Peritoneal cytology: impact on disease-free survival in clinical stage I endometrioid adenocarcinoma of the uterus

The prognostic significance of positive peritoneal cytology in endometrial carcinoma has led to the incorporation of peritoneal cytology into the current FIGO staging system, While cytology was shown to be prognostically relevant in patients with stage II and III disease, conflicting data exists about its significance in patients who would have been stage I but were classified as stage III solely and exclusively on the basis of positive peritoneal cytology (clinical stage I). Analysis was based on the data of 369 consecutive patients with clinical stage I endometrioid adenocarcinoma of the endometrium. Standard treatment consisted of an abdominal total hysterectomy, bilateral salpingo-oophorectomy with or without pelvic lymph node dissection. Peritoneal cytology was obtained at laparotomy by peritoneal washing of the pouch of Douglas and was considered positive if malignant cells could be detected regardless of the number of malignant cells present. Disease-free survival (DFS) was considered the primary statistical endpoint. In 13/369 (3.5%) patients, positive peritoneal cytology was found. The median follow-up was 29 months and 15 recurrences occurred. Peritoneal cytology was independent of the depth of myometrial invasion and the grade of tumour differentiation, Patients with negative washings had a DFS of 96'7e at 36 months compared with 67% for patients with positive washings (log-rank P < 0.001). The presence of positive peritoneal cytology in patients with clinically stage I endometrioid adenocarcinoma of the endometrium is considered an adverse prognostic factor. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

Strategic maintenance management

The approach to maintenance management has changed over the last one hundred years. Over the last few years, the Reliability Engineering and Risk Management Group (RERMG) at the University of Queensland has developed an approach called the strategic maintenance management (SMM) approach. The paper outlines the approach and contrasts it with the current approaches. It then discusses the industry-university partnership in the implementation of this approach and the current activities at the University of Queensland to assist industry in the implementation of the SMM approach.

A new preventive maintenance strategy for items sold under warranty

When products are sold under warranty, the manufacturer incurs additional costs for warranty servicing. Preventive maintenance actions can be used to reduce this cost and these are worthwhile only if the extra cost incurred is less than the reduction achieved. In this paper we propose a new preventive maintenance policy where the parameters are selected optimally to minimize the total warranty servicing cost.

Who does not gain weight? Prevalence and predictors of weight maintenance in young women

OBJECTIVE: To investigate the prevalence and predictors of weight maintenance over time in a large sample of young Australian women. DESIGN: This population study examined baseline and 4y follow-up data from the cohort of young women participating in the Australian Longitudinal Study on Women's Health. SUBJECTS: A total of 8726 young women aged 18 - 23y at baseline. MEASURES: Height, weight and body mass index (BMI); physical activity; time spent sitting; selected eating behaviours (eg dieting, disordered eating, takeaway food consumption); cigarette smoking, alcohol consumption; parity; and socio-demographic characteristics. RESULTS: Only 44% of the women reported their BMI at follow-up to be within 5% of their baseline BMI (maintainers); 41% had gained weight and 15% had lost weight. Weight maintainers were more likely to be in managerial or professional occupations; to have never married; to be currently studying; and not to be mothers. Controlling for sociodemographic factors, weight maintainers were more likely to be in a healthy weight range at baseline, and to report that they spent less time sitting, and consumed less takeaway food, than women who gained weight. CONCLUSIONS: Fewer than half the young women in this community sample maintained their weight over this 4y period in their early twenties. Findings of widespread weight gain, particularly among those already overweight, suggest that early adulthood, which is a time of significant life changes for many women, may be an important time for implementing strategies to promote maintenance of healthy weight. Strategies which encourage decreased sitting time and less takeaway food consumption may be effective for encouraging weight maintenance at this life stage.

The impact of positive peritoneal washings and serosal and adnexal involvement on survival in patients with stage IIIA uterine cancer

Objective. The aim of this study was to determine the prognostic significance of serosal involvement (SER), adnexal involvement (ADN), and positive peritoneal washings (PPW) in patients with Stage IIIA uterine cancer. We also sought to determine patterns of recurrence in patients with this disease. Methods. The records of 136 patients with Stage IIIA uterine cancer treated at the Queensland Centre for Gynecological Cancer between March 1983 and August 2001 were reviewed. One hundred thirty-six patients underwent surgery and 58 (42.6%) had full surgical staging. Seventy-five patients (55.2%) had external beam radiotherapy and/or brachytherapy postoperatively. Overall survival was the primary statistical endpoint. Statistical analysis included univariate and multivariate Cox models. Results. Forty-six patients (33.8%) had adnexal involvement, 23 (16.9%) had serosal involvement, and 40 (29.4%) had positive peritoneal washings. Median follow-up was 55.1 months (95% confidence interval, 36.9 to 73.4 months) after which time 71 patients (52.2%) remained alive. For patients with endometrioid adenocarcinoma, ADN and SER were associated with impaired survival on multivariate analysis (odds ratio 2.8 and 3.2, respectively). In the subgroup of patients with high-risk tumors (including papillary serous carcinomas, clear cell carcinomas, and uterine sarcomas), neither ADN, nor SER, nor PPW influenced survival. Conclusion. Patients with Stage IIIA uterine cancer constitute a heterogeneous group. For patients with endometrioid adenocarcinoma, both ADN and SER, but not PPW, were associated with impaired prognosis. For patients with high-risk histological types, prognosis is poor for all three factors. (C) 2002 Elsevier Science (USA).

Adoption and maintenance of contour bunds and hedgerows in a dynamic environment - Experience in the Philippine uplands

The widespread adoption of soil conservation technologies by farmers (notably contour hedgerows) observed in Guba, Cebu City, Philippines, is not often observed elsewhere In the country. Adoption of these technologies was because of the interaction of such phenomena as site-specific factors, appropriate extension systems, and technologies. However, lack of hedgerow maintenance, decreasing hedgerow quality, and disappearance of hedgerows raised concerns about sustainability. The dynamic nature of upland farming systems suggests the need for a location-specific farming system development framework, which provides farmers with ongoing extension for continual promotion of appropriate conservation practices.

Comments on "Maintenance policies with two-dimensional warranty"

Chen and Popova [Res. Engng Syst. Saf. 77 (2002) 61] discuss maintenance policies for items sold with a two-dimensional warranty. However, their paper fails to give a proper review of the literature and it also contains errors. In this note we first review the relevant literature and then comment on the errors in their analysis. (C) 2003 Elsevier Ltd. All rights reserved.

A randomised controlled trial of methadone maintenance treatment versus wait list control in an Australian prison system

Objectives: The aim was to determine whether methadone maintenance treatment reduced heroin use, syringe sharing and HIV or hepatitis C incidence among prisoners. Methods: All eligible prisoners seeking drug treatment were randomised to methadone or a waitlist control group from 1997 to 1998 and followed up after 4 months. Heroin use was measured by hair analysis and self report; drugs used and injected and syringe sharing were measured by self report. Hepatitis C and HIV incidence was measured by serology. Results: Of 593 eligible prisoners, 382 (64%) were randomised to MMT (n = 191) or control (n = 191). 129 treated and 124 control subjects were followed up at 5 months. Heroin use was significantly lower among treated than control subjects at follow up. Treated subjects reported lower levels of drug injection and syringe sharing at follow up. There was no difference in HIV or hepatitis C incidence. Conclusions: Consideration should be given to the introduction of prison methadone programs particular where community based programs exist. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

Applications of artificial intelligence to condition-based maintenance

In this paper we discuss interesting developments of expert systems for machine diagnosis and condition-based maintenance. We review some elements of condition-based maintenance and its applications, expert systems for machine diagnosis, and an example of machine diagnosis. In the last section we note some problems to be resolved so that expert systems for machine diagnosis may gain wider acceptance in the future.

Implementação da total Productive maintenance (TPM) numa empresa de produção

No âmbito do Ciclo de Estudos conducente ao grau de Mestre em Engenharia Mecânica, Per-fil de Manutenção e Produção, foi desenvolvida esta Dissertação, que consiste no estudo do estado actual de implementação da “Total Productive Maintenance – TPM” na Área de Pren-sas da Volkswagen Autoeuropa, identificando os benefícios colhidos com a referida imple-mentação, e também algumas dificuldades. No final desta Dissertação, são enunciadas as considerações resultantes do presente estudo e são emitidas algumas sugestões, no sentido de que este trabalho se torne uma mais-valia para a Área de Prensas da Volkswagen Autoeuropa, contribuindo positivamente na busca da melhoria contínua, dos zero defeitos e das zero falhas e dos zero desperdícios e, finalmente propor um plano de melhoria, ou seja, uma adaptação do actual modelo funcional face ao modelo teórico.

Análise do line Maintenance Manual numa perspectiva de melhoria contínua do programa de manutenção avião

Este relatório, escrito no âmbito do estágio profissional realizado no departamento de Manutenção e Engenharia da TAP Portugal, com o tema “Análise do Line Maintenance Manual numa perspectiva de melhoria contínua do Programa de Manutenção Avião”, tem como objectivo descrever a análise efectuada e as oportunidades de melhoria identificadas no Line Maintenance Manual, documento que serve de suporte às actividades da Manutenção de Linha. Espera-se que o trabalho realizado traga benefícios para a TAP Manutenção e Engenharia a médio e longo prazo, tais como a agilização das futuras revisões ao referido documento, a redução de recursos envolvidos nas inspecções de trânsito e, quiçá, a correcção de aspectos com implicações directas na operação segura das aeronaves. O trabalho desenvolvido no estágio implicou um estudo aprofundado do processo que resulta no estabelecimento dos programas de manutenção das aeronaves actuais, bem como dos documentos nele envolvidos, pelo que a análise específica do Line Maintenance Manual foi realizada no contexto muito mais abrangente da teoria da Manutenção Aeronáutica.

Modelos de risk based inspection e risk based inspection and maintenance aplicados a sistemas de produção de energias renováveis

A utilização de recursos energéticos renováveis apresenta-se como um caminho vital para a humanidade alcançar um desenvolvimento sustentável. Nesta campanha, a energia eólica surge como um dos principais vectores de orientação tendo evoluído de forma quase exponencial nos últimos anos. No entanto, apesar da sua relativa maturidade, esta tecnologia enfrenta ainda alguns problemas e desafios. Não obstante a experiência empírica da indústria eólica, adquirida nos últimos trinta anos e dos esforços para melhorar a fiabilidade operacional das turbinas, as taxas de falha ainda se apresentam elevadas. Face às correntes práticas de Manutenção das turbinas e parques eólicos e às características de falha, (por vezes catastróficas), existe a necessidade de optimizar as estratégias de manutenção das turbinas eólicas e reduzir os custos durante o ciclo de vida, de modo a maximizar o retorno do investimento. Descreve-se neste trabalho o estado do conhecimento actual face ao objectivo pretendido, a recolha de dados reais da operação e Manutenção, a aplicabilidade dos modelos escolhidos para obtenção da probabilidade de falha, e as consequências e avaliação do risco. Assim, desenvolveu-se uma ferramenta de apoio à decisão, baseada em Modelos de RBI (Risk Based Inspection) e RBIM (Risk Based Inspection and Maintenance) aplicados a turbinas eólicas.

Multi-criteria short-term maintenance outage scheduling in smart distribution systems

Effective legislation and standards for the coordination procedures between consumers, producers and the system operator supports the advances in the technologies that lead to smart distribution systems. In short-term (ST) maintenance scheduling procedure, the energy producers in a distribution system access to the long-term (LT) outage plan that is released by the distribution system operator (DSO). The impact of this additional information on the decision-making procedure of producers in ST maintenance scheduling is studied in this paper. The final ST maintenance plan requires the approval of the DSO that has the responsibility to secure the network reliability and quality, and other players have to follow the finalized schedule. Maintenance scheduling in the producers’ layer and the coordination procedure between them and the DSO is modelled in this paper. The proposed method is applied to a 33-bus distribution system.

A regulatory framework for short-term stochastic maintenance outage scheduling in smart grids

The current regulatory framework for maintenance outage scheduling in distribution systems needs revision to face the challenges of future smart grids. In the smart grid context, generation units and the system operator perform new roles with different objectives, and an efficient coordination between them becomes necessary. In this paper, the distribution system operator (DSO) of a microgrid receives the proposals for shortterm (ST) planned outages from the generation and transmission side, and has to decide the final outage plans, which is mandatory for the members to follow. The framework is based on a coordination procedure between the DSO and other market players. This paper undertakes the challenge of optimization problem in a smart grid where the operator faces with uncertainty. The results show the effectiveness and applicability of the proposed regulatory framework in the modified IEEE 34- bus test system.