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The numbers of providers in need of EHR replacement is growing in 2014. They are not sure if their current health IT system is capable of handling healthcare changes including, stage 2 Meaningful Use and ICD-10 compliance. goo.gl/34dRDh
http://bloomingtonford.com/inventory/newsearch/New/ | Whether you are looking for style, fuel efficiency, top speeds, high-tech gadgets, eco-friendly components or deluxe safety features Ford’s 2015 models won’t disappoint. We cruise through some of the most popular cars in America and highlight some of the amazing features.
[b] If clutch contact face is scored or worn, the flywheel may be refaced. [c] If clutch contact face is cracked, the flywheel must be replaced. NOTE: Do not remove more than 0.508 mm (0.020 in.) material from the flywheel. Maintain all of the radii when resurfacing. 2. Inspect the ring gear. [a] Check ring gear for excessively worn or damaged gear teeth. [b] If damaged gear teeth are detected, replace the ring gear. Refer to Section 1.15.3. 3. Inspect crankshaft and flywheel contact surface. [a] Check the butt end of the crankshaft and flywheel contact surface for fretting, brinelling, or burrs. See Figure 1-212. [b] Lightly stone the contact surface to remove any fretting, brinelling, or burrs. Figure 1-212 1.14.3 Crankshaft and Flywheel Mating Surfaces Installation of Flywheel Install the flywheel as follows: 1. Install two flywheel guide studs, J 36235, into two of the tapped holes in the crankshaft at the 3 and 9 o’clock position. 2. Attach the flywheel lifting tool and, using a chain hoist, position the flywheel in the flywheel housing. Align the flywheel bolt holes with the crankshaft bolt holes. All information subject to change without notice. (Rev. 2004) 6SE50 0403 Copyright © 2004 DETROIT DIESEL CORPORATION From Bulletin 2-50-04 1-261 1.14 FLYWHEEL NOTICE: A new scuff plate must be used whenever the flywheel is removed. Failure to replace the scuff plate may cause the flywheel bolts to loosen, even when torqued correctly. 3. Using a new scuff plate, install two bolts with International Compound #2® (or equivalent) through the plate 180 from each other. 4. Install the flywheel lock, J 36375–A. See Figure 1-195. 5. Remove the flywheel lifting tool and guide studs. 6. Apply International Compound #2® (or equivalent) to the threads and to the bolt head contact area (underside) of the remaining bolts. The bolt threads must be completely filled with International Compound #2® (or equivalent). Any excess must be wiped off. See Figure 1-213.
Additional service information is available in the Detroit Diesel Series 60 Service Manual, 6SE483. The next revision to this manual will include the revised information. As a convenience to holders of the Series 60 Service Manual, information in service manual format is attached. The page(s) may be inserted into the manual. NOTE: Manual insert pages are numbered for insertion into the current Series 60 Service Manual dated January 2004. Service manuals are available from authorized Detroit Diesel distributors. If this bulletin was obtained from the Internet, service manual page(s) are available by returning to the screen “SIB Index”, selecting attachment pages, and printing the page(s). Detroit Diesel®, DDC®, Series 60® and the spinning arrows design are registered trademarks of Detroit Diesel Corporation. © Copyright 2004 Detroit Diesel Corporation. All rights reserved. Printed in U.S.A.
The major cause of clutch failure is excessive heat. Excessive heat generated between the flywheel, driven discs, intermediate plate and pressure plate can cause the metal to flow and the material to be destroyed. If this occurs, the clutch can burst which can cause property damage, serious bodily injury or death. In order to prevent clutch failure resulting from excessive heat: 1. Do not exceed recommended vehicle loads. 2. The clutch should only be used for the recommended applications. 3. Drivers should be properly trained in starting, shifting and operation of the clutch. 4. Drivers should report erratic clutch operation as soon as possible to permit maintenance personnel to inspect, adjust or lubricate as required. 5. The removal and installation procedure described for each component may vary for your vehicle. For Solo and Heavy-Duty ECA clutches only, install shipping bolts before removing clutch assembly from the flywheel. IMPORTANT For service information and assistance, call the Roadranger Help Desk at 1-800-826-HELP (4357) (Mexico: 01-800-826HELP (4357). You may also find more information about Eaton Clutches at www.Roadranger.com. Mechanics must be familiar with proper clutch adjustment, linkage adjustment, lubrication and other maintenance troubleshooting procedures outlined in the Failure Analysis Guide. Every effort has been made to ensure the accuracy of the information contained in this manual. However, Eaton Corporation makes no warranty, expressed or implied, based on the information provided.
The crankshaft is precision-forged with seven main bearings and eight custom-forged counter weights, and a vibration damper at the front end. For an exploded view of the crankshaft, main bearings, and main bearing caps, see Figure 1-42. 1. Crankshaft 5. Lower Bearing Shell (center) 2. Upper Bearing Shell(s) 6. Main Bearing Cap(s) 3. Upper Bearing Shell (center) 7. Main Bearing Cap (center) 4. Lower Bearing Shell(s) 8. Main Bearing Cap Bolt Figure 1-42 Crankshaft, Main Bearings, and Main Bearing Caps All information subject to change without notice. (Rev. 3/04) 6SE412 0403 Copyright © 2006 DETROIT DIESEL CORPORATION From Bulletin 1–MBE4000–06 1-57 1.9 CRANKSHAFT ASSEMBLY 1.9.1 Crankshaft Removal Remove the crankshaft as follows: FALLING ENGINE To avoid injury from a falling engine, an adequate lifting device with a spreader bar and sling should be used to lift the engine. The sling and spreader bar should be adjusted so the lifting hooks are vertical to prevent bending the lifter brackets. To ensure proper weight distribution, all provided lifter brackets must be used. NOTICE: A spreader bar must be used at all times in conjunction with the front and rear lifter brackets to lift the EGR engine to ensure that no engine damage will result. The brackets are designed to lift vertically. 1. Remove the engine from the vehicle.
Emergency Department Visits for Chest Pain and Abdominal Pain: United States, 1999–2008 Farida A. Bhuiya, M.P.H.; Stephen R. Pitts, M.D., M.P.H., F.A.C.E.P.; and Linda F. McCaig, M.P.H., Division of Health Care Statistics Key findings Data from the National Hospital Ambulatory Medical Care Survey: 1999–2008 • The number of noninjury emergency department (ED) visits in which abdominal pain was the primary reason for the visit increased 31.8%. • The percentage of ED visits for which chest pain was the primary reason decreased 10.0%. • Use of advanced medical imaging increased strongly for ED visits related to abdominal pain (122.6%) and chest pain (367.6%). Chest and abdominal pain are the most common reasons that persons aged 15 years and over visit the emergency department (ED) (1). Because EDs provide both emergency and nonemergency care (2,3), visits for these symptoms may vary in their acuity. Advanced medical imaging is often ordered to assist in both diagnosing and ruling out serious illness associated with these symptoms (4,5). This report describes trends in visits for chest and abdominal pain in adults and the seriousness of illness and use of imaging in these visits. All data shown are for persons aged 18 and over whose visit was not injury related. Keywords: National Hospital Ambulatory Medical Care Survey • advanced medical imaging • reason for visit Are ED visits for chest or abdominal pain increasing?
Many organizations today would seemingly be content with having achieved an information architecture that features a broad-scope enterprise resource management environment feeding data in batch for reporting and analytics to a robust data warehouse environment. As a bonus, the data warehouses in this post-operational environment may consist of solid-state components and automated archival abilities. Irreversibly, the environment also has been inundated with data marts fed from original source and from the data warehouse itself. There is frequently a multidimensional database in the mix. Or a hundred. If there is any contentment with such an architecture, it will be short-lived. With information the “new gold” for companies, each shop must do everything it can to nurture, protect, make available and otherwise exploit the information asset. This will frequently mean venturing into new technology domains for the management of the asset. One may be tempted to consider the NoSQL movement as the epitome of these new technology domains. However, many possibilities have been laid on the table by the vendor community in the years prior to NoSQL. Most have merit in an enterprise today. We clearly need to get away from the winner-take-all mentality where every workload – sometimes whether it is analytical or operational – will be solved the same way as the last one. Frequently, that way was with a data integration operation with the data warehouse followed by the deployment of more reports in the business intelligence tool. Force-fitting a workload into a technology that it was not designed for creates more problems than it solves.
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