Incidence and risk factors for pulmonary exacerbation treatment failures in cystic fibrosis patients chronically infected with Pseudomonas aeruginosa

Background: Pulmonary exacerbations (PEx) are responsible for much of the morbidity and mortality associated with cystic fibrosis (CF). However, there is a paucity of data on outcomes in CF PEx and factors influencing outcomes.

Methods: We reviewed all PEx in patients infected with Pseudomonas aeruginosa treated with parenteral antibiotics over 4 years at our center. Treatment failures were categorized a priori as those PEx requiring antibiotic regimen change, prolongation of therapy > 20 days because of failure to respond, an early recurrent event within < 45 days, or failure to recover lung function to > 90% of baseline FEV1.

Results: A total of 101 patients were followed for 452 PEx. Treatment failures were observed in 125 (28%) of PEx; antibiotic regimen change was observed in 27 (6%), prolongation of therapy in 29 (6%), early recurrent events in 63 (14%), and failure to recover lung function to > 90% of baseline FEV1 in 66 (15%). Demographic factors associated with one or more treatment failures per year included advanced airways disease, use of enteric feeds, CF-related diabetes, and CF liver disease but did not include female sex or F508del homozygosity. Increased treatment failure risk was associated with lower admission FEV1 and increased markers of inflammation. At therapeutic completion, increased inflammatory markers correlated with treatment failure. Failure rates decreased with increasing number of active antimicrobial agents used based on in vitro susceptibility (zero, 28/65 [43%]; one, 38/140 [27%]; two, 59/245 [24%]; three, 0/2 [0%]; P = .02).

Conclusions: One-fourth of PEx fail to respond adequately to initial management. Patient demographic and episode-specific clinical information can be used to identify individuals at increased risk of initial management failure.

Investigation of failures in Irish raised bogs

This paper presents the results of field geophysical testing and laboratory testing of peat from Carn Park and Roosky raised bogs in the Irish Midlands. The motivation for the work was highlight the importance of these areas and to begin to attempt to understand the reasons for the failure of the bogs despite them having surface slopes of some 1°. It was found that the peat is typical of that of Irish raised bogs being up to 8m thick towards the “high” dome of the bogs. The peat is characterised by low density, high water content, high organic content, low undrained shear strength and high compressibility. The peat is also relatively permeable at in situ stress. Geophysical electrical resistivity tomography and ground penetrating radar data shows a clear thinning of the peat in the area of the failures corresponding to a reduction in volume from dewatering by edge drains/peat harvesting. This finding is supported by detailed water content measurements. It was also shown that the peat base topography is relatively flat and indicates that the observed surface movement has come from within the peat rather than from the material below the peat. Potential causes of the failures include conventional slope instability, the effect of seepage forces or the release of built-up gas in the peat mass. Further measurements are required in order to study these in more detail.

Prediction of integral type failures in semiconductor manufacturing through classification methods

Smart management of maintenances has become fundamental in manufacturing environments in order to decrease downtime and costs associated with failures. Predictive Maintenance (PdM) systems based on Machine Learning (ML) techniques have the possibility with low added costs of drastically decrease failures-related expenses; given the increase of availability of data and capabilities of ML tools, PdM systems are becoming really popular, especially in semiconductor manufacturing. A PdM module based on Classification methods is presented here for the prediction of integral type faults that are related to machine usage and stress of equipment parts. The module has been applied to an important class of semiconductor processes, ion-implantation, for the prediction of ion-source tungsten filament breaks. The PdM has been tested on a real production dataset. © 2013 IEEE.

Bank Failures of the 1990s::An Exploratory Analysis

Past research has frequently attributed the incidence of bank failures to macroeconomic cycles and/or downturns in the regional economy. More recent analyses have suggested that the incidence and severity of bank failures can be linked to governance failures, which may be preventable through more stringent disclosure and auditing requirements. Using data on bank failures during the years 1991 to 1997, for the US, Canada, the UK and Germany, this study examines the relationship between institutional characteristics of national legal and auditing systems and the incidence of bank failures. In the second part of our analysis we then examined the relationship between the same institutional variables and the severity of bank failures.
The first part of our study notes a significant correlation between the law and order tradition (‘rule of law’) of a national legal system and the incidence of bank failures. Nations which were assigned high 'rule of law’ scores by country risk guides appear to have been less likely to experience bank failures. Another variable which appears to impact on bank failure rates is the ‘risk of contract repudiation’. Countries with a greater ‘risk of contract repudiation’ appear to be more likely to experience bank failures. We suggest that this may be due to a greater ex ante protection of stakeholders in countries where contract enforcement is more stringent.
The results of the second part of our study are less clear cut. However, there appears to be a significant correlation between the amount paid out by national deposit insurers (our proxy for the severity of bank failures) and the macroeconomic variable 'GDP change'. Here our findings follow the conventional wisdom; with greater amounts of deposit insurance funds being paid during economic downturns (i.e. low or negative GDP 'growth' correlates with high amounts of deposit insurance being paid out). A less pronounced relationship with the severity of bank failures can also be established for the institutional variables ' accounting standards' as well as 'risk of contract repudiation'. Countries with more stringent ‘accounting standards’ and a low ‘risk of contract repudiation’ appear to have been less prone to severe bank failures.

Finite element modeling of debonding failures in FRP-strengthened RC beams: A dynamic approach

This paper is concerned with the finite element simulation of debonding failures in FRP-strengthened concrete beams. A key challenge for such simulations is that common solution techniques such as the Newton-Raphson method and the arc-length method often fail to converge. This paper examines the effectiveness of using a dynamic analysis approach in such FE simulations, in which debonding failure is treated as a dynamic problem and solved using an appropriate time integration method. Numerical results are presented to show that an appropriate dynamic approach effectively overcomes the convergence problem and provides accurate predictions of test results.

Delayed failure of a deep cutting in lodgement till

Recent research on the delayed failure of cuttings in clay clearly recognises and predicts progressive delayed failure of deep cuttings. This is due to a combination of strain-softening, weathering, dissipation of negative excess pore water pressure generated at the time of excavation, and frequent occurrence of prolonged periods of wet weather. There have been several slope failures of this kind in Northern Ireland. This paper discusses a case study based on a failure of a deep cutting, excavated at a slope of 1 in 2, on the A1 near Dromore (County Down) in Northern Ireland. The cutting was in lodgement till, a stiff, heavily overconsolidated clay. The failure occurred approximately 30 years after the cutting was excavated, following a prolonged period of heavy rainfall. An analysis of the failure, together with laboratory test data on soil samples taken from the site, confirmed that by using long-term soil strength parameters the factor of safety of this slope was unity. The conclusion of the analysis is that slopes excavated in this soil should be designed (and assessed) on long-term strength parameters.

Politicians, elections and catastrophe: the general election of 1847

Over the last decade, much new research has appeared on the subject of the Great Irish Famine but, remarkably, a major political event during the famine - the 1847 general election - has received virtually no mention. Recent work on politics in this period has tended to concentrate on political reaction in Britain rather than Ireland. The aim of this article is to examine the response of Irish politicians to the famine during the general election of 1847. The main source has been the political addresses and nomination speeches of most of the 140 candidates. The evidence from this material shows that, although the famine was an important matter in many constituencies, it was not the dominant issue countrywide. Various proposals to deal with the famine emerged, but there was an absence of agreed, practical measures to deal with immediate problems. The parties in Ireland failed to create a common platform to challenge the government over its efforts. Ideological constraints played an important part in these failures. The general election of 1847 represents a lost opportunity to tackle some of the effects of the famine.