259 resultados para MARROW FAILURE SYNDROMES


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In this preliminary study the initial failure of a bolted composite joint was investigated. The results of an experimental program using two simple beams bolted together with offset loading are presented. These test specimens were used to simulate a typical skin-spar attachment in a composite wing undergoing hydraulic shock. Initial failure was found to be due to a prying force induced at the outer sections of the joint leading to transverse shear failure.

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The radical cations He-2(+) (H2O)(2)(+), and (NH3)(2)(+) with two-center three-electron A-A bonds are investigated at the configuration interaction (CI), accurate Kohn-Sham (KS), generalized gradient approximation (GGA), and meta-GGA levels. Assessment of seven different GGA and six meta-GGA methods shows that the A(2)(+) systems remain a difficult case for density functional theory (DFT). All methods tested consistently overestimate the stability of A(2)(+): the corresponding D-e errors decrease for more diffuse valence densities in the series He-2(+) > (H2O)(2)(+) > (NH3)(2)(+). Upon comparison to the energy terms of the accurate Kohn-Sham solutions, the approximate exchange functionals are found to be responsible for the errors of GGA-type methods, which characteristically overestimate the exchange in A(2)(+). These so-called exchange functionals implicitly use localized holes. Such localized holes do occur if there is left-right correlation, i.e., the exchange functionals then also describe nondynamical correlation. However, in the hemibonded A(2)(+) systems the typical molecular (left-right, nondynamical) correlation of the two-electron pair bond is absent. The nondynamical correlation built into the exchange functionals is then spurious and yields too low energies.

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The purpose of this study was to explore the care processes experienced by community-dwelling adults dying from advanced heart failure, their family caregivers, and their health-care providers. A descriptive qualitative design was used to guide data collection, analysis, and interpretation. The sample comprised 8 patients, 10 informal caregivers, 11 nurses, 3 physicians, and 3 pharmacists. Data analysis revealed that palliative care was influenced by unique contextual factors (i.e., cancer model of palliative care, limited access to resources, prognostication challenges). Patients described choosing interventions and living with fatigue, pain, shortness of breath, and functional decline. Family caregivers described surviving caregiver burden and drawing on their faith. Health professionals described their role as trying to coordinate care, building expertise, managing medications, and optimizing interprofessional collaboration. Participants strove towards 3 outcomes: effective symptom management, satisfaction with care, and a peaceful death. © McGill University School of Nursing.