A Survey of Systems Engineering Effectiveness - Initial Results

This survey quantifies the relationship between the application of Systems Engineering (SE) best practices to projects and programs, and the performance of those projects and programs. The survey population consisted of projects and programs executed by defense contractors who are members of the Systems Engineering Division (SED) of the National Defense Industrial Association (NDIA). The deployment of SE practices on a project or program was measured through the availability and characteristics of specific SE-related work products. Project Performance was measured through typically available project measures of cost performance, schedule performance, and scope performance. Additional project and program information such as project size, project domain, and other data was also collected to aid in characterizing the respondent's project. Analysis of the survey responses revealed moderately strong statistical relationships between Project Performance and several categorizations of specific of SE best practices. Notably stronger relationships are apparent by combining the effects of more than one the best practices categories. Of course, Systems Engineering Capability alone does not ensure outstanding Project Performance. The survey results show notable differences in the relationship between SE best practices and performance between more challenging as compared to less challenging projects. The statistical relationship between Project Performance and the combination of SE Capability and Project Challenge is quite strong for survey data of this type

Aortic injuries following stents in bariatric surgery: our experience

Background: Due to the large number of laparoscopic sleeve gastrectomy (LSG) performed over the last decade, the management of the leak following LSG has been increasingly reported. The role of covered Self Expandable Metal Stents (cSEMS) for the treatment of the leak is still controversial because of the poor tolerance and high risk of complications. Objectives: The aim of the present study was to analyze the foregut wall perforation and aorta injuries, a very rare but potentially fatal complication, related to the treatment of the leak following LSG using cSEMS. Setting: Private hospital, France. Methods: An audit was conducted in 2 French tertiary bariatric endoscopic centers focusing on aortic injuries after cSEMS use for leak. We examined and classified the initial procedure, leak characteristics, primary endoscopic treatment, and outcome of endoscopic complication for each eligible case. Results: A total of 5 patients were identified with foregut wall perforation and aorta injuries. All stents were deployed for staple line leak following LSG. The recorded mortality in case of esophageal-aortic injuries related to cSEMS use was 80%. Conclusion: cSEMS are potentially effective tools for the management of foregut leaks in bariatric surgery. The biggest challenges with this approach are stent migration and poor quality of life. Caution is required due to the risk of fatal complications such as foregut wall perforation and aortic injury

Epigenetic therapies for heart failure: Current insights and future potential

Despite the current reductionist approach providing an optimal indication for diagnosis and treatment of patients with heart failure with reduced ejection fraction (HFrEF), there are no standard pharmacological therapies for heart failure with preserved ejection fraction (HFpEF). Although in its infancy in cardiovascular diseases, the epigenetic-based therapy (“epidrugs”) is capturing the interest of physician community. In fact, an increasing number of controlled clinical trials is evaluating the putative beneficial effects of: 1) direct epigenetic-oriented drugs, eg, apabetalone, and 2) repurposed drugs with a possible indirect epigenetic interference, eg, metformin, statins, sodium glucose transporter inhibitors 2 (SGLT2i), and omega 3 polyunsaturated fatty acids (PUFAs) in both HFrEF and HFpEF, separately. Apabetalone is the first and unique direct epidrug tested in cardiovascular patients to date, and the BETonMACE trial has reported a reduction in first HF hospitalization (any EF value) and cardiovascular death in patients with type 2 diabetes and recent acute coronary syndrome, suggesting a possible role in secondary prevention. Patients with HFpEF seem to benefit from supplementation to the standard therapy with statins, metformin, and SGLT2i owing to their ability in reducing mortality. In contrast, the vasodilator hydralazine, with or without isosorbide dinitrate, did not provide beneficial effects. In HFrEF, metformin and SGLT2i could reduce the risk of incident HF and mortality in affected patients whereas clinical trials based on statins provided mixed results. Furthermore, PUFAs diet supplementation was significantly associated with reduced cardiovascular risk in both HFpEF and HFrEF. Future large trials will reveal whether direct and indirect epitherapy will remain a work in progress or become a useful way to customize the therapy in the real-world management of HFpEF and HFrEF. Our goal is to discuss the recent advancement in the epitherapy as a possible way to improve personalized therapy of HF

MRI cortical feature of bulbar impairment in patients with amyotrophic lateral sclerosis

The decline of voluntary bulbar functions such as speech and swallowing are among the clinical manifestations of amyotrophic lateral sclerosis (ALS) influencing a worst prognosis. Differential diagnosis between the contribution of upper motor neuron (UMN) and lower motor neuron degeneration to the bulbar impairment is often hard. Thinning and T2* hypointensity of the primary motor cortex have been recently suggested as possible MRI markers of UMN impairment in ALS patients, but little research has purposely targeted the orofacial region of the primary motor cortex (fM1). With the aim of finding an MRI marker of UMN impairment responsible for bulbar dysfunction, we investigated the T2* signal intensity of fM1 and the relationship with bulbar impairment in ALS patients. Fifty-five ALS patients were examined with 3 T MRI. Their fM1 was evaluated both qualitatively in terms of T2* signal intensity and quantitatively by measuring its magnetic susceptibility with Quantitative Susceptibility Mapping (QSM). Bulbar functions were assessed clinically, by neurological examination and using the items 1–3 of the ALSFRS-R, and with neurophysiological tests. The marked hypointensity of fM1 was detected in 25% of ALS patients, including all patients with bulbar onset, and was 74% sensitive, 100% specific and 91% accurate in diagnosing functional bulbar impairment. Such hypointensity involved the middle and ventral part of fM1 and was usually visible in both hemispheres. The magnetic susceptibility was significantly higher in patients with marked fM1 hypointensity than in the other patients (p ≤ .001). The relationship with clinical and neurophysiological data suggests that such feature could be a marker of UMN degeneration for voluntary bulbar functions

Analysis of Oscillations and Defect Measures for the Quasineutral Limit in Plasma Physics

We perform a rigorous analysis of the quasineutral limit for a hydrodynamical model of a viscous plasma represented by the Navier Stokes Poisson system in $3-D$. We show that as $\lambda\to 0$ the velocity field $u^{\lambda}$ strongly converges towards an incompressible velocity vector field $u$ and the density fluctuation $\rho^{\lambda}-1$ weakly converges to zero. In general the limit velocity field cannot be expected to satisfy the incompressible Navier Stokes equation, indeed the presence of high frequency oscillations strongly affects the quadratic nonlinearities and we have to take care of self interacting wave packets. We shall provide a detailed mathematical description of the convergence process by using microlocal defect measures and by developing an explicit correctors analysis. Moreover we will be able to identify an explicit pseudo parabolic pde satisfied by the leading correctors terms. Our results include all the previous results in literature, in particular we show that the formal limit holds rigorously in the case of well prepared data.Comment: Submitted pape

Semiautomated Evaluation of the Primary Motor Cortex in Patients with Amyotrophic Lateral Sclerosis at 3T

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Semiautomated evaluation of the primary motor cortex in patients with amyotrophic lateral sclerosis at 3t

Amyotrophic lateral sclerosis is a neurodegenerative disease involving the upper and lower motor neurons. In amyotrophic lateral sclerosis, pathologic changes in the primary motor cortex include Betz cell depletion and the presence of reactive iron-loaded microglia, detectable on 7T MR images as atrophy and T2*-hypointensity. Our purposes were the following: 1) to investigate the signal hypointensity-to-thickness ratio of the primary motor cortex as a radiologic marker of upper motor neuron involvement in amyotrophic lateral sclerosis with a semiautomated method at 3T, 2) to compare 3T and 7T results, and 3) to evaluate whether semiautomated measurement outperforms visual image assessment

Efficient CSL Model Checking Using Stratification

For continuous-time Markov chains, the model-checking problem with respect to continuous-time stochastic logic (CSL) has been introduced and shown to be decidable by Aziz, Sanwal, Singhal and Brayton in 1996. Their proof can be turned into an approximation algorithm with worse than exponential complexity. In 2000, Baier, Haverkort, Hermanns and Katoen presented an efficient polynomial-time approximation algorithm for the sublogic in which only binary until is allowed. In this paper, we propose such an efficient polynomial-time approximation algorithm for full CSL. The key to our method is the notion of stratified CTMCs with respect to the CSL property to be checked. On a stratified CTMC, the probability to satisfy a CSL path formula can be approximated by a transient analysis in polynomial time (using uniformization). We present a measure-preserving, linear-time and -space transformation of any CTMC into an equivalent, stratified one. This makes the present work the centerpiece of a broadly applicable full CSL model checker. Recently, the decision algorithm by Aziz et al. was shown to work only for stratified CTMCs. As an additional contribution, our measure-preserving transformation can be used to ensure the decidability for general CTMCs.Comment: 18 pages, preprint for LMCS. An extended abstract appeared in ICALP 201

THE EFFECT OF THE THERMODYNAMIC MODELS ON THE THERMOECONOMIC RESULTS FOR COST ALLOCATION IN A GAS TURBINE COGENERATION SYSTEM

The thermoeconomics combines economics and thermodynamics to provide information not available from conventional energy and economic analysis. For thermoeconomics modeling one of the keys points is the thermodynamic model that should be adopted. Different thermodynamic models can be used in the modeling of a gas turbine system depending on the accuracy required. A detailed study of the performance of gas turbine would take into account many features. These would include the combustion process, the change of composition of working fluid during combustion, the effects of irreversibilities associated with friction and with pressure and temperature gradients and heat transfer between the gases and walls. Owing to these and others complexities, the accurate modeling of gas turbine normally involves computer simulation. To conduct elementary thermodynamic analyses, considerable simplifications are required. Thus, there are simplified models that lead to different results in thermoeconomics. At this point, three questions arise: How different can the results be? Are these simplifications reasonable? Is it worth using such a complex model? In order to answer these questions, this paper compares three thermodynamic models in a gas turbine cogeneration system from thermoeconomic point of view: cold air-standard model, CGAM model and complete combustion with excess air