Search

[english] IEC 80001-1 is an international standard and offers recommendations for a risk management process for medical information technology networks (MITs). MITs are defined as IT networks incorporating at least one medical device. The goal is to build and maintain reliable and secure MITs for hospitals of all kids. To achieve it, the standard suggests applying risk management and defines the roles involved as well as their responsibilities. A central role is the medical IT-network risk manager, assigned by the top management of organizations. He communicates with and mediates between clinical, medical device and IT divisions and compiles risk relevant facts usually distributed among them. All identified risks are analyzed, evaluated and documented in the risk management file along with counter measures and a final assessment of acceptability.We acknowledge that implementing the suggested process will create an overhead cost in documentation and – partly by extension – in personnel. However we believe that the investment at the start of projects is worthwhile, because it helps to prevent or solve problems in later stages. Especially consecutive projects can profit from the investment, reducing required effort and costs. Furthermore, a reliable and secure MIT forms the basis for frictionless routine operations and innovations for connected medical devices. Hence the investment is justified. Applying risk management to the whole cooperation all at once is unrealistic. Focusing on parts of the network, which are crucial to a new project is more recommendable. With a smaller scope, risk management remains feasible and can later be expanded to other parts of the network.IEC 80001-1 demands communication among involved employees from different specialties and divisions. This offers a chance for cooperation to find better decisions and solutions regarding an organization’s medical IT network.[german] Die IEC 80001-1 ist eine Norm, die Empfehlungen für einen Risikomanagementprozess für medizinische IT-Netzwerke (MIT) – also Netzwerke mit angeschlossenen Medizinprodukten – gibt. Das Ziel ist der Aufbau und Betrieb von stabilen und sicheren IT-Netzwerken in Kliniken. Die Empfehlungen richten sich vor allem an die Betreiber von Krankenhäusern, weisen Verantwortlichkeiten innerhalb einer verantwortlichen Organisation (meist einer Klinik) zu und geben deren Interaktion vor. Eine zentrale Rolle ist der MIT Risiko-Manager, der von der Geschäftsführung beauftragt wird und die Anstrengungen in Richtung Risikomanagement koordiniert. Dazu steht er in Kontakt mit Mitarbeitern von klinischen Abteilungen, der Medizintechnik, der IT-Abteilung und auch den Herstellern der beteiligten Medizinprodukte. Auf diese Art wird Wissen, das oft nur an diesen verschiedenen Stellen vorhanden ist, gesammelt und in der Risikomanagement-Akte dokumentiert. Jede gefundene Bedrohungs-Situation wird analysiert und nach ihrer Wahrscheinlichkeit und ihren (geschätzten) Folgen bewertet. Danach wird festgelegt, ob ein bestehendes Restrisiko tragbar ist und wie Gegenmaßnahmen umgesetzt werden. Der Dialog, der während des Informationsaustausches entsteht, nützt allen Parteien und trägt maßgeblich dazu bei, MITs stabiler und sicherer zu machen.Die Umsetzung der Norm erfordert einen Mehraufwand an Personal und Dokumentation. Nach Einschätzung der Autoren lohnt sich diese Investition am Anfang von Projekten, da sich dadurch Probleme im späteren Projektverlauf vermeiden oder zumindest reduzieren lassen. Spätestens bei Anschlussprojekten ist hier mit einer Aufwands- und damit Kostenersparnis zu rechnen. Ein stabiles und sicheres Netzwerk stellt die Basis für reibungslosen Routinebetrieb aber vor allem auch für Innovation im Bereich der vernetzten Medizingeräte dar. Eine sofortige unternehmensweite Einführung der IEC 80001-1 ist ein unrealistischer Ansatz. Vielmehr ist zu empfehlen, sich zunächst auf bestimmte Subnetze zu konzentrieren, die innerhalb eines Projektes oder eines bestimmten Prozesses wichtig sind. In einem solchen kleineren Rahmen bleibt der Aufwand für das Risikomanagement beherrschbar und lässt sich danach auf weitere Bereiche ausdehnen.Die IEC 80001-1 fordert alle Beteiligten zur Kommunikation auf und bietet so die Chance, aus einer Kooperation heraus die besten Entscheidungen im Sinne der verantwortlichen Organisation zu treffen.

IEC 80001-1 is an international standard and offers recommendations for a risk management process for medical information technology networks (MITs). MITs are defined as IT networks incorporating at least one medical device. The goal is to build and maintain reliable and secure MITs for hospitals of all kids. To achieve it, the standard suggests applying risk management and defines the roles involved as well as their responsibilities. A central role is the medical IT-network risk manager, assigned by the top management of organizations. He communicates with and mediates between clinical, medical device and IT divisions and compiles risk relevant facts usually distributed among them. All identified risks are analyzed, evaluated and documented in the risk management file along with counter measures and a final assessment of acceptability. We acknowledge that implementing the suggested process will create an overhead cost in documentation and - partly by extension - in personnel. However we believe that the investment at the start of projects is worthwhile, because it helps to prevent or solve problems in later stages. Especially consecutive projects can profit from the investment, reducing required effort and costs. Furthermore, a reliable and secure MIT forms the basis for frictionless routine operations and innovations for connected medical devices. Hence the investment is justified. Applying risk management to the whole cooperation all at once is unrealistic. Focusing on parts of the network, which are crucial to a new project is more recommendable. With a smaller scope, risk management remains feasible and can later be expanded to other parts of the network. IEC 80001-1 demands communication among involved employees from different specialties and divisions. This offers a chance for cooperation to find better decisions and solutions regarding an organization's medical IT network. [ABSTRACT FROM AUTHOR]

Copyright of Railway Standard Design is the property of Railway Standard Design Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This research paper employs a comprehensive risk matrix approach to analyze the potential risks associated with the Orange Line Metro Rail Transit System (OLMRTS). The major focus of this study revolves around two critical safety variables: human error and equipment failure, with a particular emphasis on human error as the most significant contributing factor. The research methodology involves the development of risk assessment models based on various incident scenarios. To identify potential hazards and assess their severity, historical incident data from a range of sources was collected and analyzed. This data made it possible to identify a number of potentially hazardous circumstances that could have an adverse impact on OLMRTS depot operations. The frequency and severity of each hazardous event were carefully evaluated based on the historical incident data, providing valuable insights into the potential risks faced by the system. The key findings of this investigation highlight that human-related activities emerge as the most significant potential cause of risk within the context of OLMRTS. The data analysis indicates a high level of risk associated with human error, underscoring the importance of addressing and mitigating these risks to enhance the overall safety and reliability of the OLMRTS system. [ABSTRACT FROM AUTHOR]

Power generation from wind farms is growing rapidly around the world. In the past decade, wind energy has played an important role in contributing to sustainable development. However, wind turbines are extremely susceptible to component damage under complex environments and over long-term operational cycles, which directly affects their maintenance, reliability, and operating costs. It is crucial to realize efficient early warning of wind turbine failure to avoid equipment breakdown, to prolong the service life of wind turbines, and to maximize the revenue and efficiency of wind power projects. For this purpose, wind turbines are used as the research object. Firstly, this paper outlines the main components and failure mechanisms of wind turbines and analyzes the causes of equipment failure. Secondly, a brief analysis of the cost of wind power projects based on equipment failure is presented. Thirdly, the current key technologies for intelligent operation and maintenance (O&M) in the wind power industry are discussed, and the key research on decision support systems, fault diagnosis models, and life-cycle costs is presented. Finally, current challenges and future development directions are summarized. [ABSTRACT FROM AUTHOR]

Equipment failure is a common problem in mining operations, resulting in significant delays and reductions in production efficiency. To address this problem, this paper proposes a dynamic scheduling model for underground metal mines under equipment failure conditions. The model aims to minimize the impact of equipment failures on production operations while avoiding extensive equipment changes. A case study of the southeastern mining area of the Chambishi Copper Mine is presented to demonstrate the effectiveness of the proposed model. The initial plan was generated using the multi-equipment task assignment model for the horizontal stripe pre-cut mining method. After equipment breakdown, the proposed model was used to reschedule the initial plan. Then, a comparative analysis was carried out. The results show that the proposed model effectively reduces the impact of equipment failures on production operations and improves overall mining execution at a low management cost. In general, the proposed model can assist schedulers in allocating equipment, coping with the disturbing effects of equipment failure, and improving mine production efficiency. [ABSTRACT FROM AUTHOR]

Over the past decade, international organizations have instituted strict regulations for the safe use of connected medical devices. The International Organization for Standardization and the Medical Device Single Audit Program instituted certifications to ensure that connected devices are compatible and operate within their proper clinical parameters. These efforts came about, in part, as a consequence of clinicians' decisions to use nonstandard, modified, or improvised devices for purposes outside the original manufacturers' approved parameters. Unapproved device modifications can be associated with increased risk of dosing errors, monitoring errors, tubing misconnections and serious or potentially fatal adverse events; furthermore, health care providers who implement unapproved device modifications may assume legal and financial liability should harm come to patients as a consequence of the modification. Using the inhaled nitric oxide delivery system as an example, the objective of this paper is to raise awareness of the potential dangers associated with unapproved modification and interfacing of therapeutic gas delivery systems and ventilators in the neonatal intensive care unit setting. The paper also highlights the rationale and necessity for rigorous validation processes that ensure that interfaced medical devices perform as intended in the clinical setting. [ABSTRACT FROM AUTHOR]

The aim of this paper is to propose a method to create features that can be used as prognostic indicators in the prognostics and health management context. The features are described by combinations of n-dimensional mappings, which are related to the information embedded into the different axis. Each axis are derived from a reduced set of signals strongly related with the performed task, which, in turn, are associated with specific degradation types. In order to illustrate the method, a case study of an aircraft pneumatic actuator is presented, based on tasks that are closed loop control operations. In this case, because the tasks are segments of normal operation, no special experimentation needs to be implemented. Moreover, it was observed that using only the already available sensors a set of features could be created to characterize the valve's degradation. The adopted approach is hybrid in the sense that one part is derived from simulations awhile another part is based on the actual aircraft flight data. [ABSTRACT FROM AUTHOR]

This paper deals with the scale modeling method to investigate the overheat failure mechanism and the processes of bus contacts in gas-insulated switchgears (GIS). Mathematical models of the physical phenomenon in the overheat failure process are summarized to derive the coupled eddy current-fluid-heat field scaling relationships. In pursuit of better availability of the model, the scaling relationships are then simplified and a partial scale model is further designed with the dimension parameters, physical parameters, and boundary conditions presented. Temperature distributions and current densities of the scale model are compared with those of the prototype to verify the effectiveness of the scale model by 3-D finite-element method. The test scale model is fabricated, and the temperature rise tests are conducted to validate the correctness of the scale modeling and the simulation calculation. [ABSTRACT FROM AUTHOR]

The cross-border trading among electricity markets in an interconnected multi-area system (e.g., in central Europe) and the integration of renewable resources (e.g., wind energy) have remarkably increased in recent years. To efficiently operate such system, a proper coordination among different areas is required. Within this context, a decentralized algorithm for market clearing is proposed in this paper to dispatch simultaneously energy and reserve under wind generation uncertainty and equipment failures. The proposed technique does not require a central operator but just a moderate interchange of information among neighboring areas. Additionally, the benefit of cross-border trading is studied. [ABSTRACT FROM PUBLISHER]

This study aimed to reduce instrument packaging defects in the Central Sterile Supply Department (CSSD) using action research. Data of the instrument packs packaged by the packaging personnel at the CSSD of the authors' institution during March to May 2023 were collected and analyzed. After identifying the problems, 2 rounds of cyclic process of "plan-action-observe-reflect" were implemented to standardize the packaging procedures and develop and improve the applicable check of standard operating procedures for the CSSD. After strictly implementing the packaging operation standards and checklists, the number of packaging defect cases dropped from 274 to 41. A significant difference was identified between the number of packaging personnel who achieved a "pass" in the assessment of 3 items for maintenance. Also, 1 item for assembly had significant differences compared with the baseline number after the first cycle (P ≤ 0.001). A significant difference was identified between the number of packaging personnel who achieved a "pass" in the assessment of 20 items for 6 components after the second cycle compared with that after the first cycle (P ≤ 0.05). Through action research methodology, strict implementation of standardized packaging procedures in the CSSD can reduce packaging defects, thereby decreasing clinical complaints and ensuring patient safety. [ABSTRACT FROM AUTHOR]

The failure rate is an important indicator to assess the reliability of substation equipment, and the failure rate prediction is an effective way to master the operation status of substation equipment. According to the characteristics of failure rate data, such as failure period segmentation and stochastic variation, this paper proposes a combined prediction method by the data decomposition of failure rate time series and the segmentation theory of failure periods and then establishes a new failure rate prediction model of the substation equipment based on the Weibull distribution and time series analysis. Compared with the traditional Weibull distribution function model which cannot describe the stochastic variation of failure rate data and cannot identify the failure period automatically, the proposed model in this paper uses the minimum sum algorithm of residual squares obtained by the Weibull distribution to accurately identify the demarcation point between different failure periods and then establishes the autoregressive moving average (ARMA) model to achieve combined prediction. Finally, the effectiveness of the proposed model is verified by the engineering example and comparison with the traditional failure rate prediction methods.

Moisture in transformer insulation is a topic of major interest to power system equipment operators. Moisture plays a large role in the degradation of insulation within the transformer, impacting on the longevity and the failure rate of this crucial asset. Therefore, understanding of how moisture behaves in the transformer insulation has been the focus of many studies. One particular matter that can occur during high-temperature events is the formation of bubbles of water vapor which are released from the cellulosic paper wrapped on the transformer windings. During such events, the presence of these bubbles could lead to an electrical failure of the transformer, and so it is desirable to be able to set operational criteria which prevent such occurrences. A formula which can predict the temperature at which bubbles will form from the paper insulation can allow operators to restrict transformer operation in order to avoid such situations. However, it has proven difficult to generate a formula with global applicability that is simplistic enough for generic use. This paper assesses the current formula against existing data in literature and compares a suggested alternative, drawing on fundamental science to assist in development of both formulae. The alternative formula is based on a better representation of bubbling activity and requires fewer input variables. Finally, adjustments are suggested to the formulae which allow them to be used more generally throughout the transformer fleet, including on service-aged transformers and with alternative insulation materials.

Highlights • Universal CACC evaluation platform that is compatible with any CACC controller. • Provide quantitative safety performance evaluation. • Consistent benchmark for various CACC controllers. • Capable of modeling the impact of vehicle dynamics, sensor errors, and communication latencies. • Shed light on the state-of-the-art CACC system's cyber security. Abstract While safety is one of the most critical contributions of Cooperative Adaptive Cruise Control (CACC), it is impractical to assess such impacts in a real world. Even with simulation, many factors including vehicle dynamics, sensor errors, automated vehicle control algorithms and crash severity need to be properly modeled. In this paper, a simulation platform is proposed which explicitly features: (i) vehicle dynamics; (ii) sensor errors and communication delays; (iii) compatibility with CACC controllers; (iv) state-of-the-art predecessor leader following (PLF) based cooperative adaptive cruise control (CACC) controller; and (v) ability to quantify crash severity and CACC stability. The proposed simulation platform evaluated the CACC performance under normal and cybersecurity attack scenarios using speed variation, headway ratio, and injury probability. The first two measures of effectiveness (MOEs) represent the stability of CACC platoon while the injury probability quantifies the severity of a crash. The proposed platform can evaluate the safety performance of CACC controllers of interest under various paroxysmal or extreme events. It is particularly useful when traditional empirical driver models are not applicable. Such situations include, but are not limited to, cyber-attacks, sensor failures, and heterogeneous traffic conditions. The proposed platform is validated against data collected from real field tests and tested under various cyber-attack scenarios. [ABSTRACT FROM AUTHOR]

Wheeled mobility and seating (WMS) devices allow users to achieve greater mobility independence. Previous studies determined that 53% of wheelchair users required one or more repairs over a 6-month period; however, there are a limited number of studies that have evaluated types of repairs. The purpose of this study was to describe the types of manual wheelchair, power wheelchair, and scooter repairs within the Wheelchair Repair Registry (WRR) and examine the association between WMS devices and the frequency of repairs. A dataset of 4,645 devices distributed in the United States was collected from equipment suppliers who performed and logged community-based wheelchair repair services. The results demonstrated common repairs found across devices were within the wheels/tires/forks and batteries/ cables categories. Device type was the most significant predictor of variance in the number of repairs. Customizable manual wheelchairs, tilt-in-space, Groups 2 & 3 power wheelchairs, and scooters were associated with higher number of repairs compared to non-customizable manual wheelchairs, pediatric, heavy-duty manual wheelchairs, and Group 4 power wheelchairs. The higher failure rate found in specific devices may be associated with a population of more active users, environment/conditions where equipment is used, time spent in equipment, additional features on device, or lower durability. [ABSTRACT FROM AUTHOR]

This paper proposes a rule base construction method of section out of limit disposal strategy for thermal power unit equipment fault, which can solve the problems of abnormal power transmission and grid real-time scheduling caused by section out of limit. Through the improved Apriori algorithm, the section out of limit disposal strategy of thermal power unit equipment fault is designed. In the mining result of thermal power unit equipment fault section out of limit, the association rules between section state and unit and load disposal strategy are established. By using the improved Apriori algorithm, the policy data and section state data are set as the preceding and following constraints of the association rules, The strong association rules are obtained, and the rule base of cross section out of limit disposal strategy is constructed according to the association rules. The experimental results show that: the number of association rules obtained by the improved Apriori algorithm mining each database is less than 1000, and the rule effectiveness and analysis efficiency are significantly improved; The rule base built by this method can effectively deal with the out of limit problems of different sections and units, and the sensitivity of each generator node increases greatly after the treatment.

Objective: Serious device-related complications for hypoglossal nerve stimulators are rare, but surgeons should implement a prompt and systematic approach to quickly troubleshoot a non-functioning device. Method: Records were queried at a single academic tertiary referral centre between January 2019 and June 2021. Results: The authors present four cases of non-functioning hypoglossal nerve stimulator devices: one case in which migration of the stimulation lead required a revision implantation, one in which the implantable pulse generator was found to be non-functional intra-operatively, one case of an intramuscular sensory lead tract causing pain and one case of implantable pulse generator failure that was probably triggered by implantable cardiac device discharge. In this study, computed tomography imaging was critical to the diagnosis for the first and third cases. Conclusion: Given the limited complication reporting available for hypoglossal nerve stimulators, these cases highlight management and unique imaging findings. The authors present an algorithm to work-up non-functioning hypoglossal nerve stimulator devices. [ABSTRACT FROM AUTHOR]

According to existing study into the remote fault diagnosis procedure, the current diagnostic approach has an imperfect decision model, which only supports communication in a close distance. An Internet of Things (IoT)- based remote fault diagnostic approach for wind power equipment is created to address this issue and expand the communication distance of fault diagnosis. Specifically, a decision model for active power coordination is built with the mechanical energy storage of power generation equipment with a remote diagnosis mode set by decision tree algorithms. These models help calculate the failure frequency of bearings in power generation equipment, summarize the characteristics of failure types and detect the operation status of wind power equipment through IoT. In addition, they can also generate the point inspection data and evaluate the equipment status. The findings demonstrate that the average communication distances of the designed remote diagnosis method and the other two remote diagnosis methods are 587.46 m, 435.61 m, and 454.32 m, respectively, indicating its application value. [ABSTRACT FROM AUTHOR]

Historically, failures of distribution transformers due to transient overvoltage phenomena have led to the development of resistor–capacitor snubber circuits for the protection of the transformer and winding insulation. These transients are most often observed when dry-type transformers are close coupled to vacuum switching devices. Typically, snubber circuit design has been specific for the particular application, and complex engineering studies were required. However, the design of a snubber circuit itself may be performed without these detailed studies. If snubber studies are required, the procedures for system modeling and simulation are explained in a step-by-step manner. [ABSTRACT FROM AUTHOR]

Background: Surgical instrument packaging quality directly affects the safety and performance of surgery. We aimed to investigate the factors causing defects in surgical instrument packaging and recommend strategies to prevent defects in surgical instrument packaging.Methods: We collected surgical instrument packaging data regarding age, gender, length of service, educational background, number of staff dealing with packaging, time period of packaging, instrument specification, where the wrap was intact, whether the wrap reached the required quality of cleaning, and whether the instruments were satisfactorily cleaned in compliance with guidelines from 5000 surgical instrument packages during June-December 2018 at Central Sterile Supply Department of the West China Second University Hospital, Sichuan University. Meanwhile, a questionnaire survey completed by the operating room staff using surgical instruments was used to measure the level of their satisfaction with the instruments in the packages. We utilized single-factor analysis to investigate possible factors that might cause defects in surgical instrument packaging, and conducted multivariate logistic regression analysis of the factors associated with defects in packaging.Results: Length of service, educational background, number of staff dealing with packaging, time period of packaging, instrument structure, whether the wrap was intact, whether the wrap reached the required quality of cleaning, and whether the surgical instruments were satisfactorily cleaned in compliance with guidelines were the factors significantly (P < 0.05) associated with defects in surgical instrument packaging.Conclusion: This study reveals that various factors are associated with defects in surgical instrument packaging. Recommendations for reducing incidences of defects include improved scheduling of packaging workload, greater provision of training in packaging skills, and standardization of packaging procedure. [ABSTRACT FROM AUTHOR]

Aim: To discover the perceived level of nursing interruptions during care activities. The study evaluates the contributing factors of alarms, equipment failures, visitors, and telephone calls in predicting interruptions according to the site of nurses' work. It also examines the potential association of demographic factors of nurses with interruption levels. Design: A crosssectional study. Methods: The study included nurses working at a tertiary hospital in Amman, the capital of Jordan. Data collections were carried out between May and July 2020. The analysis was performed using 257 valid questionnaires, compromising 128 male and 129 female respondents. The study used a nursing interruptions scale and an interruptions scale related to patients and hospitals. Results: Results indicated that the participating nurses generally experienced a high level of interruptions during nursing care activities. Visitors were found to be the main predictor of nursing interruptions on the surgical / medical floor; whereas equipment failure was found to be the main predictor of nursing interruptions in intensive care units. Finally, the demographic factors of marital status and educational level were associated with interruptions. Conclusion: Visitors and equipment failures are the main predictors of interruptions during nursing care activities. Our results provide a clear explanation for organizations, nurse managers, and clinicians of the factors behind nursing interruptions. [ABSTRACT FROM AUTHOR]

Abstract: One or more interconnected steam power plants (SPPs) are constructed in a petrochemical complex to supply utility energy to the process. To avoid large economic penalties or process shutdowns, these SPPs should be flexible and reliable enough to meet the process energy requirement under varying conditions. Unexpected utility equipment failure is inevitable and difficult to be predicted. Most of the conventional methods are based on the assumption that SPPs do not experience any kind of equipment failure. Unfortunately, a process shutdown cannot be avoided when equipment fails unexpectedly. In this paper, a systematic methodology is presented to minimize the total cost under normal conditions while reserving enough flexibility and safety for unexpected equipment failure conditions. The proposed method transforms the different conditions into real periods to indicate normal scenarios and virtual periods to indicate unexpected equipment failure scenarios. The optimization strategy incorporating various operation redundancy scheduling, the transition constraints from equipment failure conditions to normal conditions, and the boiler load increase behavior modeling are presented to save cost and guarantee operation safety. A detailed industrial case study shows that the proposed systematic methodology is effective and practical in coping with equipment failure conditions with only few additional cost penalties. [Copyright &y& Elsevier]

Abstract: Human reliability assessment (HRA) currently uses various approaches to determine and quantify human error. These approaches are increasingly being employed in various safety-critical domains, such as air traffic management and its ground component air traffic control. HRA research over the years has shown the important role of the context in which human errors take place. Recent techniques now put more emphasis on the definition of key contextual factors and their impact on the reliability of human performance. This paper presents a review of the current understanding of contextual factors in various industries. It uses this together with results from controller interviews to identify the contextual factors relevant to controller recovery from equipment failures in air traffic control. These factors should be used in conjunction with an appropriate method to analyse the performance of a controller during the process of recovery from failures. [Copyright &y& Elsevier]

We consider a coal mine that extracts raw coal by a set of coal mining equipment (CME), separates out multiple products by a set of coal washing equipment, and delivers the products through a fleet of trains over a multi-period horizon. The equipment requires a daily preventive maintenance (PM) and each CME is subject to random failures and repairs. We study a joint PM, production, and delivery problem that determines when to perform the PM and how to manage coal production and delivery in each period, to minimize the expected total cost. We formulate a multi-period stochastic optimization model that delicately integrates the static PM decisions with the adaptive production-delivery decisions, which is extremely difficult to solve due to CME's decision-dependent operating status. We propose a novel two-phase solution approach to overcome this difficulty. Phase 1 firstly determines the PM decisions using a scenario-based variable neighborhood search algorithm. Using the PM solution and the resultant set of scenarios as input parameters, Phase 2 adaptively determines the production-delivery decisions using a forward-looking algorithm in a rolling horizon manner. We show numerically that our approach consistently produces good-quality and robust solutions while preserving tractability for varying problem instances. [ABSTRACT FROM AUTHOR]

Background The Medical Equipment Network Documentation System (MENDS) provides a simple communication network for equipment servicing from failure to restoration. It is a text messaging-based platform, designed to use existing technologies in place in low- and middle-income settings. The system gathers and relays information about equipment service requests and reports and automatically saves them to an online database. Methods MENDS was deployed at a high volume, rural, charity medical facility in Kijabe, Kenya for a 3-mo pilot test. Results The results show MENDS more than tripled documentation and enhanced ease and speed of communication. Conclusions Comprehensive data provided by MENDS created more accurate measures of equipment performance, which can be used to decrease the time that equipment is out of service and improve the efficiency of repairs, equipment quality and procurement. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of MediSur is the property of Centro Provincial de Informacion de Ciencias Medicas de Cinfuegos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

For several decades, The U.S. Army Corps of Engineers has maintained a unique database of equipment failure and maintenance data for critical facilities. This article takes a closer look at historical transformer failure and maintenance data, and provides a unique analysis of failure trends. Detailed analysis shows that failure rates for different categories of transformers demonstrate unique trends over time, with equipment age, and with respect to preventative maintenance levels. By analyzing over 144 thousand unit years of operational data, this article paints a more complete picture of component reliability. The data show that careful consideration of detailed failure and maintenance can better upgrade facility design and maintenance decisions, ultimately leading to improved system reliability and reduced operational costs. [ABSTRACT FROM AUTHOR]

The presence of free conductive particles in gas-insulated transmission lines (GIL) is the most significant threat to their insulation. The non-invasive identification of free conductive particle defects in GILs is extremely challenging. Existing identification methods which use the acoustic amplitude-flight time (AAFT) pattern are not often adopted on site due to their faulty theory, non-robust extraction algorithm, and generally inaccurate calibration. In this study, the theory established by L. E. Lundgaard is expanded by deriving estimation equations related to the particle's moving state. A new method for extracting the state information from the raw data of acoustic signals is established and the robustness of the acoustic identification method is enhanced. A convenient calibration method is also developed by building a standard collision signal generator. The proposed methods are validated in a scale GIL model and a real GIL model. The results of this study may represent a workable reference for GIL condition monitoring. [ABSTRACT FROM AUTHOR]

In men with post-prostatectomy incontinence, persistent or recurrent urinary leakage following artificial urinary sphincter placement is a frustrating complaint. Surgical failure can be classified as occurring early in the post-operative period vs. late-following a period of established continence-and should be managed according to the time course and severity of urinary leakage. We present a systematic approach for the evaluation and treatment of the failed artificial urinary sphincter. After considering the patient's individualized treatment goals and impact on quality of life, the clinician can more appropriately advise patients on a management strategy for their recurrent or persistent urinary incontinence following artificial urinary sphincter placement. [ABSTRACT FROM AUTHOR]

Objective:To create a system for the uniform registration and classification of complications and failures in cochlear implant surgery, and apply it to all the patients who underwent implantation in our clinic.Method:The definition of a medical complication was established, and data for all cochlear implantations performed between 1987 and 2012 were entered into a custom-made database system.Results:One or more medical complications were registered in 19.0 per cent of 1003 cochlear implantations. The incidence of ‘hard failure’ was 2.3 per cent. Findings revealed a decrease in device failures over the years; the rate of medical complications remained constant.Conclusion:Our database system, which is available free of charge, enables fast and accurate data entry. There were a relatively high number of (minor) complications in our series, but comparison with the relevant literature is difficult. This emphasises the need for a uniform definition of ‘complication’ as it relates to cochlear implant surgery, and an appropriate classification system for such complications. [ABSTRACT FROM PUBLISHER]

Background: Our goal was to analyze reported instances of the da Vinci robotic surgical system instrument failures using the FDA's MAUDE (Manufacturer and User Facility Device Experience) database. From these data we identified some root causes of failures as well as trends that may assist surgeons and users of the robotic technology. Methods: We conducted a survey of the MAUDE database and tallied robotic instrument failures that occurred between January 2009 and December 2010. We categorized failures into five main groups (cautery, shaft, wrist or tool tip, cable, and control housing) based on technical differences in instrument design and function. Results: A total of 565 instrument failures were documented through 528 reports. The majority of failures (285) were of the instrument's wrist or tool tip. Cautery problems comprised 174 failures, 76 were shaft failures, 29 were cable failures, and 7 were control housing failures. Of the reports, 10 had no discernible failure mode and 49 exhibited multiple failures. Conclusions: The data show that a number of robotic instrument failures occurred in a short period of time. In reality, many instrument failures may go unreported, thus a true failure rate cannot be determined from these data. However, education of hospital administrators, operating room staff, surgeons, and patients should be incorporated into discussions regarding the introduction and utilization of robotic technology. We recommend institutions incorporate standard failure reporting policies so that the community of robotic surgery companies and surgeons can improve on existing technologies for optimal patient safety and outcomes. [ABSTRACT FROM AUTHOR]

A fault-tolerant operation method for a dynamic electric vehicle propulsion system using variable torque versus speed characteristics is presented. With this method, the electrically powered vehicle can continue driving with a minimum performance reduction, and without the need for redundant systems on machine or electronics level. One of the possible single module fault scenarios, during which the system must continue operation, is shown. The accompanying theoretical analysis of the fault scenario is presented, and simulations and measurements are executed to demonstrate the presented solution. [ABSTRACT FROM AUTHOR]

AimsTo determine the nature of intraocular lens (IOL) surface abnormalities seen after the injection of hydrophilic acrylic lenses (Rayner C-flex™ 570C), through their accompanying pre-packaged disposable injectors. Hexagonal and round nozzle injectors from the same lens manufacturer were compared.MethodsA series of lenses were injected into a petri dish, using two different manufacturer-supplied disposable injectors. The injector nozzle, plunger, and IOL were subsequently examined by light and scanning electron microscopy (SEM) for defects.ResultsWhen using the hexagonal nozzle, eight out of nine lenses had linear surface abnormalities along the posterior surface of the IOL in the direction of injection. These abnormalities appeared to be scratches on the surface of the IOL and there were no corresponding defects on the nozzle. A newly introduced injector, with an oval nozzle and a larger compressible plunger, eliminated the vast majority of these surface abnormalities.ConclusionsManufacturer-supplied hexagonal nozzle injectors, but not oval nozzle injectors, produce linear scratches on the posterior surface of the IOL. These scratches did not disappear with time in vivo. [ABSTRACT FROM AUTHOR]

Background: Self-expanding metallic stents are widely used for relieving biliary duct obstruction in patients with unresectable periampullary malignancies. However, only a few studies have assessed the occurrence of fractures in these stents. Purpose: To determine the prevalence and significance of stent fracture after placement of self-expanding metallic stents for periampullary malignant biliary obstruction. Material and Methods: Over a 5-year period, 48 patients underwent placement of self-expanding metallic stents for periampullary malignant biliary obstructions. Stents were introduced 2-6 weeks after a percutaneous transhepatic biliary decompression. The medical records and relevant images were reviewed for stent patency, stent fracture, type of stent, and stent-related complications. Results: Stent fracture was detected in four of the 48 patients (8%): in one patient at 1 month and in three patients between 10 and 21 months after stenting. All four fractures involved one type of nitinol stent used in 38 patients. In one of the patients, fracture was complicated by life-threatening gastrointestinal bleeding. The mean survival time for all patients was 251 days (standard deviation [SD]±275 days) and the mean overall patency time for all stents was 187 days (SD±205 days). Conclusion: Stent fracture occurs after placement of self-expanding nitinol stents for periampullary malignant biliary obstruction. The low reported incidence of this complication may be due to a lack of awareness of and difficulty in detecting stent fracture. Fracture should be considered as a possible contributing factor in recurrent biliary obstruction after self-expanding metallic stent insertion. [ABSTRACT FROM AUTHOR]

OBJECTIVE To address the usability and safety aspects of current equipment for indwelling urinary catheter (IDC) manipulation, by assessing the attitudes of doctors and nurses to infection control, occupational health and environmental waste, and the perceived adequacy of available catheter packs, particularly drapes, when performing such manipulations. SUBJECTS AND METHODS A self-administered survey instrument was created using an online database and completed by doctors and nurses. The survey covered basic demographics and experience with IDC, attitudes to infection control, occupational health and safety, and the environment, as well as adequacy of current equipment in containing spillage of urine and/or blood. RESULTS In all, 87 doctors and 228 nurses completed 315 of 350 (90%) surveys. Doctors and nurses were concerned about infection control, occupational health and safety issues, and environmental waste. Incidents involving spillage of urine and/or blood often go unreported. There were no differences between nurses and doctors having specialist training in urology or experience ( P > 0.05). The second major finding is that available catheter packs, particularly drapes, when manipulating IDCs, are inadequate and spillage is likely. These findings were more pronounced in doctors and those with urology training ( P < 0.05). CONCLUSION The attitudes of health professionals involved with IDC manipulations are consistent with other fields, as is the under-reporting of episodes of contamination by bodily fluids. The current equipment, particularly drapes, are inadequate for containing urine and blood, leading to infection control, occupational health, environmental and cost implications. [ABSTRACT FROM AUTHOR]

The aging domestic oil production infrastructure represents a high risk to the environment because of the type of fluids being handled (oil and brine) and the potential for accidental release of these fluids into sensitive ecosystems. Currently, there is not a quantitative risk model directly applicable to onshore oil exploration and production (E&P) facilities. We report on a probabilistic reliability model created for onshore exploration and production (E&P) facilities. Reliability theory, failure modes and effects analysis (FMEA), and event trees were used to develop the model estimates of the failure probability of typical oil production equipment. Monte Carlo simulation was used to translate uncertainty in input parameter values to uncertainty in the model output. The predicted failure rates were calibrated to available failure rate information by adjusting probability density function parameters used as random variates in the Monte Carlo simulations. The mean and standard deviation of normal variate distributions from which the Weibull distribution characteristic life was chosen were used as adjustable parameters in the model calibration. The model was applied to oil production leases in the Tallgrass Prairie Preserve, Oklahoma. We present the estimated failure probability due to the combination of the most significant failure modes associated with each type of equipment (pumps, tanks, and pipes). The results show that the estimated probability of failure for tanks is about the same as that for pipes, but that pumps have much lower failure probability. The model can provide necessary equipment reliability information for proactive risk management at the lease level by providing quantitative information to base allocation of maintenance resources to high-risk equipment that will minimize both lost production and ecosystem damage. [ABSTRACT FROM AUTHOR]