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This research examines how the construction industry addresses the roles of schedulers and schedules, with the goal of improving current practices. We use a mixed-mode approach of qualitative and q...

This perspectives article addresses risk in cyber defense and identifies opportunities to incorporate risk analysis principles into the cybersecurity field. The Science of Security (SoS) initiative at the National Security Agency seeks to further and promote interdisciplinary research in cybersecurity. SoS organizes its research into the Five Hard Problems (5HP): (1) scalability and composability; (2) policy-governed secure collaboration; (3) security-metrics-driven evaluation, design, development, and deployment; (4) resilient architectures; and (5) understanding and accounting for human behavior. However, a vast majority of the research sponsored by SoS does not consider risk and when it does so, only implicitly. Therefore, we identify opportunities for risk analysis in each hard problem and propose approaches to address these objectives. Such collaborations between risk and cybersecurity researchers will enable growth and insight in both fields, as risk analysts may apply existing methodology in a new realm, while the cybersecurity community benefits from accepted practices for describing, quantifying, working with, and mitigating risk.

A value model is developed for military logistics that fulfill emergent requests for tailored resupply packages from the sea. Asset tracking technologies, including radio frequency identification, barcoding, internal positioning systems (IPS), and camera-aided technology, are considered as alternatives to a multi-objective decision model. Model measures include registration of inventory in the system, stowage factor enablement, storage location precision, retrieval identification accuracy, system compatibility, and security. The decision model is presented using insights from subject matter experts. Given the requirements of selective offloading in dense storage environments, IPS is the preferred asset tracking technology. Sensitivity analysis and recommendations for engineering managers are provided.

Data analytics is a foundational topic for engineering as well as business students given its importance in subsequent coursework and curriculum. Many common, interdisciplinary analytical topics exist between the engineering and business fields; undergraduate students may approach learning those topics in various ways depending on program or major. This research examines differences in performance on analytics between engineering and business students that may be explained by differences in motivation and attitude. We use a survey and a lecture on trendlines with a common homework assignment to compare the two groups of students. Instructors of an engineering and a business course that incorporate analytics gave the same lecture on the use of spreadsheets to analyze trendline data, assigned the same individual homework assignment, and administered an end-of-module survey. The survey was built from the established MUSIC® Model of Academic Motivation. Analysis of the student data will address differences in motivation and how the program or major impacts student perception of analytical problem solving and contributes to performance on related assignments. We discuss quantitative and qualitative differences between engineering and business majors, concluding with a discussion of future work and some strategies for educators to use when teaching analytics.

TPS384 Background: Men with intermediate risk prostate cancer are often recommended external beam radiation therapy (EBRT) with or without 4-6 months of androgen deprivation therapy (ADT). However, ADT can be associated with prolonged erectile dysfunction due to delayed testosterone recovery. Darolutamide is a second-generation androgen receptor with low blood-brain barrier penetration. We hypothesize that men who receive Darolutamide with RT rather than ADT with RT are able to achieve surrogate PSA endpoints indicative of long-term disease control while preserving erectile function. Methods: This is an open label, phase 2B, multi-center, randomized controlled trial. Eligibility criteria include intermediate risk prostate cancer, good erectile quality per the EPIC-26 questionnaire, and archival tissue suitable for submission to Decipher Biosciences (San Diego, CA). Men will be stratified by Decipher score (low/intermediate vs high), RT modality (EBRT vs Brachytherapy/stereotactic body radiation therapy/combination RT), and age (>65 vs

This paper presents a methodology for developing a spare parts inventory management system with a focus on the nuclear power sector. Often, demand for spare parts is highly intermittent and cannot be accurately forecasted through traditional methods. Examples include nuclear power generation equipment, ground space systems, and aircraft engine parts. We take a data-driven engineering management approach and develop a four-step methodology for spare parts management in such environments. These steps comprise an influence diagram for identifying relevant factors, weighting of influences through the analytic hierarchy process, grouping parts according to inventory criticality indices, and the development of base stock inventory policies for each group. This approach allows the system to be actively managed within a continuous improvement framework through employee engagement and input, and mathematical assumptions are not made in the models. To our knowledge, no such integrated, comprehensive methodology for spare parts has been developed. The techniques employed in this research can be effectively used together to holistically manage the entire spare parts process, or they may be used separately to manage portions of the process. This paper provides an overview of the methodology, and the entire approach is illustrated via a test bed nuclear power generation facility.

Oral cancer is usually treated combining surgery, radiation therapy and chemotherapy, following effective therapeutic protocols. Severe maxillary and mandibular bone atrophy resulting after therapies are usually treated with autologous bone grafting procedures even though these techniques often present a significant risk of postoperative complications and disadvantages. We describe the case of a 59-year-old woman presenting severe bone defect after being treated with surgery and radiotherapy for recurrent oral verrucous squamous cell carcinoma. We performed bone regeneration using Platelet-Derived Growth Factors (PDGF) in combination with autologous bone chips. Our procedure of bone regeneration allowed the placement of dental implants and the achievement of a good aesthetic and functional result. Regenerative surgery may enable the regeneration of substantial bone defects. Moreover, PDGF application decreases the risk of implant failure in irradiated patients.

The Stimulated Raman adiabatic passage (STIRAP) in three-state systems in the presence of quantum noise is considered. A comparison is made between different models, one based on a phenomenological introduction of decays, one traceable back to a microscopic description of the system-environment interaction. Effects related, to off-resonance in the coupling between the involved states are considered.

This paper overviews some recent S&T innovations in smart materials and structures at the Australian Defence Science and Technology Organisation (DSTO) under a Corporate Enabling Research Program (CERP) on Signatures, Materials and Energy. The CERP program includes development and transitioning of technology across the maritime, air and land domains, with the major focus of the smart materials program component being to increase the safety, availability and maintainability of Defence assets. Three specific examples are provided of the smart materials and structures program, ranging across the spectrum of technology readiness from new concept phase to technology transitioning, viz.: (i) Advances in smart sensing for prognostics-based platform management; (ii) Fabrication of nanostructured and ultrafine grained materials through top-down severe plastic deformation processing of bulk materials; (iii) Innovative application of carbon nanotubes/conducting polymers as artificial muscles for low-power propulsion and control of small autonomous underwater systems. In each case, the DSTO effort is underpinned by strong university or industry linkages to deliver challenging interdisciplinary S&T.

Delayed diagnosis of injury (DDI) during hospitalization and missed injuries (MI) on autopsy in trauma deaths result in untoward outcomes. Autopsy is an effective educational tool for health care providers to evaluate trauma care. A retrospective study of trauma registry patients and coroner's records was categorized into groups 1 (alive patients) and 2 (trauma deaths) and analyzed. DDI incidence was similar in group 1 (1.8%) and group 2 (1.9%). Autopsy analysis (163 patients) yielded 139 MI in 94 patients (57.6%)

The objective of this study was to assess adherence of childhood cancer survivors in comparison to cancer-free adults of comparable age and sex (or "controls") to the 2012 American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity.As part of the Chicago Healthy Living Study, 431 childhood cancer survivors (18.5 ± 8.1 years from diagnosis) and 361 controls completed a structured, health-focused interview including the Block Brief Food Frequency Questionnaire and Modifiable Activity Questionnaire. From these data, modified adherence scores were computed based on ACS guidelines (maximum score of 8 reflecting complete adherence). Comparisons were made between survivors and controls and among racial-ethnic groups of survivors and controls.There was no difference in overall ACS adherence scores between survivors and controls (4.3 ± 1.5 vs. 4.2 ± 1.5, p = 0.54). As compared to controls, survivors, on average, had a lower body mass index or BMI (27.9 ± 7.0 vs. 29.3 ± 7.8 kg/m(2), p = 0.01) and consumed less fiber (9.2 ± 3.5 vs. 9.7 ± 3.8 g/1,000 kcal, p = 0.05). Within the survivor group, ACS adherence scores did not differ across racial-ethnic groups, but differences were observed with respect to component behaviors. Hispanic survivors had a higher BMI when compared to those of whites (29.2 ± 7.4 vs. 26.2 ± 5.3 kg/m(2), p = 0.001). Daily alcohol consumption was greater for whites among both survivors and controls as compared to other racial-ethnic groups (p 0.017 for all comparisons).Compared to controls, survivors were not practicing healthier behaviors. Among minority survivors, excess body weight, particularly among Hispanics, is a major concern. Assessment of these behaviors should be incorporated into survivor follow-up care.There is much room for improvement in educating and encouraging survivors to follow healthier diet and lifestyle routines to prevent obesity and further morbidity.

Current treatment of nasopharyngeal carcinomas includes radiation therapy (RT) alone or combined with chemotherapy and neck dissection. Consequently all patients with nasopharyngeal carcinomas are treated with RT. To evaluate the CT and MRI appearance of nasopharyngeal carcinomas treated with RT and the ability of CT and MRI to differentiate persistent or residual tumour from radio-induced changes of head and neck tissues. Post-treatment CT and MRI examinations of 28 patients with primary nasopharyngeal cancers treated with RT (6000–7500 cGy) were retrospectively evaluated. We divided the patients in three groups on the basis of the differences in the CT and MRI appearance of the primary tumours treated with RT 1. Responders (9 patients): complete resolution of tumour or reduction in tumour size = or > 75%; 2. Non-Responders (8 patients): persistent tumour or residual mass with reduction in tumour size = or < 50%; 3. Partial Responders: (11 patients) persistent residual mass with reduction in tumour size from 50% to 75% or persistent asymmetry of the mucosal surface. There are some points to analyse in the interpretation of CT and MRI imaging of post-treated nasopharynx: Transient changes of irradiated soft tissues are more prominent during the first three months after RT (increased en-hancement of the pharyngeal mucosa and thickening of the pharyngeal walls). Persis-tent changes are subgrouped in 1. Soft tissue changes: a. Glandular (major salivary glands scialoadenitis and fatty degeneration); b. Deep (reticulation and fibrous degeneration of pre- and post-styloid parapharyngeal fat; c. Visceral (retraction of the pharyngeal wall and distorsion of lateral recess); d. Nervous (radio-induced damage of the CNS such myelopathy and radionecrosis. 2. Bone tissue changes: a. Fatty degeneration of bone marrow of the skull base; b. Sclerosis of the cortical bone of the basisphenoid. 3. Sinonasal changes: Reactive chronic sinusitis. Perineural-perivascular spread and skull base erosion is indicative of a poor outcome. The patients of the third group may also be followed with seriated CT because they have a significant percentage of recurrence.

The aim of this study is to evaluate the impact of CT and MRI staging on the RT plan analyzing the patterns of spread of nasopharyngeal tumours. Pre-treatment CT and MRI examinations of 28 patients (28–65 years old, mean age 42; 16 men, 12 women) with primary nasopharyngeal cancer were retrospectively evaluated. CT and MRI in clinically known or suspected nasopharyngeal cancer showed in all cases the extent and spread of the pathologic tissue; consequently the Americal Joint Committee on Cancer (AJCC) staging system for primary nasopharyngeal tumours was strictly respected. Imaging permitted in all cases a good evaluation of neck nodes; retropharyngeal, junctional, jugulo-digastric and accessory spinal lymph nodes were correctly staged on the basis of size, density-intensity, shape and contrast enhancement. The impact of non- and minimally-invasive diagnostic imaging techniques on head and neck diseases is well known. Clinical evaluation of the nasopharynx and nearby deep fascial planes is hard and fiberoptic examination detects only mucosal surfaces of the organ. Consequently prognosis and therapy of nasopharyngeal carcinomas depend on CT and MR staging both of the primary site and neck nodes. The RT beam and portals are focused on the basis of imaging and the results of the therapy may be correctly investigated only by the comparative analysis of the first follow-up examination with pre-treatment morphological data.

Aufbauend auf die Berechnung der inneren Vorgange eines Transformators entsteht ein Monitoring- und Diagnosesystem, das dem Betreiber als Instrument zur optimalen Nutzung seines Transformators dient. Zusatzliche Sensorik berucksichtigt den Einflus von Feuchtigkeit sowie den Sicherheitsaspekt.

To investigate whether the immune system improvement induced by pidotimod increases the rate of spontaneous disappearance of vulvar papillomatous lesions, a multicenter, double-blind, placebo-controlled, randomized clinical trial was performed. Forty-nine patients (23 in the pidotimod group and 26 in the placebo group) with first diagnosis of vulvar papillomatosis as shown by clinical and histological findings underwent 90-day treatment with oral 800-mg pidotimod once a day or identical placebo. The main outcome measure was the difference between vulvar papillomatous infected area before and after treatment judged by the following: complete regression (complete disappearance of all papillomatous lesions); partial regression (a decrease of at least 75% of the infected area); no response (a decrease of less than 75% of the infected area or new viral lesions not present at baseline). Forty patients completed the trial according to the study protocol and were entered in the "per protocol" analysis of efficacy. Complete regression was observed in 12 of 18 patients (66.7%) receiving pidotimod compared with 7 of 22 patients (31.8%) receiving placebo. The total infected surface area at the end of treatment was 10.1 +/- 18.5 mm2 (mean +/- SD) in the pidotimod arm and 198.3 +/- 399.2 mm2 in the placebo arm (p < 0.05 between treatment). Notwithstanding the fact that better results were obtained in the pidotimod group, more data are needed to confirm our encouraging results.

Owing to a rise in necrotizing enterocolitis (NEC, stage ⩾ 2) among very low birth weight (VLBW, birth weight1500 g) infants from 4% in 2005 to 2006 to 10% in 2007 to 2008, we developed and implemented quality improvement (QI) initiatives. The objective was to evaluate the impact of QI initiatives on NEC incidence in VLBW infants.In September 2009, we developed an NEC QI multidisciplinary team that conducted literature reviews and reviewed practices from other institutions to develop a feeding protocol, which was implemented in December 2009. The team tracked intervention compliance and occurrence of NEC stage ⩾ 2. In May 2010, we reviewed our nasogastric tube practice and relevant literature to develop a second intervention that reduced nasogastric tube indwelling time. The infants were divided into three groups: baseline (January 2008 to Novovember 2009, n219), QI phase 1 (December 2009 to May 2010, n62) and QI phase 2 (June 2010 to November 2011, n170).The NEC incidence did not decrease after implementation of the feeding protocol in QI phase 1 (19.4%) but did decline significantly after changing nasogastric tube management in QI phase 2 (2.9%). Multivariable logistic regression analysis demonstrated a significant relationship between QI phase and the incidence of NEC.QI initiatives were effective in decreasing NEC incidence in our high human milk-feeding NICU. Nasogastric tube bacterial contamination may have contributed to our peak in NEC incidence.

Scopo del lavoro è quello di delineare le indicazioni generali alla radioterapia, definitiva o in associazione alla chirurgia, nei pazienti affetti da carcinoma del distretto testa-collo, anche sulla base delle informazioni TC ed RM, e di descrivere le alterazioni morfologiche radiologiche che emergono, differenziando quelle suggestive di persistenza o recidiva neoplastica, da quelle indotte dalla radioterapia. Sono stati selezionati 95 pazienti che hanno praticato radioterapia come unico trattamento o in associazione alla chirurgia. Il primo controllo radiologico è stato effettuato di norma in un periodo di tempo compreso tra i 3 e i 4, 5 mesi dal termine della radioterapia. I pazienti sono stati seguiti nel tempo con esami seriati rispettivamente a 6, 9 e 12 mesi a distanza dal termine della radioterapia, a seconda dei rilievi emersi al primo controllo a ciclo terapeutico ultimato. Per quanto concerne la valutazione della risposta del tumore primitivo alla radioterapia sono stati distinti tre gruppi di pazienti. Il primo gruppo comprende soggetti nei quali il tumore primitivo, valutato alla TC e/o RM prima del trattamento radioterapico, ha dimostrato una regressione volumetrica superiore al 75% nei controlli tra i 3 ed i 12 mesi dalla fine del ciclo terapeutico (31 pazienti). Il secondo gruppo comprende soggetti nei quali il volume tissutale residuo dopo radioterapia, nei controlli a tre mesi, ha dimostrato una regressione inferiore al 50%, una persistenza o addirittura una progressione (44 pazienti). Un terzo gruppo è costituito da soggetti nei quali la regressione volumetrica del tessuto neoplastico nel controllo a tre mesi dal termine del ciclo terapeutico radioterapico è compresa tra il 50 ed il 75%. Quest'ultimo gruppo è quello che pone i maggiori problemi diagnostici e che viene seguito con controlli seriati ogni tre mesi, anche in presenza di negatività degli esami clinici ed endoscopici (20 pazienti). Le alterazioni tissutali post-radioterapiche sono state distinte in transitorie e permanenti. Quelle transitorie hanno raggiunto il massimo della loro espressività al termine del ciclo di trattamento, con visualizzazione di una massa conglomerata più estesa del tumore primitivo. Quelle permanenti si sono verificate a carico dei tessuti superficiali (ispessimenti della cute e del platisma, addensamenti nel tessuto adiposo sottocutaneo), nei piani fasciali profondi periviscerali (fibrosi del connettivo lasso adiposo parafaringeo, cervicale anteriore e posteriore, pericarotideo), nelle logge salivari (scialoadenite reattiva e degenerazione grassa), a livello degli spazi mucosi profondi (ispessimento simmetrico e infiltrazione delle pliche ariepiglottiche e delle corde vocali false, obliterazione dei piani adiposi pre- e paraglottici). La difficoltà di interpretazione delle immagini, con particolare riguardo ai possibili falsi positivi e falsi negativi, rappresenta soltanto una delle diverse facce della complessa problematica in corso di carcinoma del distretto testa-collo. Infatti i quesiti da risolvere coinvolgono anche il clinico, il chirurgo, il radioterapista oltre che il radiologo, il cui sforzo comune deve essere quello di garantire al paziente la migliore terapia possibile a fronte di una qualità di vita accettabile.

Highly stressed or damaged regions in aircraft structures are increasingly being reinforced by adhesively bonding an overlay of a unidirectional boron fiber-epoxy composite to the aircraft metallic substrate. While conventional C-scan ultrasonics can be used to detect disbonding of the overlay, nondestructive methods are also required to detect weak adhesive bonding. This paper describes a preliminary experimental investigation of the existence of ultrasonic leaky interface waves between overlays and 2024-T351 aluminum alloy and D6ac steel substrates, and their possible use for detection of weak bonds. The approach used was to excite these leaky waves using Rayleigh waves generated by a laser line-source on the substrate. The existence of the leaky waves, traveling normal to the composite fibers, between boron-epoxy overlays and either an aluminum or steel substrate, was confirmed by observations of the quasishear pulses leaked to the top of the overlay, and of the Rayleigh wave transmitted to the free surface beyond the overlay. When quantitative measurements were possible, measured values of the complex interface wave speed agreed satisfactorily with predicted values. This paper also demonstrates one case for which leaky interface waves are sensitive to weak bonding caused by the presence of a contaminant on the substrate surface prior to bonding: application of a low-concentration aqueous solution of hydraulic oil to the aluminum substrate prior to bonding of the overlay caused a marked increase, over that for the well-bonded case, in the observed amplitude of the quasi-shear pulses leaked to the top of the overlay by decay of the interface wave. More experiments are needed to establish whether leaky interface waves are sensitive to bond condition for various other combinations of substrate, overlay and contaminant.

Purpose Stereotactic body radiotherapy (SBRT) is being used with increasing frequency as definitive treatment of early stage prostate cancer. Much of the justification for its adoption was derived from earlier clinical results using high-dose-rate (HDR) brachytherapy. We determine whether HDR's dosimetry can be achieved by virtual SBRT. Methods and Materials Patients with intermediate-risk prostate cancer on a prospective trial evaluating the efficacy of HDR monotherapy treated to dose of 9.5 Gy × 4 fractions were used for this study. A total of 5 patients were used in this analysis. Virtual SBRT plans were developed to reproduce the planning target volume (PTV) HDR dose distributions. Both normal tissue– and PTV-prioritized plans were generated. Results From the normal tissue–prioritized plan, HDR and virtual SBRT achieved similar PTV V 100 (93.8% vs. 93.1%, p = 0.20) and V 150 (40.3% vs. 42.9%, p = 0.69) coverage. However, the PTV V 200 was not attainable with SBRT (15.2% vs. 0.0%, p D max was significantly lower with HDR (94.2% vs. 99.42%, p = 0.05). The rectal D 2 cc was also lower (60.8% vs. 71.1%, p = 0.07). Difference in D 1 cc urethral dose was not significantly different (87.7% vs. 75.2%, p = 0.33). Comparing the PTV-prioritized plans, the rectal D max (94.2% vs. 111.1%, p = 0.05) and mean dose (27.1% vs. 33.3%, p = 0.03) were significantly higher using SBRT, and the rectal D 2 cc was higher using SBRT (60.8% vs. 81.8%, p = 0.07). Conclusions HDR achieves significantly higher intraprostatic doses while achieving a lower maximum rectal dose compared with our virtual SBRT treatment planning. Future studies should compare clinical outcomes and toxicity between these modalities.

One of the major challenges in extending the life of ageing aircraft is to develop improved nondestructive inspection techniques for the rapid large-area detection of various types of hidden corrosion in aircraft components. In this paper, a new one-sided ultrasonic technique is proposed to solve the generic problem of detecting hidden corrosion in thin metallic aircraft skins, where the corrosion has originated at the interface between the skin and a second layer in an aircraft component. The technique involves the use of laser-generated ultrasonic Lamb modes whose attenuation in a thin skin is increased by the presence of corrosion. This paper presents a successful demonstration of the technique on a thin-skin elevator component. The potential of the Lamb wave technique for rapid large-area scanning for hidden corrosion is also described.

Hospital malnutrition is associated with increased morbidity and mortality, particularly among patients admitted to intensive care units (ICUs). The purpose of this observational study (August to November 2007) was to examine the adequacy of oral intake and to identify predictors of oral intake after ICU patients were removed from invasive mechanical ventilation. Patients aged > or = 18 years who required mechanical ventilation for at least 24 hours, advanced to an oral diet postextubation, and did not require supplemental enteral or parenteral nutrition were included. The first 7 days of oral intake after extubation were assessed via modified multiple-pass 24-hour recall and the numbers of days on therapeutic diets and reasons for decreased intake were collected. Oral intake

The Australian Defence Science and Technology Organisation (DSTO) has established a leading-edge program to enable the development and transitioning of innovative Smart Materials and Structures technology across the spectrum from fundamental science to use in the field. This program extends and harnesses technology in the area of Smart Materials, Sensors and Systems, in order to increase safety of Defence aircraft, ships, submarines and vehicles, increase availability, reduce the cost of asset ownership and operations, and enhance overall military capability. The program has linkages into broad networks, with strong university and industry relationships, and is also very relevant to the management of civil infrastructure and other equipment. We present here an overview of some key research areas within the DSTO Smart Materials and Structures Initiative, highlighting developments in : (i) Smart Materials, including environmentallyfriendly coatings that exhibit properties of greater flexibility and durability for aerospace applications, nano-crystalline coatings that provide increased wear resistance, and Defence applications for carbon nanotubes; (ii) Smart Sensing, including chemical, structural fatigue, fuel contamination, environmental degradation, corrosion and its precursors, and overheating and mechanical wear; and (iii) Smart Systems that employ innovative techniques to acquire and process data from a range of sensors by harvesting energy from local structures to power microelectronic circuits.

This investigation of sensor technologies needed for measuring the real time performance of gas turbine engines was motivated by the fact that under certain severe environmental operating conditions, such a s a sand storm, a helicopter engine ingests particulate matter. Exposure to such environments leads to compressor component erosion, which decreases compressor efficiency. This decrease in compressor efficiency subsequently results in a decrease in deliv ered shaft horsepower, which can be reduced to the point where there is an inadequate amount of power delivered to the helicopter main rotor to produce lift for takeoff and sustained flight. Although real time engine health monitoring systems are currently available and installed aboard some aircraft, none have the capability to monitor sand ingestion and provide the pilot with a display of remaining engine power margin based upon compressor blade damage incurred by such ingestion. In order to better und erstand the physical parameters that an onboard sensor suite would have to measure, work focused on relating gas turbine engine particulate ingestion to the engine remaining power margin. The engine remaining power margin, which can be utilized by the pil ot to effectively assess engine health, can be displayed in real -time. The information resulting from this work provides an understanding of what type of data a gas turbine engine contaminant ingestion sensor (GTECIS) suite would be expected to provide, including particle size, particle number density, and volumetric flow rate of air. As a result of a better understanding of the data that this type of sensor suite would have to measure, an effort was initiated to establish a set of physical and operationa l parameters that the sensors would have to meet in order to provide the data required for real time engine health monitoring in the presence of compressor blade erosion. The established physical and operational parameters can be used to benchmark sensors during laboratory and subsequent field validation testing. To begin with, a Venn diagram was constructed that showed the interrelationships among the physical measurements desired and the operational sensor requirements, and which illustrated the param eters necessary to qualify a sensor suite as a suitable choice for use as a real time engine health monitoring system. This paper will provide quantitative parameters relating to the Venn diagram for a variety of operational environments and engine types and will provide the requirements for a GTECIS.

A novel approach to the problem of detecting finely distributed surface cracks in a structure is proposed. The approach relies on the detection of anisotropy introduced into the surface by an oriented array of cracks and can be used for crack detection even when individual cracks in the array are below the practical threshold of detectability by conventional inspection techniques. The feasibility of detecting anisotropy associated with distributed cracking was established experimentally using: (i) a directional eddy‐current probe to detect anisotropy in the effective electrical conductivity and (ii) a line‐focused laser‐ultrasonic source to detect anisotropy in the attenuation of ultrasonic Rayleigh waves.

The Australian Defence Force is increasingly facing escalating costs on through-life support for major platforms (ships, aircraft and land vehicles). The application of smart materials and structures technologies in platform management systems is seen as a very promising approach to reduce these costs and to potentially achieve significant enhancement of platform capability. A new DSTO Key Initiative, 'Smart Materials and Structures', has been recently developed and funded to address these technologies. The Initiative will build on and grow the current activities within DSTO and promote collaboration with external Australian institutes and industry. This paper will present an overview of the Initiative and the generic sensor and system issues inherent in the 'whole-of-platform' and 'whole-of-life' monitoring and management of major defence platforms. Examples for some particular elements of this will be drawn from current work in DSTO. Other presentations in the conference will cover the technical and scientific aspects of these in more detail.

In the present paper, we present the results of an experimental and theoretical study in which laser ultrasonics is applied to surface crack depth measurement using transmitted Rayleigh waves measured in the near field of a crack. Such measurements are readily achievable using laser ultrasonics but extremely difficult using conventional ultrasonic techniques. The technique involves determination of crack depth by comparing experimental Rayleigh wave data in the frequency regime with exact theory for the transmission of a Rayleigh wave by a crack. In the experimental study, the Rayleigh waves were generated using a laser line-source and were detected using a Mach-Zender interferometer. The measurements were made using simulated cracks in an aircraft aluminum alloy in the form of EDM slots with depths of 0.5 mm, 1.0 mm and 1.5 mm respectively. In each case, the spectral Rayleigh wave technique gave the crack depth to an accuracy of within 4%. These promising results provide incentive to extend the work to more practical applications.

This paper presents the results of recent DSTO research to develop NDE for crack monitoring under boron reinforcement/repairs adhesively bonded to curved surfaces. Experimental results are given for the application of a range of innovative eddy-current and ultrasonic techniques to reinforced curved surfaces in both F-18 aileron hinges and bulkheads. The presence of curved surfaces made the application of conventional ultrasonics techniques difficult, due to the resulting complex wave propagation paths in the composite/substrate combination and the difficulty of maintaining probe coupling. However, a novel ultrasonic technique was developed which successfully detected very small cracks. The curved surfaces also complicated the application of eddy-current testing, particularly in terms of controlling probe lift-off. The paper addresses the effect of variations in lift-off in detail, particularly in relation to their effect on the sensitivity of eddy-current techniques as applied to bonded repairs on curved ...

This paper presents results of recent research at DSTO Aeronautical and Maritime Research Laboratory to develop NDE techniques to assess bond degradation in metal-skin honeycomb and composite skin honeycomb control surfaces. In particular, it covers the detection of fillet bond failure where the honeycomb core and adhesive separate. Realistic fillet bond failure specimens, one of which had only 20% of the good bond strength, were generated by the application of spray-release agent to the honeycomb. 20MHz ultrasonic pulse-echo imaging was successfully used to detect fillet bond failure in these specimens. This technique was successful in detecting defined areas of fillet bond failure for a range of skin type and thickness Promising results were also obtained for the application to actual components, whilst also highlighting effects due to the presence of repairs. Further work will involve the evaluation of a range of other NDE methods to the detection and sizing of fillet bond failure.

Purpose/Objective(s): Ipilimumab is an immunostimulatory anti-CTLA 4 antibody that has been shown to improve survival in patients with metastatic melanoma. Unfortunately, 10-15% of patients treated with ipilimumab develop hypophysitis, which is often treated with systemic steroids or ipilimumab cessation or dose reduction. As these treatments are not optimal for patients who may be responding to ipilimumab, we present here our initial experience treating ipilimumab-induced hypophysitis with low-dose conformal radiation therapy. Materials/Methods: This is a single institution retrospective review of metastatic melanoma patients with ipilimumab-induced hypophysitis who were treated with low-dose pituitary radiation therapy. All patients had biochemical evidence of pituitary dysfunction and MRI features of hypophysitis, including diffuse pituitary enlargement and enhancement. Radiation therapy was linear accelerator-based and consisted of three daily 150 cGy fractions delivered using 6or 15-MV photons. The PTV consisted of the pituitary gland and a 0.5-1 cm margin, which was treated via a three or five field conformal plan. A thermoplastic mask was employed for immobilization. Clinical follow-up as well as preand post-treatment MRIs were used to evaluate treatment efficacy, with pituitary volumes calculated using the volumetric formula for an ellipsoid (4/3 x p x R1 x R2 x R3). Mean preand post-radiation therapy pituitary volumes were compared using the Student’s t-test. Results: Between September 10, 2010 and February 24, 2012, seven patients (3 women, 4 men) with a median age of 65 years (range, 39-88) were treated. At a median follow-up of 31 weeks (range, 1-77), no patients experienced acute radiation therapy toxicity or developed new symptoms following treatment. Mean preand post-radiation therapy pituitary volumes were 796.7 (range, 433.1-962.5) and 380.8 (range, 266.8-569.7) mm, respectively (p Z 0.005). Radiation therapy was delivered over a median of 5 days (range, 3-5) and without interruption in any patient. All patients who presented with generalized symptoms of fatigue, anorexia, and headache reported symptomatic improvement following treatment. Every patient who presented with a hormonal deficiency had persistent endocrine dysfunction at last follow-up. Conclusion: Low-dose conformal radiation therapy results in significant clinical improvement and radiographic response in patients with ipilimumab-induced hypophysitis, although there is no amelioration of endocrine dysfunction following treatment. This treatment represents a promising therapeutic option for patients with ipilimumab-induced hypophysitis whose survival may be adversely affected by treatment with systemic steroids or interference of ipilimumab administration. Additional exploration and follow-up is necessary to determine whether early treatment initiation can reverse endocrine dysfunction. Author Disclosure: P.L. Menzel: None. A. Geng: None. C. Marquez: None. M. Scala: None. D. Minor: None. R. Abendroth: None.

Bleeding and lymphorrhea are very frequent side effects in breast cancer (BC) and in head and neck cancer (HNC). They are related to wide muscular resection and/or lymphatic dissection which can delay wound healing in tissue repair. In order to reduce such side effects, between January 1989 and February 1992 two separate groups of patients with BC and HNC underwent intraoperative topical fibrin glue application. In both groups, a reduction in lymphorrhea, wound infection, and, consequently, length of hospitalization was observed as compared to previous experience.

615 Background: Small bowel and bladder toxicities (bleeding, obstruction, perforation, and stricture) are rare but serious late complications of pelvic radiotherapy (RT) related to dose received by these organs. IMRT has been used effectively in other pelvic malignancies (prostate and gynecologic) to decrease the dose to normal tissues when compared to 3D-CRT. Few studies have examined the use of IMRT in rectal cancer to assess whether a similar dose reduction is feasible. Methods: Eight consecutively treated patients with T2/T3 and N0/N1 rectal adenocarcinoma underwent 5-FU based neoadjuvant chemo-RT using 7-field sliding-window IMRT between 2008 and 2010. Retrospectively, conventional 4-field 3D-CRT plans were generated for dosimetric comparison with IMRT treatment plans. Planning target volumes included the gross tumor, rectum, peri-rectal tissues, pre-sacral space, and common and internal iliac lymphatics. Organs at risk included small bowel (contoured as all small bowel identified on the planning CT plus a 1 cm symmetrical expansion), bladder, and femoral heads. Small bowel, bladder, and femoral head mean doses and volumes receiving 45 Gy (V45) were compared between conventional and IMRT plans, respectively. Paired Student's t-test was used for statistical analysis. Results: Mean prescription dose was 52.9 ± 3.3 Gy. Compared to 3D-CRT, IMRT plans had an 11% lower mean dose delivered to the bladder (38.2 ± 4.5 Gy vs 43.1 ± 1.9 Gy, p = 0.028) and 24% lower mean dose to the small bowel (24.0 ± 2.9 Gy vs 31.7 ± 7.7 Gy, p = 0.014). IMRT plans also had a 55% lower bladder V45 (27 ± 19% vs 61 ± 22%, p = 0.0077) and a 96% lower small bowel V45 (1 ± 0% vs 21± 20%, p = 0.021). The femoral heads received a nonsignificant higher mean dose (19.2 ± 3.9 Gy vs 16.6 ± 3.0 Gy, p = 0.069). Conclusions: Small bowel and bladder volume receiving 45 Gy and mean dose were significantly lower using IMRT compared with 3D-CRT planning. More stringent volumetric planning constraints may be necessary to further reduce the dose to the femoral heads. Further study is warranted to examine the clinical benefit of these dosimetric findings. No significant financial relationships to disclose.

The impact of major risk factors for stroke on EEG mapping and routine EEG findings was evaluated in volunteers with no clinical signs of cerebrovascular or other neuropsychiatric disease. Focal changes were seen in 22 subjects (30%) by means of EEG mapping, but in only 12 cases (16%) when routine-EEG was used (p

The use of unidirectional boron-epoxy composites to reinforce highly stressed or damaged regions in defence aircraft structures is increasing rapidly [1]. Critical nondestructive evaluation problems related to such repair technology include the need to ensure the integrity of the bond between the composite reinforcement and the substrate, and to detect and measure the depth of a crack underneath the reinforcement. Among possible ultrasonic techniques, leaky interface waves have shown promise for the measurement of adhesive bond strength [2], and could also allow extension to second-layer cracks of crack depth measurement techniques such as Rayleigh wave spectral modulation [3,4]. However, it is first necessary to measure elastic constants, C;1, for the composite, as these constants are needed to determine whether leaky interface waves occur for a particular composite/substrate combination.

Unidirectional boron fiber-epoxy composites are used for crack repair and for reinforcement of highly stressed regions in aircraft components and structures [1]. Critical nondestructive evaluation problems related to such repair technology include the need to ensure the integrity of the bond between the composite reinforcement and the substrate, and to detect and measure the depth of a crack underneath the reinforcement. Among possible ultrasonic techniques, leaky interface waves have shown promise for the measurement of adhesive bond strength [2], and could also allow extension to second-layer cracks of crack depth measurement techniques such as Rayleigh wave spectral modulation [3,4]. However, it is first necessary to measure elastic constants, Cij, for the composite, as these constants are needed to determine whether leaky interlace waves occur for a particular composite/substrate combination. Note that it is insufficient to measure Cij for composite material nominally identical to that used in a specific repair application, as the existence or otherwise of interface waves can be altered by small variations in Cij.

A method is presented to 1) account for ductility effects in the response of one degree of freedom systems by means of evaluating the frequency shift and additional damping; 2) evaluate the energy dissipation which takes place in piping due to local yielding in elbows.

The problem of crack instability is examined, with the following results 1. (a) the conventional SHA defined collapse locus is a conservative assessment of the pipe loading capability within the plastic range; 2. (b) a large safety margin exists considering actual loads, even if secondary loads are included; 3. (c) a parameter is defined which gives the rate of hinge rotation increment with respect to crack extension; 4. (d) comparisons with tearing moduli are given, showing that the crack is generally stable.

A strategy for dealing with employee apprehension about handling cytotoxic agents without a biological safety cabinet is described. Available evidence in the literature concerning the health risks of handling cytotoxic drugs was reviewed with employees. A committee was appointed to evaluate the institution's needs and current practices for handling cytotoxic agents. Airflow studies were conducted in the pharmacy department's sterile preparation areas, and policies and procedures were developed for use until biological safety cabinets could be installed. Plans were developed for dealing with special situations, such as exemption of certain employees from preparation of cytotoxic drugs or refusal of an employee to prepare these drugs. Managers can substantially reduce employees' apprehension about handling cytotoxic drugs by keeping employees informed about departmental plans, listening to their concerns, and developing procedures for safe handling of these agents.

The generation of elastic waves by illumination of a free metal surface with a laser pulse was studied to establish a quantitative basis for laser ultrasonics in nondestructive evaluation of surfaces. Experiments were carried out using a Q‐switched Nd:YAG laser for generation and a wideband piezoelectric sensor for detection. A theoretical model for laser generation was developed for the thermoelastic energy regime. This model integrates over point source Green’s functions, suitably spread throughout the illuminated region. Good agreement was found between experiment and theory for characteristics in both time and frequency domains, for surface waves excited in the thermoelastic regime. For a given laser pulse energy, the highest Rayleigh wave peak frequency and bandwidth occurred when the Gaussian laser‐beam half‐width a was reduced just enough to begin surface damage. Once such damage commenced, further spot size reduction slightly lowered the peak frequency. Quantitative agreement with theory was found...

The percentage of time required by drug-administration technicians to perform predefined activities was determined using a work-sampling technique. Two trained pharmacists used random-sampling techniques to estimate the amount of time technicians spent performing activities in each of four major work categories. These categories, which included drug administration and related activities, clerical, communication, and "other," were divided into 24 activity elements, and technicians were randomly observed during the first or second work shift (8 1/2 hours) for 20 days in a one-month period. Drug-administration technicians spent the most time in the drug administration and related activities category (40.4 +/- 2.5%), followed by "other" (24.1 +/- 2.2%), communication (17.9 +/- 2.0%), and clerical (17.6 +/- 2.0%) activities. In the "other" category, technicians were not observed 11.6 +/- 1.7% of the time, but this was expected since the technicians were granted a 30-minute lunch period and two 15-minute breaks. A work-sampling technique was effective in quantifying activities performed by drug-administration technicians.

The computer program PAULA for the 3-D non linear analysis of piping is considered with particular reference to the finite elements library (straight pipe, elbow, T-joint, transition, restraint, non-linear superelement). The particular cases of the earthquake and pipe whip analysis are briefly discussed, in the latter case some attention is given to the relative merits of 2-D and 3-D analyses.

Candidal endocarditis can develop if candidemia occurs during Swan-Ganz catheterization. Candida endocarditis may persist for many months and is fatal unless the infected valve is resected. Herein is reported the first case of rupture of a mycotic pulmonary artery aneurysm caused by chronic candidal endocarditis. The endocarditis followed Swan-Ganz catheterization and aneurysm progressed despite appropriate medical and surgical therapy.