Advanced Monitoring Techniques Research Articles

Simulation of snow management in Alpine ski resorts using three different snow models

Snow management, i. e., snowmaking and grooming, is an integral part of modern ski resort management. While the current snow cover distribution on the slopes is often well known thanks to the usage of advanced monitoring techniques, information about its future evolution is usually lacking. Management-enabled numerical snowpack models driven by meteorological forecasts can help to fill this gap.In the frame of the H2020 project PROSNOW, the snowpack models AMUNDSEN, Crocus, and SNOWPACK/Alpine3D are applied in nine pilot ski resorts across the European Alps for forecasting snow conditions in time scales from days to several months ahead. We present the integration of detailed snowmaking and grooming practices implemented in the three models and show how they can be adapted to individual ski resorts. An ensemble of snow management configurations accounting for a comprehensive set of possible tactical and strategic operational choices is introduced, along with an approach to homogeneously spatialize the results of the three snow models over different areas of the ski resorts. First simulation results are presented for the nine pilot ski resorts in the form of distributed snow water equivalent (SWE) maps along with SWE and snow depth time series for two selected seasons in the past.

Healing fine cracks in concrete with bacterial cement for an advanced non-destructive monitoring

Cracks in concrete are inevitable and they can adversely affect the service life of structures. An efficient method to heal the cracks coupled with a reliable monitoring technique is of paramount importance. Standard crack healing materials are unable to penetrate thin cracks [1]. This paper presents an experimental demonstration of healing of fine cracks of around 0.6 mm using the bacterial based healing technique. Simultaneously, the evidence and efficiency of bacterial healing is investigated using advanced monitoring techniques. Ultrasonic signals passing through the healing area have been recorded and the waveform has been studied to interpret the condition of the crack. It has been validated through a series of water-tightness tests. The bacterial technique was able to heal the crack to the extent that no water was seen to permeate through the crack. The evidence of bacterial healing was confirmed through scanning electron microscopy and X-ray dispersion spectrum. It was found that the ultrasonic technique is able to monitor the progression of healing.

Condition Monitoring of Wind Turbine Planetary Gearboxes Under Different Operating Conditions

Abstract Digitally enhanced services for wind power could reduce operations and maintenance costs as well as the levelized cost of energy. Therefore, there is a continuous need for advanced monitoring techniques, which can exploit the opportunities of internet of things and big data analytics, revolutionizing the future of the energy sector. The heart of wind turbines is a rather complex epicyclic gearbox. Among others, extremely critical gearbox components, which are often responsible for machinery stops, are the rolling element bearings. The vibration signatures of bearings are rather weak compared to other components, such as gears, and as a result, an extended number of signal processing techniques and tools have been proposed during the last decades, focusing toward accurate, early, and on time bearing fault detection with limited false alarms and missed detections. Envelope analysis is one of the most important methodologies, where an envelope of the vibration signal is estimated usually after filtering around a frequency band excited by impacts due to the bearing faults. Different tools, such as Kurtogram, have been proposed in order to accurately select the optimum filter parameters (center frequency and bandwidth). Cyclic spectral correlation (CSC) and cyclic spectral coherence (CSCoh), based on cyclostationary analysis, have been proved as very powerful tools for condition monitoring. The monitoring techniques seem to have reached a mature level in case a machinery operates under steady speed and load. On the other hand, in case the operating conditions change, it is still unclear whether the change of the monitoring indicators is due to the change of the health of the machinery or due to the change of the operating parameters. Recently, the authors have proposed a new tool called improved envelope spectrum via feature optimization-gram (IESFOgram), which is based on CSCoh and can automatically select the filtering band. Furthermore, the CSCoh is integrated along the selected frequency band leading to an improved envelope spectrum (IES). In this paper, the performance of the tool is evaluated and further extended on cases operating under different speeds and different loads. The effectiveness of the methodology is tested and validated on the National Renewable Energy Laboratory (NREL) wind turbine gearbox vibration condition monitoring benchmarking dataset, which includes various faults with different levels of diagnostic complexity as well as various speed and load operating conditions.

A narrative review of the impact of surgery and anaesthesia on acute kidney injury.

The epidemiology of peri-operative acute kidney injury varies depending on the definition, type of surgery and acute and chronic comorbidities. Haemodynamic instability, disturbance of the microcirculation, endothelial dysfunction, inflammation and tubular cell injury are the main factors contributing to the pathogenesis. There are no specific therapies. The most effective strategies to protect renal function during the peri-operative period are: the avoidance of nephrotoxic insults; optimisation of haemodynamics; prevention of hypotension; and meticulous fluid management, including avoidance of both hypovolaemia and hypervolaemia. Peri-operative acute kidney injury is associated with an increased risk of short- and long-term postoperative complications, including a longer stay in hospital, development of premature chronic kidney disease and increased mortality. Resource utilisation and healthcare costs are also higher. In future, the development of advanced clinical prediction scores, new imaging and monitoring techniques and the application of new biomarkers for acute kidney injury have the prospect of identifying acute kidney injury earlier and allowing a more personalised management approach with the aim of reducing the global burden of acute kidney injury.

A Bayesian Network Analysis of the Diagnostic Process and Its Accuracy to Determine How Clinicians Estimate Cardiac Function in Critically Ill Patients: Prospective Observational Cohort Study.

BackgroundHemodynamic assessment of critically ill patients is a challenging endeavor, and advanced monitoring techniques are often required to guide treatment choices. Given the technical complexity and occasional unavailability of these techniques, estimation of cardiac function based on clinical examination is valuable for critical care physicians to diagnose circulatory shock. Yet, the lack of knowledge on how to best conduct and teach the clinical examination to estimate cardiac function has reduced its accuracy to almost that of “flipping a coin.”ObjectiveThe aim of this study was to investigate the decision-making process underlying estimates of cardiac function of patients acutely admitted to the intensive care unit (ICU) based on current standardized clinical examination using Bayesian methods.MethodsPatient data were collected as part of the Simple Intensive Care Studies-I (SICS-I) prospective cohort study. All adult patients consecutively admitted to the ICU with an expected stay longer than 24 hours were included, for whom clinical examination was conducted and cardiac function was estimated. Using these data, first, the probabilistic dependencies between the examiners’ estimates and the set of clinically measured variables upon which these rely were analyzed using a Bayesian network. Second, the accuracy of cardiac function estimates was assessed by comparison to the cardiac index values measured by critical care ultrasonography.ResultsA total of 1075 patients were included, of which 783 patients had validated cardiac index measurements. A Bayesian network analysis identified two clinical variables upon which cardiac function estimate is conditionally dependent, namely, noradrenaline administration and presence of delayed capillary refill time or mottling. When the patient received noradrenaline, the probability of cardiac function being estimated as reasonable or good P(ER,G) was lower, irrespective of whether the patient was mechanically ventilated (P[ER,G|ventilation, noradrenaline]=0.63, P[ER,G|ventilation, no noradrenaline]=0.91, P[ER,G|no ventilation, noradrenaline]=0.67, P[ER,G|no ventilation, no noradrenaline]=0.93). The same trend was found for capillary refill time or mottling. Sensitivity of estimating a low cardiac index was 26% and 39% and specificity was 83% and 74% for students and physicians, respectively. Positive and negative likelihood ratios were 1.53 (95% CI 1.19-1.97) and 0.87 (95% CI 0.80-0.95), respectively, overall.ConclusionsThe conditional dependencies between clinical variables and the cardiac function estimates resulted in a network consistent with known physiological relations. Conditional probability queries allow for multiple clinical scenarios to be recreated, which provide insight into the possible thought process underlying the examiners’ cardiac function estimates. This information can help develop interactive digital training tools for students and physicians and contribute toward the goal of further improving the diagnostic accuracy of clinical examination in ICU patients.Trial RegistrationClinicalTrials.gov NCT02912624; https://clinicaltrials.gov/ct2/show/NCT02912624

Feasibility study on real-scale, self-healing concrete slab by developing a smart capsules network and assessed by a plethora of advanced monitoring techniques

The study presents the design, manufacturing and testing of the first concrete structural element that carries a plane network of long, brittle macro-capsules into which chemical repair agent circulates to provide autonomous and repeatable healing of formed cracks under service loads. The vascular network design emerges as the most promising concept based on a decade of research, the milestones of which are briefly reported. In this experimental attempt, the network of simultaneously occurring and interacting cracks formed on a real-scale steel reinforced concrete slab loaded under four-point bending are tracked by an integrated sensing configuration that combines advanced acoustic monitoring techniques (Acoustic Emission, Elastic Wave Tomography, Ultrasound Pulse Velocity measurements) with Digital Image Correlation and visual crack inspection. Macro-capsules rupture is depicted by AE monitoring of high energy burst signals. It is shown that effective healing occurs locally, detected by sealing of open cracks and regain in mechanical properties. Indicatively, pulse velocity regain up to 100% is detected on healed zones, result also obtained by elastic wave tomography. Limited repair is measured on cracks with openings larger than 0.5 mm. This outcome could only be verified by correlating the experimental evidence of different monitoring methods, highlighting the need for design optimization and establishment of an advanced tempo-spatial structural health monitoring protocol.

Treatment of Infiltrative Superficial Tumors in Awake Standing Horses Using Novel High-Frequency Pulsed Electrical Fields

Irreversible electroporation is a proven ablation modality for local ablation of soft tissue tumors in animals and humans. However, the strong muscle contractions associated with the electrical impulses (duration, 50–100 μs) requires the use of general anesthesia and, in most situations, application of neuromuscular blockade. As such, this technology is not used in an outpatient setting for ablating common cutaneous tumors (e.g., squamous cell carcinoma or melanoma) in humans or animals. Recently, high-frequency irreversible electroporation (H-FIRE) technology has been developed to enable electroporation of tumors without stimulation of nearby skeletal muscle. H-FIRE administers bursts of electrical pulses (duration, 0.5–2 μs) through bipolar electrodes placed in tumor parenchyma. We hypothesized that H-FIRE could be used to safely ablate superficial tumors in standing, awake horses without the need for general anesthesia. Here, we describe the treatment of superficial tumors in five horses using this novel ablation therapy without the need for general anesthesia. In each case, H-FIRE therapy predictably ablated tumor volume. All patients tolerated the procedure, no complications developed, and veterinary personnel safety was maintained. The H-FIRE treatment may be useful for treatment in veterinary and human patients in an outpatient setting without the need for hospitalization, general anesthesia, and advanced monitoring techniques.

Sitting Position in Neurosurgery

AbstractNeurosurgery in the sitting position is used for resection of tumors located in the cerebellopontine angle, pineal region, other technically difficult tumors in the infratentorial region, as well as surgeries of the cervical spine. Since its inception, the use of this particular position has been contentious due its risk-benefit analysis. With improved microsurgical equipment and surgical and anesthetic techniques, as well as advanced monitoring techniques to assure patient safety, many centers are revisiting the sitting position for its potential benefits.

Enhancing the Usability of Brain-Computer Interface Systems.

Brain-computer interfaces (BCIs) aim to enable people to interact with the external world through an alternative, nonmuscular communication channel that uses brain signal responses to complete specific cognitive tasks. BCIs have been growing rapidly during the past few years, with most of the BCI research focusing on system performance, such as improving accuracy or information transfer rate. Despite these advances, BCI research and development is still in its infancy and requires further consideration to significantly affect human experience in most real-world environments. This paper reviews the most recent studies and findings about ergonomic issues in BCIs. We review dry electrodes that can be used to detect brain signals with high enough quality to apply in BCIs and discuss their advantages, disadvantages, and performance. Also, an overview is provided of the wide range of recent efforts to create new interface designs that do not induce fatigue or discomfort during everyday, long-term use. The basic principles of each technique are described, along with examples of current applications in BCI research. Finally, we demonstrate a user-friendly interface paradigm that uses dry capacitive electrodes that do not require any preparation procedure for EEG signal acquisition. We explore the capacitively measured steady-state visual evoked potential (SSVEP) response to an amplitude-modulated visual stimulus and the auditory steady-state response (ASSR) to an auditory stimulus modulated by familiar natural sounds to verify their availability for BCI. We report the first results of an online demonstration that adopted this ergonomic approach to evaluating BCI applications. We expect BCI to become a routine clinical, assistive, and commercial tool through advanced EEG monitoring techniques and innovative interface designs.

Real-time broken rotor bar fault detection and classification by shallow 1D convolutional neural networks

Application of advanced fault diagnosis and monitoring techniques allows more efficient, reliable and safe operation of many complex industrial systems. Recently, there has been a significant increase in application of various data-driven deep learning models for motor fault detection and diagnosis problems. Due to high computational complexity and large training dataset requirements of deep learning models, in this study, shallow and adaptive 1D convolutional neural networks (CNNs) are applied to real-time detection and classification of broken rotor bars in induction motors. As opposed to traditional fault diagnosis systems with separately designed feature extraction and classification blocks, the proposed system takes directly raw stator current signals as input and it can automatically learn optimal features with the proper training. The other advantages of the proposed approach are (1) its compact architecture configuration performing only 1D convolutions with a set of filters and subsampling, making it suitable for implementing with real-time circuit monitoring, (2) its requirement for a limited size of training dataset for efficient training of the classifier and (3) its cost-effective implementation. Effectiveness and feasibility of the proposed method is validated by applying it to real motor current data from an induction motor under full load.

Long-Term Clinical and Angiographic Outcomes of Wrap-Clipping for Ruptured Blood Blister-Like Aneurysms of the Internal Carotid Artery Using Advanced Monitoring

Wrap-clipping is one of the recommended treatments for ruptured blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA). However, the long-term clinical and angiographic outcomes of this procedure have not yet been elucidated. The present study examined the long-term efficacy of wrap-clipping using a polytetrafluoroethylene membrane, an ideal wrapping material, for BBAs. The data from 9 patients with ruptured BBAs treated at our institutes from 2007 to 2016 were retrospectively analyzed. Wrap-clipping was performed with advanced monitoring techniques, including fluorescence video angiography and endoscopy. Angiographic follow-up was achieved using 3-dimensional computed tomography angiography or digital subtraction angiography. Clinical outcomes were assessed using the modified Rankin scale. Wrap-clipping was performed without any permanent morbidity in all patients. Endoscopy visualized accurate margins of the aneurysmal pathological wall with high magnification and revealed the position of the clip blades and the surrounding perforators in the dead angles of the microscope. Fluorescence video angiography could confirm the blood flow of the ICA and the surrounding arteries. Regrowth of the aneurysm owing to the presence of a neck remnant occurred 1 month after treatment in 1 case that was repaired surgically. However, no other recurrence of BBAs or progression of ICA stenosis was observed by angiography with a mean follow-up period of 37 months. No repeat rupture or ischemic complications occurred, and all patients had a modified Rankin scale score of 0 with a mean follow-up period of 61 months. Wrap-clipping using a polytetrafluoroethylene membrane for ruptured BBAs is a useful and acceptable procedure with long-term effectiveness. The effectiveness of this method can be ensured using modern monitoring methods.

Rational Use of Antibiotics in Neonates: Still in Search of Tailored Tools.

Rational medicine use in neonates implies the prescription and administration of age-appropriate drug formulations, selecting the most efficacious and safe dose, all based on accurate information on the drug and its indications in neonates. This review illustrates that important uncertainties still exist concerning the different aspects (when, what, how) of rational antibiotic use in neonates. Decisions when to prescribe antibiotics are still not based on robust decision tools. Choices (what) on empiric antibiotic regimens should depend on the anticipated pathogens, and the available information on the efficacy and safety of these drugs. Major progress has been made on how (beta-lactam antibiotics, aminoglycosides, vancomycin, route and duration) to dose. Progress to improve rational antibiotic use necessitates further understanding of neonatal pharmacology (short- and long-term safety, pharmacokinetics, duration and route) and the use of tailored tools and smarter practices (biomarkers, screening for colonization, and advanced therapeutic drug monitoring techniques). Implementation strategies should not only facilitate access to knowledge and guidelines, but should also consider the most effective strategies (‘skills’) and psychosocial aspects involved in the prescription process: we should be aware that both the decision not to prescribe as well as the decision to prescribe antibiotics is associated with risks and benefits.

Invasive Procedures and Length of Stay among Critically Ill Patients in ICU over Three Years: A Retrospective Study

Introduction: Intensive care unit (ICU) provides advanced specialized medical and nursing care for critically ill patients. Advanced monitoring techniques are needed to prevent physiologic deterioration, while the underlying disease treated and resolved. Frequents invasive procedure and treatment are used and affect the death rate and length of hospitalization. This study aimed to describe the variables associated with critically ill patients and describe the standard invasive procedures or treatments used among patients in ICU. Method: A retrospective comparative study which utilized the ICU electronic database. The data of 446 dead patients who have admitted to ICU between January 2014 and December 2016 as a case of sepsis, heart failure or COPD exacerbation were enrolled. Result: Almost of all patients had received intravenous fluid and vasoactive drugs. The mechanical ventilation support and insertion of the indwelling urethral catheter commonly used among patients with critical illnesses; 78.3%, 41.3% respectively. One-third of all sepsis and heart failure patients were received CVC during ICU stay; patients with sepsis illness had less hospital length of stay than patients with heart failure and COPD (p < 0.05). Also, patients with sepsis illness had less hospital LOS than patients with heart failure and COPD (p < 0.05). There were no significant differences between ICU length of stay based on patients critical illness. Conclusion: We found a reduction in the death number among sepsis, heart failure and COPD patients with move forwards in years, the variety of death rate depends on the type of invasive procedure and treatment performed for each illness, mechanical ventilation support and insertion of indwelling urethral catheter commonly used among patients with critical illnesses.

Incorporating delayed measurements in an improved high-degree cubature Kalman filter for the nonlinear state estimation of chemical processes

The on-line estimation of process quality variables has a large impact on the advanced monitoring and control techniques of chemical processes. The present study offers an improved high-degree cubature Kalman filter (HCKF) to solve the nonlinear state estimation problem of high-dimensional chemical processes. We substituted the Cholesky decomposition in the HCKF filter with a diagonalization transformation of the matrix. In addition, we enhanced numerical stability and estimation accuracy. On this basis, we present one nonlinear state estimation method based on the sample-state augmentation and improved HCKF to handle issues with delayed measurements. Finally, we used the nonlinear state estimation experiments for the polymerization process to validate the proposed method. The numerical results indicated the achievement of state estimation with higher accuracy and better stability following the effective utilization of the delayed measurements for nonlinear chemical processes.

A practical framework for implementing multivariate monitoring techniques into distributed control system

A large number of advanced multivariate techniques have been yet proposed to improve the performance of process monitoring. These advanced monitoring methods are usually implemented on separate hardware/software, which interconnect with Distributed Control System (DCS) using extra communication links. In this paper, the advanced monitoring algorithms are directly implemented and embedded into the DCS structure for the first time. Hence, the need to extra computers connected to the DCS will be eliminated, which brings in several advantages from the performance perspective. In the proposed approach, the advanced monitoring technique is first simplified and split into several functions. Next, Dynamic Link Libraries (DLLs) are created and used for fast execution of different functions in the DCS. Finally, using the generated DLLs and defining functions in WinCC, the monitoring algorithm is executed in real-time. In addition to fault detection, a fault classification algorithm is proposed, which effectively identifies different disturbances in the process. For this purpose, Support Vector Machine (SVM) classifier is used. The advanced monitoring technique is implemented in DCS SIMATIC PCS7 from Siemens©. The proposed condition monitoring method is tested on a real Gas Pressure Regulating Station (GPRS). The feasibility and effectiveness of the proposed method is experimentally confirmed.

Less or more hemodynamic monitoring in critically ill patients.

Hemodynamic investigations are required in patients with shock to identify the type of shock, to select the most appropriate treatments and to assess the patient's response to the selected therapy. We discuss how to select the most appropriate hemodynamic monitoring techniques in patients with shock as well as the future of hemodynamic monitoring. Over the last decades, the hemodynamic monitoring techniques have evolved from intermittent toward continuous and real-time measurements and from invasive toward less-invasive approaches. In patients with shock, current guidelines recommend the echocardiography as the preferred modality for the initial hemodynamic evaluation. In patients with shock nonresponsive to initial therapy and/or in the most complex patients, it is recommended to monitor the cardiac output and to use advanced hemodynamic monitoring techniques. They also provide other useful variables that are useful for managing the most complex cases. Uncalibrated and noninvasive cardiac output monitors are not reliable enough in the intensive care setting. The use of echocardiography should be initially encouraged in patients with shock to identify the type of shock and to select the most appropriate therapy. The use of more invasive hemodynamic monitoring techniques should be discussed on an individualized basis.

Direct pedicle visualization and disc space orientation as the only guide for lumbar pedicular screw insertion

BackgroundDifferent methods for lumbar pedicular screw insertion have been advocated; however, each technique has its cons and pros. Limited resources for O-arm and navigation in our locality enforced us to use our surgical skills to minimize the need for such advanced modalities.The aim of the study is to clarify the benefits of the use of free-hand technique using direct visualization of the pedicles and disc space as the only guide for pedicular screw insertion using postoperative CT for evaluation of the accuracy of pedicle screw insertion.Patients and methodsOne hundred forty-four screws were inserted in 32 patients using direct pedicle visualization and disc space orientation as a single intraoperative reference guide. The study was conducted in Zagazig University Hospitals from May, 2014, to June, 2015. CT was done for all patients as a direct postoperative evaluation tool.ResultsThere were 24 cases of single-level lumbar degenerative spondylolisthesis (96 screws) and eight with double-level degenerative spondylolisthesis DSL (48 screws). One hundred forty-four screws were inserted. Only three out of 144 screws were not purely intrapedicular; superior and lateral violations were not clinically significant.ConclusionsDirect pedicle visualization with the use of disc space orientation as a reference guide is a good alternative to the most advanced intraoperative monitoring techniques that are more readily available in developed countries.Trial registrationClinicalTrials.gov identifier: NCT03327298. Registered 30 October 2017.

Syndromic Surveillance – Reports of Successes from the Field

Objective: This panel will:● Discuss the importance of identifying and developing success stories● Highlight successes from state and local health departments to show how syndromic surveillance activities enhance situational awareness and address public health concerns● Encourage discussion on how to further efforts for developing and disseminating success storiesIntroduction: Syndromic surveillance uses near-real-time emergency department and other health care data for enhancing public health situational awareness and informing public health activities. In recent years, continued progress has been made in developing and strengthening syndromic surveillance activities. At the national level, syndromic surveillance activities are facilitated by the National Syndromic Surveillance Program (NSSP), a collaboration among state and local health departments, the CDC, other federal organizations, and other organizations that enabled collection of syndromic surveillance data in a timely manner, application of advanced data monitoring and analysis techniques, and sharing of best practices. This panel will highlight the importance of success stories. Examples of successes from state and local health departments will be presented and the audience will be encouraged to provide feedback.Description: ●Success stories – acknowledging and informing syndromic surveillance practiceThis presentation will discuss the importance of success stories for NSSP focused on increasing syndromic surveillance representativeness, improving data quality, and strengthening syndromic surveillance practices among grant recipients and partners. From the beginning of the program, the identification of success stories has been an important part of the efforts to develop knowledge base that better guide syndromic surveillance program activities.●NJ and BioSense – Making The Connection The New Jersey Department of Health (NJDOH) uses Health Monitoring’s EpiCenter as its primary ED data for syndromic surveillance. This data is also submitted to CDC’s NSSP BioSense Platform. In April 2017, a spike in ED Visits of Interest was identified by a CDC NSSP subject matter expert and brought to the attention of NJDOH’s data analyst. Data showed an increase in “Exposure” and “School Exposure” chief complaints in two contiguous counties. News reports showed the visits resulted from a dormitory fire at a university in the area. The NSSP and NJDOH staff collaboration integrated data from both NJDOH’s EpiCenter and CDC’s BioSense Platform for further investigation. This activity shows BioSense Platform’s potential as an additional syndromic surveillance tool because of its different classifications and keyword groupings.●Evaluation and Performance Measures at the Utah Department of HealthSyndromic surveillance related evaluation activities at the Utah Department of Health requires collaboration between subject matter experts and system users from the UT-NSSP workgroup. The progress is examined quarterly and outcomes compared with the short-, mid-, and long-term outcomes listed in the NSSP logic model to ensure activities are in sync with the program’s overall goals. Throughout the budget year, a variety of tools were used to keep track of the progress. During this session, challenges and successes, lessons learned, and effective strategies will be discussed.●NSSP R tool Data Download Useful in NHThe New Hampshire Department of Health and Human Services (NH DHHS) uses the state-wide Automated Hospital Emergency Department Data (AHEDD) system as its primary syndromic surveillance system. A copy of this data is submitted to CDC’s NSSP BioSense Platform. In July of 2017, NH worked with the NSSP vendor, CDC staff, a jurisdictional expert, NH Division of Information Technology staff, and an external vendor to create an “R” software download in CSV format and home-based NSSP Cognos report. This allowed NH DHHS staff to compare these data to the home-based data and ultimately, it proved to be an important step in the NSSP data quality assessment process.●Achieving success to improve data quality through collaborative Community of Practice partnerships The Data Quality Committee is a forum to identify, discuss, and attempt to address syndromic surveillance data quality issues. Maintaining data quality for the chief complaint field is a priority as it can impact the creation and refinement in the successful application of a syndrome definition for one of the fundamental data elements. An issue was observed in the Arizona data in the BioSense Platform, where chief complaint was being truncated at 200 characters. Through efforts to build relationships from the committee in the Community of Practice, Arizona was able to discover the root causes for the issue, assess if it affected other jurisdictions, and work with the partners to find a feasible resolution. This talk will discuss how this collaborative approach helped improve data quality.How the Moderator Intends to Engage the Audience in Discussions on the Topic: The moderator will introduce the session and the panelists, and will invite questions and comments from the audience.

Precursors of instability in a natural slope due to rainfall: a full-scale experiment

A full-scale landslide-triggering experiment was conducted on a natural sandy slope subjected to an artificial rainfall event, which resulted in mobilisation of 130 m3 of soil mass. Novel slope deformation sensors (SDSs) were applied to monitor the subsurface pre-failure movements and the precursors of the artificially triggered landslide. These fully automated sensors are more flexible than the conventional inclinometers by several orders of magnitude and therefore are able to detect fine movements (< 1 mm) of the soil mass reliably. Data from high-frequency measurements of the external bending work, indicating the transmitted energy from the surrounding soil to these sensors, pore water pressure at various depths, horizontal soil pressure and advanced surface monitoring techniques, contributed to an integrated analysis of the processes that led to triggering of the landslide. Precursors of movements were detected before the failure using the horizontal earth pressure measurements, as well as surface and subsurface movement records. The measurements showed accelerating increases of the horizontal earth pressure in the compression zone of the unstable area and external bending work applied to the slope deformation sensors. These data are compared to the pore water pressure and volumetric water content changes leading to failure.

How should we monitor patients with acute respiratory failure treated with noninvasive ventilation?

Noninvasive ventilation (NIV) is currently one of the most commonly used support methods in hypoxaemic and hypercapnic acute respiratory failure (ARF). With advancing technology and increasing experience, not only are indications for NIV getting broader, but more severe patients are treated with NIV. Depending on disease type and clinical status, NIV can be applied both in the general ward and in high-dependency/intensive care unit settings with different environmental opportunities. However, it is important to remember that patients with ARF are always very fragile with possible high mortality risk. The delay in recognition of unresponsiveness to NIV, progression of respiratory failure or new-onset complications may result in devastating and fatal outcomes. Therefore, it is crucial to understand that timely action taken according to monitoring variables is one of the key elements for NIV success. The purpose of this review is to outline basic and advanced monitoring techniques for NIV during an ARF episode.