Performance Centered Maintenance as a Core Policy in Strategic Maintenance Control

Rolling stock maintenance in the Netherlands traditionally is performed on several levels of complexity and therefore on levels of non-availability and cost. The challenge in optimizing performance and cost of rolling stock maintenance is to integrate the policy on maintenance concepts, maintenance locations and maintenance intervals (what, when & where). NedTrain as a subsidiary of the Netherlands Railways is developing and implementing this improved concept of maintenance. On one hand maintenance concepts are being improved based on the philosophy of Risk Based Maintenance, with customer demands on risks regarding safety, reliability, availability and cost as a basis for maintenance renewal. On the other hand - during analysis of current maintenance concepts and risk based improvements – modularization of maintenance tasks is taken into account leading to possibilities to perform these tasks on a lower complexity level, during natural non-availability moments of train sets (off-peak hours in daytime or at night) in local depots instead of larger workshops. With this maintenance policy “Performance Centered Maintenance”, performance improvements and cost reduction are being achieved. New strategies arise for investments in depots, train equipment (e.g. Real Time Monitoring) and training of mechanics.In this document a general overview and first results will be given of the approach

Orbital-selective Mott transitions in the anisotropic two-band Hubbard model at finite temperatures

The anisotropic degenerate two-orbital Hubbard model is studied within dynamical mean-field theory at low temperatures. High-precision calculations on the basis of a refined quantum Monte Carlo (QMC) method reveal that two distinct orbital-selective Mott transitions occur for a bandwidth ratio of 2 even in the absence of spin-flip contributions to the Hund exchange. The second transition -- not seen in earlier studies using QMC, iterative perturbation theory, and exact diagonalization -- is clearly exposed in a low-frequency analysis of the self-energy and in local spectra.Comment: 4 pages, 5 figure

Virtual reality training for endoscopic surgery: voluntary or obligatory?

INTRODUCTION: Virtual reality (VR) simulators have been developed to train basic endoscopic surgical skills outside of the operating room. An important issue is how to create optimal conditions for integration of these types of simulators into the surgical training curriculum. The willingness of surgical residents to train these skills on a voluntary basis was surveyed. METHODS: Twenty-one surgical residents were given unrestricted access to a VR simulator for a period of four months. After this period, a competitive element was introduced to enhance individual training time spent on the simulator. The overall end-scores for individual residents were announced periodically to the full surgical department, and the winner was awarded a prize. RESULTS: In the first four months of study, only two of the 21 residents (10%) trained on the simulator, for a total time span of 163 minutes. After introducing the competitive element the number of trainees increased to seven residents (33%). The amount of training time spent on the simulator increased to 738 minutes. CONCLUSIONS: Free unlimited access to a VR simulator for training basic endoscopic skills, without any form of obligation or assessment, did not motivate surgical residents to use the simulator. Introducing a competitive element for enhancing training time had only a marginal effect. The acquisition of expensive devices to train basic psychomotor skills for endoscopic surgery is probably only effective when it is an integrated and mandatory part of the surgical curriculu

The impact of loco-regional recurrences on metastatic progression in early-stage breast cancer: a multistate model

To study whether the effects of prognostic factors associated with the occurrence of distant metastases (DM) at primary diagnosis change after the incidence of loco-regional recurrences (LRR) among women treated for invasive stage I or II breast cancer. The study population consisted of 3,601 women, enrolled in EORTC trials 10801, 10854, or 10902 treated for early-stage breast cancer. Data were analysed in a multivariate, multistate model by using multivariate Cox regression models, including a state-dependent covariate. The presence of a LRR in itself is a significant prognostic risk factor (HR: 3.64; 95%-CI: 2.02-6.5) for the occurrence of DM. Main prognostic risk factors for a DM are young age at diagnosis (</=40: HR: 1.79; 95%-CI: 1.28-2.51), larger tumour size (HR: 1.58; 95%-CI: 1.35-1.84) and node positivity (HR: 2.00; 95%-CI: 1.74-2.30). Adjuvant chemotherapy is protective for a DM (HR: 0.66; 95%-CI: 0.55-0.80). After the occurrence of a LRR the latter protective effect has disappeared (P = 0.009). The presence of LRR in itself is a significant risk factor for DM. For patients who are at risk of developing LRR, effective local control should be the main target of therapy

High CD33-antigen loads in peripheral blood limit the efficacy of gemtuzumab ozogamicin |(Mylotarg®) treatment in acute myeloid leukemia patients

Gemtuzumab ozogamicin (Mylotarg®) induces remission in approximately 30% of relapsed AML patients. We previously demonstrated that gemtuzumab infusion results in near-complete CD33 saturation in peripheral blood, and that saturating gemtuzumab levels result in continuous binding and internalization of gemtuzumab due to renewed CD33 expression. We now demonstrate that a high CD33-antigen load in peripheral blood is an independent adverse prognostic factor, likely due to peripheral consumption of gemtuzumab. Indeed, CD33 saturation in bone marrow is significantly reduced (40-90% saturation) as compared with CD33 saturation in corresponding peripheral blood samples (>90%). In vitro, such reduced CD33 saturation levels were strongly related with reduced cell kill. Apparently, high CD33-antigen loads in blood consume gemtuzumab and thereby limit its penetration into bone marrow. Consequently, CD33 saturation in bone marrow is reduced, which hampers efficient cell kill. Therefore, gemtuzumab should be administered at higher or repeated doses, or, preferably, after reduction of the leukemic cell burden by classical chemotherapy

Cerebellar output controls generalized spike-and-wave discharge occurence

© 2015 The Authors Annals of Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (CC BY-NC-ND 4.0) which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Disrupting thalamocortical activity patterns has proven to be a promising approach to stop generalized spike-and-wave discharges (GSWDs) characteristic of absence seizures. Here, we investigated to what extent modulation of neuronal firing in cerebellar nuclei (CN), which are anatomically in an advantageous position to disrupt cortical oscillations through their innervation of a wide variety of thalamic nuclei, is effective in controlling absence seizuresPeer reviewedFinal Published versio

Exact Solution of a Drop-push Model for Percolation

Motivated by a computer science algorithm known as `linear probing with hashing' we study a new type of percolation model whose basic features include a sequential `dropping' of particles on a substrate followed by their transport via a `pushing' mechanism. Our exact solution in one dimension shows that, unlike the ordinary random percolation model, the drop-push model has nontrivial spatial correlations generated by the dynamics itself. The critical exponents in the drop-push model are also different from that of the ordinary percolation. The relevance of our results to computer science is pointed out.Comment: 4 pages revtex, 2 eps figure