demonstrate a superior structural design and a simple, low-cost CMOS-compatible process for the engineering of high-performance wearable photodetectors.
Analysis for the Progressive Failure Response of Textile Composite Fuselage Frames
NASA Technical Reports Server (NTRS)
Johnson, Eric R.; Boitnott, Richard L. (Technical Monitor)
2002-01-01
A part of aviation accident mitigation is a crash worthy airframe structure, and an important measure of merit for a crash worthy structure is the amount of kinetic energy that can be absorbed in the crush of the structure. Prediction of the energy absorbed from finite element analyses requires modeling the progressive failure sequence. Progressive failure modes may include material degradation, fracture and crack growth, and buckling and collapse. The design of crash worthy airframe components will benefit from progressive failure analyses that have been validated by tests. The subject of this research is the development of a progressive failure analysis for textile composite. circumferential fuselage frames subjected to a quasi-static, crash-type load. The test data for these frames are reported, and these data, along with stub column test data, are to be used to develop and to validate methods for the progressive failure response.
Probabilistic safety analysis of earth retaining structures during earthquakes
NASA Astrophysics Data System (ADS)
Grivas, D. A.; Souflis, C.
1982-07-01
A procedure is presented for determining the probability of failure of Earth retaining structures under static or seismic conditions. Four possible modes of failure (overturning, base sliding, bearing capacity, and overall sliding) are examined and their combined effect is evaluated with the aid of combinatorial analysis. The probability of failure is shown to be a more adequate measure of safety than the customary factor of safety. As Earth retaining structures may fail in four distinct modes, a system analysis can provide a single estimate for the possibility of failure. A Bayesian formulation of the safety retaining walls is found to provide an improved measure for the predicted probability of failure under seismic loading. The presented Bayesian analysis can account for the damage incurred to a retaining wall during an earthquake to provide an improved estimate for its probability of failure during future seismic events.
Ix, Joachim H; Katz, Ronit; Bansal, Nisha; Foster, Meredith; Weiner, Daniel E; Tracy, Russell; Jotwani, Vasantha; Hughes-Austin, Jan; McKay, Dianne; Gabbai, Francis; Hsu, Chi-Yuan; Bostom, Andrew; Levey, Andrew S; Shlipak, Michael G
2017-03-01
Kidney tubulointerstitial fibrosis marks risk for allograft failure in kidney transplant recipients, but is poorly captured by estimated glomerular filtration rate (eGFR) or urine albumin-creatinine ratio (ACR). Whether urinary markers of tubulointerstitial fibrosis can noninvasively identify risk for allograft failure above and beyond eGFR and ACR is unknown. Case-cohort study. The FAVORIT (Folic Acid for Vascular Outcome Reduction in Transplantation) Trial was a randomized double-blind trial testing vitamin therapy to lower homocysteine levels in stable kidney transplant recipients. We selected a subset of participants at random (n=491) and all individuals with allograft failure during follow-up (cases; n=257). Using spot urine specimens from the baseline visit, we measured 4 urinary proteins known to correlate with tubulointerstitial fibrosis on biopsy (urine α 1 -microglobulin [A1M], monocyte chemoattractant protein 1 [MCP-1], and procollagen type III and type I amino-terminal amino pro-peptide). Death-censored allograft failure. In models adjusted for demographics, chronic kidney disease risk factors, eGFR, and ACR, higher concentrations of urine A1M (HR per doubling, 1.73; 95% CI, 1.43-2.08) and MCP-1 (HR per doubling, 1.60; 95% CI, 1.32-1.93) were strongly associated with allograft failure. When additionally adjusted for concentrations of other urine fibrosis and several urine injury markers, urine A1M (HR per doubling, 1.76; 95% CI, 1.27-2.44]) and MCP-1 levels (HR per doubling, 1.49; 95% CI, 1.17-1.89) remained associated with allograft failure. Urine procollagen type III and type I levels were not associated with allograft failure. We lack kidney biopsy data, BK titers, and HLA antibody status. Urine measurement of tubulointerstitial fibrosis may provide a noninvasive method to identify kidney transplant recipients at higher risk for future allograft failure, above and beyond eGFR and urine ACR. Published by Elsevier Inc.
Interior shadings for office indoor visual comfort in humid climate region
NASA Astrophysics Data System (ADS)
Dinapradipta, Asri; Sudarma, Erwin; Defiana, Ima; Erwindi, Collinthia
2018-03-01
As part of the fenestration system, the interior shadings have also a role to control the indoor environment to maintain indoor visual comfort. As the occupants have personal access to control these, their control behavior then, might enhance or even worsen indoor comfort performance. The controlling behavior might not only influence indoor comfort performance but can also indicate the success or failure of interior shading as a control device element. This paper is intended to report control behavior patterns, as represented by the variety of the slats’ openings of two types of interior shading i.e. Venetian and Vertical blinds and to analyze these on the concurrent impacts to indoor office building’s indoor illuminance and luminance distribution. The purpose of this research is to figure out the shading control patterns as well as to examine the effectiveness of these two types of interior shadings to control indoor visual environment. This study is a quantitative research using experimentation on the slats’ opening of two types of shadings at two identical office rooms. The research results suggested that both types of blinds seem unsuitable for gaining proper illumination values at work planes in humid tropics area. However, these shadings demonstrate good performance for luminance distribution except for that of the closed Venetian blinds.
Simple minds: a qualified defence of associative learning
Heyes, Cecilia
2012-01-01
Using cooperation in chimpanzees as a case study, this article argues that research on animal minds needs to steer a course between ‘association-blindness’—the failure to consider associative learning as a candidate explanation for complex behaviour—and ‘simple-mindedness’—the assumption that associative explanations trump more cognitive hypotheses. Association-blindness is challenged by the evidence that associative learning occurs in a wide range of taxa and functional contexts, and is a major force guiding the development of complex human behaviour. Furthermore, contrary to a common view, association-blindness is not entailed by the rejection of behaviourism. Simple-mindedness is founded on Morgan's canon, a methodological principle recommending ‘lower’ over ‘higher’ explanations for animal behaviour. Studies in the history and philosophy of science show that Morgan failed to offer an adequate justification for his canon, and subsequent attempts to justify the canon using evolutionary arguments and appeals to simplicity have not been successful. The weaknesses of association-blindness and simple-mindedness imply that there are no short-cuts to finding out about animal minds. To decide between associative and yet more cognitive explanations for animal behaviour, we have to spell them out in sufficient detail to allow differential predictions, and to test these predictions through observation and experiment. PMID:22927568
2013-01-01
REPORT Friction Stir Weld Failure Mechanisms in Aluminum -Armor Structures Under Ballistic Impact Loading Conditions 14. ABSTRACT 16. SECURITY...Stir Weld Failure Mechanisms in Aluminum -Armor Structures Under Ballistic Impact Loading Conditions M. Grujicic, B. Pandurangan, A. Arakere, C-F. Yen...K.O. Pedersen, Fracture Mechanisms of Aluminum Alloy AA7075-T651 Under Various Loading Conditions , Int. J. Impact Eng., 2010, 37, p 537–551 24. T
Hazir, Tabish; Nisar, Yasir Bin; Abbasi, Saleem; Ashraf, Yusra Pervaiz; Khurshid, Joza; Tariq, Perveen; Asghar, Rai; Murtaza, Asifa; Masood, Tahir; Maqbool, Sajid
2011-02-01
world Health Organization (WHO) acute respiratory illness case management guidelines classify children with fast breathing as having pneumonia and recommend treatment with an antibiotic. There is concern that many of these children may not have pneumonia and are receiving antibiotics unnecessarily. This could increase antibiotic resistance in the community. The aim was to compare the clinical outcome at 72 h in children with WHO-defined nonsevere pneumonia when treated with amoxicillin, compared with placebo. we performed a double-blind, randomized, equivalence trial in 4 tertiary hospitals in Pakistan. Nine hundred children aged 2-59 months with WHO defined nonsevere pneumonia were randomized to receive either 3 days of oral amoxicillin (45mg/kg/day) or placebo; 873 children completed the study. All children were followed up on days 3, 5, and 14. The primary outcome was therapy failure defined a priori at 72 h. in per-protocol analysis at day 3, 31 (7.2%) of the 431 children in the amoxicillin arm and 37 (8.3%) of the 442 in placebo group had therapy failure. This difference was not statistically significant (odds ratio [OR], .85; 95%CI, .50-1.43; P = .60). The multivariate analysis identified history of difficult breathing (OR, 2.86; 95% CI, 1.29-7.23; P = .027) and temperature >37.5°C 100°F at presentation (OR, 1.99; 95% CI, 1.37-2.90; P = .0001) as risk factors for treatment failure by day 5. clinical outcome in children aged 2-59 months with WHO-defined nonsevere pneumonia is not different when treated with an antibiotic or placebo. Similar trials are needed in countries with a high burden of pneumonia to rationalize the use of antibiotics in these communities.
Thermal clothing to reduce heart failure morbidity during winter: a randomised controlled trial
Stewart, Ian; Beevers, Andrea; Fraser, John F; Platts, David
2017-01-01
Objective To examine whether providing thermal clothing improved the health of patients with heart failure during winter. Design Parallel group randomised controlled trial. Setting Large public hospital in Brisbane during winter 2016. Participants 91 patients with systolic or diastolic heart failure who were over 50 years old. Intervention 47 patients were randomised to receive thermal clothes (socks, top and hat) and 44 received usual care. Patients could not be blinded to their randomised group. All patients’ data were available for the primary outcome which was collected blind to randomised group. Main outcome measures The primary outcome was the mean number of days in hospital during winter. Secondary outcomes included quality of life and sleep, and blood tests were collected for cardiovascular risk factors. Participants completed clothing diaries in midwinter which were used to estimate their overall clothing insulation using the ‘clo’. Monitors inside the participants’ homes recorded indoor temperatures throughout winter. Results The mean number of days in hospital during winter was 4.2 in the usual care group and 3.0 in the thermal clothing group (mean difference –1.2 days, 95% CI –4.8 to 2.5 days). Most participants (85%) in the thermal clothing group reported using the thermals. There was an increase in overall clothing insulation at night in the thermal clothing group (mean difference 0.13 clo, 95% CI 0.03 to 0.23). Most participants in both groups did not wear sufficient clothing (defined as a clo below 1) and regularly experienced indoor temperatures below 18°C during midwinter. Conclusions There was no clear statistical improvement in health in the thermal clothing group. Efforts to improve health during winter may need to focus on passive interventions such as home insulation rather than interventions that target behaviour change. Trial registration number ACTRN12615001023549; Results. PMID:28993390
Thermal clothing to reduce heart failure morbidity during winter: a randomised controlled trial.
Barnett, Adrian Gerard; Stewart, Ian; Beevers, Andrea; Fraser, John F; Platts, David
2017-10-08
To examine whether providing thermal clothing improved the health of patients with heart failure during winter. Parallel group randomised controlled trial. Large public hospital in Brisbane during winter 2016. 91 patients with systolic or diastolic heart failure who were over 50 years old. 47 patients were randomised to receive thermal clothes (socks, top and hat) and 44 received usual care. Patients could not be blinded to their randomised group. All patients' data were available for the primary outcome which was collected blind to randomised group. The primary outcome was the mean number of days in hospital during winter. Secondary outcomes included quality of life and sleep, and blood tests were collected for cardiovascular risk factors. Participants completed clothing diaries in midwinter which were used to estimate their overall clothing insulation using the 'clo'. Monitors inside the participants' homes recorded indoor temperatures throughout winter. The mean number of days in hospital during winter was 4.2 in the usual care group and 3.0 in the thermal clothing group (mean difference -1.2 days, 95% CI -4.8 to 2.5 days). Most participants (85%) in the thermal clothing group reported using the thermals. There was an increase in overall clothing insulation at night in the thermal clothing group (mean difference 0.13 clo, 95% CI 0.03 to 0.23). Most participants in both groups did not wear sufficient clothing (defined as a clo below 1) and regularly experienced indoor temperatures below 18°C during midwinter. There was no clear statistical improvement in health in the thermal clothing group. Efforts to improve health during winter may need to focus on passive interventions such as home insulation rather than interventions that target behaviour change. ACTRN12615001023549; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Barron, Anthony J.; Zaman, Nabeela; Cole, Graham D.; Wensel, Roland; Okonko, Darlington O.; Francis, Darrel P.
2013-01-01
Background Patients trying life-preserving agents such as beta-blockers may be discouraged by listings of harmful effects provided in good faith by doctors, drug information sheets, and media. We systematically review the world experience of side-effect information in blinded, placebo-controlled beta-blockade in heart failure. We present information for a physician advising a patient experiencing an unwanted symptom and suspecting the drug. Methods We searched Medline for double-blinded randomized trials of beta-blocker versus placebo in heart failure reporting side-effects. We calculated, per 100 patients reporting the symptom on beta-blockade, how many would have experienced it on placebo: the “proportion of symptoms non-pharmacological”. Results 28 of the 33 classically-described side-effects are not significantly more common on beta-blockers than placebo. Of the 100 patients developing dizziness on beta-blockers, 81 (95% CI 73–89) would have developed it on placebo. For diarrhoea this proportion is 82/100 (70–95), and hyperglycaemia 83/100 (68–98). For only two side-effects is this under half (i.e. predominantly due to beta-blocker): bradycardia (33/100, CI 21–44) and intermittent claudication (41/100, 2–81). At least 6 so-called side-effects are less common on beta-blocker than placebo, including depression (reduced by 35%, p < 0.01) and insomnia (by 27%, p = 0.01). Conclusions Clinicians might reconsider whether it is scientifically and ethically correct to warn a patient that a drug might cause them a certain side-effect, when randomized controlled trials show no significant increase, or indeed a significant reduction. A better informed consultation could, in patients taking beta-blockers, alleviate suffering. In patients who might otherwise not take the drug, it might prevent deaths. PMID:23796325
A controlled clinical trial of vitamin E supplementation in patients with congestive heart failure.
Keith, M E; Jeejeebhoy, K N; Langer, A; Kurian, R; Barr, A; O'Kelly, B; Sole, M J
2001-02-01
Oxidative stress is increased in patients with congestive heart failure and can contribute to the progressive deterioration observed in these patients. Increased oxidative stress is the result of either an increased production of free radicals or a depletion of endogenous antioxidants, such as vitamin E. We aimed to determine whether vitamin E supplementation of patients with advanced heart failure would modify levels of oxidative stress, thereby preventing or delaying the deterioration associated with free radical injury. Fifty-six outpatients with advanced heart failure (New York Heart Association functional class III or IV) were enrolled in a double-blind randomized controlled trial for 12 wk. At a baseline visit and at 2 follow-up visits, blood and breath samples were collected for the measurement of indexes of heart function and disease state, including malondialdehyde, isoprostanes, and breath pentane and ethane. Quality of life was also assessed at baseline and after 12 wk of treatment. Vitamin E treatment significantly increased plasma concentrations of alpha-tocopherol in the treatment group but failed to significantly affect any other marker of oxidative stress or quality of life. In addition, concentrations of atrial natriuretic peptide (a humoral marker of ventricular dysfunction), neurohormonal-cytokine markers of prognosis, tumor necrosis factor, epinephrine, and norepinephrine were unchanged with treatment and were not significantly different from those in the control group. Supplementation with vitamin E did not result in any significant improvements in prognostic or functional indexes of heart failure or in the quality of life of patients with advanced heart failure.
Arnold, Amy C.; Okamoto, Luis E.; Gamboa, Alfredo; Shibao, Cyndya; Raj, Satish R.; Robertson, David; Biaggioni, Italo
2013-01-01
At least half of primary autonomic failure patients exhibit supine hypertension, despite profound impairments in sympathetic activity. While the mechanisms underlying this hypertension are unknown, plasma renin activity is often undetectable suggesting renin-angiotensin pathways are not involved. However, because aldosterone levels are preserved, we tested the hypothesis that angiotensin II is intact and contributes to the hypertension of autonomic failure. Indeed, circulating angiotensin II was paradoxically increased in hypertensive autonomic failure patients (52±5 pg/ml, n=11) compared to matched healthy controls (27±4 pg/ml, n=10; p=0.002), despite similarly low renin activity (0.19±0.06 versus 0.34±0.13 ng/ml/hr, respectively; p=0.449). To determine the contribution of angiotensin II to supine hypertension in these patients, we administered the AT1 receptor blocker losartan (50 mg) at bedtime in a randomized, double-blind, placebo-controlled study (n=11). Losartan maximally reduced systolic blood pressure by 32±11 mmHg at 6 hours after administration (p<0.05), decreased nocturnal urinary sodium excretion (p=0.0461), and did not worsen morning orthostatic tolerance. In contrast, there was no effect of the captopril on supine blood pressure in a subset of these patients. These findings suggest that angiotensin II formation in autonomic failure is independent of plasma renin activity, and perhaps angiotensin converting enzyme. Furthermore, these studies suggest that elevations in angiotensin II contribute to the hypertension of autonomic failure, and provide rationale for the use of AT1 receptor blockers for treatment of these patients. PMID:23266540
Khoury, George A; Smadbeck, James; Kieslich, Chris A; Koskosidis, Alexandra J; Guzman, Yannis A; Tamamis, Phanourios; Floudas, Christodoulos A
2017-06-01
Protein structure refinement is the challenging problem of operating on any protein structure prediction to improve its accuracy with respect to the native structure in a blind fashion. Although many approaches have been developed and tested during the last four CASP experiments, a majority of the methods continue to degrade models rather than improve them. Princeton_TIGRESS (Khoury et al., Proteins 2014;82:794-814) was developed previously and utilizes separate sampling and selection stages involving Monte Carlo and molecular dynamics simulations and classification using an SVM predictor. The initial implementation was shown to consistently refine protein structures 76% of the time in our own internal benchmarking on CASP 7-10 targets. In this work, we improved the sampling and selection stages and tested the method in blind predictions during CASP11. We added a decomposition of physics-based and hybrid energy functions, as well as a coordinate-free representation of the protein structure through distance-binning Cα-Cα distances to capture fine-grained movements. We performed parameter estimation to optimize the adjustable SVM parameters to maximize precision while balancing sensitivity and specificity across all cross-validated data sets, finding enrichment in our ability to select models from the populations of similar decoys generated for targets in CASPs 7-10. The MD stage was enhanced such that larger structures could be further refined. Among refinement methods that are currently implemented as web-servers, Princeton_TIGRESS 2.0 demonstrated the most consistent and most substantial net refinement in blind predictions during CASP11. The enhanced refinement protocol Princeton_TIGRESS 2.0 is freely available as a web server at http://atlas.engr.tamu.edu/refinement/. Proteins 2017; 85:1078-1098. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
75 FR 31731 - Airworthiness Directives; Bombardier, Inc. Model BD-700-1A10 and BD-700-1A11 Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-04
... turbine imbalance. Such imbalance could potentially result in RAT structural failure (including blade... turbine imbalance. Such imbalance could potentially result in RAT structural failure (including blade... reported cases of balance washer screw failure on similar RATs [ram air turbines]/air driven generators...
NASA Astrophysics Data System (ADS)
Wang, Zhiyuan
Solar-blind ultraviolet detection refers to photon detection specifically in the wavelength range of 200 nm to 320 nm. Without background noises from solar radiation, it has broad applications from homeland security to environmental monitoring. In this thesis, we design and fabricate a nanophotonic metal-oxide-semiconductor device for solar-blind UV detection. Instead of using semiconductors as the active absorber, we use metal Sn nano- grating structures to absorb UV photons and generate hot electrons for internal photoemission across the Sn/SiO 2 interfacial barrier, thereby generating photocurrent between metal and semiconductor region upon UV excitation. The large metal/oxide interfacial energy barrier enables solar-blind UV detection by blocking the less energetic electrons excited by visible photons. With optimized design, 85% UV absorption and hot electron excitation can be achieved within the mean free path of 20 nm from the metal/oxide interface. This feature greatly enhances hot electron transport across the interfacial barrier to generate photocurrent. Various fabrication techniques have been developed for preparing nano gratings. For nominally 20 nm-thick deposited Sn, the self- formed pseudo-periodic nanostructure help achieve 75% UV absorption from lambda=200 nm to 300 nm. With another layer of nominally 20 nm-thick Sn, similar UV absorption is maintained while conductivity is improved, which is beneficial for overall device efficiency. The Sn/SiO2/Si MOS devices show good solar-blind character while achieving 13% internal quantum efficiency for 260 nm UV with only 20 nm-thick Sn and some devices demonstrate much higher (even >100%) internal quantum efficiency. While a more accurate estimation of device effective area is needed for proving our calculation, these results indeed show a great potential for this type of hot-electron-based photodetectors and for Sn nanostructure as an effective UV absorber. The simple geometry of the self- assembled Sn nano-gratings and MOS structure make this novel type of device easy to fabricate and integrate with Si ROICs compared to existing solar-blind UV detection schemes. The presented device structure also breaks through the conventional notion that photon absorption by metal is always a loss in solid-state photodetectors, and it can potentially be extended to other active metal photonic devices.
Mabaso, Raymond G; Oduntan, Olalekan A
2014-11-21
Diabetes mellitus (DM) is a common systemic disease amongst Black South Africans. It may lead to diabetic retinopathy (DR), a common cause of visual impairment (VI) and blindness. DR may signifiantly increase the prevalence of VI and blindness. To assess risk factors for VI and blindness amongst a black diabetic South African population aged ≥ 40 years. The study was conducted in seven Government healthcare facilities (two hospitals, four clinics and one health centre) in Mopani District, Limpopo province, South Africa. This was a cross-sectional health facility-based quantitative study. Structured interviews were used to obtain information, which included sociodemographic profie, knowledge about DM and its ocular complications, presence of hypertension and accessibility to health facilities. Subsequently participants were examined for VI and blindness using an autorefractor, pinhole disc, ophthalmoscope and logMAR visual acuity chart. Anthropometric measurements (height, weight and waist) were also taken. Associations between 31 risk factors and VI as well as blindness were statistically examined. Participants (N = 225) included 161 women and 64 men aged 40-90 years (mean 61.5 ± 10.49 years); 41.3% of them had VI and 3.6% were blind. Cataracts (76.8%) and DR (7.1%) were the common causes of compensated VI and blindness. Risk factors that were associated with VI and blindness were age, monthly income, compliance with losing weight and physical activity. Findings suggest that lifestyle intervention and appropriate eyecare programmes may reduce VI and blindness in this population.
Oduntan, Olalekan A.
2014-01-01
Abstract Background Diabetes mellitus (DM) is a common systemic disease amongst Black South Africans. It may lead to diabetic retinopathy (DR), a common cause of visual impairment (VI) and blindness. DR may significantly increase the prevalence of VI and blindness. Aim To assess risk factors for VI and blindness amongst a black diabetic South African population aged ≥ 40 years. Setting The study was conducted in seven Government healthcare facilities (two hospitals, four clinics and one health centre) in Mopani District, Limpopo province, South Africa. Methods This was a cross-sectional health facility-based quantitative study. Structured interviews were used to obtain information, which included sociodemographic profile, knowledge about DM and its ocular complications, presence of hypertension and accessibility to health facilities. Subsequently participants were examined for VI and blindness using an autorefractor, pinhole disc, ophthalmoscope and logMAR visual acuity chart. Anthropometric measurements (height, weight and waist) were also taken. Associations between 31 risk factors and VI as well as blindness were statistically examined. Results Participants (N = 225) included 161 women and 64 men aged 40–90 years (mean 61.5 ± 10.49 years); 41.3% of them had VI and 3.6% were blind. Cataracts (76.8%) and DR (7.1%) were the common causes of compensated VI and blindness. Risk factors that were associated with VI and blindness were age, monthly income, compliance with losing weight and physical activity. Conclusion Findings suggest that lifestyle intervention and appropriate eyecare programmes may reduce VI and blindness in this population. PMID:26245418
Reliability and mode of failure of bonded monolithic and multilayer ceramics.
Alessandretti, Rodrigo; Borba, Marcia; Benetti, Paula; Corazza, Pedro Henrique; Ribeiro, Raissa; Della Bona, Alvaro
2017-02-01
To evaluate the reliability of monolithic and multilayer ceramic structures used in the CAD-on technique (Ivoclar), and the mode of failure produced in ceramic structures bonded to a dentin analog material (NEMA-G10). Ceramic specimens were fabricated as follows (n=30): CAD-on- trilayer structure (IPS e.max ZirCAD/IPS e.max Crystall./Connect/IPS e.max CAD); YLD- bilayer structure (IPS e.max ZirCAD/IPS e.max Ceram); LDC- monolithic structure (IPS e.max CAD); and YZW- monolithic structure (Zenostar Zr Translucent). All ceramic specimens were bonded to G10 and subjected to compressive load in 37°C distilled water until the sound of the first crack, monitored acoustically. Failure load (L f ) values were recorded (N) and statistically analyzed using Weibull distribution, Kruskal-Wallis test, and Student-Newman-Keuls test (α=0.05). L f values of CAD-on and YZW structures were statistically similar (p=0.917), but higher than YLD and LDC (p<0.01). Weibull modulus (m) values were statistically similar for all experimental groups. Monolithic structures (LDC and YZW) failed from radial cracks. Failures in the CAD-on and YLD groups showed, predominantly, both radial and cone cracks. Monolithic zirconia (YZW) and CAD-on structures showed similar failure resistance and reliability, but a different fracture behavior. Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
Fan, Ruoxun; Liu, Jie; Jia, Zhengbin; Deng, Ying; Liu, Jun
2018-01-01
Macro-level failure in bone structure could be diagnosed by pain or physical examination. However, diagnosing tissue-level failure in a timely manner is challenging due to the difficulty in observing the interior mechanical environment of bone tissue. Because most fractures begin with tissue-level failure in bone tissue caused by continually applied loading, people attempt to monitor the tissue-level failure of bone and provide corresponding measures to prevent fracture. Many tissue-level mechanical parameters of bone could be predicted or measured; however, the value of the parameter may vary among different specimens belonging to a kind of bone structure even at the same age and anatomical site. These variations cause difficulty in representing tissue-level bone failure. Therefore, determining an appropriate tissue-level failure evaluation standard is necessary to represent tissue-level bone failure. In this study, the yield and failure processes of rat femoral cortical bones were primarily simulated through a hybrid computational-experimental method. Subsequently, the tissue-level strains and the ratio between tissue-level failure and yield strains in cortical bones were predicted. The results indicated that certain differences existed in tissue-level strains; however, slight variations in the ratio were observed among different cortical bones. Therefore, the ratio between tissue-level failure and yield strains for a kind of bone structure could be determined. This ratio may then be regarded as an appropriate tissue-level failure evaluation standard to represent the mechanical status of bone tissue.
Exenatide and the treatment of patients with Parkinson’s disease
Aviles-Olmos, Iciar; Dickson, John; Kefalopoulou, Zinovia; Djamshidian, Atbin; Ell, Peter; Soderlund, Therese; Whitton, Peter; Wyse, Richard; Isaacs, Tom; Lees, Andrew; Limousin, Patricia; Foltynie, Thomas
2013-01-01
Background. There is increasing interest in methods to more rapidly and cost-efficiently investigate drugs that are approved for clinical use in the treatment of another condition. Exenatide is a type 2 diabetes treatment that has been shown to have neuroprotective/neurorestorative properties in preclinical models of neurodegeneration. Methods. As a proof of concept, using a single-blind trial design, we evaluated the progress of 45 patients with moderate Parkinson’s disease (PD), randomly assigned to receive subcutaneous exenatide injection for 12 months or to act as controls. Their PD was compared after overnight withdrawal of conventional PD medication using blinded video assessment of the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), together with several nonmotor tests, at baseline, 6 months, and 12 months and after a further 2-month washout period (14 months). Results. Exenatide was well tolerated, although weight loss was common and l-dopa dose failures occurred in a single patient. Single-blinded rating of the exenatide group suggested clinically relevant improvements in PD across motor and cognitive measures compared with the control group. Exenatide-treated patients had a mean improvement at 12 months on the MDS-UPDRS of 2.7 points, compared with mean decline of 2.2 points in control patients (P = 0.037). Conclusion. These results demonstrate a potential cost-efficient approach through which preliminary clinical data of possible biological effects are obtainable, prior to undertaking the major investment required for double-blind trials of a potential disease-modifying drug in PD. Trial registration. Clinicaltrials.gov NCT01174810. Funding. Cure Parkinson’s Trust. PMID:23728174
Ponikowski, Piotr; van Veldhuisen, Dirk J; Comin-Colet, Josep; Ertl, Georg; Komajda, Michel; Mareev, Viacheslav; McDonagh, Theresa A; Parkhomenko, Alexander; Tavazzi, Luigi; Levesque, Victoria; Mori, Claudio; Roubert, Bernard; Filippatos, Gerasimos; Ruschitzka, Frank; Anker, Stefan D
2014-09-01
Iron deficiency (ID) is a common co-morbidity associated with chronic heart failure (CHF), which has unfavourable clinical and prognostic consequences. In Ferinject Assessment in Patients with IRon Deficiency and Chronic Heart Failure (FAIR-HF), the treatment with i.v. ferric carboxymaltose (FCM) improved symptoms and quality of life over a 24 week period. Ferric CarboxymaltOse evaluatioN on perFormance in patients with IRon deficiency in coMbination with chronic Heart Failure (CONFIRM-HF) was designed to test a simplifieddosage scheme of FCM during a longer follow-up period. CONFIRM-HF, a double-blind, multi-centre, prospective, randomized, two-arm study, enrolled ambulatory patients with symptomatic CHF [New York Heart Association (NYHA) class II/III] with left ventricular ejection fraction ≤45%, BNP >100 pg/mL, or NT-proBNP >400 pg/mL, presence of ID [defined as ferritin <100 ng/mL, or ferritin 100-300 ng/mL if transferrin saturation (TSAT) <20%], and haemoglobin (Hb) <15 g/dL. Patients were randomized 1:1 to treatment with FCM or placebo for 52 weeks. Primary endpoint is change in 6-minute walk test (6MWT) distance from baseline to Week 24. Secondary endpoints are: change in 6MWT from baseline to Weeks 6, 12, 36, and 52; Patient Global Assessment score at Weeks 6, 12, 24, 36, and 52; and change from baseline to Weeks 6, 12, 24, 36, and 52 in NYHA class, fatigue score, and quality of life. Safety endpoints include overall safety over the treatment period of 52 weeks. Study medication was administered in single doses as undiluted bolus injection of up to 1000 mg of iron or normal saline at Day 0 and Week 6 up to iron repletion. Further doses of study medication could be administered at Weeks 12, 24, and 36 if a patient still had ID. Overall, 304 patients were recruited in 41 centres in nine countries. This study will provide further information on the efficacy and safety of iron therapy with i.v. FCM in CHF patients with ID over a 1 year period using a simplified dosing scheme. © 2014 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
NASA Technical Reports Server (NTRS)
Dorris, William J.; Hairr, John W.; Huang, Jui-Tien; Ingram, J. Edward; Shah, Bharat M.
1992-01-01
Non-linear analysis methods were adapted and incorporated in a finite element based DIAL code. These methods are necessary to evaluate the global response of a stiffened structure under combined in-plane and out-of-plane loading. These methods include the Arc Length method and target point analysis procedure. A new interface material model was implemented that can model elastic-plastic behavior of the bond adhesive. Direct application of this method is in skin/stiffener interface failure assessment. Addition of the AML (angle minus longitudinal or load) failure procedure and Hasin's failure criteria provides added capability in the failure predictions. Interactive Stiffened Panel Analysis modules were developed as interactive pre-and post-processors. Each module provides the means of performing self-initiated finite elements based analysis of primary structures such as a flat or curved stiffened panel; a corrugated flat sandwich panel; and a curved geodesic fuselage panel. This module brings finite element analysis into the design of composite structures without the requirement for the user to know much about the techniques and procedures needed to actually perform a finite element analysis from scratch. An interactive finite element code was developed to predict bolted joint strength considering material and geometrical non-linearity. The developed method conducts an ultimate strength failure analysis using a set of material degradation models.
Kim, Gangmi
2015-10-14
Acupuncture is a widely serviced complementary medicine. Although acupuncture is suggested for managing postoperative ileus and pain, supporting evidence is weak. The AcuLap trial is designed to provide high-level evidence regarding whether or not electroacupuncture is effective in promoting gastrointestinal motility and controlling pain after laparoscopic surgery. This study is a prospective randomized controlled trial with a three-arm, parallel-group structure evaluating the efficacy of electroacupuncture for gastrointestinal motility and postoperative pain after laparoscopic appendectomy. Patients with appendicitis undergoing laparoscopic surgery are included and randomized into three groups: 1) electroacupuncture group, 2) sham acupuncture group, and 3) control group. Patients receive 1) acupuncture with electrostimulation or 2) fake electroacupuncture with sham device twice a day or 3) no acupuncture after laparoscopic appendectomy. The primary outcome is time to first passing flatus after operation. Secondary outcomes include postoperative pain, analgesics, nausea/vomiting, bowel motility, time to tolerable diet, complications, hospital stay, readmission rates, time to recovery, quality of life, medical costs, and protocol failure rate. Patients and hospital staff (physicians and nurses) are blinded to which group the patient is assigned, electroacupuncture or sham acupuncture. Data analysis personnel are blinded to group assignment among all three groups. Estimated sample size to detect a minimum difference of time to first flatus with 80 % power, 5 % significance, and 10 % drop rate is 29 × 3 groups = 87 patients. Analysis will be performed according to the intention-to-treat principle. The AcuLap trial will provide evidence on the merits and/or demerits of electroacupuncture for bowel motility recovery and pain relief after laparoscopic appendectomy. The trial was registered in Clinical Research Information Service (CRiS), Republic of Korea ( KCT0001486 ) on 14 May 2015.
Energy Efficiency and Renewables: Market and Behavioral Failures
James Sweeney
2017-12-09
Thursday, January 28, 2010: Policies to promote renewable energy and energy efficiency have been gaining momentum throughout the world, often justified by environmental and energy security concerns. This presentation first talks about energy efficiency options, then delves into the economic motivation for energy efficiency and renewable energy policies by articulating the classes of relevant behavioral failures and market failures. Such behavioral and market failures may vary intertemporally or atemporally; the temporal structure and the extent of the failures are the critical considerations in the development of energy policies. The talk discusses key policy instruments and assess the extent to which they are well-suited to correct for failures with different structures. http://eetd.lbl.gov/dls/lecture-01-28...
NASA Astrophysics Data System (ADS)
Xue, Fei; Bompard, Ettore; Huang, Tao; Jiang, Lin; Lu, Shaofeng; Zhu, Huaiying
2017-09-01
As the modern power system is expected to develop to a more intelligent and efficient version, i.e. the smart grid, or to be the central backbone of energy internet for free energy interactions, security concerns related to cascading failures have been raised with consideration of catastrophic results. The researches of topological analysis based on complex networks have made great contributions in revealing structural vulnerabilities of power grids including cascading failure analysis. However, existing literature with inappropriate assumptions in modeling still cannot distinguish the effects between the structure and operational state to give meaningful guidance for system operation. This paper is to reveal the interrelation between network structure and operational states in cascading failure and give quantitative evaluation by integrating both perspectives. For structure analysis, cascading paths will be identified by extended betweenness and quantitatively described by cascading drop and cascading gradient. Furthermore, the operational state for cascading paths will be described by loading level. Then, the risk of cascading failure along a specific cascading path can be quantitatively evaluated considering these two factors. The maximum cascading gradient of all possible cascading paths can be used as an overall metric to evaluate the entire power grid for its features related to cascading failure. The proposed method is tested and verified on IEEE30-bus system and IEEE118-bus system, simulation evidences presented in this paper suggests that the proposed model can identify the structural causes for cascading failure and is promising to give meaningful guidance for the protection of system operation in the future.
Blindness alters the microstructure of the ventral but not the dorsal visual stream.
Reislev, Nina L; Kupers, Ron; Siebner, Hartwig R; Ptito, Maurice; Dyrby, Tim B
2016-07-01
Visual deprivation from birth leads to reorganisation of the brain through cross-modal plasticity. Although there is a general agreement that the primary afferent visual pathways are altered in congenitally blind individuals, our knowledge about microstructural changes within the higher-order visual streams, and how this is affected by onset of blindness, remains scant. We used diffusion tensor imaging and tractography to investigate microstructural features in the dorsal (superior longitudinal fasciculus) and ventral (inferior longitudinal and inferior fronto-occipital fasciculi) visual pathways in 12 congenitally blind, 15 late blind and 15 normal sighted controls. We also studied six prematurely born individuals with normal vision to control for the effects of prematurity on brain connectivity. Our data revealed a reduction in fractional anisotropy in the ventral but not the dorsal visual stream for both congenitally and late blind individuals. Prematurely born individuals, with normal vision, did not differ from normal sighted controls, born at term. Our data suggest that although the visual streams are structurally developing without normal visual input from the eyes, blindness selectively affects the microstructure of the ventral visual stream regardless of the time of onset. We suggest that the decreased fractional anisotropy of the ventral stream in the two groups of blind subjects is the combined result of both degenerative and cross-modal compensatory processes, affecting normal white matter development.
Detecting Blind Fault with Fractal and Roughness Factors from High Resolution LiDAR DEM at Taiwan
NASA Astrophysics Data System (ADS)
Cheng, Y. S.; Yu, T. T.
2014-12-01
There is no obvious fault scarp associated with blind fault. The traditional method of mapping this unrevealed geological structure is the cluster of seismicity. Neither the seismic event nor the completeness of cluster could be captured by network to chart the location of the entire possible active blind fault within short period of time. High resolution DEM gathered by LiDAR could denote actual terrain information despite the existence of plantation. 1-meter interval DEM of mountain region at Taiwan is utilized by fractal, entropy and roughness calculating with MATLAB code. By jointing these handing, the regions of non-sediment deposit are charted automatically. Possible blind fault associated with Chia-Sen earthquake at southern Taiwan is served as testing ground. GIS layer help in removing the difference from various geological formation, then multi-resolution fractal index is computed around the target region. The type of fault movement controls distribution of fractal index number. The scale of blind fault governs degree of change in fractal index. Landslide induced by rainfall and/or earthquake possesses larger degree of geomorphology alteration than blind fault; special treatment in removing these phenomena is required. Highly weathered condition at Taiwan should erase the possible trace remained upon DEM from the ruptured of blind fault while reoccurrence interval is higher than hundreds of years. This is one of the obstacle in finding possible blind fault at Taiwan.
Seki, Shoji; Hirano, Norikazu; Kawaguchi, Yoshiharu; Nakano, Masato; Yasuda, Taketoshi; Suzuki, Kayo; Watanabe, Kenta; Makino, Hiroto; Kanamori, Masahiko; Kimura, Tomoatsu
2017-08-01
Complications of adult spinal deformity surgery are problematic in osteoporotic individuals. We compared outcomes between Japanese patients treated perioperatively with teriparatide vs. low-dose bisphosphonates. Fifty-eight osteoporotic adult Japanese female patients were enrolled and assigned to perioperative teriparatide (33 patients) and bisphosphonate (25 patients) groups in non-blinded fashion. Pre- and post-operative X-ray and computed tomography imaging were used to assess outcome, and rates were compared between the groups and according to age. Pain scores and Oswestry Disability Indices (ODI) were calculated before and 2 years after surgery. Adjacent vertebral fractures and implant failure, fusion failure, and poor pain and ODI outcomes were significantly more common in the bisphosphonates group than the teriparatide group. Perioperative administration of teriparatide is more effective than that of low-dose bisphosphonates in preventing complications and maintaining fusion rates in osteoporotic Japanese females with spinal deformities undergoing surgery.
Moore, Michael G; Deschler, Daniel G
2007-04-01
To evaluate the effect of clopidogrel on the rate of thrombosis in a rat model for venous microvascular failure. Forty rats were treated with clopidogrel or saline control via gastric gavage in a randomized, blinded fashion. After allowing for absorption and activation, each femoral vein was isolated and a venous "tuck" procedure was performed. The bleeding time and vessel patency were subsequently evaluated. The rate of vessel thrombosis was decreased in the clopidogrel-treated group compared to controls (7.9% vs 31.4%, P < 0.025). The bleeding time was longer in the clopidogrel-treated group compared to controls (250 +/- 100 seconds vs 173 +/- 59 seconds, P < 0.015). Clopidogrel decreased the rate of thrombosis in the rat model for venous microvascular failure. The use of clopidogrel may reduce the rate of venous thrombosis after free tissue transfer and may be indicated in select patients.
Fulminant hepatic failure due to metastatic choroidal melanoma
Escobar-Valdivia, Emmanuel; Monreal-Robles, Roberto; Delgado-García, Guillermo; Hernández-Velazquez, Badir
2017-01-01
Background: Acute liver failure (ALF) as a consequence of metastatic disease is extremely uncommon. The liver is the most commonly affected organ by metastatic disease, but only a few cases of ALF in the setting of metastatic choroidal melanoma have been reported. Case Presentation: We describe the case of a 47-year-old man with right upper quadrant pain, progressive jaundice, and unintentional weight loss. He also reported that he had experienced reduced left visual acuity which progressed to blindness over 2 months. On physical examination, we found a pigmented scleral lesion in the left eye. He had a coagulopathy and, during his hospital stay, he also developed encephalopathy. The diagnosis of ALF was therefore established and was later attributed to metastatic uveal melanoma. In addition, we briefly review the relevant literature. Conclusion: Liver metastasis should be kept in mind when assessing abnormal liver function tests in patients with uveal malignant melanoma. PMID:28503286
Ahmadian, Mehdi; Dabidi Roshan, Valiollah; Ashourpore, Eadeh
2017-07-04
Taurine is an amino acid found abundantly in the heart in very high concentrations. It is assumed that taurine contributes to several physiological functions of mammalian cells, such as osmoregulation, anti-inflammation, membrane stabilization, ion transport modulation, and regulation of oxidative stress and mitochondrial protein synthesis. The objective of the current study was to evaluate the effectiveness of taurine supplementation on functional capacity, myocardial oxygen consumption, and electrical activity in patients with heart failure. In a double-blind and randomly designed study, 16 patients with heart failure were assigned to two groups: taurine (TG, n = 8) and placebo (PG, n = 8). TG received 500-mg taurine supplementation three times per day for two weeks. Significant decrease in the values of Q-T segments (p < 0.01) and significant increase in the values of P-R segments (p < 0.01) were detected following exercise post-supplementation in TG rather than in PG. Significantly higher values of taurine concentration, T wave, Q-T segment, physical capacities, and lower values of cardiovascular capacities were detected post-supplementation in TG as compared with PG (all p values <0.01). Taurine significantly enhanced the physical function and significantly reduced the cardiovascular function parameters following exercise. Our results also suggest that the short-term taurine supplementation is an effective strategy for improving some selected hemodynamic parameters in heart failure patients. Together, these findings support the view that taurine improves cardiac function and functional capacity in patients with heart failure. This idea warrants further study.
User-Defined Material Model for Progressive Failure Analysis
NASA Technical Reports Server (NTRS)
Knight, Norman F. Jr.; Reeder, James R. (Technical Monitor)
2006-01-01
An overview of different types of composite material system architectures and a brief review of progressive failure material modeling methods used for structural analysis including failure initiation and material degradation are presented. Different failure initiation criteria and material degradation models are described that define progressive failure formulations. These progressive failure formulations are implemented in a user-defined material model (or UMAT) for use with the ABAQUS/Standard1 nonlinear finite element analysis tool. The failure initiation criteria include the maximum stress criteria, maximum strain criteria, the Tsai-Wu failure polynomial, and the Hashin criteria. The material degradation model is based on the ply-discounting approach where the local material constitutive coefficients are degraded. Applications and extensions of the progressive failure analysis material model address two-dimensional plate and shell finite elements and three-dimensional solid finite elements. Implementation details and use of the UMAT subroutine are described in the present paper. Parametric studies for composite structures are discussed to illustrate the features of the progressive failure modeling methods that have been implemented.
DOT National Transportation Integrated Search
2012-12-01
Corrosion can lead to the premature deterioration and failure of transportation structures. In pre-stressed bridge structures corrosion is more severe, : leading to sudden failures when cracking is induced at pitting sites by tensile or compressive s...
Margulies, Kenneth B.; Hernandez, Adrian F.; Redfield, Margaret M.; Givertz, Michael M.; Oliveira, Guilherme H.; Cole, Robert; Mann, Douglas L.; Whellan, David J.; Kiernan, Michael S.; Felker, G. Michael; McNulty, Steven E.; Anstrom, Kevin J.; Shah, Monica R.; Braunwald, Eugene; Cappola, Thomas P.
2016-01-01
IMPORTANCE Abnormal cardiac metabolism contributes to the pathophysiology of advanced heart failure with reduced left ventricular ejection fraction (LVEF). Glucagon-like peptide 1 (GLP-1) agonists have shown cardioprotective effects in early clinical studies of patients with advanced heart failure, irrespective of type 2 diabetes status. OBJECTIVE To test whether therapy with a GLP-1 agonist improves clinical stability following hospitalization for acute heart failure. DESIGN, SETTING, AND PARTICIPANTS Phase 2, double-blind, placebo-controlled randomized clinical trial of patients with established heart failure and reduced LVEF who were recently hospitalized. Patients were enrolled between August 2013 and March 2015 at 24 US sites. INTERVENTIONS The GLP-1 agonist liraglutide (n = 154) or placebo (n = 146) via a daily subcutaneous injection; study drug was advanced to a dosage of 1.8 mg/d during the first 30 days as tolerated and continued for 180 days. MAIN OUTCOMES AND MEASURES The primary end point was a global rank score in which all patients, regardless of treatment assignment, were ranked across 3 hierarchical tiers: time to death, time to rehospitalization for heart failure, and time-averaged proportional change in N-terminal pro-B-type natriuretic peptide level from baseline to 180 days. Higher values indicate better health (stability). Exploratory secondary outcomes included primary end point components, cardiac structure and function, 6-minute walk distance, quality of life, and combined events. RESULTS Among the 300 patients who were randomized (median age, 61 years [interquartile range {IQR}, 52–68 years]; 64 [21%] women; 178 [59%] with type 2 diabetes; median LVEF of 25% [IQR, 19%–33%]; median N-terminal pro-B-type natriuretic peptide level of 2049 pg/mL [IQR, 1054–4235 pg/mL]), 271 completed the study. Compared with placebo, liraglutide had no significant effect on the primary end point (mean rank of 146 for the liraglutide group vs 156 for the placebo group, P = .31). There were no significant between-group differences in the number of deaths (19 [12%] in the liraglutide group vs 16 [11%] in the placebo group; hazard ratio, 1.10 [95% CI, 0.57–2.14]; P = .78) or rehospitalizations for heart failure (63 [41%] vs 50 [34%], respectively; hazard ratio, 1.30 [95% CI, 0.89–1.88]; P = .17) or for the exploratory secondary end points. Prespecified subgroup analyses in patients with diabetes did not reveal any significant between-group differences. The number of investigator-reported hyperglycemic events was 16 (10%) in the liraglutide group vs 27 (18%) in the placebo group and hypoglycemic events were infrequent (2 [1%] vs 4 [3%], respectively). CONCLUSIONS AND RELEVANCE Among patients recently hospitalized with heart failure and reduced LVEF, the use of liraglutide did not lead to greater posthospitalization clinical stability. These findings do not support the use of liraglutide in this clinical situation. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01800968 PMID:27483064
Margulies, Kenneth B; Hernandez, Adrian F; Redfield, Margaret M; Givertz, Michael M; Oliveira, Guilherme H; Cole, Robert; Mann, Douglas L; Whellan, David J; Kiernan, Michael S; Felker, G Michael; McNulty, Steven E; Anstrom, Kevin J; Shah, Monica R; Braunwald, Eugene; Cappola, Thomas P
2016-08-02
Abnormal cardiac metabolism contributes to the pathophysiology of advanced heart failure with reduced left ventricular ejection fraction (LVEF). Glucagon-like peptide 1 (GLP-1) agonists have shown cardioprotective effects in early clinical studies of patients with advanced heart failure, irrespective of type 2 diabetes status. To test whether therapy with a GLP-1 agonist improves clinical stability following hospitalization for acute heart failure. Phase 2, double-blind, placebo-controlled randomized clinical trial of patients with established heart failure and reduced LVEF who were recently hospitalized. Patients were enrolled between August 2013 and March 2015 at 24 US sites. The GLP-1 agonist liraglutide (n = 154) or placebo (n = 146) via a daily subcutaneous injection; study drug was advanced to a dosage of 1.8 mg/d during the first 30 days as tolerated and continued for 180 days. The primary end point was a global rank score in which all patients, regardless of treatment assignment, were ranked across 3 hierarchical tiers: time to death, time to rehospitalization for heart failure, and time-averaged proportional change in N-terminal pro-B-type natriuretic peptide level from baseline to 180 days. Higher values indicate better health (stability). Exploratory secondary outcomes included primary end point components, cardiac structure and function, 6-minute walk distance, quality of life, and combined events. Among the 300 patients who were randomized (median age, 61 years [interquartile range {IQR}, 52-68 years]; 64 [21%] women; 178 [59%] with type 2 diabetes; median LVEF of 25% [IQR, 19%-33%]; median N-terminal pro-B-type natriuretic peptide level of 2049 pg/mL [IQR, 1054-4235 pg/mL]), 271 completed the study. Compared with placebo, liraglutide had no significant effect on the primary end point (mean rank of 146 for the liraglutide group vs 156 for the placebo group, P = .31). There were no significant between-group differences in the number of deaths (19 [12%] in the liraglutide group vs 16 [11%] in the placebo group; hazard ratio, 1.10 [95% CI, 0.57-2.14]; P = .78) or rehospitalizations for heart failure (63 [41%] vs 50 [34%], respectively; hazard ratio, 1.30 [95% CI, 0.89-1.88]; P = .17) or for the exploratory secondary end points. Prespecified subgroup analyses in patients with diabetes did not reveal any significant between-group differences. The number of investigator-reported hyperglycemic events was 16 (10%) in the liraglutide group vs 27 (18%) in the placebo group and hypoglycemic events were infrequent (2 [1%] vs 4 [3%], respectively). Among patients recently hospitalized with heart failure and reduced LVEF, the use of liraglutide did not lead to greater posthospitalization clinical stability. These findings do not support the use of liraglutide in this clinical situation. clinicaltrials.gov Identifier: NCT01800968.
X-33 LH2 Tank Failure Investigation Findings
NASA Technical Reports Server (NTRS)
Niedermeyer, Mindy; Clinton, R. G., Jr. (Technical Monitor)
2000-01-01
This presentation focuses on the tank history, test objectives, failure description, investigation and conclusions. The test objectives include verify structural integrity at 105% expected flight load limit varying the following parameters: cryogenic temperature; internal pressure; and mechanical loading. The Failure description includes structural component of the aft body, quad-lobe design, and sandwich - honeycomb graphite epoxy construction.
NASA Astrophysics Data System (ADS)
Trentham, Neil; Tully, R. Brent; Verheijen, Marc A. W.
2001-07-01
Results are presented of a deep optical survey of the Ursa Major cluster, a spiral-rich cluster of galaxies at a distance of 18.6Mpc which contains about 30 per cent of the light but only 5 per cent of the mass of the nearby Virgo cluster. Fields around known cluster members and a pattern of blind fields along the major and minor axes of the cluster were studied with mosaic CCD cameras on the Canada-France-Hawaii Telescope. The dynamical crossing time for the Ursa Major cluster is only slightly less than a Hubble time. Most galaxies in the local Universe exist in similar moderate-density environments. The Ursa Major cluster is therefore a good place to study the statistical properties of dwarf galaxies, since this structure is at an evolutionary stage representative of typical environments, yet has enough galaxies that reasonable counting statistics can be accumulated. The main observational results of our survey are as follows. (i) The galaxy luminosity function is flat, with a logarithmic slope α=-1.1 for -17
Failure behavior of generic metallic and composite aircraft structural components under crash loads
NASA Technical Reports Server (NTRS)
Carden, Huey D.; Robinson, Martha P.
1990-01-01
Failure behavior results are presented from crash dynamics research using concepts of aircraft elements and substructure not necessarily designed or optimized for energy absorption or crash loading considerations. To achieve desired new designs incorporating improved energy absorption capabilities often requires an understanding of how more conventional designs behave under crash loadings. Experimental and analytical data are presented which indicate some general trends in the failure behavior of a class of composite structures including individual fuselage frames, skeleton subfloors with stringers and floor beams without skin covering, and subfloors with skin added to the frame-stringer arrangement. Although the behavior is complex, a strong similarity in the static/dynamic failure behavior among these structures is illustrated through photographs of the experimental results and through analytical data of generic composite structural models.
NASA Technical Reports Server (NTRS)
Wanthal, Steven; Schaefer, Joseph; Justusson, Brian; Hyder, Imran; Engelstad, Stephen; Rose, Cheryl
2017-01-01
The Advanced Composites Consortium is a US Government/Industry partnership supporting technologies to enable timeline and cost reduction in the development of certified composite aerospace structures. A key component of the consortium's approach is the development and validation of improved progressive damage and failure analysis methods for composite structures. These methods will enable increased use of simulations in design trade studies and detailed design development, and thereby enable more targeted physical test programs to validate designs. To accomplish this goal with confidence, a rigorous verification and validation process was developed. The process was used to evaluate analysis methods and associated implementation requirements to ensure calculation accuracy and to gage predictability for composite failure modes of interest. This paper introduces the verification and validation process developed by the consortium during the Phase I effort of the Advanced Composites Project. Specific structural failure modes of interest are first identified, and a subset of standard composite test articles are proposed to interrogate a progressive damage analysis method's ability to predict each failure mode of interest. Test articles are designed to capture the underlying composite material constitutive response as well as the interaction of failure modes representing typical failure patterns observed in aerospace structures.
A systematic approach to emergencies in uveitis.
Al-Dhibi, Hassan A; Al-Mahmood, Ammar M; Arevalo, J Fernando
2014-01-01
Uveitis is a common cause of preventable blindness although it is consider a sight-threatening condition particularly in cases with posterior segment inflammation. To deal with emergency conditions in uveitis, we must aware of the essential signs and symptoms that reflect a true uveitic emergency. Failure to recognize these essential signs and symptoms of a true uveitic emergency may result in a devastating visual outcome. This review provides general ophthalmologists and residents, clinical guidelines for the main uveitic entities that require immediate recognition and urgent intervention in the emergency room to prevent severe permanent visual loss.
Changing scenes: memory for naturalistic events following change blindness.
Mäntylä, Timo; Sundström, Anna
2004-11-01
Research on scene perception indicates that viewers often fail to detect large changes to scene regions when these changes occur during a visual disruption such as a saccade or a movie cut. In two experiments, we examined whether this relative inability to detect changes would produce systematic biases in event memory. In Experiment 1, participants decided whether two successively presented images were the same or different, followed by a memory task, in which they recalled the content of the viewed scene. In Experiment 2, participants viewed a short video, in which an actor carried out a series of daily activities, and central scenes' attributes were changed during a movie cut. A high degree of change blindness was observed in both experiments, and these effects were related to scene complexity (Experiment 1) and level of retrieval support (Experiment 2). Most important, participants reported the changed, rather than the initial, event attributes following a failure in change detection. These findings suggest that attentional limitations during encoding contribute to biases in episodic memory.
One hundred years of return period: Strengths and limitations
NASA Astrophysics Data System (ADS)
Volpi, E.; Fiori, A.; Grimaldi, S.; Lombardo, F.; Koutsoyiannis, D.
2015-10-01
One hundred years from its original definition by Fuller, the probabilistic concept of return period is widely used in hydrology as well as in other disciplines of geosciences to give an indication on critical event rareness. This concept gains its popularity, especially in engineering practice for design and risk assessment, due to its ease of use and understanding; however, return period relies on some basic assumptions that should be satisfied for a correct application of this statistical tool. Indeed, conventional frequency analysis in hydrology is performed by assuming as necessary conditions that extreme events arise from a stationary distribution and are independent of one another. The main objective of this paper is to investigate the properties of return period when the independence condition is omitted; hence, we explore how the different definitions of return period available in literature affect results of frequency analysis for processes correlated in time. We demonstrate that, for stationary processes, the independence condition is not necessary in order to apply the classical equation of return period (i.e., the inverse of exceedance probability). On the other hand, we show that the time-correlation structure of hydrological processes modifies the shape of the distribution function of which the return period represents the first moment. This implies that, in the context of time-dependent processes, the return period might not represent an exhaustive measure of the probability of failure, and that its blind application could lead to misleading results. To overcome this problem, we introduce the concept of Equivalent Return Period, which controls the probability of failure still preserving the virtue of effectively communicating the event rareness.
Myatra, Sheila Nainan; Shah, Amit; Kundra, Pankaj; Patwa, Apeksh; Ramkumar, Venkateswaran; Divatia, Jigeeshu Vasishtha; Raveendra, Ubaradka S; Shetty, Sumalatha Radhakrishna; Ahmed, Syed Moied; Doctor, Jeson Rajan; Pawar, Dilip K; Ramesh, Singaravelu; Das, Sabyasachi; Garg, Rakesh
2016-12-01
The All India Difficult Airway Association (AIDAA) guidelines for management of the unanticipated difficult airway in adults provide a structured, stepwise approach to manage unanticipated difficulty during tracheal intubation in adults. They have been developed based on the available evidence; wherever robust evidence was lacking, or to suit the needs and situation in India, recommendations were arrived at by consensus opinion of airway experts, incorporating the responses to a questionnaire sent to members of the AIDAA and the Indian Society of Anaesthesiologists. We recommend optimum pre-oxygenation and nasal insufflation of 15 L/min oxygen during apnoea in all patients, and calling for help if the initial attempt at intubation is unsuccessful. Transnasal humidified rapid insufflations of oxygen at 70 L/min (transnasal humidified rapid insufflation ventilatory exchange) should be used when available. We recommend no more than three attempts at tracheal intubation and two attempts at supraglottic airway device (SAD) insertion if intubation fails, provided oxygen saturation remains ≥ 95%. Intubation should be confirmed by capnography. Blind tracheal intubation through the SAD is not recommended. If SAD insertion fails, one final attempt at mask ventilation should be tried after ensuring neuromuscular blockade using the optimal technique for mask ventilation. Failure to intubate the trachea as well as an inability to ventilate the lungs by face mask and SAD constitutes 'complete ventilation failure', and emergency cricothyroidotomy should be performed. Patient counselling, documentation and standard reporting of the airway difficulty using a 'difficult airway alert form' must be done. In addition, the AIDAA provides suggestions for the contents of a difficult airway cart.
Failure of underground concrete structures subjected to blast loadings
NASA Technical Reports Server (NTRS)
Ross, C. A.; Nash, P. T.; Griner, G. R.
1979-01-01
The response and failure of two edges of free reinforced concrete slabs subjected to intermediate blast loadings are examined. The failure of the reinforced concrete structures is defined as a condition where actual separation or fracture of the reinforcing elements has occurred. Approximate theoretical methods using stationary and moving plastic hinge mechanisms with linearly varying and time dependent loadings are developed. Equations developed to predict deflection and failure of reinforced concrete beams are presented and compared with the experimental results.
Failure mechanisms in energy-absorbing composite structures
NASA Astrophysics Data System (ADS)
Johnson, Alastair F.; David, Matthew
2010-11-01
Quasi-static tests are described for determination of the energy-absorption properties of composite crash energy-absorbing segment elements under axial loads. Detailed computer tomography scans of failed specimens were used to identify local compression crush failure mechanisms at the crush front. These mechanisms are important for selecting composite materials for energy-absorbing structures, such as helicopter and aircraft sub-floors. Finite element models of the failure processes are described that could be the basis for materials selection and future design procedures for crashworthy structures.
ERIC Educational Resources Information Center
Siller, Jerome; And Others
To describe and to develop instruments to measure attitudes toward amputees, the blind, and those with cosmetic conditions, three groups of subjects responded to one of three large pools of items tapping attitudes toward the three disability conditions. Three new groups of about 500 subjects of diverse demographic characteristics were given one of…
Cortical plasticity and preserved function in early blindness
Renier, Laurent; De Volder, Anne G.; Rauschecker, Josef P.
2013-01-01
The “neural Darwinism” theory predicts that when one sensory modality is lacking, as in congenital blindness, the target structures are taken over by the afferent inputs from other senses that will promote and control their functional maturation (Edelman, 1993). This view receives support from both cross-modal plasticity experiments in animal models and functional imaging studies in man, which are presented here. PMID:23453908
The Alcoa ram fastener: A reusable blind rivet
NASA Technical Reports Server (NTRS)
Dewalt, W. J.
1972-01-01
Results of tensile, shear, fatigue and accelerated weathering tests are presented for the ram fastener, a reusable, single unit blind rivet. The effects of variations in hole size, grip length and sheet thickness on strength properties of the fastener were determined. The test results show these fasteners to have strength characteristics suitable for light structural applications. Exposure to accelerated weathering did not impair their performance.
Verbalism in the Narrative Language of Children Who Are Blind and Sighted
ERIC Educational Resources Information Center
Rosel, Jesus; Caballer, Antonio; Jara, Pilar; Oliver, Juan Carlos
2005-01-01
This study examined the use of verbalisms by 62 children aged 7-14 who were totally blind from birth and 64 sighted children. It found that a child's degree of sight and gender did not affect the frequency with which verbalisms were used; only age had a significant positive effect. The study shows that language is a flexible structure that is used…
Development and Validation of the Self-Acceptance Scale for Persons with Early Blindness: The SAS-EB
Morgado, Fabiane Frota da Rocha; Campana, Angela Nogueira Neves Betanho; Tavares, Maria da Consolação Gomes Cunha Fernandes
2014-01-01
Investigations of self-acceptance are critical to understanding the development and maintenance of psychological health. However, valid and reliable instruments for measuring self-acceptance in persons with early blindness have yet to be developed. The current research describes three studies designed to develop and validate the Self-acceptance Scale for Persons with Early Blindness (SAS-EB). In Study 1, we developed the initial item pool. Thirty-three items were generated, based on data from specialized literature and from 2 focus groups. Items were organized in a three-factor structure, theoretically predicted for SAS-EB - (1) body acceptance, (2) self-protection from social stigmas, and (3) feeling and believing in one's capacities. In Study 2, information obtained from a panel of 9 experts and 22 persons with early blindness representing the target population was used to refine the initial item pool, generating a new pool of 27 items. In Study 3, 318 persons with early blindness (141 women and 177 men), between 18 and 60 years of age (M = 37.74 years, SD = 12.37) answered the new pool of 27 items. After the elimination of 9 items using confirmatory factor analysis, we confirmed the theoretical three-factor structure of the SAS-EB. Study 3 also provided support for the scale's internal consistency and construct validity. Finally, the psychometric properties of the SAS-EB, its utility, and its limitations are discussed along with considerations for future research. PMID:25268633
Rodrigues, Samantha A; Thambyah, Ashvin; Broom, Neil D
2015-03-01
The annulus-endplate anchorage system performs a critical role in the disc, creating a strong structural link between the compliant annulus and the rigid vertebrae. Endplate failure is thought to be associated with disc herniation, a recent study indicating that this failure mode occurs more frequently than annular rupture. The aim was to investigate the structural principles governing annulus-endplate anchorage and the basis of its strength and mechanisms of failure. Loading experiments were performed on ovine lumbar motion segments designed to induce annulus-endplate failure, followed by macro- to micro- to fibril-level structural analyses. The study was funded by a doctoral scholarship from our institution. Samples were loaded to failure in three modes: torsion using intact motion segments, in-plane tension of the anterior annulus-endplate along one of the oblique fiber angles, and axial tension of the anterior annulus-endplate. The anterior region was chosen for its ease of access. Decalcification was used to investigate the mechanical influence of the mineralized component. Structural analysis was conducted on both the intact and failed samples using differential interference contrast optical microscopy and scanning electron microscopy. Two main modes of anchorage failure were observed--failure at the tidemark or at the cement line. Samples subjected to axial tension contained more tidemark failures compared with those subjected to torsion and in-plane tension. Samples decalcified before testing frequently contained damage at the cement line, this being more extensive than in fresh samples. Analysis of the intact samples at their anchorage sites revealed that annular subbundle fibrils penetrate beyond the cement line to a limited depth and appear to merge with those in the vertebral and cartilaginous endplates. Annulus-endplate anchorage is more vulnerable to failure in axial tension compared with both torsion and in-plane tension and is probably due to acute fiber bending at the soft-hard interface of the tidemark. This finding is consistent with evidence showing that flexion, which induces a similar pattern of axial tension, increases the risk of herniation involving endplate failure. The study also highlights the important strengthening role of calcification at this junction and provides new evidence of a fibril-based form of structural integration across the cement line. Copyright © 2015 Elsevier Inc. All rights reserved.
Determinants of performance failure in the nursing home industry☆
Zinn, Jacqueline; Mor, Vincent; Feng, Zhanlian; Intrator, Orna
2013-01-01
This study investigates the determinants of performance failure in U.S. nursing homes. The sample consisted of 91,168 surveys from 10,901 facilities included in the Online Survey Certification and Reporting system from 1996 to 2005. Failed performance was defined as termination from the Medicare and Medicaid programs. Determinants of performance failure were identified as core structural change (ownership change), peripheral change (related diversification), prior financial and quality of care performance, size and environmental shock (Medicaid case mix reimbursement and prospective payment system introduction). Additional control variables that could contribute to the likelihood of performance failure were included in a cross-sectional time series generalized estimating equation logistic regression model. Our results support the contention, derived from structural inertia theory, that where in an organization’s structure change occurs determines whether it is adaptive or disruptive. In addition, while poor prior financial and quality performance and the introduction of case mix reimbursement increases the risk of failure, larger size is protective, decreasing the likelihood of performance failure. PMID:19128865
Determinants of performance failure in the nursing home industry.
Zinn, Jacqueline; Mor, Vincent; Feng, Zhanlian; Intrator, Orna
2009-03-01
This study investigates the determinants of performance failure in U.S. nursing homes. The sample consisted of 91,168 surveys from 10,901 facilities included in the Online Survey Certification and Reporting system from 1996 to 2005. Failed performance was defined as termination from the Medicare and Medicaid programs. Determinants of performance failure were identified as core structural change (ownership change), peripheral change (related diversification), prior financial and quality of care performance, size and environmental shock (Medicaid case mix reimbursement and prospective payment system introduction). Additional control variables that could contribute to the likelihood of performance failure were included in a cross-sectional time series generalized estimating equation logistic regression model. Our results support the contention, derived from structural inertia theory, that where in an organization's structure change occurs determines whether it is adaptive or disruptive. In addition, while poor prior financial and quality performance and the introduction of case mix reimbursement increases the risk of failure, larger size is protective, decreasing the likelihood of performance failure.
Spironolactone for heart failure with preserved ejection fraction.
Pitt, Bertram; Pfeffer, Marc A; Assmann, Susan F; Boineau, Robin; Anand, Inder S; Claggett, Brian; Clausell, Nadine; Desai, Akshay S; Diaz, Rafael; Fleg, Jerome L; Gordeev, Ivan; Harty, Brian; Heitner, John F; Kenwood, Christopher T; Lewis, Eldrin F; O'Meara, Eileen; Probstfield, Jeffrey L; Shaburishvili, Tamaz; Shah, Sanjiv J; Solomon, Scott D; Sweitzer, Nancy K; Yang, Song; McKinlay, Sonja M
2014-04-10
Mineralocorticoid-receptor antagonists improve the prognosis for patients with heart failure and a reduced left ventricular ejection fraction. We evaluated the effects of spironolactone in patients with heart failure and a preserved left ventricular ejection fraction. In this randomized, double-blind trial, we assigned 3445 patients with symptomatic heart failure and a left ventricular ejection fraction of 45% or more to receive either spironolactone (15 to 45 mg daily) or placebo. The primary outcome was a composite of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure. With a mean follow-up of 3.3 years, the primary outcome occurred in 320 of 1722 patients in the spironolactone group (18.6%) and 351 of 1723 patients in the placebo group (20.4%) (hazard ratio, 0.89; 95% confidence interval [CI], 0.77 to 1.04; P=0.14). Of the components of the primary outcome, only hospitalization for heart failure had a significantly lower incidence in the spironolactone group than in the placebo group (206 patients [12.0%] vs. 245 patients [14.2%]; hazard ratio, 0.83; 95% CI, 0.69 to 0.99, P=0.04). Neither total deaths nor hospitalizations for any reason were significantly reduced by spironolactone. Treatment with spironolactone was associated with increased serum creatinine levels and a doubling of the rate of hyperkalemia (18.7%, vs. 9.1% in the placebo group) but reduced hypokalemia. With frequent monitoring, there were no significant differences in the incidence of serious adverse events, a serum creatinine level of 3.0 mg per deciliter (265 μmol per liter) or higher, or dialysis. In patients with heart failure and a preserved ejection fraction, treatment with spironolactone did not significantly reduce the incidence of the primary composite outcome of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure. (Funded by the National Heart, Lung, and Blood Institute; TOPCAT ClinicalTrials.gov number, NCT00094302.).
Pushover analysis of reinforced concrete frames considering shear failure at beam-column joints
NASA Astrophysics Data System (ADS)
Sung, Y. C.; Lin, T. K.; Hsiao, C. C.; Lai, M. C.
2013-09-01
Since most current seismic capacity evaluations of reinforced concrete (RC) frame structures are implemented by either static pushover analysis (PA) or dynamic time history analysis, with diverse settings of the plastic hinges (PHs) on such main structural components as columns, beams and walls, the complex behavior of shear failure at beam-column joints (BCJs) during major earthquakes is commonly neglected. This study proposes new nonlinear PA procedures that consider shear failure at BCJs and seek to assess the actual damage to RC structures. Based on the specifications of FEMA-356, a simplified joint model composed of two nonlinear cross struts placed diagonally over the location of the plastic hinge is established, allowing a sophisticated PA to be performed. To verify the validity of this method, the analytical results for the capacity curves and the failure mechanism derived from three different full-size RC frames are compared with the experimental measurements. By considering shear failure at BCJs, the proposed nonlinear analytical procedures can be used to estimate the structural behavior of RC frames, including seismic capacity and the progressive failure sequence of joints, in a precise and effective manner.
A brief review of Boston type-1 and osteo-odonto keratoprostheses.
Avadhanam, Venkata S; Liu, Christopher S C
2015-07-01
Globally there are ≈4.9 million bilaterally corneal blind and 23 million unilaterally corneal blind. Majority of this blindness exists in the developing countries, where resources for corneal banking and transplant surgery are less than adequate. Survival of corneal grafts gradually declines over the long term. Corneal transplantation has poor prognosis in vascularised corneal beds, ocular surface disease and viral keratitis. Keratoprosthesis (KPro) remains as a final option for end-stage ocular surface disease, multiple corneal transplant failures and high-risk corneal grafts. Boston type-1 KPro and osteo-odonto-keratoprosthesis are the two devices proven useful in recent years. Choice of a keratoprosthetic device is patient specific based on the underlying diagnosis, ocular morbidity and patient suitability. KPro surgery demands a high level of clinical and surgical expertise, lifelong commitment and extensive resources. Improvements in techniques and biomaterials may in the future provide retainable KPros that do not need regular follow-up of patients, have low complications but high retention rates and may be produced at a low cost on a mass scale to be available as 'off the shelf' devices. Because KPros have the potential to effectively address the burden of surgically treatable corneal blindness and may also eliminate the problems of corneal transplantation, more research is required to develop KPros as substitutes for corneal transplantation even in low-risk cases. In those countries where corneal blindness is a major liability, we need a two pronged approach: one to develop eye donation, eye banking and corneal transplantation and the second to establish centres for keratoprostheses, which are affordable and technically not challenging, in a population where default on follow-up visits are high. Until the latter is achieved, KPros should be viewed as a temporary means for visual restoration and be offered in national and supraregional specialised centres only. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Visible-blind and solar-blind ultraviolet photodiodes based on (In{sub x}Ga{sub 1−x}){sub 2}O{sub 3}
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhang, Zhipeng; Wenckstern, Holger von; Lenzner, Jörg
UV and deep-UV selective photodiodes from visible-blind to solar-blind were realized based on a Si-doped (In{sub x}Ga{sub 1–x}){sub 2}O{sub 3} thin film with a monotonic lateral variation of 0.0035 < x < 0.83. Such layer was deposited by employing a continuous composition spread approach relying on the ablation of a single segmented target in pulsed-laser deposition. The photo response signal is provided from a metal-semiconductor-metal structure upon backside illumination. The absorption onset was tuned from 4.83 to 3.22 eV for increasing x. Higher responsivities were observed for photodiodes fabricated from indium-rich part of the sample, for which an internal gain mechanism could be identified.
Balarabe, Aliyu Hamza; Hassan, Ramatu; Fatai, Olatunji O
2014-01-01
The aim of the following study was to determine the types of intervention sought by the blind street beggars and assess the barriers to accessing available eye care services. This cross-sectional study was conducted among consenting blind street beggars in Sokoto, Nigeria between May and June, 2009. A semi-structured interview was conducted to probe issues on historical antecedents of the blindness and the eye heath seeking behavior including the use of traditional eye medications. Assessment of barriers to accessing curative services among the blind persons was explored. Questions were asked and the individual responses were recorded in the questionnaire under the appropriate sections. Two hundred and two of 216 (94.7%) of the examined subjects were found to be blind and included in the analysis. The principal cause of blindness was corneal opacity. Overall 82% of the blindness was due to avoidable causes with majority irreversibly blind. Only 38 subjects (18.8%) sought for intervention in hospitals, others resorted to self-medication (42.1%), medicine store (31.2%) and traditional facility (7.9%). Those that accessed treatment at a hospital did so mainly at a primary health center (50.0%) and General Hospitals (34.2%). The barriers to accessing treatment at the hospital were mainly due to "not taken to any hospital" by the parents/relatives (50.3%) and "services not available" (25.2%). Most respondents resorted to ocular self-medication particularly traditional eye medicines. We advocate for a provision of affordable, accessible and qualitative eye care services with a strong health education component on avoidable causes of blindness.
15. Detail, cracks evidencing structural failure, northeast rear, view to ...
15. Detail, cracks evidencing structural failure, northeast rear, view to southwest, 90mm lens. - Benicia Arsenal, Powder Magazine No. 5, Junction of Interstate Highways 680 & 780, Benicia, Solano County, CA
An ethnographic study of night blindness "ratauni" among women in the Terai of Nepal.
Christian, P; Bentley, M E; Pradhan, R; West, K P
1998-04-01
Night blindness is the most common ocular condition representing moderate-to-severe vitamin A deficiency in children. Very little, however, is known about maternal night blindness, which has recently been reported to occur frequently during pregnancy in parts of south-east Asia. In Nepal, the prevalence of night blindness is reported to be 16%. We carried out an ethnographic study of night blindness during pregnancy in the south-eastern, rural plains of Nepal as preliminary research for a case-control study of the determinants of this condition. The purpose of the research was to identify local terms and concepts of night blindness and to examine women's perceptions of its causes, symptoms, severity, and consequences during pregnancy. Data collection involved in-depth interviews, case studies, unstructured observations and structured anthropologic methods, such as free listing and quick sort ranking. Women considered night blindness to be an important illness of pregnancy, ranking it second (to vaginal bleeding) in perceived severity from a list of 15 "women's illnesses". Local terms for night blindness were identified in three different languages from the region. Informants described a complex ethnomedical model of night blindness that included causes, symptomatology, and treatment alternatives. However, there was no perceived link between food intake and the occurrence of night blindness. The major causes of night blindness were attributed to pregnancy, weakness, or "hotness". Some women sought treatment for the condition but most women chose not to treat it since they believed that it was a transient condition of pregnancy. Interviews with women who had previously experienced night blindness and home-based observations of women exhibiting concurrent night blindness showed that it adversely affected their activity patterns, especially those related to child care and food preparation. Night blindness increased reliance on family members to perform various domestic chores and was also associated with personal injury and accidents. The findings of this study have relevance for women's reproductive health and nutrition throughout the Indian sub-continent. A simple history of night blindness may be a practical tool to identify women with nutritional and health risks. Maternal night blindness should be more routinely investigated in vitamin A deficient areas of the world, both to define the magnitude of the problem, and to develop programs/interventions that specifically target this population.
Investigating students’ failure in fractional concept construction
NASA Astrophysics Data System (ADS)
Kurniawan, Henry; Sutawidjaja, Akbar; Rahman As’ari, Abdur; Muksar, Makbul; Setiawan, Iwan
2018-04-01
Failure is a failure to achieve goals. This failure occurs because a larger scheme integrates the schemes in mind that are related to the problem at hand. These schemes are integrated so that they are interconnected to form new structures. This new scheme structure is used to interpret the problems at hand. This research is a qualitative research done to trace student’s failure which happened in fractional concept construction. Subjects in this study as many as 2 students selected from 15 students with the consideration of these students meet the criteria that have been set into two groups that fail in solving the problem. Both groups, namely group 1 is a search group for the failure of students of S1 subject and group 2 is a search group for the failure of students of S2 subject.
Failure of flight feathers under uniaxial compression.
Schelestow, Kristina; Troncoso, Omar P; Torres, Fernando G
2017-09-01
Flight feathers are light weight engineering structures. They have a central shaft divided in two parts: the calamus and the rachis. The rachis is a thinly walled conical shell filled with foam, while the calamus is a hollow tube-like structure. Due to the fact that bending loads are produced during birds' flight, the resistance to bending of feathers has been reported in different studies. However, the analysis of bent feathers has shown that compression could induce failure by buckling. Here, we have studied the compression of feathers in order to assess the failure mechanisms involved. Axial compression tests were carried out on the rachis and the calamus of dove and pelican feathers. The failure mechanisms and folding structures that resulted from the compression tests were observed from images obtained by scanning electron microscopy (SEM). The rachis and calamus fail due to structural instability. In the case of the calamus, this instability leads to a progressive folding process. In contrast, the rachis undergoes a typical Euler column-type buckling failure. The study of failed specimens showed that delamination buckling, cell collapse and cell densification are the primary failure mechanisms of the rachis structure. The role of the foam is also discussed with regard to the mechanical response of the samples and the energy dissipated during the compression tests. Critical stress values were calculated using delamination buckling models and were found to be in very good agreement with the experimental values measured. Failure analysis and mechanical testing have confirmed that flight feathers are complex thin walled structures with mechanical adaptations that allow them to fulfil their functions. Copyright © 2017 Elsevier B.V. All rights reserved.
Stein, Ross S.; Lin, Jian
2006-01-01
We review seismicity, surface faulting, and Coulomb stress changes associated with the 1994 Northridge, California, earthquake. All of the observed surface faulting is shallow, extending meters to tens of meters below the surface. Relocated aftershocks reveal no seismicity shallower than 2 km depth. Although many of the aftershocks lie along the thrust fault and its up-dip extension, there are also a significant number of aftershocks in the core of the gentle anticline above the thrust, and elsewhere on the up-thrown block. These aftershocks may be associated with secondary ramp thrusts or flexural slip faults at a depth of 2-4 km. The geological structures typically associated with a blind thrust fault, such as anticlinal uplift and an associated syncline, are obscured and complicated by surface thrust faults associated with the San Fernando fault that overly the Northridge structures. Thus the relationship of the geological structure and topography to the underlying thrust fault is much more complex for Northridge than it is for the 1983 Coalinga, California, earthquake. We show from a Coulomb stress analysis that secondary surface faulting, diffuse aftershocks, and triggered sequences of moderate-sized mainshocks, are expected features of moderate-sized blind thrust earthquakes.
Pieske, Burkert; Butler, Javed; Filippatos, Gerasimos; Lam, Carolyn; Maggioni, Aldo Pietro; Ponikowski, Piotr; Shah, Sanjiv; Solomon, Scott; Kraigher-Krainer, Elisabeth; Samano, Eliana Tibana; Scalise, Andrea Viviana; Müller, Katharina; Roessig, Lothar; Gheorghiade, Mihai
2014-09-01
The clinical outcomes for patients with worsening chronic heart failure (WCHF) remain exceedingly poor despite contemporary evidence-based therapies, and effective therapies are urgently needed. Accumulating evidence supports augmentation of cyclic guanosine monophosphate (cGMP) signalling as a potential therapeutic strategy for HF with reduced or preserved ejection fraction (HFrEF and HFpEF, respectively). Direct soluble guanylate cyclase (sGC) stimulators target reduced cGMP generation due to insufficient sGC stimulation and represent a promising method for cGMP enhancement. The phase II SOluble guanylate Cyclase stimulatoR in heArT failurE Study (SOCRATES) programme consists of two randomized, parallel-group, placebo-controlled, double-blind, multicentre studies, SOCRATES-REDUCED (in patients with LVEF <45%) and SOCRATES-PRESERVED (in those with LVEF ≥ 45%), that will explore the pharmacodynamic effects, safety and tolerability, and pharmacokinetics of four dose regimens of the once-daily oral sGC stimulator vericiguat (BAY 1021189) over 12 weeks compared with placebo. These studies will enrol patients stabilized during hospitalization for HF at the time of discharge or within 4 weeks thereafter. The primary endpoint in SOCRATES-REDUCED is change in NT-proBNP at 12 weeks. The primary endpoints in SOCRATES-PRESERVED are change in NT-proBNP and left atrial volume at 12 weeks. SOCRATES will be the first programme to enrol specifically both inpatients and outpatients with WCHF and patients with reduced or preserved ejection fraction. Results will inform the benefits of pursuing subsequent event-driven clinical outcome trials with sGC stimulators in this patient population. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.
Duncan, Michael J; Smith, Mike; Cook, Kathryn; James, Rob S
2012-10-01
The efficacy of caffeine ingestion in enhancing aerobic performance is well established. The evidence for caffeine's effects on resistance exercise is mixed and has not fully examined the associated psychological and psychophysiological changes. This study examined acute effects of ingesting a caffeine-containing energy drink on repetitions to failure, the rating of perceived exertion (RPE), and the readiness to invest physical effort (RTIPE) and mental effort during resistance exercise to failure. Thirteen resistance-trained men took part in this double-blind, randomized cross-over experimental study whereby they ingested a caffeinated (179 mg) energy drink or placebo solution 60 minutes before completing a bout of resistance exercise comprising bench press, deadlift, prone row, and back squat exercise to failure at an intensity of 60% 1-repetition maximum. Experimental conditions were separated by at least 48 hours. Participants completed significantly greater repetitions to failure, irrespective of exercise, in the energy drink condition (p = 0.015). Rating of perceived exertion was significantly higher in the placebo condition (p = 0.02) and was significantly higher during lower-body exercises compared with upper-body exercises irrespective of the substance ingested (p = 0.0001). Readiness to invest mental effort was greater with the energy drink condition (p = 0.04), irrespective of time. A significant time × substance interaction (p = 0.036) for RTIPE indicated that RTIPE increased for both placebo and energy drink conditions preingestion to pre-exercise, but the magnitude of increase was greater with the energy drink condition compared with placebo. This resulted in higher RTIPE postexercise for the energy drink condition. These results suggest that acute ingestion of a caffeine-containing energy drink can enhance resistance exercise performance to failure and positively enhance psychophysiological factors related to exertion in trained men.
Treatment of anemia with darbepoetin alfa in systolic heart failure.
Swedberg, Karl; Young, James B; Anand, Inder S; Cheng, Sunfa; Desai, Akshay S; Diaz, Rafael; Maggioni, Aldo P; McMurray, John J V; O'Connor, Christopher; Pfeffer, Marc A; Solomon, Scott D; Sun, Yan; Tendera, Michal; van Veldhuisen, Dirk J
2013-03-28
Patients with systolic heart failure and anemia have worse symptoms, functional capacity, and outcomes than those without anemia. We evaluated the effects of darbepoetin alfa on clinical outcomes in patients with systolic heart failure and anemia. In this randomized, double-blind trial, we assigned 2278 patients with systolic heart failure and mild-to-moderate anemia (hemoglobin level, 9.0 to 12.0 g per deciliter) to receive either darbepoetin alfa (to achieve a hemoglobin target of 13 g per deciliter) or placebo. The primary outcome was a composite of death from any cause or hospitalization for worsening heart failure. The primary outcome occurred in 576 of 1136 patients (50.7%) in the darbepoetin alfa group and 565 of 1142 patients (49.5%) in the placebo group (hazard ratio in the darbepoetin alfa group, 1.01; 95% confidence interval, 0.90 to 1.13; P=0.87). There was no significant between-group difference in any of the secondary outcomes. The neutral effect of darbepoetin alfa was consistent across all prespecified subgroups. Fatal or nonfatal stroke occurred in 42 patients (3.7%) in the darbepoetin alfa group and 31 patients (2.7%) in the placebo group (P=0.23). Thromboembolic adverse events were reported in 153 patients (13.5%) in the darbepoetin alfa group and 114 patients (10.0%) in the placebo group (P=0.01). Cancer-related adverse events were similar in the two study groups. Treatment with darbepoetin alfa did not improve clinical outcomes in patients with systolic heart failure and mild-to-moderate anemia. Our findings do not support the use of darbepoetin alfa in these patients. (Funded by Amgen; RED-HF ClinicalTrials.gov number, NCT00358215.).
Portable Sleep Monitoring for Diagnosing Sleep Apnea in Hospitalized Patients With Heart Failure.
Aurora, R Nisha; Patil, Susheel P; Punjabi, Naresh M
2018-04-21
Sleep apnea is an underdiagnosed condition in patients with heart failure. Efficient identification of sleep apnea is needed, as treatment may improve heart failure-related outcomes. Currently, use of portable sleep monitoring in hospitalized patients and those at risk for central sleep apnea is discouraged. This study examined whether portable sleep monitoring with respiratory polygraphy can accurately diagnose sleep apnea in patients hospitalized with decompensated heart failure. Hospitalized patients with decompensated heart failure underwent concurrent respiratory polygraphy and polysomnography. Both recordings were scored for obstructive and central disordered breathing events in a blinded fashion, using standard criteria, and the apnea-hypopnea index (AHI) was determined. Pearson's correlation coefficients and Bland-Altman plots were used to examine the concordance among the overall, obstructive, and central AHI values derived by respiratory polygraphy and polysomnography. The sample consisted of 53 patients (47% women) with a mean age of 59.0 years. The correlation coefficient for the overall AHI from the two diagnostic methods was 0.94 (95% CI, 0.89-0.96). The average difference in AHI between the two methods was 3.6 events/h. Analyses of the central and obstructive AHI values showed strong concordance between the two methods, with correlation coefficients of 0.98 (95% CI, 0.96-0.99) and 0.91 (95% CI, 0.84-0.95), respectively. Complete agreement in the classification of sleep apnea severity between the two methods was seen in 89% of the sample. Portable sleep monitoring can accurately diagnose sleep apnea in hospitalized patients with heart failure and may promote early initiation of treatment. Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
Frawley, Geoff; Bell, Graham; Disma, Nicola; Withington, Davinia E.; de Graaff, Jurgen C.; Morton, Neil S.; McCann, Mary Ellen; Arnup, Sarah J.; Bagshaw, Oliver; Wolfler, Andrea; Bellinger, David; Davidson, Andrew J.
2015-01-01
Background Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes. The General Anesthesia compared to Spinal anesthesia (GAS) study compares neurodevelopmental outcomes following awake RA or GA in otherwise healthy infants. Our aim was to describe success and failure rates of RA in this study and report factors associated with failure. Methods This was a nested cohort study within a prospective randomized, controlled, observer blind, equivalence trial. Seven hundred twenty two infants ≤ 60 weeks postmenstrual age, scheduled for herniorrhaphy under anesthesia were randomly assigned to receive RA (spinal, caudal epidural or combined spinal caudal anesthetic) or GA with sevoflurane. The data of 339 infants, where spinal or combined spinal caudal anesthetic was attempted, was analyzed. Possible predictors of failure were assessed including: patient factors, technique, experience of site and anesthetist and type of local anesthetic. Results RA was sufficient for the completion of surgery in 83.2% of patients. Spinal anesthesia was successful in 86.9% of cases and combined spinal caudal anesthetic in 76.1%. Thirty four patients required conversion to GA and an additional 23 (6.8%) required brief sedation. Bloody tap on the first attempt at lumbar puncture was the only risk factor significantly associated with block failure (OR = 2.46). Conclusions The failure rate of spinal anesthesia was low. Variability in application of combined spinal caudal anesthetic limited attempts to compare the success of this technique to spinal alone. PMID:26001028
Cascading failures in complex networks with community structure
NASA Astrophysics Data System (ADS)
Lin, Guoqiang; di, Zengru; Fan, Ying
2014-12-01
Much empirical evidence shows that when attacked with cascading failures, scale-free or even random networks tend to collapse more extensively when the initially deleted node has higher betweenness. Meanwhile, in networks with strong community structure, high-betweenness nodes tend to be bridge nodes that link different communities, and the removal of such nodes will reduce only the connections among communities, leaving the networks fairly stable. Understanding what will affect cascading failures and how to protect or attack networks with strong community structure is therefore of interest. In this paper, we have constructed scale-free Community Networks (SFCN) and Random Community Networks (RCN). We applied these networks, along with the Lancichinett-Fortunato-Radicchi (LFR) benchmark, to the cascading-failure scenario to explore their vulnerability to attack and the relationship between cascading failures and the degree distribution and community structure of a network. The numerical results show that when the networks are of a power-law distribution, a stronger community structure will result in the failure of fewer nodes. In addition, the initial removal of the node with the highest betweenness will not lead to the worst cascading, i.e. the largest avalanche size. The Betweenness Overflow (BOF), an index that we developed, is an effective indicator of this tendency. The RCN, however, display a different result. In addition, the avalanche size of each node can be adopted as an index to evaluate the importance of the node.
Probabilistic confidence for decisions based on uncertain reliability estimates
NASA Astrophysics Data System (ADS)
Reid, Stuart G.
2013-05-01
Reliability assessments are commonly carried out to provide a rational basis for risk-informed decisions concerning the design or maintenance of engineering systems and structures. However, calculated reliabilities and associated probabilities of failure often have significant uncertainties associated with the possible estimation errors relative to the 'true' failure probabilities. For uncertain probabilities of failure, a measure of 'probabilistic confidence' has been proposed to reflect the concern that uncertainty about the true probability of failure could result in a system or structure that is unsafe and could subsequently fail. The paper describes how the concept of probabilistic confidence can be applied to evaluate and appropriately limit the probabilities of failure attributable to particular uncertainties such as design errors that may critically affect the dependability of risk-acceptance decisions. This approach is illustrated with regard to the dependability of structural design processes based on prototype testing with uncertainties attributable to sampling variability.
Williams, Logan D A
2018-03-01
The global network to eradicate blindness emerged out of the work of Western and South Asian professionals to eradicate smallpox which was endemic in South Asia. The history of the emergence of the global network to eradicate blindness demonstrates a shift from vertical command and control public health programs directed by the WHO, to the decentralized public health services originating in non-profit, non-governmental organizations and coordinated by the WHO. The WHO constitution started with a federal regionalist structure that encouraged collaboration and coordination with NGOs. In South Asia in particular, epidemiologists and general medical practitioners moved from eradicating smallpox through the WHO to creating their own domestic and international NGOs based in various countries with a mission to control blindness in South Asia and Africa. In 1975, pushed by the WHO Director General, these new NGOs in turn joined with individual ophthalmologists and existing blind member associations to form the International Agency for the Prevention of Blindness. Thus, the WHO was shaped by, and shaping, international NGOs such as the IAPB. The IAPB pushed for the formation of the WHO Prevention of Blindness program. This was the earliest example of how the IAPB facilitates bottom-up agenda-setting in the WHO. In 1980, when the WHO officially closed the smallpox program, the Prevention of Blindness program first received independent funding. Presently, the IAPB acts as a decentralized arm of the WHO. Copyright © 2018 Elsevier Ltd. All rights reserved.
Lovely, Lyndsay M; Chishti, Yasmin Z; Woodland, Jennifer L; Lalonde, Donald H
2018-05-01
Many surgeons and emergentologists use non-ultrasound-guided wrist nerve blocks. There is little evidence to guide the ideal volume of local anesthesia or how long we should wait after injection before performing pain-free procedures. This pilot study examined time to maximal anesthesia to painful needle stick in 14 volunteer participants receiving bilateral wrist blocks of 6 versus 11 mL of local. One surgeon performed all 14 bilateral wrist median nerve blocks in participants who remained blinded until after bandages were applied to their wrist. No one could see which wrist received the larger 11-mL volume injection versus the 6-mL block. Blinded sensory assessors then measured perceived maximal numbness time and numbness to needle stick pain in the fingertips of the median nerve distribution. Failure to get a complete median nerve block occurred in seven of fourteen 6-mL wrist blocks versus failure in only one of fourteen 11-mL blocks. Perceived maximal numbness occurred at roughly 40 minutes after injection, but actual numbness to painful needle stick took around 100 minutes. Incomplete median nerve numbness occurred with both 6- and 11-mL non-ultrasound-guided blocks at the wrist. In those with complete blocks, it took a surprisingly long time of 100 minutes for maximal anesthesia to occur to painful needle stick stimuli to the fingertips of the median nerve distribution. Non-ultrasound-guided median nerve blocks at the wrist as described in this article lack reliability and take too long to work.
NASA Technical Reports Server (NTRS)
Keil, Joachim; Herfort, Ulrich
2007-01-01
The three interplanetary ESA missions Mars-Express, Rosetta and Venus-Express (launched 2003, 2004 and 2005 resp.) are three-axes stabilized spacecraft (s/c) that estimate their inertial attitude (i.e. the attitude of the s/c w.r.t. the inertial frame) using measurements from a redundant set of star trackers (STR). Each s/c is equipped with four reaction wheels, a reaction control system based on thrusters and a redundant set of ring laser gyroscopes (gyros). The STR h/w layout of the three s/c is identical whereas there is a difference in the star pattern recognition algorithm of Rosetta which uses five neighbouring stars around a central star instead of star triads. The Rosetta algorithm has been implemented to cope with the presence of false stars which are expected to be seen during operations around the comet. The attitude acquisition capability from lost in space is different also in terms of AOCMS: The survival mode of Rosetta which is entered upon STR failure is presented. The AOCMS of Mars- and Venus-Express manages temporary STR outages during sky occultation by the planet not even by using redundancy. Though, a blinding of both STR during cruise lasting for the order of days confronts the ground operators with the limits of the AOCMS design. The operations and analyses that have been planned and partially been performed to compensate for the outage of the STR are demonstrated for Mars-Express. The caution measures taken before Venus orbit insertion of Venus-Express are detailed.
DeMarzo, Arthur P; Kelly, Russell F; Calvin, James E
2007-01-01
Early detection of asymptomatic left ventricular systolic dysfunction (LVSD) is beneficial in managing heart failure. Recent studies have cast doubt on the usefulness of cardiac output as an indicator of LVSD. In impedance cardiography (ICG), the dZ/dt waveform has a systolic wave called the E wave. This study looked at measurements of the amplitude and area of the E wave compared with ICG-derived cardiac output, stroke volume, cardiac index, and stroke index as methods of assessing LVSD. ICG data were obtained from patients (n=26) admitted to a coronary care unit. Clinical LVSD severity was stratified into 4 groups (none, mild, moderate, and severe) based on echocardiography data and standard clinical assessment by a cardiologist blinded to ICG data. Statistical analysis showed that the E wave amplitude and area were better indicators of the level of LVSD than cardiac output, stroke volume, cardiac index, or stroke index. ICG waveform analysis has potential as a simple point-of-care test for detecting LVSD in asymptomatic patients at high risk for developing heart failure and for monitoring LVSD in patients being treated for heart failure.
Amanatkar, Hamid Reza; Papagiannopoulos, Bill; Grossberg, George Thomas
2017-01-01
Pharmaceutical companies and the NIH have invested heavily in a variety of potential disease-modifying therapies for Alzheimer's disease (AD) but unfortunately all double-blind placebo-controlled Phase III studies of these drugs have failed to show statistically significant results supporting their clinical efficacy on cognitive measures. These negative results are surprising as most of these medications have the capability to impact the biomarkers which are associated with progression of Alzheimer's disease. Areas covered: This contradiction prompted us to review all study phases of Intravenous Immunoglobulin (IVIG), Bapineuzumab, Solanezumab, Avagacestat and Dimebolin to shed more light on these recent failures. We critically analyzed these studies, recommending seven lessons from these failures which should not be overlooked. Expert commentary: We suggest a new methodology for future treatment research in Alzheimer's disease considering early intervention with more focus on cognitive decline as a screening tool, more sophisticated exclusion criteria with more reliance on biomarkers, stratification of subjects based on the rate of cognitive decline aiming less heterogeneity, and a longer study duration with periodic assessment of cognition and activities of daily living during the study and also after a washout period.
NASA Astrophysics Data System (ADS)
Kosztowny, Cyrus Joseph Robert
Use of carbon fiber textiles in complex manufacturing methods creates new implementations of structural components by increasing performance, lowering manufacturing costs, and making composites overall more attractive across industry. Advantages of textile composites include high area output, ease of handling during the manufacturing process, lower production costs per material used resulting from automation, and provide post-manufacturing assembly mainstreaming because significantly more complex geometries such as stiffened shell structures can be manufactured with fewer pieces. One significant challenge with using stiffened composite structures is stiffener separation under compression. Axial compression loading conditions have frequently observed catastrophic structural failure due to stiffeners separating from the shell skin. Characterizing stiffener separation behavior is often costly computationally and experimentally. The objectives of this research are to demonstrate unitized stiffened textile composite panels can be manufactured to produce quality test specimens, that existing characterization techniques applied to state-of-the-art high-performance composites provide valuable information in modeling such structures, that the unitized structure concept successfully removes stiffener separation as a primary structural failure mode, and that modeling textile material failure modes are sufficient to accurately capture postbuckling and final failure responses of the stiffened structures. The stiffened panels in this study have taken the integrally stiffened concept to an extent such that the stiffeners and skin are manufactured at the same time, as one single piece, and from the same composite textile layers. Stiffener separation is shown to be removed as a primary structural failure mode for unitized stiffened composite textile panels loaded under axial compression well into the postbuckling regime. Instead of stiffener separation, a material damaging and failure model effectively captures local post-peak material response via incorporating a mesoscale model using a multiscaling framework with a smeared crack element-based failure model in the macroscale stiffened panel. Material damage behavior is characterized by simple experimental tests and incorporated into the post-peak stiffness degradation law in the smeared crack implementation. Computational modeling results are in overall excellent agreement compared to the experimental responses.
NASA Astrophysics Data System (ADS)
Li, Hui; Ou, Jinping
2008-07-01
A number of researchers have been focused on structural vibration control in the past three decades over the world and fruit achievements have been made. This paper introduces the recent advances in structural vibration control including passive, active and semiactive control in mainland China. Additionally, the co-author extends the structural vibration control to failure mode control. The research on the failure mode control is also involved in this paper. For passive control, this paper introduces full scale tests of buckling-restrained braces conducted to investigate the performance of the dampers and the second-editor of the Code of Seismic Design for Buildings. For active control, this paper introduces the HMD system for wind-induced vibration control of the Guangzhou TV tower. For semiactive control, the smart damping devices, algorithms for semi-active control, design methods and applications of semi-active control for structures are introduced in this paper. The failure mode control for bridges is also introduced.
Towards crystal structure prediction of complex organic compounds – a report on the fifth blind test
Bardwell, David A.; Adjiman, Claire S.; Arnautova, Yelena A.; Bartashevich, Ekaterina; Boerrigter, Stephan X. M.; Braun, Doris E.; Cruz-Cabeza, Aurora J.; Day, Graeme M.; Della Valle, Raffaele G.; Desiraju, Gautam R.; van Eijck, Bouke P.; Facelli, Julio C.; Ferraro, Marta B.; Grillo, Damian; Habgood, Matthew; Hofmann, Detlef W. M.; Hofmann, Fridolin; Jose, K. V. Jovan; Karamertzanis, Panagiotis G.; Kazantsev, Andrei V.; Kendrick, John; Kuleshova, Liudmila N.; Leusen, Frank J. J.; Maleev, Andrey V.; Misquitta, Alston J.; Mohamed, Sharmarke; Needs, Richard J.; Neumann, Marcus A.; Nikylov, Denis; Orendt, Anita M.; Pal, Rumpa; Pantelides, Constantinos C.; Pickard, Chris J.; Price, Louise S.; Price, Sarah L.; Scheraga, Harold A.; van de Streek, Jacco; Thakur, Tejender S.; Tiwari, Siddharth; Venuti, Elisabetta; Zhitkov, Ilia K.
2011-01-01
Following on from the success of the previous crystal structure prediction blind tests (CSP1999, CSP2001, CSP2004 and CSP2007), a fifth such collaborative project (CSP2010) was organized at the Cambridge Crystallographic Data Centre. A range of methodologies was used by the participating groups in order to evaluate the ability of the current computational methods to predict the crystal structures of the six organic molecules chosen as targets for this blind test. The first four targets, two rigid molecules, one semi-flexible molecule and a 1:1 salt, matched the criteria for the targets from CSP2007, while the last two targets belonged to two new challenging categories – a larger, much more flexible molecule and a hydrate with more than one polymorph. Each group submitted three predictions for each target it attempted. There was at least one successful prediction for each target, and two groups were able to successfully predict the structure of the large flexible molecule as their first place submission. The results show that while not as many groups successfully predicted the structures of the three smallest molecules as in CSP2007, there is now evidence that methodologies such as dispersion-corrected density functional theory (DFT-D) are able to reliably do so. The results also highlight the many challenges posed by more complex systems and show that there are still issues to be overcome. PMID:22101543
Self-Study and Evaluation Guide/Revised 1979. Section C-1: Function and Structure.
ERIC Educational Resources Information Center
National Accreditation Council for Agencies Serving the Blind and Visually Handicapped, New York, NY.
The self study guide designed for accreditation of programs serving the blind and visually handicapped covers function and structure standards, standards address five areas: basic characteristics of the organization (legal base, planning, consumer rights), governing authority, the Chief administrator, basic administrative structure (fees for…
Boonmak, S; Boonmak, P; Bunsaengjaroen, P; Srichaipanha, S
2006-05-01
To evaluate disposable LMA for endotracheal intubation using the FOB guidance and blind techniques. The authors included ASA class I-II patients between 15 and 60 years of age, with mouth opening more than 3 cm, scheduled for elective surgery. The authors excluded patients with any history of gastro-esophageal reflux, full stomach or a body weight < 30 kg. All of the patients received standard general anesthesia. After inducing anesthesia, a disposable LMA No. 3 or No. 4 (Soft Seal, Smiths Medical, Portex Inc, USA) was inserted while the patient was in the sniff position. The authors recorded the insertion time, the ease of insertion, the anatomic placement and position. The authors then inserted a flexible endotracheal tube (No. 6.5 for LMA No. 4 and No. 6 for LMA No. 3) and recorded the success rate and the ease of insertion. After three failures, the authors used FOB guidance. Sixty patients were enrolled (32 males). The mean +/- SD age and BMI was 43.2 +/- 13.4 years and 22.6 +/- 3.9, respectively. Most of the patients had a Mallampati of grade I. The mean +/- SD insertion time was 24.6 +/- 16.1 sec. After the FOB evaluation, only 27 patients had an anatomic placement in full view of the glottis. Eighteen patients had vocal cords in the middle part of the opening. The success rate of blind endotracheal intubation was 5 percent (95%CI 1.0-13.9) (3/60); while the success rate with FOB guidance was 85 percent (95%CI 73.4-92.9). A disposable laryngeal mask airway (Soft Seal) for blind endotracheal intubation had a low success rate, but it could be used more successfully with FOB guidance.
NASA Technical Reports Server (NTRS)
Westrup, R. W.
1971-01-01
The application of general design approaches for preventing failures due to repeated load cycles is briefly discussed. Program objective, mission requirements, and structural design criteria are summarized. Discrete structural elements and associated sections were selected for detailed strength, fatigue, and fracture mechanics investigations.
NASA Astrophysics Data System (ADS)
Ishiyama, T.; Mueller, K.; Togo, M.
2004-12-01
We present structural models constrained by tectonic geomorphology, surface geologic mapping, shallow borehole transects and a high-resolution S-wave seismic reflection profile to define the kinematic evolution of a coseismic fold scarp along the Nobi-Ise fault zone (NIFZ). The NIFZ is an active intraplate fault system in central Japan, and consists of a 110-km-long array of active, east-verging reverse faults. Fold scarps along the Yoro fault are interpreted as produced during a large historic blind-thrust earthquake. The Yoro Mountains form the stripped core of the largest structure in the NIFZ and expose Triassic-Jurassic basement that are thrust eastward over a 2-km-thick sequence of Pliocene-Pleistocene strata deposited in the Nobi basin. This basement-cored fold is underlain by an active blind thrust that is expressed as late Holocene fold scarps along its eastern flank. Drilling investigations across the fold scarp at a site near Shizu identified at least three episodes of active folding associated with large earthquakes on the Yoro fault. Radiocarbon ages constrain the latest event as having occurred in a period that contains historical evidence for a large earthquake in A.D. 1586. A high resolution, S-wave seismic reflection profile at the same site shows that the topographic fold scarp coincides with the projected surface trace of the synclinal axis, across which the buried, early Holocene to historic sedimentary units are folded. This is interpreted to indicate that the structure accommodated coseismic fault-propagation folding during the A.D. 1586 blind thrust earthquake. Flexural-slip folding associated with secondary bedding-parallel thrusts may also deform late Holocene strata and act to consume slip on the primary blind thrust across the synclinal axial surfaces. The best-fitting trishear model for folded ca. 13 ka gravels deposited across the forelimb requires a 28\\deg east-dipping thrust fault. This solution suggests that a 4.2 mm/yr of slip rate has been accommodated on the Yoro fault during the late Holocene, with an average vertical rate of 1.9 mm/yr. This is consistent with longer-term slip rates calculated by a structural relief across a ca. 7.3 ka volcanic ash horizon (1.6 mm/yr), and ca. 110 ka innerbay clays (1.3 mm/yr) deposited across the forelimb. Our trishear model is thus able to account for the bulk of the folding history accommodated at shorter millennial timescales, suggesting that this technique may be used to adequately define slip rates on blind thrust faults.
Unique failure behavior of metal/composite aircraft structural components under crash type loads
NASA Technical Reports Server (NTRS)
Carden, Huey D.
1990-01-01
Failure behavior results are presented on some of the crash dynamics research conducted with concepts of aircraft elements and substructure which have not necessarily been designed or optimized for energy absorption or crash loading considerations. To achieve desired new designs which incorporate improved energy absorption capabilities often requires an understanding of how more conventional designs behave under crash type loadings. Experimental and analytical data are presented which indicate some general trends in the failure behavior of a class of composite structures which include individual fuselage frames, skeleton subfloors with stringers and floor beams but without skin covering, and subfloors with skin added to the frame-stringer arrangement. Although the behavior is complex, a strong similarity in the static/dynamic failure behavior among these structures is illustrated through photographs of the experimental results and through analytical data of generic composite structural models. It is believed that the thread of similarity in behavior is telling the designer and dynamists a great deal about what to expect in the crash behavior of these structures and can guide designs for improving the energy absorption and crash behavior of such structures.
Detecting Structural Failures Via Acoustic Impulse Responses
NASA Technical Reports Server (NTRS)
Bayard, David S.; Joshi, Sanjay S.
1995-01-01
Advanced method of acoustic pulse reflectivity testing developed for use in determining sizes and locations of failures within structures. Used to detect breaks in electrical transmission lines, detect faults in optical fibers, and determine mechanical properties of materials. In method, structure vibrationally excited with acoustic pulse (a "ping") at one location and acoustic response measured at same or different location. Measured acoustic response digitized, then processed by finite-impulse-response (FIR) filtering algorithm unique to method and based on acoustic-wave-propagation and -reflection properties of structure. Offers several advantages: does not require training, does not require prior knowledge of mathematical model of acoustic response of structure, enables detection and localization of multiple failures, and yields data on extent of damage at each location.
NASA Astrophysics Data System (ADS)
Lara, Gabriela; Klinger, Federico Lince; Perucca, Laura; Rojo, Guillermo; Vargas, Nicolás; Leiva, Flavia
2017-08-01
A high-resolution superficial geophysical study was carried out in an area of the retroarc region of the Andes mountains, located in the southwest of San Juan Province (31°45‧ S, 68°50‧ W), Central Precordillera of Argentina. The main objectives of this study were to confirm the presence of blind neotectonic structures and characterize them by observing variations in magnetic susceptibility, density and p-wave velocities. Geological evidence demonstrates the existence of a neotectonic fault scarps affecting Quaternary alluvial deposits in eastern piedmont of de Las Osamentas range, in addition to direct observation of the cinematic of this feature in several natural exposures. The Maradona valley is characterized by the imbricated eastern-vergence Maradona Fault System that uplifts Neogene sedimentary rocks (Albarracín Formation) over Quaternary (Late Pleistocene-Holocene) alluvial deposits. The combined application of different geophysical methods has allowed the characterization of a blind fault geometry also identified on a natural exposure. The magnetic data added to the gravimetric model, and its integration with a seismic profile clearly shows the existence of an anomalous zone, interpreted as uplifted blocks of Miocene sedimentary rocks of Formation Albarracín displaced over Quaternary deposits. The application and development of different geophysical methods, together with geological studies allow to significantly improving the knowledge of an area affected by Quaternary tectonic activity. Finally, this multidisciplinary study, applied in active blind structures is very relevant for future seismic hazard analysis on areas located very close to populated centers.
Ołdziej, S; Czaplewski, C; Liwo, A; Chinchio, M; Nanias, M; Vila, J A; Khalili, M; Arnautova, Y A; Jagielska, A; Makowski, M; Schafroth, H D; Kaźmierkiewicz, R; Ripoll, D R; Pillardy, J; Saunders, J A; Kang, Y K; Gibson, K D; Scheraga, H A
2005-05-24
Recent improvements in the protein-structure prediction method developed in our laboratory, based on the thermodynamic hypothesis, are described. The conformational space is searched extensively at the united-residue level by using our physics-based UNRES energy function and the conformational space annealing method of global optimization. The lowest-energy coarse-grained structures are then converted to an all-atom representation and energy-minimized with the ECEPP/3 force field. The procedure was assessed in two recent blind tests of protein-structure prediction. During the first blind test, we predicted large fragments of alpha and alpha+beta proteins [60-70 residues with C(alpha) rms deviation (rmsd) <6 A]. However, for alpha+beta proteins, significant topological errors occurred despite low rmsd values. In the second exercise, we predicted whole structures of five proteins (two alpha and three alpha+beta, with sizes of 53-235 residues) with remarkably good accuracy. In particular, for the genomic target TM0487 (a 102-residue alpha+beta protein from Thermotoga maritima), we predicted the complete, topologically correct structure with 7.3-A C(alpha) rmsd. So far this protein is the largest alpha+beta protein predicted based solely on the amino acid sequence and a physics-based potential-energy function and search procedure. For target T0198, a phosphate transport system regulator PhoU from T. maritima (a 235-residue mainly alpha-helical protein), we predicted the topology of the whole six-helix bundle correctly within 8 A rmsd, except the 32 C-terminal residues, most of which form a beta-hairpin. These and other examples described in this work demonstrate significant progress in physics-based protein-structure prediction.
Tonin, Fernanda S; Piazza, Thais; Wiens, Astrid; Fernandez-Llimos, Fernando; Pontarolo, Roberto
2015-12-01
Objective:We aimed to gather evidence of the discontinuation rates owing to adverse events or treatment failure for four recently approved antipsychotics (asenapine, blonanserin, iloperidone, and lurasidone).Methods: A systematic review followed by pairwise meta-analysis and mixed treatment comparison meta analysis(MTC) was performed, including randomized controlled trials (RCTs) that compared the use of the above-mentioned drugs versus placebo in patients with schizophrenia. An electronic search was conducted in PubMed, Scopus, Science Direct, Scielo, the Cochrane Library, and International Pharmaceutical Abstracts(January 2015). The included trials were at least single blinded. The main outcome measures extracted were discontinuation owing to adverse events and discontinuation owing to treatment failure.Results: Fifteen RCTs were identified (n = 5400 participants) and 13 of them were amenable for use in our meta-analyses. No significant differences were observed between any of the four drugs and placebo as regards discontinuation owing to adverse events, whether in pairwise meta-analysis or in MTC. All drugs presented a better profile than placebo on discontinuation owing to treatment failure, both in pairwise meta-analysis and MTC. Asenapine was found to be the best therapy in terms of tolerability owing to failure,while lurasidone was the worst treatment in terms of adverse events. The evidence around blonanserin is weak.Conclusion: MTCs allowed the creation of two different rank orders of these four antipsychotic drugs in two outcome measures. This evidence-generating method allows direct and indirect comparisons, supporting approval and pricing decisions when lacking sufficient, direct, head-to-head trials.
The Failure Envelope Concept Applied To The Bone-Dental Implant System.
Korabi, R; Shemtov-Yona, K; Dorogoy, A; Rittel, D
2017-05-17
Dental implants interact with the jawbone through their common interface. While the implant is an inert structure, the jawbone is a living one that reacts to mechanical stimuli. Setting aside mechanical failure considerations of the implant, the bone is the main component to be addressed. With most failure criteria being expressed in terms of stress or strain values, their fulfillment can mean structural flow or fracture. However, in addition to those effects, the bony structure is likely to react biologically to the applied loads by dissolution or remodeling, so that additional (strain-based) criteria must be taken into account. While the literature abounds in studies of particular loading configurations, e.g. angle and value of the applied load to the implant, a general study of the admissible implant loads is still missing. This paper introduces the concept of failure envelopes for the dental implant-jawbone system, thereby defining admissible combinations of vertical and lateral loads for various failure criteria of the jawbone. Those envelopes are compared in terms of conservatism, thereby providing a systematic comparison of the various failure criteria and their determination of the admissible loads.
Chen, Horng H; Anstrom, Kevin J; Givertz, Michael M; Stevenson, Lynne W; Semigran, Marc J; Goldsmith, Steven R; Bart, Bradley A; Bull, David A; Stehlik, Josef; LeWinter, Martin M; Konstam, Marvin A; Huggins, Gordon S; Rouleau, Jean L; O'Meara, Eileen; Tang, W H Wilson; Starling, Randall C; Butler, Javed; Deswal, Anita; Felker, G Michael; O'Connor, Christopher M; Bonita, Raphael E; Margulies, Kenneth B; Cappola, Thomas P; Ofili, Elizabeth O; Mann, Douglas L; Dávila-Román, Víctor G; McNulty, Steven E; Borlaug, Barry A; Velazquez, Eric J; Lee, Kerry L; Shah, Monica R; Hernandez, Adrian F; Braunwald, Eugene; Redfield, Margaret M
2013-12-18
Small studies suggest that low-dose dopamine or low-dose nesiritide may enhance decongestion and preserve renal function in patients with acute heart failure and renal dysfunction; however, neither strategy has been rigorously tested. To test the 2 independent hypotheses that, compared with placebo, addition of low-dose dopamine (2 μg/kg/min) or low-dose nesiritide (0.005 μg/kg/min without bolus) to diuretic therapy will enhance decongestion and preserve renal function in patients with acute heart failure and renal dysfunction. Multicenter, double-blind, placebo-controlled clinical trial (Renal Optimization Strategies Evaluation [ROSE]) of 360 hospitalized patients with acute heart failure and renal dysfunction (estimated glomerular filtration rate of 15-60 mL/min/1.73 m2), randomized within 24 hours of admission. Enrollment occurred from September 2010 to March 2013 across 26 sites in North America. Participants were randomized in an open, 1:1 allocation ratio to the dopamine or nesiritide strategy. Within each strategy, participants were randomized in a double-blind, 2:1 ratio to active treatment or placebo. The dopamine (n = 122) and nesiritide (n = 119) groups were independently compared with the pooled placebo group (n = 119). Coprimary end points included 72-hour cumulative urine volume (decongestion end point) and the change in serum cystatin C from enrollment to 72 hours (renal function end point). Compared with placebo, low-dose dopamine had no significant effect on 72-hour cumulative urine volume (dopamine, 8524 mL; 95% CI, 7917-9131 vs placebo, 8296 mL; 95% CI, 7762-8830 ; difference, 229 mL; 95% CI, -714 to 1171 mL; P = .59) or on the change in cystatin C level (dopamine, 0.12 mg/L; 95% CI, 0.06-0.18 vs placebo, 0.11 mg/L; 95% CI, 0.06-0.16; difference, 0.01; 95% CI, -0.08 to 0.10; P = .72). Similarly, low-dose nesiritide had no significant effect on 72-hour cumulative urine volume (nesiritide, 8574 mL; 95% CI, 8014-9134 vs placebo, 8296 mL; 95% CI, 7762-8830; difference, 279 mL; 95% CI, -618 to 1176 mL; P = .49) or on the change in cystatin C level (nesiritide, 0.07 mg/L; 95% CI, 0.01-0.13 vs placebo, 0.11 mg/L; 95% CI, 0.06-0.16; difference, -0.04; 95% CI, -0.13 to 0.05; P = .36). Compared with placebo, there was no effect of low-dose dopamine or nesiritide on secondary end points reflective of decongestion, renal function, or clinical outcomes. In participants with acute heart failure and renal dysfunction, neither low-dose dopamine nor low-dose nesiritide enhanced decongestion or improved renal function when added to diuretic therapy. clinicaltrials.gov Identifier: NCT01132846.
Corrosion protection and steel-concrete bond improvement of prestressing strand.
DOT National Transportation Integrated Search
2012-12-01
Corrosion can lead to the premature deterioration and failure of transportation structures. In pre-stressed bridge structures corrosion is more severe, : leading to sudden failures when cracking is induced at pitting sites by tensile or compressive s...
Effect of congenital blindness on the semantic representation of some everyday concepts.
Connolly, Andrew C; Gleitman, Lila R; Thompson-Schill, Sharon L
2007-05-15
This study explores how the lack of first-hand experience with color, as a result of congenital blindness, affects implicit judgments about "higher-order" concepts, such as "fruits and vegetables" (FV), but not others, such as "household items" (HHI). We demonstrate how the differential diagnosticity of color across our test categories interacts with visual experience to produce, in effect, a category-specific difference in implicit similarity. Implicit pair-wise similarity judgments were collected by using an odd-man-out triad task. Pair-wise similarities for both FV and for HHI were derived from this task and were compared by using cluster analysis and regression analyses. Color was found to be a significant component in the structure of implicit similarity for FV for sighted participants but not for blind participants; and this pattern remained even when the analysis was restricted to blind participants who had good explicit color knowledge of the stimulus items. There was also no evidence that either subject group used color knowledge in making decisions about HHI, nor was there an indication of any qualitative differences between blind and sighted subjects' judgments on HHI.
Code of Federal Regulations, 2014 CFR
2014-01-01
... pool slide shall be such that no structural failures of any component part shall cause failures of any... such fasteners shall not cause a failure of the tread under the ladder loading conditions specified in... without failure or permanent deformation. (d) Handrails. Swimming pool slide ladders shall be equipped...
Code of Federal Regulations, 2012 CFR
2012-01-01
... pool slide shall be such that no structural failures of any component part shall cause failures of any... such fasteners shall not cause a failure of the tread under the ladder loading conditions specified in... without failure or permanent deformation. (d) Handrails. Swimming pool slide ladders shall be equipped...
The ethics of pharmaceutical research funding: a social organization approach.
Gray, Garry C
2013-01-01
This paper advances a social organization approach to examining unethical behavior. While unethical behaviors may stem in part from failures in individual morality or psychological blind spots, they are both generated and performed through social interactions among individuals and groups. To illustrate the value of a social organization approach, a case study of a medical school professor's first experience with pharmaceutical-company-sponsored research is provided in order to examine how funding arrangements can constrain research integrity. The case illustrates three significant ways that institutional corruption can occur in the research process. First, conflicts of norms between pharmaceutical companies, universities, and affiliated teaching hospitals can result in compromises and self-censorship. Second, normal behavior is shaped through routine interactions. Unethical behaviors can be (or can become) normal behaviors when they are produced and reproduced through a network of social interactions. Third, funding arrangements can create networks of dependency that structurally distort the independence of the academic researcher in favor of the funder's interests. More broadly, the case study demonstrates how the social organization approach deepens our understanding of the practice of ethics. © 2013 American Society of Law, Medicine & Ethics, Inc.
A new multipartite plate system for anterior cervical spine surgery; finite element analysis.
Şimşek, Hakan; Zorlu, Emre; Kaya, Serdar; Baydoğan, Murat; Atabey, Cem; Çolak, Ahmet
2017-12-19
There are numerous available plates, almost all of which are compact one-piece plates. During the placement of relatively long plates in the treatment of multi-level cervical pathologies, instrument related complications might appear. In order to overcome this potential problem, a novel 'articulated plate system' is designed. We aimed to delineate finite element analysis and mechanical evaluations. A new plate system consisting of multi partite structure for anterior cervical stabilization was designed. Segmental plates were designed for application onto the ventral surface of the vertebral body. Plates differed from 9 to13 mm in length. There are rods at one end and hooks at the other end. Terminal points consisted of either hooks or rods at one end but the other ends are blind. Finite element and mechanical tests of the construct were performed applying bending, axial loading, and distraction forces. Finite element and mechanical testing results yielded the cut off values for functional failure and breakage of the system. The articulated system proved to be mechanically safe and it lets extension of the system on either side as needed. Ease of application needs further verification via a cadaveric study.
Roth, Alexis M; Ackermann, Ronald T; Downs, Stephen M; Downs, Anne M; Zillich, Alan J; Holmes, Ann M; Katz, Barry P; Murray, Michael D; Inui, Thomas S
2010-06-01
In 2003, the Indiana Office of Medicaid Policy and Planning launched the Indiana Chronic Disease Management Program (ICDMP), a programme intended to improve the health and healthcare utilization of 15,000 Aged, Blind and Disabled Medicaid members living with diabetes and/or congestive heart failure in Indiana. Within ICDMP, programme components derived from the Chronic Care Model and education based on an integrated theoretical framework were utilized to create a telephonic care management intervention that was delivered by trained, non-clinical Care Managers (CMs) working under the supervision of a Registered Nurse. CMs utilized computer-assisted health education scripts to address clinically important topics, including medication adherence, diet, exercise and prevention of disease-specific complications. Employing reflective listening techniques, barriers to optimal self-management were assessed and members were encouraged to engage in health-improving actions. ICDMP evaluation results suggest that this low-intensity telephonic intervention shifted utilization and lowered costs. We discuss this patient-centred method for motivating behaviour change, the theoretical constructs underlying the scripts and the branched-logic format that makes them suitable to use as a computer-based application. Our aim is to share these public-domain materials with other programmes.
[From inside to outside? Blind alleys in the discussion of psychoanalysis and society].
Reiche, R
1995-03-01
The attempt first instituted by Freud to use the instruments of psychoanalysis to improve understanding not only of the individual but also of society as a whole has a long tradition, particularly in Germany. Reviewing the last thirty years of discourse on the range of the applicability of psychoanalysis in this context, the author comes to the conclusion that the fruits of this discussion are negligible. Reiche distinguishes five major lines of discourse to illustrate this failure to establish the relevance of a psychoanalytic approach to illuminating the "out-side" world: the first is one of assimilation and desiccation, reference here being to psychoanalytic culture critique; the second a pathological reaction of collective grieving bound up with the Critical Theory; the third the aggressive rebuffs levelled at psychoanalytic insights by systems theory; the fourth a line of devaluation and usurpation as represented by post-structuralism and deconstructionism. In the fifth and final strand of psychoanalytic application discourse discernible in the theory of communicative action, the author discerns a tentative new rapprochement between sociology and psychoanalysis. The author's final conclusion is that psychoanalysis is suitable for the perspective on the inside world, while the outside world is beyond the scope of psychoanalytic theory.
Development of GENOA Progressive Failure Parallel Processing Software Systems
NASA Technical Reports Server (NTRS)
Abdi, Frank; Minnetyan, Levon
1999-01-01
A capability consisting of software development and experimental techniques has been developed and is described. The capability is integrated into GENOA-PFA to model polymer matrix composite (PMC) structures. The capability considers the physics and mechanics of composite materials and structure by integration of a hierarchical multilevel macro-scale (lamina, laminate, and structure) and micro scale (fiber, matrix, and interface) simulation analyses. The modeling involves (1) ply layering methodology utilizing FEM elements with through-the-thickness representation, (2) simulation of effects of material defects and conditions (e.g., voids, fiber waviness, and residual stress) on global static and cyclic fatigue strengths, (3) including material nonlinearities (by updating properties periodically) and geometrical nonlinearities (by Lagrangian updating), (4) simulating crack initiation. and growth to failure under static, cyclic, creep, and impact loads. (5) progressive fracture analysis to determine durability and damage tolerance. (6) identifying the percent contribution of various possible composite failure modes involved in critical damage events. and (7) determining sensitivities of failure modes to design parameters (e.g., fiber volume fraction, ply thickness, fiber orientation. and adhesive-bond thickness). GENOA-PFA progressive failure analysis is now ready for use to investigate the effects on structural responses to PMC material degradation from damage induced by static, cyclic (fatigue). creep, and impact loading in 2D/3D PMC structures subjected to hygrothermal environments. Its use will significantly facilitate targeting design parameter changes that will be most effective in reducing the probability of a given failure mode occurring.
Structural Analysis for the American Airlines Flight 587 Accident Investigation: Global Analysis
NASA Technical Reports Server (NTRS)
Young, Richard D.; Lovejoy, Andrew E.; Hilburger, Mark W.; Moore, David F.
2005-01-01
NASA Langley Research Center (LaRC) supported the National Transportation Safety Board (NTSB) in the American Airlines Flight 587 accident investigation due to LaRC's expertise in high-fidelity structural analysis and testing of composite structures and materials. A Global Analysis Team from LaRC reviewed the manufacturer s design and certification procedures, developed finite element models and conducted structural analyses, and participated jointly with the NTSB and Airbus in subcomponent tests conducted at Airbus in Hamburg, Germany. The Global Analysis Team identified no significant or obvious deficiencies in the Airbus certification and design methods. Analysis results from the LaRC team indicated that the most-likely failure scenario was failure initiation at the right rear main attachment fitting (lug), followed by an unstable progression of failure of all fin-to-fuselage attachments and separation of the VTP from the aircraft. Additionally, analysis results indicated that failure initiates at the final observed maximum fin loading condition in the accident, when the VTP was subjected to loads that were at minimum 1.92 times the design limit load condition for certification. For certification, the VTP is only required to support loads of 1.5 times design limit load without catastrophic failure. The maximum loading during the accident was shown to significantly exceed the certification requirement. Thus, the structure appeared to perform in a manner consistent with its design and certification, and failure is attributed to VTP loads greater than expected.
Bristow, Michael R; Kao, David P; Breathett, Khadijah K; Altman, Natasha L; Gorcsan, John; Gill, Edward A; Lowes, Brian D; Gilbert, Edward M; Quaife, Robert A; Mann, Douglas L
2017-11-01
Diagnosis, prognosis, treatment, and development of new therapies for diseases or syndromes depend on a reliable means of identifying phenotypes associated with distinct predictive probabilities for these various objectives. Left ventricular ejection fraction (LVEF) provides the current basis for combined functional and structural phenotyping in heart failure by classifying patients as those with heart failure with reduced ejection fraction (HFrEF) and those with heart failure with preserved ejection fraction (HFpEF). Recently the utility of LVEF as the major phenotypic determinant of heart failure has been challenged based on its load dependency and measurement variability. We review the history of the development and adoption of LVEF as a critical measurement of LV function and structure and demonstrate that, in chronic heart failure, load dependency is not an important practical issue, and we provide hemodynamic and molecular biomarker evidence that LVEF is superior or equal to more unwieldy methods of identifying phenotypes of ventricular remodeling. We conclude that, because it reliably measures both left ventricular function and structure, LVEF remains the best current method of assessing pathologic remodeling in heart failure in both individual clinical and multicenter group settings. Because of the present and future importance of left ventricular phenotyping in heart failure, LVEF should be measured by using the most accurate technology and methodologic refinements available, and improved characterization methods should continue to be sought. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Schackman, Bruce R; Ribaudo, Heather J; Krambrink, Amy; Hughes, Valery; Kuritzkes, Daniel R; Gulick, Roy M
2007-12-15
Blacks had higher rates of virologic failure than whites on efavirenz-containing regimens in the AIDS Clinical Trials Group (ACTG) A5095 study; preliminary analyses also suggested an association with adherence. We rigorously examined associations over time among race, virologic failure, 4 self-reported adherence metrics, and quality of life (QOL). ACTG A5095 was a double-blind placebo-controlled study of treatment-naive HIV-positive patients randomized to zidovudine/lamivudine/abacavir versus zidovudine/lamivudine plus efavirenz versus zidovudine/lamivudine/abacavir plus efavirenz. Virologic failure was defined as confirmed HIV-1 RNA >or=200 copies/mL at >or=16 weeks on study. The zidovudine/lamivudine/abacavir arm was discontinued early because of virologic inferiority. We examined virologic failure differences for efavirenz-containing arms according to missing 0 (adherent) versus at least 1 dose (nonadherent) during the past 4 days, alternative self-reported adherence metrics, and QOL. Analyses used the Fisher exact, log rank tests, and Cox proportional hazards models. The study population included white (n = 299), black (n = 260), and Hispanic (n = 156) patients with >or=1 adherence evaluation. Virologic failure was associated with week 12 nonadherence during the past 4 days for blacks (53% nonadherent failed vs. 25% adherent; P < 0.001) but not for whites (20% nonadherent failed vs. 20% adherent; P = 0.91). After adjustment for baseline covariates and treatment, there was a significant interaction between race and week 12 adherence (P = 0.02). In time-dependent Cox models using self-reports over time to reflect recent adherence, there was a significantly higher failure risk for nonadherent subjects (hazard ratio [HR] = 2.07; P < 0.001). Significant race-adherence interactions were seen in additional models of adherence: missing at least 1 medication dose ever (P = 0.04), past month (P < 0.01), or past weekend (P = 0.05). Lower QOL was significantly associated with virologic failure (P < 0.001); there was no evidence of an interaction between QOL and race (P = 0.39) or adherence (P = 0.51) in predicting virologic failure. There was a greater effect of nonadherence on virologic failure in blacks given efavirenz-containing regimens than in whites. Self-reported adherence and QOL are independent predictors of virologic failure.
Pre-configured polyhedron based protection against multi-link failures in optical mesh networks.
Huang, Shanguo; Guo, Bingli; Li, Xin; Zhang, Jie; Zhao, Yongli; Gu, Wanyi
2014-02-10
This paper focuses on random multi-link failures protection in optical mesh networks, instead of single, the dual or sequential failures of previous studies. Spare resource efficiency and failure robustness are major concerns in link protection strategy designing and a k-regular and k-edge connected structure is proved to be one of the optimal solutions for link protection network. Based on this, a novel pre-configured polyhedron based protection structure is proposed, and it could provide protection for both simultaneous and sequential random link failures with improved spare resource efficiency. Its performance is evaluated in terms of spare resource consumption, recovery rate and average recovery path length, as well as compared with ring based and subgraph protection under probabilistic link failure scenarios. Results show the proposed novel link protection approach has better performance than previous works.
Melani, Christopher; Advani, Ranjana; Roschewski, Mark; Walters, Kelsey M; Chen, Clara C; Baratto, Lucia; Ahlman, Mark A; Miljkovic, Milos D; Steinberg, Seth M; Lam, Jessica; Shovlin, Margaret; Dunleavy, Kieron; Pittaluga, Stefania; Jaffe, Elaine S; Wilson, Wyndham H
2018-05-10
Dose-adjusted-EPOCH-R obviates the need for radiotherapy in most patients with primary mediastinal B-cell lymphoma. End-of-treatment PET, however, does not accurately identify patients at risk of treatment failure, thereby confounding clinical decision making. To define the role of PET in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R, we extended enrollment and follow-up on our published phase II trial and independent series. Ninety-three patients received dose-adjusted-EPOCH-R without radiotherapy. End-of-treatment PET was performed in 80 patients, of whom 57 received 144 serial scans. One nuclear medicine physician from each institution blindly reviewed all scans from their respective institution. End-of-treatment PET was negative (Deauville 1-3) in 55 (69%) patients with one treatment failure (8-year event-free and overall survival of 96.0% and 97.7%). Among 25 (31%) patients with a positive (Deauville 4-5) end-of-treatment PET, there were 5 (20%) treatment failures (8-year event-free and overall survival of 71.1% and 84.3%). Linear regression analysis of serial scans showed a significant decrease in SUVmax in positive end-of-treatment PET non-progressors compared to an increase in treatment failures. Among 6 treatment failures, the median end-of-treatment SUVmax was 15.4 (range, 1.9-21.3) and 4 achieved long-term remission with salvage therapy. Virtually all patients with a negative end-of-treatment PET following dose-adjusted-EPOCH-R achieved durable remissions and should not receive radiotherapy. Among patients with a positive end-of-treatment PET, only 5/25 (20%) had treatment-failure. Serial PET imaging distinguished end-of-treatment PET positive patients without treatment failure, thereby reducing unnecessary radiotherapy by 80%, and should be considered in all patients with an initial positive PET following dose-adjusted-EPOCH-R (NCT00001337). Copyright © 2018, Ferrata Storti Foundation.
Abnormalities of the QT interval in primary disorders of autonomic failure.
Choy, A M; Lang, C C; Roden, D M; Robertson, D; Wood, A J; Robertson, R M; Biaggioni, I
1998-10-01
Experimental evidence shows that activation of the autonomic nervous system influences ventricular repolarization and, therefore, the QT interval on the ECG. To test the hypothesis that the QT interval is abnormal in autonomic dysfunction, we examined ECGs in patients with severe primary autonomic failure and in patients with congenital dopamine beta-hydroxylase (DbetaH) deficiency who are unable to synthesize norepinephrine and epinephrine. Maximal QT and rate-corrected QT (QTc) intervals and adjusted QTc dispersion [(maximal QTc - minimum QTc on 12 lead ECG)/square root of the number of leads measured] were determined in blinded fashion from ECGs of 67 patients with primary autonomic failure (36 patients with multiple system atrophy [MSA], and 31 patients with pure autonomic failure [PAF]) and 17 age- and sex-matched healthy controls. ECGs of 5 patients with congenital DbetaH deficiency and 6 age- and sex-matched controls were also analyzed. Patients with MSA and PAF had significantly prolonged maximum QTc intervals (492+/-58 ms(1/2) and 502+/-61 ms(1/2) [mean +/- SD]), respectively, compared with controls (450+/-18 ms(1/2), P < .05 and P < .01, respectively). A similar but not significant trend was observed for QT. QTc dispersion was also increased in MSA (40+/-20 ms(1/2), P < .05 vs controls) and PAF patients (32+/-19 ms(1/2), NS) compared with controls (21+/-5 ms(1/2)). In contrast, patients with congenital DbetaH deficiency did not have significantly different RR, QT, QTc intervals, or QTc dispersion when compared with controls. Patients with primary autonomic failure who have combined parasympathetic and sympathetic failure have abnormally prolonged QT interval and increased QT dispersion. However, QT interval in patients with congenital DbetaH deficiency was not significantly different from controls. It is possible, therefore, that QT abnormalities in patients with primary autonomic failure are not solely caused by lesions of the sympathetic nervous system, and that the parasympathetic nervous system is likely to have a modulatory role in ventricular repolarization.
Gasbarro, Gregory; Ye, Jason; Newsome, Hillary; Jiang, Kevin; Wright, Vonda; Vyas, Dharmesh; Irrgang, James J; Musahl, Volker
2016-10-01
To evaluate whether morphologic characteristics of rotator cuff tear have prognostic value in determining symptomatic structural failure of arthroscopic rotator cuff repair independent of age or gender. Arthroscopic rotator cuff repair cases performed by five fellowship-trained surgeons at our institution from 2006 to 2013 were retrospectively reviewed. Data extraction included demographics, comorbidities, repair technique, clinical examination, and radiographic findings. Failure in symptomatic patients was defined as structural defect on postoperative magnetic resonance imaging or pseudoparalysis on examination. Failures were age and gender matched with successful repairs in a 1:2 ratio. A total of 30 failures and 60 controls were identified. Supraspinatus atrophy (P = .03) and tear size (18.3 mm failures v 13.9 mm controls; P = .02) were significant risk factors for failure, as was the presence of an infraspinatus tear greater than 10 mm (62% v 17%, P < .01). Single-row repair (P = .06) and simple suture configuration (P = .17) were more common but similar between groups. Diabetes mellitus and active tobacco use were not significantly associated with increased failure risk but psychiatric medication use was more frequent in the failure group. This study confirms previous suspicions that tear size and fatty infiltration are associated with failure of arthroscopic rotator cuff repair but independent of age or gender in symptomatic patients. There is also a quantitative cutoff on magnetic resonance imaging for the size of infraspinatus involvement that can be used clinically as a predicting factor. Although reported in the literature, smoking and diabetes were not associated with failure. Level III, retrospective case control. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
NASA Technical Reports Server (NTRS)
Packard, Michael H.
2002-01-01
Probabilistic Structural Analysis (PSA) is now commonly used for predicting the distribution of time/cycles to failure of turbine blades and other engine components. These distributions are typically based on fatigue/fracture and creep failure modes of these components. Additionally, reliability analysis is used for taking test data related to particular failure modes and calculating failure rate distributions of electronic and electromechanical components. How can these individual failure time distributions of structural, electronic and electromechanical component failure modes be effectively combined into a top level model for overall system evaluation of component upgrades, changes in maintenance intervals, or line replaceable unit (LRU) redesign? This paper shows an example of how various probabilistic failure predictions for turbine engine components can be evaluated and combined to show their effect on overall engine performance. A generic model of a turbofan engine was modeled using various Probabilistic Risk Assessment (PRA) tools (Quantitative Risk Assessment Software (QRAS) etc.). Hypothetical PSA results for a number of structural components along with mitigation factors that would restrict the failure mode from propagating to a Loss of Mission (LOM) failure were used in the models. The output of this program includes an overall failure distribution for LOM of the system. The rank and contribution to the overall Mission Success (MS) is also given for each failure mode and each subsystem. This application methodology demonstrates the effectiveness of PRA for assessing the performance of large turbine engines. Additionally, the effects of system changes and upgrades, the application of different maintenance intervals, inclusion of new sensor detection of faults and other upgrades were evaluated in determining overall turbine engine reliability.
[Cystinosis : Diagnosis, cystine-depleting therapy, and transition].
Kaufeld, Jessica; Weber, Lutz T; Kurschat, Christine; Canaan-Kuehl, Sima; Brand, Eva; Oh, Jun; Pape, Lars
2018-04-18
This article presents a case of cystinosis in a young man. Diagnosis of the disease and the problem of transition to adult care are described. Cystinosis is a rare lysosomal storage disease with first manifestation in early childhood presenting as renal Fanconi syndrome. Without treatment, the disease leads to severe health impairment. Due to the rarity of the disease, a correct diagnosis is often delayed. Without treatment, cystinosis often leads to end-stage renal failure, blindness, hypothyroidism, diabetes mellitus, and rickets. Cystine-depleting therapy with cysteamine significantly improves mortality and quality of life.
Predicting Error Bars for QSAR Models
NASA Astrophysics Data System (ADS)
Schroeter, Timon; Schwaighofer, Anton; Mika, Sebastian; Ter Laak, Antonius; Suelzle, Detlev; Ganzer, Ursula; Heinrich, Nikolaus; Müller, Klaus-Robert
2007-09-01
Unfavorable physicochemical properties often cause drug failures. It is therefore important to take lipophilicity and water solubility into account early on in lead discovery. This study presents log D7 models built using Gaussian Process regression, Support Vector Machines, decision trees and ridge regression algorithms based on 14556 drug discovery compounds of Bayer Schering Pharma. A blind test was conducted using 7013 new measurements from the last months. We also present independent evaluations using public data. Apart from accuracy, we discuss the quality of error bars that can be computed by Gaussian Process models, and ensemble and distance based techniques for the other modelling approaches.
A Systematic Approach to Emergencies in Uveitis
Al-Dhibi, Hassan A.; Al-Mahmood, Ammar M.; Arevalo, J. Fernando
2014-01-01
Uveitis is a common cause of preventable blindness although it is consider a sight-threatening condition particularly in cases with posterior segment inflammation. To deal with emergency conditions in uveitis, we must aware of the essential signs and symptoms that reflect a true uveitic emergency. Failure to recognize these essential signs and symptoms of a true uveitic emergency may result in a devastating visual outcome. This review provides general ophthalmologists and residents, clinical guidelines for the main uveitic entities that require immediate recognition and urgent intervention in the emergency room to prevent severe permanent visual loss. PMID:25100911
Cacciamani, Laura; Likova, Lora T.
2017-01-01
The perirhinal cortex (PRC) is a medial temporal lobe structure that has been implicated in not only visual memory in the sighted, but also tactile memory in the blind (Cacciamani & Likova, 2016). It has been proposed that, in the blind, the PRC may contribute to modulation of tactile memory responses that emerge in low-level “visual” area V1 as a result of training-induced cortical reorganization (Likova, 2012; 2015). While some studies in the sighted have indicated that the PRC is indeed structurally and functionally connected to the visual cortex (Clavagnier et al., 2004; Peterson et al., 2012), the PRC’s direct modulation of V1 is unknown—particularly in those who lack the visual input that typically stimulates this region. In the present study, we tested Likova’s PRC modulation hypothesis; specifically, we used fMRI to assess the PRC’s Granger causal influence on V1 activation in the blind during a tactile memory task. To do so, we trained congenital and acquired blind participants on a unique memory-guided drawing technique previously shown to result in V1 reorganization towards tactile memory representations (Likova, 2012). The tasks (20s each) included: tactile exploration of raised line drawings of faces and objects, tactile memory retrieval via drawing, and a scribble motor/memory control. FMRI before and after a week of the Cognitive-Kinesthetic training on these tasks revealed a significant increase in PRC-to-V1 Granger causality from pre- to post-training during the memory drawing task, but not during the motor/memory control. This increase in causal connectivity indicates that the training strengthened the top-down modulation of visual cortex from the PRC. This is the first study to demonstrate enhanced directed functional connectivity from the PRC to the visual cortex in the blind, implicating the PRC as a potential source of the reorganization towards tactile representations that occurs in V1 in the blind brain (Likova, 2012). PMID:28347878
Cacciamani, Laura; Likova, Lora T
2017-05-01
The perirhinal cortex (PRC) is a medial temporal lobe structure that has been implicated in not only visual memory in the sighted, but also tactile memory in the blind (Cacciamani & Likova, 2016). It has been proposed that, in the blind, the PRC may contribute to modulation of tactile memory responses that emerge in low-level "visual" area V1 as a result of training-induced cortical reorganization (Likova, 2012, 2015). While some studies in the sighted have indicated that the PRC is indeed structurally and functionally connected to the visual cortex (Clavagnier, Falchier, & Kennedy, 2004; Peterson, Cacciamani, Barense, & Scalf, 2012), the PRC's direct modulation of V1 is unknown-particularly in those who lack the visual input that typically stimulates this region. In the present study, we tested Likova's PRC modulation hypothesis; specifically, we used fMRI to assess the PRC's Granger causal influence on V1 activation in the blind during a tactile memory task. To do so, we trained congenital and acquired blind participants on a unique memory-guided drawing technique previously shown to result in V1 reorganization towards tactile memory representations (Likova, 2012). The tasks (20s each) included: tactile exploration of raised line drawings of faces and objects, tactile memory retrieval via drawing, and a scribble motor/memory control. FMRI before and after a week of the Cognitive-Kinesthetic training on these tasks revealed a significant increase in PRC-to-V1 Granger causality from pre- to post-training during the memory drawing task, but not during the motor/memory control. This increase in causal connectivity indicates that the training strengthened the top-down modulation of visual cortex from the PRC. This is the first study to demonstrate enhanced directed functional connectivity from the PRC to the visual cortex in the blind, implicating the PRC as a potential source of the reorganization towards tactile representations that occurs in V1 in the blind brain (Likova, 2012). Copyright © 2017 Elsevier Inc. All rights reserved.
Failure Analysis of Discrete Damaged Tailored Extension-Shear-Coupled Stiffened Composite Panels
NASA Technical Reports Server (NTRS)
Baker, Donald J.
2005-01-01
The results of an analytical and experimental investigation of the failure of composite is tiffener panels with extension-shear coupling are presented. This tailored concept, when used in the cover skins of a tiltrotor aircraft wing has the potential for increasing the aeroelastic stability margins and improving the aircraft productivity. The extension-shear coupling is achieved by using unbalanced 45 plies in the skin. The failure analysis of two tailored panel configurations that have the center stringer and adjacent skin severed is presented. Finite element analysis of the damaged panels was conducted using STAGS (STructural Analysis of General Shells) general purpose finite element program that includes a progressive failure capability for laminated composite structures that is based on point-stress analysis, traditional failure criteria, and ply discounting for material degradation. The progressive failure predicted the path of the failure and maximum load capability. There is less than 12 percent difference between the predicted failure load and experimental failure load. There is a good match of the panel stiffness and strength between the progressive failure analysis and the experimental results. The results indicate that the tailored concept would be feasible to use in the wing skin of a tiltrotor aircraft.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-10
... the system responses and performances. They cannot be considered in isolation but should be included... maintained. (iv) Failures of the system that result in forced structural vibrations (oscillatory failures...
Wang, Ping; Zheng, Qinghong; Tang, Qing; Yang, Yintang; Guo, Lixin; Huang, Feng; Song, Zhenjie; Zhang, Zhiyong
2014-01-15
The application of asymmetric Schottky barrier and electrode area in an MgZnO metal-semiconductor-metal (MSM) solar-blind ultraviolet photodetector has been investigated by a physical-based numerical model in which the electron mobility is obtained by an ensemble Monte Carlo simulation combined with first principle calculations using the density functional theory. Compared with the experimental data of symmetric and asymmetric MSM structures based on ZnO substrate, the validity of this model is verified. The asymmetric Schottky barrier and electrode area devices exhibit reductions of 20 times and 1.3 times on dark current, respectively, without apparent photocurrent scarification. The plots of photo-to-dark current ratio (PDR) indicate that the asymmetric MgZnO MSM structure has better dark current characteristic than that of the symmetric one.
Probability of failure prediction for step-stress fatigue under sine or random stress
NASA Technical Reports Server (NTRS)
Lambert, R. G.
1979-01-01
A previously proposed cumulative fatigue damage law is extended to predict the probability of failure or fatigue life for structural materials with S-N fatigue curves represented as a scatterband of failure points. The proposed law applies to structures subjected to sinusoidal or random stresses and includes the effect of initial crack (i.e., flaw) sizes. The corrected cycle ratio damage function is shown to have physical significance.
Rosa-Garrido, Manuel; Chapski, Douglas J.; Schmitt, Anthony D.; Kimball, Todd H.; Karbassi, Elaheh; Monte, Emma; Balderas, Enrique; Pellegrini, Matteo; Shih, Tsai-Ting; Soehalim, Elizabeth; Liem, David; Ping, Peipei; Galjart, Niels J.; Ren, Shuxun; Wang, Yibin; Ren, Bing
2017-01-01
Background: Cardiovascular disease is associated with epigenomic changes in the heart; however, the endogenous structure of cardiac myocyte chromatin has never been determined. Methods: To investigate the mechanisms of epigenomic function in the heart, genome-wide chromatin conformation capture (Hi-C) and DNA sequencing were performed in adult cardiac myocytes following development of pressure overload–induced hypertrophy. Mice with cardiac-specific deletion of CTCF (a ubiquitous chromatin structural protein) were generated to explore the role of this protein in chromatin structure and cardiac phenotype. Transcriptome analyses by RNA-seq were conducted as a functional readout of the epigenomic structural changes. Results: Depletion of CTCF was sufficient to induce heart failure in mice, and human patients with heart failure receiving mechanical unloading via left ventricular assist devices show increased CTCF abundance. Chromatin structural analyses revealed interactions within the cardiac myocyte genome at 5-kb resolution, enabling examination of intra- and interchromosomal events, and providing a resource for future cardiac epigenomic investigations. Pressure overload or CTCF depletion selectively altered boundary strength between topologically associating domains and A/B compartmentalization, measurements of genome accessibility. Heart failure involved decreased stability of chromatin interactions around disease-causing genes. In addition, pressure overload or CTCF depletion remodeled long-range interactions of cardiac enhancers, resulting in a significant decrease in local chromatin interactions around these functional elements. Conclusions: These findings provide a high-resolution chromatin architecture resource for cardiac epigenomic investigations and demonstrate that global structural remodeling of chromatin underpins heart failure. The newly identified principles of endogenous chromatin structure have key implications for epigenetic therapy. PMID:28802249
Rosa-Garrido, Manuel; Chapski, Douglas J; Schmitt, Anthony D; Kimball, Todd H; Karbassi, Elaheh; Monte, Emma; Balderas, Enrique; Pellegrini, Matteo; Shih, Tsai-Ting; Soehalim, Elizabeth; Liem, David; Ping, Peipei; Galjart, Niels J; Ren, Shuxun; Wang, Yibin; Ren, Bing; Vondriska, Thomas M
2017-10-24
Cardiovascular disease is associated with epigenomic changes in the heart; however, the endogenous structure of cardiac myocyte chromatin has never been determined. To investigate the mechanisms of epigenomic function in the heart, genome-wide chromatin conformation capture (Hi-C) and DNA sequencing were performed in adult cardiac myocytes following development of pressure overload-induced hypertrophy. Mice with cardiac-specific deletion of CTCF (a ubiquitous chromatin structural protein) were generated to explore the role of this protein in chromatin structure and cardiac phenotype. Transcriptome analyses by RNA-seq were conducted as a functional readout of the epigenomic structural changes. Depletion of CTCF was sufficient to induce heart failure in mice, and human patients with heart failure receiving mechanical unloading via left ventricular assist devices show increased CTCF abundance. Chromatin structural analyses revealed interactions within the cardiac myocyte genome at 5-kb resolution, enabling examination of intra- and interchromosomal events, and providing a resource for future cardiac epigenomic investigations. Pressure overload or CTCF depletion selectively altered boundary strength between topologically associating domains and A/B compartmentalization, measurements of genome accessibility. Heart failure involved decreased stability of chromatin interactions around disease-causing genes. In addition, pressure overload or CTCF depletion remodeled long-range interactions of cardiac enhancers, resulting in a significant decrease in local chromatin interactions around these functional elements. These findings provide a high-resolution chromatin architecture resource for cardiac epigenomic investigations and demonstrate that global structural remodeling of chromatin underpins heart failure. The newly identified principles of endogenous chromatin structure have key implications for epigenetic therapy. © 2017 The Authors.
Investigating Effects of Invasive Species on Plant Community Structure
ERIC Educational Resources Information Center
Franklin, Wilfred
2008-01-01
In this article, the author presents a field study project that explores factors influencing forest community structure and lifts the veil off of "plant blindness." This ecological study consists of three laboratories: (1) preliminary field trip to the study site; (2) plant survey; and (3) analyzing plant community structure with descriptive…
Clegg, Herbert W; Ryan, Amy G; Dallas, Steven D; Kaplan, Edward L; Johnson, Dwight R; Norton, H James; Roddey, Oliver F; Martin, Edward S; Swetenburg, Raymond L; Koonce, Elizabeth W; Felkner, Mary M; Giftos, P Michael
2006-09-01
Two relatively small previous studies comparing once-daily amoxicillin with conventional therapy for group A streptococcal (GAS) pharyngitis reported similar rates of bacteriologic success for each treatment group. The purpose of this study was to further evaluate once-daily amoxicillin for GAS pharyngitis in a larger study. In a single pediatric practice, from October through May for 2 consecutive years (2001-2003), we recruited children 3 to 18 years of age who had symptoms and signs suggestive of GAS pharyngitis. Patients with a positive rapid test for GAS were stratified by weight (<40 kg or >or=40 kg) and then randomly assigned to receive once-daily (750 mg or 1000 mg) or twice-daily (2 doses of 375 mg or 500 mg) amoxicillin for 10 days. We determined bacteriologic failure rates for GAS in the pharynx from subsequent swabs taken at 14 to 21 (visit 2) and 28 to 35 (visit 3) days after treatment initiation. We conducted a randomized, controlled, investigator-blinded, noninferiority trial to evaluate whether amoxicillin given once daily would have a bacteriologic failure rate no worse than that of amoxicillin given twice daily within a prespecified margin of 10%. GAS isolates were characterized to distinguish bacteriologic failures from new acquisitions. Adverse events were described and adherence was evaluated by review of returned daily logs and dosage bottles. Of 2139 potential study patients during the 2-year period, we enrolled 652 patients, 326 into each treatment group. Children in the 2 groups were comparable with respect to all demographic and clinical characteristics except that children <40 kg more often presented with rash in each treatment group. At visit 2, failure rates were 20.1% (59 of 294) for the once-daily group and 15.5% (46 of 296) for the twice-daily group (difference, 4.53%; 90% confidence interval [CI], -0.6 to 9.7). At visit 3, failure rates were 2.8% (6 of 216) for the once-daily group and 7.1% (16 of 225) for the twice-daily group (difference, -4.33; 90% CI, -7.7 to -1.0). Gastrointestinal and other adverse events occurred in the once-daily treatment group with a frequency comparable to that in the twice-daily treatment group. Presumed allergic reactions occurred in 0.9% (6 of 635). More than 95% (516 of 541) of patients complied with 10 days of therapy with no significant differences between groups. We conclude that amoxicillin given once daily is not inferior to amoxicillin given twice daily. Gastrointestinal and other events did not occur significantly more often in the once-daily treatment group. From the data in this large, investigator-blinded, controlled study, once-daily amoxicillin appears to be a suitable regimen for treatment of GAS pharyngitis.
Monitoring Corrosion of Steel Bars in Reinforced Concrete Structures
Verma, Sanjeev Kumar; Bhadauria, Sudhir Singh; Akhtar, Saleem
2014-01-01
Corrosion of steel bars embedded in reinforced concrete (RC) structures reduces the service life and durability of structures causing early failure of structure, which costs significantly for inspection and maintenance of deteriorating structures. Hence, monitoring of reinforcement corrosion is of significant importance for preventing premature failure of structures. This paper attempts to present the importance of monitoring reinforcement corrosion and describes the different methods for evaluating the corrosion state of RC structures, especially hal-cell potential (HCP) method. This paper also presents few techniques to protect concrete from corrosion. PMID:24558346
Monitoring corrosion of steel bars in reinforced concrete structures.
Verma, Sanjeev Kumar; Bhadauria, Sudhir Singh; Akhtar, Saleem
2014-01-01
Corrosion of steel bars embedded in reinforced concrete (RC) structures reduces the service life and durability of structures causing early failure of structure, which costs significantly for inspection and maintenance of deteriorating structures. Hence, monitoring of reinforcement corrosion is of significant importance for preventing premature failure of structures. This paper attempts to present the importance of monitoring reinforcement corrosion and describes the different methods for evaluating the corrosion state of RC structures, especially hal-cell potential (HCP) method. This paper also presents few techniques to protect concrete from corrosion.
The research on a novel type of the solar-blind UV head-mounted displays
NASA Astrophysics Data System (ADS)
Zhao, Shun-long
2011-08-01
Ultraviolet technology of detecting is playing a more and more important role in the field of civil application, especially in the corona discharge detection, in modern society. Now the UV imaging detector is one of the most important equipments in power equipment flaws detection. And the modern head-mounted displays (HMDs) have shown the applications in the fields of military, industry production, medical treatment, entertainment, 3D visualization, education and training. We applied the system of head-mounted displays to the UV image detection, and a novel type of head-mounted displays is presented: the solar-blind UV head-mounted displays. And the structure is given. By the solar-blind UV head-mounted displays, a real-time, isometric and visible image of the corona discharge is correctly displayed upon the background scene where it exists. The user will see the visible image of the corona discharge on the real scene rather than on a small screen. Then the user can easily find out the power equipment flaws and repair them. Compared with the traditional UV imaging detector, the introducing of the HMDs simplifies the structure of the whole system. The original visible spectrum optical system is replaced by the eye in the solar-blind UV head-mounted displays. And the optical image fusion technology would be used rather than the digital image fusion system which is necessary in traditional UV imaging detector. That means the visible spectrum optical system and digital image fusion system are not necessary. This makes the whole system cheaper than the traditional UV imaging detector. Another advantage of the solar-blind UV head-mounted displays is that the two hands of user will be free. So while observing the corona discharge the user can do some things about it. Therefore the solar-blind UV head-mounted displays can make the corona discharge expose itself to the user in a better way, and it will play an important role in corona detection in the future.
Kang, Xiaofeng; Dennison Himmelfarb, Cheryl R; Li, Zheng; Zhang, Jian; Lv, Rong; Guo, Jinyu
2015-01-01
The Self-care of Heart Failure Index (SCHFI) is an empirically tested instrument for measuring the self-care of patients with heart failure. The aim of this study was to develop a simplified Chinese version of the SCHFI and provide evidence for its construct validity. A total of 182 Chinese with heart failure were surveyed. A 2-step structural equation modeling procedure was applied to test construct validity. Factor analysis showed 3 factors explaining 43% of the variance. Structural equation model confirmed that self-care maintenance, self-care management, and self-care confidence are indeed indicators of self-care, and self-care confidence was a positive and equally strong predictor of self-care maintenance and self-care management. Moreover, self-care scores were correlated with the Partners in Health Scale, indicating satisfactory concurrent validity. The Chinese version of the SCHFI is a theory-based instrument for assessing self-care of Chinese patients with heart failure.
NASA Technical Reports Server (NTRS)
Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.
1992-01-01
An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with analytical modeling of failure phenomena to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in analytical modeling, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which analytical models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes. These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. State-of-the-art analytical models currently employed for designs failure prediction, or performance analysis are used in this methodology. The rationale for the statistical approach taken in the PFA methodology is discussed, the PFA methodology is described, and examples of its application to structural failure modes are presented. The engineering models and computer software used in fatigue crack growth and fatigue crack initiation applications are thoroughly documented.
NASA Technical Reports Server (NTRS)
Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.
1992-01-01
An improved methodology for quantitatively evaluating failure risk of spaceflights systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with analytical modeling of failure phenomena to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in analytical modeling, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which analytical models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes. These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. State-of-the-art analytical models currently employed for design, failure prediction, or performance analysis are used in this methodology. The rationale for the statistical approach taken in the PFA methodology is discussed, the PFA methodology is described, and examples of its application to structural failure modes are presented. The engineering models and computer software used in fatigue crack growth and fatigue crack initiation applications are thoroughly documented.
On a common critical state in localized and diffuse failure modes
NASA Astrophysics Data System (ADS)
Zhu, Huaxiang; Nguyen, Hien N. G.; Nicot, François; Darve, Félix
2016-10-01
Accurately modeling the critical state mechanical behavior of granular material largely relies on a better understanding and characterizing the critical state fabric in different failure modes, i.e. localized and diffuse failure modes. In this paper, a mesoscopic scale is introduced, in which the organization of force-transmission paths (force-chains) and cells encompassed by contacts (meso-loops) can be taken into account. Numerical drained biaxial tests using a discrete element method are performed with different initial void ratios, in order to investigate the critical state fabric on the meso-scale in both localized and diffuse failure modes. According to the displacement and strain fields extracted from tests, the failure mode and failure area of each specimen are determined. Then convergent critical state void ratios are observed in failure area of specimens. Different mechanical features of two kinds of meso-structures (force-chains and meso-loops) are investigated, to clarify whether there exists a convergent meso-structure inside the failure area of granular material, as the signature of critical state. Numerical results support a positive answer. Failure area of both localized and diffuse failure modes therefore exhibits the same fabric in critical state. Hence, these two failure modes prove to be homological with respect to the concept of the critical state.
A finite element formulation with combined loadings for shear dominant RC structures.
DOT National Transportation Integrated Search
2008-08-01
Inelastic failure of reinforced concrete (RC) structures under seismic loadings can be due either to loss of flexural, shear or bond : capacity. Specifically, the effect of combined loadings can lead to a complex failure mechanism that plays a vital ...
Wessler, Jeffrey D; Maurer, Mathew S; Hummel, Scott L
2015-03-01
Heart failure (HF) is a major public health problem affecting predominantly older adults. Nonadherence to diet remains a significant contributor to acute decompensated HF (ADHF). The sodium-restricted Dietary Approaches to Stop Hypertension (DASH/SRD) eating plan reduces cardiovascular dysfunction that can lead to ADHF and is consistent with current HF guidelines. We propose that an intervention that promotes adherence to the DASH/SRD by home-delivering meals will be safe and improve health-related quality of life (QOL) in older adults after hospitalization for ADHF. This is a 3-center, randomized, single-blind, controlled trial of 12-week duration designed to determine the safety and efficacy of home-delivered DASH/SRD-compliant meals in older adults after discharge from ADHF hospitalization. Sixty-six subjects will be randomized in a 1:1 stratified fashion by gender and left ventricular ejection fraction (<50% vs ≥50%). Study subjects will receive either preprepared, home-delivered DASH/SRD-compliant meals or usual dietary advice for 4weeks after hospital discharge. Investigators will be blinded to group assignment, food diaries, and urinary electrolyte measurements until study completion. The primary efficacy end point is the change in the Kansas City Cardiomyopathy Questionnaire summary scores for health-related QOL from study enrollment to 4weeks postdischarge. Safety evaluation will focus on hypotension, renal insufficiency, and hyperkalemia. Exploratory end points include echocardiography, noninvasive vascular testing, markers of oxidative stress, and salt taste sensitivity. This randomized controlled trial will test the efficacy, feasibility, and safety of 4weeks of DASH/SRD after ADHF hospitalization. By testing a novel dietary intervention supported by multiple levels of evidence including preliminary data in outpatients with stable HF, we will address a critical evidence gap in the care of older patients with ADHF. If effective and safe, this intervention could be scaled to assess effects on readmission and healthcare costs in older adults after ADHF. Published by Elsevier Inc.
Mordi, Natalie A; Mordi, Ify R; Singh, Jagdeep S; Baig, Fatima; Choy, Anna-Maria; McCrimmon, Rory J; Struthers, Allan D; Lang, Chim C
2017-01-01
Introduction Type 2 diabetes (T2D) and heart failure (HF) are a frequent combination, where treatment options remain limited. There has been increasing interest around the sodium–glucose cotransporter 2 (SGLT2) inhibitors and their use in patients with HF. Data on the effect of SGLT2 inhibitor use with diuretics are limited. We hypothesise that SGLT2 inhibition may augment the effects of loop diuretics and the benefits of SGLT2 inhibitors may extend beyond those of their metabolic (glycaemic parameters and weight loss) and haemodynamic parameters. The effects of SGLT2 inhibitors as an osmotic diuretic and on natriuresis may underlie the cardiovascular and renal benefits demonstrated in the recent EMPA-REG study. Methods and analysis To assess the effect of SGLT2 inhibitors when used in combination with a loop diuretic, the RECEDE-CHF (Renal and Cardiovascular Effects of SGLT2 inhibition in combination with loop Diuretics in diabetic patients with Chronic Heart Failure) trial is a single-centre, randomised, double-blind, placebo-controlled, cross-over trial conducted in a secondary care setting within NHS Tayside, Scotland. 34 eligible participants, aged between 18 and 80 years, with stable T2D and CHF will be recruited. Renal physiological testing will be performed at two points (week 1 and week 6) on each arm to assess the effect of 25 mg empagliflozin, on the primary and secondary outcomes. Participants will be enrolled in the trial for a total period between 14 and 16 weeks. The primary outcome will assess the effect of empagliflozin versus placebo on urine output. The secondary outcomes are to assess the effect of empagliflozin on glomerular filtration rate, cystatin C, urinary sodium excretion, urinary protein/creatinine ratio and urinary albumin/creatinine ratio when compared with placebo. Ethics and dissemination Ethics approval was obtained by the East of Scotland Research Ethics Service. Results of the trial will be submitted for publication in a peer-reviewed journal. Trial registration number NCT03226457; Pre-results. PMID:29042392
Accurate, noninvasive continuous monitoring of cardiac output by whole-body electrical bioimpedance.
Cotter, Gad; Moshkovitz, Yaron; Kaluski, Edo; Cohen, Amram J; Miller, Hilton; Goor, Daniel; Vered, Zvi
2004-04-01
Cardiac output (CO) is measured but sparingly due to limitations in its measurement technique (ie, right-heart catheterization). Yet, in recent years it has been suggested that CO may be of value in the diagnosis, risk stratification, and treatment titration of cardiac patients, especially those with congestive heart failure (CHF). We examine the use of a new noninvasive, continuous whole-body bioimpedance system (NICaS; NI Medical; Hod-Hasharon, Israel) for measuring CO. The aim of the present study was to test the validity of this noninvasive cardiac output system/monitor (NICO) in a cohort of cardiac patients. Prospective, double-blind comparison of the NICO and thermodilution CO determinations. We enrolled 122 patients in three different groups: during cardiac catheterization (n = 40); before, during, and after coronary bypass surgery (n = 51); and while being treated for acute congestive heart failure (CHF) exacerbation (n = 31). MEASUREMENTS AND INTERVENTION: In all patients, CO measurements were obtained by two independent blinded operators. CO was measured by both techniques three times, and an average was determined for each time point. CO was measured at one time point in patients undergoing coronary catheterization; before, during, and after bypass surgery in patients undergoing coronary bypass surgery; and before and during vasodilator treatment in patients treated for acute heart failure. Overall, 418 paired CO measurements were obtained. The overall correlation between the NICO cardiac index (CI) and the thermodilution CI was r = 0.886, with a small bias (0.0009 +/- 0.684 L) [mean +/- 2 SD], and this finding was consistent within each group of patients. Thermodilution readings were 15% higher than NICO when CI was < 1.5 L/min/m(2), and 5% lower than NICO when CI was > 3 L/min/m(2). The NICO has also accurately detected CI changes during coronary bypass operation and vasodilator administration for acute CHF. The results of the present study indicate that whole-body bioimpedance CO measurements obtained by the NICO are accurate in rapid, noninvasive measurement and the follow-up of CO in a wide range of cardiac clinical situations.
Status and Applications of Diamond and Diamond-Like Materials: An Emerging Technology
1990-04-30
solar -blind detectors. * Modulated structures incorporating layers of BN and diamond, for example, to develop materials that are harder and/or tougher...hundredfold increase in power capability over silicon transistors. e Solar -blind detectors, which take advantage of the large energy gap (greater than...Some success has already been achieved, for example, in applying diamond-like coatings to ZnS and ZnSe windows using a Ge-C intermediate layer . " Anti
Teng, Yue; Song, Le Xin; Ponchel, Anne; Yang, Zheng Kun; Xia, Juan
2014-09-01
Metastable γ-Ga2O3 nanoflowers assembled from hexagonal nanopetals are successfully constructed by the oxidation of metallic Ga in acetone solution. The nanoflowers with a hollow interior structure exhibit a short response time and a large light-current-dark-current ratio under a relatively low bias voltage, suggesting an especially important potential application in solar-blind photodetection. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Nielsen, Jens E.; Gunner, M. R.; Bertrand García-Moreno, E.
2012-01-01
The pKa Cooperative http://www.pkacoop.org was organized to advance development of accurate and useful computational methods for structure-based calculation of pKa values and electrostatic energy in proteins. The Cooperative brings together laboratories with expertise and interest in theoretical, computational and experimental studies of protein electrostatics. To improve structure-based energy calculations it is necessary to better understand the physical character and molecular determinants of electrostatic effects. The Cooperative thus intends to foment experimental research into fundamental aspects of proteins that depend on electrostatic interactions. It will maintain a depository for experimental data useful for critical assessment of methods for structure-based electrostatics calculations. To help guide the development of computational methods the Cooperative will organize blind prediction exercises. As a first step, computational laboratories were invited to reproduce an unpublished set of experimental pKa values of acidic and basic residues introduced in the interior of staphylococcal nuclease by site-directed mutagenesis. The pKa values of these groups are unique and challenging to simulate owing to the large magnitude of their shifts relative to normal pKa values in water. Many computational methods were tested in this 1st Blind Prediction Challenge and critical assessment exercise. A workshop was organized in the Telluride Science Research Center to assess objectively the performance of many computational methods tested on this one extensive dataset. This volume of PROTEINS: Structure, Function, and Bioinformatics introduces the pKa Cooperative, presents reports submitted by participants in the blind prediction challenge, and highlights some of the problems in structure-based calculations identified during this exercise. PMID:22002877
Ghahari, S. F.; Abazarsa, F.; Avci, O.; Çelebi, Mehmet; Taciroglu, E.
2016-01-01
The Robert A. Millikan Library is a reinforced concrete building with a basement level and nine stories above the ground. Located on the campus of California Institute of Technology (Caltech) in Pasadena California, it is among the most densely instrumented buildings in the U.S. From the early dates of its construction, it has been the subject of many investigations, especially regarding soil–structure interaction effects. It is well accepted that the structure is significantly interacting with the surrounding soil, which implies that the true foundation input motions cannot be directly recorded during earthquakes because of inertial effects. Based on this limitation, input–output modal identification methods are not applicable to this soil–structure system. On the other hand, conventional output-only methods are typically based on the unknown input signals to be stationary whitenoise, which is not the case for earthquake excitations. Through the use of recently developed blind identification (i.e. output-only) methods, it has become possible to extract such information from only the response signals because of earthquake excitations. In the present study, we employ such a blind identification method to extract the modal properties of the Millikan Library. We present some modes that have not been identified from force vibration tests in several studies to date. Then, to quantify the contribution of soil–structure interaction effects, we first create a detailed Finite Element (FE) model using available information about the superstructure; and subsequently update the soil–foundation system's dynamic stiffnesses at each mode such that the modal properties of the entire soil–structure system agree well with those obtained via output-only modal identification.
Montserrat-Bosch, Marta; Figueiredo, Rui; Nogueira-Magalhães, Pedro; Arnabat-Dominguez, Josep; Valmaseda-Castellón, Eduard; Gay-Escoda, Cosme
2014-07-01
To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB). A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed. A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered. Both IANB techniques used in this trial are suitable for lower third molar removal. However, performing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries.
Emotion-induced blindness reflects competition at early and late processing stages: an ERP study.
Kennedy, Briana L; Rawding, Jennifer; Most, Steven B; Hoffman, James E
2014-12-01
Emotion-induced blindness (EIB) refers to impaired awareness of items appearing soon after an irrelevant, emotionally arousing stimulus. Superficially, EIB appears to be similar to the attentional blink (AB), a failure to report a target that closely follows another relevant target. Previous studies of AB using event-related potentials suggest that the AB results from interference with selection (N2 component) and consolidation (P3b component) of the second target into working memory. The present study applied a similar analysis to EIB and, similarly, found that an irrelevant emotional distractor suppressed the N2 and P3b components associated with the following target at short lags. Emotional distractors also elicited a positive deflection that appeared to be similar to the PD component, which has been associated with attempts to suppress salient, irrelevant distractors (Kiss, Grubert, Petersen, & Eimer, 2012; Sawaki, Geng, & Luck, 2012; Sawaki & Luck, 2010). These results suggest that irrelevant emotional pictures gain access to working memory, even when observers are attempting to ignore them and, like the AB, prevent access of a closely following target.
NASA Technical Reports Server (NTRS)
Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.
1992-01-01
An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with engineering analysis to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in engineering analyses of failure phenomena, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which engineering analysis models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes. These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. Conventional engineering analysis models currently employed for design of failure prediction are used in this methodology. The PFA methodology is described and examples of its application are presented. Conventional approaches to failure risk evaluation for spaceflight systems are discussed, and the rationale for the approach taken in the PFA methodology is presented. The statistical methods, engineering models, and computer software used in fatigue failure mode applications are thoroughly documented.
NASA Technical Reports Server (NTRS)
Thomas, J. M.; Hanagud, S.
1975-01-01
The results of two questionnaires sent to engineering experts are statistically analyzed and compared with objective data from Saturn V design and testing. Engineers were asked how likely it was for structural failure to occur at load increments above and below analysts' stress limit predictions. They were requested to estimate the relative probabilities of different failure causes, and of failure at each load increment given a specific cause. Three mathematical models are constructed based on the experts' assessment of causes. The experts' overall assessment of prediction strength fits the Saturn V data better than the models do, but a model test option (T-3) based on the overall assessment gives more design change likelihood to overstrength structures than does an older standard test option. T-3 compares unfavorably with the standard option in a cost optimum structural design problem. The report reflects a need for subjective data when objective data are unavailable.
NASA Astrophysics Data System (ADS)
Koji, Yusuke; Kitamura, Yoshinobu; Kato, Yoshikiyo; Tsutsui, Yoshio; Mizoguchi, Riichiro
In conceptual design, it is important to develop functional structures which reflect the rich experience in the knowledge from previous design failures. Especially, if a designer learns possible abnormal behaviors from a previous design failure, he or she can add an additional function which prevents such abnormal behaviors and faults. To do this, it is a crucial issue to share such knowledge about possible faulty phenomena and how to cope with them. In fact, a part of such knowledge is described in FMEA (Failure Mode and Effect Analysis) sheets, function structure models for systematic design and fault trees for FTA (Fault Tree Analysis).
Design Criteria for X-CRV Honeycomb Panels: A Preliminary Study
NASA Technical Reports Server (NTRS)
Caccese, Vincent; Verinder, Irene
1997-01-01
The objective of this project is to perform the first step in developing structural design criteria for composite sandwich panels that are to be used in the aeroshell of the crew return vehicle (X-CRV). The preliminary concept includes a simplified method for assessing the allowable strength in the laminate material. Ultimately, it is intended that the design criteria be extended to address the global response of the vehicle. This task will require execution of a test program as outlined in the recommendation section of this report. The aeroshell of the X-CRV is comprised of composite sandwich panels consisting of fiberite face sheets and a phenolic honeycomb core. The function of the crew return vehicle is to enable the safe return of injured or ill crewpersons from space station, the evacuation of crew in case of emergency or the return of crew if an orbiter is not available. A significant objective of the X-CRV project is to demonstrate that this vehicle can be designed, built and operated at lower cost and at a significantly faster development time. Development time can be reduced by driving out issues in both structural design and manufacturing concurrently. This means that structural design and analysis progresses in conjunction with manufacturing and testing. Preliminary tests results on laminate coupons are presented in the report. Based on these results a method for detection material failure in the material is presented. In the long term, extrapolation of coupon data to large scale structures may be inadequate. Test coupons used to develop failure criteria at the material scale are typically small when compared to the overall structure. Their inherent small size indicates that the material failure criteria can be used to predict localized failure of the structure, however, it can not be used to predict failure for all failure modes. Some failure modes occur only when the structure or one of its sub-components are studied as a whole. Conversely, localized failure may not indicate failure of the structure as a whole and the amount of reserve capacity, if any, should be assessed. To develop a complete design criteria experimental studies of the sandwich panel are needed. Only then can a conservative and accurate design criteria be developed. This criteria should include effects of flaws and defects, and environmental factors such as temperature and moisture. Preliminary results presented in this report suggest that a simplified analysis can be used to predict the strength of a laminate. Testing for environmental effects have yet to be included in this work. The so called 'rogue flaw test' appears to be a promising method for assessing the effect of a defect in a laminate. This method fits in quite well with the philosophy of achieving a damage tolerant design.
NASA Astrophysics Data System (ADS)
Nimse, Rohit B.; Joshi, Digesh D.; Patel, Paresh V.
2014-12-01
Progressive collapse denotes a failure of a major portion of a structure that has been initiated by failure of a relatively small part of the structure such as failure of any vertical load carrying element (typically columns). Failure of large part of any structure will results into substantial loss of human lives and natural resources. Therefore, it is important to prevent progressive collapse which is also known as disproportionate collapse. Nowadays, there is an increasing trend toward construction of buildings using precast concrete. In precast concrete construction, all the components of structures are produced in controlled environment and they are being transported to the site. At site such individual components are connected appropriately. Connections are the most critical elements of any precast structure, because in past major collapse of precast structure took place because of connection failure. In this study, behavior of three different 1/3rd scaled wet precast beam column connections under progressive collapse scenario are studied and its performance is compared with monolithic connection. Precast connections are constructed by adopting different connection detailing at the junction by considering reinforced concrete corbel for two specimens and steel billet for one specimen. Performance of specimen is evaluated on the basis of ultimate load carrying capacity, maximum deflection and deflection measured along the span of the beam. From the results, it is observed that load carrying capacity and ductility of precast connections considered in this study are more than that of monolithic connections.
NASA Astrophysics Data System (ADS)
Du, Fangzhu; Li, Dongsheng
2018-03-01
As a new kind of composite structures, the using of steel confined reinforced concrete column attract increasing attention in civil engineer. During the damage process, this new structure offers highly complex and invisible failure mechanism due to the combination effects of steel tubes, concrete, and steel rebar. Acoustic emission (AE) technique has been extensively studied in nondestructive testing (NDT) and is currently applied in civil engineering for structural health monitoring (SHM) and damage evaluation. In the present study, damage property and failure evolution of steel confined and unconfined reinforced concrete (RC) columns are investigated under quasi-static loading through (AE) signal. Significantly improved loading capacity and excellent energy dissipation characteristic demonstrated the practicality of that proposed structure. AE monitoring results indicated that the progressive deformation of the test specimens occur in three stages representing different damage conditions. Sentry function compares the logarithm ratio between the stored strain energy (Es) and the released acoustic energy (Ea); explicitly disclose the damage growth and failure mechanism of the test specimens. Other extended AE features including index of damage (ID), and relax ratio are calculated to quantitatively evaluate the damage severity and critical point. Complicated temporal evolution of different AE features confirms the potential importance of integrated analysis of two or more parameters. The proposed multi-indicators analysis is capable of revealing the damage growth and failure mechanism for steel confined RC columns, and providing critical warning information for structure failure.
NASA Technical Reports Server (NTRS)
Frady, Greg; Nesman, Thomas; Zoladz, Thomas; Szabo, Roland
2010-01-01
For many years, the capabilities to determine the root-cause failure of component failures have been limited to the analytical tools and the state of the art data acquisition systems. With this limited capability, many anomalies have been resolved by adding material to the design to increase robustness without the ability to determine if the design solution was satisfactory until after a series of expensive test programs were complete. The risk of failure and multiple design, test, and redesign cycles were high. During the Space Shuttle Program, many crack investigations in high energy density turbomachines, like the SSME turbopumps and high energy flows in the main propulsion system, have led to the discovery of numerous root-cause failures and anomalies due to the coexistences of acoustic forcing functions, structural natural modes, and a high energy excitation, such as an edge tone or shedding flow, leading the technical community to understand many of the primary contributors to extremely high frequency high cycle fatique fluid-structure interaction anomalies. These contributors have been identified using advanced analysis tools and verified using component and system tests during component ground tests, systems tests, and flight. The structural dynamics and fluid dynamics communities have developed a special sensitivity to the fluid-structure interaction problems and have been able to adjust and solve these problems in a time effective manner to meet budget and schedule deadlines of operational vehicle programs, such as the Space Shuttle Program over the years.
NASA Astrophysics Data System (ADS)
Tarabusi, G.; Caputo, R.
2017-01-01
The Mirandola anticline represents a buried fault-propagation fold which has been growing during Quaternary due to the seismogenic activity of a blind segment belonging to the broader Ferrara Arc. The last reactivation occurred during the May 2012 Emilia sequence. In correspondence with this structure, the thickness of the marine and continental deposits of the Po Plain foredeep is particularly reduced. In order to better define the shallow geometry of this tectonic structure, and hence its recent activity, we investigated in a depth range which is intermediate between the surficial morphological observations and seismic profiles information. In particular, we carried out numerous passive seismic measurements (single-station microtremor) for obtaining the horizontal-to-vertical spectral ratio. The results of a combined analysis of the peak frequency and its amplitude nicely fit the available geological information, suggesting that this low-cost geophysical technique could be successfully applied in other sectors of wide morphologically flat alluvial plains to investigate blind and completely buried potential seismogenic structures.
Z-2 Threaded Insert Design and Testing
NASA Technical Reports Server (NTRS)
Ross, Amy; Rhodes, Richard; Jones, Robert J.; Graziosi, David; Ferl, Jinny; Sweeny, Mitch; Scarborough, Stephen
2016-01-01
NASA's Z-2 prototype space suit contains several components fabricated from an advanced hybrid composite laminate consisting of IM10 carbon fiber and fiber glass. One requirement was to have removable, replaceable helicoil inserts to which other suit components would be fastened. An approach utilizing bonded in inserts with helicoils inside of them was implemented. During initial assembly, cracking sounds were heard followed by the lifting of one of the blind inserts out of its hole when the screws were torqued. A failure investigation was initiated to understand the mechanism of the failure. Ultimately, it was determined that the pre-tension caused by torqueing the fasteners is a much larger force than induced from the pressure loads of the suit which was not considered in the insert design. Bolt tension is determined by dividing the torque on the screw by a k value multiplied by the thread diameter of the bolt. The k value is a factor that accounts for friction in the system. A common value used for k for a non-lubricated screw is 0.2. The k value can go down by as much as 0.1 if the screw is lubricated which means for the same torque, a much larger tension could be placed on the bolt and insert. This paper summarizes the failure investigation that was performed to identify the root cause of the suit failure and details how the insert design was modified to resist a higher pull out tension.
Ghali, Jalal K; Orlandi, Cesare; Abraham, William T
2012-06-01
Volume overload is the dominant feature of decompensated heart failure (HF) and it often results in adverse clinical outcomes. Vasopressin receptor antagonists such as lixivaptan may provide effective volume unloading. This study assessed weight loss after 1 day and 8 weeks of treatment with lixivaptan in outpatients with HF and volume overload. This phase II, 8-week, multicentre, double-blind, parallel-group study randomized participants (2:1) to receive lixivaptan 100 mg or placebo once daily (in addition to standard HF therapy). Body weight and cardiovascular assessments were made at baseline, Day 1 (not cardiovascular), Weeks 1, 2, 4, and 8, and 7 days post-treatment. The Trail-making Test, part B (TMT-B) and the Medical Outcomes Survey 6-item cognitive function scale (MOS-6) were assessed at baseline and Week 4. The study randomized 170 participants (lixivaptan, n = 111; placebo, n = 59). Most (97.1%) were receiving pharmacological therapy for HF at baseline. Demographic characteristics were generally similar between the two groups. Body weight decreased significantly from baseline to Day 1 with lixivaptan vs. placebo (least-square mean change ± standard error: - 0.38 ± 0.08 kg vs. +0.13 ± 0.11 kg; P < 0.001) and at Weeks 1, 2, and 4 (P < 0.01). Cardiovascular changes were generally similar in both groups, though orthopnoea and dyspnoea improved in the lixivaptan group vs. placebo. The TMT-B and MOS-6 showed no significant differences between groups. Lixivaptan was well tolerated-thirst and polyuria occurred more frequently vs. placebo. In outpatients with HF and volume overload, lixivaptan 100 mg once daily, when added to standard therapy, reduced body weight, improved dyspnoea and orthopnoea, and was well tolerated. NCT01055912.
King, J N; Font, A; Rousselot, J-F; Ash, R A; Bonfanti, U; Brovida, C; Crowe, I D; Lanore, D; Pechereau, D; Seewald, W; Strehlau, G
2017-07-01
Chronic kidney disease (CKD) is an important cause of morbidity and mortality in dogs. To evaluate the efficacy in prolonging survival and safety of benazepril administration to dogs with CKD. Forty-nine client-owned dogs with CKD. Dogs were randomized to benazepril (0.25 to <0.5 mg/kg) or placebo once daily for up to 2 years in a prospective, multicenter, blinded clinical trial. The primary endpoint variable was the renal survival time, defined as the time from inclusion in the study to the treatment failure endpoint of death or euthanasia or need for administration of parenteral fluids related to renal failure. No benefit of benazepril versus placebo was detected for renal survival time in all dogs; median (95% confidence interval (CI)) survival times were 305 (53-575) days in the benazepril group and 287 (152-not available) in the placebo group (P = .53). Renal survival times were not significantly longer with benazepril compared to placebo for subgroups: hazard ratios (95% CI) were 0.50 (0.21-1.22) with P = .12 for initial urine protein-to-creatinine ratio (UPC) >0.5, and 0.38 (0.12-1.19) with P = .080 for initial UPC >0.5 plus plasma creatinine ≤440 μmol/L. Proteinuria, assessed from the UPC, was significantly (P = .0032) lower after treatment with benazepril compared to placebo. There were no significant differences between groups for clinical signs or frequencies of adverse events. Benazepril significantly reduced proteinuria in dogs with CKD. Insufficient numbers of dogs were recruited to allow conclusions on survival time. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Chung, Eugene S; Fischer, Trent M; Kueffer, Fred; Anand, Inder S; Bax, Jeroen J; Gold, Michael R; Gorman, Robert C; Theres, Heinz; Udelson, James E; Stancak, Branislav; Svendsen, Jesper H; Stone, Gregg W; Leon, Angel
2015-07-01
Despite considerable improvements in the medical management of patients with myocardial infarction (MI), patients with large MI still have substantial risk of developing heart failure. In the early post-MI setting, implantable cardioverter defibrillators have reduced arrhythmic deaths but have no impact on overall mortality. Therefore, additional interventions are required to further reduce the overall morbidity and mortality of patients with large MI. The Pacing Remodeling Prevention Therapy (PRomPT) trial is designed to study the effects of peri-infarct pacing in preventing adverse post-MI remodeling. Up to 120 subjects with peak creatine phosphokinase >3,000 U/L (or troponin T >10 μg/L) at time of MI will be randomized to either dual-site or single-site biventricular pacing with the left ventricular lead implanted in a peri-infarct region or to a nonimplanted control group. Those randomized to a device will be blinded to the pacing mode, but randomization to a device or control cannot be blinded. Subjects randomized to pacing will have the device implanted within 10 days of MI. The primary objective is to assess the change in left ventricular end-diastolic volume from baseline to 18 months. Secondary objectives are to assess changes in clinical and mechanistic parameters between the groups, including rates of hospitalization for heart failure and cardiovascular events, the incidence of sudden cardiac death and all-cause mortality, New York Heart Association functional class, 6-minute walking distance, and quality of life. The PRomPT trial will provide important evidence regarding the potential of peri-infarct pacing to interrupt adverse remodeling in patients with large MI. Copyright © 2015 Elsevier Inc. All rights reserved.
Sanclemente, G; Mancilla, G A; Hernandez, G
2016-04-01
Daylight PDT (dPDT) is easy to use and does not require light equipment. Such therapy has been exhaustively proved to be successful in the treatment of actinic keratosis, but its use in skin photodamage remains unclear. To evaluate dPDT's efficacy in skin facial photodamage. This was a parallel-group double-blind, randomized placebo-controlled trial. Sixty participants with symmetric facial photodamage were allocated to topical methyl aminolevulinate (MAL) and daylight vs. matching placebo and daylight. Primary outcome was global photodamage improvement/failure 1 month after the third session. Secondary outcomes included: pain evaluation; specific photodamage severity scores; sun irradiance quantification and Skindex-29 scores. Adverse events were also investigated. Primary analysis included all randomized patients. All patients sun-exposed for 120min in 3 sessions. The risk of failure was lower in the MAL-dPDT group than in the placebo plus daylight group (RR: 0.18; 95% CI: 0.08-0.41). Mean solar irradiance (W/m(2)) during the first, second and third sessions was 480.82, 430.07 and 435.84, respectively. Items 5 and 14 of Skindex-29 in the MAL-dPDT group showed statistical significant differences. Two patients in the MAL-dPDT group had serious and non-serious events not directly related to the product. dPDT with MAL was un-painful, effective and safe for the treatment of facial photodamage. Herpes simplex prophylaxis should be considered before sessions. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.
Avraham, Sarit; Gat, Itai; Duvdevani, Nir-Ram; Haas, Jigal; Frenkel, Yair; Seidman, Daniel S
2012-03-01
To determine the efficacy of pre-emptive administration of the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen vs. a placebo on pain relief during medical abortion and to evaluate whether NSAIDs interfere with the action of misoprostol. Prospective, double-blind, randomized, controlled study. University-affiliated tertiary hospital. Sixty-one women who underwent first-trimester termination of pregnancy. Patients received 600 mg mifepristone orally, followed by 400 μg oral misoprostol 2 days later. They were randomized to receive pre-emptively two tablets of 400 mg ibuprofen orally or a placebo, when taking the misoprostol. The patients completed a questionnaire about side effects and pain score and returned for an ultrasound follow-up examination 10-14 days after the medical abortion. Significant pain, assessed by the need for additional analgesia, and failure rates, defined by a need for surgical intervention. Pre-emptive ibuprofen treatment was found to be more effective than a placebo in pain prevention, as determined by a significantly lower need for additional analgesia: 11 of 29 (38%) vs. 25 of 32 (78%), respectively. Treatment failure rate was not statistically different between the ibuprofen and placebo groups: 4 of 28 (14.2%) vs. 3 of 31 (9.7%), respectively. History of menstrual pain was predictive for the need of additional analgesia. Pre-emptive use of ibuprofen had a statistically significant beneficial effect on the need for pain relief during a mifepristone and misoprostol regimen for medical abortion. Ibuprofen did not adversely affect the outcome of medical abortion. NCT00997074. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Ramalho, Karen Müller; de Souza, Lárissa Marcondes Paladini; Tortamano, Isabel Peixoto; Adde, Carlos Alberto; Rocha, Rodney Garcia; de Paula Eduardo, Carlos
2016-12-01
This randomized placebo-blind study aimed to evaluate the effect of laser phototherapy (LPT) on pain caused by symptomatic irreversible pulpitis (SIP). Sixty patients diagnosed with SIP were randomly assigned to treatment groups (n = 15): G1 (control), G2 (laser placebo-sham irradiation), G3 (laser irradiation at 780 nm, 40 mW, 4 J/cm 2 ), and G4 (laser irradiation at 780 nm, 40 mW, 40 J/cm 2 ). Spontaneous pain was recorded using a VAS score before (T0), immediately after (T1), and 15 min after treatment (T2). Local anesthetics failure during emergency endodontic treatment was also assessed. There was no pain difference in T1 and T2 between the experimental laser groups (G3 and G4) and the placebo group (G2). The 4-J/cm 2 (G3) irradiation resulted in significant increase in the local anesthetics failure in lower jar teeth. This effect could be suggested as consequence of the LPT improvement in local circulation and vasodilatation that would result in the increase of local anesthetic agent absorption. The application of 780-nm diode laser irradiation, at 4 and 40 J/cm 2 , showed no effect in reducing the pain in SIP in comparison to the placebo group. The fluence of 4 J/cm 2 showed a negative effect in local anesthetics, resulting in significant increase of complimentary local anesthesia during emergency endodontic treatment. This work provides evidence of the consequence of LPT application on teeth with symptomatic irreversible pulpitis. LPT should be avoided in teeth with pain due to irreversible pulpitis.
Blind tests of methods for InSight Mars mission: Open scientific challenge
NASA Astrophysics Data System (ADS)
Clinton, John; Ceylan, Savas; Giardini, Domenico; Khan, Amir; van Driel, Martin; Böse, Maren; Euchner, Fabian; Garcia, Raphael F.; Drilleau, Mélanie; Lognonné, Philippe; Panning, Mark; Banerdt, Bruce
2017-04-01
The Marsquake Service (MQS) will be the ground segment service within the InSight mission to Mars, which will deploy a single seismic station on Elysium Planitia in November 2018. The main tasks of the MQS are the identification and characterisation of seismicity, and managing the Martian seismic event catalogue. In advance of the mission, we have developed a series of single station event location methods that rely on a priori 1D and 3D structural models. In coordination with the Mars Structural Service, we expect to use iterative inversion techniques to revise these structural models and event locations. In order to seek methodological advancements and test our current approaches, we have designed a blind test case using Martian synthetics combined with realistic noise models for the Martian surface. We invite all scientific parties that are interested in single station approaches and in exploring the Martian time-series to participate and contribute to our blind test. We anticipate the test will can improve currently developed location and structural inversion techniques, and also allow us explore new single station techniques for moment tensor and magnitude determination. The waveforms for our test case are computed employing AxiSEM and Instaseis for a randomly selected 1D background model and event catalogue that is statistically consistent with our current expectation of Martian seismicity. Realistic seismic surface noise is superimposed to generate a continuous time-series spanning 6 months. The event catalog includes impacts as well as Martian quakes. The temporal distribution of the seismicity in the timeseries, as well as the true structural model, are not be known to any participating parties including MQS till the end of competition. We provide our internal tools such as event location codes, suite of background models, seismic phase travel times, in order to support researchers who are willing to use/improve our current methods. Following the deadline of our blind test in late 2017, we plan to combine all outcomes in an article with all participants as co-authors.
A streamlined failure mode and effects analysis.
Ford, Eric C; Smith, Koren; Terezakis, Stephanie; Croog, Victoria; Gollamudi, Smitha; Gage, Irene; Keck, Jordie; DeWeese, Theodore; Sibley, Greg
2014-06-01
Explore the feasibility and impact of a streamlined failure mode and effects analysis (FMEA) using a structured process that is designed to minimize staff effort. FMEA for the external beam process was conducted at an affiliate radiation oncology center that treats approximately 60 patients per day. A structured FMEA process was developed which included clearly defined roles and goals for each phase. A core group of seven people was identified and a facilitator was chosen to lead the effort. Failure modes were identified and scored according to the FMEA formalism. A risk priority number,RPN, was calculated and used to rank failure modes. Failure modes with RPN > 150 received safety improvement interventions. Staff effort was carefully tracked throughout the project. Fifty-two failure modes were identified, 22 collected during meetings, and 30 from take-home worksheets. The four top-ranked failure modes were: delay in film check, missing pacemaker protocol/consent, critical structures not contoured, and pregnant patient simulated without the team's knowledge of the pregnancy. These four failure modes had RPN > 150 and received safety interventions. The FMEA was completed in one month in four 1-h meetings. A total of 55 staff hours were required and, additionally, 20 h by the facilitator. Streamlined FMEA provides a means of accomplishing a relatively large-scale analysis with modest effort. One potential value of FMEA is that it potentially provides a means of measuring the impact of quality improvement efforts through a reduction in risk scores. Future study of this possibility is needed.
Chang, Jianjun; Chen, Dunjun; Yang, Lianhong; Liu, Yanli; Dong, Kexiu; Lu, Hai; Zhang, Rong; Zheng, Youdou
2016-01-01
To realize AlGaN-based solar-blind ultraviolet distributed Bragg reflectors (DBRs), a novel tri-layer AlGaN/AlInN/AlInGaN periodical structure that differs from the traditional periodically alternating layers of high- and low-refractive-index materials was proposed and grown on an Al0.5Ga0.5N template via metal-organic chemical vapour deposition. Because of the intentional design of the AlInGaN strain transition layer, a state-of-the-art DBR structure with atomic-level-flatness interfaces was achieved using an AlGaN template. The fabricated DBR exhibits a peak reflectivity of 86% at the centre wavelength of 274 nm and a stopband with a full-width at half-maximum of 16 nm. PMID:27381651
... be caused by: Complications of abdominal surgery, including gastric bypass for obesity and gastrectomy to treat peptic ulcers and stomach cancer Structural problems in and around your small intestine, ...
Effect of congenital blindness on the semantic representation of some everyday concepts
Connolly, Andrew C.; Gleitman, Lila R.; Thompson-Schill, Sharon L.
2007-01-01
This study explores how the lack of first-hand experience with color, as a result of congenital blindness, affects implicit judgments about “higher-order” concepts, such as “fruits and vegetables” (FV), but not others, such as “household items” (HHI). We demonstrate how the differential diagnosticity of color across our test categories interacts with visual experience to produce, in effect, a category-specific difference in implicit similarity. Implicit pair-wise similarity judgments were collected by using an odd-man-out triad task. Pair-wise similarities for both FV and for HHI were derived from this task and were compared by using cluster analysis and regression analyses. Color was found to be a significant component in the structure of implicit similarity for FV for sighted participants but not for blind participants; and this pattern remained even when the analysis was restricted to blind participants who had good explicit color knowledge of the stimulus items. There was also no evidence that either subject group used color knowledge in making decisions about HHI, nor was there an indication of any qualitative differences between blind and sighted subjects' judgments on HHI. PMID:17483447
NASA Astrophysics Data System (ADS)
Trachtenberg, I.
How a reliability model might be developed with new data from accelerated stress testing, failure mechanisms, process control monitoring, and test structure evaluations is illustrated. The effects of the acceleration of temperature on operating life is discussed. Test structures that will further accelerate the failure rate are discussed. Corrosion testing is addressed. The uncoated structure is encapsulated in a variety of mold compounds and subjected to pressure-cooker testing.
Chemistry and students with blindness: The hurdles are not what you think
NASA Astrophysics Data System (ADS)
Lewis, Amy L. Micklos
Statistics have shown that individuals with disabilities are underrepresented in the science, technology, engineering, and mathematics (STEM) fields. This work focused on exploring how three students with blindness enrolled in a full-inclusion high-school chemistry class experienced and conceptualized content in order to inform educators, curriculum designers, textbook manufacturers, researchers, and individuals with vision impairments about roadblocks that can inhibit student learning. A critical theory lens was used to explore how the student participants discussed experiences, models, and visualizations (Talanquer, 2010) during six semi-structured interviews. The findings of the study suggest that students with blindness focus on direct experiences when formulating macroscopic descriptions of matter; they form alternative models of the atom and develop incomplete understandings of symbolic representations. Students with blindness also had inhibited learning experiences based on what tactile materials, tools, and vocabulary are available to them. Finally, access to scientific information requires proper organization otherwise meaning cannot be made from the common tables, graphs, or representations.
NASA Technical Reports Server (NTRS)
Vidal, A.; Mueller, K.; Golombek, M. P.
2003-01-01
We undertook axial surface mapping of selected wrinkle ridges on Solis Planum, Mars in order to assess the subsurface geometry of blind thrusts proposed to exist beneath them. This work builds on previous work that defined structural families of wrinkle ridges based on their surface morphology in this region. Although a growing consensus exists for models of wrinkle ridge kinematics and mechanics, a number of current problems remain. These include the origin of topographic offset across the edges of wrinkle ridges, the relationship between broad arches and superposed ridges, the origin of smaller wrinkles, and perhaps most importantly, the trajectory of blind thrusts that underlie wrinkle ridges and accommodate shortening at deeper crustal levels. We are particularly interested in defining the depths at which blind thrusts flatten under wrinkle ridges in order to provide constraints on the brittle-ductile transition during Early Hesperian time. We also seek to test whether wrinkle ridges on Solis Planum develop above reactivated faults or newly formed ones.
Progress in the prediction of pKa values in proteins
DOE Office of Scientific and Technical Information (OSTI.GOV)
Alexov, Emil; Mehler, Ernest L.; Baker, Nathan A.
2011-12-15
The pKa-cooperative aims to provide a forum for experimental and theoretical researchers interested in protein pKa values and protein electrostatics in general. The first round of the pKa -cooperative, which challenged computational labs to carry out blind predictions against pKas experimentally determined in the laboratory of Bertrand Garcia-Moreno, was completed and results discussed at the Telluride meeting (July 6-10, 2009). This paper serves as an introduction to the reports submitted by the blind prediction participants that will be published in a special issue of PROTEINS: Structure, Function and Bioinformatics. Here we briefly outline existing approaches for pKa calculations, emphasizing methodsmore » that were used by the participants in calculating the blind pKa values in the first round of the cooperative. We then point out some of the difficulties encountered by the participating groups in making their blind predictions, and finally try to provide some insights for future developments aimed at improving the accuracy of pKa calculations.« less
New regularization scheme for blind color image deconvolution
NASA Astrophysics Data System (ADS)
Chen, Li; He, Yu; Yap, Kim-Hui
2011-01-01
This paper proposes a new regularization scheme to address blind color image deconvolution. Color images generally have a significant correlation among the red, green, and blue channels. Conventional blind monochromatic deconvolution algorithms handle each color image channels independently, thereby ignoring the interchannel correlation present in the color images. In view of this, a unified regularization scheme for image is developed to recover edges of color images and reduce color artifacts. In addition, by using the color image properties, a spectral-based regularization operator is adopted to impose constraints on the blurs. Further, this paper proposes a reinforcement regularization framework that integrates a soft parametric learning term in addressing blind color image deconvolution. A blur modeling scheme is developed to evaluate the relevance of manifold parametric blur structures, and the information is integrated into the deconvolution scheme. An optimization procedure called alternating minimization is then employed to iteratively minimize the image- and blur-domain cost functions. Experimental results show that the method is able to achieve satisfactory restored color images under different blurring conditions.
Therapeutic efficacy test in malaria falciparum in Antioquia, Colombia
Blair, Silvia; Carmona-Fonseca, Jaime; Piñeros, Juan G; Ríos, Alexandra; Álvarez, Tania; Álvarez, Gonzalo; Tobón, Alberto
2006-01-01
Objective Evaluate the frequency of failure of eight treatments for non-complicated malaria caused by Plasmodium falciparum in patients from Turbo (Urabá region), El Bagre and Zaragoza (Bajo Cauca region), applying the 1998 protocol of the World Health Organization (WHO). Monotherapies using chloroquine (CQ), amodiaquine (AQ), mefloquine (MQ) and sulphadoxine-pyrimethamine (SP), and combinations using chloroquine-sulphadoxine-pyrimethamine (CQ-SP), amodiaquine-sulphadoxine-pyrimethamine (AQ-SP), mefloquine-sulphadoxine-pyrimethamine (MQ-SP) and artesunate-sulphadoxine-pyrimethamine (AS-SP), were examined. Methodology A balanced experimental design with eight groups. Samples were selected based on statistical and epidemiological criteria. Patients were followed for 21 to 28 days, including seven or eight parasitological and clinical evaluations, with an active search for defaulting patients. A non-blinded evaluation of the antimalarial treatment response (early failure, late failure, adequate response) was performed. Results Initially, the loss of patients to follow-up was higher than 40%, but the immediate active search for the cases and the monetary help for transportation expenses of patients, reduced the loss to 6%. The treatment failure was: CQ 82%, AQ 30%, MQ 4%, SP 24%, CQ-SP 17%, AQ-SP 2%, MQ-S-P 0%, AS-SP 3%. Conclusion The characteristics of an optimal epidemiological monitoring system of antimalarial treatment response in Colombia are discussed. It is proposed to focus this on early failure detection, by applying a screening test every two to three years, based on a seven to 14-day follow-up. Clinical and parasitological assessment would be carried out by a general physician and a field microscopist from the local hospital, with active measures to search for defaulter patients at follow-up. PMID:16504002
Prognostic Factors for Treatment Failure in Acute Otitis Media.
Tähtinen, Paula A; Laine, Miia K; Ruohola, Aino
2017-09-01
Antimicrobial treatment is effective in the management of acute otitis media (AOM), but approximately half of the children may recover without antimicrobial agents. By identifying patients who may not require antimicrobial treatment for the management of AOM, the use of antimicrobial agents could be substantially reduced. Our aim was to identify subgroups of children with AOM who would benefit most from antimicrobial treatment and children who could be suitable for initial observation. This is a secondary analysis of randomized, double-blind, placebo-controlled trial. Children 6 to 35 months of age with AOM (N = 319) were randomly allocated to receive amoxicillin-clavulanate (40/5.7 mg/kg per day) or placebo for 7 days. Our primary outcome was time until treatment failure. Treatment failure occurred in 31.7% of all children. Older age (24-35 months) and peaked tympanogram at entry decreased the hazard for treatment failure (hazard ratio, 0.53; 95% confidence interval [CI], 0.29 to 0.96; P = .04; and hazard ratio, 0.43; 95% CI, 0.21 to 0.88; P = .02, respectively). The rate difference for treatment failure between antimicrobial treatment and placebo groups was highest among children with severe bulging of the tympanic membrane (11.1% vs 64.1%; rate difference -53.0%; 95% CI, -73.5% to -32.4%), resulting in a number needed to treat of 1.9. Children with severe bulging of the tympanic membrane seem to benefit most from antimicrobial treatment of AOM. On the other hand, children with peaked tympanogram (A and C curves) may be optimal candidates for initial observation. Copyright © 2017 by the American Academy of Pediatrics.
Acetazolamide improves oxygenation in patients with respiratory failure and metabolic alkalosis.
Gulsvik, Ragnhild; Skjørten, Ingunn; Undhjem, Kenneth; Holø, Lars; Frostad, Anne; Saure, Eirunn Waatevik; Lejlic, Vasvija; Humerfelt, Sjur; Hansen, Gunnar; Bruun Wyller, Torgeir
2013-10-01
Coexistent respiratory failure and metabolic alkalosis is a common finding. Acidotic diuretics cause a fall in pH that may stimulate respiration. The purpose of the study was to evaluate the effectiveness of short-term treatment with acetazolamide for combined respiratory failure and metabolic alkalosis. A randomised, placebo-controlled and double-blind parallel group trial where oral acetazolamide 250 mg three times a day for 5 days were administered to patients hospitalised for respiratory failure because of a pulmonary disease (Pa O2 ≤ 8 kPa and/or Pa CO2 ≥ 7 kPa) who had concurrent metabolic alkalosis [base excess (BE) ≥ 8 mmol/L]. Pa O2 after 5 days was the primary effect variable. Secondary effect variables were Pa CO2 , BE and pH on day 5, and the total number of days in hospital. Of 70 patients enrolled (35 in each group), data from 54 were analysed per protocol, while last observation carried forward was used for the remaining 16. During the 5-day treatment, Pa O2 increased on average 0.81 kPa in the placebo group and 1.41 kPa in the acetazolamide group. After adjustment for baseline skewness, the difference was statistically significant (adjusted mean difference 0.55 kPa, 95% confidence interval 0.03-1.06). Pa CO2 decreased in both groups, but the difference was not statistically significant. As expected, pH and BE decreased markedly in the acetazolamide group. Acetazolamide may constitute a useful adjuvant treatment mainly to be considered in selected patients with respiratory failure combined with prominent metabolic alkalosis or where non-invasive ventilation is insufficient or infeasible. © 2013 John Wiley & Sons Ltd.
Multiscale Static Analysis of Notched and Unnotched Laminates Using the Generalized Method of Cells
NASA Technical Reports Server (NTRS)
Naghipour Ghezeljeh, Paria; Arnold, Steven M.; Pineda, Evan J.; Stier, Bertram; Hansen, Lucas; Bednarcyk, Brett A.; Waas, Anthony M.
2016-01-01
The generalized method of cells (GMC) is demonstrated to be a viable micromechanics tool for predicting the deformation and failure response of laminated composites, with and without notches, subjected to tensile and compressive static loading. Given the axial [0], transverse [90], and shear [+45/-45] response of a carbon/epoxy (IM7/977-3) system, the unnotched and notched behavior of three multidirectional layups (Layup 1: [0,45,90,-45](sub 2S), Layup 2: [0,60,0](sub 3S), and Layup 3: [30,60,90,-30, -60](sub 2S)) are predicted under both tensile and compressive static loading. Matrix nonlinearity is modeled in two ways. The first assumes all nonlinearity is due to anisotropic progressive damage of the matrix only, which is modeled, using the multiaxial mixed-mode continuum damage model (MMCDM) within GMC. The second utilizes matrix plasticity coupled with brittle final failure based on the maximum principle strain criteria to account for matrix nonlinearity and failure within the Finite Element Analysis--Micromechanics Analysis Code (FEAMAC) software multiscale framework. Both MMCDM and plasticity models incorporate brittle strain- and stress-based failure criteria for the fiber. Upon satisfaction of these criteria, the fiber properties are immediately reduced to a nominal value. The constitutive response for each constituent (fiber and matrix) is characterized using a combination of vendor data and the axial, transverse, and shear responses of unnotched laminates. Then, the capability of the multiscale methodology is assessed by performing blind predictions of the mentioned notched and unnotched composite laminates response under tensile and compressive loading. Tabulated data along with the detailed results (i.e., stress-strain curves as well as damage evolution states at various ratios of strain to failure) for all laminates are presented.
Lin, J.; Stein, R.S.
2004-01-01
We argue that key features of thrust earthquake triggering, inhibition, and clustering can be explained by Coulomb stress changes, which we illustrate by a suite of representative models and by detailed examples. Whereas slip on surface-cutting thrust faults drops the stress in most of the adjacent crust, slip on blind thrust faults increases the stress on some nearby zones, particularly above the source fault. Blind thrusts can thus trigger slip on secondary faults at shallow depth and typically produce broadly distributed aftershocks. Short thrust ruptures are particularly efficient at triggering earthquakes of similar size on adjacent thrust faults. We calculate that during a progressive thrust sequence in central California the 1983 Mw = 6.7 Coalinga earthquake brought the subsequent 1983 Mw = 6.0 Nunez and 1985 Mw = 6.0 Kettleman Hills ruptures 10 bars and 1 bar closer to Coulomb failure. The idealized stress change calculations also reconcile the distribution of seismicity accompanying large subduction events, in agreement with findings of prior investigations. Subduction zone ruptures are calculated to promote normal faulting events in the outer rise and to promote thrust-faulting events on the periphery of the seismic rupture and its downdip extension. These features are evident in aftershocks of the 1957 Mw = 9.1 Aleutian and other large subduction earthquakes. We further examine stress changes on the rupture surface imparted by the 1960 Mw = 9.5 and 1995 Mw = 8.1 Chile earthquakes, for which detailed slip models are available. Calculated Coulomb stress increases of 2-20 bars correspond closely to sites of aftershocks and postseismic slip, whereas aftershocks are absent where the stress drops by more than 10 bars. We also argue that slip on major strike-slip systems modulates the stress acting on nearby thrust and strike-slip faults. We calculate that the 1857 Mw = 7.9 Fort Tejon earthquake on the San Andreas fault and subsequent interseismic slip brought the Coalinga fault ???1 bar closer to failure but inhibited failure elsewhere on the Coast Ranges thrust faults. The 1857 earthquake also promoted failure on the White Wolf reverse fault by 8 bars, which ruptured in the 1952 Mw = 7.3 Kern County shock but inhibited slip on the left-lateral Garlock fault, which has not ruptured since 1857. We thus contend that stress transfer exerts a control on the seismicity of thrust faults across a broad spectrum of spatial and temporal scales. Copyright 2004 by the American Geophysical Union.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-13
... slat actuator structural failure (rupture) and its adjacent actuator torque limiter failing high... outboard slat actuator structural failure (rupture) and its adjacent actuator torque limiter failing high... requirements.'' Under that section, Congress charges the FAA with promoting safe flight of civil aircraft in...
Constructing failure in big biology: The socio-technical anatomy of Japan's Protein 3000 Project.
Fukushima, Masato
2016-02-01
This study focuses on the 5-year Protein 3000 Project launched in 2002, the largest biological project in Japan. The project aimed to overcome Japan's alleged failure to contribute fully to the Human Genome Project, by determining 3000 protein structures, 30 percent of the global target. Despite its achievement of this goal, the project was fiercely criticized in various sectors of society and was often branded an awkward failure. This article tries to solve the mystery of why such failure discourse was prevalent. Three explanatory factors are offered: first, because some goals were excluded during project development, there was a dynamic of failed expectations; second, structural genomics, while promoting collaboration with the international community, became an 'anti-boundary object', only the absence of which bound heterogeneous domestic actors; third, there developed an urgent sense of international competition in order to obtain patents on such structural information.
NASA Astrophysics Data System (ADS)
Helbing, Dirk; Ammoser, Hendrik; Kühnert, Christian
2006-04-01
In this paper we discuss the problem of information losses in organizations and how they depend on the organization network structure. Hierarchical networks are an optimal organization structure only when the failure rate of nodes or links is negligible. Otherwise, redundant information links are important to reduce the risk of information losses and the related costs. However, as redundant information links are expensive, the optimal organization structure is not a fully connected one. It rather depends on the failure rate. We suggest that sidelinks and temporary, adaptive shortcuts can improve the information flows considerably by generating small-world effects. This calls for modified organization structures to cope with today's challenges of businesses and administrations, in particular, to successfully respond to crises or disasters.
Global Failure Modes in High Temperature Composite Structures
NASA Technical Reports Server (NTRS)
Knauss, W. G.
1998-01-01
Composite materials have been considered for many years as the major advance in the construction of energy efficient aerospace structures. Notable advances have been made in understanding the special design considerations that set composites apart from the usual "isotropic" engineering materials such as the metals. As a result, a number of significant engineering designs have been accomplished. However, one shortcoming of the currently favored composites is their relatively unforgiving behavior with respect to failure (brittleness) under seemingly mild impact conditions and large efforts are underway to rectify that situation, much along the lines of introducing thermoplastic matrix materials. Because of their relatively more pronounced (thermo) viscoelastic behavior these materials respond with "toughness" in fracture situations. From the point of view of applications requiring material strength, this property is highly desirable. This feature impacts several important and distinct engineering problems which have been' considered under this grant and cover the 1) effect of impact damage on structural (buckling) stability of composite panels, the 2) effect of time dependence on the progression of buckling instabilities, and the 3) evolution of damage and fracture at generic thickness discontinuities in structures. The latter topic has serious implications for structural stability problems (buckling failure in reinforced shell structures) as well as failure progression in stringer-reinforced shell structures. This grant has dealt with these issues. Polymer "toughness" is usually associated with uncrosslinked or thermo-plastic polymers. But, by comparison with their thermoset counterparts they tend to exhibit more pronounced time dependent material behavior; also, that time dependence can occur at lower temperatures which places restriction in the high temperature use of these "newer and tougher" materials that are not quite so serious with the thermoset matrix materials. From a structural point of view the implications of this material behavior are potentially severe in that structural failure characteristics are no longer readily observed in short term qualification tests so characteristic for aerospace structures built from typical engineering metals.
Micromechanics of compression failures in open hole composite laminates
NASA Technical Reports Server (NTRS)
Guynn, E. Gail; Bradley, Walter L.
1987-01-01
The high strength-to-weight ratio of composite materials is ideally suited for aerospace applications where they already are used in commercial and military aircraft secondary structures and will soon be used for heavily loaded primary structures. One area impeding the widespread application of composites is their inherent weakness in compressive strength when compared to the tensile properties of the same material. Furthermore, these airframe designs typically contain many bolted or riveted joints, as well as electrical and hydraulic control lines. These applications produce areas of stress concentration, and thus, further complicate the compression failure problem. Open hole compression failures which represent a typical failure mode for composite materials are addressed.
An elastic failure model of indentation damage. [of brittle structural ceramics
NASA Technical Reports Server (NTRS)
Liaw, B. M.; Kobayashi, A. S.; Emery, A. F.
1984-01-01
A mechanistically consistent model for indentation damage based on elastic failure at tensile or shear overloads, is proposed. The model accommodates arbitrary crack orientation, stress relaxation, reduction and recovery of stiffness due to crack opening and closure, and interfacial friction due to backward sliding of closed cracks. This elastic failure model was implemented by an axisymmetric finite element program which was used to simulate progressive damage in a silicon nitride plate indented by a tungsten carbide sphere. The predicted damage patterns and the permanent impression matched those observed experimentally. The validation of this elastic failure model shows that the plastic deformation postulated by others is not necessary to replicate the indentation damage of brittle structural ceramics.
NASA Technical Reports Server (NTRS)
Ko, William L.; Chen, Tony
2006-01-01
The previously developed Ko closed-form aging theory has been reformulated into a more compact mathematical form for easier application. A new equivalent loading theory and empirical loading theories have also been developed and incorporated into the revised Ko aging theory for the prediction of a safe operational life of airborne failure-critical structural components. The new set of aging and loading theories were applied to predict the safe number of flights for the B-52B aircraft to carry a launch vehicle, the structural life of critical components consumed by load excursion to proof load value, and the ground-sitting life of B-52B pylon failure-critical structural components. A special life prediction method was developed for the preflight predictions of operational life of failure-critical structural components of the B-52H pylon system, for which no flight data are available.
Compression Strength of Composite Primary Structural Components
NASA Technical Reports Server (NTRS)
Johnson, Eric R.
1998-01-01
Research conducted under NASA Grant NAG-1-537 focussed on the response and failure of advanced composite material structures for application to aircraft. Both experimental and analytical methods were utilized to study the fundamental mechanics of the response and failure of selected structural components subjected to quasi-static loads. Most of the structural components studied were thin-walled elements subject to compression, such that they exhibited buckling and postbuckling responses prior to catastrophic failure. Consequently, the analyses were geometrically nonlinear. Structural components studied were dropped-ply laminated plates, stiffener crippling, pressure pillowing of orthogonally stiffened cylindrical shells, axisymmetric response of pressure domes, and the static crush of semi-circular frames. Failure of these components motivated analytical studies on an interlaminar stress postprocessor for plate and shell finite element computer codes, and global/local modeling strategies in finite element modeling. These activities are summarized in the following section. References to literature published under the grant are listed on pages 5 to 10 by a letter followed by a number under the categories of journal publications, conference publications, presentations, and reports. These references are indicated in the text by their letter and number as a superscript.
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.
NASA Astrophysics Data System (ADS)
Shrivastava, Sachin; Mohite, P. M.
2015-01-01
A redesign of canard control-surface of an advanced all-metallic fighter aircraft was carried out by using carbon fibre composite (CFC) for ribs and panels. In this study ply-orientations of CFC structure are optimized using a Genetic-Algorithm (GA) with an objective function to have minimum failure index (FI) according to Tsai-Wu failure criterion. The redesigned CFC structure was sufficiently strong to withstand aerodynamic loads from stress and deflection points of view. Now, in the present work CFC canard structure has been studied for its buckling strength in comparison to existing metallic design. In this study, the existing metallic design was found to be weak in buckling. Upon a detailed investigation, it was revealed that there are reported failures in the vicinity of zones where initial buckling modes are excited as predicted by the finite element based buckling analysis. In view of buckling failures, the redesigned CFC structure is sufficiently reinforced with stringers at specific locations. After providing reinforcements against buckling, the twist and the camber variations of the airfoil are checked and compared with existing structure data. Finally, the modal analysis has been carried out to compare the variation in excitation frequency due to material change. The CFC structure thus redesigned is safe from buckling and aerodynamic aspects as well.
Composite Interlaminar Shear Fracture Toughness, G(sub 2c): Shear Measurement of Sheer Myth?
NASA Technical Reports Server (NTRS)
OBrien, T. Kevin
1997-01-01
The concept of G2c as a measure of the interlaminar shear fracture toughness of a composite material is critically examined. In particular, it is argued that the apparent G2c as typically measured is inconsistent with the original definition of shear fracture. It is shown that interlaminar shear failure actually consists of tension failures in the resin rich layers between plies followed by the coalescence of ligaments created by these failures and not the sliding of two planes relative to one another that is assumed in fracture mechanics theory. Several strain energy release rate solutions are reviewed for delamination in composite laminates and structural components where failures have been experimentally documented. Failures typically occur at a location where the mode 1 component accounts for at least one half of the total G at failure. Hence, it is the mode I and mixed-mode interlaminar fracture toughness data that will be most useful in predicting delamination failure in composite components in service. Although apparent G2c measurements may prove useful for completeness of generating mixed-mode criteria, the accuracy of these measurements may have very little influence on the prediction of mixed-mode failures in most structural components.
Himalayan Sackung and Associations to Regional Structure
NASA Astrophysics Data System (ADS)
Shroder, J. F.; Bishop, M. P.; Olsenholler, J.
2003-12-01
Recognition of sackung slope failure or deep-seated, rock-slope deformation in the Himalaya has been rather limited, in part because: (1) many geoscientists do not recognize its characteristics; (2) large-scale aerial photographs and topographic maps used to identify the characteristic surficial, topographic manifestations of the failure type are commonly low-level state secrets in that region; and (3) no systematic survey for sackung has ever been made in the Himalaya. In the Pakistani-controlled, western Himalaya, some unconventional access to aerial photographs in the Kaghan and Nanga Parbat areas allowed first recognition of several characteristic ridge-top grabens and anti-slope scarps. Later release of declassified, stereo imagery from the CORONA and KEYHOLE satellite series enabled discovery of other examples in the K2 region. Comparison of mapped sackung failures with geologic base maps has demonstrated some coincidence of sackung with various structural trends, including synformal structures in upper thrust plates or along the traces of high-angle faults. In all probability these structural trends have provided plentiful ancillary planes of weakness along which gravitationally driven sackung is facilitated. Sackung failure in the Himalaya appears to be a spatially scale-dependent manifestation of a gravitational-collapse continuum of the brittle, upper crust, mainly involving mountain ridges. In contrast, gravitational collapse of the whole range may involve some similar failures but also include listric faulting, as well as subsidence movement into zones of ductility at depth. Temporal scale dependence of sackung may also be threshold dominated, wherein initial long-continued, slow failure ultimately leads to the commonly catastrophic rock-slope collapses recently recognized throughout the western Himalaya and now differentiated from their original mismapping as glacial moraines. Such sackung in Himalayan terrain undergoing active deglaciation from global warming may increase catastrophic slope-failure hazard.
Modal test of Shuttle engine nozzle
NASA Technical Reports Server (NTRS)
Johnston, G. D.; Coleman, A. D.
1983-01-01
A structural failure occurred on the main propulsion test stand at NSTL causing a hydrogen fire and damage to the engines to be used on the Orbiter Columbia. Scattered accelerometer measurements indicated very high response levels at 254 hertz and 311 hertz. The Engine Office at MSFC asked the Dynamics Test Branch to try and find out what caused the failure. All three nozzles were sent to Huntsville for testing. Modal test data revealed very quickly how the failure occurred in the steerhorn and also pointed out two other structural problems. A complete set of data is presented along with a narrative explanation of the steps taken to identify and verify the structural problem.
Structure‐function relationships at the human spinal disc‐vertebra interface
Berg‐Johansen, Britta; Fields, Aaron J.; Liebenberg, Ellen C.; Li, Alfred
2017-01-01
ABSTRACT Damage at the intervertebral disc‐vertebra interface associates with back pain and disc herniation. However, the structural and biomechanical properties of the disc‐vertebra interface remain underexplored. We sought to measure mechanical properties and failure mechanisms, quantify architectural features, and assess structure‐function relationships at this vulnerable location. Vertebra‐disc‐vertebra specimens from human cadaver thoracic spines were scanned with micro‐computed tomography (μCT), surface speckle‐coated, and loaded to failure in uniaxial tension. Digital image correlation (DIC) was used to calculate local surface strains. Failure surfaces were scanned using scanning electron microscopy (SEM), and adjacent sagittal slices were analyzed with histology and SEM. Seventy‐one percent of specimens failed initially at the cartilage endplate‐bone interface of the inner annulus region. Histology and SEM both indicated a lack of structural integration between the cartilage endplate (CEP) and bone. The interface failure strength was increased in samples with higher trabecular bone volume fraction in the vertebral endplates. Furthermore, failure strength decreased with degeneration, and in discs with thicker CEPs. Our findings indicate that poor structural connectivity between the CEP and vertebra may explain the structural weakness at this region, and provide insight into structural features that may contribute to risk for disc‐vertebra interface injury. The disc‐vertebra interface is the site of failure in the majority of herniation injuries. Here we show new structure‐function relationships at this interface that may motivate the development of diagnostics, prevention strategies, and treatments to improve the prognosis for many low back pain patients with disc‐vertebra interface injuries. © 2017 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 36:192–201, 2018. PMID:28590060
Flexural Progressive Failure of Carbon/Glass Interlayer and Intralayer Hybrid Composites.
Wang, Qingtao; Wu, Weili; Gong, Zhili; Li, Wei
2018-04-17
The flexural progressive failure modes of carbon fiber and glass fiber (C/G) interlayer and intralayer hybrid composites were investigated in this work. Results showed that the bending failure modes for interlayer hybrid composites are determined by the layup structure. Besides, the bending failure is characterized by the compression failure of the upper layer, when carbon fiber tends to distribute in the upper layer, the interlayer hybrid composite fails early, the failure force is characterized by a multi-stage slightly fluctuating decline and the fracture area exhibits a diamond shape. While carbon fiber distributes in the middle or bottom layer, the failure time starts late, and the failure process exhibits one stage sharp force/stress drop, the fracture zone of glass fiber above the carbon layers presents an inverted trapezoid shape, while the fracture of glass fiber below the carbon layers exhibits an inverted triangular shape. With regards to the intralayer hybrid composites, the C/G hybrid ratio plays a dominating role in the bending failure which could be considered as the mixed failures of four structures. The bending failure of intralayer hybrid composites occurs in advance since carbon fiber are located in each layer; the failure process shows a multi-stage fluctuating decline, and the decline slows down as carbon fiber content increases, and the fracture sound release has the characteristics of a low intensity and high frequency for a long time. By contrast, as glass fiber content increases, the bending failure of intralayer composites is featured with a multi-stage cliff decline with a high amplitude and low frequency for a short-time fracture sound release.
Edwards, Melannie; Rickard, Claire M; Rapchuk, Ivan; Corley, Amanda; Marsh, Nicole; Spooner, Amy J; Mihala, Gabor; Fraser, John F
2014-09-01
To improve arterial catheter (AC) securement and reduce AC failure; to assess feasibility of a large randomised controlled trial. A four-arm, parallel, randomised, controlled, non-blinded pilot trial with 195 intensive care patients taking part, in a tertiary referral hospital in Brisbane, Australia from May to November 2012. Standard polyurethane (SPU) dressing (controls); bordered polyurethane (BPU) + SPU dressing; tissue adhesive (TA) + SPU dressing; and sutureless securement device (SSD) + SPU dressing (no sutures used). AC failure, ie, complete dislodgement, occlusion (monitor failure, inability to infuse or fluid leaking), pain or infection (local or blood). Median AC dwell time was 26.2 hours and was comparable between groups. AC failure occurred in 26/195 patients (13%). AC failure was significantly worse with SPU dressings (10/47 [21%]) than with BPU + SPU dressings (2/ 43 [5%]; P = 0.03), but not significantly different to TA + SPU (6/56 [11%]; P = 0.18) or SSD + SPU (8/49 [16%]; P = 0.61). The dressing applied at AC insertion lasted until AC removal in 68% of controls; 56% of BPU + SPU dressings; 73% of TA + SPU dressings; and 80% of SSD + SPU dressings (all P > 0.05). There were no infections or serious adverse events. Patient and staff satisfaction with all products was high. Median costs (labour and materials) for securement per patient were significantly higher in all groups compared with the control group (SPU, $3.48 [IQR, $3.48-$9.79]; BPU + SPU, $5.07 [IQR, $5.07-$12.99]; SSD + SPU, $10.90 [IQR, $10.90-$10.90]; TA + SPU, $17.70 [IQR, $17.70-$38.36]; all P < 0.01). AC failure occurred significantly less often with BPU + SPU dressings than with SPU dressings. TA + SPU and SSD + SPU dressings should be further investigated and compared with BPU + SPU dressings as controls. The novel approach of TA + SPU dressings appeared safe and feasible.
The effect of sodium bicarbonate ingestion on back squat and bench press exercise to failure.
Duncan, Michael J; Weldon, Anthony; Price, Michael J
2014-05-01
This study examined the acute effects of NaHCO3 ingestion on repetitions to failure and rating of perceived exertion in the back squat and bench press in trained men. Eight resistance-trained men took part in this double-blind, randomized crossover experimental study whereby they ingested NaHCO3 (0.3 g·kg(-1) body mass) or placebo (sodium chloride NaCl: 0.045 g·kg(-1) body mass) solution 60 minutes before completing a bout of resistance exercise (3 sets of bench press and back squat exercise to failure at an intensity of 80% 1 repetition maximum). Experimental conditions were separated by at least 48 hours. Participants completed more repetitions to failure in the back squat after NaHCO3 ingestion (p = 0.04) but not for bench press (p = 0.679). Mean ± SD of total repetitions was 31.3 ± 15.3 and 24.6 ± 16.2 for back squat and 28.7 ± 12.2 and 26.7 ± 10.2 for bench press in NaHCO3 and placebo conditions, respectively. Repetitions to failure decreased as set increased for the back squat and bench press (p = 0.001, both). Rating of perceived exertion significantly increased with set for the back squat and bench press (p = 0.002, both). There was no significant change in blood lactate across time or between conditions. There were however treatment × time interactions for blood pH (p = 0.014) and blood HCO3 concentration (p = 0.001). After ingestion, blood pH and HCO3 (p = 0.008) concentrations were greater for the NaHCO3 condition compared with the placebo condition (p < 0.001). The results of this study suggest that sodium bicarbonate ingestion can enhance resistance exercise performance using a repetition to failure protocol in the first exercise in a resistance exercise session.
Lam, Phillip H; Dooley, Daniel J; Fonarow, Gregg C; Butler, Javed; Bhatt, Deepak L; Filippatos, Gerasimos S; Deedwania, Prakash; Forman, Daniel E; White, Michel; Fletcher, Ross D; Arundel, Cherinne; Blackman, Marc R; Adamopoulos, Chris; Kanonidis, Ioannis E; Aban, Inmaculada B; Patel, Kanan; Aronow, Wilbert S; Allman, Richard M; Anker, Stefan D; Pitt, Bertram; Ahmed, Ali
2018-02-01
To examine associations of below-target and target dose of enalapril, an angiotensin-converting enzyme (ACE) inhibitor, with outcomes in patients with heart failure and reduced ejection fraction (HFrEF) in the Studies of Left Ventricular Dysfunction (SOLVD) Treatment trial. Two thousand five hundred and sixty-nine patients with HFrEF (ejection fraction ≤35%) were randomized to below-target (5-10 mg/day) dose placebo (n = 1284) or enalapril (n = 1285). One month post-randomization, blind up-titration to target (20 mg/day) dose was attempted for both study drugs in 2458 patients. Among the 1444 patients who achieved dose up-titration (placebo, n = 748; enalapril, n = 696; mean dose for both groups, 20.0 mg/day), target dose enalapril (vs. target dose placebo) was associated with a 9% absolute lower risk of the combined endpoint of heart failure hospitalization or all-cause mortality [adjusted hazard ratio (HR) 0.70; 95% confidence interval (CI) 0.60-0.81; P < 0.001] during 4 years of follow-up. Among the 1014 patients who could not achieve target dose (placebo, n = 486; enalapril, n = 528; mean dose for both groups, 8.8 mg/day), below-target dose enalapril (vs. below-target dose placebo) was associated with a 12% absolute lower risk of the combined endpoint of heart failure hospitalization or all-cause mortality (adjusted HR 0.68; 95% CI 0.57-0.81; P < 0.001). Among the 1224 patients receiving enalapril, target (vs. below-target) dose had no association with the combined endpoint of heart failure hospitalization or all-cause mortality (adjusted HR 1.04; 95% CI 0.87-1.23; P = 0.695). In patients with HFrEF, the clinical benefits of ACE inhibitors appear to be similar at both below-target and target doses. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.
Torre-Amione, Guillermo; Anker, Stefan D; Bourge, Robert C; Colucci, Wilson S; Greenberg, Barry H; Hildebrandt, Per; Keren, Andre; Motro, Michael; Moyé, Lemuel A; Otterstad, Jan Erik; Pratt, Craig M; Ponikowski, Piotr; Rouleau, Jean Lucien; Sestier, Francois; Winkelmann, Bernhard R; Young, James B
2008-01-19
Evidence suggests that inflammatory mediators contribute to development and progression of chronic heart failure. We therefore tested the hypothesis that immunomodulation might counteract this pathophysiological mechanism in patients. We did a double-blind, placebo-controlled study of a device-based non-specific immunomodulation therapy (IMT) in patients with New York Heart Association (NYHA) functional class II-IV chronic heart failure, left ventricular (LV) systolic dysfunction, and hospitalisation for heart failure or intravenous drug therapy in an outpatient setting within the past 12 months. Patients were randomly assigned to receive IMT (n=1213) or placebo (n=1213) by intragluteal injection on days 1, 2, 14, and every 28 days thereafter. Primary endpoint was the composite of time to death from any cause or first hospitalisation for cardiovascular reasons. The study continued until 828 primary endpoint events had accrued and all study patients had been treated for at least 22 weeks. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00111969. During a mean follow-up of 10.2 months, there were 399 primary events in the IMT group and 429 in the placebo group (hazard ratio 0.92; 95% CI 0.80-1.05; p=0.22). In two prespecified subgroups of patients--those with no history of previous myocardial infarction (n=919) and those with NYHA II heart failure (n=689)--IMT was associated with a 26% (0.74; 0.57-0.95; p=0.02) and a 39% (0.61; 95% CI 0.46-0.80; p=0.0003) reduction in the risk of primary endpoint events, respectively. Non-specific immunomodulation may have a role as a potential treatment for a large segment of the heart failure population, which includes patients without a history of myocardial infarction (irrespective of their functional NYHA class) and patients within NYHA class II.
Cozzi-Lepri, Alessandro; Noguera-Julian, Marc; Di Giallonardo, Francesca; Schuurman, Rob; Däumer, Martin; Aitken, Sue; Ceccherini-Silberstein, Francesca; D'Arminio Monforte, Antonella; Geretti, Anna Maria; Booth, Clare L; Kaiser, Rolf; Michalik, Claudia; Jansen, Klaus; Masquelier, Bernard; Bellecave, Pantxika; Kouyos, Roger D; Castro, Erika; Furrer, Hansjakob; Schultze, Anna; Günthard, Huldrych F; Brun-Vezinet, Francoise; Paredes, Roger; Metzner, Karin J
2015-03-01
It is still debated if pre-existing minority drug-resistant HIV-1 variants (MVs) affect the virological outcomes of first-line NNRTI-containing ART. This Europe-wide case-control study included ART-naive subjects infected with drug-susceptible HIV-1 as revealed by population sequencing, who achieved virological suppression on first-line ART including one NNRTI. Cases experienced virological failure and controls were subjects from the same cohort whose viraemia remained suppressed at a matched time since initiation of ART. Blinded, centralized 454 pyrosequencing with parallel bioinformatic analysis in two laboratories was used to identify MVs in the 1%-25% frequency range. ORs of virological failure according to MV detection were estimated by logistic regression. Two hundred and sixty samples (76 cases and 184 controls), mostly subtype B (73.5%), were used for the analysis. Identical MVs were detected in the two laboratories. 31.6% of cases and 16.8% of controls harboured pre-existing MVs. Detection of at least one MV versus no MVs was associated with an increased risk of virological failure (OR = 2.75, 95% CI = 1.35-5.60, P = 0.005); similar associations were observed for at least one MV versus no NRTI MVs (OR = 2.27, 95% CI = 0.76-6.77, P = 0.140) and at least one MV versus no NNRTI MVs (OR = 2.41, 95% CI = 1.12-5.18, P = 0.024). A dose-effect relationship between virological failure and mutational load was found. Pre-existing MVs more than double the risk of virological failure to first-line NNRTI-based ART. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.
Predicting Error Bars for QSAR Models
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schroeter, Timon; Technische Universitaet Berlin, Department of Computer Science, Franklinstrasse 28/29, 10587 Berlin; Schwaighofer, Anton
2007-09-18
Unfavorable physicochemical properties often cause drug failures. It is therefore important to take lipophilicity and water solubility into account early on in lead discovery. This study presents log D{sub 7} models built using Gaussian Process regression, Support Vector Machines, decision trees and ridge regression algorithms based on 14556 drug discovery compounds of Bayer Schering Pharma. A blind test was conducted using 7013 new measurements from the last months. We also present independent evaluations using public data. Apart from accuracy, we discuss the quality of error bars that can be computed by Gaussian Process models, and ensemble and distance based techniquesmore » for the other modelling approaches.« less
Wind-tunnel investigation of an NACA 23012 airfoil with 30 percent-chord venetian-blind flaps
NASA Technical Reports Server (NTRS)
Rogallo, F M; Spano, Bartholomew S
1942-01-01
Report presents the results of an investigation made in the NACA 7 by 10-foot wind tunnel of a NACA 23012 airfoil with 30-percent-chord venetian-blind flaps having one, two, three, and four slats of Clark y section. The three-slat arrangements was aerodynamically the best of those tested but showed practically no improvement over the comparable arrangement used in the preliminary tests published in NACA Technical Report No. 689. The multiple-slat flaps gave slightly higher lift coefficients than the one-slat (Fowler) flap but gave considerably greater pitching-moment coefficients. An analysis of test data indicates that substitution of a thicker and more cambered section for the Clark y slats should improve the aerodynamic and the structural characteristics of the venetian-blind flap.
Lessons Learned from Recent Failure and Incident Investigations of Composite Structures
NASA Technical Reports Server (NTRS)
Ransom, J. B.; Glaessgen, E. H.; Raju, L. S.; Knight, N. F., Jr.; Reeder, J. R.
2008-01-01
During the past few decades, NASA Langley Research Center (LaRC) has supported several large-scale failure and incident investigations and numerous requests for engineering consultations. Although various extenuating circumstances contributed to each of these incidents, in all cases, the failure resulted from accumulation and/or propagation of damage that reduced the load carrying capability of the structure to a level below that which was needed to sustain structural loads. A brief overview of various failure and incident investigations supported by LaRC, including some of the computational and experimental methodologies that have been applied, is presented. An important outcome of many of these failure and incident investigations is the development of an improved understanding of not only the state-of-the-art in experimental and analytical methods but also the state-of-the-art in the design and manufacturing processes that may contribute to such failures. In order to provide insight into such large-scale investigations, a series of lessons learned were captured. Awareness of these lessons learned is highly beneficial to engineers involved in similar investigations. Therefore, it is prudent that the lessons learned are disseminated such that they can be built upon in other investigations and in ensuing research and development activities.
Risk management of key issues of FPSO
NASA Astrophysics Data System (ADS)
Sun, Liping; Sun, Hai
2012-12-01
Risk analysis of key systems have become a growing topic late of because of the development of offshore structures. Equipment failures of offloading system and fire accidents were analyzed based on the floating production, storage and offloading (FPSO) features. Fault tree analysis (FTA), and failure modes and effects analysis (FMEA) methods were examined based on information already researched on modules of relex reliability studio (RRS). Equipment failures were also analyzed qualitatively by establishing a fault tree and Boolean structure function based on the shortage of failure cases, statistical data, and risk control measures examined. Failure modes of fire accident were classified according to the different areas of fire occurrences during the FMEA process, using risk priority number (RPN) methods to evaluate their severity rank. The qualitative analysis of FTA gave the basic insight of forming the failure modes of FPSO offloading, and the fire FMEA gave the priorities and suggested processes. The research has practical importance for the security analysis problems of FPSO.
Evolutionary Construction of Block-Based Neural Networks in Consideration of Failure
NASA Astrophysics Data System (ADS)
Takamori, Masahito; Koakutsu, Seiichi; Hamagami, Tomoki; Hirata, Hironori
In this paper we propose a modified gene coding and an evolutionary construction in consideration of failure in evolutionary construction of Block-Based Neural Networks. In the modified gene coding, we arrange the genes of weights on a chromosome in consideration of the position relation of the genes of weight and structure. By the modified gene coding, the efficiency of search by crossover is increased. Thereby, it is thought that improvement of the convergence rate of construction and shortening of construction time can be performed. In the evolutionary construction in consideration of failure, the structure which is adapted for failure is built in the state where failure occured. Thereby, it is thought that BBNN can be reconstructed in a short time at the time of failure. To evaluate the proposed method, we apply it to pattern classification and autonomous mobile robot control problems. The computational experiments indicate that the proposed method can improve convergence rate of construction and shorten of construction and reconstruction time.
The unifying role of dissipative action in the dynamic failure of solids
Grady, Dennis
2015-05-19
Dissipative action, the product of dissipation energy and transport time, is fundamental to the dynamic failure of solids. Invariance of the dissipative action underlies the fourth-power nature of structured shock waves observed in selected solid metals and compounds. Dynamic failure through shock compaction, tensile spall and adiabatic shear are also governed by a constancy of the dissipative action. This commonality underlying the various modes of dynamic failure is described and leads to deeper insights into failure of solids in the intense shock wave event. These insights are in turn leading to a better understanding of the shock deformation processes underlyingmore » the fourth-power law. Experimental result and material models encompassing the dynamic failure of solids are explored for the purpose of demonstrating commonalities leading to invariance of the dissipation action. As a result, calculations are extended to aluminum and uranium metals with the intent of predicting micro-scale energetics and spatial scales in the structured shock wave.« less
A streamlined failure mode and effects analysis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ford, Eric C., E-mail: eford@uw.edu; Smith, Koren; Terezakis, Stephanie
Purpose: Explore the feasibility and impact of a streamlined failure mode and effects analysis (FMEA) using a structured process that is designed to minimize staff effort. Methods: FMEA for the external beam process was conducted at an affiliate radiation oncology center that treats approximately 60 patients per day. A structured FMEA process was developed which included clearly defined roles and goals for each phase. A core group of seven people was identified and a facilitator was chosen to lead the effort. Failure modes were identified and scored according to the FMEA formalism. A risk priority number,RPN, was calculated and usedmore » to rank failure modes. Failure modes with RPN > 150 received safety improvement interventions. Staff effort was carefully tracked throughout the project. Results: Fifty-two failure modes were identified, 22 collected during meetings, and 30 from take-home worksheets. The four top-ranked failure modes were: delay in film check, missing pacemaker protocol/consent, critical structures not contoured, and pregnant patient simulated without the team's knowledge of the pregnancy. These four failure modes hadRPN > 150 and received safety interventions. The FMEA was completed in one month in four 1-h meetings. A total of 55 staff hours were required and, additionally, 20 h by the facilitator. Conclusions: Streamlined FMEA provides a means of accomplishing a relatively large-scale analysis with modest effort. One potential value of FMEA is that it potentially provides a means of measuring the impact of quality improvement efforts through a reduction in risk scores. Future study of this possibility is needed.« less
Guerrero Arenas, Coral; Hidalgo Tobón, Silvia S; Dies Suarez, Pilar; Barragán Pérez, Eduardo; Castro Sierra, Eduardo; García, Julio; de Celis Alonso, Benito
2016-04-01
Early childhood is known to be a period when cortical plasticity phenomena are at a maximum. Music is a stimulus known to modulate these mechanisms. On the other hand, neurological impairments like blindness are also known to affect cortical plasticity. Here, we address how tonal and atonal musical stimuli are processed in control and blind young children. We aimed to understand the differences between the two groups when processing this physiological information. Atonal stimuli produced larger activations in cerebellum, fusiform, and temporal lobe structures than tonal. In contrast, tonal stimuli induced larger frontal lobe representations than atonal. Control participants presented large activations in cerebellum, fusiform, and temporal lobe. A correlation/connectivity study showed that the blind group incorporated larger amounts of perceptual information (somatosensory and motor) into tonal processing through the function of the anterior prefrontal cortex (APC). They also used the visual cortex in conjunction with the Wernicke's area to process this information. In contrast, controls processed sound with perceptual stimuli from auditory cortex structures (including Wernicke's area). In this case, information was processed through the dorsal posterior cingulate cortex and not the APC. The orbitofrontal cortex also played a key role for atonal interpretation in this group. Wernicke's area, known to be involved in speech, was heavily involved for both groups and all stimuli. The two groups presented clear differences in strategies for music processing, with very different recruitment of brain regions.
Behaviors of cavefish offer insight into developmental evolution
2015-01-01
SUMMARY Many developmental processes have evolved through natural selection, yet in only a few cases do we understand if and how a change of developmental process produces a benefit. For example, many studies in evolutionary biology have investigated the developmental mechanisms that lead to novel structures in an animal, but only a few have addressed if these structures actually benefit the animal at the behavioral level of prey hunting and mating. As such, this review discusses an animal's behavior as the integrated functional output of its evolved morphological and physiological traits. Specifically, we focus on recent findings about the blind Mexican cavefish, Astyanax mexicanus, for which clear relationships exist between its physical traits and ecosystem. This species includes two morphotypes: an eyed surface dweller versus many conspecific types of blind cave dwellers, some of which evolved independently; all of the blind subtypes derived from eyed surface dwellers. The blind cavefish evolved under clear selection pressures: food is sparse and darkness is perpetual. Simulating the major aspects of a cave ecosystem in the laboratory is relatively easy, so we can use this species to begin resolving the relationships between evolved traits and selection pressures—relationships which are more complex for other animals models. This review discusses the recent advances in cavefish research that have helped us establish some key relationships between morphological evolution and environmental shifts. Mol. Reprod. Dev. 82: 268–280, 2015. © 2015 Wiley Periodicals, Inc. PMID:25728684
Nonclinical and clinical pharmacology evidence for cardiovascular safety of saxagliptin.
Pollack, Pia S; Chadwick, Kristina D; Smith, David M; Billger, Martin; Hirshberg, Boaz; Iqbal, Nayyar; Boulton, David W
2017-09-13
In the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus (SAVOR) trial in patients with type 2 diabetes mellitus (T2D) at high risk of cardiovascular (CV) disease, saxagliptin did not increase the risk for major CV adverse events. However, there was an unexpected imbalance in events of hospitalization for heart failure (hHF), one of six components of the secondary CV composite endpoint, with a greater number of events observed with saxagliptin. Here, we examined findings from nonclinical safety and clinical pharmacology studies of saxagliptin with the aim of identifying any potential signals of myocardial injury. In vitro and in vivo (rat, dog, monkey) safety pharmacology and toxicology studies evaluating the potential effects of saxagliptin and its major active metabolite, 5-hydroxy saxagliptin, on the CV system are reviewed. In addition, results from saxagliptin clinical studies are discussed: one randomized, 2-period, double-blind, placebo-controlled single-ascending-dose study (up to 100 mg); one randomized, double-blind, placebo-controlled, sequential, multiple-ascending-high-dose study (up to 400 mg/day for 14 days); and one randomized, double-blind, 4-period, 4-treatment, cross-over thorough QTc study (up to 40 mg/day for 4 days) in healthy volunteers; as well as one randomized, placebo-controlled, sequential multiple-ascending-dose study in patients with T2D (up to 50 mg/day for 14 days). Neither saxagliptin nor 5-hydroxy saxagliptin affected ligand binding to receptors and ion channels (e.g. potassium channels) or action potential duration in in vitro studies. In animal toxicology studies, no changes in the cardiac conduction system, blood pressure, heart rate, contractility, heart weight, or heart histopathology were observed. In healthy participants and patients with T2D, there were no findings suggestive of myocyte injury or fluid overload. Serum chemistry abnormalities indicative of cardiac injury, nonspecific muscle damage, or fluid homeostasis changes were infrequent and balanced across treatment groups. There were no QTc changes associated with saxagliptin. No treatment-emergent adverse events suggestive of heart failure or myocardial damage were reported. The saxagliptin nonclinical and clinical pharmacology programs did not identify evidence of myocardial injury and/or CV harm that may have predicted or may explain the unexpected imbalance in the rate of hHF observed in SAVOR.
Self-Conscious Emotions in Response to Perceived Failure: A Structural Equation Model
ERIC Educational Resources Information Center
Bidjerano, Temi
2010-01-01
This study explored the occurrence of self-conscious emotions in response to perceived academic failure among 4th-grade students from the United States and Bulgaria, and the author investigated potential contributors to such negative emotional experiences. Results from structural equation modeling indicated that regardless of country, negative…
Failure Analysis in Platelet Molded Composite Systems
NASA Astrophysics Data System (ADS)
Kravchenko, Sergii G.
Long-fiber discontinuous composite systems in the form of chopped prepreg tapes provide an advanced, structural grade, molding compound allowing for fabrication of complex three-dimensional components. Understanding of process-structure-property relationship is essential for application of prerpeg platelet molded components, especially because of their possible irregular disordered heterogeneous morphology. Herein, a structure-property relationship was analyzed in the composite systems of many platelets. Regular and irregular morphologies were considered. Platelet-based systems with more ordered morphology possess superior mechanical performance. While regular morphologies allow for a careful inspection of failure mechanisms derived from the morphological characteristics, irregular morphologies are representative of the composite architectures resulting from uncontrolled deposition and molding with chopped prerpegs. Progressive failure analysis (PFA) was used to study the damaged deformation up to ultimate failure in a platelet-based composite system. Computational damage mechanics approaches were utilized to conduct the PFA. The developed computational models granted understanding of how the composite structure details, meaning the platelet geometry and system morphology (geometrical arrangement and orientation distribution of platelets), define the effective mechanical properties of a platelet-molded composite system, its stiffness, strength and variability in properties.
Nonlinear structural crack growth monitoring
Welch, Donald E.; Hively, Lee M.; Holdaway, Ray F.
2002-01-01
A method and apparatus are provided for the detection, through nonlinear manipulation of data, of an indicator of imminent failure due to crack growth in structural elements. The method is a process of determining energy consumption due to crack growth and correlating the energy consumption with physical phenomena indicative of a failure event. The apparatus includes sensors for sensing physical data factors, processors or the like for computing a relationship between the physical data factors and phenomena indicative of the failure event, and apparatus for providing notification of the characteristics and extent of such phenomena.
Weber, Stephen C; Kauffman, Jeffrey I; Parise, Carol; Weber, Sophia J; Katz, Stephen D
2013-02-01
Arthroscopic rotator cuff repair has a high rate of patient satisfaction. However, multiple studies have shown significant rates of anatomic failure. Biological augmentation would seem to be a reasonable technique to improve clinical outcomes and healing rates. To represent a prospective, double-blinded, randomized study to assess the use of platelet-rich fibrin matrix (PRFM) in rotator cuff surgery. Randomized controlled trial; level of evidence, 1. Prestudy power analysis demonstrated that a sample size of 30 patients in each group (PRFM vs control) would allow recognition of a 20% difference in perioperative pain scores. Sixty consecutive patients were randomized to either receive a commercially available PRFM product or not. Preoperative and postoperative range of motion (ROM), University of California-Los Angeles (UCLA), and simple shoulder test (SST) scores were recorded. Surgery was performed using an arthroscopic single-row technique. Visual analog scale (VAS) pain scores were obtained upon arrival to the recovery room and 1 hour postoperatively, and narcotic consumption was recorded and converted to standard narcotic equivalents. The SST and ROM measurements were taken at 3, 6, 9, and 12 weeks postoperatively, and final (1 year) American shoulder and elbow surgeons (ASES) shoulder and UCLA shoulder scores were assessed. There were no complications. Randomization created comparable groups except that the PRFM group was younger than the control group (mean ± SD, 59.67 ± 8.16 y vs 64.50 ± 8.59 y, respectively; P < .05). Mean surgery time was longer for the PRFM group than for the control group (83.28 ± 17.13 min vs 73.28 ± 17.18 min, respectively; P < .02). There was no significant difference in VAS scores or narcotic use between groups and no statistically significant differences in recovery of motion, SST, or ASES scores. Mean ASES scores were 82.48 ± 8.77 (PRFM group) and 82.52 ± 12.45 (controls) (F(1,56) = 0.00, P > .98). Mean UCLA shoulder scores were 27.94 ± 4.98 for the PRFM group versus 29.59 ± 1.68 for the controls (P < .046). Structural results correlated with age and size of the tear and did not differ between the groups. Platelet-rich fibrin matrix was not shown to significantly improve perioperative morbidity, clinical outcomes, or structural integrity. While longer term follow-up or different platelet-rich plasma formulations may show differences, early follow-up does not show significant improvement in perioperative morbidity, structural integrity, or clinical outcome.
Precise Analysis of Microstructural Effects on Mechanical Properties of Cast ADC12 Aluminum Alloy
NASA Astrophysics Data System (ADS)
Okayasu, Mitsuhiro; Takeuchi, Shuhei; Yamamoto, Masaki; Ohfuji, Hiroaki; Ochi, Toshihiro
2015-04-01
The effects of microstructural characteristics (secondary dendrite arm spacing, SDAS) and Si- and Fe-based eutectic structures on the mechanical properties and failure behavior of an Al-Si-Cu alloy are investigated. Cast Al alloy samples are produced using a special continuous-casting technique with which it is easy to control both the sizes of microstructures and the direction of crystal orientation. Dendrite cells appear to grow in the casting direction. There are linear correlations between SDAS and tensile properties (ultimate tensile strength σ UTS, 0.2 pct proof strength σ 0.2, and fracture strain ɛ f). These linear correlations, however, break down, especially for σ UTS vs SDAS and ɛ f vs SDAS, as the eutectic structures become more than 3 μm in diameter, when the strength and ductility ( σ UTS and ɛ f) decrease significantly. For eutectic structures larger than 3 μm, failure is dominated by the brittle eutectic phases, for which SDAS is no longer strongly correlated with σ UTS and ɛ f. In contrast, a linear correlation is obtained between σ 0.2 and SDAS, even for eutectic structures larger than 3 μm, and the eutectic structure does not have a strong effect on yield behavior. This is because failure in the eutectic phases occurs just before final fracture. In situ failure observation during tensile testing is performed using microstructural and lattice characteristics. From the experimental results obtained, models of failure during tensile loading are proposed.
Stresses in Circular Plates with Rigid Elements
NASA Astrophysics Data System (ADS)
Velikanov, N. L.; Koryagin, S. I.; Sharkov, O. V.
2018-05-01
Calculations of residual stress fields are carried out by numerical and static methods, using the flat cross-section hypothesis. The failure of metal when exposed to residual stresses is, in most cases, brittle. The presence in the engineering structures of rigid elements often leads to the crack initiation and structure failure. This is due to the fact that rigid elements under the influence of external stresses are stress concentrators. In addition, if these elements are fixed by welding, the residual welding stresses can lead to an increase in stress concentration and, ultimately, to failure. The development of design schemes for such structures is a very urgent task for complex technical systems. To determine the stresses in a circular plate with a welded circular rigid insert under the influence of an external load, one can use the solution of the plane stress problem for annular plates in polar coordinates. The polar coordinates of the points are the polar radius and the polar angle, and the stress state is determined by normal radial stresses, tangential and shearing stresses. The use of the above mentioned design schemes, formulas, will allow more accurate determination of residual stresses in annular welded structures. This will help to establish the most likely directions of failure and take measures at the stages of designing, manufacturing and repairing engineering structures to prevent these failures. However, it must be taken into account that the external load, the presence of insulation can lead to a change in the residual stress field.
A global analysis approach for investigating structural resilience in urban drainage systems.
Mugume, Seith N; Gomez, Diego E; Fu, Guangtao; Farmani, Raziyeh; Butler, David
2015-09-15
Building resilience in urban drainage systems requires consideration of a wide range of threats that contribute to urban flooding. Existing hydraulic reliability based approaches have focused on quantifying functional failure caused by extreme rainfall or increase in dry weather flows that lead to hydraulic overloading of the system. Such approaches however, do not fully explore the full system failure scenario space due to exclusion of crucial threats such as equipment malfunction, pipe collapse and blockage that can also lead to urban flooding. In this research, a new analytical approach based on global resilience analysis is investigated and applied to systematically evaluate the performance of an urban drainage system when subjected to a wide range of structural failure scenarios resulting from random cumulative link failure. Link failure envelopes, which represent the resulting loss of system functionality (impacts) are determined by computing the upper and lower limits of the simulation results for total flood volume (failure magnitude) and average flood duration (failure duration) at each link failure level. A new resilience index that combines the failure magnitude and duration into a single metric is applied to quantify system residual functionality at each considered link failure level. With this approach, resilience has been tested and characterised for an existing urban drainage system in Kampala city, Uganda. In addition, the effectiveness of potential adaptation strategies in enhancing its resilience to cumulative link failure has been tested. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Software reliability experiments data analysis and investigation
NASA Technical Reports Server (NTRS)
Walker, J. Leslie; Caglayan, Alper K.
1991-01-01
The objectives are to investigate the fundamental reasons which cause independently developed software programs to fail dependently, and to examine fault tolerant software structures which maximize reliability gain in the presence of such dependent failure behavior. The authors used 20 redundant programs from a software reliability experiment to analyze the software errors causing coincident failures, to compare the reliability of N-version and recovery block structures composed of these programs, and to examine the impact of diversity on software reliability using subpopulations of these programs. The results indicate that both conceptually related and unrelated errors can cause coincident failures and that recovery block structures offer more reliability gain than N-version structures if acceptance checks that fail independently from the software components are available. The authors present a theory of general program checkers that have potential application for acceptance tests.
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.
Cvetkovic, Dean
2013-01-01
The Cooperative Learning in Engineering Design curriculum can be enhanced with structured and timely self and peer assessment teaching methodologies which can easily be applied to any Biomedical Engineering curriculum. A study was designed and implemented to evaluate the effectiveness of this structured and timely self and peer assessment on student team-based projects. In comparing the 'peer-blind' and 'face-to-face' Fair Contribution Scoring (FCS) methods, both had advantages and disadvantages. The 'peer-blind' self and peer assessment method would cause high discrepancy between self and team ratings. But the 'face-to-face' method on the other hand did not have the discrepancy issue and had actually proved to be a more accurate and effective, indicating team cohesiveness and good cooperative learning.
A review of failure models for unidirectional ceramic matrix composites under monotonic loads
NASA Technical Reports Server (NTRS)
Tripp, David E.; Hemann, John H.; Gyekenyesi, John P.
1989-01-01
Ceramic matrix composites offer significant potential for improving the performance of turbine engines. In order to achieve their potential, however, improvements in design methodology are needed. In the past most components using structural ceramic matrix composites were designed by trial and error since the emphasis of feasibility demonstration minimized the development of mathematical models. To understand the key parameters controlling response and the mechanics of failure, the development of structural failure models is required. A review of short term failure models with potential for ceramic matrix composite laminates under monotonic loads is presented. Phenomenological, semi-empirical, shear-lag, fracture mechanics, damage mechanics, and statistical models for the fast fracture analysis of continuous fiber unidirectional ceramic matrix composites under monotonic loads are surveyed.
Solar-blind ultraviolet optical system design for missile warning
NASA Astrophysics Data System (ADS)
Chen, Yu; Huo, Furong; Zheng, Liqin
2015-03-01
Solar-blind region of Ultraviolet (UV) spectrum has very important application in military field. The spectrum range is from 240nm to 280nm, which can be applied to detect the tail flame from approaching missile. A solar-blind UV optical system is designed to detect the UV radiation, which is an energy system. iKon-L 936 from ANDOR company is selected as the UV detector, which has pixel size 13.5μm x 13.5 μm and active image area 27.6mm x 27.6 mm. CaF2 and F_silica are the chosen materials. The original structure is composed of 6 elements. To reduce the system structure and improve image quality, two aspheric surfaces and one diffractive optical element are adopted in this paper. After optimization and normalization, the designed system is composed of five elements with the maximum spot size 11.988μ m, which is less than the pixel size of the selected CCD detector. Application of aspheric surface and diffractive optical element makes each FOV have similar spot size, which shows the system almost meets the requirements of isoplanatic condition. If the focal length can be decreased, the FOV of the system can be enlarged further.
Yoshioka, S; Matsuhana, B; Tanaka, S; Inouye, Y; Oshima, N; Kinoshita, S
2011-01-06
The structural colour of the neon tetra is distinguishable from those of, e.g., butterfly wings and bird feathers, because it can change in response to the light intensity of the surrounding environment. This fact clearly indicates the variability of the colour-producing microstructures. It has been known that an iridophore of the neon tetra contains a few stacks of periodically arranged light-reflecting platelets, which can cause multilayer optical interference phenomena. As a mechanism of the colour variability, the Venetian blind model has been proposed, in which the light-reflecting platelets are assumed to be tilted during colour change, resulting in a variation in the spacing between the platelets. In order to quantitatively evaluate the validity of this model, we have performed a detailed optical study of a single stack of platelets inside an iridophore. In particular, we have prepared a new optical system that can simultaneously measure both the spectrum and direction of the reflected light, which are expected to be closely related to each other in the Venetian blind model. The experimental results and detailed analysis are found to quantitatively verify the model.
Abnormalities of the QT interval in primary disorders of autonomic failure
NASA Technical Reports Server (NTRS)
Choy, A. M.; Lang, C. C.; Roden, D. M.; Robertson, D.; Wood, A. J.; Robertson, R. M.; Biaggioni, I.
1998-01-01
BACKGROUND: Experimental evidence shows that activation of the autonomic nervous system influences ventricular repolarization and, therefore, the QT interval on the ECG. To test the hypothesis that the QT interval is abnormal in autonomic dysfunction, we examined ECGs in patients with severe primary autonomic failure and in patients with congenital dopamine beta-hydroxylase (DbetaH) deficiency who are unable to synthesize norepinephrine and epinephrine. SUBJECTS AND METHODS: Maximal QT and rate-corrected QT (QTc) intervals and adjusted QTc dispersion [(maximal QTc - minimum QTc on 12 lead ECG)/square root of the number of leads measured] were determined in blinded fashion from ECGs of 67 patients with primary autonomic failure (36 patients with multiple system atrophy [MSA], and 31 patients with pure autonomic failure [PAF]) and 17 age- and sex-matched healthy controls. ECGs of 5 patients with congenital DbetaH deficiency and 6 age- and sex-matched controls were also analyzed. RESULTS: Patients with MSA and PAF had significantly prolonged maximum QTc intervals (492+/-58 ms(1/2) and 502+/-61 ms(1/2) [mean +/- SD]), respectively, compared with controls (450+/-18 ms(1/2), P < .05 and P < .01, respectively). A similar but not significant trend was observed for QT. QTc dispersion was also increased in MSA (40+/-20 ms(1/2), P < .05 vs controls) and PAF patients (32+/-19 ms(1/2), NS) compared with controls (21+/-5 ms(1/2)). In contrast, patients with congenital DbetaH deficiency did not have significantly different RR, QT, QTc intervals, or QTc dispersion when compared with controls. CONCLUSIONS: Patients with primary autonomic failure who have combined parasympathetic and sympathetic failure have abnormally prolonged QT interval and increased QT dispersion. However, QT interval in patients with congenital DbetaH deficiency was not significantly different from controls. It is possible, therefore, that QT abnormalities in patients with primary autonomic failure are not solely caused by lesions of the sympathetic nervous system, and that the parasympathetic nervous system is likely to have a modulatory role in ventricular repolarization.
Angiotensin-neprilysin inhibition versus enalapril in heart failure.
McMurray, John J V; Packer, Milton; Desai, Akshay S; Gong, Jianjian; Lefkowitz, Martin P; Rizkala, Adel R; Rouleau, Jean L; Shi, Victor C; Solomon, Scott D; Swedberg, Karl; Zile, Michael R
2014-09-11
We compared the angiotensin receptor-neprilysin inhibitor LCZ696 with enalapril in patients who had heart failure with a reduced ejection fraction. In previous studies, enalapril improved survival in such patients. In this double-blind trial, we randomly assigned 8442 patients with class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either LCZ696 (at a dose of 200 mg twice daily) or enalapril (at a dose of 10 mg twice daily), in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure, but the trial was designed to detect a difference in the rates of death from cardiovascular causes. The trial was stopped early, according to prespecified rules, after a median follow-up of 27 months, because the boundary for an overwhelming benefit with LCZ696 had been crossed. At the time of study closure, the primary outcome had occurred in 914 patients (21.8%) in the LCZ696 group and 1117 patients (26.5%) in the enalapril group (hazard ratio in the LCZ696 group, 0.80; 95% confidence interval [CI], 0.73 to 0.87; P<0.001). A total of 711 patients (17.0%) receiving LCZ696 and 835 patients (19.8%) receiving enalapril died (hazard ratio for death from any cause, 0.84; 95% CI, 0.76 to 0.93; P<0.001); of these patients, 558 (13.3%) and 693 (16.5%), respectively, died from cardiovascular causes (hazard ratio, 0.80; 95% CI, 0.71 to 0.89; P<0.001). As compared with enalapril, LCZ696 also reduced the risk of hospitalization for heart failure by 21% (P<0.001) and decreased the symptoms and physical limitations of heart failure (P=0.001). The LCZ696 group had higher proportions of patients with hypotension and nonserious angioedema but lower proportions with renal impairment, hyperkalemia, and cough than the enalapril group. LCZ696 was superior to enalapril in reducing the risks of death and of hospitalization for heart failure. (Funded by Novartis; PARADIGM-HF ClinicalTrials.gov number, NCT01035255.).
14 CFR 21.3 - Reporting of failures, malfunctions, and defects.
Code of Federal Regulations, 2014 CFR
2014-01-01
... crew compartment or passenger cabin. (4) A malfunction, failure, or defect of a propeller control... structural or flight control system malfunction, defect, or failure which causes an interference with normal control of the aircraft for which derogates the flying qualities. (12) A complete loss of more than one...
14 CFR 21.3 - Reporting of failures, malfunctions, and defects.
Code of Federal Regulations, 2013 CFR
2013-01-01
... crew compartment or passenger cabin. (4) A malfunction, failure, or defect of a propeller control... structural or flight control system malfunction, defect, or failure which causes an interference with normal control of the aircraft for which derogates the flying qualities. (12) A complete loss of more than one...
14 CFR 21.3 - Reporting of failures, malfunctions, and defects.
Code of Federal Regulations, 2012 CFR
2012-01-01
... crew compartment or passenger cabin. (4) A malfunction, failure, or defect of a propeller control... structural or flight control system malfunction, defect, or failure which causes an interference with normal control of the aircraft for which derogates the flying qualities. (12) A complete loss of more than one...
Register of experts for information on mechanics of structural failure
NASA Technical Reports Server (NTRS)
Carpenter, J. L., Jr.; Moya, N.
1973-01-01
A list of approximately 150 experts from approximately 60 organizations who have published results of theoretical and/or experimental research related to six problem areas in the mechanics of structural failure is presented. Each author included is listed by organizational affiliation, address and principal field of expertise. The initial criteria for the selection of names for the register are recent contributions to the literature, participation in or support of relevant research programs, and referral by peers. The purpose of the register is to present, in easy reference form, sources for dependable information regarding failure modes and mechanisms of aerospace structures. The Register includes two indexes: an alphabetical listing of the experts and an alphabetical listing of the organizations with whom they are affiliated.
Analysis of the STS-126 Flow Control Valve Structural-Acoustic Coupling Failure
NASA Technical Reports Server (NTRS)
Jones, Trevor M.; Larko, Jeffrey M.; McNelis, Mark E.
2010-01-01
During the Space Transportation System mission STS-126, one of the main engine's flow control valves incurred an unexpected failure. A section of the valve broke off during liftoff. It is theorized that an acoustic mode of the flowing fuel, coupled with a structural mode of the valve, causing a high cycle fatigue failure. This report documents the analysis efforts conducted in an attempt to verify this theory. Hand calculations, computational fluid dynamics, and finite element methods are all implemented and analyses are performed using steady-state methods in addition to transient analysis methods. The conclusion of the analyses is that there is a critical acoustic mode that aligns with a structural mode of the valve
Strategic issues in preventing cataract blindness in developing countries.
Ellwein, L. B.; Kupfer, C.
1995-01-01
Cataract blindness is a public health problem of major proportions in developing countries. Intracapsular cataract extraction with aphakic spectacles has been the standard surgical technique for restoring sight. Because of image magnification in the operated eye, however, the result in unilaterally blind patients is less than satisfactory. Fortunately, with the availability of low-cost intraocular lenses (IOL) and ophthalmologists trained in extracapsular surgery, it is now practical to intervene successfully in the unilateral case. The need for increased attention on the quality of the visual high prevalence of cataract blindness in developing countries and an increasing cataract incidence due to an aging population require substantial increases in surgical volume. The third issue relates to cost. If significant increases in surgical volume and quality of outcomes are to be realized without an increased need for external funding, service delivery must be made more efficient. The expansion of IOL surgery for unilateral blindness is a favourable trend in ensuring financial sustainability of delivery systems; patients can be operated on while still economically productive and able to pay rather than waiting for bilateral blindness and a less favourable economic and social impact. If the quality, volume, and cost issues are to be successfully addressed, operational and structural changes to eye care delivery systems are necessary. These changes can be effected through training, technology introduction, management of facilities, social marketing, organizational partnerships, and evaluation. With improved understanding of the critical factors in successful models their widespread replication will be facilitated. PMID:8846495
Flexural Progressive Failure of Carbon/Glass Interlayer and Intralayer Hybrid Composites
Wu, Weili; Gong, Zhili
2018-01-01
The flexural progressive failure modes of carbon fiber and glass fiber (C/G) interlayer and intralayer hybrid composites were investigated in this work. Results showed that the bending failure modes for interlayer hybrid composites are determined by the layup structure. Besides, the bending failure is characterized by the compression failure of the upper layer, when carbon fiber tends to distribute in the upper layer, the interlayer hybrid composite fails early, the failure force is characterized by a multi-stage slightly fluctuating decline and the fracture area exhibits a diamond shape. While carbon fiber distributes in the middle or bottom layer, the failure time starts late, and the failure process exhibits one stage sharp force/stress drop, the fracture zone of glass fiber above the carbon layers presents an inverted trapezoid shape, while the fracture of glass fiber below the carbon layers exhibits an inverted triangular shape. With regards to the intralayer hybrid composites, the C/G hybrid ratio plays a dominating role in the bending failure which could be considered as the mixed failures of four structures. The bending failure of intralayer hybrid composites occurs in advance since carbon fiber are located in each layer; the failure process shows a multi-stage fluctuating decline, and the decline slows down as carbon fiber content increases, and the fracture sound release has the characteristics of a low intensity and high frequency for a long time. By contrast, as glass fiber content increases, the bending failure of intralayer composites is featured with a multi-stage cliff decline with a high amplitude and low frequency for a short-time fracture sound release. PMID:29673236
Gutzwiller, Florian S; Pfeil, Alena M; Comin-Colet, Josep; Ponikowski, Piotr; Filippatos, Gerasimos; Mori, Claudio; Braunhofer, Peter G; Szucs, Thomas D; Schwenkglenks, Matthias; Anker, Stefan D
2013-10-09
Heart failure (HF) is a burden to patients and health care systems. The objectives of HF treatment are to improve health related quality of life (HRQoL) and reduce mortality and morbidity. We aimed to evaluate determinants of health-related quality of life (HRQoL) in patients with iron deficiency and HF treated with intravenous (i.v.) iron substitution or placebo. A randomised, double-blind, placebo-controlled trial (n = 459) in iron-deficient chronic heart failure (CHF) patients with or without anaemia studied clinical and HRQoL benefits of i.v. iron substitution using ferric carboxymaltose (FCM) over a 24-week trial period. Multivariate analysis was carried out with various clinical variables as independent variables and HRQoL measures as dependent variables. Mean change from baseline of European Quality of Life - 5 Dimensions (EQ-5D) (value set-based) utilities (on a 0 to 100 scale) at week 24 was 8.91 (i.v. iron) and 0.68 (placebo; p < 0.01). In a multivariate analysis excluding baseline HRQoL, a higher exercise tolerance and i.v. iron substitution positively influenced HRQoL, whereas impaired renal function and a history of stroke had a negative effect. The level of HRQoL was also influenced by country of residence. When baseline HRQoL was factored in, the multivariate model remained stable. In this study, i.v. iron substitution, exercise tolerance, stroke, country of residence and renal function influenced measures of HRQoL in patients with heart failure and iron deficiency. © 2013.
USDA-ARS?s Scientific Manuscript database
OBJECTIVE: To test whether a long term, structured physical activity program compared with a health education program reduces the risk of serious fall injuries among sedentary older people with functional limitations. DESIGN: Multicenter, single blinded randomized trial (Lifestyle Interventions and ...
Intervention for Verb Argument Structure in Children with Persistent SLI: A Randomized Control Trial
ERIC Educational Resources Information Center
Ebbels, Susan H.; van der Lely, Heather K. J.; Dockrell, Julie E.
2007-01-01
Purpose: The authors aimed to establish whether 2 theoretically motivated interventions could improve use of verb argument structure in pupils with persistent specific language impairment (SLI). Method: Twenty-seven pupils with SLI (ages 11;0-16;1) participated in this randomized controlled trial with "blind" assessment. Participants were randomly…
An application of artificial intelligence theory to reconfigurable flight control
NASA Technical Reports Server (NTRS)
Handelman, David A.
1987-01-01
Artificial intelligence techniques were used along with statistical hpyothesis testing and modern control theory, to help the pilot cope with the issues of information, knowledge, and capability in the event of a failure. An intelligent flight control system is being developed which utilizes knowledge of cause and effect relationships between all aircraft components. It will screen the information available to the pilots, supplement his knowledge, and most importantly, utilize the remaining flight capability of the aircraft following a failure. The list of failure types the control system will accommodate includes sensor failures, actuator failures, and structural failures.
Mosuro, Adedamola L.; Ajaiyeoba, Ayotunde I.; Bekibele, Charles O.; Eniola, Michael S.; Adedokun, Babatunde A.
2012-01-01
Purpose: The aim of this study is to determine the prevalence of low vision among students attending all the schools for the blind in Oyo State, Nigeria. The study set out to determine the proportion of students with low vision/severe visual impairment after best correction, to determine the causes of the low vision, to document the associated pathologies, to determine the types of treatment and visual aid devices required, and to provide the visual aids needed to the students in the schools. Materials and Methods: All schools students for the blind in Oyo State were evaluated between August 2007 and January 2008. All the students underwent a thorough ophthalmic examination that included measurement of visual acuity, retinoscopy and subjective refraction, tests for visual aids where indicated, and a structured questionnaire was administered. Results: A total of 86 students were included in the study and the mean age was 19.4 ± 8.19 years. Twenty six (30%) were under 16 years of age. The most common cause of blindness was bilateral measles keratopathy/vitamin A deficiency (VAD) in 25 students (29.1%). The most common site affected was the cornea in 25 students (29.1%), the lens in 23 (26.7%), and the retina/optic nerve in 16 (18.6%). Preventable blindness was mainly from measles keratopathy/VAD (29.1%). Eleven students benefited from refraction and correction with visual aids; two having severe visual impairment (SVI), and nine having visual impairment (VI) after correction. Conclusion: The prevalence of low vision in the schools for the blind in Oyo State is 2.3%, while the prevalence of visual impairment is 10.5%. These results suggest that preventable and treatable ocular conditions are the source of significant childhood blindness in Oyo State. PMID:23248540
Mosuro, Adedamola L; Ajaiyeoba, Ayotunde I; Bekibele, Charles O; Eniola, Michael S; Adedokun, Babatunde A
2012-10-01
The aim of this study is to determine the prevalence of low vision among students attending all the schools for the blind in Oyo State, Nigeria. The study set out to determine the proportion of students with low vision/severe visual impairment after best correction, to determine the causes of the low vision, to document the associated pathologies, to determine the types of treatment and visual aid devices required, and to provide the visual aids needed to the students in the schools. All schools students for the blind in Oyo State were evaluated between August 2007 and January 2008. All the students underwent a thorough ophthalmic examination that included measurement of visual acuity, retinoscopy and subjective refraction, tests for visual aids where indicated, and a structured questionnaire was administered. A total of 86 students were included in the study and the mean age was 19.4 ± 8.19 years. Twenty six (30%) were under 16 years of age. The most common cause of blindness was bilateral measles keratopathy/vitamin A deficiency (VAD) in 25 students (29.1%). The most common site affected was the cornea in 25 students (29.1%), the lens in 23 (26.7%), and the retina/optic nerve in 16 (18.6%). Preventable blindness was mainly from measles keratopathy/VAD (29.1%). Eleven students benefited from refraction and correction with visual aids; two having severe visual impairment (SVI), and nine having visual impairment (VI) after correction. The prevalence of low vision in the schools for the blind in Oyo State is 2.3%, while the prevalence of visual impairment is 10.5%. These results suggest that preventable and treatable ocular conditions are the source of significant childhood blindness in Oyo State.
Thermal changes of the environment and their influence on reinforced concrete structures
NASA Astrophysics Data System (ADS)
Fojtik, R.; Cajka, R.
2018-04-01
The thermal expansion of concrete elements concerns both monolithic and prefabricated structures. Inappropriate design of dilation segments may cause minor but even larger failures. Critical environment factors are temperature-changing operations, such as unheated underground garages, where temperature fluctuations may occur depending on the exterior conditions. This paper numerically and experimentally analyses the thermal deformation of selected girders in the underground garages and the consequent structure failures, their causes, possible prevention and appropriate remediation.
NASA Technical Reports Server (NTRS)
Bednarcyk, Brett A.; Arnold, Steven M.
2006-01-01
A framework is presented that enables coupled multiscale analysis of composite structures. The recently developed, free, Finite Element Analysis - Micromechanics Analysis Code (FEAMAC) software couples the Micromechanics Analysis Code with Generalized Method of Cells (MAC/GMC) with ABAQUS to perform micromechanics based FEA such that the nonlinear composite material response at each integration point is modeled at each increment by MAC/GMC. As a result, the stochastic nature of fiber breakage in composites can be simulated through incorporation of an appropriate damage and failure model that operates within MAC/GMC on the level of the fiber. Results are presented for the progressive failure analysis of a titanium matrix composite tensile specimen that illustrate the power and utility of the framework and address the techniques needed to model the statistical nature of the problem properly. In particular, it is shown that incorporating fiber strength randomness on multiple scales improves the quality of the simulation by enabling failure at locations other than those associated with structural level stress risers.
NASA Technical Reports Server (NTRS)
Bednarcyk, Brett A.; Arnold, Steven M.
2007-01-01
A framework is presented that enables coupled multiscale analysis of composite structures. The recently developed, free, Finite Element Analysis-Micromechanics Analysis Code (FEAMAC) software couples the Micromechanics Analysis Code with Generalized Method of Cells (MAC/GMC) with ABAQUS to perform micromechanics based FEA such that the nonlinear composite material response at each integration point is modeled at each increment by MAC/GMC. As a result, the stochastic nature of fiber breakage in composites can be simulated through incorporation of an appropriate damage and failure model that operates within MAC/GMC on the level of the fiber. Results are presented for the progressive failure analysis of a titanium matrix composite tensile specimen that illustrate the power and utility of the framework and address the techniques needed to model the statistical nature of the problem properly. In particular, it is shown that incorporating fiber strength randomness on multiple scales improves the quality of the simulation by enabling failure at locations other than those associated with structural level stress risers.
Measurement of multiaxial ply strength by an off-axis flexure test
NASA Technical Reports Server (NTRS)
Crews, John H., Jr.; Naik, Rajiv A.
1992-01-01
An off-axis flexure (OAF) test was performed to measure ply strength under multiaxial stress states. This test involves unidirectional off-axis specimens loaded in bending, using an apparatus that allows these anisotropic specimens to twist as well as flex without the complications of a resisting torque. A 3D finite element stress analysis verified that simple beam theory could be used to compute the specimen bending stresses at failure. Unidirectional graphite/epoxy specimens with fiber angles ranging from 90 deg to 15 deg have combined normal and shear stresses on their failure planes that are typical of 45 deg plies in structural laminates. Tests for a range of stress states with AS4/3501-6 specimens showed that both normal and shear stresses on the failure plane influenced cracking resistance. This OAF test may prove to be useful for generating data needed to predict ply cracking in composite structures and may also provide an approach for studying fiber-matrix interface failures under stress states typical of structures.
Impact Damage and Strain Rate Effects for Toughened Epoxy Composite Structures
NASA Technical Reports Server (NTRS)
Chamis, Christos C.; Minnetyan, Levon
2006-01-01
Structural integrity of composite systems under dynamic impact loading is investigated herein. The GENOA virtual testing software environment is used to implement the effects of dynamic loading on fracture progression and damage tolerance. Combinations of graphite and glass fibers with a toughened epoxy matrix are investigated. The effect of a ceramic coating for the absorption of impact energy is also included. Impact and post impact simulations include verification and prediction of (1) Load and Impact Energy, (2) Impact Damage Size, (3) Maximum Impact Peak Load, (4) Residual Strength, (5) Maximum Displacement, (6) Contribution of Failure Modes to Failure Mechanisms, (7) Prediction of Impact Load Versus Time, and (8) Damage, and Fracture Pattern. A computer model is utilized for the assessment of structural response, progressive fracture, and defect/damage tolerance characteristics. Results show the damage progression sequence and the changes in the structural response characteristics due to dynamic impact. The fundamental premise of computational simulation is that the complete evaluation of composite fracture requires an assessment of ply and subply level damage/fracture processes as the structure is subjected to loads. Simulation results for the graphite/epoxy composite were compared with the impact and tension failure test data, correlation and verification was obtained that included: (1) impact energy, (2) damage size, (3) maximum impact peak load, (4) residual strength, (5) maximum displacement, and (6) failure mechanisms of the composite structure.