Modeling of a Sequential Two-Stage Combustor

NASA Technical Reports Server (NTRS)

Hendricks, R. C.; Liu, N.-S.; Gallagher, J. R.; Ryder, R. C.; Brankovic, A.; Hendricks, J. A.

2005-01-01

A sequential two-stage, natural gas fueled power generation combustion system is modeled to examine the fundamental aerodynamic and combustion characteristics of the system. The modeling methodology includes CAD-based geometry definition, and combustion computational fluid dynamics analysis. Graphical analysis is used to examine the complex vortical patterns in each component, identifying sources of pressure loss. The simulations demonstrate the importance of including the rotating high-pressure turbine blades in the computation, as this results in direct computation of combustion within the first turbine stage, and accurate simulation of the flow in the second combustion stage. The direct computation of hot-streaks through the rotating high-pressure turbine stage leads to improved understanding of the aerodynamic relationships between the primary and secondary combustors and the turbomachinery.

Advanced High Pressure O2/H2 Technology

NASA Technical Reports Server (NTRS)

Morea, S. F. (Editor); Wu, S. T. (Editor)

1985-01-01

Activities in the development of advanced high pressure oxygen-hydrogen stage combustion rocket engines are reported. Particular emphasis is given to the Space Shuttle main engine. The areas of engine technology discussed include fracture and fatigue in engine components, manufacturing and producibility engineering, materials, bearing technology, structure dynamics, fluid dynamics, and instrumentation technology.

Two stage indirect evaporative cooling system

DOEpatents

Bourne, Richard C.; Lee, Brian E.; Callaway, Duncan

2005-08-23

A two stage indirect evaporative cooler that moves air from a blower mounted above the unit, vertically downward into dry air passages in an indirect stage and turns the air flow horizontally before leaving the indirect stage. After leaving the dry passages, a major air portion travels into the direct stage and the remainder of the air is induced by a pressure drop in the direct stage to turn 180.degree. and returns horizontally through wet passages in the indirect stage and out of the unit as exhaust air.

High cost of stage IV pressure ulcers.

PubMed

Brem, Harold; Maggi, Jason; Nierman, David; Rolnitzky, Linda; Bell, David; Rennert, Robert; Golinko, Michael; Yan, Alan; Lyder, Courtney; Vladeck, Bruce

2010-10-01

The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and analyzed. Costs directly related to the treatment of pressure ulcers and their associated complications were calculated. Nineteen patients with stage IV pressure ulcers (11 hospital-acquired and 8 community-acquired) were identified and their charts were reviewed. The average hospital treatment cost associated with stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers during 1 admission, and $124,327 for community-acquired ulcers over an average of 4 admissions. The costs incurred from stage IV pressure ulcers are much greater than previously estimated. Halting the progression of early stage pressure ulcers has the potential to eradicate enormous pain and suffering, save thousands of lives, and reduce health care expenditures by millions of dollars. Copyright © 2010 Elsevier Inc. All rights reserved.

Pressure ulcer prevention in patients with advanced illness.

PubMed

White-Chu, E Foy; Reddy, Madhuri

2013-03-01

Pressure ulcers can be challenging to prevent, particularly in patients with advanced illnesses. This review summarizes the relevant literature since 2011. Through a MEDLINE and CINAHL database search from January 1, 2011 to June 1, 2012, a total of 14 abstracts were found addressing the prevention of pressure ulcers in persons with advanced illness. Search terms included pressure ulcer, prevention, and control. Advanced illness was defined as patients transitioning from curative to supportive and palliative care. Ten original studies and four review articles specifically addressed pressure ulcer prevention. There were four articles that specifically addressed patients with advanced illness. The studies varied in quality. One systematic review, one randomized controlled trial, three prospective trials, two retrospective trials, one cost-effectiveness analysis, one quality improvement project, one comparative descriptive design, and four review articles were found. The interventions for pressure ulcer prevention were risk assessment, repositioning, surface selection, nutritional support and maintenance of skin integrity with or without incontinence. The quality of pressure ulcer prevention studies in persons with advanced illness is poor. Increased number and higher quality studies are needed to further investigate this important topic for these fragile patients.

Pressure ulcer-related pelvic osteomyelitis: evaluation of a two-stage surgical strategy (debridement, negative pressure therapy and flap coverage) with prolonged antimicrobial therapy.

PubMed

Andrianasolo, Johan; Ferry, Tristan; Boucher, Fabien; Chateau, Joseph; Shipkov, Hristo; Daoud, Fatiha; Braun, Evelyne; Triffault-Fillit, Claire; Perpoint, Thomas; Laurent, Frédéric; Mojallal, Alain-Ali; Chidiac, Christian; Valour, Florent

2018-04-10

A two-stage surgical strategy (debridement-negative pressure therapy (NPT) and flap coverage) with prolonged antimicrobial therapy is usually proposed in pressure ulcer-related pelvic osteomyelitis but has not been widely evaluated. Adult patients with pressure ulcer-related pelvic osteomyelitis treated by a two-stage surgical strategy were included in a retrospective cohort study. Determinants of superinfection (i.e., additional microbiological findings at reconstruction) and treatment failure were assessed using binary logistic regression and Kaplan-Meier curve analysis. Sixty-four pressure ulcer-related pelvic osteomyelitis in 61 patients (age, 47 (IQR, 36-63)) were included. Osteomyelitis was mostly polymicrobial (73%), with a predominance of S. aureus (47%), Enterobacteriaceae spp. (44%) and anaerobes (44%). Flap coverage was performed after 7 (IQR, 5-10) weeks of NPT, with 43 (68%) positive bone samples among which 39 (91%) were superinfections, associated with a high ASA score (OR, 5.8; p = 0.022). An increased prevalence of coagulase negative staphylococci (p = 0.017) and Candida spp. (p = 0.003) was observed at time of flap coverage. An ESBL Enterobacteriaceae spp. was found in 5 (12%) patients, associated with fluoroquinolone consumption (OR, 32.4; p = 0.005). Treatment duration was as 20 (IQR, 14-27) weeks, including 11 (IQR, 8-15) after reconstruction. After a follow-up of 54 (IQR, 27-102) weeks, 15 (23%) failures were observed, associated with previous pressure ulcer (OR, 5.7; p = 0.025) and Actinomyces spp. infection (OR, 9.5; p = 0.027). Pressure ulcer-related pelvic osteomyelitis is a difficult-to-treat clinical condition, generating an important consumption of broad-spectrum antibiotics. The lack of correlation between outcome and the debridement-to-reconstruction interval argue for a short sequence to limit the total duration of treatment.

Fundal pressure during the second stage of labour.

PubMed

Hofmeyr, G Justus; Vogel, Joshua P; Cuthbert, Anna; Singata, Mandisa

2017-03-07

Fundal pressure during the second stage of labour (also known as the 'Kristeller manoeuvre') involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal, in an attempt to assist spontaneous vaginal birth and avoid prolonged second stage or the need for operative birth. Fundal pressure has also been applied using an inflatable belt. Fundal pressure is widely used, however methods of its use vary widely. Despite strongly held opinions in favour of and against the use of fundal pressure, there is limited evidence regarding its maternal and neonatal benefits and harms. There is a need for objective evaluation of the effectiveness and safety of fundal pressure in the second stage of labour. To determine if fundal pressure is effective in achieving spontaneous vaginal birth, and preventing prolonged second stage or the need for operative birth, and to explore maternal and neonatal adverse effects related to fundal pressure. We searched Cochrane Pregnancy and Childbirth's Trials Register (30 November 2016) and reference lists of retrieved studies. Randomised and quasi-randomised controlled trials of fundal pressure (manual or by inflatable belt) versus no fundal pressure in women in the second stage of labour with singleton cephalic presentation. Two or more review authors independently assessed potential studies for inclusion and quality. We extracted data using a pre-designed form. We entered data into Review Manager 5 software and checked for accuracy. Nine trials are included in this updated review. Five trials (3057 women) compared manual fundal pressure versus no fundal pressure. Four trials (891 women) compared fundal pressure by means of an inflatable belt versus no fundal pressure. It was not possible to blind women and staff to this intervention. We assessed two trials as being at high risk of attrition bias and another at high risk of reporting bias. All other trials were low or unclear for other risk of bias

Performance of two-stage fan with larger dampers on first-stage rotor

NASA Technical Reports Server (NTRS)

Urasek, D. C.; Cunnan, W. S.; Stevans, W.

1979-01-01

The performance of a two stage, high pressure-ratio fan, having large, part-span vibration dampers on the first stage rotor is presented and compared with an identical aerodynamically designed fan having smaller dampers. Comparisons of the data for the two damper configurations show that with increased damper size: (1) very high losses in the damper region reduced overall efficiency of first stage rotor by approximately 3 points, (2) the overall performance of each blade row, downstream of the damper was not significantly altered, although appreciable differences in the radial distributions of various performance parameters were noted, and (3) the lower performance of the first stage rotor decreased the overall fan efficiency more than 1 percentage point.

Fundal pressure during the second stage of labour.

PubMed

Verheijen, Evelyn C; Raven, Joanna H; Hofmeyr, G Justus

2009-10-07

Fundal pressure during the second stage of labour involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal in an attempt to assist spontaneous vaginal delivery and avoid prolonged second stage or the need for operative delivery. Fundal pressure has also been applied using an inflatable girdle. A survey in the United States found that 84% of the respondents used fundal pressure in their obstetric centres.There is little evidence to demonstrate that the use of fundal pressure is effective to improve maternal and/or neonatal outcomes. Several anecdotal reports suggest that fundal pressure is associated with maternal and neonatal complications: for example, uterine rupture, neonatal fractures and brain damage. There is a need for objective evaluation of the effectiveness and safety of fundal pressure in the second stage of labour. To determine the benefits and adverse effects of fundal pressure in the second stage of labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). Randomised and quasi-randomised controlled trials of fundal pressure versus no fundal pressure in women in the second stage of labour with singleton cephalic presentation. Three review authors independently assessed for inclusion all the potential studies. We extracted the data using a pre-designed form. We entered data into Review Manager software and checked for accuracy. We excluded two of three identified trials from the analyses for methodological reasons. This left no studies on manual fundal pressure. We included one study (500 women) of fundal pressure by means of an inflatable belt versus no fundal pressure to reduce operative delivery rates. The methodological quality of the included study was good.Use of the inflatable belt did not change the rate of operative deliveries (RR 0.94, 95% CI 0.80 to 1.11). Fetal outcomes in terms of five-minute Apgar scores below seven (RR 4.62, 95% CI 0.22 to 95

Staging laparoscopy improves treatment decision-making for advanced gastric cancer.

PubMed

Hu, Yan-Feng; Deng, Zhen-Wei; Liu, Hao; Mou, Ting-Yu; Chen, Tao; Lu, Xin; Wang, Da; Yu, Jiang; Li, Guo-Xin

2016-02-07

To evaluate the clinical value of staging laparoscopy in treatment decision-making for advanced gastric cancer (GC). Clinical data of 582 patients with advanced GC were retrospectively analyzed. All patients underwent staging laparoscopy. The strength of agreement between computed tomography (CT) stage, endoscopic ultrasound (EUS) stage, laparoscopic stage, and final stage were determined by weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted. A χ(2) test was used to analyze the correlation between peritoneal metastasis or positive cytology and clinical characteristics. Among the 582 patients, the distributions of pathological T classifications were T2/3 (153, 26.3%), T4a (262, 45.0%), and T4b (167, 28.7%). Treatment plans for 211 (36.3%) patients were changed after staging laparoscopy was performed. Two (10.5%) of 19 patients in M1 regained the opportunity for potential radical resection by staging laparoscopy. Unnecessary laparotomy was avoided in 71 (12.2%) patients. The strength of agreement between preoperative T stage and final T stage was in almost perfect agreement (Kw = 0.838; 95% confidence interval (CI): 0.803-0.872; P < 0.05) for staging laparoscopy; compared with CT and EUS, which was in fair agreement. The strength of agreement between preoperative M stage and final M stage was in almost perfect agreement (Kw = 0.990; 95% CI: 0.977-1.000; P < 0.05) for staging laparoscopy; compared with CT, which was in slight agreement. Multivariate analysis revealed that tumor size (≥ 40 mm), depth of tumor invasion (T4b), and Borrmann type (III or IV) were significantly correlated with either peritoneal metastasis or positive cytology. The best performance in diagnosing P-positive was obtained when two or three risk factors existed. Staging laparoscopy can improve treatment decision-making for advanced GC and decrease unnecessary exploratory laparotomy.

Pressure, stress, and strain distribution in the double-stage diamond anvil cell

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lobanov, Sergey S., E-mail: slobanov@carnegiescience.edu; V.S. Sobolev Institute of Geology and Mineralogy SB RAS, Novosibirsk 630090; Prakapenka, Vitali B.

Double stage diamond anvil cells (DACs) of two designs have been assembled and tested. We used a standard symmetric DAC with flat or beveled culets as a primary stage and CVD microanvils machined by a focused ion beam as a second. We evaluated pressure, stress, and strain distributions in gold and a mixture of gold and iron as well as in secondary anvils using synchrotron x-ray diffraction with a micro-focused beam. A maximum pressure of 240 GPa was reached independent of the first stage anvil culet size. We found that the stress field generated by the second stage anvils is typicalmore » of conventional DAC experiments. The maximum pressures reached are limited by strains developing in the secondary anvil and by cupping of the first stage diamond anvil in the presented experimental designs. Also, our experiments show that pressures of several megabars may be reached without sacrificing the first stage diamond anvils.« less

Ares I Upper Stage Pressure Tests in Wind Tunnel

NASA Technical Reports Server (NTRS)

2007-01-01

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, the first stage reentry 1/2% model is undergoing pressure measurements inside the wind tunnel testing facility at MSFC. (Highest resolution available)

Advanced research and technology program for advanced high pressure oxygen-hydrogen rocket propulsion

NASA Technical Reports Server (NTRS)

Marsik, S. J.; Morea, S. F.

1985-01-01

A research and technology program for advanced high pressure, oxygen-hydrogen rocket propulsion technology is presently being pursued by the National Aeronautics and Space Administration (NASA) to establish the basic discipline technologies, develop the analytical tools, and establish the data base necessary for an orderly evolution of the staged combustion reusable rocket engine. The need for the program is based on the premise that the USA will depend on the Shuttle and its derivative versions as its principal Earth-to-orbit transportation system for the next 20 to 30 yr. The program is focused in three principal areas of enhancement: (1) life extension, (2) performance, and (3) operations and diagnosis. Within the technological disciplines the efforts include: rotordynamics, structural dynamics, fluid and gas dynamics, materials fatigue/fracture/life, turbomachinery fluid mechanics, ignition/combustion processes, manufacturing/producibility/nondestructive evaluation methods and materials development/evaluation. An overview of the Advanced High Pressure Oxygen-Hydrogen Rocket Propulsion Technology Program Structure and Working Groups objectives are presented with highlights of several significant achievements.

Advanced research and technology programs for advanced high-pressure oxygen-hydrogen rocket propulsion

NASA Technical Reports Server (NTRS)

Marsik, S. J.; Morea, S. F.

1985-01-01

A research and technology program for advanced high pressure, oxygen-hydrogen rocket propulsion technology is presently being pursued by the National Aeronautics and Space Administration (NASA) to establish the basic discipline technologies, develop the analytical tools, and establish the data base necessary for an orderly evolution of the staged combustion reusable rocket engine. The need for the program is based on the premise that the USA will depend on the Shuttle and its derivative versions as its principal Earth-to-orbit transportation system for the next 20 to 30 yr. The program is focused in three principal areas of enhancement: (1) life extension, (2) performance, and (3) operations and diagnosis. Within the technological disciplines the efforts include: rotordynamics, structural dynamics, fluid and gas dynamics, materials fatigue/fracture/life, turbomachinery fluid mechanics, ignition/combustion processes, manufacturing/producibility/nondestructive evaluation methods and materials development/evaluation. An overview of the Advanced High Pressure Oxygen-Hydrogen Rocket Propulsion Technology Program Structure and Working Groups objectives are presented with highlights of several significant achievements.

Advanced research and technology programs for advanced high-pressure oxygen-hydrogen rocket propulsion

NASA Astrophysics Data System (ADS)

Marsik, S. J.; Morea, S. F.

1985-03-01

A research and technology program for advanced high pressure, oxygen-hydrogen rocket propulsion technology is presently being pursued by the National Aeronautics and Space Administration (NASA) to establish the basic discipline technologies, develop the analytical tools, and establish the data base necessary for an orderly evolution of the staged combustion reusable rocket engine. The need for the program is based on the premise that the USA will depend on the Shuttle and its derivative versions as its principal Earth-to-orbit transportation system for the next 20 to 30 yr. The program is focused in three principal areas of enhancement: (1) life extension, (2) performance, and (3) operations and diagnosis. Within the technological disciplines the efforts include: rotordynamics, structural dynamics, fluid and gas dynamics, materials fatigue/fracture/life, turbomachinery fluid mechanics, ignition/combustion processes, manufacturing/producibility/nondestructive evaluation methods and materials development/evaluation. An overview of the Advanced High Pressure Oxygen-Hydrogen Rocket Propulsion Technology Program Structure and Working Groups objectives are presented with highlights of several significant achievements.

Use of leaning vanes in a two stage fan

NASA Technical Reports Server (NTRS)

Rao, G. V. R.; Digumarthi, R. V.

1975-01-01

The use of leaning vanes for tone noise reduction was examined in terms of their application in a typical two-stage high pressure ratio fan. In particular for stages designed with outlet guide vanes and zero swirl between stages, leaning the vanes of the first stage stator was studied, since increasing the number of vanes and the gap between stages do not provide the desired advantage. It was shown that noise reduction at higher harmonics of blade passing frequency can be obtained by leaning the vanes.

Staged, High-Pressure Oxy-Combustion Technology: Development and Scale-Up

DOE Office of Scientific and Technical Information (OSTI.GOV)

Axelbaum, Richard; Kumfer, Benjamin; Gopan, Akshay

The immediate need for a high efficiency, low cost carbon capture process has prompted the recent development of pressurized oxy-combustion. With a greater combustion pressure the dew point of the flue gas is increased, allowing for effective integration of the latent heat of flue gas moisture into the Rankine cycle. This increases the net plant efficiency and reduces costs. A novel, transformational process, named Staged, Pressurized Oxy-Combustion (SPOC), achieves additional step changes in efficiency and cost reduction by significantly reducing the recycle of flue gas. The research and development activities conducted under Phases I and II of this project (FE0009702)more » include: SPOC power plant cost and performance modeling, CFD-assisted design of pressurized SPOC boilers, theoretical analysis of radiant heat transfer and ash deposition, boiler materials corrosion testing, construction of a 100 kWth POC test facility, and experimental testing. The results of this project have advanced the technology readiness level (TRL) of the SPOC technology from 1 to 5.« less

Investigation on a thermal-coupled two-stage Stirling-type pulse tube cryocooler

NASA Astrophysics Data System (ADS)

Yang, Luwei

2008-11-01

Multi-stage Stirling-type pulse tube cryocoolers with high frequency (30-60 Hz) are one important direction in recent years. A two-stage Stirling-type pulse tube cryocooler with thermally coupled stages has been designed and established two years ago and some results have been published. In order to study the effect of first stage precooling temperature, related characteristics on performance are experimentally investigated. It shows that at high input power, when the precooling temperature is lower than 110 K, its effect on second stage temperature is quite small. There is also the evident effect of precooling temperature on pulse tube temperature distribution; this is for the first time that author notice the phenomenon. The mean working pressure is investigated and the 12.8 K lowest temperature with 500 W input power and 1.22 MPa average pressure have been gained, this is the lowest reported temperature for high frequency two-stage PTCS. Simulation has reflected upper mentioned typical features in experiments.

Staging properties of potassium-ammonia ternary graphite intercalation compounds at high ammonia pressure

NASA Astrophysics Data System (ADS)

Qian, X. W.; Solin, S. A.

1989-04-01

The pressure dependence of the (00l) x-ray diffraction patterns of the ternary graphite intercalation compound K(NH3)xC24 has been studied in the range 0.5-11 kbar (for which x~4.5) using a diamond anvil cell. A special apparatus for loading the cell with liquid ammonia at room temperature has been constructed and is briefly described. In these experiments, the pressure-transmitting fluid was also an intercalant, namely ammonia. Therefore, the chemical potential of this species was linearly coupled to the applied pressure in contrast to the usual case where the pressure-transmitting fluid is chemically passive. The pressure dependences of the basal spacings and of the relative intensities of key reflections have been measured, as have the compressibilities of the stage-1 and stage-2 components of the two-phase system. Basal-spacing anomalies and anomalies in the relative intensities occur at pressures of ~3.5 and 8.0 kbar and are tentatively attributed to in-plane coordination changes in the potassium-ammonia ratio. Using thermodynamic arguments and Le Chatelier's principle we show quantitatively that a staging phase transition from pure stage-1 phase to an admixture of stage-1 and stage-2 is expected with increased pressure above 10 bar in agreement with experiment. The saturation ammonia compositions (x values) of the admixed stages are found to be 4.5 and 5.4 for the stage-1 and -2 components, respectively. This result is interpreted as evidence that the composition is not sterically limited but is determined by the binding energy of ammonia for potassium and by the perturbation to this energy from the guest-host interaction.

Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer.

PubMed

Grob, Charles S; Danforth, Alicia L; Chopra, Gurpreet S; Hagerty, Marycie; McKay, Charles R; Halberstadt, Adam L; Greer, George R

2011-01-01

Researchers conducted extensive investigations of hallucinogens in the 1950s and 1960s. By the early 1970s, however, political and cultural pressures forced the cessation of all projects. This investigation reexamines a potentially promising clinical application of hallucinogens in the treatment of anxiety reactive to advanced-stage cancer. To explore the safety and efficacy of psilocybin in patients with advanced-stage cancer and reactive anxiety. A double-blind, placebo-controlled study of patients with advanced-stage cancer and anxiety, with subjects acting as their own control, using a moderate dose (0.2 mg/kg) of psilocybin. A clinical research unit within a large public sector academic medical center. Twelve adults with advanced-stage cancer and anxiety. In addition to monitoring safety and subjective experience before and during experimental treatment sessions, follow-up data including results from the Beck Depression Inventory, Profile of Mood States, and State-Trait Anxiety Inventory were collected unblinded for 6 months after treatment. Safe physiological and psychological responses were documented during treatment sessions. There were no clinically significant adverse events with psilocybin. The State-Trait Anxiety Inventory trait anxiety subscale demonstrated a significant reduction in anxiety at 1 and 3 months after treatment. The Beck Depression Inventory revealed an improvement of mood that reached significance at 6 months; the Profile of Mood States identified mood improvement after treatment with psilocybin that approached but did not reach significance. This study established the feasibility and safety of administering moderate doses of psilocybin to patients with advanced-stage cancer and anxiety. Some of the data revealed a positive trend toward improved mood and anxiety. These results support the need for more research in this long-neglected field. clinicaltrials.gov Identifier: NCT00302744.

The advanced-stage therapy group.

PubMed

Berman, A; Weinberg, H

1998-10-01

Many authors describe a stage of maturity in the development of groups, but each highlights a different dimension. This article describes the characteristics of the advanced stage and the main axes along which it develops (internalization and containment, symbolization, self and self-other development, differentiation and individuation). It also offers a conceptual explanation for these developments and attempts to identify the conditions necessary for the emergence of this stage of maturity. An understanding of this stage and the conditions required for its development can be used by the group leader as a compass to help him or her navigate the group toward this objective.

Pulsations Induced by Vibrations in Aircraft Engine Two-Stage Pump

NASA Astrophysics Data System (ADS)

Gafurov, S. A.; Salmina, V. A.; Handroos, H.

2018-01-01

This paper describes a phenomenon of induced pressure pulsations inside a two-stage aircraft engine pump. A considered pumps consists of a screw-centrifugal and gear stages. The paper describes the cause of two-stage pump elements loading. A number of hypothesis of pressure pulsations generation inside a pump were considered. The main focus in this consideration is made on phenomena that are not related to pump mode of operation. Provided analysis has shown that pump vibrations as well as pump elements self-oscillations are the main causes that lead to trailing vortices generation. Analysis was conducted by means FEM and CFD simulations as well by means of experimental investigations to obtain natural frequencies and flow structure inside a screw-centrifugal stage. To perform accurate simulations adequate boundary conditions were considered. Cavitation and turbulence phenomena have been also taken into account. Obtained results have shown generated trailing vortices lead to high-frequency loading of the impeller of screw-centrifugal stage and can be a cause of the bearing damage.

Two-stage autoignition and edge flames in a high pressure turbulent jet

DOE PAGES

Krisman, Alex; Hawkes, Evatt R.; Chen, Jacqueline H.

2017-07-04

A three-dimensional direct numerical simulation is conducted for a temporally evolving planar jet of n-heptane at a pressure of 40 atmospheres and in a coflow of air at 1100 K. At these conditions, n-heptane exhibits a two-stage ignition due to low- and high-temperature chemistry, which is reproduced by the global chemical model used in this study. The results show that ignition occurs in several overlapping stages and multiple modes of combustion are present. Low-temperature chemistry precedes the formation of multiple spatially localised high-temperature chemistry autoignition events, referred to as ‘kernels’. These kernels form within the shear layer and core ofmore » the jet at compositions with short homogeneous ignition delay times and in locations experiencing low scalar dissipation rates. An analysis of the kernel histories shows that the ignition delay time is correlated with the mixing rate history and that the ignition kernels tend to form in vortically dominated regions of the domain, as corroborated by an analysis of the topology of the velocity gradient tensor. Once ignited, the kernels grow rapidly and establish edge flames where they envelop the stoichiometric isosurface. A combination of kernel formation (autoignition) and the growth of existing burning surface (via edge-flame propagation) contributes to the overall ignition process. In conclusion, an analysis of propagation speeds evaluated on the burning surface suggests that although the edge-flame speed is promoted by the autoignitive conditions due to an increase in the local laminar flame speed, edge-flame propagation of existing burning surfaces (triggered initially by isolated autoignition kernels) is the dominant ignition mode in the present configuration.« less

Examination of the accuracy of coding hospital-acquired pressure ulcer stages.

PubMed

Coomer, Nicole M; McCall, Nancy T

2013-01-01

Pressure ulcers (PU) are considered harmful conditions that are reasonably prevented if accepted standards of care are followed. They became subject to the payment adjustment for hospitalacquired conditions (HACs) beginning October 1, 2008. We examined several aspects of the accuracy of coding for pressure ulcers under the Medicare Hospital-Acquired Condition Present on Admission (HAC-POA) Program. We used the "4010" claim format as a basis of reference to show some of the issues of the old format, such as the underreporting of pressure ulcer stages on pressure ulcer claims and how the underreporting varied by hospital characteristics. We then used the rate of Stage III and IV pressure ulcer HACs reported in the Hospital Cost and Utilization Project State Inpatient Databases data to look at the sensitivity of PU HAC-POA coding to the number of diagnosis fields. We examined Medicare claims data for FYs 2009 and 2010 to examine the degree that the presence of stage codes were underreported on pressure ulcer claims. We selected all claims with a secondary diagnosis code of pressure ulcer site (ICD-9 diagnosis codes 707.00-707.09) that were not reported as POA (POA of "N" or "U"). We then created a binary indicator for the presence of any pressure ulcer stage diagnosis code. We examine the percentage of claims with a diagnosis of a pressure ulcer site code with no accompanying pressure ulcer stage code. Our results point to underreporting of PU stages under the "4010" format and that the reporting of stage codes varied across hospital type and location. Further, our results indicate that under the "5010" format, a higher number of pressure ulcer HACs can be expected to be reported and we should expect to encounter a larger percentage of pressure ulcers incorrectly coded as POA under the new format. The combination of the capture of 25 diagnosis codes under the new "5010" format and the change from ICD-9 to ICD-10 will likely alleviate the observed underreporting of

Health-related quality-of-life outcomes: a reflexology trial with patients with advanced-stage breast cancer.

PubMed

Wyatt, Gwen; Sikorskii, Alla; Rahbar, Mohammad Hossein; Victorson, David; You, Mei

2012-11-01

To evaluate the safety and efficacy of reflexology, a complementary therapy that applies pressure to specific areas of the feet. Longitudinal, randomized clinical trial. Thirteen community-based medical oncology clinics across the midwestern United States. A convenience sample of 385 predominantly Caucasian women with advanced-stage breast cancer receiving chemotherapy and/or hormonal therapy. Following the baseline interview, women were randomized into three primary groups: reflexology (n = 95), lay foot manipulation (LFM) (n = 95), or conventional care (n = 96). Two preliminary reflexology (n = 51) and LFM (n = 48) test groups were used to establish the protocols. Participants were interviewed again postintervention at study weeks 5 and 11. Breast cancer-specific health-related quality of life (HRQOL), physical functioning, and symptoms. No adverse events were reported. A longitudinal comparison revealed significant improvements in physical functioning for the reflexology group compared to the control group (p = 0.04). Severity of dyspnea was reduced in the reflexology group compared to the control group (p < 0.01) and the LFM group (p = 0.02). No differences were found on breast cancer-specific HRQOL, depressive symptomatology, state anxiety, pain, and nausea. Reflexology may be added to existing evidence-based supportive care to improve HRQOL for patients with advanced-stage breast cancer during chemotherapy and/or hormonal therapy. Reflexology can be recommended for safety and usefulness in relieving dyspnea and enhancing functional status among women with advanced-stage breast cancer.

Experimental Investigation of a High Pressure Ratio Aspirated Fan Stage

NASA Technical Reports Server (NTRS)

Merchant, Ali; Kerrebrock, Jack L.; Adamczyk, John J.; Braunscheidel, Edward

2004-01-01

The experimental investigation of an aspirated fan stage designed to achieve a pressure ratio of 3.4:1 at 1500 ft/sec is presented in this paper. The low-energy viscous flow is aspirated from diffusion-limiting locations on the blades and flowpath surfaces of the stage, enabling a very high pressure ratio to be achieved in a single stage. The fan stage performance was mapped at various operating speeds from choke to stall in a compressor facility at fully simulated engine conditions. The experimentally determined stage performance, in terms of pressure ratio and corresponding inlet mass flow rate, was found to be in good agreement with the three-dimensional viscous computational prediction, and in turn close to the design intent. Stage pressure ratios exceeding 3:1 were achieved at design speed, with an aspiration flow fraction of 3.5 percent of the stage inlet mass flow. The experimental performance of the stage at various operating conditions, including detailed flowfield measurements, are presented and discussed in the context of the computational analyses. The sensitivity of the stage performance and operability to reduced aspiration flow rates at design and off design conditions are also discussed.

Single stage, low noise, advanced technology fan. Volume 5: Fan acoustics. Section 1: Results and analysis

NASA Technical Reports Server (NTRS)

Jutras, R. R.

1976-01-01

The acoustic tests and data analysis for a 0.508-scale fan vehicle of a 111,300 newton (25,000 pound) thrust, full-size engine, which would have application on an advanced transport aircraft, is described. The single-stage advanced technology fan was designed to a pressure ratio of 1.8 at a tip speed of 503 m/sec (1,650 ft/sec) to achieve the desired pressure ratio in a single-stage fan with low radius ratio (0.38), and to maintain adequate stall margin. The fan has 44 tip-shrouded rotor blades and 90 outlet guide vanes. The two basic approaches taken in the acoustic design were: (1) minimization of noise at the source, and (2) suppression of the generated noise in the inlet and bypass exhaust duct. Suppression of the generated noise was accomplished in the inlet through use of the hybrid concept (wall acoustic treatment plus airflow acceleration suppression) and in the exhaust duct with extensive acoustic treatment including a splitter. The goal of the design was attainment of twenty effective perceived noise decibels (20 EPNdB) below current Federal Air Regulation noise standards for a full-scale fan at the takeoff, cutback, and approach conditions. The suppression goal of FAR 36-20 was not reached, but improvements in the technology of both front and aft fan-noise suppression were realized. The suppressed fan noise was shown to be consistent with the proposed federal regulation on aircraft noise.

Techniques for measuring ultrahigh-pressure Hugoniot equation of state on a three-stage gas gun

NASA Astrophysics Data System (ADS)

Wang, Xiang; Hu, Jianbo; Dai, Chengda; Wang, Qiangsong; Bo, Jingsong; Tan, Hua; Yu, Yuying

2011-06-01

A three-stage gas gun was developed by mounting an extending launcher tube on a two-stage gas gun, and was successfully applied to perform ultrahigh-pressure Hugoniot measurements for Ta and Pt by using this three-stage gun. Here we introduced the three-stag gas gun launcher and Hugoniot measurement techniques, including shock front shape diagnosis, shock wave velocity and impact velocity measurement as well as numerical simulation. By using this three-stage gun, Ta or Pt impactors were launched up to ~10 km/s, and the Hugoniot data were respectively measured with high accuracy up to 750 GPa for Ta and 1TPa for Pt. It is demonstrated that the three-stage gas gun is a promising technique for studying the ultrahigh-pressure properties of materials, which never before obtained by utilizing two-stage light-gas-gun.

Propagation of solutes and pressure into aquifers following river stage rise

NASA Astrophysics Data System (ADS)

Welch, Chani; Cook, Peter G.; Harrington, Glenn A.; Robinson, Neville I.

2013-09-01

Water level rises associated with river flow events induce both pressure and solute movement into adjacent aquifers at vastly different rates. We present a simple analytical solution that relates the travel time and travel distance of solutes into an aquifer following river stage rise to aquifer properties. Combination with an existing solution for pressure propagation indicates that the ratio of solute to pressure travel times is proportional to the ratio of the volume of water stored in the aquifer before the river stage rise and the volume added by the stage rise and is independent of hydraulic conductivity. Two-dimensional numerical simulations of an aquifer slice perpendicular to a river demonstrate that the solutions are broadly applicable to variably saturated aquifers and partially penetrating rivers. The solutions remain applicable where river stage rise and fall occur, provided that regional hydraulic gradients are low and the duration of the river stage rise is less than pressure and solute travel times to the observation point in the aquifer. Consequently, the solutions provide new insight into the relationships between aquifer properties and distance and time of solute propagation and, in some cases, may be used to estimate system characteristics. Travel time metrics obtained for a flood event in the Cockburn River in eastern Australia using electrical conductivity measurements enabled estimates of aquifer properties and a lateral extent of river-aquifer mixing of 25 m. A detailed time series of any soluble tracer with distinctly different concentrations in river water and groundwater may be used.

Interior ballistics of a two-stage light gas gun using velocity interferometry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Munson, D.E.; May, R.P.

1976-02-01

An extensive interior ballistics study of a two-stage light gas gun was performed which resulted in a detailed measurement of the projectile velocity as a continuous function of time. The two-stage gun consisted of a 88.9-mm i.d. pump stage and a 28.6-mm i.d. launch stage. Five main parameters of gun operation, propellant mass, piston mass, pump gas, pump gas pressure, and projectile mass were varied in this study. Projectile velocities were measured using a very precise velocity interferometer for any reflecting surface (VISAR) technique. The measurements showed that the initial acceleration of the projectile is discontinuous due to the shockmore » nature of the applied pressure on the projectile upon rupture of the burst diaphragm. These shock accelerations are understood easily via simple shock-tube theory. 9 figures, 3 tables.« less

Health-Related Quality-of-Life Outcomes: A Reflexology Trial With Patients With Advanced-Stage Breast Cancer

PubMed Central

Wyatt, Gwen; Sikorskii, Alla; Rahbar, Mohammad Hossein; Victorson, David; You, Mei

2013-01-01

Purpose/Objectives To evaluate the safety and efficacy of reflexology, a complementary therapy that applies pressure to specific areas of the feet. Design Longitudinal, randomized clinical trial. Setting Thirteen community-based medical oncology clinics across the midwestern United States. Sample A convenience sample of 385 predominantly Caucasian women with advanced-stage breast cancer receiving chemotherapy and/or hormonal therapy. Methods Following the baseline interview, women were randomized into three primary groups: reflexology (n = 95), lay foot manipulation (LFM) (n = 95), or conventional care (n = 96). Two preliminary reflexology (n = 51) and LFM (n = 48) test groups were used to establish the protocols. Participants were interviewed again postintervention at study weeks 5 and 11. Main Research Variables Breast cancer–specific health-related quality of life (HRQOL), physical functioning, and symptoms. Findings No adverse events were reported. A longitudinal comparison revealed significant improvements in physical functioning for the reflexology group compared to the control group (p = 0.04). Severity of dyspnea was reduced in the reflexology group compared to the control group (p < 0.01) and the LFM group (p = 0.02). No differences were found on breast cancer–specific HRQOL, depressive symptomatology, state anxiety, pain, and nausea. Conclusions Reflexology may be added to existing evidence-based supportive care to improve HRQOL for patients with advanced-stage breast cancer during chemotherapy and/or hormonal therapy. Implications for Nursing Reflexology can be recommended for safety and usefulness in relieving dyspnea and enhancing functional status among women with advanced-stage breast cancer. PMID:23107851

Two-stage agglomeration of fine-grained herbal nettle waste

NASA Astrophysics Data System (ADS)

Obidziński, Sławomir; Joka, Magdalena; Fijoł, Olga

2017-10-01

This paper compares the densification work necessary for the pressure agglomeration of fine-grained dusty nettle waste, with the densification work involved in two-stage agglomeration of the same material. In the first stage, the material was pre-densified through coating with a binder material in the form of a 5% potato starch solution, and then subjected to pressure agglomeration. A number of tests were conducted to determine the effect of the moisture content in the nettle waste (15, 18 and 21%), as well as the process temperature (50, 70, 90°C) on the values of densification work and the density of the obtained pellets. For pre-densified pellets from a mixture of nettle waste and a starch solution, the conducted tests determined the effect of pellet particle size (1, 2, and 3 mm) and the process temperature (50, 70, 90°C) on the same values. On the basis of the tests, we concluded that the introduction of a binder material and the use of two-stage agglomeration in nettle waste densification resulted in increased densification work (as compared to the densification of nettle waste alone) and increased pellet density.

Single stage, low noise, advanced technology fan. Volume 5: Fan acoustics. Section 2: One-third octave data tabulations and selected narrowband traces

NASA Technical Reports Server (NTRS)

Jutras, R. R.

1976-01-01

The raw-acoustic data corrected to standard day, from acoustic tests performed on a 0.508-scale fan vehicle of a 111,300 newton thrust, full-size engine, which has application on an advanced transport aircraft, are presented. The single-stage advanced technology fan was designed to a pressure ratio of 1.8 at a tip speed of 503 m/sec to achieve the desired pressure ratio in a single-stage fan with low radius ratio, and to maintain adequate stall margin. The two basic approaches taken in the acoustic design were: (1) minimization of noise at the source, and (2) suppression of the generated noise in the inlet and bypass exhaust duct. Suppression of the generated noise was accomplished in the inlet through use of the hybrid concept (wall acoustic treatment plus airflow acceleration suppression) and in the exhaust duct with extensive acoustic treatment including a splitter. The goal of the design was attainment of twenty effective perceived noise decibels. The suppression goal of FAR 36-20 was not reached, but improvements in the technology of both front and aft fan-noise suppression were realized.

Multicenter comparison of the efficacy on prevention of pressure ulcer in postoperative patients between two types of pressure-relieving mattresses in China

PubMed Central

Jiang, Qixia; Li, Xiaohua; Zhang, Aiqin; Guo, Yanxia; Liu, Yahong; Liu, Haiying; Qu, Xiaolong; Zhu, Yajun; Guo, Xiujun; Liu, Li; Zhang, Liyan; Bo, Suping; Jia, Jing; Chen, Yuejuan; Zhang, Rui; Wang, Jiandong

2014-01-01

Objective: Present study is designed to evaluate the effects of preventing pressure ulcer in surgical patients with two types of pressure-relieving mattresses. Methods: 1074 surgical patients from 12 hospitals in China were divided into A group (static air mattress with repositioning every 2 hours, n = 562) and B group (power pressure air mattress with repositioning every 2 hours, n = 512). The patient was subjected to a pressure-relieving mattress and observed from 0-5 days after surgery. Indications include the Braden scores, hospital-acquired pressure ulcers (HAPU) incidence and stage. Results: The Braden scores between two groups in five days after surgery were no significant (P > 0.05). The incidence of HAPU between two groups in same days also was no significant (1.07% vs. 0.98%, P > 0.05). The incidence of Stage I and stage II pressure ulcers in group A and B were 1.07% (6/562) and 0.98% (5/512), respectively (χ2 = 0.148, P = 0.882). Conclusion: The effects of preventing pressure ulcer in surgical patients with two types of pressure-relieving mattresses are similar, but the protocol by static air mattress with repositioning every 2 hours is benefit when no power. PMID:25356144

The NIRIM two-stage light-gas gun: Performance test results

NASA Astrophysics Data System (ADS)

Sekine, T.; Tashiro, S.; Kobayashi, T.; Matsumura, T.

1996-05-01

A two-stage light-gun has been installed at the NIRIM in order to investigate the high pressure behavior of materials. For operation and safety test, we used helium and carried out performance test shots. Piston velocity in the pump tube and projectile velocity during free flight are measured by means of gas-pressure profile records at fixed locations and x-ray beam cutting method, respectively.

Effect of hydronephrosis on survival in advanced stage cervical cancer.

PubMed

Goklu, Mehmet Rıfat; Seckin, Kerem Doga; Togrul, Cihan; Goklu, Yasemin; Tahaoglu, Ali Emre; Oz, Murat; Ertas, Ibrahim Egemen

2015-01-01

Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant. The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (p<0.05). There was no significant survival difference between patients with unilateral and bilateral hydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (p<0.05). Hydronephrosis was found to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be

Porous media fracturing dynamics: stepwise crack advancement and fluid pressure oscillations

NASA Astrophysics Data System (ADS)

Cao, Toan D.; Hussain, Fazle; Schrefler, Bernhard A.

2018-02-01

We present new results explaining why fracturing in saturated porous media is not smooth and continuous but is a distinct stepwise process concomitant with fluid pressure oscillations. All exact solutions and almost all numerical models yield smooth fracture advancement and fluid pressure evolution, while recent experimental results, mainly from the oil industry, observation from geophysics and a very few numerical results for the quasi-static case indeed reveal the stepwise phenomenon. We summarize first these new experiments and these few numerical solutions for the quasi-static case. Both mechanical loading and pressure driven fractures are considered because their behaviours differ in the direction of the pressure jumps. Then we explore stepwise crack tip advancement and pressure fluctuations in dynamic fracturing with a hydro-mechanical model of porous media based on the Hybrid Mixture Theory. Full dynamic analyses of examples dealing with both hydraulic fracturing and mechanical loading are presented. The stepwise fracture advancement is confirmed in the dynamic setting as well as in the pressure fluctuations, but there are substantial differences in the frequency contents of the pressure waves in the two loading cases. Comparison between the quasi-static and fully dynamic solutions reveals that the dynamic response gives much more information such as the type of pressure oscillations and related frequencies and should be applied whenever there is a doubt about inertia forces playing a role - the case in most fracturing events. In the absence of direct relevant dynamic tests on saturated media some experimental results on dynamic fracture in dry materials, a fast hydraulic fracturing test and observations from geophysics confirm qualitatively the obtained results such as the type of pressure oscillations and the substantial difference in the behaviour under the two loading cases.

Multi-stage versus single-stage inflation and deflation cycle for alternating low pressure air mattresses to prevent pressure ulcers in hospitalised patients: a randomised-controlled clinical trial.

PubMed

Demarré, L; Beeckman, D; Vanderwee, K; Defloor, T; Grypdonck, M; Verhaeghe, S

2012-04-01

The duration and the amount of pressure and shear must be reduced in order to minimize the risk of pressure ulcer development. Alternating low pressure air mattresses with multi-stage inflation and deflation cycle of the air cells have been developed to relieve pressure by sequentially inflating and deflating the air cells. Evidence about the effectiveness of this type of mattress in clinical practice is lacking. This study aimed to compare the effectiveness of an alternating low pressure air mattress that has a standard single-stage inflation and deflation cycle of the air cells with an alternating low pressure air mattress with multi-stage inflation and deflation cycle of the air cells. A randomised controlled trial was performed in a convenience sample of 25 wards in five hospitals in Belgium. In total, 610 patients were included and randomly assigned to the experimental group (n=298) or the control group (n=312). In the experimental group, patients were allocated to an alternating low pressure air mattress with multi-stage inflation and deflation cycle of the air cells. In the control group, patients were allocated to an alternating low pressure air mattress with a standard single-stage inflation and deflation cycle of the air cells. The outcome was defined as cumulative pressure ulcer incidence (Grade II-IV). An intention-to-treat analysis was performed. There was no significant difference in cumulative pressure ulcer incidence (Grade II-IV) between both groups (Exp.=5.7%, Contr.=5.8%, p=0.97). When patients developed a pressure ulcer, the median time was 5.0 days in the experimental group (IQR=3.0-8.5) and 8.0 days in the control group (IQR=3.0-8.5) (Mann-Whitney U-test=113, p=0.182). The probability to remain pressure ulcer free during the observation period in this trial did not differ significantly between the experimental group and the control group (log-rank χ(2)=0.013, df=1, p=0.911). An alternating low pressure air mattress with multi-stage inflation

The last stage of Earth's formation: Increasing the pressure

NASA Astrophysics Data System (ADS)

Lock, S. J.; Stewart, S. T.; Mukhopadhyay, S.

2017-12-01

A range of high-energy, high-angular momentum (AM) giant impacts have been proposed as a potential trigger for lunar origin. High-energy, high-AM collisions create a previously unrecognized planetary object, called a synestia. Terrestrial synestias exceed the corotation limit for a rocky planet, forming an extended structure with a corotating inner region and disk-like outer region. We demonstrate that the internal pressures of Earth-like planets do not increase monotonically during the giant impact stage, but can vary substantially in response to changes in rotation and thermal state. The internal pressures in an impact-generated synestia are much lower than in condensed, slowly rotating planets of the same mass. For example, the core-mantle boundary (CMB) pressure can be as low as 60 GPa for a synestia with Earth mass and composition, compared to 136 GPa in the present-day Earth. The lower pressures are due to the low density and rapid rotation of the post-impact structure. After a high-AM Moon-forming impact, the internal pressures in the interior of the synestia would have increased to present-day Earth values in two stages: first by vapor condensation and second by removal of AM from the Earth during the tidal evolution of the Moon. The pressure evolution of the Earth has several implications. Metal-silicate equilibration after the impact would have occurred at much lower pressures than has previously been assumed. The observed moderately siderophile element abundances in the mantle may be consistent with equilibration at the bottom of a deep, lower-pressure magma ocean. In addition, the pressure at the CMB during cooling is coincident with, or lower than, the proposed intersection of liquid adiabats with the mantle liquidus. The mantle would hence freeze from the bottom up and there would be no basal magma ocean. The subsequent pressure increase and tidal heating due to the Moon's orbital evolution likely induces melting in the lowermost mantle. Increasing

Design and performance of a 427-meter-per-second-tip-speed two-stage fan having a 2.40 pressure ratio

NASA Technical Reports Server (NTRS)

Cunnan, W. S.; Stevans, W.; Urasek, D. C.

1978-01-01

The aerodynamic design and the overall and blade-element performances are presented of a 427-meter-per-second-tip-speed two-stage fan designed with axially spaced blade rows to reduce noise transmitted upstream of the fan. At design speed the highest recorded adiabatic efficiency was 0.796 at a pressure of 2.30. Peak efficiency was not established at design speed because of a damper failure which terminated testing prematurely. The overall efficiencies, at 60 and 80 percent of design speed, peaked at approximately 0.83.

Advanced Extra-Vehicular Activity Pressure Garment Requirements Development

NASA Technical Reports Server (NTRS)

Ross, Amy; Aitchison, Lindsay; Rhodes, Richard

2015-01-01

The NASA Johnson Space Center advanced pressure garment technology development team is addressing requirements development for exploration missions. Lessons learned from the Z-2 high fidelity prototype development have reiterated that clear low-level requirements and verification methods reduce risk to the government, improve efficiency in pressure garment design efforts, and enable the government to be a smart buyer. The expectation is to provide requirements at the specification level that are validated so that their impact on pressure garment design is understood. Additionally, the team will provide defined verification protocols for the requirements. However, in reviewing exploration space suit high level requirements there are several gaps in the team's ability to define and verify related lower level requirements. This paper addresses the efforts in requirement areas such as mobility/fit/comfort and environmental protection (dust, radiation, plasma, secondary impacts) to determine the method by which the requirements can be defined and use of those methods for verification. Gaps exist at various stages. In some cases component level work is underway, but no system level effort has begun; in other cases no effort has been initiated to close the gap. Status of on-going efforts and potential approaches to open gaps are discussed.

A prospective study evaluating the Pressure Ulcer Scale for Healing (PUSH Tool) to assess stage II, stage III, and stage IV pressure ulcers.

PubMed

Günes, Ulkü Yapucu

2009-05-01

Many valid and reliable tools and techniques are available for wound measurement. However, few prospective clinical studies assessing these instruments have been conducted. A prospective, methodological study was conducted between September 2006 and November 2007 to evaluate use of the Pressure Ulcer Scale for Healing (PUSH) version 3 in patients with one or more pressure ulcer. A convenience sample of 72 persons (mean age 66.9 +/- 12.8 years) with 86 pressure ulcers (49% Stage II, 47% Stage III, and 4% Stage IV) was recruited and assessed weekly until healing, transfer, patient death, or end of study for a maximum of 8 weeks. Most ulcers (77%) were in the sacral area and 56% had been present for 1 month or longer. Repeated measures analysis revealed that PUSH total scores decreased significantly (P < 0.001) over the 8-week study, with significant differences in PUSH total scores between healed and unhealed ulcers each week, starting on week 1. The total PUSH score as well as the length x width item in the tool accurately differentiated between healed and nonhealed ulcers. Although the PUSH tool is practical, easy-to-use, and generally sensitive to change, some modifications would improve its value--ie, a wound size/depth subscale. Additional studies to help clinicians more accurately evaluate the effectiveness of their interventions, including studies to determine whether wound measurements alone may suffice to monitor healing, are needed.

Conceptual design of a two stage to orbit spacecraft

NASA Technical Reports Server (NTRS)

Armiger, Scott C.; Kwarta, Jennifer S.; Horsley, Kevin B.; Snow, Glenn A.; Koe, Eric C.; Single, Thomas G.

1993-01-01

This project, undertaken through the Advanced Space Design Program, developed a 'Conceptual Design of a Two Stage To Orbit Spacecraft (TSTO).' The design developed utilizes a combination of air breathing and rocket propulsion systems and is fully reusable, with horizontal takeoff and landing capability. The orbiter is carried in an aerodynamically designed bay in the aft section of the booster vehicle to the staging altitude. This TSTO Spacecraft design meets the requirements of replacing the aging Space Shuttle system with a more easily maintained vehicle with more flexible mission capability.

Tumor angiogenesis in advanced stage ovarian carcinoma.

PubMed

Hollingsworth, H C; Kohn, E C; Steinberg, S M; Rothenberg, M L; Merino, M J

1995-07-01

Tumor angiogenesis has been found to have prognostic significance in many tumor types for predicting an increased risk of metastasis. We assessed tumor vascularity in 43 cases of advanced stage (International Federation of Gynecologists and Obstetricians stages III and IV) ovarian cancer by using the highly specific endothelial cell marker CD34. Microvessel counts and stage were associated with disease-free survival and with overall survival by Kaplan-Meier analysis. The plots show that higher stage, higher average vessel count at 200x (200x avg) and 400x (400x avg) magnification and highest vessel count at 400x (400x high) magnification confer a worse prognosis for disease-free survival. Average vessel count of less than 16 (400x avg, P2 = 0.01) and less than 45 (200x avg, P2 = 0.026) suggested a better survival. Similarly, a high vessel count of less than 20 (400x high, P2 = 0.019) conferred a better survival as well. The plots suggest that higher stage, higher average vessel count at 200x and 400x, and highest vessel count at 200x and 400x show a trend to worse overall survival as well. With the Cox proportional hazards model, stage was the best predictor of overall survival, however, the average microvessel count at 400x was found to be the best predictor of disease-free survival. These results suggest that analysis of neovascularization in advanced stage ovarian cancer may be a useful prognostic factor.

Relationship between indirect blood pressure and various stages of chronic kidney disease in cats.

PubMed

Hori, Yasutomo; Heishima, Yasuhiro; Yamashita, Yohei; Isayama, Noriko; Kanno, Nobuyuki; Nakamura, Kensuke; Iguchi, Masayuki; Ibaragi, Toshiki; Onodera, Hideyuki; Aramaki, Yoshitaka; Hirakawa, Atsushi; Yamano, Shigeki; Katagi, Michio; Kitade, Akihito; Sawada, Tamotsu

2018-03-24

Chronic kidney disease (CKD) is a common cause of secondary systemic hypertension in cats. We investigated the relationship between indirect blood pressure and the prevalence of systemic hypertension in various CKD stages in cats. Client-owned cats (24 control cats and 77 cats with CKD) were included. Biochemical examinations of plasma were conducted by a commercial laboratory. Diseased cats were divided into two groups based on the International Renal Interest Society (IRIS) guidelines (II and III-IV). Indirect blood pressure was measured using an oscillometric technique. Severe hypertension was diagnosed if systolic blood pressure (SBP) was ≥180 mmHg. Indirect blood pressures were significantly higher in IRIS stage III-IV than in the control cats. Of 77 cats with CKD, 25 (32.5%) had severe hypertension. The frequency of severe hypertension increased with an increase in IRIS stage; 0% in the controls, 27.6% in the IRIS stage II, and 47.4% in the IRIS stage III-IV, respectively. The indirect SBP was weakly correlated with urea nitrogen (r=0.27) and creatinine (r=0.23) concentrations in plasma. Binary logistic regression analysis showed that if plasma creatinine concentration is >3.7 mg/dl, cats with CKD had an increased risk for developing severe hypertension (P<0.001). Our results suggest that indirect blood pressure was correlated with the severity of CKD, and the prevalence of severe hypertension increased in cats with severe CKD. The risk of severe hypertension may be high in cats with severe CKD.

Meta-analysis of Gaussian individual patient data: Two-stage or not two-stage?

PubMed

Morris, Tim P; Fisher, David J; Kenward, Michael G; Carpenter, James R

2018-04-30

Quantitative evidence synthesis through meta-analysis is central to evidence-based medicine. For well-documented reasons, the meta-analysis of individual patient data is held in higher regard than aggregate data. With access to individual patient data, the analysis is not restricted to a "two-stage" approach (combining estimates and standard errors) but can estimate parameters of interest by fitting a single model to all of the data, a so-called "one-stage" analysis. There has been debate about the merits of one- and two-stage analysis. Arguments for one-stage analysis have typically noted that a wider range of models can be fitted and overall estimates may be more precise. The two-stage side has emphasised that the models that can be fitted in two stages are sufficient to answer the relevant questions, with less scope for mistakes because there are fewer modelling choices to be made in the two-stage approach. For Gaussian data, we consider the statistical arguments for flexibility and precision in small-sample settings. Regarding flexibility, several of the models that can be fitted only in one stage may not be of serious interest to most meta-analysis practitioners. Regarding precision, we consider fixed- and random-effects meta-analysis and see that, for a model making certain assumptions, the number of stages used to fit this model is irrelevant; the precision will be approximately equal. Meta-analysts should choose modelling assumptions carefully. Sometimes relevant models can only be fitted in one stage. Otherwise, meta-analysts are free to use whichever procedure is most convenient to fit the identified model. © 2018 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

Single-Stage, 3.4:1-Pressure-Ratio Aspirated Fan Developed and Demonstrated

NASA Technical Reports Server (NTRS)

Braunscheidel, Edward P.

2004-01-01

Researchers are constantly pursuing technologies that will increase the performance of gas turbine engines. The aspirated compressor concept discussed here would allow the compression system to perform its task with about one-half of the compressor blades. To accomplish this, the researchers applied boundary layer control to the blades, casing, and hub. This method of boundary layer control consisted of removing small amounts of air from the main flow path at critical areas of the compressor. This bleed air could be used by other systems such as engine cooling or could be re-injected into lower pressure areas that require air for enhanced performance. This effort was initiated by the Massachusetts Institute of Technology (MIT) in response to a solicitation from the Defense Advanced Research Projects Agency (DARPA) who sought to advance research in flow control technology. The NASA Glenn Research Center partnered with MIT (principal investigator), Honeywell Aircraft Engines (cycle analysis, structural analysis, and mechanical design), and Pratt & Whitney (cycle analysis and aero-analysis) to conceptualize, design, analyze, build, and test the aspirated fan stage. The aero-design and aero-analysis of this fan stage were jointly executed by MIT and Glenn to minimize the amount of bleed flow needed and to maintain the highest efficiency possible (ref. 1). Mechanical design issues were complicated by the need to have a shrouded rotor with hollow blades, with rotor stress levels beyond the capabilities of titanium. The high stress issues were addressed by designing a shroud that was filament wound with a carbon fiber/epoxy matrix, resulting in an assembly that was strong enough to handle the high stresses. Both the rotor (preceding photographs) and stator (following photograph) were fabricated in two halves and then bolted together at the hub and tip, permitting the bleed passages to be machined into each half before assembly.

Nurses' knowledge of pressure ulcer prevention, staging, and description.

PubMed

Pieper, B; Mott, M

1995-01-01

The purpose of this study was to examine registered nurses' (N = 228) knowledge of pressure ulcer prevention, pressure ulcer staging, and wound description. A 47-item, true-false Pressure Ulcer Knowledge Test was developed for he study. Nurses' knowledge was significantly higher the more recently they had heard a lecture or read an article about pressure ulcers. Knowledge scores were not related to educational background, age, or years of work experience.

Development of a double-stage DDIA apparatus and its application to in-situ melting experiments at high pressures

NASA Astrophysics Data System (ADS)

Jing, Z.; Wang, Y.; Tange, Y.; Hilairet, N.; Yu, T.; Sakamaki, T.

2010-12-01

Melting experiments at high pressures are critical to our studies on the chemical evolution and dynamics of Earth and other terrestrial planets. A large volume press can generate a homogeneous and stable high-temperature environment, which is the key to melting experiments. However, previous in-situ melting experiments using a large volume press were often restricted to relatively low pressures. In order to expand the P-T conditions, a double-stage 6-8 configuration (6 first-stage anvils and 8 second stage-anvils) has been developed in a DDIA apparatus (DDIA-30), recently installed at the GSECARS Beamline 13-ID-D at the Advanced Photon Source. 27 mm DIA-type first-stage anvils and 14 mm second-stage anvils with the truncation edge length (TEL) of 1.5 mm are employed. A cell assembly that is suitable for synchrotron X-ray studies developed by Tange et al. (2008) has been adopted for melting experiments. High pressure and temperature conditions are generated up to 27 GPa and 2473 K by using tungsten carbide anvils, and up to 35 GPa and 1773 K by using sintered diamond anvils. Both LaCrO3 and TiB2 heater materials have been successfully applied for high-temperature generation. Although TiB2 shows a decrease of resistance at temperatures higher than 2000 K at 20 GPa, we are able to achieve 2473 K with temperature fluctuations in the range of ±30 K. Using tungsten carbide anvils and TiB2 heaters, we have determined the melting curve of gold up to 20 GPa. We constrain the melting temperature based on the disappearance of the gold peaks in energy dispersive X-ray diffraction patterns and the change of sample shape in the radiographic images. The combination of these two observations can reduce the uncertainties in melting temperatures to within 100 K. The measured melting temperatures of gold at 8, 13, and 20 GPa are consistent with the low-pressure results (up to 6 GPa) such as Mirwald and Kennedy (1979). Melting experiments with sintered diamond anvils are currently

Advanced Hepatocellular Carcinoma: Which Staging Systems Best Predict Prognosis?

PubMed Central

Huitzil-Melendez, Fidel-David; Capanu, Marinela; O'Reilly, Eileen M.; Duffy, Austin; Gansukh, Bolorsukh; Saltz, Leonard L.; Abou-Alfa, Ghassan K.

2010-01-01

Purpose The purpose of cancer staging systems is to accurately predict patient prognosis. The outcome of advanced hepatocellular carcinoma (HCC) depends on both the cancer stage and the extent of liver dysfunction. Many staging systems that include both aspects have been developed. It remains unknown, however, which of these systems is optimal for predicting patient survival. Patients and Methods Patients with advanced HCC treated over a 5-year period at Memorial Sloan-Kettering Cancer Center were identified from an electronic medical record database. Patients with sufficient data for utilization in all staging systems were included. TNM sixth edition, Okuda, Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), Chinese University Prognostic Index (CUPI), Japan Integrated Staging (JIS), and Groupe d'Etude et de Traitement du Carcinome Hepatocellulaire (GETCH) systems were ranked on the basis of their accuracy at predicting survival by using concordance index (c-index). Other independent prognostic variables were also identified. Results Overall, 187 eligible patients were identified and were staged by using the seven staging systems. CLIP, CUPI, and GETCH were the three top-ranking staging systems. BCLC and TNM sixth edition lacked any meaningful prognostic discrimination. Performance status, AST, abdominal pain, and esophageal varices improved the discriminatory ability of CLIP. Conclusion In our selected patient population, CLIP, CUPI, and GETCH were the most informative staging systems in predicting survival in patients with advanced HCC. Prospective validation is required to determine if they can be accurately used to stratify patients in clinical trials and to direct the appropriate need for systemic therapy versus best supportive care. BCLC and TNM sixth edition were not helpful in predicting survival outcome, and their use is not supported by our data. PMID:20458042

Cost analysis of surgically treated pressure sores stage III and IV.

PubMed

Filius, A; Damen, T H C; Schuijer-Maaskant, K P; Polinder, S; Hovius, S E R; Walbeehm, E T

2013-11-01

Health-care costs associated with pressure sores are significant and their financial burden is likely to increase even further. The aim of this study was to analyse the direct medical costs of hospital care for surgical treatment of pressure sores stage III and IV. We performed a retrospective chart study of patients who were surgically treated for stage III and IV pressure sores between 2007 and 2010. Volumes of health-care use were obtained for all patients and direct medical costs were subsequently calculated. In addition, we evaluated the effect of location and number of pressure sores on total costs. A total of 52 cases were identified. Average direct medical costs in hospital were €20,957 for the surgical treatment of pressure sores stage III or IV; average direct medical costs for patients with one pressure sore on an extremity (group 1, n = 5) were €30,286, €10,113 for patients with one pressure sore on the trunk (group 2, n = 32) and €40,882 for patients with multiple pressure sores (group 3, n = 15). The additional costs for patients in group 1 and group 3 compared to group 2 were primarily due to longer hospitalisation. The average direct medical costs for surgical treatment of pressure sores stage III and IV were high. Large differences in costs were related to the location and number of pressure sores. Insight into the distribution of these costs allows identification of high-risk patients and enables the development of specific cost-reducing measures. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Retinopathy of prematurity: mutations in the Norrie disease gene and the risk of progression to advanced stages.

PubMed

Haider, M Z; Devarajan, L V; Al-Essa, M; Srivastva, B S; Kumar, H; Azad, R; Rashwan, N

2001-04-01

Retinopathy of prematurity (ROP) is a retinal vascular disease that occurs in infants with short gestational age and low birth weight and may lead to retinal detachment and blindness. Missense mutations in the Norrie disease (ND) gene have been associated with the risk of progression to advanced stages in cases of ROP from the US and also in clinically similar ND and familial exudative vitreoretinopathy. We have screened two ND gene mutations, namely A105T and Val60Glu, by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific PCR methods, respectively, in 210 Kuwaiti premature newborns to replicate these findings in a different ethnic group. In the Kuwaiti premature newborn cohort, 115 of 210 babies had no eye problems and served as controls, while 95 were cases of ROP. In 71 of 95 ROP cases, the disease regressed spontaneously on or before stage 3, while in 24 of 95 ROP cases the disease progressed to advanced stages 4 and 5. In case of missense mutation (A105T), the AA genotype was detected in 96% of controls compared with 87% of ROP cases (NS); similarly no significant difference was found between spontaneously regressed ROP cases and those who progressed to advanced stages. For the Val60Glu mutation, no significant association was detected between the genotype and progression of ROP to advanced stages. Unlike data from the US, our findings from a Kuwaiti cohort of ROP cases and controls suggest a lack of association between the two ND gene mutations (A105T and Val60Glu) and ROP and the risk of progression of the disease to advanced stages.

Fundal pressure during the second stage of labor in a tertiary obstetric center: a prospective analysis.

PubMed

Moiety, Fady M Shawky; Azzam, Amal Z

2014-04-01

To ascertain whether uterine fundal pressure should have a role in the management of the second stage of labor and to determine its prevalence, benefits and adverse maternal-fetal outcomes. This was a prospective observational study set in a tertiary teaching and research obstetric hospital. A total of 8097 women in labor between 37 and 42 gestational weeks with a singleton cephalic presentation were enrolled. Subjects were subdivided into two groups: fundal pressure group (n=1974 women) and control group (n=6123 women). The primary outcome measure was the duration of the second stage. The secondary outcome measures were maternal outcomes (immediate or delayed) and neonatal outcomes. The prevalence of fundal pressure in our center was 24.38%. Fundal pressure maneuver significantly shortened the duration of the second stage among primiparous women, increased the risk of severe perineal laceration and admission to neonatal intensive care unit in comparison to the non-fundal group. Delayed maternal outcomes showed significant increase in dyspareunia and de novo stress urinary incontinence in the fundal pressure group. Although fundal pressure maneuver shortens the duration of the second stage of labor among primiparous women, it should not be used except when indicated, and under strict guidelines owing to its adverse maternal and fetal outcomes. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

[Prognostic factors of advanced stage non-small-cell lung cancer].

PubMed

Kwas, H; Guermazi, E; Khattab, A; Hrizi, C; Zendah, I; Ghédira, H

2017-09-01

Primary lung cancer is the leading cause of cancer death in men in the world. Although the introduction of new drugs, new therapeutic strategies and despite therapeutic advances, the prognosis is relatively improved during the last years. To evaluate the prognosis of patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) and to identify prognostic factors at these stages. A retrospective study, including 140 cases of locally advanced or metastatic NSCLC diagnosed in our department between 2003 and 2013. The average age was 61±10 years (35 to 90 years). Sex ratio was 18. The delays management were 80±25 days for presentation, 45±20 days for the diagnostic, while the treatment delay was 8±2.33 days. The cancer was at stage IIIA in 14%, IIIB in 27% and IV in 59%. Six months and one-year survival was between 50 and 74% and between 9 and 25%, respectively. Better survival was observed in patients with NSCLC on stage III, having better performance status, having comorbid conditions, with prolonged delays management, a short therapeutic delay and patients who received specific antitumor treatment. The prognostic factors in locally advanced and metastatic NSCLC in our patients were: stage of cancer, performance status, comorbid conditions, delay of management and specific antitumoral treatment. These factors should be considered in the management of patients with advanced NSCLC. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A method for measuring the local gas pressure within a gas-flow stage in situ in the transmission electron microscope

DOE Office of Scientific and Technical Information (OSTI.GOV)

Colby, Robert J.; Alsem, Daan H.; Liyu, Andrey V.

2015-06-01

The development of environmental transmission electron microscopy (TEM) has enabled in situ experiments in a gaseous environment with high resolution imaging and spectroscopy. Addressing scientific challenges in areas such as catalysis, corrosion, and geochemistry can require pressures much higher than the ~20 mbar achievable with a differentially pumped, dedicated environmental TEM. Gas flow stages, in which the environment is contained between two semi-transparent thin membrane windows, have been demonstrated at pressures of several atmospheres. While this constitutes significant progress towards operando measurements, the design of many current gas flow stages is such that the pressure at the sample cannot necessarilymore » be directly inferred from the pressure differential across the system. Small differences in the setup and design of the gas flow stage can lead to very different sample pressures. We demonstrate a method for measuring the gas pressure directly, using a combination of electron energy loss spectroscopy and TEM imaging. This method requires only two energy filtered TEM images, limiting the measurement time to a few seconds and can be performed during an ongoing experiment at the region of interest. This approach provides a means to ensure reproducibility between different experiments, and even between very differently designed gas flow stages.« less

A two-stage rotary blood pump design with potentially lower blood trauma: a computational study.

PubMed

Thamsen, Bente; Mevert, Ricardo; Lommel, Michael; Preikschat, Philip; Gaebler, Julia; Krabatsch, Thomas; Kertzscher, Ulrich; Hennig, Ewald; Affeld, Klaus

2016-06-15

In current rotary blood pumps, complications related to blood trauma due to shear stresses are still frequently observed clinically. Reducing the rotor tip speed might decrease blood trauma. Therefore, the aim of this project was to design a two-stage rotary blood pump leading to lower shear stresses. Using the principles of centrifugal pumps, two diagonal rotor stages were designed with an outer diameter of 22 mm. The first stage begins with a flow straightener and terminates with a diffusor, while a volute casing behind the second stage is utilized to guide fluid to the outlet. Both stages are combined into one rotating part which is pivoted by cup-socket ruby bearings. Details of the flow field were analyzed employing computational fluid dynamics (CFD). A functional model of the pump was fabricated and the pressure-flow dependency was experimentally assessed. Measured pressure-flow performance of the developed pump indicated its ability to generate adequate pressure heads and flows with characteristic curves similar to centrifugal pumps. According to the CFD results, a pressure of 70 mmHg was produced at a flow rate of 5 L/min and a rotational speed of 3200 rpm. Circumferential velocities could be reduced to 3.7 m/s as compared to 6.2 m/s in a clinically used axial rotary blood pump. Flow fields were smooth with well-distributed pressure fields and comparatively few recirculation or vortices. Substantially smaller volumes were exposed to high shear stresses >150 Pa. Hence, blood trauma might be reduced with this design. Based on these encouraging results, future in vitro investigations to investigate actual blood damage are intended.

Nomogram for suboptimal cytoreduction at primary surgery for advanced stage ovarian cancer.

PubMed

Gerestein, Cornelis G; Eijkemans, Marinus J; Bakker, Jeanette; Elgersma, Otto E; van der Burg, Maria E L; Kooi, Geertruida S; Burger, Curt W

2011-11-01

Maximal cytoreduction to minimal residual tumor is the most important determinant of prognosis in patients with advanced stage epithelial ovarian cancer (EOC). Preoperative prediction of suboptimal cytoreduction, defined as residual tumor >1 cm, could guide treatment decisions and improve counseling. The objective of this study was to identify predictive computed tomographic (CT) scan and clinical parameters for suboptimal cytoreduction at primary cytoreductive surgery for advanced stage EOC and to generate a nomogram with the identified parameters, which would be easy to use in daily clinical practice. Between October 2005 and December 2008, all patients with primary surgery for suspected advanced stage EOC at six participating teaching hospitals in the South Western part of the Netherlands entered the study protocol. To investigate independent predictors of suboptimal cytoreduction, a Cox proportional hazard model with backward stepwise elimination was utilized. One hundred and fifteen patients with FIGO stage III/IV EOC entered the study protocol. Optimal cytoreduction was achieved in 52 (45%) patients. A suboptimal cytoreduction was predicted by preoperative blood platelet count (p=0.1990; odds ratio (OR)=1.002), diffuse peritoneal thickening (DPT) (p=0.0074; OR=3.021), and presence of ascites on at least two thirds of CT scan slices (p=0.0385; OR=2.294) with a for-optimism corrected c-statistic of 0.67. Suboptimal cytoreduction was predicted by preoperative platelet count, DPT and presence of ascites. The generated nomogram can, after external validation, be used to estimate surgical outcome and to identify those patients, who might benefit from alternative treatment approaches.

[Staging gastritis with the OLGA system: prevalence of advanced stages of gastric atrophy in Mexican patients].

PubMed

Ramírez-Mendoza, P; Ruiz-Castillo, S A; Maroun-Marun, C; Trujillo-Benavides, O; Baltazar-Montúfar, P; Méndez del Monte, R; Angeles-Garay, U

2011-01-01

Gastric adenocarcinoma of intestinal type is preceded by inflammation, which produces mucosal atrophy and intestinal metaplasia, progressing eventually to dysplasia and invasive cancer. Recently an international group, the Operative Link on Gastritis Assessment (OLGA) proponed a staging system for gastric biopsies. To recognize the distribution of advanced stages of gastric mucosal atrophy in Mexican patients with dyspepsia according to the OLGA system. We apply the OLGA system for cancer risk (Stages 0 to IV) to 322 gastric biopsies from consecutive patients with dyspepsia. Using the Sydney protocol, we recorded the presence of atrophy, dysplasia and the relationship with ulcer disease. We report the stage of atrophy for each region and the Helicobacter pylori infection status. We documented 72 (22.4%) cases with atrophy, 50 of them (69.4%) were metaplastic-type. Overall, nine biopsies (2.78%) were stage III (all of them with metaplastic-type atrophy) and there was not stage IV cases. We did not find high-grade dysplasia or intramucosal carcinoma. In 8 of subjects with stage III, we observed low-grade dysplasia. We documented gastric ulcer in 5 patients with stage II, 60% of them with associated low-grade dysplasia. Five patients with duodenal ulcer were found in stages 0 and I. We found low prevalence of advanced stages of mucosal gastric atrophy among patients with dyspepsia. However we recognized 9 patients with stage III according to OLGA system worthy of follow-up because the high risk for developing gastric cancer.

Catalytic two-stage coal hydrogenation and hydroconversion process

DOEpatents

MacArthur, James B.; McLean, Joseph B.; Comolli, Alfred G.

1989-01-01

A process for two-stage catalytic hydrogenation and liquefaction of coal to produce increased yields of low-boiling hydrocarbon liquid and gas products. In the process, the particulate coal is slurried with a process-derived liquid solvent and fed at temperature below about 650.degree. F. into a first stage catalytic reaction zone operated at conditions which promote controlled rate liquefaction of the coal, while simultaneously hydrogenating the hydrocarbon recycle oils at conditions favoring hydrogenation reactions. The first stage reactor is maintained at 650.degree.-800.degree. F. temperature, 1000-4000 psig hydrogen partial pressure, and 10-60 lb coal/hr/ft.sup.3 reactor space velocity. The partially hydrogenated material from the first stage reaction zone is passed directly to the close-coupled second stage catalytic reaction zone maintained at a temperature at least about 25.degree. F. higher than for the first stage reactor and within a range of 750.degree.-875.degree. F. temperature for further hydrogenation and thermal hydroconversion reactions. By this process, the coal feed is successively catalytically hydrogenated and hydroconverted at selected conditions, which results in significantly increased yields of desirable low-boiling hydrocarbon liquid products and minimal production of undesirable residuum and unconverted coal and hydrocarbon gases, with use of less energy to obtain the low molecular weight products, while catalyst life is substantially increased.

Optics of two-stage photovoltaic concentrators with dielectric second stages.

PubMed

Ning, X; O'Gallagher, J; Winston, R

1987-04-01

Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

Optics of two-stage photovoltaic concentrators with dielectric second stages

NASA Astrophysics Data System (ADS)

Ning, Xiaohui; O'Gallagher, Joseph; Winston, Roland

1987-04-01

Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

Single-stage-to-orbit versus two-stage-two-orbit: A cost perspective

NASA Astrophysics Data System (ADS)

Hamaker, Joseph W.

1996-03-01

This paper considers the possible life-cycle costs of single-stage-to-orbit (SSTO) and two-stage-to-orbit (TSTO) reusable launch vehicles (RLV's). The analysis parametrically addresses the issue such that the preferred economic choice comes down to the relative complexity of the TSTO compared to the SSTO. The analysis defines the boundary complexity conditions at which the two configurations have equal life-cycle costs, and finally, makes a case for the economic preference of SSTO over TSTO.

Advanced cooling techniques for high-pressure hydrocarbon-fueled engines

NASA Technical Reports Server (NTRS)

Cook, R. T.

1979-01-01

The regenerative cooling limits (maximum chamber pressure) for 02/hydrocarbon gas generator and staged combustion cycle rocket engines over a thrust range of 89,000 N (20,000lbf) to 2,669,000 N (600,000 lbf) for a reusable life of 250 missions were defined. Maximum chamber pressure limits were first determined for the three propellant combinations (O2/CH4, O2/C3H8, and O2/RP-1 without a carbon layer (unenhanced designs). Chamber pressure cooling enhancement limits were then established for seven thermal barriers. The thermal barriers evaluated for these designs were: carbon layer, ceramic coating, graphite liner, film cooling, transpiration cooling, zoned combustion, and a combination of two of the above. All fluid barriers were assessed a 3 percent performance loss. Sensitivity studies were then conducted to determine the influence of cycle life and RP-1 decomposition temperature on chamber pressure limits. Chamber and nozzle design parameters are presented for the unenahanced and enhanced designs. The maximum regenerative cooled chamber pressure limits were attained with the O2/CH4 propellant combination. The O2/RP-1 designs relied on a carbon layer and liquid gas injection chamber contours, short chamber, to be competitive with the other two propellant combinations. This was attributed to the low decomposition temperature of RP-1.

Characteristics of Boundary Layer Transition in a Multi-Stage Low-Pressure Turbine

NASA Technical Reports Server (NTRS)

Wisler, Dave; Halstead, David E.; Okiishi, Ted

2007-01-01

An experimental investigation of boundary layer transition in a multi-stage turbine has been completed using surface-mounted hot-film sensors. Tests were carried out using the two-stage Low Speed Research Turbine of the Aerodynamics Research Laboratory of GE Aircraft Engines. Blading in this facility models current, state-of-the-art low pressure turbine configurations. The instrumentation technique involved arrays of densely-packed hot-film sensors on the surfaces of second stage rotor and nozzle blades. The arrays were located at mid-span on both the suction and pressure surfaces. Boundary layer measurements were acquired over a complete range of relevant Reynolds numbers. Data acquisition capabilities provided means for detailed data interrogation in both time and frequency domains. Data indicate that significant regions of laminar and transitional boundary layer flow exist on the rotor and nozzle suction surfaces. Evidence of relaminarization both near the leading edge of the suction surface and along much of the pressure surface was observed. Measurements also reveal the nature of the turbulent bursts occuring within and between the wake segments convecting through the blade row. The complex character of boundary layer transition resulting from flow unsteadiness due to nozzle/nozzle, rotor/nozzle, and nozzle/rotor wake interactions are elucidated using these data. These measurements underscore the need to provide turbomachinery designers with models of boundary layer transition to facilitate accurate prediction of aerodynamic loss and heat transfer.

Upper stage technology evaluation studies

NASA Technical Reports Server (NTRS)

1972-01-01

Studies to evaluate advanced technology relative to chemical upper stages and orbit-to-orbit stages are reported. The work described includes: development of LH2/LOX stage data, development of data to indicate stage sensitivity to engine tolerance, modified thermal routines to accommodate storable propellants, added stage geometries to computer program for monopropellant configurations, determination of the relative gain obtainable through improvement of stage mass fraction, future propulsion concepts, effect of ultrahigh chamber-pressure increases, and relative gains obtainable through improved mass fraction.

Results of Two-Stage Light-Gas Gun Development Efforts and Hypervelocity Impact Tests of Advanced Thermal Protection Materials

NASA Technical Reports Server (NTRS)

Cornelison, C. J.; Watts, Eric T.

1998-01-01

Gun development efforts to increase the launching capabilities of the NASA Ames 0.5-inch two-stage light-gas gun have been investigated. A gun performance simulation code was used to guide initial parametric variations and hardware modifications, in order to increase the projectile impact velocity capability to 8 km/s, while maintaining acceptable levels of gun barrel erosion and gun component stresses. Concurrent with this facility development effort, a hypervelocity impact testing series in support of the X-33/RLV program was performed in collaboration with Rockwell International. Specifically, advanced thermal protection system materials were impacted with aluminum spheres to simulate impacts with on-orbit space debris. Materials tested included AETB-8, AETB-12, AETB-20, and SIRCA-25 tiles, tailorable advanced blanket insulation (TABI), and high temperature AFRSI (HTA). The ballistic limit for several Thermal Protection System (TPS) configurations was investigated to determine particle sizes which cause threshold TPS/structure penetration. Crater depth in tiles was measured as a function of impact particle size. The relationship between coating type and crater morphology was also explored. Data obtained during this test series was used to perform a preliminary analysis of the risks to a typical orbital vehicle from the meteoroid and space debris environment.

Two-Stage Fan I: Aerodynamic and Mechanical Design

NASA Technical Reports Server (NTRS)

Messenger, H. E.; Kennedy, E. E.

1972-01-01

A two-stage, highly-loaded fan was designed to deliver an overall pressure ratio of 2.8 with an adiabatic efficiency of 83.9 percent. At the first rotor inlet, design flow per unit annulus area is 42 lbm/sec/sq ft (205 kg/sec/sq m), hub/tip ratio is 0.4 with a tip diameter of 31 inches (0.787 m), and design tip speed is 1450 ft/sec (441.96 m/sec). Other features include use of multiple-circular-arc airfoils, resettable stators, and split casings over the rotor tip sections for casing treatment tests.

Aerodynamic performance of a 1.25-pressure-ratio axial-flow fan stage

NASA Technical Reports Server (NTRS)

Moore, R. D.; Steinke, R. J.

1974-01-01

Aerodynamic design parameters and overall and blade-element performances of a 1.25-pressure-ratio fan stage are reported. Detailed radial surveys were made over the stable operating flow range at rotative speeds from 70 to 120 percent of design speed. At design speed, the measured stage peak efficiency of 0.872 occurred at a weight flow of 34.92 kilograms per second and a pressure ratio of 1.242. Stage stall margin is about 20 percent based on the peak efficiency and stall conditions. The overall peak efficiency for the rotor was 0.911. The overall stage performance showed no significant change when the stators were positioned at 1, 2, or 4 chords downstream of the rotor.

One-stage vs. two-stage BAHA implantation in a pediatric population.

PubMed

Saliba, Issam; Froehlich, Patrick; Bouhabel, Sarah

2012-12-01

BAHA implantation surgery in a pediatric population is usually done in two-stage surgeries. This study aims to evaluate the safety and possible superiority of the one-stage over the two-stage BAHA implantation and which one would be the best standard of care for our pediatric patients. A retrospective chart review of 55 patients operated in our tertiary care institutions between 2005 and 2010 was conducted. The actual tendency in our institutions, applied at the time of the study, is to perform a one-stage surgery for all operated patients (pediatric and adult), except for patients undergoing translabyrinthine surgeries for cerebellopontine tumor excision. These patients indeed had a two-stage insertion. 26 patients underwent one-stage surgery (group I) while 29 patients had a two-stage (group II) BAHA insertion. A period of 4 months was allowed for osseointegration before BAHA processor fitting. As for the safety assessment of the one-stage surgery, we compared both groups regarding the incidence and severity (minor, moderate and major) of encountered complications, as well as the operating time and follow-up. The operating time of the two-stage surgery includes the time of the first and of the second stage. The mean age at surgery was 8.5 years old for the group I and 50 years old for the group II patients. There was no difference in the incidence of minor (p=0.12), moderate (p=0.41) nor severe (p=0.68) complications between groups I and II. Two cases of traumatic extrusion were noted in the group I. Furthermore, the one-stage BAHA implantation requests a significantly lower operating time (mean: 54 [32-100] min) than the two-stage surgery (mean: 79 [63-148] min) (p=0.012). All pediatric cases of BAHA insertion were performed in a one day surgery. The mean postoperative follow-up was 114 and 96 weeks for groups I and II respectively (p=0.058). One-stage BAHA insertion surgery in the pediatric population is a reliable, safe and efficient therapeutic option that

Two stages and three components of the postural preparation to action.

PubMed

Krishnan, Vennila; Aruin, Alexander S; Latash, Mark L

2011-07-01

Previous studies of postural preparation to action/perturbation have primarily focused on anticipatory postural adjustments (APAs), the changes in muscle activation levels resulting in the production of net forces and moments of force. We hypothesized that postural preparation to action consists of two stages: (1) Early postural adjustments (EPAs), seen a few hundred ms prior to an expected external perturbation and (2) APAs seen about 100 ms prior to the perturbation. We also hypothesized that each stage consists of three components, anticipatory synergy adjustments seen as changes in covariation of the magnitudes of commands to muscle groups (M-modes), changes in averaged across trials levels of muscle activation, and mechanical effects such as shifts of the center of pressure. Nine healthy participants were subjected to external perturbations created by a swinging pendulum while standing in a semi-squatting posture. Electrical activity of twelve trunk and leg muscles and displacements of the center of pressure were recorded and analyzed. Principal component analysis was used to identify four M-modes within the space of muscle activations using indices of integrated muscle activation. This analysis was performed twice, over two phases, 400-700 ms prior to the perturbation and over 200 ms just prior to the perturbation. Similar robust results were obtained using the data from both phases. An index of a multi-M-mode synergy stabilizing the center of pressure displacement was computed using the framework of the uncontrolled manifold hypothesis. The results showed high synergy indices during quiet stance. Each of the two stages started with a drop in the synergy index followed by a change in the averaged across trials activation levels in postural muscles. There was a very long electromechanical delay during the early postural adjustments and a much shorter delay during the APAs. Overall, the results support our main hypothesis on the two stages and three components

The experience of living with advanced-stage cancer: a thematic synthesis of the literature.

PubMed

García-Rueda, N; Carvajal Valcárcel, A; Saracíbar-Razquin, M; Arantzamendi Solabarrieta, M

2016-07-01

The aim of the study was to understand the experience of people living with advanced-stage cancer through literature. The search included The Cochrane Library, PubMed, PsycInfo, CINAHL and Cuiden. Thirteen studies were included. A qualitative meta-synthesis was conducted. One thread emerged from the thematic synthesis: the desire to live as normally as possible, despite being aware of the proximity of death. Three themes also emerged: "a process that is unique" with its four sub-themes; "support network" and "health context," each of them having two sub-themes. This study concludes that living with advanced-stage cancer is a unique and complex process which has both positive and negative aspects. The review provides a comprehensive view of the experience, which considers the importance of the support network and the health context in which the person lives. In this study, "normalcy" is the adjustment to the new reality and living as closely as possible to the way one lived before the disease, while developing a new relationship with being finite and death. A better understanding of the experience of living with advanced-stage cancer will help health professionals to identify the needs of the patients in order to plan individual, high-quality care. © 2016 John Wiley & Sons Ltd.

Generation of High Pressure Oxygen via Electrochemical Pumping in a Multi-stage Electrolysis Stack

NASA Technical Reports Server (NTRS)

Setlock, John A (Inventor); Green, Robert D (Inventor); Farmer, Serene (Inventor)

2016-01-01

An oxygen pump can produce high-purity high-pressure oxygen. Oxygen ions (O.sup.2-) are electrochemically pumped through a multi-stage electrolysis stack of cells. Each cell includes an oxygen-ion conducting solid-state electrolyte between cathode and anode sides. Oxygen dissociates into the ions at the cathode side. The ions migrate across the electrolyte and recombine at the anode side. An insulator is between adjacent cells to electrically isolate each individual cell. Each cell receives a similar volt potential. Recombined oxygen from a previous stage can diffuse through the insulator to reach the cathode side of the next stage. Each successive stage similarly incrementally pressurizes the oxygen to produce a final elevated pressure.

Generation of High Pressure Oxygen via Electrochemical Pumping in a Multi-Stage Electrolysis Stack

NASA Technical Reports Server (NTRS)

Setlock, John A (Inventor); Green, Robert D (Inventor); Farmer, Serene (Inventor)

2017-01-01

An oxygen pump can produce high-purity high-pressure oxygen. Oxygen ions (O(2-)) are electrochemically pumped through a multi-stage electrolysis stack of cells. Each cell includes an oxygen-ion conducting solid-state electrolyte between cathode and anode sides. Oxygen dissociates into the ions at the cathode side. The ions migrate across the electrolyte and recombine at the anode side. An insulator is between adjacent cells to electrically isolate each individual cell. Each cell receives a similar volt potential. Recombined oxygen from a previous stage can diffuse through the insulator to reach the cathode side of the next stage. Each successive stage similarly incrementally pressurizes the oxygen to produce a final elevated pressure.

Pressure-Sensitive Paints Advance Rotorcraft Design Testing

NASA Technical Reports Server (NTRS)

2013-01-01

The rotors of certain helicopters can spin at speeds as high as 500 revolutions per minute. As the blades slice through the air, they flex, moving into the wind and back out, experiencing pressure changes on the order of thousands of times a second and even higher. All of this makes acquiring a true understanding of rotorcraft aerodynamics a difficult task. A traditional means of acquiring aerodynamic data is to conduct wind tunnel tests using a vehicle model outfitted with pressure taps and other sensors. These sensors add significant costs to wind tunnel testing while only providing measurements at discrete locations on the model's surface. In addition, standard sensor solutions do not work for pulling data from a rotor in motion. "Typical static pressure instrumentation can't handle that," explains Neal Watkins, electronics engineer in Langley Research Center s Advanced Sensing and Optical Measurement Branch. "There are dynamic pressure taps, but your costs go up by a factor of five to ten if you use those. In addition, recovery of the pressure tap readings is accomplished through slip rings, which allow only a limited amount of sensors and can require significant maintenance throughout a typical rotor test." One alternative to sensor-based wind tunnel testing is pressure sensitive paint (PSP). A coating of a specialized paint containing luminescent material is applied to the model. When exposed to an LED or laser light source, the material glows. The glowing material tends to be reactive to oxygen, explains Watkins, which causes the glow to diminish. The more oxygen that is present (or the more air present, since oxygen exists in a fixed proportion in air), the less the painted surface glows. Imaged with a camera, the areas experiencing greater air pressure show up darker than areas of less pressure. "The paint allows for a global pressure map as opposed to specific points," says Watkins. With PSP, each pixel recorded by the camera becomes an optical pressure

Pair-wise comparison analysis of differential expression of mRNAs in early and advanced stage primary colorectal adenocarcinomas

PubMed Central

Lau, Tze Pheng; Roslani, April Camilla; Lian, Lay Hoong; Chai, Hwa Chia; Lee, Ping Chin; Hilmi, Ida; Goh, Khean Lee; Chua, Kek Heng

2014-01-01

Objectives To characterise the mRNA expression patterns of early and advanced stage colorectal adenocarcinomas of Malaysian patients. Design Comparative expression analysis. Setting and participants We performed a combination of annealing control primer (ACP)-based PCR and reverse transcription-quantitative real-time PCR for the identification of differentially expressed genes (DEGs) associated with early and advanced stage primary colorectal tumours. We recruited four paired samples from patients with colorectal cancer (CRC) of Dukes’ A and B for the preliminary differential expression study, and a total of 27 paired samples, ranging from CRC stages I to IV, for subsequent confirmatory test. The tumouric samples were obtained from the patients with CRC undergoing curative surgical resection without preoperative chemoradiotherapy. The recruited patients with CRC were newly diagnosed with CRC, and were not associated with any hereditary syndromes, previously diagnosed cancer or positive family history of CRC. The paired non-cancerous tissue specimens were excised from macroscopically normal colonic mucosa distally located from the colorectal tumours. Primary and secondary outcome measures The differential mRNA expression patterns of early and advanced stage colorectal adenocarcinomas compared with macroscopically normal colonic mucosa were characterised by ACP-based PCR and reverse transcription-quantitative real-time PCR. Results The RPL35, RPS23 and TIMP1 genes were found to be overexpressed in both early and advanced stage colorectal adenocarcinomas (p<0.05). However, the ARPC2 gene was significantly underexpressed in early colorectal adenocarcinomas, while the advanced stage primary colorectal tumours exhibited an additional overexpression of the C6orf173 gene (p<0.05). Conclusions We characterised two distinctive gene expression patterns to aid in the stratification of primary colorectal neoplasms among Malaysian patients with CRC. Further work can be done to

High frequency two-stage pulse tube cryocooler with base temperature below 20 K

NASA Astrophysics Data System (ADS)

Yang, L. W.; Thummes, G.

2005-02-01

High frequency (30-50 Hz) multi-stage pulse tube coolers that are capable of reaching temperatures close to 20 K or even lower are a subject of recent research and development activities. This paper reports on the design and test of a two-stage pulse tube cooler which is driven by a linear compressor with nominal input power of 200 W at an operating frequency of 30-45 Hz. A parallel configuration of the two pulse tubes is used with the warm ends of the pulse tubes located at ambient temperature. For both stages, the regenerator matrix consists of a stack of stainless steel screen. At an operating frequency of 35 Hz and with the first stage at 73 K a lowest stationary temperature of 19.6 K has been achieved at the second stage. The effects of input power, frequency, average pressure, and cold head orientation on the cooling performance are also reported. An even lower no-load temperature can be expected from the use of lead or other regenerator materials of high heat capacity in the second stage.

Rectosigmoidian Involvement in Advanced-stage Ovarian Cancer - Intraoperative Decisions.

PubMed

Bacalbasa, Nicolae; Balescu, Irina; Dima, Simona

2017-01-01

Ovarian cancer remains one of the most commonly encountered malignancies affecting women worldwide, that is unfortunately commonly diagnosed in advanced stages of the disease. In these stages, the tumoral process usually involves the surrounding viscera throughout contiguity or induces the apparition of distant metastases via peritoneal, lymphatic or hematogenous spread, multiple resections being needed in order to achieve a good control of the disease. In the present study, we present a case series of 12 patients in whom various surgical procedures on the rectosigmoidian loop were performed in order to achieve debulking surgery to no residual disease. Digestive tract resections consisted of rectosigmoidian resection with left colostomy in three cases, low rectosigmoidian resections with anastomosis in eight cases and a stripping procedure of the peritoneal layer in one case. Due to the close proximity of the digestive and gynecological tract, advanced-stage ovarian tumors frequently involve the rectosigmoidian loop, imposing association of digestive tract surgical procedures. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Two-Stage Series-Resonant Inverter

NASA Technical Reports Server (NTRS)

Stuart, Thomas A.

1994-01-01

Two-stage inverter includes variable-frequency, voltage-regulating first stage and fixed-frequency second stage. Lightweight circuit provides regulated power and is invulnerable to output short circuits. Does not require large capacitor across ac bus, like parallel resonant designs. Particularly suitable for use in ac-power-distribution system of aircraft.

Design of 9.271-pressure-ratio 5-stage core compressor and overall performance for first 3 stages

NASA Technical Reports Server (NTRS)

Steinke, Ronald J.

1986-01-01

Overall aerodynamic design information is given for all five stages of an axial flow core compressor (74A) having a 9.271 pressure ratio and 29.710 kg/sec flow. For the inlet stage group (first three stages), detailed blade element design information and experimental overall performance are given. At rotor 1 inlet tip speed was 430.291 m/sec, and hub to tip radius ratio was 0.488. A low number of blades per row was achieved by the use of low-aspect-ratio blading of moderate solidity. The high reaction stages have about equal energy addition. Radial energy varied to give constant total pressure at the rotor exit. The blade element profile and shock losses and the incidence and deviation angles were based on relevant experimental data. Blade shapes are mostly double circular arc. Analysis by a three-dimensional Euler code verified the experimentally measured high flow at design speed and IGV-stator setting angles. An optimization code gave an optimal IGV-stator reset schedule for higher measured efficiency at all speeds.

Racial/Ethnic, socioeconomic, and geographic disparities of cervical cancer advanced-stage diagnosis in Texas.

PubMed

Zhan, F Benjamin; Lin, Yan

2014-01-01

Advanced-stage diagnosis is among the primary causes of mortality among cervical cancer patients. With the wide use of Pap smear screening, cervical cancer advanced-stage diagnosis rates have decreased. However, disparities of advanced-stage diagnosis persist among different population groups. A challenging task in cervical cancer disparity reduction is to identify where underserved population groups are. Based on cervical cancer incidence data between 1995 and 2008, this study investigated advanced-stage cervical cancer disparities in Texas from three social domains: Race/ethnicity, socioeconomic status (SES), and geographic location. Effects of individual and contextual factors, including age, tumor grade, race/ethnicity, as well as contextual SES, spatial access to health care, sociocultural factors, percentage of African Americans, and insurance expenditures, on these disparities were examined using multilevel logistic regressions. Significant variations by race/ethnicity and SES were found in cervical cancer advanced-stage diagnosis. We also found a decline in racial/ethnic disparities of advanced cervical cancer diagnosis rate from 1995 to 2008. However, the progress was slower among African Americans than Hispanics. Geographic disparities could be explained by age, race/ethnicity, SES, and the percentage of African Americans in a census tract. Our findings have important implications for developing effective cervical cancer screening and control programs. We identified the location of underserved populations who need the most assistance with cervical cancer screening. Cervical cancer intervention programs should target Hispanics and African Americans, as well as individuals from communities with lower SES in geographic areas where higher advanced-stage diagnosis rates were identified in this study. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Core compressor exit stage study. 1: Aerodynamic and mechanical design

NASA Technical Reports Server (NTRS)

Burdsall, E. A.; Canal, E., Jr.; Lyons, K. A.

1979-01-01

The effect of aspect ratio on the performance of core compressor exit stages was demonstrated using two three stage, highly loaded, core compressors. Aspect ratio was identified as having a strong influence on compressors endwall loss. Both compressors simulated the last three stages of an advanced eight stage core compressor and were designed with the same 0.915 hub/tip ratio, 4.30 kg/sec (9.47 1bm/sec) inlet corrected flow, and 167 m/sec (547 ft/sec) corrected mean wheel speed. The first compressor had an aspect ratio of 0.81 and an overall pressure ratio of 1.357 at a design adiabatic efficiency of 88.3% with an average diffusion factor or 0.529. The aspect ratio of the second compressor was 1.22 with an overall pressure ratio of 1.324 at a design adiabatic efficiency of 88.7% with an average diffusion factor of 0.491.

Development of a Two-Stage Mars Ascent Vehicle Using In-Situ Propellant Production

NASA Technical Reports Server (NTRS)

Paxton, Laurel; Vaughan, David

2014-01-01

Mars Sample Return (MSR) and Mars In-Situ Resource Utilization (ISRU) present two main challenges for the advancement of Mars science. MSR would demonstrate Mars lift-off capability, while ISRU would test the ability to produce fuel and oxidizer using Martian resources, a crucial step for future human missions. A two-stage Mars Ascent Vehicle (MAV) concept was developed to support sample return as well as in-situ propellant production. The MAV would be powered by a solid rocket first stage and a LOX-propane second stage. A liquid second-stage provides higher orbit insertion reliability than a solid second stage as well as a degree of complexity eventually required for manned missions. Propane in particular offers comparable performance to methane without requiring cryogenic storage. The total MAV mass would be 119.9 kg to carry an 11 kg payload to orbit. The feasibility of in-situ fuel and oxidizer production was also examined. Two potential schemes were evaluated for production capability, size and power requirements. The schemes examined utilize CO2 and water as starting blocks to produce LOX and a propane blend. The infrastructure required to fuel and launch the MAV was also explored.

Performance of a low-pressure fan stage with reverse flow

NASA Technical Reports Server (NTRS)

Moore, R. D.; Lewis, G. W., Jr.; Tysl, E. R.

1976-01-01

The reverse flow aerodynamic performance of a 51-centimeter-diameter fan stage is presented. The stage was tested with the variable pitch rotor blades set through feather at -75 deg, -80 deg, and -85 deg from design setting angle. Of the three tested the stage with the rotor blades set at -75 deg exhibited the highest pressure ratio and highest flow. For all three configurations, there was little or no flow in the inner third of the exit passage due to the rotor blade being almost perpendicular to the axial direction in the hub region.

Two stage to orbit design

NASA Technical Reports Server (NTRS)

1991-01-01

A preliminary design of a two-stage to orbit vehicle was conducted with the requirements to carry a 10,000 pound payload into a 300 mile low-earth orbit using an airbreathing first stage, and to take off and land unassisted on a 15,000 foot runway. The goal of the design analysis was to produce the most efficient vehicle in size and weight which could accomplish the mission requirements. Initial parametric analysis indicated that the weight of the orbiter and the transonic performance of the system were the two parameters that had the largest impact on the design. The resulting system uses a turbofan ramjet powered first stage to propel a scramjet and rocket powered orbiter to the stage point of Mach 6 to 6.5 at an altitude of 90,000 ft.

Long-Term Results of Concurrent Chemoradiotherapy for Advanced N2-3 Stage Nasopharyngeal Carcinoma

PubMed Central

Wang, Xue; Chen, Meng; Wu, Jing; Xu, Jian-Hua; Qian, Pu-Dong; Guo, Wen-Jie; Jiang, Xue-Song; Zhu, Huan-Feng; Gu, Jia-Jia; Wu, Jian-Feng; Zhang, Ye-wei; He, Xia

2015-01-01

Background N-stage is related to distant metastasis in nasopharyngeal carcinoma (NPC) patients. The purpose of this study was to evaluate the efficacy and toxicity of different nedaplatin-based chemotherapy regimens in advanced N2-3 stage NPC patients treated with intensity modulated radiation therapy (IMRT). Patients and Methods Between April 2005 and December 2009, a total of 128 patients with N2-3 advanced NPC were retrospectively analyzed. Patients were treated with IMRT concurrent with 2 cycles of chemotherapy consisting of either nedaplatin plus paclitaxel (NP group, n = 67) or nedaplatin plus fluorouracil and paclitaxel (NFP group, n = 61). Two to four cycles of adjuvant chemotherapy were then administered every 21 days following concurrent chemoradiotherapy. Results With a median follow-up of 60 months, the 5-year overall survival (OS), progression-free survival (PFS), local-regional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) for all patients were 81.4%, 71.5%, 87.8% and 82.0%, respectively. No significant difference in PFS (66.6% vs. 76.7%, P = 0.212) and LRRFS rates (89.0% vs. 86.3%, P = 0.664) was observed between the NP and NFP groups. The 5-year OS (75.4% vs. 88.5%, P = 0.046) and DMFS (75.1% vs. 89.0%, P = 0.042) rate were superior in the NFP group compared with the NP group. The NFP group had a higher incidence of grade 3–4 acute toxicities including bone marrow suppression (leukopenia: χ2 = 3.935, P = 0.047; anemia: χ2 = 9.760, P = 0.002; thrombocytopenia: χ2 = 8.821, P = 0.003), and both liver and renal dysfunction (χ2 = 5.206, P = 0.023) compared with the NP group. Late toxicities were moderate and no difference was observed between the two groups. Conclusion IMRT concurrent with nedaplatin-based chemotherapy is an advocated regimen for patients with advanced N2-3 stage NPC. Patients with advanced N2-3 stage may be better candidates for the NFP regimen although this regimen was associated with a high acute

Rectosigmoidian Involvement in Advanced-stage Ovarian Cancer – Intraoperative Decisions

PubMed Central

BACALBASA, NICOLAE; BALESCU, IRINA; DIMA, SIMONA

2017-01-01

Background/Aim: Ovarian cancer remains one of the most commonly encountered malignancies affecting women worldwide, that is unfortunately commonly diagnosed in advanced stages of the disease. In these stages, the tumoral process usually involves the surrounding viscera throughout contiguity or induces the apparition of distant metastases via peritoneal, lymphatic or hematogenous spread, multiple resections being needed in order to achieve a good control of the disease. Patients and Methods: In the present study, we present a case series of 12 patients in whom various surgical procedures on the rectosigmoidian loop were performed in order to achieve debulking surgery to no residual disease. Results: Digestive tract resections consisted of rectosigmoidian resection with left colostomy in three cases, low rectosigmoidian resections with anastomosis in eight cases and a stripping procedure of the peritoneal layer in one case. Conclusion: Due to the close proximity of the digestive and gynecological tract, advanced-stage ovarian tumors frequently involve the rectosigmoidian loop, imposing association of digestive tract surgical procedures. PMID:28882968

Combined treatment of advanced stages of recurrent skin cancer of the head.

PubMed

Pompucci, Angelo; Rea, Giancarla; Farallo, Eugenio; Salgarello, Marzia; Campanella, Antonino; Fernandez, Eduardo

2004-04-01

The authors investigated whether skull base resection and primary free-flap reconstruction in a single-stage surgery is oncologically effective for treating advanced stages of recurrent skin cancer (RSC) of the head. Eighteen consecutive patients were surgically treated. Twelve of them underwent an anterolateral skull base resection, which was performed using a pterional craniotomy combined with an orbitozygomatic osteotomy. Six patients underwent a posterolateral skull base resection, which was performed using an asterional craniotomy combined with a retrolabyrinthine petrosectomy. The wide postoperative defects were covered with muscular or myocutaneous free flaps. The main factor influencing survival was the extent of the resection: patients with no or minimal residual disease showed a statistically significant longer survival time than those with consistent residual disease. Basal cell carcinoma had a better prognosis than squamous cell carcinoma. A trend toward improved survival was observed in patients classified as T4M0 with negative lymph nodes (N0), but this trend was not statistically significant. Adjuvant radiotherapy significantly influenced both survival time and the rate of local recurrence. The surgical morbidity rate was 27.8%; there were two transient cerebrospinal fluid leaks and three seventh cranial nerve injuries. Late complications included radionecrosis in one patient and skin erosion requiring a second surgery in another patient. No deaths occurred during a 30-day postoperative period. Advances in skull base surgery and free-flap reconstruction allowed the authors to treat patients with advanced-stage RSC of the head in a rather satisfactory manner. Only when it is impossible to achieve no or minimal residual disease should aggressive treatment be considered.

Compressed gas combined single- and two-stage light-gas gun

NASA Astrophysics Data System (ADS)

Lamberson, L. E.; Boettcher, P. A.

2018-02-01

With more than 1 trillion artificial objects smaller than 1 μm in low and geostationary Earth orbit, space assets are subject to the constant threat of space debris impact. These collisions occur at hypervelocity or speeds greater than 3 km/s. In order to characterize material behavior under this extreme event as well as study next-generation materials for space exploration, this paper presents a unique two-stage light-gas gun capable of replicating hypervelocity impacts. While a limited number of these types of facilities exist, they typically are extremely large and can be costly and dangerous to operate. The design presented in this paper is novel in two distinct ways. First, it does not use a form of combustion in the first stage. The projectile is accelerated from a pressure differential using air and inert gases (or purely inert gases), firing a projectile in a nominal range of 1-4 km/s. Second, the design is modular in that the first stage sits on a track sled and can be pulled back and used in itself to study lower speed impacts without any further modifications, with the first stage piston as the impactor. The modularity of the instrument allows the ability to investigate three orders of magnitude of impact velocities or between 101 and 103 m/s in a single, relatively small, cost effective instrument.

Compressed gas combined single- and two-stage light-gas gun.

PubMed

Lamberson, L E; Boettcher, P A

2018-02-01

With more than 1 trillion artificial objects smaller than 1 μm in low and geostationary Earth orbit, space assets are subject to the constant threat of space debris impact. These collisions occur at hypervelocity or speeds greater than 3 km/s. In order to characterize material behavior under this extreme event as well as study next-generation materials for space exploration, this paper presents a unique two-stage light-gas gun capable of replicating hypervelocity impacts. While a limited number of these types of facilities exist, they typically are extremely large and can be costly and dangerous to operate. The design presented in this paper is novel in two distinct ways. First, it does not use a form of combustion in the first stage. The projectile is accelerated from a pressure differential using air and inert gases (or purely inert gases), firing a projectile in a nominal range of 1-4 km/s. Second, the design is modular in that the first stage sits on a track sled and can be pulled back and used in itself to study lower speed impacts without any further modifications, with the first stage piston as the impactor. The modularity of the instrument allows the ability to investigate three orders of magnitude of impact velocities or between 10 1 and 10 3 m/s in a single, relatively small, cost effective instrument.

Two-stage solar power tower cavity-receiver design and thermal performance analysis

NASA Astrophysics Data System (ADS)

Pang, Liping; Wang, Ting; Li, Ruihua; Yang, Yongping

2017-06-01

New type of two-stage solar power tower cavity-receiver is designed and a calculating procedure of radiation, convection and flow under the Gaussian heat flux is established so as to determine the piping layout and geometries in the receiver I and II and the heat flux distribution in different positions is obtained. Then the main thermal performance on water/steam temperature, steam quality, wall temperature along the typical tubes and pressure drop are specified according to the heat transfer and flow characteristics of two-phase flow. Meanwhile, a series of systematic design process is promoted and analysis on thermal performance of the two receivers is conducted. Results show that this type of two-stage cavity-receivers can minimize the size and reduce the mean temperature of receiver I while raise the average heat flux, thus increase the thermal efficiency of the two receivers; besides, the multiple serpentine tubes from header can make a more uniform distribution of the outlet parameters, preventing wall overheated.

Two-stage implant systems.

PubMed

Fritz, M E

1999-06-01

Since the advent of osseointegration approximately 20 years ago, there has been a great deal of scientific data developed on two-stage integrated implant systems. Although these implants were originally designed primarily for fixed prostheses in the mandibular arch, they have been used in partially dentate patients, in patients needing overdentures, and in single-tooth restorations. In addition, this implant system has been placed in extraction sites, in bone-grafted areas, and in maxillary sinus elevations. Often, the documentation of these procedures has lagged. In addition, most of the reports use survival criteria to describe results, often providing overly optimistic data. It can be said that the literature describes a true adhesion of the epithelium to the implant similar to adhesion to teeth, that two-stage implants appear to have direct contact somewhere between 50% and 70% of the implant surface, that the microbial flora of the two-stage implant system closely resembles that of the natural tooth, and that the microbiology of periodontitis appears to be closely related to peri-implantitis. In evaluations of the data from implant placement in all of the above-noted situations by means of meta-analysis, it appears that there is a strong case that two-stage dental implants are successful, usually showing a confidence interval of over 90%. It also appears that the mandibular implants are more successful than maxillary implants. Studies also show that overdenture therapy is valid, and that single-tooth implants and implants placed in partially dentate mouths have a success rate that is quite good, although not quite as high as in the fully edentulous dentition. It would also appear that the potential causes of failure in the two-stage dental implant systems are peri-implantitis, placement of implants in poor-quality bone, and improper loading of implants. There are now data addressing modifications of the implant surface to alter the percentage of

Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers.

PubMed

Romanò, C L; Gala, L; Logoluso, N; Romanò, D; Drago, L

2012-12-01

The best method for treating chronic periprosthetic knee infection remains controversial. Randomized, comparative studies on treatment modalities are lacking. This systematic review of the literature compares the infection eradication rate after two-stage versus one-stage revision and static versus articulating spacers in two-stage procedures. We reviewed full-text papers and those with an abstract in English published from 1966 through 2011 that reported the success rate of infection eradication after one-stage or two-stage revision with two different types of spacers. In all, 6 original articles reporting the results after one-stage knee exchange arthoplasty (n = 204) and 38 papers reporting on two-stage revision (n = 1,421) were reviewed. The average success rate in the eradication of infection was 89.8% after a two-stage revision and 81.9% after a one-stage procedure at a mean follow-up of 44.7 and 40.7 months, respectively. The average infection eradication rate after a two-stage procedure was slightly, although significantly, higher when an articulating spacer rather than a static spacer was used (91.2 versus 87%). The methodological limitations of this study and the heterogeneous material in the studies reviewed notwithstanding, this systematic review shows that, on average, a two-stage procedure is associated with a higher rate of eradication of infection than one-stage revision for septic knee prosthesis and that articulating spacers are associated with a lower recurrence of infection than static spacers at a comparable mean duration of follow-up. IV.

Effects of reset stators and a rotating, grooved stator hub on performance of a 1.92-pressure-ratio compressor stage

NASA Technical Reports Server (NTRS)

Lewis, G. W., Jr.; Urasek, D. C.; Reid, L.

1977-01-01

The overall performance and blade-element performance of a transonic fan stage are presented for two modified test configurations and are compared with the unmodified stage. Tests were conducted with reset stators 2 deg open and reset stators with a rotating grooved stator hub. Detailed radial and circumferential (behind stator) surveys of the flow conditions were made over the stable operating range at rotative speeds of 70, 90, and 100 percent of design speed. Reset stator blade tests indicated a small increase in stage efficiency, pressure ratio, and maximum weight flow at each speed. Performance with reset stators and a rotating, grooved stator hub resulted in an additional increase in stage efficiency and pressure ratio at all speeds. The rotating grooved stator hub reduced hub losses considerably.

Single stage experimental evaluation of tandem-airfoil rotor and stator blading for compressors. Part 4: Data and performance for stage B

NASA Technical Reports Server (NTRS)

Brent, J. A.; Cheatham, J. G.

1973-01-01

Stage B, composed of tandem-airfoil rotor B and stator B, was tested with uniform inlet flow and with hub radial, tip radial and 90 degree one-per-revolution circumferential distortion of the inlet flow as part of an overall program to evaluate the effectiveness of tandem airfoils for increasing the design point loading capability and stable operating range of rotor and stator blading. The results of this series of tests provide overall performance and blade element data for evaluating: (1) the potential of tandem blading for extending the loading limit and stable operating range of a stage representative of a middle stage of an advanced high pressure compressor, (2) the effect of loading split between the two airfoils in tandem on the performance of tandem blading, and (3) the effects of inlet flow distortion on the stage performance. The rotor had an inlet hub/tip ratio of 0.8 and a design tip velocity of 757 ft/sec. With uniform inlet flow, rotor B achieved a maximum adiabatic efficiency of 88.4% at design equivalent rotor speed and a pressure ratio of 1.31. The stage maximum adiabatic efficiency at design equivalent rotor speed with uniform inlet flow was 82.5% at a pressure ratio of 1.28. Tip radial and circumferential distortion of the inlet flow caused substantial reductions in surge margin.

[Clinical Advanced in Early-stage ALK-positive Non-small Cell Lung Cancer Patients].

PubMed

Gao, Qiongqiong; Jiang, Xiangli; Huang, Chun

2017-02-20

Lung cancer is the leading cause of cancer death in China. Non-small cell lung cancer (NSCLC) accounts for 85% of lung cancer cases, with the majority of the cases diagnosed at the advanced stage. Molecular targeted therapy is becoming the focus attention for advanced NSCLC. Echinoderm microtubule-associated protein-like 4 gene and the anaplastic lymphoma kinase gene (EML4-ALK) is among the most common molecular targets of NSCLC; its specific small-molecule tyrosine kinase inhibitors (TKIs) are approved for use in advanced NSCLC cases of ALK-positive. However, the influence of EML4-ALK fusion gene on the outcome of early-stage NSCLC cases and the necessity of application of TKIs for early-stage ALK-positive NSCLC patients are still uncertain. In this paper, we summarized the progression of testing methods for ALK-positive NSCLC patients as well as clinicopathological implication, outcome, and necessity of application of TKIs for early-stage ALK-positive NSCLC patients.

Potential of two-stage membrane system with recycle stream for CO{sub 2} capture from postcombustion gas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dongxiao Yang; Zhi Wang; Jixiao Wang

2009-09-15

In order to restrict greenhouse gases emissions, CO{sub 2} should be captured from the postcombustion gas for further treatment, for example, geosequestration. In this work, the separation performance of the two-stage membrane system with a recycle stream was investigated using the cross-flow model. For larger CO{sub 2}/N{sub 2} selectivities that can be achieved in the lab, for example, selectivity of 52, the separation target of CO{sub 2} purity >95% and CO{sub 2} recovery >90% can be fulfilled by the two-stage system. The process cost of the two-stage membrane process was investigated. There is an optimum pressure ratio with which themore » capital cost and the energy cost can be balanced to minimize the total cost. Using the optimum pressure ratios and efficient membranes, the total cost of the two-stage system can be reduced to a range that is competitive with the process cost of the traditional chemical absorption method. For example, with feed compression applied, the total cost of the two-stage membrane system using the membrane with CO{sub 2}/N{sub 2} selectivity of 52 and CO{sub 2} permeance of 3.12 x 10{sup -3} m{sup 3} (STP) m{sup -2} s{sup -1} MPa{sup -1} is estimated to be $47.9/(ton CO{sub 2} recovered). 22 refs., 11 figs., 3 tabs.« less

CFD modeling of two-stage ignition in a rapid compression machine: Assessment of zero-dimensional approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mittal, Gaurav; Raju, Mandhapati P.; Sung, Chih-Jen

2010-07-15

In modeling rapid compression machine (RCM) experiments, zero-dimensional approach is commonly used along with an associated heat loss model. The adequacy of such approach has not been validated for hydrocarbon fuels. The existence of multi-dimensional effects inside an RCM due to the boundary layer, roll-up vortex, non-uniform heat release, and piston crevice could result in deviation from the zero-dimensional assumption, particularly for hydrocarbons exhibiting two-stage ignition and strong thermokinetic interactions. The objective of this investigation is to assess the adequacy of zero-dimensional approach in modeling RCM experiments under conditions of two-stage ignition and negative temperature coefficient (NTC) response. Computational fluidmore » dynamics simulations are conducted for n-heptane ignition in an RCM and the validity of zero-dimensional approach is assessed through comparisons over the entire NTC region. Results show that the zero-dimensional model based on the approach of 'adiabatic volume expansion' performs very well in adequately predicting the first-stage ignition delays, although quantitative discrepancy for the prediction of the total ignition delays and pressure rise in the first-stage ignition is noted even when the roll-up vortex is suppressed and a well-defined homogeneous core is retained within an RCM. Furthermore, the discrepancy is pressure dependent and decreases as compressed pressure is increased. Also, as ignition response becomes single-stage at higher compressed temperatures, discrepancy from the zero-dimensional simulations reduces. Despite of some quantitative discrepancy, the zero-dimensional modeling approach is deemed satisfactory from the viewpoint of the ignition delay simulation. (author)« less

An Effective Technique for Endoscopic Resection of Advanced Stage Angiofibroma

PubMed Central

Mohammadi Ardehali, Mojtaba; Samimi, Seyyed Hadi; Bakhshaee, Mehdi

2014-01-01

Introduction: In recent years, the surgical management of angiofibroma has been greatly influenced by the use of endoscopic techniques. However, large tumors that extend into difficult anatomic sites present major challenges for management by either endoscopy or an open-surgery approach which needs new technique for the complete en block resection. Materials and Methods: In a prospective observational study we developed an endoscopic transnasal technique for the resection of angiofibroma via pushing and pulling the mass with 1/100000 soaked adrenalin tampons. Thirty two patients were treated using this endoscopic technique over 7 years. The mean follow-up period was 36 months. The main outcomes measured were tumor staging, average blood loss, complications, length of hospitalization, and residual and/or recurrence rate of the tumor. Results: According to the Radkowski staging, 23,5, and 4 patients were at stage IIC, IIIA, and IIIB, respectively. Twenty five patients were operated on exclusively via transnasal endoscopy while 7 patients were managed using endoscopy-assisted open-surgery techniques. Mean blood loss in patients was 1261± 893 cc. The recurrence rate was 21.88% (7 cases) at two years following surgery. Mean hospitalization time was 3.56 ± 0.6 days. Conclusion: Using this effective technique, endoscopic removal of more highly advanced angiofibroma is possible. Better visualization, less intraoperative blood loss, lower rates of complication and recurrence, and shorter hospitalization time are some of the advantages. PMID:24505571

Prognostic impact of perineural invasion and lymphovascular invasion in advanced stage oral squamous cell carcinoma.

PubMed

Jardim, J F; Francisco, A L N; Gondak, R; Damascena, A; Kowalski, L P

2015-01-01

Perineural invasion (PNI) and lymphovascular invasion (LVI) have been associated with the risk of local recurrences and lymph node metastasis. The aim of this study was to evaluate the prognostic impact of PNI and LVI in patients with advanced stage squamous cell carcinoma of the tongue and floor of the mouth. One hundred and forty-two patients without previous treatment were selected. These patients underwent radical surgery with neck dissection and adjuvant treatment. Clinicopathological data were retrieved from the medical charts, including histopathology and surgery reports. Univariate analysis was performed to assess the impact of studied variables on survival. Overall survival was negatively influenced by six tumour-related factors: increasing T stage (P = 0.003), more than two clinically positive nodes (P = 0.002), extracapsular spread of lymph node metastasis (P < 0.001), tumour thickness (P = 0.04), PNI (P < 0.001), and LVI (P = 0.012). Disease-free survival was influenced by PNI (P = 0.04), extracapsular spread of lymph node metastasis (P = 0.008), and N stage (P = 0.006). Multivariate analysis showed PNI to be an independent predictor for overall survival (P = 0.01) and disease-free survival (P = 0.03). Thus the presence of PNI in oral carcinoma surgical specimens has a significant impact on survival outcomes in patients with advanced stage tumours submitted to radical surgery and adjuvant radiotherapy/radiochemotherapy. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Two Regimes of Bandgap Red Shift and Partial Ambient Retention in Pressure-Treated Two-Dimensional Perovskites

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Gang; Kong, Lingping; Guo, Peijun

The discovery of elevated environmental stability in two-dimensional (2D) Ruddlesden–Popper hybrid perovskites represents a significant advance in low-cost, high-efficiency light absorbers. In comparison to 3D counterparts, 2D perovskites of organo-lead-halides exhibit wider, quantum-confined optical bandgaps that reduce the wavelength range of light absorption. Here, we characterize the structural and optical properties of 2D hybrid perovskites as a function of hydrostatic pressure. We observe bandgap narrowing with pressure of 633 meV that is partially retained following pressure release due to an atomic reconfiguration mechanism. We identify two distinct regimes of compression dominated by the softer organic and less compressible inorganic sublattices.more » Our findings, which also include PL enhancement, correlate well with density functional theory calculations and establish structure–property relationships at the atomic scale. These concepts can be expanded into other hybrid perovskites and suggest that pressure/strain processing could offer a new route to improved materials-by-design in applications.« less

A Two-Stage Foot Repair in a 55-Year-Old Man with Poliomyelitis.

PubMed

Pollack, Daniel

2018-01-01

A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub-first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure. The second stage corrected the osseous deformity with a dorsiflexory wedge osteotomy of the first metatarsal. The ulceration has remained closed since the procedures, with complete resolution of pain.

Three-dimensional unsteady flow calculations in an advanced gas generator turbine

NASA Technical Reports Server (NTRS)

Rangwalla, Akil A.

1993-01-01

This paper deals with the application of a three-dimensional, unsteady Navier-Stokes code for predicting the unsteady flow in a single stage of an advanced gas generator turbine. The numerical method solves the three-dimensional thin-layer Navier-Stokes equations, using a system of overlaid grids, which allow for relative motion between the rotor and stator airfoils. Results in the form of time averaged pressures and pressure amplitudes on the airfoil surfaces will be shown. In addition, instantaneous contours of pressure, Mach number, etc. will be presented in order to provide a greater understanding of the inviscid as well as the viscous aspects of the flowfield. Also, relevant secondary flow features such as cross-plane velocity vectors and total pressure contours will be presented. Prior work in two-dimensions has indicated that for the advanced designs, the unsteady interactions can play a significant role in turbine performance. These interactions affect not only the stage efficiency but can substantially alter the time-averaged features of the flow. This work is a natural extension of the work done in two-dimensions and hopes to address some of the issues raised by the two-dimensional calculations. These calculations are being performed as an integral part of an actual design process and demonstrate the value of unsteady rotor-stator interaction calculations in the design of turbomachines.

Study of blade aspect ratio on a compressor front stage

NASA Technical Reports Server (NTRS)

Behlke, R. F.; Brooky, J. D.; Canal, E., Jr.

1980-01-01

A single stage, low aspect ratio, compressor with a 442.0 m/sec (1450 ft/sec) tip speed and a 0.597 hub/tip ratio typical of an advanced core compressor front stage was tested. The test stage incorporated an inlet duct which was representative of an engine transition duct between fan and high pressure compressors. At design speed, the rotor stator stage achieved a peak adiabatic efficiency of 86.6 percent at a flow of 44.35 kg/sec (97.8 lbm/sec) and a pressure ratio of 1.8. Surge margin was 12.5 percent from the peak stage efficiency point.

Numerical analysis of flow interaction of turbine system in two-stage turbocharger of internal combustion engine

NASA Astrophysics Data System (ADS)

Liu, Y. B.; Zhuge, W. L.; Zhang, Y. J.; Zhang, S. Y.

2016-05-01

To reach the goal of energy conservation and emission reduction, high intake pressure is needed to meet the demand of high power density and high EGR rate for internal combustion engine. Present power density of diesel engine has reached 90KW/L and intake pressure ratio needed is over 5. Two-stage turbocharging system is an effective way to realize high compression ratio. Because turbocharging system compression work derives from exhaust gas energy. Efficiency of exhaust gas energy influenced by design and matching of turbine system is important to performance of high supercharging engine. Conventional turbine system is assembled by single-stage turbocharger turbines and turbine matching is based on turbine MAP measured on test rig. Flow between turbine system is assumed uniform and value of outlet physical quantities of turbine are regarded as the same as ambient value. However, there are three-dimension flow field distortion and outlet physical quantities value change which will influence performance of turbine system as were demonstrated by some studies. For engine equipped with two-stage turbocharging system, optimization of turbine system design will increase efficiency of exhaust gas energy and thereby increase engine power density. However flow interaction of turbine system will change flow in turbine and influence turbine performance. To recognize the interaction characteristics between high pressure turbine and low pressure turbine, flow in turbine system is modeled and simulated numerically. The calculation results suggested that static pressure field at inlet to low pressure turbine increases back pressure of high pressure turbine, however efficiency of high pressure turbine changes little; distorted velocity field at outlet to high pressure turbine results in swirl at inlet to low pressure turbine. Clockwise swirl results in large negative angle of attack at inlet to rotor which causes flow loss in turbine impeller passages and decreases turbine

Structure design of and experimental research on a two-stage laval foam breaker for foam fluid recycling.

PubMed

Wang, Jin-song; Cao, Pin-lu; Yin, Kun

2015-07-01

Environmental, economical and efficient antifoaming technology is the basis for achievement of foam drilling fluid recycling. The present study designed a novel two-stage laval mechanical foam breaker that primarily uses vacuum generated by Coanda effect and Laval principle to break foam. Numerical simulation results showed that the value and distribution of negative pressure of two-stage laval foam breaker were larger than that of the normal foam breaker. Experimental results showed that foam-breaking efficiency of two-stage laval foam breaker was higher than that of normal foam breaker, when gas-to-liquid ratio and liquid flow rate changed. The foam-breaking efficiency of normal foam breaker decreased rapidly with increasing foam stability, whereas the two-stage laval foam breaker remained unchanged. Foam base fluid would be recycled using two-stage laval foam breaker, which would reduce the foam drilling cost sharply and waste disposals that adverse by affect the environment.

Impact of Pulmonary Flow Study Pressure on Outcomes After One-Stage Unifocalization.

PubMed

Trezzi, Matteo; Albanese, Sonia B; Albano, Antonio; Rinelli, Gabriele; D'Anna, Carolina; Polito, Angelo; Cetrano, Enrico; Carotti, Adriano

2017-12-01

The purpose of this study was to evaluate the accuracy of the pulmonary flow study in (1) predicting the feasibility of concomitant intracardiac repair after one-stage unifocalization; and in (2) predicting long-term survival and the onset of right ventricular dysfunction after surgery. Between October 1996 and July 2015, a flow study was obtained in 95 patients undergoing complete one-stage unifocalization for pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals. The ability to achieve 100% flow (approximately 2.5 L · min -1 · m -2 ) into the pulmonary bed at a mean pressure of 30 mm Hg or less was utilized as an indicator for acceptability of ventricular septal defect closure. Overall survival was 78% ± 6% at 15 years. Sixty-four patients underwent successful one-stage intracardiac repair. The flow study accurately predicted suitability for VSD closure (area under the curve = 0.855). After one-stage ventricular septal defect closure, no difference in survival was observed after stratification according to flow study pressures (25 mm Hg or less versus greater than 25 mm Hg, log rank p = 0.20). At a median follow-up of 7 years, no association was found between flow study pressure and the onset of right ventricular dysfunction (p = 0.21). Overall, the inability to achieve final intracardiac repair was a strong predictor of death (hazard ratio 9.14, 95% confidence interval: 1.98 to 42.07, p < 0.0001). Suitability for ventricular septal defect closure is reliably defined by the flow study with a cutoff of 30 mm Hg. Flow study pressure values do not affect long-term outcomes. The ability to obtain intracardiac repair (in either one or more stages) is the strongest predictor of survival. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Accuracy of the One-Stage and Two-Stage Impression Techniques: A Comparative Analysis.

PubMed

Jamshidy, Ladan; Mozaffari, Hamid Reza; Faraji, Payam; Sharifi, Roohollah

2016-01-01

Introduction . One of the main steps of impression is the selection and preparation of an appropriate tray. Hence, the present study aimed to analyze and compare the accuracy of one- and two-stage impression techniques. Materials and Methods . A resin laboratory-made model, as the first molar, was prepared by standard method for full crowns with processed preparation finish line of 1 mm depth and convergence angle of 3-4°. Impression was made 20 times with one-stage technique and 20 times with two-stage technique using an appropriate tray. To measure the marginal gap, the distance between the restoration margin and preparation finish line of plaster dies was vertically determined in mid mesial, distal, buccal, and lingual (MDBL) regions by a stereomicroscope using a standard method. Results . The results of independent test showed that the mean value of the marginal gap obtained by one-stage impression technique was higher than that of two-stage impression technique. Further, there was no significant difference between one- and two-stage impression techniques in mid buccal region, but a significant difference was reported between the two impression techniques in MDL regions and in general. Conclusion . The findings of the present study indicated higher accuracy for two-stage impression technique than for the one-stage impression technique.

Post-operative radiation therapy for advanced-stage oropharyngeal cancer.

PubMed

Hansen, Eric; Panwala, Kathryn; Holland, John

2002-11-01

Between 1985 and 1999, 43 patients with locally-advanced, resectable oropharyngeal cancer were treated with combined surgery and post-operative radiation therapy (RT) at Oregon Health and Science University. Five patients (12 per cent) had Stage III disease and 38 patients (88 per cent) had Stage IV disease. All patients had gross total resections of the primary tumour. Thirty-seven patients had neck dissections for regional disease. RT consisted of a mean tumour-bed dose of 63.0 Gy delivered in 1.8-2.0 Gy fractions over a mean of 49 days. At three- and five-years, the actuarial local control was 96 per cent and the actuarial local/regional control was 80 per cent. The three- and five-year actuarial rates of distant metastases were 41 per cent and 46 per cent, respectively. The actuarial overall survival at three- and five-years was 41 per cent and 34 per cent, respectively. The actuarial rates of progression-free survival were 49 per cent at three-years and 45 per cent at five years. Combined surgery and post-operative RT for advanced-stage oropharyngeal cancer results in excellent local/regional control. This particular group of patients experienced a high-rate of developing distant metastases.

Two-stage fan. 4: Performance data for stator setting angle optimization

NASA Technical Reports Server (NTRS)

Burger, G. D.; Keenan, M. J.

1975-01-01

Stator setting angle optimization tests were conducted on a two-stage fan to improve efficiency at overspeed, stall margin at design speed, and both efficiency and stall margin at partspeed. The fan has a design pressure ratio of 2.8, a flow rate of 184.2 lb/sec (83.55 kg/sec) and a 1st-stage rotor tip speed of 1450 ft/sec (441.96 in/sec). Performance was obtained at 70,100, and 105 percent of design speed with different combinations of 1st-stage and 2nd-stage stator settings. One combination of settings, other than design, was common to all three speeds. At design speed, a 2.0 percentage point increase in stall margin was obtained at the expense of a 1.3 percentage point efficiency decrease. At 105 percent speed, efficiency was improved by 1.8 percentage points but stall margin decreased 4.7 percentage points. At 70 percent speed, no change in stall margin or operating line efficiency was obtained with stator resets although considerable speed-flow requlation occurred.

Two-stage unilateral versus one-stage bilateral single-port sympathectomy for palmar and axillary hyperhidrosis†

PubMed Central

Ibrahim, Mohsen; Menna, Cecilia; Andreetti, Claudio; Ciccone, Anna Maria; D'Andrilli, Antonio; Maurizi, Giulio; Poggi, Camilla; Vanni, Camilla; Venuta, Federico; Rendina, Erino Angelo

2013-01-01

OBJECTIVES Video-assisted thoracoscopic sympathectomy is currently the best treatment for palmar and axillary hyperhidrosis. It can be performed through either one or two stages of surgery. This study aimed to evaluate the operative and postoperative results of two-stage unilateral vs one-stage bilateral thoracoscopic sympathectomy. METHODS From November 1995 to February 2011, 270 patients with severe palmar and/or axillary hyperhidrosis were recruited for this study. One hundred and thirty patients received one-stage bilateral, single-port video-assisted thoracoscopic sympathectomy (one-stage group) and 140, two-stage unilateral, single-port video-assisted thoracoscopic sympathectomy, with a mean time interval of 4 months between the procedures (two-stage group). RESULTS The mean postoperative follow-up period was 12.5 (range: 1–24 months). After surgery, hands and axillae of all patients were dry and warm. Sixteen (12%) patients of the one-stage group and 15 (11%) of the two-stage group suffered from mild/moderate pain (P = 0.8482). The mean operative time was 38 ± 5 min in the one-stage group and 39 ± 8 min in the two-stage group (P = 0.199). Pneumothorax occurred in 8 (6%) patients of the one-stage group and in 11 (8%) of the two-stage group. Compensatory sweating occurred in 25 (19%) patients of the one-stage group and in 6 (4%) of the two-stage group (P = 0.0001). No patients developed Horner's syndrome. CONCLUSIONS Both two-stage unilateral and one-stage bilateral single-port video-assisted thoracoscopic sympathectomies are effective, safe and minimally invasive procedures. Two-stage unilateral sympathectomy can be performed with a lower occurrence of compensatory sweating, improving permanently the quality of life in patients with palmar and axillary hyperhidrosis. PMID:23442937

Two-stage unilateral versus one-stage bilateral single-port sympathectomy for palmar and axillary hyperhidrosis.

PubMed

Ibrahim, Mohsen; Menna, Cecilia; Andreetti, Claudio; Ciccone, Anna Maria; D'Andrilli, Antonio; Maurizi, Giulio; Poggi, Camilla; Vanni, Camilla; Venuta, Federico; Rendina, Erino Angelo

2013-06-01

Video-assisted thoracoscopic sympathectomy is currently the best treatment for palmar and axillary hyperhidrosis. It can be performed through either one or two stages of surgery. This study aimed to evaluate the operative and postoperative results of two-stage unilateral vs one-stage bilateral thoracoscopic sympathectomy. From November 1995 to February 2011, 270 patients with severe palmar and/or axillary hyperhidrosis were recruited for this study. One hundred and thirty patients received one-stage bilateral, single-port video-assisted thoracoscopic sympathectomy (one-stage group) and 140, two-stage unilateral, single-port video-assisted thoracoscopic sympathectomy, with a mean time interval of 4 months between the procedures (two-stage group). The mean postoperative follow-up period was 12.5 (range: 1-24 months). After surgery, hands and axillae of all patients were dry and warm. Sixteen (12%) patients of the one-stage group and 15 (11%) of the two-stage group suffered from mild/moderate pain (P = 0.8482). The mean operative time was 38 ± 5 min in the one-stage group and 39 ± 8 min in the two-stage group (P = 0.199). Pneumothorax occurred in 8 (6%) patients of the one-stage group and in 11 (8%) of the two-stage group. Compensatory sweating occurred in 25 (19%) patients of the one-stage group and in 6 (4%) of the two-stage group (P = 0.0001). No patients developed Horner's syndrome. Both two-stage unilateral and one-stage bilateral single-port video-assisted thoracoscopic sympathectomies are effective, safe and minimally invasive procedures. Two-stage unilateral sympathectomy can be performed with a lower occurrence of compensatory sweating, improving permanently the quality of life in patients with palmar and axillary hyperhidrosis.

Fertility-sparing surgery in advanced stage malignant ovarian germ cell tumor: a case report.

PubMed

Ghalleb, Montassar; Bouzaiene, Hatem; Slim, Skander; Hadiji, Achraf; Hechiche, Monia; Ben Hassouna, Jamel; Rahal, Khaled

2017-12-17

Malignant ovarian germ cell tumor is a rare type of disease, which generally has a good prognosis due to the high chemosensitivity of this type of tumor. Fertility preservation is an important issue because malignant ovarian germ cell tumor commonly affects young women. Although conservation is the standard for early stage, it becomes more debatable as the disease progresses to more advanced stages. Report the case of a patient with an International Federation of Gynecology and Obstetrics Stage IIIc malignant ovarian germ cell tumor, who had conservative surgery and chemotherapy with a good fertility outcome. A 23-year-old North African woman with a left malignant ovarian germ cell tumor stage IIIc was treated by left adnexectomy and omentectomy followed by chemotherapy. A 15-year follow-up showed no signs of relapse, and she completed three full-term natural pregnancies. Malignant ovarian germ cell tumor is a rare ovarian tumor with a good prognosis. It is usually associated with a good fertility outcome in early stages. However, due to the rarity of the disease in advanced stages, the fertility outcome for this group of patients is not clear. This lack of data surrounding advanced stages points to the need for a meta-analysis of all published cases.

Study on a high capacity two-stage free piston Stirling cryocooler working around 30 K

NASA Astrophysics Data System (ADS)

Wang, Xiaotao; Zhu, Jian; Chen, Shuai; Dai, Wei; Li, Ke; Pang, Xiaomin; Yu, Guoyao; Luo, Ercang

2016-12-01

This paper presents a two-stage high-capacity free-piston Stirling cryocooler driven by a linear compressor to meet the requirement of the high temperature superconductor (HTS) motor applications. The cryocooler system comprises a single piston linear compressor, a two-stage free piston Stirling cryocooler and a passive oscillator. A single stepped displacer configuration was adopted. A numerical model based on the thermoacoustic theory was used to optimize the system operating and structure parameters. Distributions of pressure wave, phase differences between the pressure wave and the volume flow rate and different energy flows are presented for a better understanding of the system. Some characterizing experimental results are presented. Thus far, the cryocooler has reached a lowest cold-head temperature of 27.6 K and achieved a cooling power of 78 W at 40 K with an input electric power of 3.2 kW, which indicates a relative Carnot efficiency of 14.8%. When the cold-head temperature increased to 77 K, the cooling power reached 284 W with a relative Carnot efficiency of 25.9%. The influences of different parameters such as mean pressure, input electric power and cold-head temperature are also investigated.

Accuracy of the One-Stage and Two-Stage Impression Techniques: A Comparative Analysis

PubMed Central

Jamshidy, Ladan; Faraji, Payam; Sharifi, Roohollah

2016-01-01

Introduction. One of the main steps of impression is the selection and preparation of an appropriate tray. Hence, the present study aimed to analyze and compare the accuracy of one- and two-stage impression techniques. Materials and Methods. A resin laboratory-made model, as the first molar, was prepared by standard method for full crowns with processed preparation finish line of 1 mm depth and convergence angle of 3-4°. Impression was made 20 times with one-stage technique and 20 times with two-stage technique using an appropriate tray. To measure the marginal gap, the distance between the restoration margin and preparation finish line of plaster dies was vertically determined in mid mesial, distal, buccal, and lingual (MDBL) regions by a stereomicroscope using a standard method. Results. The results of independent test showed that the mean value of the marginal gap obtained by one-stage impression technique was higher than that of two-stage impression technique. Further, there was no significant difference between one- and two-stage impression techniques in mid buccal region, but a significant difference was reported between the two impression techniques in MDL regions and in general. Conclusion. The findings of the present study indicated higher accuracy for two-stage impression technique than for the one-stage impression technique. PMID:28003824

Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer?

PubMed Central

Fieira, Eva; Delgado, Maria; Mendez, Lucía; Fernandez, Ricardo; de la Torre, Mercedes

2014-01-01

Objectives Conventional video-assisted thoracoscopic (VATS) lobectomy for advanced lung cancer is a feasible and safe surgery in experienced centers. The aim of this study is to assess the feasibility of uniportal VATS approach in the treatment of advanced non-small cell lung cancer (NSCLC) and compare the perioperative outcomes and survival with those in early-stage tumors operated through the uniportal approach. Methods From June 2010 to December 2012, we performed 163 uniportal VATS major pulmonary resections. Only NSCLC cases were included in this study (130 cases). Patients were divided into two groups: (A) early stage and (B) advanced cases (>5 cm, T3 or T4, or tumors requiring neoadjuvant treatment). A descriptive and retrospective study was performed, comparing perioperative outcomes and survival obtained in both groups. A survival analysis was performed with Kaplan-Meier curves and the log-rank test was used to compare survival between patients with early and advanced stages. Results A total of 130 cases were included in the study: 87 (A) vs. 43 (B) patients (conversion rate 1.1 vs. 6.5%, P=0.119). Mean global age was 64.9 years and 73.8% were men. The patient demographic data was similar in both groups. Upper lobectomies (A, 52 vs. B, 21 patients) and anatomic segmentectomies (A, 4 vs. B, 0) were more frequent in group A while pneumonectomy was more frequent in B (A, 1 vs. B, 6 patients). Surgical time was longer (144.9±41.3 vs. 183.2±48.9, P<0.001), and median number of lymph nodes (14 vs. 16, P=0.004) were statistically higher in advanced cases. Median number of nodal stations (5 vs. 5, P=0.165), days of chest tube (2 vs. 2, P=0.098), HOS (3 vs. 3, P=0.072), and rate of complications (17.2% vs. 14%, P=0.075) were similar in both groups. One patient died on the 58th postoperative day. The 30-month survival rate was 90% for the early stage group and 74% for advanced cases Conclusions Uniportal VATS lobectomy for advanced cases of NSCLC is a safe and

Discussion on back-to-back two-stage centrifugal compressor compact design techniques

NASA Astrophysics Data System (ADS)

Huo, Lei; Liu, Huoxing

2013-12-01

Design a small flow back-to-back two-stage centrifugal compressor in the aviation turbocharger, the compressor is compact structure, small axial length, light weighted. Stationary parts have a great influence on their overall performance decline. Therefore, the stationary part of the back-to-back two-stage centrifugal compressor should pay full attention to the diffuser, bend, return vane and volute design. Volute also impact downstream return vane, making the flow in circumferential direction is not uniformed, and several blade angle of attack is drastically changed in downstream of the volute with the airflow can not be rotated to required angle. Loading of high-pressure rotor blades change due to non-uniformed of flow in circumferential direction, which makes individual blade load distribution changed, and affected blade passage load decreased to reduce the capability of work, the tip low speed range increases.

Advanced expander test bed engine

NASA Technical Reports Server (NTRS)

Mitchell, J. P.

1992-01-01

The Advanced Expander Test Bed (AETB) is a key element in NASA's Space Chemical Engine Technology Program for development and demonstration of expander cycle oxygen/hydrogen engine and advanced component technologies applicable to space engines as well as launch vehicle upper stage engines. The AETB will be used to validate the high pressure expander cycle concept, study system interactions, and conduct studies of advanced mission focused components and new health monitoring techniques in an engine system environment. The split expander cycle AETB will operate at combustion chamber pressures up to 1200 psia with propellant flow rates equivalent to 20,000 lbf vacuum thrust.

Investigation of gas stripping and pervaporation for improved feasibility of two-stage butanol production process.

PubMed

Setlhaku, Mpho; Heitmann, Sebastian; Górak, Andrzej; Wichmann, Rolf

2013-05-01

Gas stripping and pervaporation are investigated for butanol recovery in a two-stage acetone-butanol-ethanol (ABE) fermentation process. The first stage is operated in a continuous mode and the second stage as a fed-batch. Gas stripping coupled to the second stage and operated intermittently enabled additional glucose feeding in the second stage and up to 59 g/L butanol and 73 g/L total ABE solvents in the condensate. Concentration of 167 g/L butanol and 269 g/L ABE in the permeate was measured in ex situ pervaporation experiments using a PDMS membrane at temperature of 37 °C and pressure of 10mbars. The "operating window" tool is introduced to evaluate the feasibility of the existing ABE fermentations operated as continuous with cell recycle, as two-stages, with biomass immobilization or with integrated product removal. This tool enables the identification of the most favorable process configuration, which is the combination of cell immobilization and integrated product removal. Copyright © 2013 Elsevier Ltd. All rights reserved.

Acoustic pressures emanating from a turbomachine stage

NASA Technical Reports Server (NTRS)

Ramachandra, S. M.

1984-01-01

A knowledge of the acoustic energy emission of each blade row of a turbomachine is useful for estimating the overall noise level of the machine and for determining its discrete frequency noise content. Because of the close spacing between the rotor and stator of a compressor stage, the strong aerodynamic interactions between them have to be included in obtaining the resultant flow field. A three dimensional theory for determining the discrete frequency noise content of an axial compressor consisting of a rotor and a stator each with a finite number of blades are outlined. The lifting surface theory and the linearized equation of an ideal, nonsteady compressible fluid motion are used for thin blades of arbitrary cross section. The combined pressure field at a point of the fluid is constructed by linear addition of the rotor and stator solutions together with an interference factor obtained by matching them for net zero vorticity behind the stage.

Advancing Early Detection of Autism Spectrum Disorder by Applying an Integrated Two-Stage Screening Approach

ERIC Educational Resources Information Center

Oosterling, Iris J.; Wensing, Michel; Swinkels, Sophie H.; van der Gaag, Rutger Jan; Visser, Janne C.; Woudenberg, Tim; Minderaa, Ruud; Steenhuis, Mark-Peter; Buitelaar, Jan K.

2010-01-01

Background: Few field trials exist on the impact of implementing guidelines for the early detection of autism spectrum disorders (ASD). The aims of the present study were to develop and evaluate a clinically relevant integrated early detection programme based on the two-stage screening approach of Filipek et al. (1999), and to expand the evidence…

High-Pressure Design of Advanced BN-Based Materials.

PubMed

Kurakevych, Oleksandr O; Solozhenko, Vladimir L

2016-10-20

The aim of the present review is to highlight the state of the art in high-pressure design of new advanced materials based on boron nitride. Recent experimental achievements on the governing phase transformation, nanostructuring and chemical synthesis in the systems containing boron nitride at high pressures and high temperatures are presented. All these developments allowed discovering new materials, e.g., ultrahard nanocrystalline cubic boron nitride (nano-cBN) with hardness comparable to diamond, and superhard boron subnitride B 13 N₂. Thermodynamic and kinetic aspects of high-pressure synthesis are described based on the data obtained by in situ and ex situ methods. Mechanical and thermal properties (hardness, thermoelastic equations of state, etc.) are discussed. New synthetic perspectives, combining both soft chemistry and extreme pressure-temperature conditions are considered.

Advanced Low-Noise Research Fan Stage Design

NASA Technical Reports Server (NTRS)

Neubert, Robert; Bock, Larry; Malmborg, Eric; Owen-Peer, William

1997-01-01

This report describes the design of the Advanced Low-Noise Research Fan stage. The fan is a variable pitch design, which is designed at the cruise pitch condition. Relative to the cruise setting, the blade is closed at takeoff and opened for reverse thrust operation. The fan stage is a split flow design with fan exit guide vanes (FEGVs) and core stators. The fan stage design is combined with a nacelle and engine core duct to form a powered fan/nacelle subscale model. This model is intended for use in combined aerodynamic, acoustic, and structural testing in a wind tunnel. The fan has an outer diameter of 22 in. and a hub-to-tip of 0.426 in., which allows the use of existing NASA fan and cowl force balance and rig drive systems. The design parameters were selected to permit valid acoustic and aerodynamic comparisons with the Pratt & Whitney (P&W) 17- and 22-in. rigs previously tested under NASA contract. The fan stage design is described in detail. The results of the design axisymmetric and Navier-Stokes aerodynamic analysis are presented at the critical design conditions. The structural analysis of the fan rotor and attachment is included. The blade and attachment are predicted to have adequate low-cycle fatigue life and an acceptable operating range without resonant stress or flutter. The stage was acoustically designed with airfoil counts in the FEGV and core stator to minimize noise. A fan/FEGV tone analysis developed separately under NASA contract was used to determine the optimum airfoil counts. The fan stage was matched to the existing nacelle, designed under the previous P&W low-noise contract, to form a fan/nacelle model for wind tunnel testing. It is an axisymmetric nacelle for convenience in testing and analysis. Previous testing confirmed that the nacelle performed as required at various aircraft operating conditions.

Ares First Stage "Systemology" - Combining Advanced Systems Engineering and Planning Tools to Assure Mission Success

NASA Technical Reports Server (NTRS)

Seiler, James; Brasfield, Fred; Cannon, Scott

2008-01-01

Ares is an integral part of NASA s Constellation architecture that will provide crew and cargo access to the International Space Station as well as low earth orbit support for lunar missions. Ares replaces the Space Shuttle in the post 2010 time frame. Ares I is an in-line, two-stage rocket topped by the Orion Crew Exploration Vehicle, its service module, and a launch abort system. The Ares I first stage is a single, five-segment reusable solid rocket booster derived from the Space Shuttle Program's reusable solid rocket motor. The Ares second or upper stage is propelled by a J-2X main engine fueled with liquid oxygen and liquid hydrogen. This paper describes the advanced systems engineering and planning tools being utilized for the design, test, and qualification of the Ares I first stage element. Included are descriptions of the current first stage design, the milestone schedule requirements, and the marriage of systems engineering, detailed planning efforts, and roadmapping employed to achieve these goals.

The relationship of subepidermal moisture and early stage pressure injury by visual skin assessment.

PubMed

Kim, Chul-Gyu; Park, Seungmi; Ko, Ji Woon; Jo, Sungho

2018-05-08

The purpose of this study was to examine the relationship of subepidermal moisture and early stage pressure injury by visual skin assessment in elderly Korean. Twenty-nine elderly participated at a particular nursing home. Data were collected for 12 weeks by one wound care nurse. Visual skin assessment and subepidermal moisture value were measured at both buttocks, both ischia, both trochanters, sacrum, and coccyx of each subject once a week. Subepidermal moisture value of stage 1 pressure injury was significantly higher than that of no injury and blanching erythema. After adjustment with covariates, odds ratios of blanching erythema to normal skin and stage 1 pressure injury to blanching erythema/normal skin were statistically significant (p < 0.05). Odds ratio of blanching erythema to normal skin was 1.003 (p = .047) by 1-week prior subepidermal moisture value, and that of concurrent subepidermal moisture value was 1.004 (p = .011). Odds ratio of stage 1 pressure injury to normal skin/blanching erythema was 1.003 (p = .005) by 1-week prior subepidermal moisture value, and that for concurrent subepidermal moisture value was 1.007 (p = .030). Subepidermal moisture was associated with concurrent and future (1 week later) skin damage at both trochanters. Subepidermal moisture would be used to predict early skin damage in clinical nursing field for the effective pressure injury prevention. Copyright © 2018. Published by Elsevier Ltd.

Single stage, low noise, advanced technology fan. Volume 1: Aerodynamic design

NASA Technical Reports Server (NTRS)

Sullivan, T. J.; Younghans, J. L.; Little, D. R.

1976-01-01

The aerodynamic design for a half-scale fan vehicle, which would have application on an advanced transport aircraft, is described. The single stage advanced technology fan was designed to a pressure ratio of 1.8 at a tip speed of 503 m/sec 11,650 ft/sec). The fan and booster components are designed in a scale model flow size convenient for testing with existing facility and vehicle hardware. The design corrected flow per unit annulus area at the fan face is 215 kg/sec sq m (44.0 lb m/sec sq ft) with a hub-tip ratio of 0.38 at the leading edge of the fan rotor. This results in an inlet corrected airflow of 117.9 kg/sec (259.9 lb m/sec) for the selected rotor tip diameter if 90.37 cm (35.58 in.). The variable geometry inlet is designed utilizing a combination of high throat Mach number and acoustic treatment in the inlet diffuser for noise suppression (hybrid inlet). A variable fan exhaust nozzle was assumed in conjunction with the variable inlet throat area to limit the required area change of the inlet throat at approach and hence limit the overall diffusion and inlet length. The fan exit duct design was primarily influenced by acoustic requirements, including length of suppressor wall treatment; length, thickness and position on a duct splitter for additional suppressor treatment; and duct surface Mach numbers.

Design considerations for a pressure-driven multi-stage rocket

NASA Astrophysics Data System (ADS)

Sauerwein, Steven Craig

2002-01-01

The purpose of this study was to examine the feasibility of using propellant tank pressurization to eliminate the use of high-pressure turbopumps in multi-stage liquid-fueled satellite launchers. Several new technologies were examined to reduce the mass of such a rocket. Composite materials have a greater strength-to-weight ratio than metals and can be used to reduce the weight of rocket propellant tanks and structure. Catalytically combined hydrogen and oxygen can be used to heat pressurization gas, greatly reducing the amount of gas required. Ablatively cooled rocket engines can reduce the complexity and cost of the rocket. Methods were derived to estimate the mass of the various rocket components. These included a method to calculate the amount of gas needed to pressurize a propellant tank by modeling the behavior of the pressurization gas as the liquid propellant flows out of the tank. A way to estimate the mass and size of a ablatively cooled composite cased rocket engine. And a method to model the flight of such a rocket through the atmosphere in conjunction with optimization of the rockets trajectory. The results show that while a liquid propellant rocket using tank pressurization are larger than solid propellant rockets and turbopump driven liquid propellant rockets, they are not impractically large.

Pressure Safety: Advanced Self-Study 30120

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glass, George

2016-02-29

Pressure Safety Advance Self-Study (Course 30120) consists of an introduction, five modules, and a quiz. To receive credit in UTrain for completing this course, you must score 80% or better on the 15-question quiz (check UTrain). Directions for initiating the quiz are appended to the end of this training manual. This course contains several links to LANL websites. UTrain might not support active links, so please copy links into the address line in your browser.

Two-stage coal liquefaction process

DOEpatents

Skinner, Ronald W.; Tao, John C.; Znaimer, Samuel

1985-01-01

An improved SRC-I two-stage coal liquefaction process which improves the product slate is provided. Substantially all of the net yield of 650.degree.-850.degree. F. heavy distillate from the LC-Finer is combined with the SRC process solvent, substantially all of the net 400.degree.-650.degree. F. middle distillate from the SRC section is combined with the hydrocracker solvent in the LC-Finer, and the initial boiling point of the SRC process solvent is increased sufficiently high to produce a net yield of 650.degree.-850.degree. F. heavy distillate of zero for the two-stage liquefaction process.

The changes in resting anal pressure after performing full-thickness rectal advancement flaps.

PubMed

Balciscueta, Zutoia; Uribe, Natalia; Mínguez, Miguel; García-Granero, Eduardo

2017-09-01

Advancement flap is an accepted approach for treating complex fistula-in-ano.The purpose was to evaluate the changes in resting pressure along the anal canal after performing a full-thickness flap. Manometric review of patients who have undergone a full-thickness rectal advancement flap procedure for complex anal fistulas of cryptoglandular origin. Recurrence and continence were evaluated. Resting Anal Pressure was assessed along the anal canal by two measures: maximum resting pressure(MRP) and inferior resting pressure(IRP) at 0.5 cm from the anal verge. 119 patients were evaluated. Overall recurrence rate was5.9%. Anal continence was maintained intact in 76.5%. Manometric study showed a significant decrease in postoperative MRP(90.6 ± 31.9 to 45.2 ± 20 mmHg; p < 0.001), while IRP values did not differ significantly(28.2 ± 18.3 to 23.2 ± 13.5 mmHg; p = 0.1). Performing a full-thickness rectal flap causes a decrease of the MRP in the middle third of the anal canal, due to the inclusion of the internal sphincter in flap. It seems crucial to preserve the distal internal sphincter intact as it helps both to maintain the resting pressure in the lower third and avoid deformities of the anal margin. Copyright © 2017 Elsevier Inc. All rights reserved.

Ares I-X Upper Stage Simulator Compartment Pressure Comparisons During Ascent

NASA Technical Reports Server (NTRS)

Downs. William J.; Kirchner, Robert D.; McLachlan, Blair G.; Hand, Lawrence A.; Nelson, Stuart L.

2011-01-01

Predictions of internal compartment pressures are necessary in the design of interstage regions, systems tunnels, and protuberance covers of launch vehicles to assess potential burst and crush loading of the structure. History has proven that unexpected differential pressure loads can lead to catastrophic failure. Pressures measured in the Upper Stage Simulator (USS) compartment of Ares I-X during flight were compared to post-flight analytical predictions using the CHCHVENT chamber-to-chamber venting analysis computer program. The measured pressures were enveloped by the analytical predictions for most of the first minute of flight but were outside of the predictions thereafter. This paper summarizes the venting system for the USS, discusses the probable reasons for the discrepancies between the measured and predicted pressures, and provides recommendations for future flight vehicles.

Prevalence and incidence studies of pressure ulcers in two long-term care facilities in Canada.

PubMed

Davis, C M; Caseby, N G

2001-11-01

A study was initiated to determine the prevalence and incidence of pressure ulcers in two long-term care facilities in Canada, one with 95 residents and the other with 92 residents. The prevalence study was conducted at both facilities on a single day. The incidence study was completed after 41 and 42 days, respectively, at each facility. Data were collected on demographics, medical information, and possible contributing factors. Each resident was assessed for the presence of a pressure ulcer. Each ulcer was staged and anatomical location was noted. The prevalence of pressure ulcers in the two long-term care facilities was 36.8% and 53.2%, respectively. The incidence of pressure ulcers in the two long-term care facilities was 11.7% and 11.6%, respectively. In conclusion, the pressure ulcer prevalence is higher than published figures for the long-term care setting. However, a pressure ulcer incidence of less than 12% in each facility suggests an equal and acceptable level of nursing care in both facilities. The disparity of pressure ulcer prevalence between the two facilities may be explained by a difference of case mix.

Para-aortic lymphadenectomy in advanced stage cervical cancer, a protocol for comparing safety, feasibility and diagnostic accuracy of surgical staging versus PET-CT; PALDISC trial.

PubMed

Tax, Casper; Abbink, Karin; Rovers, Maroeska M; Bekkers, Ruud L M; Zusterzeel, Petra L M

2018-01-01

Currently, a PET-CT is used to assess the need for extended field radiotherapy of para-aortic lymph nodes (PALN) in International Federation of Gynaecology and Obstetrics (FIGO) stage IB2, IIA2-IVA (locally advanced stage) cervical cancer. A small study established a sensitivity and specificity estimate for PALN metastases of 50% (95% CI; 7-93%) and 83% (95% CI; 52-98%), respectively. Surgical staging of PALN may lead to a higher diagnostic accuracy. However, surgical staging of para-aortic lymph nodes in locally advanced stage cervical cancer is not common practice. Therefore, a phase 2 randomised controlled trial is needed to assess its safety and feasibility. In addition to standard imaging (MRI or CT scan) with PET-CT, 30 adult women with FIGO stage IB2, IIA2-IVA cervical cancer will be randomised to receive either surgical staging or usual PET-CT staging. Administering extended field radiotherapy will be based on lymphadenectomy results for the intervention group and on the PET-CT results for the control group. Follow-up visits at 0, 3, 6, 9 and 12 months will assess health-related quality of life and progression-free survival.Primary safety and feasibility outcomes of surgical staging will be assessed by calculating means with 95% confidence intervals for duration of surgery, number of complications, blood loss, nodal yield after para-aortic lymphadenectomy and treatment delay due to surgical staging. Secondary patient-centred outcomes on quality of life and first year survival will be documented and compared between the two groups. Estimates of sensitivity, specificity and negative and positive predictive values of MRI, PET-CT and surgical staging will be presented with 95% CI.. All analysis will be performed according to the intention to treat principle. This study will assess safety and feasibility, expressed as the number and severity of complications, effect on quality of life and the treatment delay due to surgically staging para-aortic lymph nodes in

Experimental Investigation of a Model of a Two-Stage Turboblower

NASA Technical Reports Server (NTRS)

Dovjik, s.; Polikovsky, W.

1943-01-01

In the present paper an investigation is made of two stages of a multistage turboblower having a vaneless diffuser behind the impeller and guide vanes at the inlet to the nest stage. The method employed was that of investigating the performance of the successive elements of the blower (the impeller, vaneless diffuser, ets.) whereby the kinematics of the flow through the blower could be followed and the pressure at the different points computed. The character of the flow and the physical significance of the loss coefficients could thereby be determined so as to secure the best agreement of the computed with the actual performance of the blower. Since the tests were carried out for various delivery volumes, the dependence of the coefficients on a number of factors (angle of attack, velocities, etc.) could be obtained. The distribution of the losses that occur during the transformation of dynamic pressure at the impeller exit into static pressure could be found and likewise the range within which the friction coefficient varies in the vaneless diffuser. With the aid of factors having a certain physical significance, the centrifugal blower could be computed on the basis of a more or less schematical consideration of the phenomena occuring during the air flow through it, and the use of arbitrary factors and recourse to the geometrical similtude law thus avoided. The present investigation largely summarizes all the previous work af the CHI Blower Section on the different elements of a centrifugal blower. Some considerations on the analysis of model test data for application to full-scale are presented in the appendix.

Advances in single- and multi-stage Stirling-type pulse tube cryocoolers for space applications in NLIP/SITP/CAS

NASA Astrophysics Data System (ADS)

Dang, Haizheng; Tan, Jun; Zha, Rui; Li, Jiaqi; Zhang, Lei; Zhao, Yibo; Gao, Zhiqian; Bao, Dingli; Li, Ning; Zhang, Tao; Zhao, Yongjiang; Zhao, Bangjian

2017-12-01

This paper presents a review of recent advances in single- and multi-stage Stirling-type pulse tube cryocoolers (SPTCs) for space applications developed at the National Laboratory for Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences (NLIP/SITP/CAS). A variety of single-stage SPTCs operating at 25-150 K have been developed, including several mid-sized ones operating at 80-110 K. Significant progress has been achieved in coolers operating at 30-40 K which use common stainless steel meshes as regenerator matrices. Another important advance is the micro SPTCs with an overall mass of 300-800 g operating at high frequencies varying from 100 Hz to 400 Hz. The main purpose of developing two-stage SPTCs is to simultaneously acquire cooling capacities at both stages, obviating the need for auxiliary precooling in various applications. The three-stage SPTCs are developed mainly for applications at around 10 K, which are also used for precooling the J-T coolers to achieve further lower temperatures. The four-stage SPTCs are developed to directly achieve the liquid helium temperature for cooling space low-Tc superconducting devices and for the deep space exploration as well. Several typical development programs are described and an overview of the cooler performances is presented.

Numerical Investigation of the Interaction between Mainstream and Tip Shroud Leakage Flow in a 2-Stage Low Pressure Turbine

NASA Astrophysics Data System (ADS)

Jia, Wei; Liu, Huoxing

2014-06-01

The pressing demand for future advanced gas turbine requires to identify the losses in a turbine and to understand the physical mechanisms producing them. In low pressure turbines with shrouded blades, a large portion of these losses is generated by tip shroud leakage flow and associated interaction. For this reason, shroud leakage losses are generally grouped into the losses of leakage flow itself and the losses caused by the interaction between leakage flow and mainstream. In order to evaluate the influence of shroud leakage flow and related losses on turbine performance, computational investigations for a 2-stage low pressure turbine is presented and discussed in this paper. Three dimensional steady multistage calculations using mixing plane approach were performed including detailed tip shroud geometry. Results showed that turbines with shrouded blades have an obvious advantage over unshrouded ones in terms of aerodynamic performance. A loss mechanism breakdown analysis demonstrated that the leakage loss is the main contributor in the first stage while mixing loss dominates in the second stage. Due to the blade-to-blade pressure gradient, both inlet and exit cavity present non-uniform leakage injection and extraction. The flow in the exit cavity is filled with cavity vortex, leakage jet attached to the cavity wall and recirculation zone induced by main flow ingestion. Furthermore, radial gap and exit cavity size of tip shroud have a major effect on the yaw angle near the tip region in the main flow. Therefore, a full calculation of shroud leakage flow is necessary in turbine performance analysis and the shroud geometric features need to be considered during turbine design process.

Clinical and Cost Implications of Universal Versus Locally Advanced-Stage and Advanced-Stage-Only Molecular Testing for Epidermal Growth Factor Receptor Mutations and Anaplastic Lymphoma Kinase Rearrangements in Non-Small Cell Lung Carcinoma: A Tertiary Academic Institution Experience.

PubMed

Sauter, Jennifer L; Butnor, Kelly J

2016-04-01

Although epidermal growth factor receptor (EGFR)- and anaplastic lymphoma kinase (ALK)-directed therapies are not approved for patients with early-stage non-small cell lung carcinoma (NSCLC), many institutions perform EGFR and ALK testing for all patients with NSCLC at the time of initial diagnosis. Current consensus guidelines recommend EGFR testing and suggest ALK testing at the time of initial diagnosis for patients with advanced disease. To examine the cost and clinical impact of EGFR and ALK testing of patients with early-stage NSCLC. Records from all patients with a diagnosis of NSCLC made on a nonresection specimen at our institution during a single calendar year (2012) were reviewed, and a cost analysis was performed. Of 133 total patients, 47 (35%) had early-stage (stage I or II) disease and 86 (65%) had locally advanced (stage III) or advanced (stage IV) disease at presentation. Eight of 47 patients with early-stage disease (17%) had progression/recurrence during 18 to 30 months of follow-up, 6 of 8 (75%) of whom had pathologic confirmation of progression/recurrence. The estimated additional cost of EGFR and ALK testing for all newly diagnosed patients with NSCLC at our institution is $75,200 per year, compared to testing only patients with locally advanced and advanced-stage disease. The cost of universal molecular testing of NSCLC is substantial. EGFR and ALK testing of patients with early-stage disease appears to have negligible clinical impact, as most patients do not have disease recurrence/progression. Those whose disease recurs/progresses typically undergo rebiopsy. Our findings do not support the practice of universal EGFR and ALK testing in NSCLC at the time of initial diagnosis.

PVDF Gauge Piezoelectric Response under Two-Stage Light Gas Gun Impact Loading

NASA Astrophysics Data System (ADS)

Bauer, Francois

2002-07-01

Stress gauges based on ferroelectric polymer (PVDF) studies under very high pressure shock compression have shown that the piezoelectric response exhibits a precise reproducible behavior up to 25 GPa. Shock pressure profiles obtained with "in situ" PVDF gauges in porous H.E. (Formex) in a detonation regime have been achieved. Observations of a fast superpressure of a few nanoseconds followed by a pressure release have raised the question of the loading path dependence of the piezoelectric response of PVDF at high shock pressure levels. Consequently, studies of the piezoelectric behavior of PVDF gauges under impact loading using a two-stage light gas gun have been conducted recently. Symmetric impact as well as non symmetric impact and reverse impact techniques have been achieved. Strong viscoplastic behavior of some materials is observed. In typical experiments, the piezoelectric response of PVDF at shock equilibrium could be determined. These results show that the PVDF response appears independent of the loading path up to 30 GPa. Accurate measurements in situ H.E. are also reported with very low inductance PVDF gauges.

Performances of single and two-stage pulse tube cryocoolers under different vacuum levels with and without thermal radiation shields

NASA Astrophysics Data System (ADS)

Kasthurirengan, Srinivasan; Behera, Upendra; Nadig, D. S.; Krishnamoorthy, V.

2012-06-01

Single and two-stage Pulse Tube Cryocoolers (PTC) have been designed, fabricated and experimentally studied. The single stage PTC reaches a no-load temperature of ~ 29 K at its cold end, the two-stage PTC reaches ~ 2.9 K in its second stage cold end and ~ 60 K in its first stage cold end. The two-stage Pulse Tube Cryocooler provides a cooling power of ~ 250 mW at 4.2 K. The single stage system uses stainless steel meshes along with Pb granules as its regenerator materials, while the two-stage PTC uses combinations of Pb along with Er3Ni / HoCu2 as the second stage regenerator materials. Normally, the above systems are insulated by thermal radiation shields and mounted inside a vacuum chamber which is maintained at high vacuum. To evaluate the performance of these systems in the possible conditions of loss of vacuum with and without radiation shields, experimental studies have been performed. The heat-in-leak under such severe conditions has been estimated from the heat load characteristics of the respective stages. The experimental results are analyzed to obtain surface emissivities and effective thermal conductivities as a function of interspace pressure.

Two stage gear tooth dynamics program

NASA Technical Reports Server (NTRS)

Boyd, Linda S.

1989-01-01

The epicyclic gear dynamics program was expanded to add the option of evaluating the tooth pair dynamics for two epicyclic gear stages with peripheral components. This was a practical extension to the program as multiple gear stages are often used for speed reduction, space, weight, and/or auxiliary units. The option was developed for either stage to be a basic planetary, star, single external-external mesh, or single external-internal mesh. The two stage system allows for modeling of the peripherals with an input mass and shaft, an output mass and shaft, and a connecting shaft. Execution of the initial test case indicated an instability in the solution with the tooth paid loads growing to excessive magnitudes. A procedure to trace the instability is recommended as well as a method of reducing the program's computation time by reducing the number of boundary condition iterations.

Unsteady blade-surface pressures on a large-scale advanced propeller: Prediction and data

NASA Technical Reports Server (NTRS)

Nallasamy, M.; Groeneweg, J. F.

1990-01-01

An unsteady 3-D Euler analysis technique is employed to compute the flow field of an advanced propeller operating at an angle of attack. The predicted blade pressure waveforms are compared with wind tunnel data at two Mach numbers, 0.5 and 0.2. The inflow angle is three degrees. For an inflow Mach number of 0.5, the predicted pressure response is in fair agreement with data: the predicted phases of the waveforms are in close agreement with data while the magnitudes are underpredicted. At the low Mach number of 0.2 (takeoff), the numerical solution shows the formation of a leading edge vortex which is in qualitative agreement with measurements. However, the highly nonlinear pressure response measured on the blade suction surface is not captured in the present inviscid analysis.

Unsteady blade surface pressures on a large-scale advanced propeller - Prediction and data

NASA Technical Reports Server (NTRS)

Nallasamy, M.; Groeneweg, J. F.

1990-01-01

An unsteady three dimensional Euler analysis technique is employed to compute the flowfield of an advanced propeller operating at an angle of attack. The predicted blade pressure waveforms are compared with wind tunnel data at two Mach numbers, 0.5 and 0.2. The inflow angle is three degrees. For an inflow Mach number of 0.5, the predicted pressure response is in fair agreement with data: the predicted phases of the waveforms are in close agreement with data while the magnitudes are underpredicted. At the low Mach number of 0.2 (take-off) the numerical solution shows the formation of a leading edge vortex which is in qualitative agreement with measurements. However, the highly nonlinear pressure response measured on the blade suction surface is not captured in the present inviscid analysis.

Prediction of 30-day morbidity after primary cytoreductive surgery for advanced stage ovarian cancer.

PubMed

Gerestein, C G; Nieuwenhuyzen-de Boer, G M; Eijkemans, M J; Kooi, G S; Burger, C W

2010-01-01

Treatment in advanced stage epithelial ovarian cancer (EOC) is based on primary cytoreductive surgery followed by platinum-based chemotherapy. Successful cytoreduction to minimal residual tumour burden is the most important determinant of prognosis. However, extensive surgical procedures to achieve maximal debulking are inevitably associated with postoperative morbidity and mortality. The objective of this study is to determine predictors of 30-day morbidity after primary cytoreductive surgery for advanced stage EOC. All patients in the South Western part of the Netherlands who underwent primary cytoreductive surgery for advanced stage EOC between January 2004 and December 2007 were identified from the Rotterdam Cancer Registry database. All peri- and postoperative complications within 30 days after surgery were registered and classified according to the definitions of the National Surgical Quality Improvement Programme (NSQIP). To investigate independent predictors of 30-day morbidity, a Cox proportional hazards model with backward stepwise elimination was utilised. The identified predictors were entered into a nomogram. Two hundred and ninety-three patients entered the study protocol. Optimal cytoreduction was achieved in 136 (46%) patients. 30-day morbidity was seen in 99 (34%) patients. Postoperative morbidity could be predicted by age (P=0.007; odds ratio [OR] 1.034), WHO performance status (P=0.046; OR 1.757), extent of surgery (P=0.1308; OR=2.101), and operative time (P=0.017; OR 1.007) with an optimism corrected c-statistic of 0.68. 30-day morbidity could be predicted by age, WHO performance status, operative time and extent of surgery. The generated nomogram could be valuable for predicting operative risk in the individual patient.

Testing of polyimide second-stage rod seals for single-state applications in advanced aircraft hydraulic systems

NASA Technical Reports Server (NTRS)

Waterman, A. W.

1977-01-01

Machined polyimide second-stage rod seals were evaluated to determine their suitability for single-stage applications where full system pressure acts on the upstream side of the seal. The 6.35-cm (2.5-in.) K-section seal was tested in impulse screening tests where peak pressure was increased in 3.448-MPa (500-psi) increments each 20,000 cycles. Seal failure occurred at 37.92 MPa (5,500 psi), indicating a potential for acceptability in a 27.58-MPa (4,000-psi) system. Static pressurization for 600 sec at pressures in excess of 10.34 MPa (1,500 psi) revealed structural inadequacy of the seal cross section to resist fracture and extrusion. Endurance testing showed the seals capable of at least 65,000 1.27-cm (0.5-in.) cycles at 450 K (350 F) without leakage. It was concluded that the second-stage seals were proven to be exceptional in the 1.379-MPa (200-psi) applications for which they were designed, but polyimide material properties are not adequate for use in this design at pressure loading equivalent to that present in single-stage applications.

Two-stage free electron laser research

NASA Astrophysics Data System (ADS)

Segall, S. B.

1984-10-01

KMS Fusion, Inc. began studying the feasibility of two-stage free electron lasers for the Office of Naval Research in June, 1980. At that time, the two-stage FEL was only a concept that had been proposed by Luis Elias. The range of parameters over which such a laser could be successfully operated, attainable power output, and constraints on laser operation were not known. The primary reason for supporting this research at that time was that it had the potential for producing short-wavelength radiation using a relatively low voltage electron beam. One advantage of a low-voltage two-stage FEL would be that shielding requirements would be greatly reduced compared with single-stage short-wavelength FEL's. If the electron energy were kept below about 10 MeV, X-rays, generated by electrons striking the beam line wall, would not excite neutron resonance in atomic nuclei. These resonances cause the emission of neutrons with subsequent induced radioactivity. Therefore, above about 10 MeV, a meter or more of concrete shielding is required for the system, whereas below 10 MeV, a few millimeters of lead would be adequate.

Numerical simulation of abutment pressure redistribution during face advance

NASA Astrophysics Data System (ADS)

Klishin, S. V.; Lavrikov, S. V.; Revuzhenko, A. F.

2017-12-01

The paper presents numerical simulation data on the abutment pressure redistribution in rock mass during face advance, including isolines of maximum shear stress and pressure epures. The stress state of rock in the vicinity of a breakage heading is calculated by the finite element method using a 2D nonlinear model of a structurally heterogeneous medium with regard to plasticity and internal self-balancing stress. The thus calculated stress field is used as input data for 3D discrete element modeling of the process. The study shows that the abutment pressure increases as the roof span extends and that the distance between the face breast and the peak point of this pressure depends on the elastoplastic properties and internal self-balancing stress of a rock medium.

Design of a Two-Stage Light Gas Gun for Muzzle Velocities of 10 - 11 kms

NASA Technical Reports Server (NTRS)

Bogdanoff, David W.

2016-01-01

Space debris poses a major risk to spacecraft. In low earth orbit, impact velocities can be 10 11 kms and as high as 15 kms. For debris shield design, it would be desirable to be able to launch controlled shape projectiles to these velocities. The design of the proposed 10 11 kmsec gun uses, as a starting point, the Ames 1.280.22 two stage gun, which has achieved muzzle velocities of 10 11.3 kmsec. That gun is scaled up to a 0.3125 launch tube diameter. The gun is then optimized with respect to maximum pressures by varying the pump tube length to diameter ratio (LD), the piston mass and the hydrogen pressure. A pump tube LD of 36.4 is selected giving the best overall performance. Piezometric ratios for the optimized guns are found to be 2.3, much more favorable than for more traditional two stage light gas guns, which range from 4 to 6. The maximum powder chamber pressures are 20 to 30 ksi. To reduce maximum pressures, the desirable range of the included angle of the cone of the high pressure coupling is found to be 7.3 to 14.6 degrees. Lowering the break valve rupture pressure is found to lower the maximum projectile base pressure, but to raise the maximum gun pressure. For the optimized gun with a pump tube LD of 36.4, increasing the muzzle velocity by decreasing the projectile mass and increasing the powder loads is studied. It appears that saboted spheres could be launched to 10.25 and possibly as high as 10.7 10.8 kmsec, and that disc-like plastic models could be launched to 11.05 kms. The use of a tantalum liner to greatly reduce bore erosion and increase muzzle velocity is discussed. With a tantalum liner, CFD code calculations predict muzzle velocities as high as 12 to 13 kms.

Prognosis for advanced-stage primary peritoneal serous papillary carcinoma and serous ovarian cancer in Taiwan.

PubMed

Chao, Kuan-Chong; Chen, Yi-Jen; Juang, Chi-Mou; Lau, Hei-Yu; Wen, Kuo-Chang; Sung, Pi-Lin; Fang, Feng-Ying; Twu, Nae-Fang; Yen, Ming-Shyen

2013-03-01

To compare the prognosis of patients with advanced-stage primary peritoneal serous papillary carcinoma (PSPC) or papillary serous ovarian cancer (PSOC). This was a retrospective case-control study and included two study groups: one with stage III/IV PSPC (n = 38) patients and the other with PSOC (n = 53) patients. Patients were matched for histologic subtype (serous tumor), tumor stage, tumor grade, residual disease at the end of debulking surgery (primary or interval), and age (±5 years). Mean age was significantly greater for patients with PSPC (63.03 ± 11.88 years) than for patients with PSOC (55.92 ± 12.56 years, p = 0.008). Optimal debulking surgery was performed initially in 71.9% of PSPC patients and 66.0% of PSOC patients. In addition, 93.9% of PSPC patients and 92.3% of PSOC patients were treated with platinum-paclitaxel chemotherapy. The frequency of high-grade tumors was significantly higher in the PSPC (100%) than in the PSOC group (68.3%; p < 0.001). Progression-free survival (PFS) was similar in the PSPC [median 12 months, 95% confidence interval (CI) 7.3-16.7] and PSOC groups (median 16.7 months, 95% CI 12.9-20.4; p = 0.470). Overall survival was shorter in the PSPC (median 62 months, 95% CI 19.6-104.4) than in the PSOC group (median 77.5 months, 95% CI 69.7-85.2; p = 0.006, log-rank statistic). PFS was similar for advanced-stage PSPC and PSOC patients. Since the PSPC patients tended to be older and have more high-grade tumors, OS was shorter for PSPC than for POSC patients. Thus, management of the two types of cancer should not differ. Copyright © 2013. Published by Elsevier B.V.

Constant-Differential-Pressure Two-Fluid Accumulator

NASA Technical Reports Server (NTRS)

Piecuch, Benjamin; Dalton, Luke T.

2010-01-01

A two-fluid accumulator has been designed, built, and demonstrated to provide an acceptably close approximation to constant differential static pressure between two fluids over the full ranges of (1) accumulator stroke, (2) rates of flow of the fluids, and (3) common static pressure applied to the fluids. Prior differential- pressure two-fluid accumulators are generally not capable of maintaining acceptably close approximations to constant differential pressures. The inadequacies of a typical prior differential-pressure two-fluid accumulator can be summarized as follows: The static differential pressure is governed by the intrinsic spring rate (essentially, the stiffness) of an accumulator tank. The spring rate can be tailored through selection of the tank-wall thickness, selection of the number and/or shape of accumulator convolutions, and/or selection of accumulator material(s). Reliance on the intrinsic spring rate of the tank results in three severe limitations: (1) The spring rate and the expulsion efficiency tend to be inversely proportional to each other: that is to say, as the stiffness (and thus the differential pressure) is increased, the range of motion of the accumulator is reduced. (2) As the applied common static pressure increases, the differential pressure tends to decrease. An additional disadvantage, which may or may not be considered limiting, depending on the specific application, is that an increase in stiffness entails an increase in weight. (3) The additional weight required by a low expulsion efficiency accumulator eliminates the advantage given to such gas storage systems. The high expulsion efficiency provided by this two-fluid accumulator allows for a lightweight, tightly packaged system, which can be used in conjunction with a fuel cell-based system.

A stage is a stage is a stage: a direct comparison of two scoring systems.

PubMed

Dawson, Theo L

2003-09-01

L. Kohlberg (1969) argued that his moral stages captured a developmental sequence specific to the moral domain. To explore that contention, the author compared stage assignments obtained with the Standard Issue Scoring System (A. Colby & L. Kohlberg, 1987a, 1987b) and those obtained with a generalized content-independent stage-scoring system called the Hierarchical Complexity Scoring System (T. L. Dawson, 2002a), on 637 moral judgment interviews (participants' ages ranged from 5 to 86 years). The correlation between stage scores produced with the 2 systems was .88. Although standard issue scoring and hierarchical complexity scoring often awarded different scores up to Kohlberg's Moral Stage 2/3, from his Moral Stage 3 onward, scores awarded with the two systems predominantly agreed. The author explores the implications for developmental research.

Characterisation of two-stage ignition in diesel engine-relevant thermochemical conditions using direct numerical simulation

DOE PAGES

Krisman, Alex; Hawkes, Evatt R.; Talei, Mohsen; ...

2016-08-30

With the goal of providing a more detailed fundamental understanding of ignition processes in diesel engines, this study reports analysis of a direct numerical simulation (DNS) database. In the DNS, a pseudo turbulent mixing layer of dimethyl ether (DME) at 400 K and air at 900 K is simulated at a pressure of 40 atmospheres. At these conditions, DME exhibits a two-stage ignition and resides within the negative temperature coefficient (NTC) regime of ignition delay times, similar to diesel fuel. The analysis reveals a complex ignition process with several novel features. Autoignition occurs as a distributed, two-stage event. The high-temperaturemore » stage of ignition establishes edge flames that have a hybrid premixed/autoignition flame structure similar to that previously observed for lifted laminar flames at similar thermochemical conditions. In conclusion, a combustion mode analysis based on key radical species illustrates the multi-stage and multi-mode nature of the ignition process and highlights the substantial modelling challenge presented by diesel combustion.« less

Recent advances in lightweight, filament-wound composite pressure vessel technology

NASA Technical Reports Server (NTRS)

Lark, R. F.

1977-01-01

A review of recent advances is presented for lightweight, high performance composite pressure vessel technology that covers the areas of design concepts, fabrication procedures, applications, and performance of vessels subjected to single cycle burst and cyclic fatigue loading. Filament wound fiber/epoxy composite vessels were made from S glass, graphite, and Kevlar 49 fibers and were equipped with both structural and nonstructural liners. Pressure vessels structural efficiencies were attained which represented weight savings, using different liners, of 40 to 60 percent over all titanium pressure vessels. Significant findings in each area are summarized.

Pretreatment tables predicting pathologic stage of locally advanced prostate cancer.

PubMed

Joniau, Steven; Spahn, Martin; Briganti, Alberto; Gandaglia, Giorgio; Tombal, Bertrand; Tosco, Lorenzo; Marchioro, Giansilvio; Hsu, Chao-Yu; Walz, Jochen; Kneitz, Burkhard; Bader, Pia; Frohneberg, Detlef; Tizzani, Alessandro; Graefen, Markus; van Cangh, Paul; Karnes, R Jeffrey; Montorsi, Francesco; van Poppel, Hein; Gontero, Paolo

2015-02-01

Pretreatment tables for the prediction of pathologic stage have been published and validated for localized prostate cancer (PCa). No such tables are available for locally advanced (cT3a) PCa. To construct tables predicting pathologic outcome after radical prostatectomy (RP) for patients with cT3a PCa with the aim to help guide treatment decisions in clinical practice. This was a multicenter retrospective cohort study including 759 consecutive patients with cT3a PCa treated with RP between 1987 and 2010. Retropubic RP and pelvic lymphadenectomy. Patients were divided into pretreatment prostate-specific antigen (PSA) and biopsy Gleason score (GS) subgroups. These parameters were used to construct tables predicting pathologic outcome and the presence of positive lymph nodes (LNs) after RP for cT3a PCa using ordinal logistic regression. In the model predicting pathologic outcome, the main effects of biopsy GS and pretreatment PSA were significant. A higher GS and/or higher PSA level was associated with a more unfavorable pathologic outcome. The validation procedure, using a repeated split-sample method, showed good predictive ability. Regression analysis also showed an increasing probability of positive LNs with increasing PSA levels and/or higher GS. Limitations of the study are the retrospective design and the long study period. These novel tables predict pathologic stage after RP for patients with cT3a PCa based on pretreatment PSA level and biopsy GS. They can be used to guide decision making in men with locally advanced PCa. Our study might provide physicians with a useful tool to predict pathologic stage in locally advanced prostate cancer that might help select patients who may need multimodal treatment. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Nomogram for 30-day morbidity after primary cytoreductive surgery for advanced stage ovarian cancer.

PubMed

Nieuwenhuyzen-de Boer, G M; Gerestein, C G; Eijkemans, M J C; Burger, C W; Kooi, G S

2016-01-01

Extensive surgical procedures to achieve maximal cytoreduction in patients with advanced stage epithelial ovarian cancer (EOC) are inevitably associated with postoperative morbidity and mortality. This study aimed to identify preoperative predictors of 30-day morbidity after primary cytoreductive surgery for advanced stage EOC and to develop a nomogram for individual risk assessment. Patients in The Netherlands who underwent primary cytoreductive surgery for advanced stage EOC between January 2004 and December 2007. All peri- and postoperative complications within 30 days after surgery were registered and classified. To investigate predictors of 30-day morbidity, a Cox proportional hazard model with backward stepwise elimination was utilized. The identified predictors were entered into a nomogram. The main outcome was to identify parameters that predict operative risk. 293 patients entered the study protocol. Optimal cytoreduction was achieved in 136 (46%) patients. Thirty-day morbidity was seen in 99 (34%) patients. Morbidity could be predicted by age (p = 0.033; OR 1.024), preoperative hemoglobin (p = 0.194; OR 0.843), and WHO performance status (p = 0.015; OR 1.821) with a optimism-corrected c-statistic of 0.62. Determinants co-morbidity status, serum CA125 level, platelet count, and presence of ascites were comparable in both groups. Thirty-day morbidity after primary cytoreductive surgery for advanced stage EOC could be predicted by age, hemoglobin, and WHO performance status. The generated nomogram could be valuable for predicting operative risk in the individual patient.

Performance Evaluation of Reduced-Chord Rotor Blading as Applied to J73 Two-Stage Turbine

NASA Technical Reports Server (NTRS)

Schurn, Harold J.

1957-01-01

The multistage turbine from the J73 turbojet engine has previously been investigated with standard and with reduced-chord rotor blading in order to determine the individual performance characteristics of each configuration over a range of over-all pressure ratio and speed. Because both turbine configurations exhibited peak efficiencies of over 90 percent, and because both units had relatively wide efficient operating ranges, it was considered of interest to determine the performance of the first stage of the turbine as a separate component. Accordingly, the standard-bladed multistage turbine was modified by removing the second-stage rotor disk and stator and altering the flow passage so that the first stage of the unit could be operated independently. The modified single-stage turbine was then operated over a range of stage pressure ratio and speed. The single-stage turbine operated at a peak brake internal efficiency of over 90 percent at an over-all stage pressure ratio of 1.4 and at 90 percent of design equivalent speed. Furthermore, the unit operated at high efficiencies over a relatively wide operating range. When the single-stage results were compared with the multistage results at the design operating point, it was found that the first stage produced approximately half the total multistage-turbine work output.

SPIRIT advance care planning intervention in early stage dementias: An NIH stage I behavioral intervention development trial.

PubMed

Song, Mi-Kyung; Ward, Sandra E; Hepburn, Kenneth; Paul, Sudeshna; Shah, Raj C; Morhardt, Darby J

2018-06-02

People in the early stages of Alzheimer's disease and related dementias (ADRD) are encouraged to engage in advance care planning (ACP) while they are still competent to appoint a surrogate decision maker and meaningfully participate in ACP discussions with the surrogate. In this NIH Stage I behavioral intervention development trial, we will adapt and test an efficacious ACP intervention, SPIRIT (Sharing Patient's Illness Representation to Increase Trust), with people with mild dementia and their surrogates to promote open, honest discussions while such discussions about end-of-life care are possible. We will first adapt SPIRIT (in person) to target people with mild dementia and their surrogates through a process of modification-pretesting-refinement using stakeholders (persons with mild dementia, family caregivers, and clinicians) and experts, including adapting the delivery mode to interactive web-based videoconference format (SPIRIT-remote). Then in a 3-group RCT with 120 patient-surrogate dyads, we will evaluate the feasibility and acceptability of SPIRIT in-person and SPIRIT remote, and preliminary efficacy of SPIRIT compared to usual care on preparedness outcomes for end-of-life decision making (dyad congruence on goals of care, patient decisional conflict, and surrogate decision-making confidence) shortly after the intervention. This Stage I research of SPIRIT will generate valuable insights regarding how to improve ACP for people with mild dementia who will progress to an advanced stage of the disease in the foreseeable future. ClinicalTrials.gov NCT03311711, Registered 10/12/2017. Copyright © 2018. Published by Elsevier Inc.

Experimental investigation of 20 K two-stage layered active magnetic regenerative refrigerator

NASA Astrophysics Data System (ADS)

Park, Inmyong; Jeong, Sangkwon

2015-12-01

The performance of a two-stage layered AMRR is experimentally investigated. The test apparatus includes two-stage layered AMRs, low temperature superconducting (LTS) magnet which generates maximum magnetic field of 4 T, and the helium gas flow system. The helium compressor with the tandem rotary valve is employed to generate the oscillating flow of the helium gas minimizing the pressure swing effect. The mass flow rate of working fluid is controlled separately at the first and second stages of the AMR by solenoid valves. The mass flow rate of the AMRs is measured by the mass flow meter and the cryogenic hot-film sensor which is calibrated at cryogenic temperature range from 20 K to 77 K. In order to reduce the heat leak by shuttle heat transfer of the working fluid, void volumes have been implemented and connected to the cold ends of the AMR1 and AMR2. The temperature span of the AMR is recorded as 52 K and the performance of the AMR with the variation of the mass flow rate is analysed. The results show that the mass flow rate and the heat leak due to the shuttle heat transfer by oscillating working fluid are crucial factors in the AMR performance.

Radar stage uncertainty

USGS Publications Warehouse

Fulford, J.M.; Davies, W.J.

2005-01-01

The U.S. Geological Survey is investigating the performance of radars used for stage (or water-level) measurement. This paper presents a comparison of estimated uncertainties and data for radar water-level measurements with float, bubbler, and wire weight water-level measurements. The radar sensor was also temperature-tested in a laboratory. The uncertainty estimates indicate that radar measurements are more accurate than uncorrected pressure sensors at higher water stages, but are less accurate than pressure sensors at low stages. Field data at two sites indicate that radar sensors may have a small negative bias. Comparison of field radar measurements with wire weight measurements found that the radar tends to measure slightly lower values as stage increases. Copyright ASCE 2005.

Conceptual design of a two-stage-to-orbit vehicle

NASA Technical Reports Server (NTRS)

1991-01-01

A conceptual design study of a two-stage-to-orbit vehicle is presented. Three configurations were initially investigated with one configuration selected for further development. The major objective was to place a 20,000-lb payload into a low Earth orbit using a two-stage vehicle. The first stage used air-breathing engines and employed a horizontal takeoff, while the second stage used rocket engines to achieve a 250-n.m. orbit. A two-stage-to-orbit vehicle seems a viable option for the next-generation space shuttle.

The study on a gas-coupled two-stage stirling-type pulse tube cryocooler

NASA Astrophysics Data System (ADS)

Wu, X. L.; Chen, L. B.; Zhu, X. S.; Pan, C. Z.; Guo, J.; Wang, J. J.; Zhou, Y.

2017-12-01

A two-stage gas-coupled Stirling-type pulse tube cryocooler (SPTC) driven by a linear dual-opposed compressor has been designed, manufactured and tested. Both of the stages adopted coaxial structure for compactness. The effect of a cold double-inlet at the second stage on the cooling performance was investigated. The test results show that the cold double-inlet will help to achieve a lower cooling temperature, but it is not conducive to achieving a higher cooling capacity. At present, without the cold double-inlet, the second stage has achieved a no-load temperature of 11.28 K and a cooling capacity of 620 mW/20 K with an input electric power of 450 W. With the cold double-inlet, the no-load temperature is lowered to 9.4 K, but the cooling capacity is reduced to 400 mW/20 K. The structure of the developed cryocooler and the influences of charge pressure, operating frequency and hot end temperature will also be introduced in this paper.

BH3-only protein Bim predicts advanced stage of cutaneous melanoma.

PubMed

Gambichler, T; Rooms, I; Scholl, L; Stockfleth, E; Stücker, M; Sand, M

2016-11-01

Bim having strong pro-apoptotic effects belongs to the BH3-only proteins of the Bcl-2 protein family and contributes to survival pathways in cancer cells. We aimed to investigate Bim protein expression in cutaneous melanoma (CM). Bim protein expression was assessed by immunohistochemistry in primary and metastatic melanomas and correlated with clinical and histopathological features. The Bim immunoreactivity score of the primary melanomas investigated (4.6 ± 1.5) was significantly (P < 0.0001) higher than that observed in metastases (2.8 ± 1.1). Low Bim expression was significantly associated with primary nodular melanoma type (P = 0.005). Moreover, Bim expression was significantly inversely correlated with tumour thickness (r = -0.36; P = 0.0035), advanced stage of disease (stage III and IV; r = -0.60; P < 0.0001), disease relapse (r = -0.18; P = 0.034) and disease-related death (r = -0.19; P = 0.026). Advanced stage of disease was independently predicted by low Bim expression (P = 0.0010, odds ratio: 0.22, 95% CI: 0.10-0.56) on multivariate analysis; however, Bim was not shown to be an independent predictor for disease relapse (P = 0.40) and disease-related death (P = 0.77). Our data demonstrate that Bim protein expression is significantly inversely correlated with melanoma features that are associated with worse prognosis. We have shown that Bim protein expression in CM is an independent predictor for advanced disease confirming that this pro-apoptotic BH3-only protein might be a potent biomarker and promising therapeutic target. © 2016 European Academy of Dermatology and Venereology.

A comparison of direct and two-stage transportation of patients to hospital in Poland.

PubMed

Rosiek, Anna; Rosiek-Kryszewska, Aleksandra; Leksowski, Łukasz; Leksowski, Krzysztof

2015-04-24

The rapid international expansion of telemedicine reflects the growth of technological innovations. This technological advancement is transforming the way in which patients can receive health care. The study was conducted in Poland, at the Department of Cardiology of the Regional Hospital of Louis Rydygier in Torun. The researchers analyzed the delay in the treatment of patients with acute coronary syndrome. The study was conducted as a survey and examined 67 consecutively admitted patients treated invasively in a two-stage transport system. Data were analyzed statistically. Two-stage transportation does not meet the timeframe guidelines for the treatment of patients with acute myocardial infarction. Intervals for the analyzed group of patients were statistically significant (p < 0.0001). Direct transportation of the patient to a reference center with interventional cardiology laboratory has a significant impact on reducing in-hospital delay in case of patients with acute coronary syndrome. This article presents the results of two-stage transportation of the patient with acute coronary syndrome. This measure could help clinicians who seek to assess time needed for intervention. It also shows how time from the beginning of pain in chest is important and may contribute to patient disability, death or well-being.

Catalytic two-stage coal liquefaction process having improved nitrogen removal

DOEpatents

Comolli, Alfred G.

1991-01-01

A process for catalytic multi-stage hydrogenation and liquefaction of coal to produce high yields of low-boiling hydrocarbon liquids containing low concentrations of nitogen compounds. First stage catalytic reaction conditions are 700.degree.-800.degree. F. temperature, 1500-3500 psig hydrogen partial pressure, with the space velocity maintained in a critical range of 10-40 lb coal/hr ft.sup.3 catalyst settled volume. The first stage catalyst has 0.3-1.2 cc/gm total pore volume with at least 25% of the pore volume in pores having diameters of 200-2000 Angstroms. Second stage reaction conditions are 760.degree.-870.degree. F. temperature with space velocity exceeding that in the first stage reactor, so as to achieve increased hydrogenation yield of low-boiling hydrocarbon liquid products having at least 75% removal of nitrogen compounds from the coal-derived liquid products.

DEVELOPMENT OF COLD CLIMATE HEAT PUMP USING TWO-STAGE COMPRESSION

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shen, Bo; Rice, C Keith; Abdelaziz, Omar

2015-01-01

This paper uses a well-regarded, hardware based heat pump system model to investigate a two-stage economizing cycle for cold climate heat pump applications. The two-stage compression cycle has two variable-speed compressors. The high stage compressor was modelled using a compressor map, and the low stage compressor was experimentally studied using calorimeter testing. A single-stage heat pump system was modelled as the baseline. The system performance predictions are compared between the two-stage and single-stage systems. Special considerations for designing a cold climate heat pump are addressed at both the system and component levels.

Simulation and Analyses of Stage Separation Two-Stage Reusable Launch Vehicles

NASA Technical Reports Server (NTRS)

Pamadi, Bandu N.; Neirynck, Thomas A.; Hotchko, Nathaniel J.; Tartabini, Paul V.; Scallion, William I.; Murphy, Kelly J.; Covell, Peter F.

2005-01-01

NASA has initiated the development of methodologies, techniques and tools needed for analysis and simulation of stage separation of next generation reusable launch vehicles. As a part of this activity, ConSep simulation tool is being developed which is a MATLAB-based front-and-back-end to the commercially available ADAMS(registered Trademark) solver, an industry standard package for solving multi-body dynamic problems. This paper discusses the application of ConSep to the simulation and analysis of staging maneuvers of two-stage-to-orbit (TSTO) Bimese reusable launch vehicles, one staging at Mach 3 and the other at Mach 6. The proximity and isolated aerodynamic database were assembled using the data from wind tunnel tests conducted at NASA Langley Research Center. The effects of parametric variations in mass, inertia, flight path angle, altitude from their nominal values at staging were evaluated. Monte Carlo runs were performed for Mach 3 staging to evaluate the sensitivity to uncertainties in aerodynamic coefficients.

One-stage versus two-stage exchange arthroplasty for infected total knee arthroplasty: a systematic review.

PubMed

Nagra, Navraj S; Hamilton, Thomas W; Ganatra, Sameer; Murray, David W; Pandit, Hemant

2016-10-01

Infection complicating total knee arthroplasty (TKA) has serious implications. Traditionally the debate on whether one- or two-stage exchange arthroplasty is the optimum management of infected TKA has favoured two-stage procedures; however, a paradigm shift in opinion is emerging. This study aimed to establish whether current evidence supports one-stage revision for managing infected TKA based on reinfection rates and functional outcomes post-surgery. MEDLINE/PubMed and CENTRAL databases were reviewed for studies that compared one- and two-stage exchange arthroplasty TKA in more than ten patients with a minimum 2-year follow-up. From an initial sample of 796, five cohort studies with a total of 231 patients (46 single-stage/185 two-stage; median patient age 66 years, range 61-71 years) met inclusion criteria. Overall, there were no significant differences in risk of reinfection following one- or two-stage exchange arthroplasty (OR -0.06, 95 % confidence interval -0.13, 0.01). Subgroup analysis revealed that in studies published since 2000, one-stage procedures have a significantly lower reinfection rate. One study investigated functional outcomes and reported that one-stage surgery was associated with superior functional outcomes. Scarcity of data, inconsistent study designs, surgical technique and antibiotic regime disparities limit recommendations that can be made. Recent studies suggest one-stage exchange arthroplasty may provide superior outcomes, including lower reinfection rates and superior function, in select patients. Clinically, for some patients, one-stage exchange arthroplasty may represent optimum treatment; however, patient selection criteria and key components of surgical and post-operative anti-microbial management remain to be defined. III.

Two stage surgical procedure for root coverage

PubMed Central

George, Anjana Mary; Rajesh, K. S.; Hegde, Shashikanth; Kumar, Arun

2012-01-01

Gingival recession may present problems that include root sensitivity, esthetic concern, and predilection to root caries, cervical abrasion and compromising of a restorative effort. When marginal tissue health cannot be maintained and recession is deep, the need for treatment arises. This literature has documented that recession can be successfully treated by means of a two stage surgical approach, the first stage consisting of creation of attached gingiva by means of free gingival graft, and in the second stage, a lateral sliding flap of grafted tissue to cover the recession. This indirect technique ensures development of an adequate width of attached gingiva. The outcome of this technique suggests that two stage surgical procedures are highly predictable for root coverage in case of isolated deep recession and lack of attached gingiva. PMID:23162343

Two-stage fan. 2: Data and performance with redesigned second stage rotor uniform and distorted inlet flows

NASA Technical Reports Server (NTRS)

Messenger, H. E.; Keenan, M. J.

1974-01-01

A two-stage fan with a first rotor tip speed of 1450 ft/sec (441.96 m/sec) and no inlet guide vanes was tested with uniform and distorted inlet flows, with a redesigned second rotor having a part span shroud to prevent flutter, with variable-stagger stators set in nominal positions, and without rotor casing treatment. The fan achieved a pressure ratio 2.8 at a corrected flow of 185.4 lbm/sec (84.0 kg/sec), an adiabatic efficiency of 85.0 percent, and a stall margin of 12 percent. The redesigned second rotor did not flutter. Tip radial distortion reduced the stall margin at intermediate speed, but had little effect on stall margin at high or low speeds. Hub radial distortion reduced the stall margin at design speed but increased stall margin at low speed. Circumferential distortion reduced stall pressure ratio and flow to give approximately the same stall lines with uniform inlet flow. Distortions were attenuated by the fan. For Vol. 1, see N74-11421.

Residential Two-Stage Gas Furnaces - Do They Save Energy?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lekov, Alex; Franco, Victor; Lutz, James

2006-05-12

Residential two-stage gas furnaces account for almost a quarter of the total number of models listed in the March 2005 GAMA directory of equipment certified for sale in the United States. Two-stage furnaces are expanding their presence in the market mostly because they meet consumer expectations for improved comfort. Currently, the U.S. Department of Energy (DOE) test procedure serves as the method for reporting furnace total fuel and electricity consumption under laboratory conditions. In 2006, American Society of Heating Refrigeration and Air-conditioning Engineers (ASHRAE) proposed an update to its test procedure which corrects some of the discrepancies found in themore » DOE test procedure and provides an improved methodology for calculating the energy consumption of two-stage furnaces. The objectives of this paper are to explore the differences in the methods for calculating two-stage residential gas furnace energy consumption in the DOE test procedure and in the 2006 ASHRAE test procedure and to compare test results to research results from field tests. Overall, the DOE test procedure shows a reduction in the total site energy consumption of about 3 percent for two-stage compared to single-stage furnaces at the same efficiency level. In contrast, the 2006 ASHRAE test procedure shows almost no difference in the total site energy consumption. The 2006 ASHRAE test procedure appears to provide a better methodology for calculating the energy consumption of two-stage furnaces. The results indicate that, although two-stage technology by itself does not save site energy, the combination of two-stage furnaces with BPM motors provides electricity savings, which are confirmed by field studies.« less

Advanced radial inflow turbine rotor program: Design and dynamic testing

NASA Technical Reports Server (NTRS)

Rodgers, C.

1976-01-01

The advancement of small, cooled, radial inflow turbine technology in the area of operation at higher turbine inlet temperature is discussed. The first step was accomplished by designing, fabricating, and subjecting to limited mechanical testing an advanced gas generator rotating assembly comprising a radial inflow turbine and two-stage centrifugal compressor. The radial inflow turbine and second-stage compressor were designed as an integrally machined monorotor with turbine cooling taking place basically by conduction to the compressor. Design turbine inlet rotor gas temperature, rotational speed, and overall gas generator compressor pressure ratio were 1422 K (2560 R), 71,222 rpm, and 10/1 respectively. Mechanical testing on a fabricated rotating assembly and bearing system covered 1,000 cold start/stop cycles and three spins to 120 percent design speed (85,466 rpm).

Adaptive Urban Stormwater Management Using a Two-stage Stochastic Optimization Model

NASA Astrophysics Data System (ADS)

Hung, F.; Hobbs, B. F.; McGarity, A. E.

2014-12-01

In many older cities, stormwater results in combined sewer overflows (CSOs) and consequent water quality impairments. Because of the expense of traditional approaches for controlling CSOs, cities are considering the use of green infrastructure (GI) to reduce runoff and pollutants. Examples of GI include tree trenches, rain gardens, green roofs, and rain barrels. However, the cost and effectiveness of GI are uncertain, especially at the watershed scale. We present a two-stage stochastic extension of the Stormwater Investment Strategy Evaluation (StormWISE) model (A. McGarity, JWRPM, 2012, 111-24) to explicitly model and optimize these uncertainties in an adaptive management framework. A two-stage model represents the immediate commitment of resources ("here & now") followed by later investment and adaptation decisions ("wait & see"). A case study is presented for Philadelphia, which intends to extensively deploy GI over the next two decades (PWD, "Green City, Clean Water - Implementation and Adaptive Management Plan," 2011). After first-stage decisions are made, the model updates the stochastic objective and constraints (learning). We model two types of "learning" about GI cost and performance. One assumes that learning occurs over time, is automatic, and does not depend on what has been done in stage one (basic model). The other considers learning resulting from active experimentation and learning-by-doing (advanced model). Both require expert probability elicitations, and learning from research and monitoring is modelled by Bayesian updating (as in S. Jacobi et al., JWRPM, 2013, 534-43). The model allocates limited financial resources to GI investments over time to achieve multiple objectives with a given reliability. Objectives include minimizing construction and O&M costs; achieving nutrient, sediment, and runoff volume targets; and community concerns, such as aesthetics, CO2 emissions, heat islands, and recreational values. CVaR (Conditional Value at Risk) and

Frequency analysis of a two-stage planetary gearbox using two different methodologies

NASA Astrophysics Data System (ADS)

Feki, Nabih; Karray, Maha; Khabou, Mohamed Tawfik; Chaari, Fakher; Haddar, Mohamed

2017-12-01

This paper is focused on the characterization of the frequency content of vibration signals issued from a two-stage planetary gearbox. To achieve this goal, two different methodologies are adopted: the lumped-parameter modeling approach and the phenomenological modeling approach. The two methodologies aim to describe the complex vibrations generated by a two-stage planetary gearbox. The phenomenological model describes directly the vibrations as measured by a sensor fixed outside the fixed ring gear with respect to an inertial reference frame, while results from a lumped-parameter model are referenced with respect to a rotating frame and then transferred into an inertial reference frame. Two different case studies of the two-stage planetary gear are adopted to describe the vibration and the corresponding spectra using both models. Each case presents a specific geometry and a specific spectral structure.

Blood pressure variability of two ambulatory blood pressure monitors.

PubMed

Kallem, Radhakrishna R; Meyers, Kevin E C; Cucchiara, Andrew J; Sawinski, Deirdre L; Townsend, Raymond R

2014-04-01

There are no data on the evaluation of blood pressure (BP) variability comparing two ambulatory blood pressure monitoring monitors worn at the same time. Hence, this study was carried out to compare variability of BP in healthy untreated adults using two ambulatory BP monitors worn at the same time over an 8-h period. An Accutorr device was used to measure office BP in the dominant and nondominant arms of 24 participants.Simultaneous 8-h BP and heart rate data were measured in 24 untreated adult volunteers by Mobil-O-Graph (worn for an additional 16 h after removing the Spacelabs monitor) and Spacelabs with both random (N=12) and nonrandom (N=12) assignment of each device to the dominant arm. Average real variability (ARV), SD, coefficient of variation, and variation independent of mean were calculated for systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure (PP). Whether the Mobil-O-Graph was applied to the dominant or the nondominant arm, the ARV of mean systolic (P=0.003 nonrandomized; P=0.010 randomized) and PP (P=0.009 nonrandomized; P=0.005 randomized) remained significantly higher than the Spacelabs device, whereas the ARV of the mean arterial pressure was not significantly different. The average BP readings and ARVs for systolic blood pressure and PP obtained by the Mobil-O-Graph were considerably higher for the daytime than the night-time. Given the emerging interest in the effect of BP variability on health outcomes, the accuracy of its measurement is important. Our study raises concerns about the accuracy of pooling international ambulatory blood pressure monitoring variability data using different devices.

Aerodynamic Design Study of Advanced Multistage Axial Compressor

NASA Technical Reports Server (NTRS)

Larosiliere, Louis M.; Wood, Jerry R.; Hathaway, Michael D.; Medd, Adam J.; Dang, Thong Q.

2002-01-01

As a direct response to the need for further performance gains from current multistage axial compressors, an investigation of advanced aerodynamic design concepts that will lead to compact, high-efficiency, and wide-operability configurations is being pursued. Part I of this report describes the projected level of technical advancement relative to the state of the art and quantifies it in terms of basic aerodynamic technology elements of current design systems. A rational enhancement of these elements is shown to lead to a substantial expansion of the design and operability space. Aerodynamic design considerations for a four-stage core compressor intended to serve as a vehicle to develop, integrate, and demonstrate aerotechnology advancements are discussed. This design is biased toward high efficiency at high loading. Three-dimensional blading and spanwise tailoring of vector diagrams guided by computational fluid dynamics (CFD) are used to manage the aerodynamics of the high-loaded endwall regions. Certain deleterious flow features, such as leakage-vortex-dominated endwall flow and strong shock-boundary-layer interactions, were identified and targeted for improvement. However, the preliminary results were encouraging and the front two stages were extracted for further aerodynamic trimming using a three-dimensional inverse design method described in part II of this report. The benefits of the inverse design method are illustrated by developing an appropriate pressure-loading strategy for transonic blading and applying it to reblade the rotors in the front two stages of the four-stage configuration. Multistage CFD simulations based on the average passage formulation indicated an overall efficiency potential far exceeding current practice for the front two stages. Results of the CFD simulation at the aerodynamic design point are interrogated to identify areas requiring additional development. In spite of the significantly higher aerodynamic loadings, advanced CFD

Variation in advanced stage at diagnosis of lung and female breast cancer in an English region 2006-2009.

PubMed

Lyratzopoulos, G; Abel, G A; Barbiere, J M; Brown, C H; Rous, B A; Greenberg, D C

2012-03-13

Understanding variation in stage at diagnosis can inform interventions to improve the timeliness of diagnosis for patients with different cancers and characteristics. We analysed population-based data on 17,836 and 13,286 East of England residents diagnosed with (female) breast and lung cancer during 2006-2009, with stage information on 16,460 (92%) and 10,435 (79%) patients, respectively. Odds ratios (ORs) of advanced stage at diagnosis adjusted for patient and tumour characteristics were derived using logistic regression. We present adjusted ORs of diagnosis in stages III/IV compared with diagnosis in stages I/II. For breast cancer, the frequency of advanced stage at diagnosis increased stepwise among old women (ORs: 1.21, 1.46, 1.68 and 1.78 for women aged 70-74, 75-79, 80-84 and ≥85, respectively, compared with those aged 65-69 , P<0.001). In contrast, for lung cancer advanced stage at diagnosis was less frequent in old patients (ORs: 0.82, 0.74, 0.73 and 0.66, P<0.001). Advanced stage at diagnosis was more frequent in more deprived women with breast cancer (OR: 1.23 for most compared with least deprived, P=0.002), and in men with lung cancer (OR: 1.14, P=0.011). The observed patterns were robust to sensitivity analyses approaches for handling missing stage data under different assumptions. Interventions to help improve the timeliness of diagnosis of different cancers should be targeted at specific age groups.

A CFD Case Study of a Fan Stage with Split Flow Path Subject to Total Pressure Distortion Inflow

NASA Technical Reports Server (NTRS)

To, Wai-Ming

2017-01-01

This report is the documentation of the work performed under the Hypersonic Project of the NASA's Fundamental Aeronautics Program. It was funded through Task Number NNC10E444T under GESS-2 Contract NNC06BA07B. The objective of the task is to develop advanced computational tools for the simulation of multi-stage turbomachinery in support of aeropropulsion. This includes work elements in extending the TURBO code and validating the multi-stage URANS (Unsteady Reynolds Averaged Navier Stokes) simulation results with the experimental data. The unsteady CFD (Computation Fluid Dynamics) calculations were performed in full wheel mode with and without screen generated total pressure distortion at the computational inflow boundary, as well as in single passage phase lag mode for uniform inflow. The experimental data were provided by NASA from the single stage RTA (Revolutionary Turbine Accelerator) fan test program.Significant non-uniform flow condition at the fan-face of the aeropropulsion system is frequentlyencountered in many of the advanced aerospace vehicles. These propulsion systems can be eithera podded or an embedded design employed in HWB (Hybrid Wing Body) airframe concept. It isalso a topic of interest in military applications, in which advanced air vehicles have already deployedsome form of embedded propulsion systems in their design because of the requirementsof compact and low observable inlets. Even in the conventional airframe/engine design, the fancould operate under such condition when the air vehicle is undergoing rapid maneuvering action.It is believed that a better understanding of the fan’s aerodynamic and aeromechanical responseto this type of operating condition or off design operation would be beneficial to designing distortiontolerant blades for improved engine operability.The objective for this research is to assess the capability of turbomachinery code as an analysistool in understanding the effects and evaluating the impact of flow distortion

Systematic genomic identification of colorectal cancer genes delineating advanced from early clinical stage and metastasis

PubMed Central

2013-01-01

Background Colorectal cancer is the third leading cause of cancer deaths in the United States. The initial assessment of colorectal cancer involves clinical staging that takes into account the extent of primary tumor invasion, determining the number of lymph nodes with metastatic cancer and the identification of metastatic sites in other organs. Advanced clinical stage indicates metastatic cancer, either in regional lymph nodes or in distant organs. While the genomic and genetic basis of colorectal cancer has been elucidated to some degree, less is known about the identity of specific cancer genes that are associated with advanced clinical stage and metastasis. Methods We compiled multiple genomic data types (mutations, copy number alterations, gene expression and methylation status) as well as clinical meta-data from The Cancer Genome Atlas (TCGA). We used an elastic-net regularized regression method on the combined genomic data to identify genetic aberrations and their associated cancer genes that are indicators of clinical stage. We ranked candidate genes by their regression coefficient and level of support from multiple assay modalities. Results A fit of the elastic-net regularized regression to 197 samples and integrated analysis of four genomic platforms identified the set of top gene predictors of advanced clinical stage, including: WRN, SYK, DDX5 and ADRA2C. These genetic features were identified robustly in bootstrap resampling analysis. Conclusions We conducted an analysis integrating multiple genomic features including mutations, copy number alterations, gene expression and methylation. This integrated approach in which one considers all of these genomic features performs better than any individual genomic assay. We identified multiple genes that robustly delineate advanced clinical stage, suggesting their possible role in colorectal cancer metastatic progression. PMID:24308539

Six-minute walk test and heart rate variability: lack of association in advanced stages of heart failure.

PubMed

Woo, M A; Moser, D K; Stevenson, L W; Stevenson, W G

1997-09-01

The 6-minute walk and heart rate variability have been used to assess mortality risk in patients with heart failure, but their relationship to each other and their usefulness for predicting mortality at 1 year are unknown. To assess the relationships between the 6-minute walk test, heart rate variability, and 1-year mortality. A sample of 113 patients in advanced stages of heart failure (New York Heart Association Functional Class III-IV, left ventricular ejection < 0.25) were studied. All 6-minute walks took place in an enclosed, level, measured corridor and were supervised by the same nurse. Heart rate variability was measured by using (1) a standard-deviation method and (2) Poincaré plots. Data on RR intervals obtained by using 24-hour Holter monitoring were analyzed. Survival was determined at 1 year after the Holter recording. The results showed no significant associations between the results of the 6-minute walk and the two measures of heart rate variability. The results of the walk were related to 1-year mortality but not to the risk of sudden death. Both measures of heart rate variability had significant associations with 1-year mortality and with sudden death. However, only heart rate variability measured by using Poincaré plots was a predictor of total mortality and risk of sudden death, independent of left ventricular ejection fraction, serum levels of sodium, results of the 6-minute walk test, and the standard-deviation measure of heart rate variability. Results of the 6-minute walk have poor association with mortality and the two measures of heart rate variability in patients with advanced-stage heart failure and a low ejection fraction. Further studies are needed to determine the optimal clinical usefulness of the 6-minute walk and heart rate variability in patients with advanced-stage heart failure.

Interferon after surgery for women with advanced (Stage II-IV) epithelial ovarian cancer.

PubMed

Lawal, Aramide O; Musekiwa, Alfred; Grobler, Liesl

2013-06-06

Epithelial ovarian cancer (EOC) is a life-threatening disease. Most often women become symptomatic only in the advanced stages of the disease, increasing the difficulty of treatment. Whilst the disease responds well to surgery and chemotherapy, the relapse rate is high. New treatments to prevent disease recurrence or progression, prolong survival, and increase the quality of life are needed. To assess the effectiveness and safety of interferon after surgery in the treatment of advanced (stage II-IV) EOC. The Cochrane Gynaecological Cancer Review Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL) Issue 1, 2012, MEDLINE and EMBASE were searched to January 2012. Handsearching of conference proceedings was also undertaken. Reference lists of reviews and included trials were screened and experts in the field were contacted for additional trials. Clinical trials registers were searched for ongoing trials. Randomised controlled trials (RCTs) involving participants with advanced EOC that compared post-operative chemotherapy alone with post-operative interferon therapy in combination with chemotherapy or post-operative chemotherapy followed by interferon or observation alone Two review authors (AL and AM) independently screened the search results for relevant trials and extracted pre-specified information from each included trial. Data were managed using Review Manager 5.1. Hazard ratios (HR) were calculated for time-to-event outcomes and risk ratios (RR) for dichotomous outcomes, with corresponding 95% confidence intervals (CI). Five trials, including 1476 participants, were included in the review. Two trials compared interferon with observation alone and three trials compared interferon plus chemotherapy with chemotherapy alone. A meta-analysis of two trials involving 370 participants found no significant difference in both overall survival (HR 1.14, 95% CI 0.84 to 1.55) and progression free survival (HR 0.99, 95% CI 0.79 to 1.24) between

Study of the design and efficiency of single stage EHD thrusters at the sub-atmospheric pressure of 1.3 kPa

NASA Astrophysics Data System (ADS)

Granados, Victor H.; Pinheiro, Mario J.; Sá, Paulo A.

2017-12-01

The goal of this article is to contribute to the advancement and the improvement of the performances of electrohydrodynamic (EHD) propulsion systems for space missions, especially in what concerns the control of the geometries of the electrodes and the employed gas and its efficiency. We use a previously developed self-consistent model to compare and study the performance of these systems using three different working gases (argon, nitrogen, and oxygen) in terms of net thrust production and thrust-to-power efficiency of single-stage EHD thrusters. In order to verify the dependency of those physical parameters on the configuration and orientation of the electrodes, we conduct systematic simulations of three thruster cathode configurations (conical, cylindrical, and funnel-like). In the present study, the working pressure is ≈1.3 kPa (10 Torr), well below the normal atmospheric pressure, and the gas temperature is 300 K. A similar systematic investigation was conducted in a recent paper at a relatively much lower pressure of 0.5 Torr (20 times less) for the same cathode duct geometries and working gases, which permit to compare the performances of the considered thrusters and gases at these two pressures; then and now, the distance between the electrodes is fixed at 28 mm, but in addition to the pressure, other parameters were modified. Thus, the input voltage is fixed at 3 kV, and the resistance of the ballast varies in the range of 500-5000 MΩ. Nitrogen gas performed better than argon for all proposed geometries, doubling the produced thrust while presenting higher T/P ratios in almost all cases. Oxygen presented significantly better performance than nitrogen's and argon's, e.g., funnel like cathode configuration presented a net thrust higher than 0.1 mN, about one order of magnitude higher than nitrogen's.

A two-stage adaptive stochastic collocation method on nested sparse grids for multiphase flow in randomly heterogeneous porous media

NASA Astrophysics Data System (ADS)

Liao, Qinzhuo; Zhang, Dongxiao; Tchelepi, Hamdi

2017-02-01

A new computational method is proposed for efficient uncertainty quantification of multiphase flow in porous media with stochastic permeability. For pressure estimation, it combines the dimension-adaptive stochastic collocation method on Smolyak sparse grids and the Kronrod-Patterson-Hermite nested quadrature formulas. For saturation estimation, an additional stage is developed, in which the pressure and velocity samples are first generated by the sparse grid interpolation and then substituted into the transport equation to solve for the saturation samples, to address the low regularity problem of the saturation. Numerical examples are presented for multiphase flow with stochastic permeability fields to demonstrate accuracy and efficiency of the proposed two-stage adaptive stochastic collocation method on nested sparse grids.

A CFD Analysis of Steam Flow in the Two-Stage Experimental Impulse Turbine with the Drum Rotor Arrangement

NASA Astrophysics Data System (ADS)

Yun, Kukchol; Tajč, L.; Kolovratník, M.

2016-03-01

The aim of the paper is to present the CFD analysis of the steam flow in the two-stage turbine with a drum rotor and balancing slots. The balancing slot is a part of every rotor blade and it can be used in the same way as balancing holes on the classical rotor disc. The main attention is focused on the explanation of the experimental knowledge about the impact of the slot covering and uncovering on the efficiency of the individual stages and the entire turbine. The pressure and temperature fields and the mass steam flows through the shaft seals, slots and blade cascades are calculated. The impact of the balancing slots covering or uncovering on the reaction and velocity conditions in the stages is evaluated according to the pressure and temperature fields. We have also concentrated on the analysis of the seal steam flow through the balancing slots. The optimized design of the balancing slots has been suggested.

Expression signatures of early-stage and advanced medaka melanomas.

PubMed

Klotz, Barbara; Kneitz, Susanne; Regensburger, Martina; Hahn, Lena; Dannemann, Michael; Kelso, Janet; Nickel, Birgit; Lu, Yuan; Boswell, William; Postlethwait, John; Warren, Wesley; Kunz, Manfred; Walter, Ronald B; Schartl, Manfred

2018-06-01

Melanoma is one of the most aggressive tumors with a very low survival rate once metastasized. The incidence of newly detected cases increases every year suggesting the necessity of development and application of innovative treatment strategies. Human melanoma develops from melanocytes localized in the epidermis of the skin to malignant tumors because of deregulated effectors influencing several molecular pathways. Despite many advances in describing the molecular changes accompanying melanoma formation, many critical and clinically relevant molecular features of the transformed pigment cells and the underlying mechanisms are largely unknown. To contribute to a better understanding of the molecular processes of melanoma formation, we use a transgenic medaka melanoma model that is well suited for the investigation of melanoma tumor development because fish and human melanocytes are both localized in the epidermis. The purpose of our study was to gain insights into melanoma development from the first steps of tumor formation up to melanoma progression and to identify gene expression patterns that will be useful for monitoring treatment effects in drug screening approaches. Comparing transcriptomes from juvenile fish at the tumor initiating stage with nevi and advanced melanoma of adults, we identified stage specific expression signatures and pathways that are characteristic for the development of medaka melanoma, and are also found in human malignancies. Copyright © 2017 Elsevier Inc. All rights reserved.

[Therapeutic options for pressure ulcers].

PubMed

Damert, H-G; Meyer, F; Altmann, S

2015-04-01

The aim of this overview is based on remarks on the pathogenesis of and therapy for pressure ulcers and selected but representative cases to demonstrate current options of plastic coverage. As a consequence of the demographic developments, in particular, with regard to the increasing proportion of older patients as well as the advances in modern medicine, the number of multimorbid, geriatric and bedridden patients and of those with prolonged sickbed periods has been steadily growing. Therefore, partly severe manifestations of pressure ulcers at various exposed body regions can be observed in spite of the best preventive intention of care. While in the early stages rather conservative treatment is adequate, surgical intervention might become important and indispensable for a sufficient treatment in advanced stages. To facilitate basic care and to appropriately treat the infectious focus, the methods and procedures of plastic surgery can become relevant. Although there are several options and approaches existing to sanitise and cover defects of pressure ulcers, which are described within the article based on representative cases, preventive measures can still be considered the best approach. Georg Thieme Verlag KG Stuttgart · New York.

Effect of ammoniacal nitrogen on one-stage and two-stage anaerobic digestion of food waste

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ariunbaatar, Javkhlan, E-mail: jaka@unicas.it; UNESCO-IHE Institute for Water Education, Westvest 7, 2611 AX Delft; Scotto Di Perta, Ester

Highlights: • Almost 100% of the biomethane potential of food waste was recovered during AD in a two-stage CSTR. • Recirculation of the liquid fraction of the digestate provided the necessary buffer in the AD reactors. • A higher OLR (0.9 gVS/L·d) led to higher accumulation of TAN, which caused more toxicity. • A two-stage reactor is more sensitive to elevated concentrations of ammonia. • The IC{sub 50} of TAN for the AD of food waste amounts to 3.8 g/L. - Abstract: This research compares the operation of one-stage and two-stage anaerobic continuously stirred tank reactor (CSTR) systems fed semi-continuouslymore » with food waste. The main purpose was to investigate the effects of ammoniacal nitrogen on the anaerobic digestion process. The two-stage system gave more reliable operation compared to one-stage due to: (i) a better pH self-adjusting capacity; (ii) a higher resistance to organic loading shocks; and (iii) a higher conversion rate of organic substrate to biomethane. Also a small amount of biohydrogen was detected from the first stage of the two-stage reactor making this system attractive for biohythane production. As the digestate contains ammoniacal nitrogen, re-circulating it provided the necessary alkalinity in the systems, thus preventing an eventual failure by volatile fatty acids (VFA) accumulation. However, re-circulation also resulted in an ammonium accumulation, yielding a lower biomethane production. Based on the batch experimental results the 50% inhibitory concentration of total ammoniacal nitrogen on the methanogenic activities was calculated as 3.8 g/L, corresponding to 146 mg/L free ammonia for the inoculum used for this research. The two-stage system was affected by the inhibition more than the one-stage system, as it requires less alkalinity and the physically separated methanogens are more sensitive to inhibitory factors, such as ammonium and propionic acid.« less

Effect of ammoniacal nitrogen on one-stage and two-stage anaerobic digestion of food waste.

PubMed

Ariunbaatar, Javkhlan; Scotto Di Perta, Ester; Panico, Antonio; Frunzo, Luigi; Esposito, Giovanni; Lens, Piet N L; Pirozzi, Francesco

2015-04-01

This research compares the operation of one-stage and two-stage anaerobic continuously stirred tank reactor (CSTR) systems fed semi-continuously with food waste. The main purpose was to investigate the effects of ammoniacal nitrogen on the anaerobic digestion process. The two-stage system gave more reliable operation compared to one-stage due to: (i) a better pH self-adjusting capacity; (ii) a higher resistance to organic loading shocks; and (iii) a higher conversion rate of organic substrate to biomethane. Also a small amount of biohydrogen was detected from the first stage of the two-stage reactor making this system attractive for biohythane production. As the digestate contains ammoniacal nitrogen, re-circulating it provided the necessary alkalinity in the systems, thus preventing an eventual failure by volatile fatty acids (VFA) accumulation. However, re-circulation also resulted in an ammonium accumulation, yielding a lower biomethane production. Based on the batch experimental results the 50% inhibitory concentration of total ammoniacal nitrogen on the methanogenic activities was calculated as 3.8 g/L, corresponding to 146 mg/L free ammonia for the inoculum used for this research. The two-stage system was affected by the inhibition more than the one-stage system, as it requires less alkalinity and the physically separated methanogens are more sensitive to inhibitory factors, such as ammonium and propionic acid. Copyright © 2014 Elsevier Ltd. All rights reserved.

Experimental research on a 12.1 K gas-coupled two-stage high frequency pulse tube cryocooler

NASA Astrophysics Data System (ADS)

Xiaoshuang, Zhu; Yuan, Zhou; Wenxiu, Zhu; Wei, Dai; Junjie, Wang

2017-02-01

High frequency pulse tube cryocoolers (HFPTC) have been widely used in many fields like physics experimental research and aerospace, for no moving part in cold region, low vibration and long life. A gas-coupled two-stage high frequency pulse tube cryocooler with single compressor is introduced in this paper. In the first stage of the cryocooler, double-inlet and multi-bypass has been adopted as phase shifters. To get a better performance in phase shifting the reservoir and the inertance tube of the second stage has been located on the cold head of the first stage. With SS mesh screen as the regenerator of both stage, no-load temperature of 13.5K has been achieved. To improve the heat capacity of the regenerator of the second stage magnetic material Er3Ni has been employed in the second stage as regenerator matrix. With the charge pressure of 1.8MPa, input power of 260W and operating frequency of 23.5 Hz, the no-load temperature of 12.1K has been achieved.

Recent advances in lightweight, filament-wound composite pressure vessel technology

NASA Technical Reports Server (NTRS)

Lark, R. F.

1977-01-01

A review of recent advances is presented for lightweight, high-performance composite pressure vessel technology that covers the areas of design concepts, fabrication procedures, applications, and performance of vessels subjected to single-cycle burst and cyclic fatigue loading. Filament-wound fiber/epoxy composite vessels were made from S-glass, graphite, and Kevlar 49 fibers and were equipped with both structural and nonstructural liners. Pressure vessel structural efficiencies were attained which represented weight savings, using different liners, of 40 to 60 percent over all-titanium pressure vessels. Significant findings in each area are summarized including data from current NASA-Lewis Research Center contractual and in-house programs.

Calculation of pressure drop in the developmental stages of the medaka fish heart and microvasculature

NASA Astrophysics Data System (ADS)

Chakraborty, Sreyashi; Vlachos, Pavlos

2016-11-01

Peristaltic contraction of the developing medaka fish heart produces temporally and spatially varying pressure drop across the atrioventricular (AV) canal. Blood flowing through the tail vessels experience a slug flow across the developmental stages. We have performed a series of live imaging experiments over 14 days post fertilization (dpf) of the medaka fish egg and cross-correlated the red blood cell (RBC) pattern intensities to obtain the two-dimensional velocity fields. Subsequently we have calculated the pressure field by integrating the pressure gradient in the momentum equation. Our calculations show that the pressure drop across the AV canal increases from 0.8mm Hg during 3dpf to 2.8 mm Hg during 14dpf. We have calculated the time-varying wall shear stress for the blood vessels by assuming a spatially constant velocity magnitude in each vessel. The calculated wall shear stress matches the wall shear stress sensed by human endothelial cells (10-12 dyne/sq. cm). The pressure drop per unit length of the vessel is obtained by doing a control volume analysis of flow in the caudal arteries and veins. The current results can be extended to investigate the effect of the fluid dynamic parameters on the vascular and cardiac morphogenesis.

Physical activity in patients with advanced-stage cancer: a systematic review of the literature.

PubMed

Albrecht, Tara A; Taylor, Ann Gill

2012-06-01

The importance of physical activity for chronic disease prevention and management has become generally well accepted. The number of research interventions and publications examining the benefits of physical activity for patients with cancer has been rising steadily. However, much of that research has focused on the impact of physical activity either prior to or early in the cancer diagnosis, treatment, and survivorship process. Research focusing on the effects of physical activity, specifically for patients with advanced-stage cancer and poorer prognostic outcomes, has been addressed only recently. The purpose of this article is to examine the state of the science for physical activity in the advanced-stage disease subset of the cancer population. Exercise in a variety of intensities and forms, including yoga, walking, biking, and swimming, has many health benefits for people, including those diagnosed with cancer. Research has shown that, for people with cancer (including advanced-stage cancer), exercise can decrease anxiety, stress, and depression while improving levels of pain, fatigue, shortness of breath, constipation, and insomnia. People diagnosed with cancer should discuss with their oncologist safe, easy ways they can incorporate exercise into their daily lives.

Advanced Packaging Technology Used in Fabricating a High-Temperature Silicon Carbide Pressure Sensor

NASA Technical Reports Server (NTRS)

Beheim, Glenn M.

2003-01-01

The development of new aircraft engines requires the measurement of pressures in hot areas such as the combustor and the final stages of the compressor. The needs of the aircraft engine industry are not fully met by commercially available high-temperature pressure sensors, which are fabricated using silicon. Kulite Semiconductor Products and the NASA Glenn Research Center have been working together to develop silicon carbide (SiC) pressure sensors for use at high temperatures. At temperatures above 850 F, silicon begins to lose its nearly ideal elastic properties, so the output of a silicon pressure sensor will drift. SiC, however, maintains its nearly ideal mechanical properties to extremely high temperatures. Given a suitable sensor material, a key to the development of a practical high-temperature pressure sensor is the package. A SiC pressure sensor capable of operating at 930 F was fabricated using a newly developed package. The durability of this sensor was demonstrated in an on-engine test. The SiC pressure sensor uses a SiC diaphragm, which is fabricated using deep reactive ion etching. SiC strain gauges on the surface of the diaphragm sense the pressure difference across the diaphragm. Conventionally, the SiC chip is mounted to the package with the strain gauges outward, which exposes the sensitive metal contacts on the chip to the hostile measurement environment. In the new Kulite leadless package, the SiC chip is flipped over so that the metal contacts are protected from oxidation by a hermetic seal around the perimeter of the chip. In the leadless package, a conductive glass provides the electrical connection between the pins of the package and the chip, which eliminates the fragile gold wires used previously. The durability of the leadless SiC pressure sensor was demonstrated when two 930 F sensors were tested in the combustor of a Pratt & Whitney PW4000 series engine. Since the gas temperatures in these locations reach 1200 to 1300 F, the sensors were

Two Linguists on Freshman English: Pressure from Below.

ERIC Educational Resources Information Center

Francis, W. Nelson

1964-01-01

The importance of improving English instructors' attitudes toward three broadly classified forms of language expression is examined. The author notes an increased interest in languages among college freshmen and defines the differences between (1) artistic, (2) playful, and (3) intellectual expression. Pressure resulting from advanced teaching…

Validation of a Computational Model for the SLS Core Stage Oxygen Tank Diffuser Concept and the Low Profile Diffuser - An Advanced Development Design for the SLS

NASA Technical Reports Server (NTRS)

Brodnick, Jacob; Richardson, Brian; Ramachandran, Narayanan

2015-01-01

The Low Profile Diffuser (LPD) project originated as an award from the Marshall Space Flight Center (MSFC) Advanced Development (ADO) office to the Main Propulsion Systems Branch (ER22). The task was created to develop and test an LPD concept that could produce comparable performance to a larger, traditionally designed, ullage gas diffuser while occupying a smaller volume envelope. Historically, ullage gas diffusers have been large, bulky devices that occupy a significant portion of the propellant tank, decreasing the tank volume available for propellant. Ullage pressurization of spacecraft propellant tanks is required to prevent boil-off of cryogenic propellants and to provide a positive pressure for propellant extraction. To achieve this, ullage gas diffusers must slow hot, high-pressure gas entering a propellant tank from supersonic speeds to only a few meters per second. Decreasing the incoming gas velocity is typically accomplished through expansion to larger areas within the diffuser which has traditionally led to large diffuser lengths. The Fluid Dynamics Branch (ER42) developed and applied advanced Computational Fluid Dynamics (CFD) analysis methods in order to mature the LPD design from and initial concept to an optimized test prototype and to provide extremely accurate pre-test predictions of diffuser performance. Additionally, the diffuser concept for the Core Stage of the Space Launch System (SLS) was analyzed in a short amount of time to guide test data collection efforts of the qualification of the device. CFD analysis of the SLS diffuser design provided new insights into the functioning of the device and was qualitatively validated against hot wire anemometry of the exterior flow field. Rigorous data analysis of the measurements was performed on static and dynamic pressure data, data from two microphones, accelerometers and hot wire anemometry with automated traverse. Feasibility of the LPD concept and validation of the computational model were

Comparative assessment of single-stage and two-stage anaerobic digestion for the treatment of thin stillage.

PubMed

Nasr, Noha; Elbeshbishy, Elsayed; Hafez, Hisham; Nakhla, George; El Naggar, M Hesham

2012-05-01

A comparative evaluation of single-stage and two-stage anaerobic digestion processes for biomethane and biohydrogen production using thin stillage was performed to assess the impact of separating the acidogenic and methanogenic stages on anaerobic digestion. Thin stillage, the main by-product from ethanol production, was characterized by high total chemical oxygen demand (TCOD) of 122 g/L and total volatile fatty acids (TVFAs) of 12 g/L. A maximum methane yield of 0.33 L CH(4)/gCOD(added) (STP) was achieved in the two-stage process while a single-stage process achieved a maximum yield of only 0.26 L CH(4)/gCOD(added) (STP). The separation of acidification stage increased the TVFAs to TCOD ratio from 10% in the raw thin stillage to 54% due to the conversion of carbohydrates into hydrogen and VFAs. Comparison of the two processes based on energy outcome revealed that an increase of 18.5% in the total energy yield was achieved using two-stage anaerobic digestion. Copyright © 2012 Elsevier Ltd. All rights reserved.

Two-stage revisions for culture-negative infected total knee arthroplasties: A five-year outcome in comparison with one-stage and two-stage revisions for culture-positive cases.

PubMed

Li, Heng; Ni, Ming; Li, Xiang; Zhang, Qingmeng; Li, Xin; Chen, Jiying

2017-03-01

Culture-negative periprosthetic joint infection (PJI) is very intractable when dealing with an infected total knee arthroplasty (TKA) patient. Two-stage revision has been proved to be a reliable solution for PJI patients. Whether it is still credible for culture-negative infected patients remains uncertain. Our group retrospectively reviewed all total knee revision patients from January 2003 to January 2014, 145 PJI patients were diagnosed as infection with the PJI diagnostic criteria and 129 patients were successfully followed. As different treating strategies were utilized, these patients were divided into culture-negative (18 cases, CN) group, culture-positive with one-stage revision group (CP1, 21 cases) and culture-positive with two-stage revision group (CP2, 87 cases) groups. The CN group and CP2 group underwent two-stage revision with antibiotic loaded cement spacers and intravenous antibiotics, CP1 group received one-stage revision. All the culture results and relevant medical records were thoroughly reviewed. The mean follow-up time was 59.5 ± 32.3 months (range 12-158 months). The culture-negative rate was 14.2%. The overall infection control rate was 92.12%. Infection recurrence was observed in two cases in CP1 group (9.09%), six cases in CP2 group (6.90%) and two cases in CN group (11.1%). The reinfection rate of culture-negative patients and culture-positive patients was 7.34% and 11.1% with no significant difference (p = 0.94). No statistically difference was observed between CP2 group and CN group (p = 0.90). No Spacer fracture or dislocation was observed. With combined or broad spectrum antibiotics, two-stage revision showed comparable outcome when treating culture-negative infected TKA patients at five-year follow-up. Copyright © 2016. Published by Elsevier B.V.

Design options for advanced manned launch systems

NASA Astrophysics Data System (ADS)

Freeman, Delma C.; Talay, Theodore A.; Stanley, Douglas O.; Lepsch, Roger A.; Wilhite, Alan W.

1995-03-01

Various concepts for advanced manned launch systems are examined for delivery missions to space station and polar orbit. Included are single-and two-stage winged systems with rocket and/or air-breathing propulsion systems. For near-term technologies, two-stage reusable rocket systems are favored over single-stage rocket or two-stage air-breathing/rocket systems. Advanced technologies enable viable single-stage-to-orbit (SSTO) concepts. Although two-stage rocket systems continue to be lighter in dry weight than SSTO vehicles, advantages in simpler operations may make SSTO vehicles more cost-effective over the life cycle. Generally, rocket systems maintain a dry-weight advantage over air-breathing systems at the advanced technology levels, but to a lesser degree than when near-term technologies are used. More detailed understanding of vehicle systems and associated ground and flight operations requirements and procedures is essential in determining quantitative discrimination between these latter concepts.

Blood pressure and sexual maturity in adolescents: the Heartfelt Study.

PubMed

Cho, S D; Mueller, W H; Meininger, J C; Liehr, P; Chan, W

2001-01-01

This study investigates sexual maturity as a predictor of resting blood pressures independent of other known predictors, in 179 boys and 204 girls 11-16 years of age from the Heartfelt Study. The sample included youth of African (n = 140), Mexican (n = 117), and European and "other" (n = 126) backgrounds. Sexual maturity was assessed during clinical examination of three standard indicators for each sex. Systolic and diastolic blood pressures were higher in children of maturity stages IV and V, compared to stages I-III, in each gender/ethnic group (P < 0.01 in almost all groups). Boys and girls advanced in sexual maturity for their age group, had significantly higher systolic blood pressures (but not diastolic) than the less advanced in linear models that included height, body mass index (BMI), ethnicity, and age as co-predictors. Diastolic blood pressures were predicted by height in boys and by age and the BMI in girls. This analysis, using a very conservative approach, suggests that sexual maturity provides important and independent information on systolic blood pressure in adolescents. Further investigation of its role in 24-hr blood pressures and in blood pressures taken during physical and emotional stress, is recommended.

Evidence of two-stage melting of Wigner solids

NASA Astrophysics Data System (ADS)

Knighton, Talbot; Wu, Zhe; Huang, Jian; Serafin, Alessandro; Xia, J. S.; Pfeiffer, L. N.; West, K. W.

2018-02-01

Ultralow carrier concentrations of two-dimensional holes down to p =1 ×109cm-2 are realized. Remarkable insulating states are found below a critical density of pc=4 ×109cm-2 or rs≈40 . Sensitive dc V-I measurement as a function of temperature and electric field reveals a two-stage phase transition supporting the melting of a Wigner solid as a two-stage first-order transition.

Advanced expander test bed program

NASA Technical Reports Server (NTRS)

Riccardi, D. P.; Mitchell, J. C.

1993-01-01

The Advanced Expander Test Bed (AETB) is a key element in NASA's Space Chemical Engine Technology Program for development and demonstration of expander cycle oxygen/hydrogen engine and advanced component technologies applicable to space engines as well as launch vehicle upper stage engines. The AETB will be used to validate the high-pressure expander cycle concept, investigate system interactions, and conduct investigations of advanced mission focused components and new health monitoring techniques in an engine system environment. The split expander cycle AETB will operate at combustion chamber pressures up to 1200 psia with propellant flow rates equivalent to 20,000 lbf vacuum thrust. Contract work began 27 Apr. 1990. During 1992, a major milestone was achieved with the review of the final design of the oxidizer turbopump in Sep. 1992.

Two-stage fan. 3: Data and performance with rotor tip casing treatment, uniform and distorted inlet flows

NASA Technical Reports Server (NTRS)

Burger, G. D.; Hodges, T. R.; Keenan, M. J.

1975-01-01

A two stage fan with a 1st-stage rotor design tip speed of 1450 ft/sec, a design pressure ratio of 2.8, and corrected flow of 184.2 lbm/sec was tested with axial skewed slots in the casings over the tips of both rotors. The variable stagger stators were set in the nominal positions. Casing treatment improved stall margin by nine percentage points at 70 percent speed but decreased stall margin, efficiency, and flow by small amounts at design speed. Treatment improved first stage performance at low speed only and decreased second stage performance at all operating conditions. Casing treatment did not affect the stall line with tip radially distorted flow but improved stall margin with circumferentially distorted flow. Casing treatment increased the attenuation for both types of inlet flow distortion.

Stage design

DOEpatents

Shacter, J.

1975-12-01

A method is described of cycling gases through a plurality of diffusion stages comprising the steps of admitting the diffused gases from a first diffusion stage into an axial compressor, simultaneously admitting the undiffused gases from a second diffusion stage into an intermediate pressure zone of said compressor corresponding in pressure to the pressure of said undiffused gases, and then admitting the resulting compressed mixture of diffused and undiffused gases into a third diffusion stage.

Metal hydride hydrogen compression: recent advances and future prospects

NASA Astrophysics Data System (ADS)

Yartys, Volodymyr A.; Lototskyy, Mykhaylo; Linkov, Vladimir; Grant, David; Stuart, Alastair; Eriksen, Jon; Denys, Roman; Bowman, Robert C.

2016-04-01

Metal hydride (MH) thermal sorption compression is one of the more important applications of the MHs. The present paper reviews recent advances in the field based on the analysis of the fundamental principles of this technology. The performances when boosting hydrogen pressure, along with two- and three-step compression units, are analyzed. The paper includes also a theoretical modelling of a two-stage compressor aimed at describing the performance of the experimentally studied systems, their optimization and design of more advanced MH compressors. Business developments in the field are reviewed for the Norwegian company HYSTORSYS AS and the South African Institute for Advanced Materials Chemistry. Finally, future prospects are outlined presenting the role of the MH compression in the overall development of the hydrogen-driven energy systems. The work is based on the analysis of the development of the technology in Europe, USA and South Africa.

SEMIPARAMETRIC ADDITIVE RISKS REGRESSION FOR TWO-STAGE DESIGN SURVIVAL STUDIES

PubMed Central

Li, Gang; Wu, Tong Tong

2011-01-01

In this article we study a semiparametric additive risks model (McKeague and Sasieni (1994)) for two-stage design survival data where accurate information is available only on second stage subjects, a subset of the first stage study. We derive two-stage estimators by combining data from both stages. Large sample inferences are developed. As a by-product, we also obtain asymptotic properties of the single stage estimators of McKeague and Sasieni (1994) when the semiparametric additive risks model is misspecified. The proposed two-stage estimators are shown to be asymptotically more efficient than the second stage estimators. They also demonstrate smaller bias and variance for finite samples. The developed methods are illustrated using small intestine cancer data from the SEER (Surveillance, Epidemiology, and End Results) Program. PMID:21931467

Simulation and Analyses of Stage Separation of Two-Stage Reusable Launch Vehicles

NASA Technical Reports Server (NTRS)

Pamadi, Bandu N.; Neirynck, Thomas A.; Hotchko, Nathaniel J.; Tartabini, Paul V.; Scallion, William I.; Murphy, K. J.; Covell, Peter F.

2007-01-01

NASA has initiated the development of methodologies, techniques and tools needed for analysis and simulation of stage separation of next generation reusable launch vehicles. As a part of this activity, ConSep simulation tool is being developed which is a MATLAB-based front-and-back-end to the commercially available ADAMS(Registerd TradeMark) solver, an industry standard package for solving multi-body dynamic problems. This paper discusses the application of ConSep to the simulation and analysis of staging maneuvers of two-stage-to-orbit (TSTO) Bimese reusable launch vehicles, one staging at Mach 3 and the other at Mach 6. The proximity and isolated aerodynamic database were assembled using the data from wind tunnel tests conducted at NASA Langley Research Center. The effects of parametric variations in mass, inertia, flight path angle, altitude from their nominal values at staging were evaluated. Monte Carlo runs were performed for Mach 3 staging to evaluate the sensitivity to uncertainties in aerodynamic coefficients.

Two stage catalytic combustor

NASA Technical Reports Server (NTRS)

Alvin, Mary Anne (Inventor); Bachovchin, Dennis (Inventor); Smeltzer, Eugene E. (Inventor); Lippert, Thomas E. (Inventor); Bruck, Gerald J. (Inventor)

2010-01-01

A catalytic combustor (14) includes a first catalytic stage (30), a second catalytic stage (40), and an oxidation completion stage (49). The first catalytic stage receives an oxidizer (e.g., 20) and a fuel (26) and discharges a partially oxidized fuel/oxidizer mixture (36). The second catalytic stage receives the partially oxidized fuel/oxidizer mixture and further oxidizes the mixture. The second catalytic stage may include a passageway (47) for conducting a bypass portion (46) of the mixture past a catalyst (e.g., 41) disposed therein. The second catalytic stage may have an outlet temperature elevated sufficiently to complete oxidation of the mixture without using a separate ignition source. The oxidation completion stage is disposed downstream of the second catalytic stage and may recombine the bypass portion with a catalyst exposed portion (48) of the mixture and complete oxidation of the mixture. The second catalytic stage may also include a reticulated foam support (50), a honeycomb support, a tube support or a plate support.

Detecting early stage pressure ulcer on dark skin using multispectral imager

NASA Astrophysics Data System (ADS)

Yi, Dingrong; Kong, Linghua; Sprigle, Stephen; Wang, Fengtao; Wang, Chao; Liu, Fuhan; Adibi, Ali; Tummala, Rao

2010-02-01

We are developing a handheld multispectral imaging device to non-invasively inspect stage I pressure ulcers in dark pigmented skins without the need of touching the patient's skin. This paper reports some preliminary test results of using a proof-of-concept prototype. It also talks about the innovation's impact to traditional multispectral imaging technologies and the fields that will potentially benefit from it.

A two-stage adaptive stochastic collocation method on nested sparse grids for multiphase flow in randomly heterogeneous porous media

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liao, Qinzhuo, E-mail: liaoqz@pku.edu.cn; Zhang, Dongxiao; Tchelepi, Hamdi

A new computational method is proposed for efficient uncertainty quantification of multiphase flow in porous media with stochastic permeability. For pressure estimation, it combines the dimension-adaptive stochastic collocation method on Smolyak sparse grids and the Kronrod–Patterson–Hermite nested quadrature formulas. For saturation estimation, an additional stage is developed, in which the pressure and velocity samples are first generated by the sparse grid interpolation and then substituted into the transport equation to solve for the saturation samples, to address the low regularity problem of the saturation. Numerical examples are presented for multiphase flow with stochastic permeability fields to demonstrate accuracy and efficiencymore » of the proposed two-stage adaptive stochastic collocation method on nested sparse grids.« less

The design of two-stage-to-orbit vehicles

NASA Technical Reports Server (NTRS)

1991-01-01

Two separate student design groups developed conceptual designs for a two-stage-to-orbit vehicle, with each design group consisting of a carrier team and an orbiter team. A two-stage-to-orbit system is considered in the event that single-stage-to-orbit is deemed not feasible in the foreseeable future; the two-stage system would also be used as a complement to an already existing heavy lift vehicle. The design specifications given are to lift a 10,000-lb payload 27 ft long by 10 ft diameter, to low Earth orbit (300 n.m.) using an air breathing carrier configuration that will take off horizontally within 15,000 ft. The staging Mach number and altitude were to be determined by the design groups. One group designed a delta wing/body carrier with the orbiter nested within the fuselage of the carrier, and the other group produced a blended cranked-delta wing/body carrier with the orbiter in the more conventional piggyback configuration. Each carrier used liquid hydrogen-fueled turbofanramjet engines, with data provided by General Electric Aircraft Engine Group. While one orbiter used a full-scale Space Shuttle Main Engine (SSME), the other orbiter employed a half-scale SSME coupled with scramjet engines, with data again provided by General Electric. The two groups conceptual designs, along with the technical trade-offs, difficulties, and details that surfaced during the design process are presented.

Two-Stage Variable Sample-Rate Conversion System

NASA Technical Reports Server (NTRS)

Tkacenko, Andre

2009-01-01

A two-stage variable sample-rate conversion (SRC) system has been pro posed as part of a digital signal-processing system in a digital com munication radio receiver that utilizes a variety of data rates. The proposed system would be used as an interface between (1) an analog- todigital converter used in the front end of the receiver to sample an intermediatefrequency signal at a fixed input rate and (2) digita lly implemented tracking loops in subsequent stages that operate at v arious sample rates that are generally lower than the input sample r ate. This Two-Stage System would be capable of converting from an input sample rate to a desired lower output sample rate that could be var iable and not necessarily a rational fraction of the input rate.

The effect of uterine fundal pressure on the duration of the second stage of labor: a randomized controlled trial.

PubMed

Api, Olus; Balcin, Muge Emeksiz; Ugurel, Vedat; Api, Murat; Turan, Cem; Unal, Orhan

2009-01-01

To determine the effect of uterine fundal pressure on shortening the second stage of labor and on the fetal outcome. Randomized controlled trial. Teaching and research hospital. One hundred ninety-seven women between 37 and 42 gestational weeks with singleton cephalic presentation admitted to the delivery unit. Random allocation into groups with or without manual fundal pressure during the second stage of labor. The primary outcome measure was the duration of the second stage of labor. Secondary outcome measures were umbilical artery pH, HCO3-, base excess, pO2, pCO2 values and the rate of instrumental delivery, severe maternal morbidity/mortality, neonatal trauma, admission to neonatal intensive care unit, and neonatal death. There were no significant differences in the mean duration of the second stage of labor and secondary outcome measures except for mean pO2 which was lower and mean pCO2 which was higher in the fundal pressure group. Nevertheless, the values still remained within normal ranges and there were no neonates with an Apgar score <7 in either of the groups. Application of fundal pressure on a delivering woman was ineffective in shortening the second stage of labor.

Performance of a 1.15-pressure-ratio axial-flow fan stage with a blade tip solidity of 0.5

NASA Technical Reports Server (NTRS)

Osborn, W. M.; Steinke, R. J.

1974-01-01

The overall and blade-element performance of a low-solidity, low-pressure-ratio, low-tip-speed fan stage is presented over the stable operating range at rotative speeds from 90 to 120 percent of design speed. At design speed a stage peak efficiency of 0.836 was obtained at a weight flow of 30.27 kilograms per second and a pressure ratio of 1.111. The pressure ratio was less than design pressure ratio, and the design energy input into the rotor was not achieved. A mismatch of the rotor and stator blade elements resulted due to the lower than design pressure ratio of the rotor.

Airway reconstruction: review of an approach to the advanced-stage laryngotracheal stenosis.

PubMed

Bitar, Mohamad Ahmad; Al Barazi, Randa; Barakeh, Rana

The management of laryngotracheal stenosis is complex and is influenced by multiple factors that can affect the ultimate outcome. Advanced lesions represent a special challenge to the treating surgeon to find the best remedying technique. To review the efficacy of our surgical reconstructive approach in managing advanced-stage laryngotracheal stenosis treated at a tertiary medical center. A retrospective review of all patients that underwent open laryngotracheal repair/reconstruction by the senior author between 2002 and 2014. Patients with mild/moderate stenosis (e.g. stage 1 or 2), or those who had an open reconstructive procedure prior to referral, were excluded. Patients who had only endoscopic treatment (e.g. laser, balloon dilatation) and were not subjected to an open reconstructive procedure at our institution, were not included in this study. Variables studied included patient demographics, clinical presentation, etiology of the laryngotracheal pathology, the location of stenosis, the stage of stenosis, the type of corrective or reconstructive procedure performed with the type of graft used (where applicable), the type and duration of stent used, the post-reconstruction complications, and the duration of follow-up. Outcome measures included decannulation rate, total number of reconstructive surgeries needed to achieve decannulation, and the number of post-operative endoscopies needed to reach a safe patent airway. Twenty five patients were included, aged 0.5 months to 45 years (mean 13.5 years, median 15 years) with 16 males and 9 females. Seventeen patients (68%) were younger than 18 years. Most patients presented with stridor, failure of decannulation, or respiratory distress. Majority had acquired etiology for their stenosis with only 24% having a congenital pathology. Thirty-two reconstructive procedures were performed resulting in decannulating 24 patients (96%), with 15/17 (88%) pediatric patients and 5/8 (62.5%) adult patients requiring only a single

A gas-loading system for LANL two-stage gas guns

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gibson, Lloyd Lee; Bartram, Brian Douglas; Dattelbaum, Dana Mcgraw

A novel gas loading system was designed for the specific application of remotely loading high purity gases into targets for gas-gun driven plate impact experiments. The high purity gases are loaded into well-defined target configurations to obtain Hugoniot states in the gas phase at greater than ambient pressures.The small volume of the gas samples is challenging, as slight changing in the ambient temperature result in measurable pressure changes. Therefore, the ability to load a gas gun target and continually monitor the sample pressure prior to firing provides the most stable and reliable target fielding approach. We present the design andmore » evaluation of a gas loading system built for the LANL 50 mm bore two-stage light gas gun. Targets for the gun are made of 6061 Al or OFHC Cu, and assembled to form a gas containment cell with a volume of approximately 1.38 cc. The compatibility of materials was a major consideration in the design of the system, particularly for its use with corrosive gases. Piping and valves are stainless steel with wetted seals made from Kalrez® and Teflon®. Preliminary testing was completed to ensure proper flow rate and that the proper safety controls were in place. The system has been used to successfully load Ar, Kr, Xe, and anhydrous ammonia with purities of up to 99.999 percent. The design of the system and example data from the plate impact experiments will be shown.« less

A gas-loading system for LANL two-stage gas guns

NASA Astrophysics Data System (ADS)

Gibson, L. L.; Bartram, B. D.; Dattelbaum, D. M.; Lang, J. M.; Morris, J. S.

2017-01-01

A novel gas loading system was designed for the specific application of remotely loading high purity gases into targets for gas-gun driven plate impact experiments. The high purity gases are loaded into well-defined target configurations to obtain Hugoniot states in the gas phase at greater than ambient pressures. The small volume of the gas samples is challenging, as slight changing in the ambient temperature result in measurable pressure changes. Therefore, the ability to load a gas gun target and continually monitor the sample pressure prior to firing provides the most stable and reliable target fielding approach. We present the design and evaluation of a gas loading system built for the LANL 50 mm bore two-stage light gas gun. Targets for the gun are made of 6061 Al or OFHC Cu, and assembled to form a gas containment cell with a volume of approximately 1.38 cc. The compatibility of materials was a major consideration in the design of the system, particularly for its use with corrosive gases. Piping and valves are stainless steel with wetted seals made from Kalrez® and Teflon®. Preliminary testing was completed to ensure proper flow rate and that the proper safety controls were in place. The system has been used to successfully load Ar, Kr, Xe, and anhydrous ammonia with purities of up to 99.999 percent. The design of the system and example data from the plate impact experiments will be shown.

Nutrient Removal Benefits of Two-Stage Ditches

NASA Astrophysics Data System (ADS)

Liu, X.; Ward, A.

2016-12-01

Annually, about one-third of the corn and soybeans in the world is grown in the North Central Region of the United States. Water quality problems associated with these production systems are caused by: (1) discharges of dissolved reactive phosphorus into the Great Lakes and inland water bodies; and (2) discharges of nitrogen into the Gulf of Mexico. These discharges have caused large blue-green algal blooms in freshwater systems and hypoxia particularly in the Gulf of Mexico. Much of the region has poorly drained soils that necessitate the use of subsurface drainage system to make the fields farmable. These drains discharge into agricultural ditches that are usually 2-5 m deep and 10 to 20 m wide. These oversized ditches often form small grassed benches in their lower third. A common maintenance practice is to periodically cleanout these deposits. However, in the last 15 years a new practice has been developed by one of the co-authors. This practice does not disturb the lower portion of the ditch but widens the top portion to make the benches larger. This floodplain development practice is known as the two-stage ditch concept. The approach results in the ditches acting as intermittent linear wetlands. The practice is eligible for cost-sharing funding as a water quality Best Management Practice in Indiana and Ohio. This presentation will provide a summary of the research that has been conducted on two-stage ditches and in particular their nutrient removal potential. In addition, results of a new controlled study on the nitrogen and phosphorus removal performance of a two-stage ditch will be presented. This study introduced water with fixed concentrations of each nutrient into a two-stage ditch. Measurements were made of: (1) the retention time in the system; (2) changes in the surface water quality; (3) and changes in the water quality and water level elevations in nested piezometers and monitoring wells located in the benches and banks of the two-stage ditch.

[Implantable sensors for outpatient assessment of ventricular filling pressure in advanced heart failure : Which telemonitoring design is optimal?

PubMed

Herrmann, E; Fichtlscherer, S; Hohnloser, S H; Zeiher, A M; Aßmus, B

2016-12-01

Patients with advanced heart failure suffer from frequent hospitalizations. Non-invasive hemodynamic telemonitoring for assessment of ventricular filling pressure has been shown to reduce hospitalizations. We report on the right ventricular (RVP), the pulmonary artery (PAP) and the left atrial pressure (LAP) sensor for non-invasive assessment of the ventricular filling pressure. A literature search concerning the available implantable pressure sensors for noninvasive haemodynamic telemonitoring in patients with advanced heart failure was performed. Until now, only implantation of the PAP-sensor was able to reduce hospitalizations for cardiac decompensation and to improve quality of life. The right ventricular pressure sensor missed the primary endpoint of a significant reduction of hospitalizations, clinical data using the left atrial pressure sensor are still pending. The implantation of a pressure sensor for assessment of pulmonary artery filling pressure is suitable for reducing hospitalizations for heart failure and for improving quality of life in patients with advanced heart failure.

Staged, High-Pressure Oxy-Combustion Technology: Development and Scale-Up

DOE Office of Scientific and Technical Information (OSTI.GOV)

Axelbaum, Richard; Xia, Fei; Gopan, Akshay

Washington University in St. Louis and its project partners are developing a unique pressurized oxy-combustion process that aims to improve efficiency and costs by reducing the recycling of flue gas to near zero. Normally, in the absence of recycled flue gas or another inert gas, combustion of fuel and oxygen results in a dramatic increase in temperature of the combustion products and radiant energy, as compared to combustion in air. High heat flux to the boiler tubes may result in a tube surface temperatures that exceed safe operating limits. In the Staged Pressurized Oxy-Combustion (SPOC) process, this problem is addressedmore » by staging the delivery of fuel and by novel combustion design that allows control of heat flux. In addition, the main mode of heat transfer to the steam cycle is by radiation, as opposed to convection. Therefore, the requirement for recycling large amounts of flue gas, for temperature control or to improve convective heat transfer, is eliminated, resulting in a reduction in auxiliary loads. The following report contains a detailed summary of scientific findings and accomplishments for the period of Oct. 1, 2013 to Sept 30, 2014. Results of ASPEN process and CFD modelling activities aimed at improving the SPOC process and boiler design are presented. The effects of combustion pressure and fuel moisture on the plant efficiency are discussed. Combustor pressure is found to have only a minor impact beyond 16 bar. For fuels with moisture content greater than approx 30%, e.g. coal/water slurries, the amount of latent heat of condensation exceeds that which can be utilized in the steam cycle and plant efficiency is reduced significantly. An improved boiler design is presented that achieves a more uniform heat flux profile. In addition, a fundamental study of radiation in high-temperature, high-pressure, particle-laden flows is summarized which provides a more complete understanding of heat transfer in these unusual conditions and to allow for

An application of gap regenerator/expander precooled by two stage G-M refrigerator

NASA Technical Reports Server (NTRS)

Matsubara, Y.; Yasukochi, K.

1983-01-01

The degradation of regenerator effectiveness below 10K is due to the imbalance of the heat capacity of the regenerator material and helium gas as a working fluid. One of the attractive methods to increase this efficiency could be realized by a gap regenerator system regarding helium gas property. This paper describes an experiment using pressurized helium gas as a regenerator material. A two stage G-M cycle refrigerator has been used for precooling the gap regenerator system. With this method, minimum temperature below 5K has been obtained when the precooling temperature maintained at 10K.

Two-stage vs single-stage management for concomitant gallstones and common bile duct stones

PubMed Central

Lu, Jiong; Cheng, Yao; Xiong, Xian-Ze; Lin, Yi-Xin; Wu, Si-Jia; Cheng, Nan-Sheng

2012-01-01

AIM: To evaluate the safety and effectiveness of two-stage vs single-stage management for concomitant gallstones and common bile duct stones. METHODS: Four databases, including PubMed, Embase, the Cochrane Central Register of Controlled Trials and the Science Citation Index up to September 2011, were searched to identify all randomized controlled trials (RCTs). Data were extracted from the studies by two independent reviewers. The primary outcomes were stone clearance from the common bile duct, postoperative morbidity and mortality. The secondary outcomes were conversion to other procedures, number of procedures per patient, length of hospital stay, total operative time, hospitalization charges, patient acceptance and quality of life scores. RESULTS: Seven eligible RCTs [five trials (n = 621) comparing preoperative endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) + laparoscopic cholecystectomy (LC) with LC + laparoscopic common bile duct exploration (LCBDE); two trials (n = 166) comparing postoperative ERCP/EST + LC with LC + LCBDE], composed of 787 patients in total, were included in the final analysis. The meta-analysis detected no statistically significant difference between the two groups in stone clearance from the common bile duct [risk ratios (RR) = -0.10, 95% confidence intervals (CI): -0.24 to 0.04, P = 0.17], postoperative morbidity (RR = 0.79, 95% CI: 0.58 to 1.10, P = 0.16), mortality (RR = 2.19, 95% CI: 0.33 to 14.67, P = 0.42), conversion to other procedures (RR = 1.21, 95% CI: 0.54 to 2.70, P = 0.39), length of hospital stay (MD = 0.99, 95% CI: -1.59 to 3.57, P = 0.45), total operative time (MD = 12.14, 95% CI: -1.83 to 26.10, P = 0.09). Two-stage (LC + ERCP/EST) management clearly required more procedures per patient than single-stage (LC + LCBDE) management. CONCLUSION: Single-stage management is equivalent to two-stage management but requires fewer procedures. However, patient’s condition, operator�

One-stage free-vortex aerodynamic window with pressure ratio 100 and atmospheric exhaust

NASA Astrophysics Data System (ADS)

Malkov, Victor M.; Trilis, A. V.; Savin, Andrew V.; Druzhinin, S. L.

2005-03-01

The aerodynamic windows (AW) are intended for a high power extraction from the gas laser optical cavity, where the pressure is much lower than environment pressure. The main requirements for the aerodynamic windows are to satisfy a low level of optical disturbances in a laser beam extraction channel and an air leakage absence into the optical cavity. Free vortex AW are most economic from a point of working gas consumption and the greatest pressure differential is realized on them at an exhaust to atmosphere. For ideal gas it is possible to receive as much as large pressure differential, however for real gas a pressure differential more than P>=50 is difficult to achieve. To achieve the pressure ratio 100 in free vortex single-stage AW the method of stabilizing of boundary layer was used. The gas of curtain was decelerated in the diffuser and was exhausted into the atmosphere straightly. The pressure recovery improvement was achieved by using the boundary layer blowing inside the diffuser. Only 10% of total mass flow was used for boundary layer blowing.

Impact of paranasal sinus invasion on advanced nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: the validity of advanced T stage of AJCC/UICC eighth edition staging system.

PubMed

Wang, Ying; Zhao, Jie; Zhao, Yajie; Yang, Zhen; Lei, Mingjun; Li, Zhanzhan; Wei, Rui; Chen, Dengming; He, Yuxiang; Shen, Liangfang

2018-05-01

The aim of this study was to clarify the prognostic role of paranasal sinus invasion in advanced NPC patients. Data of patients (n = 295) with advanced NPC (T3/T4N0-3 M0) treated with intensity-modulated radiation therapy were retrospectively analyzed. Staging was according to the AJCC/UICC eighth edition staging system. Overall survival (OS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were calculated, and differences were compared between patients with and without paranasal sinus invasion. Multivariate analysis was used to identify the independent predictors of different survival parameters. Paranasal sinus invasion was present in 126 of 295 (42.7%) patients. Sphenoid, ethmoid, maxillary, and frontal sinus involvements were present in 123 of 295 (41.7%), 95 of 295 (32.2%), 45 of 295 (15.3%), and 0 of 295 (0%), respectively. All survival parameters were significantly better in patients without paranasal sinus invasion. When paranasal sinus invasion was reclassified as T4 instead of T3, all survival rates, other than LRFS (P = 0.156), were significantly better in the new T3 patients, and differences in all survival parameters remained nonsignificant between T3 with paranasal sinus invasion and T4 without paranasal sinus invasion patients (all P > 0.05). In multivariate analysis, paranasal sinus invasion was found to be an independent negative prognostic factor for OS, DFS, and DMFS (P = 0.016, P = 0.004, and P = 0.006, respectively), but not for LRFS (P = 0.068). Paranasal sinus invasion has prognostic value in advanced NPC. It may be reasonable to classify paranasal sinus invasion as T4 stage. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

A Novel Therapeutic Modality for Advanced Stage Prostate Cancer Treatment

DTIC Science & Technology

2017-10-01

Unlimited The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of...PrCa are non-selective and provide only limited response rate Thus, novel treatment modalities are needed to treat advanced stage PrCa. In this...of ORM on MTA1 protein. Considering effective therapeutic index of ORM, we are also making more potent analogues of ORM. These findings suggest that

A systematic review of the evidence for single stage and two stage revision of infected knee replacement

PubMed Central

2013-01-01

Background Periprosthetic infection about the knee is a devastating complication that may affect between 1% and 5% of knee replacement. With over 79 000 knee replacements being implanted each year in the UK, periprosthetic infection (PJI) is set to become an important burden of disease and cost to the healthcare economy. One of the important controversies in treatment of PJI is whether a single stage revision operation is superior to a two-stage procedure. This study sought to systematically evaluate the published evidence to determine which technique had lowest reinfection rates. Methods A systematic review of the literature was undertaken using the MEDLINE and EMBASE databases with the aim to identify existing studies that present the outcomes of each surgical technique. Reinfection rate was the primary outcome measure. Studies of specific subsets of patients such as resistant organisms were excluded. Results 63 studies were identified that met the inclusion criteria. The majority of which (58) were reports of two-stage revision. Reinfection rated varied between 0% and 41% in two-stage studies, and 0% and 11% in single stage studies. No clinical trials were identified and the majority of studies were observational studies. Conclusions Evidence for both one-stage and two-stage revision is largely of low quality. The evidence basis for two-stage revision is significantly larger, and further work into direct comparison between the two techniques should be undertaken as a priority. PMID:23895421

Two-statge sorption type cryogenic refrigerator including heat regeneration system

NASA Technical Reports Server (NTRS)

Jones, Jack A. (Inventor); Wen, Liang-Chi (Inventor); Bard, Steven (Inventor)

1989-01-01

A lower stage chemisorption refrigeration system physically and functionally coupled to an upper stage physical adsorption refrigeration system. Waste heat generated by the lower stage cycle is regenerated to fuel the upper stage cycle thereby greatly improving the energy efficiency of a two-stage sorption refrigerator. The two stages are joined by disposing a first pressurization chamber providing a high pressure flow of a first refrigerant for the lower stage refrigeration cycle within a second pressurization chamber providing a high pressure flow of a second refrigerant for the upper stage refrigeration cycle. The first pressurization chamber is separated from the second pressurization chamber by a gas-gap thermal switch which at times is filled with a thermoconductive fluid to allow conduction of heat from the first pressurization chamber to the second pressurization chamber.

Metal hydride hydrogen compression: Recent advances and future prospects

DOE PAGES

Bowman, Jr., Robert C.; Yartys, Volodymyr A.; Lototskyy, Mykhaylo V.; ...

2016-03-17

Metal hydride (MH) thermal sorption compression is one of the more important applications of the metal hydrides. The present paper reviews recent advances in the field based on the analysis of the fundamental principles of this technology. The performances when boosting hydrogen pressure, along with two- and three-step compression units are analyzed. The paper includes also a theoretical modeling of a two-stage compressor aimed at both describing the performance of the experimentally studied systems, but, also, on their optimization and design of more advanced MH compressors. Business developments in the field are reviewed for the Norwegian company HYSTORSYS AS andmore » the South African Institute for Advanced Materials Chemistry. Finally, future prospects are outlined presenting the role of the metal hydride compression in the overall development of the hydrogen driven energy systems. Lastly, the work is based on the analysis of the development of the technology in Europe, USA and South Africa.« less

The prediction of progression-free and overall survival in women with an advanced stage of epithelial ovarian carcinoma.

PubMed

Gerestein, C G; Eijkemans, M J C; de Jong, D; van der Burg, M E L; Dykgraaf, R H M; Kooi, G S; Baalbergen, A; Burger, C W; Ansink, A C

2009-02-01

Prognosis in women with ovarian cancer mainly depends on International Federation of Gynecology and Obstetrics stage and the ability to perform optimal cytoreductive surgery. Since ovarian cancer has a heterogeneous presentation and clinical course, predicting progression-free survival (PFS) and overall survival (OS) in the individual patient is difficult. The objective of this study was to determine predictors of PFS and OS in women with advanced stage epithelial ovarian cancer (EOC) after primary cytoreductive surgery and first-line platinum-based chemotherapy. Retrospective observational study. Two teaching hospitals and one university hospital in the south-western part of the Netherlands. Women with advanced stage EOC. All women who underwent primary cytoreductive surgery for advanced stage EOC followed by first-line platinum-based chemotherapy between January 1998 and October 2004 were identified. To investigate independent predictors of PFS and OS, a Cox' proportional hazard model was used. Nomograms were generated with the identified predictive parameters. The primary outcome measure was OS and the secondary outcome measures were response and PFS. A total of 118 women entered the study protocol. Median PFS and OS were 15 and 44 months, respectively. Preoperative platelet count (P = 0.007), and residual disease <1 cm (P = 0.004) predicted PFS with a optimism corrected c-statistic of 0.63. Predictive parameters for OS were preoperative haemoglobin serum concentration (P = 0.012), preoperative platelet counts (P = 0.031) and residual disease <1 cm (P = 0.028) with a optimism corrected c-statistic of 0.67. PFS could be predicted by postoperative residual disease and preoperative platelet counts, whereas residual disease, preoperative platelet counts and preoperative haemoglobin serum concentration were predictive for OS. The proposed nomograms need to be externally validated.

A Dual-Stage Two-Phase Model of Selective Attention

ERIC Educational Resources Information Center

Hubner, Ronald; Steinhauser, Marco; Lehle, Carola

2010-01-01

The dual-stage two-phase (DSTP) model is introduced as a formal and general model of selective attention that includes both an early and a late stage of stimulus selection. Whereas at the early stage information is selected by perceptual filters whose selectivity is relatively limited, at the late stage stimuli are selected more efficiently on a…

Use of real time gas production data for more accurate comparison of continuous single-stage and two-stage fermentation.

PubMed

Massanet-Nicolau, Jaime; Dinsdale, Richard; Guwy, Alan; Shipley, Gary

2013-02-01

Changes in fermenter gas composition within a given 24h period can cause severe bias in calculations of biogas or energy yields based on just one or two measurements of gas composition per day, as is common in other studies of two-stage fermentation. To overcome this bias, real time recording of gas composition and production were used to undertake a detailed and controlled comparison of single-stage and two-stage fermentation using a real world substrate (wheat feed pellets). When a two-stage fermentation system was used, methane yields increased from 261 L kg(-1)VS using a 20 day HRT, single-stage fermentation, to 359 L kg(-1) VS using a two-stage fermentation with the same overall retention time--an increase of 37%. Additionally a hydrogen yield of 7 L kg(-1) VS was obtained when two-stage fermentation was used. The two-stage system could also be operated at a shorter, 12 day HRT and still produce higher methane yields (306 L kg(-1) VS). Both two-stage fermentation systems evaluated exhibited methane yields in excess of that predicted by a biological methane potential test (BMP) performed using the same feedstock (260 L kg(-1)VS). Copyright © 2012 Elsevier Ltd. All rights reserved.

Two-stage anaerobic digestion enables heavy metal removal.

PubMed

Selling, Robert; Håkansson, Torbjörn; Björnsson, Lovisa

2008-01-01

To fully exploit the environmental benefits of the biogas process, the digestate should be recycled as biofertiliser to agriculture. This practice can however be jeopardized by the presence of unwanted compounds such as heavy metals in the digestate. By using two-stage digestion, where the first stage includes hydrolysis/acidification and liquefaction of the substrate, heavy metals can be transferred to the leachate. From the leachate, metals can then be removed by adsorption. In this study, up to 70% of the Ni, 40% of the Zn and 25% of the Cd present in maize was removed when the leachate from hydrolysis was circulated over a macroporous polyacrylamide column for 6 days. For Cu and Pb, the mobilization in the hydrolytic stage was lower which resulted in a low removal. A more efficient two-stage process with improved substrate hydrolysis would give lower pH and/or longer periods with low pH in the hydrolytic stage. This is likely to increase metal mobilisation, and would open up for an excellent opportunity of heavy metal removal.

Two-phase flows within systems with ambient pressure

NASA Technical Reports Server (NTRS)

Hendricks, R. C.; Braun, M. J.; Wheeler, R. L., III; Mullen, R. L.

1985-01-01

In systems where the design inlet and outlet pressures are maintained above the thermodynamic critical pressure, it is often assumed that two phase flows within the system cannot occur. Designers rely on this simple rule of thumb to circumvent problems associated with a highly compressible two phase flow occurring within the supercritical pressure system along with the uncertainties in rotordynamics, load capacity, heat transfer, fluid mechanics, and thermophysical property variations. The simple rule of thumb is adequate in many low power designs but is inadequate for high performance turbomachines and linear systems, where two phase regions can exist even though outlet pressure is greater than critical pressure. Rotordynamic-fluid-mechanic restoring forces depend on momentum differences, and those for a two phase zone can differ significantly from those for a single-phase zone. Using the Reynolds equation the angular velocity, eccentricity, geometry, and ambient conditions are varied to determine the point of two phase flow incipience.

Study of Stage-wise Pressure Pulsation in an Electric Submersible Pump under Variable Frequency Operation at Shut-off Condition

NASA Astrophysics Data System (ADS)

Dhanasekaran, A.; Kumaraswamy, S.

2018-01-01

Pressure pulsation causes vibration in the Electric Submersible Pump (ESP) and affects the life and performance of its system. ESP systems are installed at depths ranging from a few meters to several hundred meters. Unlike pumps used on the surface, once they are installed they become inaccessible for maintenance or for any kind of diagnostic measurement that might be taken directly on them. Therefore a detailed knowledge of mean and fluctuating pressures is required to achieve an optimal pressure distribution inside the ESP. This paper presents the results of an experimental investigation of the stage-wise pulsating pressure in ESP at shut-off condition at different speeds. Experiments were conducted on a pump having five stages. A variable frequency drive was used to operate the pump at five different speeds. Piezoresistive transducers were mounted at each stage of ESP to capture the unsteady pressure signals. Fast Fourier Transformation was carried out on the pressure signals to convert into frequency domain and the spectra of pressure pulsation signals were analyzed. The obtained results indicated the existence of fundamental frequency corresponding to the speed of rotation times the number of impeller blades and of the whole series of harmonics of higher frequencies.

Performance of Single-Stage Turbine of Mark 25 Torpedo Power Plant with Two Special Nozzles. III; Efficiency with Standard Rotor Blades

NASA Technical Reports Server (NTRS)

Schum, Harold J.; Whitney, Warren J.

1949-01-01

A Mark 25 torpedo power plant modified to operate as a single-stage turbine was investigated to determine the performance with two nozzle designs and a standard first-stage rotor having 0.40-inch blades with a 17O met-air angle. Both nozzles had smaller port cross-sectional areas than those nozzles of similar design, which were previously investigated. The performance of the two nozzles was compared on the basis of blade, rotor, and brake efficiencies as a function of blade-jet speed ratio for pressure ratios of 8, 15 (design), and 20. At pressure ratios of 15 and 20, the blade efficiency obtained with the nozzle having circular passages (K) was higher than that obtained with the nozzle having rectangular passages (J). At a pressure ratio of 8, the efficiencies obtained with the two nozzles were comparable for blade-jet speed ratios of less than 0.260. For blade-jet speed ratios exceeding this value, nozzle K yielded slightly higher efficiencies. The maximum blade efficiency of 0.569 was obtained with nozzle K at a pressure ratio of 8 and a blade-jet speed ratio of 0.295. At design speed and pressure ratio, nozzle K yielded a maximum blade efficiency of 0.534, an increase of 0.031 over that obtained with nozzle J. When the blade efficiencies of the two nozzles were compared with those of four other nozzles previously investigated, the maximum difference for the six nozzles with this rotor was 0.050. From, this comparison, no specific effect of nozzles size or shape on over-all performance was discernible.

Experiences of family of patient with newly diagnosed advanced terminal stage hepatocellular cancer.

PubMed

Shih, Whei-Mei Jean; Hsiao, Ping-Ju; Chen, Min-Li; Lin, Mei-Hsiang

2013-01-01

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause of cancer-related death worldwide due to its generally poor prognosis. Caregiver burden for liver cancer cases is higher than with other cancer and needs especial attention. To explore the experiences of families of patients with newly diagnosed advanced terminal stage hepatocellular cancer by interview. Nine participants were recruited in this study. Content analysis of the interviews revealed four themes: blaming oneself, disrupting the pace of life, searching all possible regimens, and not letting go. This study provides new insight into the needs and support of family members especially when they are facing loved ones with newly diagnosed advanced terminal stage HCC. These results will inform future supportive care service development and intervention research aimed at providing assistance in reducing unmet supportive care needs and psychological distress of these family members.

Catalytic two-stage coal hydrogenation process using extinction recycle of heavy liquid fraction

DOEpatents

MacArthur, J.B.; Comolli, A.G.; McLean, J.B.

1989-10-17

A process is described for catalytic two-stage hydrogenation and liquefaction of coal with selective extinction recycle of all heavy liquid fractions boiling above a distillation cut point of about 600--750 F to produce increased yields of low-boiling hydrocarbon liquid and gas products. In the process, the particulate coal feed is slurried with a process-derived liquid solvent normally boiling above about 650 F and fed into a first stage catalytic reaction zone operated at conditions which promote controlled rate liquefaction of the coal, while simultaneously hydrogenating the hydrocarbon recycle oils. The first stage reactor is maintained at 710--800 F temperature, 1,000--4,000 psig hydrogen partial pressure, and 10-90 lb/hr per ft[sup 3] catalyst space velocity. Partially hydrogenated material withdrawn from the first stage reaction zone is passed directly to the second stage catalytic reaction zone maintained at 760--860 F temperature for further hydrogenation and hydroconversion reactions. A 600--750 F[sup +] fraction containing 0--20 W % unreacted coal and ash solids is recycled to the coal slurrying step. If desired, the cut point lower boiling fraction can be further catalytically hydrotreated. By this process, the coal feed is successively catalytically hydrogenated and hydroconverted at selected conditions, to provide significantly increased yields of desirable low-boiling hydrocarbon liquid products and minimal production of hydrocarbon gases, and no net production of undesirable heavy oils and residuum materials. 2 figs.

Catalytic two-stage coal hydrogenation process using extinction recycle of heavy liquid fraction

DOEpatents

MacArthur, James B.; Comolli, Alfred G.; McLean, Joseph B.

1989-01-01

A process for catalytic two-stage hydrogenation and liquefaction of coal with selective extinction recycle of all heavy liquid fractions boiling above a distillation cut point of about 600.degree.-750.degree. F. to produce increased yields of low-boiling hydrocarbon liquid and gas products. In the process, the particulate coal feed is slurried with a process-derived liquid solvent normally boiling above about 650.degree. F. and fed into a first stage catalytic reaction zone operated at conditions which promote controlled rate liquefaction of the coal, while simultaneously hydrogenating the hydrocarbon recycle oils. The first stage reactor is maintained at 710.degree.-800.degree. F. temperature, 1000-4000 psig hydrogen partial pressure, and 10-90 lb/hr per ft.sup.3 catalyst space velocity. Partially hydrogenated material withdrawn from the first stage reaction zone is passed directly to the second stage catalytic reaction zone maintained at 760.degree.-860.degree. F. temperature for further hydrogenation and hydroconversion reactions. A 600.degree.-750.degree. F..sup.+ fraction containing 0-20 W % unreacted coal and ash solids is recycled to the coal slurrying step. If desired, the cut point lower boiling fraction can be further catalytically hydrotreated. By this process, the coal feed is successively catalytically hydrogenated and hydroconverted at selected conditions, to provide significantly increased yields of desirable low-boiling hydrocarbon liquid products and minimal production of hydrocarbon gases, and no net production of undesirable heavy oils and residuum materials.

Single-stage Acetabular Revision During Two-stage THA Revision for Infection is Effective in Selected Patients.

PubMed

Fink, Bernd; Schlumberger, Michael; Oremek, Damian

2017-08-01

The treatment of periprosthetic infections of hip arthroplasties typically involves use of either a single- or two-stage (with implantation of a temporary spacer) revision surgery. In patients with severe acetabular bone deficiencies, either already present or after component removal, spacers cannot be safely implanted. In such hips where it is impossible to use spacers and yet a two-stage revision of the prosthetic stem is recommended, we have combined a two-stage revision of the stem with a single revision of the cup. To our knowledge, this approach has not been reported before. (1) What proportion of patients treated with single-stage acetabular reconstruction as part of a two-stage revision for an infected THA remain free from infection at 2 or more years? (2) What are the Harris hip scores after the first stage and at 2 years or more after the definitive reimplantation? Between June 2009 and June 2014, we treated all patients undergoing surgical treatment for an infected THA using a single-stage acetabular revision as part of a two-stage THA exchange if the acetabular defect classification was Paprosky Types 2B, 2C, 3A, 3B, or pelvic discontinuity and a two-stage procedure was preferred for the femur. The procedure included removal of all components, joint débridement, definitive acetabular reconstruction (with a cage to bridge the defect, and a cemented socket), and a temporary cemented femoral component at the first stage; the second stage consisted of repeat joint and femoral débridement and exchange of the femoral component to a cementless device. During the period noted, 35 patients met those definitions and were treated with this approach. No patients were lost to followup before 2 years; mean followup was 42 months (range, 24-84 months). The clinical evaluation was performed with the Harris hip scores and resolution of infection was assessed by the absence of clinical signs of infection and a C-reactive protein level less than 10 mg/L. All

Two-stage coal gasification and desulfurization apparatus

DOEpatents

Bissett, Larry A.; Strickland, Larry D.

1991-01-01

The present invention is directed to a system which effectively integrates a two-stage, fixed-bed coal gasification arrangement with hot fuel gas desulfurization of a first stream of fuel gas from a lower stage of the two-stage gasifier and the removal of sulfur from the sulfur sorbent regeneration gas utilized in the fuel-gas desulfurization process by burning a second stream of fuel gas from the upper stage of the gasifier in a combustion device in the presence of calcium-containing material. The second stream of fuel gas is taken from above the fixed bed in the coal gasifier and is laden with ammonia, tar and sulfur values. This second stream of fuel gas is burned in the presence of excess air to provide heat energy sufficient to effect a calcium-sulfur compound forming reaction between the calcium-containing material and sulfur values carried by the regeneration gas and the second stream of fuel gas. Any ammonia values present in the fuel gas are decomposed during the combustion of the fuel gas in the combustion chamber. The substantially sulfur-free products of combustion may then be combined with the desulfurized fuel gas for providing a combustible fluid utilized for driving a prime mover.

Racial disparities in advanced stage colorectal cancer survival

PubMed Central

Wallace, Kristin; Hill, Elizabeth G.; Lewin, David N.; Williamson, Grace; Oppenheimer, Stephanie; Ford, Marvella E.; Wargovich, Michael J.; Berger, Franklin G.; Bolick, Susan W.; Thomas, Melanie B.; Alberg, Anthony J.

2013-01-01

Purpose African Americans (AA) have a higher incidence and lower survival from colorectal cancer (CRC) compared to European Americans (EA). In the present study, statewide, population-based data from South Carolina Central Cancer Registry (SCCCR) is used to investigate the relationship between race and age on advanced stage CRC survival. Methods The study population was comprised of 3865 advanced pathologically documented colon and rectal adenocarcinoma cases diagnosed between 01 January 1996 and 31 December 2006: 2673 (69%) EA and 1192 (31%) AA. Kaplan-Meier methods were used to generate median survival time and corresponding 95% confidence intervals (CI) by race, age, and gender. Factors associated with survival were evaluated by fitting Cox proportional hazards (CPH) regression models to generate Hazard Ratios (HR) and 95% CI. Results We observed a significant interaction between race and age on CRC survival (p = 0.04). Among younger patients (< 50 years), AA race was associated with a 1.34 (95% CI 1.06-1.71) higher risk of death compared to EA. Among older patients, we observed a modest increase risk of death among AA men compared to EA (HR 1.16 (95% CI 1.01-1.32) but no difference by race among women (HR 0.94 (95% CI 0.82-1.08)). Moreover, we observed that the disparity in survival has worsened over the past 15 years. Conclusions Future studies that integrate clinical, molecular, and treatment-related data are needed for advancing understanding of the racial disparity in CRC survival, especially for those < 50 years old. PMID:23296454

Thermodynamic analysis and economical evaluation of two 310-80 K pre-cooling stage configurations for helium refrigeration and liquefaction cycle

NASA Astrophysics Data System (ADS)

Zhu, Z. G.; Zhuang, M.; Jiang, Q. F.; Y Zhang, Q.; Feng, H. S.

2017-12-01

In 310-80 K pre-cooling stage, the temperature of the HP helium stream reduces to about 80 K where nearly 73% of the enthalpy drop from room temperature to 4.5 K occurs. Apart from the most common liquid nitrogen pre-cooling, another 310-80 K pre-cooling configuration with turbine is employed in some helium cryoplants. In this paper, thermodynamic and economical performance of these two kinds of 310-80 K pre-cooling stage configurations has been studied at different operating conditions taking discharge pressure, isentropic efficiency of turbines and liquefaction rate as independent parameters. The exergy efficiency, total UA of heat exchangers and operating cost of two configurations are computed. This work will provide a reference for choosing 310-80 K pre-cooling stage configuration during design.

Performance of two-stage fan having low-aspect-ratio first-stage rotor blading

NASA Technical Reports Server (NTRS)

Urasek, D. C.; Gorrell, W. T.; Cunnan, W. S.

1979-01-01

The NASA two stage fan was tested with a low aspect ratio first stage rotor having no midspan dampers. At design speed the fan achieved an adiabatic design efficiency of 0.846, and peak efficiencies for the first stage and rotor of 0.870 and 0.906, respectively. Peak efficiency occurred very close to the stall line. In an attempt to improve stall margin, the fan was retested with circumferentially grooved casing treatment and with a series of stator blade resets. Results showed no improvement in stall margin with casing treatment but increased to 8 percent with stator blade reset.

First staging of two laser accelerators.

PubMed

Kimura, W D; van Steenbergen, A; Babzien, M; Ben-Zvi, I; Campbell, L P; Cline, D B; Dilley, C E; Gallardo, J C; Gottschalk, S C; He, P; Kusche, K P; Liu, Y; Pantell, R H; Pogorelsky, I V; Quimby, D C; Skaritka, J; Steinhauer, L C; Yakimenko, V

2001-04-30

Staging of two laser-driven, relativistic electron accelerators has been demonstrated for the first time in a proof-of-principle experiment, whereby two distinct and serial laser accelerators acted on an electron beam in a coherently cumulative manner. Output from a CO2 laser was split into two beams to drive two inverse free electron lasers (IFEL) separated by 2.3 m. The first IFEL served to bunch the electrons into approximately 3 fs microbunches, which were rephased with the laser wave in the second IFEL. This represents a crucial step towards the development of practical laser-driven electron accelerators.

One-Stage versus Two-Stage Repair of Asymmetric Bilateral Cleft Lip: A 20-Year Retrospective Study of Clinical Outcome.

PubMed

Chung, Kyung Hoon; Lo, Lun-Jou

2018-05-01

Both one- and two-stage approaches have been widely used for patients with asymmetric bilateral cleft lip. There are insufficient long-term outcome data for comparison of these two methods. The purpose of this retrospective study was to compare the clinical outcome over the past 20 years. The senior author's (L.J.L.) database was searched for patients with asymmetric bilateral cleft lip from 1995 to 2015. Qualified patients were divided into two groups: one-stage and two-stage. The postoperative photographs of patients were evaluated subjectively by surgical professionals and laypersons. Ratios of the nasolabial region were calculated for objective analysis. Finally, the revision procedures in the nasolabial area were reviewed. Statistical analyses were performed. A total of 95 consecutive patients were qualified for evaluation. Average follow-up was 13.1 years. A two-stage method was used in 35 percent of the patients, and a one-stage approach was used in 65 percent. All underwent primary nasal reconstruction. Among the satisfaction rating scores, the one-stage repair was rated significantly higher than two-stage reconstruction (p = 0.0001). Long-term outcomes of the two-stage patients and the unrepaired mini-microform deformities were unsatisfactory according to both professional and nonprofessional evaluators. The revision rate was higher in patients with a greater-side complete cleft lip and palate as compared with those without palatal involvement. The results suggested that one-stage repair provided better results with regard to achieving a more symmetric and smooth lip and nose after primary reconstruction. The revision rate was slightly higher in the two-stage patient group. Therapeutic, III.

Blood Pressure Checker

NASA Technical Reports Server (NTRS)

1979-01-01

An estimated 30 million people in the United States have high blood pressure, or hypertension. But a great many of them are unaware of it because hypertension, in its initial stages, displays no symptoms. Thus, the simply-operated blood pressure checking devices now widely located in public places are useful health aids. The one pictured above, called -Medimax 30, is a direct spinoff from NASA technology developed to monitor astronauts in space. For manned space flights, NASA wanted a compact, highly-reliable, extremely accurate method of checking astronauts' blood pressure without the need for a physician's interpretive skill. NASA's Johnson Space Center and Technology, Inc., a contractor, developed an electronic sound processor that automatically analyzes blood flow sounds to get both systolic (contracting arteries) and diastolic (expanding arteries) blood pressure measurements. NASA granted a patent license for this technology to Advanced Life Sciences, Inc., New York City, manufacturers of Medimax 30.

The Optimization of Four-Stage Low Pressure Turbine with Outlet Guide Vane

NASA Astrophysics Data System (ADS)

Matveev, V.; Baturin, O.; Popov, G.

2018-01-01

The goal of the research was to improve efficiency of four-stage low-pressure turbine with outlet guide vane (LPT) at the design point by optimization the shape of all turbine stator vanes and the stagger angles of all rotor blades. The LPT mathematical model was created by using NUMECA FineTurbo software. Several constraints were imposed the mass flow rate through the LPT and the total pressure ratio at the design point may vary within ±0.5% from the original. Parameters of the stator blade shape and rotor blades stagger angles were obtained. This new geometry of the LPT blades produce a 0.8% increase in efficiency at the design point.

Cryogenic Pressure Control Modeling for Ellipsoidal Space Tanks

NASA Technical Reports Server (NTRS)

Lopez, Alfredo; Grayson, Gary D.; Chandler, Frank O.; Hastings, Leon J.; Heyadat, Ali

2007-01-01

A computational fluid dynamics (CFD) model is developed to simulate pressure control of an ellipsoidal-shaped liquid hydrogen tank under external heating in normal gravity. Pressure control is provided by an axial jet thermodynamic vent system (TVS) centered within the vessel that injects cooler liquid into the tank, mixing the contents and reducing tank pressure. The two-phase cryogenic tank model considers liquid hydrogen in its own vapor with liquid density varying with temperature only and a fully compressible ullage. The axisymmetric model is developed using a custom version of the commercially available FLOW-31) software. Quantitative model validation is ,provided by engineering checkout tests performed at Marshall Space Flight Center in 1999 in support of the Solar Thermal Upper Stage_ Technology Demonstrator (STUSTD) program. The engineering checkout tests provide cryogenic tank self-pressurization test data at various heat leaks and tank fill levels. The predicted self-pressurization rates, ullage and liquid temperatures at discrete locations within the STUSTD tank are in good agreement with test data. The work presented here advances current CFD modeling capabilities for cryogenic pressure control and helps develop a low cost CFD-based design process for space hardware.

The role of ontogeny in physiological tolerance: decreasing hydrostatic pressure tolerance with development in the northern stone crab Lithodes maja

PubMed Central

Munro, Catriona; Morris, James P.; Brown, Alastair; Hauton, Chris; Thatje, Sven

2015-01-01

Extant deep-sea invertebrate fauna represent both ancient and recent invasions from shallow-water habitats. Hydrostatic pressure may present a significant physiological challenge to organisms seeking to colonize deeper waters or migrate ontogenetically. Pressure may be a key factor contributing to bottlenecks in the radiation of taxa and potentially drive speciation. Here, we assess shifts in the tolerance of hydrostatic pressure through early ontogeny of the northern stone crab Lithodes maja, which occupies a depth range of 4–790 m in the North Atlantic. The zoea I, megalopa and crab I stages were exposed to hydrostatic pressures up to 30.0 MPa (equivalent of 3000 m depth), and the relative fold change of genes putatively coding for the N-methyl-d-aspartate receptor-regulated protein 1 (narg gene), two heat-shock protein 70 kDa (HSP70) isoforms and mitochondrial Citrate Synthase (CS gene) were measured. This study finds a significant increase in the relative expression of the CS and hsp70a genes with increased hydrostatic pressure in the zoea I stage, and an increase in the relative expression of all genes with increased hydrostatic pressure in the megalopa and crab I stages. Transcriptional responses are corroborated by patterns in respiratory rates in response to hydrostatic pressure in all stages. These results suggest a decrease in the acute high-pressure tolerance limit as ontogeny advances, as reflected by a shift in the hydrostatic pressure at which significant differences are observed. PMID:26041343

Fueling of magnetically confined plasmas by single- and two-stage repeating pneumatic pellet injectors

NASA Astrophysics Data System (ADS)

Gouge, M. J.; Combs, S. K.; Foust, C. R.; Milora, S. L.

Advanced plasma fueling systems for magnetic fusion confinement experiments are under development at Oak Ridge National Laboratory (ORNL). The general approach is that of producing and accelerating frozen hydrogenic pellets to speeds in the kilometer-per-second range using single shot and repetitive pneumatic (light-gas gun) pellet injectors. The millimeter-to-centimeter size pellets enter the plasma and continuously ablate because of the plasma electron heat flux, depositing fuel atoms along the pellet trajectory. This fueling method allows direct fueling in the interior of the hot plasma and is more efficient than the alternative method of injecting room temperature fuel gas at the wall of the plasma vacuum chamber. Single-stage pneumatic injectors based on the light-gas gun concept have provided hydrogenic fuel pellets in the speed range of 1 to 2 km/s in single-shot injector designs. Repetition rates up to 5 Hz have been demonstrated in repetitive injector designs. Future fusion reactor-scale devices may need higher pellet velocities because of the larger plasma size and higher plasma temperatures. Repetitive two-stage pneumatic injectors are under development at ORNL to provide long-pulse plasma fueling in the 3 to 5 km/s speed range. Recently, a repeating, two-stage light-gas gun achieved repetitive operation at 1 Hz with speeds in the range of 2 to 3 km/s.

Lunar Advanced Volatile Analysis Subsystem: Pressure Transducer Trade Study

NASA Technical Reports Server (NTRS)

Kang, Edward Shinuk

2017-01-01

In Situ Resource Utilization (ISRU) is a key factor in paving the way for the future of human space exploration. The ability to harvest resources on foreign astronomical objects to produce consumables and propellant offers potential reduction in mission cost and risk. Through previous missions, the existence of water ice at the poles of the moon has been identified, however the feasibility of water extraction for resources remains unanswered. The Resource Prospector (RP) mission is currently in development to provide ground truth, and will enable us to characterize the distribution of water at one of the lunar poles. Regolith & Environment Science and Oxygen & Lunar Volatile Extraction (RESOLVE) is the primary payload on RP that will be used in conjunction with a rover. RESOLVE contains multiple instruments for systematically identifying the presence of water. The main process involves the use of two systems within RESOLVE: the Oxygen Volatile Extraction Node (OVEN) and Lunar Advanced Volatile Analysis (LAVA). Within the LAVA subsystem, there are multiple calculations that depend on accurate pressure readings. One of the most important instances where pressure transducers (PT) are used is for calculating the number of moles in a gas transfer from the OVEN subsystem. As a critical component of the main process, a mixture of custom and commercial off the shelf (COTS) PTs are currently being tested in the expected operating environment to eventually down select an option for integrated testing in the LAVA engineering test unit (ETU).

Energy efficient engine high pressure turbine test hardware detailed design report

NASA Technical Reports Server (NTRS)

Halila, E. E.; Lenahan, D. T.; Thomas, T. T.

1982-01-01

The high pressure turbine configuration for the Energy Efficient Engine is built around a two-stage design system. Moderate aerodynamic loading for both stages is used to achieve the high level of turbine efficiency. Flowpath components are designed for 18,000 hours of life, while the static and rotating structures are designed for 36,000 hours of engine operation. Both stages of turbine blades and vanes are air-cooled incorporating advanced state of the art in cooling technology. Direct solidification (DS) alloys are used for blades and one stage of vanes, and an oxide dispersion system (ODS) alloy is used for the Stage 1 nozzle airfoils. Ceramic shrouds are used as the material composition for the Stage 1 shroud. An active clearance control (ACC) system is used to control the blade tip to shroud clearances for both stages. Fan air is used to impinge on the shroud casing support rings, thereby controlling the growth rate of the shroud. This procedure allows close clearance control while minimizing blade tip to shroud rubs.

On Two-Stage Multiple Comparison Procedures When There Are Unequal Sample Sizes in the First Stage.

ERIC Educational Resources Information Center

Wilcox, Rand R.

1984-01-01

Two stage multiple-comparison procedures give an exact solution to problems of power and Type I errors, but require equal sample sizes in the first stage. This paper suggests a method of evaluating the experimentwise Type I error probability when the first stage has unequal sample sizes. (Author/BW)

Performance of a 1.57 pressure-ratio transonic fan stage with a screen-induced 90 deg circumferential inlet flow distortion

NASA Technical Reports Server (NTRS)

Sanger, N. L.

1976-01-01

A transonic fan stage having a design pressure ratio of 1.57 was tested with a 90 degree circumferential distortion imposed on the inlet flow. The rotor diameter was approximately 50.8 cm, and the design pressure ratio was 1.60 at a tip speed of 425 m/sec. Overall performance at 70 and 100 percent of design speed showed a loss of stall pressure ratio and flow range at design speed and no significant loss in stall pressure ratio at 70 percent of design speed. Detailed flow measurements are presented to show the rotor-upstream flow interactions and the attenuation and amplification properties through the stage.

Two-stage light-gas magnetoplasma accelerator for hypervelocity impact simulation

NASA Astrophysics Data System (ADS)

Khramtsov, P. P.; Vasetskij, V. A.; Makhnach, A. I.; Grishenko, V. M.; Chernik, M. Yu; Shikh, I. A.; Doroshko, M. V.

2016-11-01

The development of macroparticles acceleration methods for high-speed impact simulation in a laboratory is an actual problem due to increasing of space flights duration and necessity of providing adequate spacecraft protection against micrometeoroid and space debris impacts. This paper presents results of experimental study of a two-stage light- gas magnetoplasma launcher for acceleration of a macroparticle, in which a coaxial plasma accelerator creates a shock wave in a high-pressure channel filled with light gas. Graphite and steel spheres with diameter of 2.5-4 mm were used as a projectile and were accelerated to the speed of 0.8-4.8 km/s. A launching of particle occurred in vacuum. For projectile velocity control the speed measuring method was developed. The error of this metod does not exceed 5%. The process of projectile flight from the barrel and the process of a particle collision with a target were registered by use of high-speed camera. The results of projectile collision with elements of meteoroid shielding are presented. In order to increase the projectile velocity, the high-pressure channel should be filled with hydrogen. However, we used helium in our experiments for safety reasons. Therefore, we can expect that the range of mass and velocity of the accelerated particles can be extended by use of hydrogen as an accelerating gas.

Racial disparities in advanced-stage colorectal cancer survival.

PubMed

Wallace, Kristin; Hill, Elizabeth G; Lewin, David N; Williamson, Grace; Oppenheimer, Stephanie; Ford, Marvella E; Wargovich, Michael J; Berger, Franklin G; Bolick, Susan W; Thomas, Melanie B; Alberg, Anthony J

2013-03-01

African-Americans (AA) have a higher incidence of and lower survival from colorectal cancer (CRC) compared with European Americans (EA). In the present study, statewide, population-based data from South Carolina Central Cancer Registry are used to investigate the relationship between race and age on advanced-stage CRC survival. The study population was comprised of 3,865 advanced pathologically documented colon and rectal adenocarcinoma cases diagnosed between 01 January 1996 and 31 December 2006: 2,673 (69 %) EA and 1,192 (31 %) AA. Kaplan-Meier methods were used to generate median survival time and corresponding 95 % confidence intervals (CI) by race, age, and gender. Factors associated with survival were evaluated by fitting Cox proportional hazards regression models to generate hazard ratios (HR) and 95 % CI. We observed a significant interaction between race and age on CRC survival (p = 0.04). Among younger patients (<50 years), AA race was associated with a 1.34 times (95 % CI 1.06-1.71) higher risk of death compared with EA. Among older patients, we observed a modest increase in risk of death among AA men compared with EA [HR 1.16 (95 % CI 1.01-1.32)] but no difference by race between women [HR 0.94 (95 % CI 0.82-1.08)]. Moreover, we observed that the disparity in survival has worsened over the past 15 years. Future studies that integrate clinical, molecular, and treatment-related data are needed for advancing understanding of the racial disparity in CRC survival, especially for those <50 years old.

Comparison of the effects of continuous positive airway pressure and mandibular advancement devices on sleepiness in patients with obstructive sleep apnoea: a network meta-analysis.

PubMed

Bratton, Daniel J; Gaisl, Thomas; Schlatzer, Christian; Kohler, Malcolm

2015-11-01

Excessive daytime sleepiness is the most important symptom of obstructive sleep apnoea and can affect work productivity, quality of life, and the risk of road traffic accidents. We aimed to quantify the effects of the two main treatments for obstructive sleep apnoea (continuous positive airway pressure and mandibular advancement devices) on daytime sleepiness and to establish predictors of response to continuous positive airway pressure. We searched MEDLINE and the Cochrane Library from inception to May 31, 2015, to identify randomised controlled trials comparing the effects of continuous positive airway pressure, mandibular advancement devices or an inactive control (eg, placebo or no treatment) on the Epworth Sleepiness Scale (ESS, range 0-24 points) in patients with obstructive sleep apnoea. We did a network meta-analysis using multivariate random-effects meta-regression to assess the effect of each treatment on ESS. We used meta-regression to assess the association of the reported effects of continuous positive airway pressure versus inactive controls with the characteristics of trials and their risk of bias. We included 67 studies comprising 6873 patients in the meta-analysis. Compared with an inactive control, continuous positive airway pressure was associated with a reduction in ESS score of 2·5 points (95% CI 2·0-2·9) and mandibular advancement devices of 1·7 points (1·1-2·3). We estimated that, on average, continuous positive airway pressure reduced the ESS score by a further 0·8 points compared with mandibular advancement devices (95% CI 0·1-1·4; p=0·015). However, there was a possibility of publication bias in favour of continuous positive airway pressure that might have resulted in this difference. We noted no evidence that studies reporting higher continuous positive airway pressure adherence also reported larger treatment effects (p=0·70). Continuous positive airway pressure and mandibular advancement devices are effective treatments for

Evaluation of PET and laparoscopy in STagIng advanced gastric cancer: a multicenter prospective study (PLASTIC-study).

PubMed

Brenkman, H J F; Gertsen, E C; Vegt, E; van Hillegersberg, R; van Berge Henegouwen, M I; Gisbertz, S S; Luyer, M D P; Nieuwenhuijzen, G A P; van Lanschot, J J B; Lagarde, S M; de Steur, W O; Hartgrink, H H; Stoot, J H M B; Hulsewe, K W E; Spillenaar Bilgen, E J; van Det, M J; Kouwenhoven, E A; van der Peet, D L; Daams, F; van Sandick, J W; van Grieken, N C T; Heisterkamp, J; van Etten, B; Haveman, J W; Pierie, J P; Jonker, F; Thijssen, A Y; Belt, E J T; van Duijvendijk, P; Wassenaar, E; van Laarhoven, H W M; Wessels, F J; Haj Mohammad, N; van Stel, H F; Frederix, G W J; Siersema, P D; Ruurda, J P

2018-04-20

Initial staging of gastric cancer consists of computed tomography (CT) and gastroscopy. In locally advanced (cT3-4) gastric cancer, fluorodeoxyglucose positron emission tomography with CT (FDG-PET/CT or PET) and staging laparoscopy (SL) may have a role in staging, but evidence is scarce. The aim of this study is to evaluate the impact and cost-effectiveness of PET and SL in addition to initial staging in patients with locally advanced gastric cancer. This prospective observational cohort study will include all patients with a surgically resectable, advanced gastric adenocarcinoma (cT3-4b, N0-3, M0), that are scheduled for treatment with curative intent after initial staging with gastroscopy and CT. The modalities to be investigated in this study is the addition of PET and SL. The primary outcome of this study is the proportion of patients in whom the PET or SL lead to a change in treatment strategy. Secondary outcome parameters are: diagnostic performance, morbidity and mortality, quality of life, and cost-effectiveness of these additional diagnostic modalities. The study recently started in August 2017 with a duration of 36 months. At least 239 patients need to be included in this study to demonstrate that the diagnostic modalities are break-even. Based on the annual number of gastrectomies in the participating centers, it is estimated that approximately 543 patients are included in this study. In this study, it is hypothesized that performing PET and SL for locally advanced gastric adenocarcinomas results in a change of treatment strategy in 27% of patients and an annual cost-reduction in the Netherlands of €916.438 in this patient group by reducing futile treatment. The results of this study may be applicable to all countries with comparable treatment algorithms and health care systems. NCT03208621 . This trial was registered prospectively on June 30, 2017.

High GMS score hypospadias: Outcomes after one- and two-stage operations.

PubMed

Huang, Jonathan; Rayfield, Lael; Broecker, Bruce; Cerwinka, Wolfgang; Kirsch, Andrew; Scherz, Hal; Smith, Edwin; Elmore, James

2017-06-01

Established criteria to assist surgeons in deciding between a one- or two-stage operation for severe hypospadias are lacking. While anatomical features may preclude some surgical options, the decision to approach severe hypospadias in a one- or two-stage fashion is generally based on individual surgeon preference. This decision has been described as a dilemma as outcomes range widely and there is lack of evidence supporting the superiority of one approach over the other. The aim of this study is to determine whether the GMS hypospadias score may provide some guidance in choosing the surgical approach used for correction of severe hypospadias. GMS scores were preoperatively assigned to patients having primary surgery for hypospadias. Those patients having surgery for the most severe hypospadias were selected and formed the study cohort. The records of these patients were reviewed and pertinent data collected. Complications requiring further surgery were assessed and correlated with the GMS score and the surgical technique used for repair (one-stage vs. two-stage). Eighty-seven boys were identified with a GMS score (range 3-12) of 10 or higher. At a mean follow-up of 22 months the overall complication rate for the cohort after final planned surgery was 39%. For intended one-stage procedures (n = 48) an acceptable result was achieved with one surgery for 28 patients (58%), with two surgeries for 14 (29%), and with three to five surgeries for six (13%). For intended two-stage procedures (n = 39) an acceptable result was achieved with two surgeries for 26 patients (67%), three surgeries for eight (21%), and four surgeries for three (8%). Two other patients having two-stage surgery required seven surgeries to achieve an acceptable result. Complication rates are summarized in the Table. The complication rates for GMS 10 patients were similar (27% and 33%, p = 0.28) for one- and two-stage repairs, respectively. GMS 11 patients having a one-stage repair had a

Multifunctional two-stage riser fluid catalytic cracking process.

PubMed

Zhang, Jinhong; Shan, Honghong; Chen, Xiaobo; Li, Chunyi; Yang, Chaohe

This paper described the discovering process of some shortcomings of the conventional fluid catalytic cracking (FCC) process and the proposed two-stage riser (TSR) FCC process for decreasing dry gas and coke yields and increasing light oil yield, which has been successfully applied in 12 industrial units. Furthermore, the multifunctional two-stage riser (MFT) FCC process proposed on the basis of the TSR FCC process was described, which were carried out by the optimization of reaction conditions for fresh feedstock and cycle oil catalytic cracking, respectively, by the coupling of cycle oil cracking and light FCC naphtha upgrading processes in the second-stage riser, and the specially designed reactor for further reducing the olefin content of gasoline. The pilot test showed that it can further improve the product quality, increase the diesel yield, and enhance the conversion of heavy oil.

Treatment of corn ethanol distillery wastewater using two-stage anaerobic digestion.

PubMed

Ráduly, B; Gyenge, L; Szilveszter, Sz; Kedves, A; Crognale, S

In this study the mesophilic two-stage anaerobic digestion (AD) of corn bioethanol distillery wastewater is investigated in laboratory-scale reactors. Two-stage AD technology separates the different sub-processes of the AD in two distinct reactors, enabling the use of optimal conditions for the different microbial consortia involved in the different process phases, and thus allowing for higher applicable organic loading rates (OLRs), shorter hydraulic retention times (HRTs) and better conversion rates of the organic matter, as well as higher methane content of the produced biogas. In our experiments the reactors have been operated in semi-continuous phase-separated mode. A specific methane production of 1,092 mL/(L·d) has been reached at an OLR of 6.5 g TCOD/(L·d) (TCOD: total chemical oxygen demand) and a total HRT of 21 days (5.7 days in the first-stage, and 15.3 days in the second-stage reactor). Nonetheless the methane concentration in the second-stage reactor was very high (78.9%); the two-stage AD outperformed the reference single-stage AD (conducted at the same reactor loading rate and retention time) by only a small margin in terms of volumetric methane production rate. This makes questionable whether the higher methane content of the biogas counterbalances the added complexity of the two-stage digestion.

Treatment with DAV for advanced-stage hemangiosarcoma in dogs.

PubMed

Dervisis, Nikolaos G; Dominguez, Pedro A; Newman, Rebecca G; Cadile, Casey D; Kitchell, Barbara E

2011-01-01

Hemangiosarcoma (HSA) is an aggressive disease that is fairly common in the dog. The authors evaluated a doxorubicin, dacarbazine, and vincristine (DAV) combination protocol in dogs with nonresectable stage II and stage III HSA. Twenty-four dogs were enrolled in this prospective, phase 2 study. Doxorubicin and dacarbazine were administered on day 1 while vincristine was administered on days 8 and 15. The protocol was repeated every 21 days for a maximum of six cycles or until disease progression. Toxicity and efficacy were assessed by clinical and laboratory evaluation and by questionnaires completed by the owners. Of the 24 included dogs, 19 were evaluable for response. The response rate (including five complete responses and four partial responses) was 47.4%. Median time to tumor progression was 101 days and median overall survival was 125 days. Significant toxicities were noted, including 41 high-grade hematologic and 12 high-grade gastrointestinal toxic events. Five dogs discontinued treatment due to chemotherapy-related toxicities, but no treatment-related deaths occurred. Multivariate analysis identified patient age (relative risk [RR], 2.3, P=0.049) to be negatively associated with time to progression whereas dacarbazine dose reductions (RR, 0.06, P=0.031) were positively associated with time to progression. Dacarbazine dose reduction was the sole factor positively associated with overall survival (RR, 0.28, P=0.015). In conclusion, the DAV combination appears to offer clinical responses and may prolong survival in dogs with advanced-stage HSA.

A retrospective study using the pressure ulcer scale for healing (PUSH) tool to examine factors affecting stage II pressure ulcer healing in a Korean acute care hospital.

PubMed

Park, Kyung Hee

2014-09-01

Stage II pressure ulcers (PUs) should be managed promptly and appropriately in order to prevent complications. To identify the factors affecting Stage II PU healing and optimize care, the electronic medical records of patients with a Stage II PU in an acute care hospital were examined. Patient and ulcer characteristics as well as nutritional assessment variables were retrieved, and ulcer variables were used to calculate Pressure Ulcer Scale for Healing (PUSH) scores. The effect of all variables on healing status (healed versus nonhealed) and change in PUSH score for healing rate were compared. Records of 309 Stage II PUs from 155 patients (mean age 61.2 ± 15.2 [range 5-89] years, 182 [58.9%] male) were retrieved and analyzed. Of those, 221 healed and 88 were documented as not healed at the end of the study. The variables that were significantly different between patients with PUs that did and did not heal were: major diagnosis (P = 0.001), peripheral arterial disease (P = 0.007), smoking (P = 0.048), serum albumin ( <2.5 g/dL) (P = 0.002), antidepressant use (P = 0.035), vitamin use (P = 0.006), history of surgery (P <0.001), PU size (P = 0.003), Malnutrition Universal Screening Tool (MUST) score (P = 0.020), Braden scale score (P = 0.003), and mean arterial pressure (MAP, mm Hg) (P = 0.026). The Cox proportional hazard model showed a significant positive difference in PUSH score change -indicative of healing - when pressure-redistribution surfaces were used (P <0.001, HR = 2.317), PU size was small (≤3.0 cm2, P = 0.006, HR = 1.670), MAP (within a range of 52-112 mm Hg) was higher P = 0.010, HR = 1.016), and patients were provided multivitamins (P = 0.037, HR=1.431). The results of this study suggest strategies for healing Stage II PUs in the acute care setting should include early recognition of lower-stage PUs, the provision of static pressure-redistribution surfaces and multivitamins, and maintaining higher MAP may facilitate healing and prevent deterioration

Two-stage phase II oncology designs using short-term endpoints for early stopping.

PubMed

Kunz, Cornelia U; Wason, James Ms; Kieser, Meinhard

2017-08-01

Phase II oncology trials are conducted to evaluate whether the tumour activity of a new treatment is promising enough to warrant further investigation. The most commonly used approach in this context is a two-stage single-arm design with binary endpoint. As for all designs with interim analysis, its efficiency strongly depends on the relation between recruitment rate and follow-up time required to measure the patients' outcomes. Usually, recruitment is postponed after the sample size of the first stage is achieved up until the outcomes of all patients are available. This may lead to a considerable increase of the trial length and with it to a delay in the drug development process. We propose a design where an intermediate endpoint is used in the interim analysis to decide whether or not the study is continued with a second stage. Optimal and minimax versions of this design are derived. The characteristics of the proposed design in terms of type I error rate, power, maximum and expected sample size as well as trial duration are investigated. Guidance is given on how to select the most appropriate design. Application is illustrated by a phase II oncology trial in patients with advanced angiosarcoma, which motivated this research.

Number of pins in two-stage stratified sampling for estimating herbage yield

Treesearch

William G. O' Regan; C. Eugene Conrad

1975-01-01

In a two-stage stratified procedure for sampling herbage yield, plots are stratified by a pin frame in stage one, and clipped. In stage two, clippings from selected plots are sorted, dried, and weighed. Sample size and distribution of plots between the two stages are determined by equations. A way to compute the effect of number of pins on the variance of estimated...

Three-Dimensional Unsteady Simulation of Aerodynamics and Heat Transfer in a Modern High Pressure Turbine Stage

NASA Technical Reports Server (NTRS)

Shyam, Vikram; Ameri, Ali

2009-01-01

Unsteady 3-D RANS simulations have been performed on a highly loaded transonic turbine stage and results are compared to steady calculations as well as to experiment. A low Reynolds number k-epsilon turbulence model is employed to provide closure for the RANS system. A phase-lag boundary condition is used in the tangential direction. This allows the unsteady simulation to be performed by using only one blade from each of the two rows. The objective of this work is to study the effect of unsteadiness on rotor heat transfer and to glean any insight into unsteady flow physics. The role of the stator wake passing on the pressure distribution at the leading edge is also studied. The simulated heat transfer and pressure results agreed favorably with experiment. The time-averaged heat transfer predicted by the unsteady simulation is higher than the heat transfer predicted by the steady simulation everywhere except at the leading edge. The shock structure formed due to stator-rotor interaction was analyzed. Heat transfer and pressure at the hub and casing were also studied. Thermal segregation was observed that leads to the heat transfer patterns predicted by steady and unsteady simulations to be different.

Broad-beam high-current dc ion source based on a two-stage glow discharge plasma.

PubMed

Vizir, A V; Oks, E M; Yushkov, G Yu

2010-02-01

We have designed, made, and demonstrated a broad-beam, dc, ion source based on a two-stage, hollow-cathode, and glow discharges plasma. The first-stage discharge (auxiliary discharge) produces electrons that are injected into the cathode cavity of a second-stage discharge (main discharge). The electron injection causes a decrease in the required operating pressure of the main discharge down to 0.05 mTorr and a decrease in required operating voltage down to about 50 V. The decrease in operating voltage of the main discharge leads to a decrease in the fraction of impurity ions in the ion beam extracted from the main gas discharge plasma to less than 0.2%. Another feature of the source is a single-grid accelerating system in which the ion accelerating voltage is applied between the plasma itself and the grid electrode. The source has produced steady-state Ar, O, and N ion beams of about 14 cm diameter and current of more than 2 A at an accelerating voltage of up to 2 kV.

Liquid biopsy: A potential and promising diagnostic tool for advanced stage non-small cell lung cancer patients.

PubMed

Doval, D C; Deshpande, R; Dhabhar, B; Babu, K G; Prabhash, K; Chopra, R; Sripada, P V; Deshmukh, C; Suryavanshi, M

2017-12-01

More than 50% of non-small cell lung cancer (NSCLC) cases harbor an actionable mutation, and molecular testing at different intervals can help in personalized and targeted treatment. Core tissue biopsy and needle biopsy done at the time of diagnosis/disease progression are interventional, time-consuming and can affect the patients adversely. Noninterventional biomarker testing by liquid biopsy promises to revolutionize advanced stage cancer screening. The present report was formulated based on an expert panel meeting of renowned oncologists who gave their opinions for minimally invasive liquid biopsy to detect targetable molecular biomarkers in advanced NSCLC cases. An exhaustive literature search was done to support their recommendations. Clinical utility of minimally invasive liquid biopsy, for detection of molecular biomarkers in advanced stage NSCLC patients, was broadly discussed by the key opinion leaders.

Teaching basic life support with an automated external defibrillator using the two-stage or the four-stage teaching technique.

PubMed

Bjørnshave, Katrine; Krogh, Lise Q; Hansen, Svend B; Nebsbjerg, Mette A; Thim, Troels; Løfgren, Bo

2018-02-01

Laypersons often hesitate to perform basic life support (BLS) and use an automated external defibrillator (AED) because of self-perceived lack of knowledge and skills. Training may reduce the barrier to intervene. Reduced training time and costs may allow training of more laypersons. The aim of this study was to compare BLS/AED skills' acquisition and self-evaluated BLS/AED skills after instructor-led training with a two-stage versus a four-stage teaching technique. Laypersons were randomized to either two-stage or four-stage teaching technique courses. Immediately after training, the participants were tested in a simulated cardiac arrest scenario to assess their BLS/AED skills. Skills were assessed using the European Resuscitation Council BLS/AED assessment form. The primary endpoint was passing the test (17 of 17 skills adequately performed). A prespecified noninferiority margin of 20% was used. The two-stage teaching technique (n=72, pass rate 57%) was noninferior to the four-stage technique (n=70, pass rate 59%), with a difference in pass rates of -2%; 95% confidence interval: -18 to 15%. Neither were there significant differences between the two-stage and four-stage groups in the chest compression rate (114±12 vs. 115±14/min), chest compression depth (47±9 vs. 48±9 mm) and number of sufficient rescue breaths between compression cycles (1.7±0.5 vs. 1.6±0.7). In both groups, all participants believed that their training had improved their skills. Teaching laypersons BLS/AED using the two-stage teaching technique was noninferior to the four-stage teaching technique, although the pass rate was -2% (95% confidence interval: -18 to 15%) lower with the two-stage teaching technique.

Direct variable cost of the topical treatment of stages III and IV pressure injuries incurred in a public university hospital.

PubMed

Chacon, Julieta M F; Blanes, Leila; Borba, Luis G; Rocha, Luis R M; Ferreira, Lydia M

2017-05-01

to estimate the direct variable costs of the topical treatment of stages III and IV pressure injuries of hospitalized patients in a public university hospital, and assess the correlation between these costs and hospitalization time. Forty patients of both sexes who had been admitted to the São Paulo Hospital, São Paulo, SP, Brazil, from 2011 to 2012, with pressure injuries in the sacral, ischial or trochanteric region were included. The patients had a total of 57 pressure injuries in the selected regions, and the lesions were monitored daily until patient release, transfer or death. The quantities and types of materials, as well as the amount of professional labor time spent on each procedure and each patient were recorded. The unit costs of the materials and the hourly costs of the professional labor were obtained from the hospital's purchasing and human resources departments, respectively. Spearman's correlation coefficient and the Mann-Whitney and Kruskal-Wallis tests were used for the statistical analyses. The mean topical treatment costs for stages III and IV PIs were significantly different (US$ 854.82 versus US$ 1785.35; p = 0.004). The mean topical treatment cost of stages III and IV pressure injuries per patient was US$ 1426.37. The mean daily topical treatment cost per patient was US$ 40.83. There was a significant correlation between hospitalization time and the total costs of labor and materials (p < 0.05). There was no significant difference between hospitalization time periods for stages III and IV pressure injuries (40.80 days and 45.01 days, respectively; p = 0.834). The mean direct variable cost of the topical treatment for stages III and IV pressure injuries per patient in this public university hospital was US$ 1426.37. Copyright © 2016. Published by Elsevier Ltd.

A controlled, randomized, comparative study of a radiant heat bandage on the healing of stage 3-4 pressure ulcers: a pilot study.

PubMed

Thomas, David R; Diebold, Marilyn R; Eggemeyer, Linda M

2005-01-01

Pressure ulcers, like other chronic wounds, fail to proceed through an orderly and timely process to produce anatomical or functional integrity. Treatment of pressure ulcers is directed to improving host factors and providing an optimum wound environment. In addition to providing a moist wound environment, it has been theorized that preventing hypothermia in a wound and maintaining a normothermic state might improve wound healing. Forty-one subjects with a stage 3 or stage 4 truncal pressure ulcer >1.0 cm(2) were recruited from outpatient clinics, long-term care nursing homes, and a rehabilitation center. The experimental group was randomized to a radiant-heat dressing device and the control group was randomized to a hydrocolloid dressing, with or without a calcium alginate filler. Subjects were followed until healed or for 12 weeks. Eight subjects (57%) in the experimental group had complete healing of their pressure ulcer compared with 7 subjects (44%) with complete healing in the control group (P = .46). Although a 13% difference in healing rate between the two arms of the study was found, this difference was not statistically significant. At almost all points along the healing curve, the proportion not healed was higher in the control arm.

CFD Modelling of Bore Erosion in Two-Stage Light Gas Guns

NASA Technical Reports Server (NTRS)

Bogdanoff, D. W.

1998-01-01

A well-validated quasi-one-dimensional computational fluid dynamics (CFD) code for the analysis of the internal ballistics of two-stage light gas guns is modified to explicitly calculate the ablation of steel from the gun bore and the incorporation of the ablated wall material into the hydrogen working cas. The modified code is used to model 45 shots made with the NASA Ames 0.5 inch light gas gun over an extremely wide variety of gun operating conditions. Good agreement is found between the experimental and theoretical piston velocities (maximum errors of +/-2% to +/-6%) and maximum powder pressures (maximum errors of +/-10% with good igniters). Overall, the agreement between the experimental and numerically calculated gun erosion values (within a factor of 2) was judged to be reasonably good, considering the complexity of the processes modelled. Experimental muzzle velocities agree very well (maximum errors of 0.5-0.7 km/sec) with theoretical muzzle velocities calculated with loading of the hydrogen gas with the ablated barrel wall material. Comparison of results for pump tube volumes of 100%, 60% and 40% of an initial benchmark value show that, at the higher muzzle velocities, operation at 40% pump tube volume produces much lower hydrogen loading and gun erosion and substantially lower maximum pressures in the gun. Large muzzle velocity gains (2.4-5.4 km/sec) are predicted upon driving the gun harder (that is, upon using, higher powder loads and/or lower hydrogen fill pressures) when hydrogen loading is neglected; much smaller muzzle velocity gains (1.1-2.2 km/sec) are predicted when hydrogen loading is taken into account. These smaller predicted velocity gains agree well with those achieved in practice. CFD snapshots of the hydrogen mass fraction, density and pressure of the in-bore medium are presented for a very erosive shot.

The Two-Word Stage: Motivated by Linguistic or Cognitive Constraints?

PubMed Central

Berk, Stephanie; Lillo-Martin, Diane

2012-01-01

Child development researchers often discuss a “two-word” stage during language acquisition. However, there is still debate over whether the existence of this stage reflects primarily cognitive or linguistic constraints. Analyses of longitudinal data from two Deaf children, Mei and Cal, not exposed to an accessible first language (American Sign Language - ASL) until the age of 6 years, suggest that a linguistic constraint is observed when cognition is relatively spared. These older children acquiring a first language after delayed exposure exhibit aspects of a two-word stage of language development. Results from intelligence assessments, achievement tests, drawing tasks, and qualitative cognitive analyses show that Mei and Cal are at least of average intelligence and ability. However, results from language analyses clearly show differences from both age peers and younger native signers in the early two-word stage, providing new insights into the nature of this phase of language development. PMID:22475876

Two-stage reimplantation for treating prosthetic shoulder infections.

PubMed

Sabesan, Vani J; Ho, Jason C; Kovacevic, David; Iannotti, Joseph P

2011-09-01

Two-stage reimplantation for prosthetic joint infection reportedly has the lowest risk for recurrent infection. Most studies to date have evaluated revision surgery for infection using an anatomic prosthetic. As compared with anatomic prostheses, reverse total shoulder arthroplasty is reported to have a higher rate of infection. We determined reinfection rates, functional improvement, types and rates of complications, and influence of rotator cuff tissue on function for two-stage reimplantation for prosthetic joint infection treated with reverse shoulder arthroplasty. We retrospectively reviewed 27 patients treated with a two-stage reimplantation for prosthetic shoulder infection using a uniform protocol for management of infection; of these, 17 had reverse shoulder arthroplasty at second-stage surgery. Types of organisms cultured, recurrence rates, complications, function, and radiographic followup were reviewed for all patients. One of the 17 patients had recurrence of infection. The mean (± SD) Penn shoulder scores for patients treated with reverse shoulder arthroplasty improved from 24.9 ± 22.3 to 66.4 ± 20.8. The average motion at last followup was 123° ± 33° of forward flexion and 26° ± 8° of external rotation in patients treated with a reverse shoulder arthroplasty. The major complication rate was 35% in reverse shoulder arthroplasty, with five dislocations and one reinfection. There was no difference in final Penn score between patients with and without external rotation weakness. Shoulder function and pain improved in patients treated with a second-stage reimplantation of a reverse prosthesis and the reinfection rate was low. Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.

Final Report on Two-Stage Fast Spectrum Fuel Cycle Options

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Won Sik; Lin, C. S.; Hader, J. S.

2016-01-30

This report presents the performance characteristics of two “two-stage” fast spectrum fuel cycle options proposed to enhance uranium resource utilization and to reduce nuclear waste generation. One is a two-stage fast spectrum fuel cycle option of continuous recycle of plutonium (Pu) in a fast reactor (FR) and subsequent burning of minor actinides (MAs) in an accelerator-driven system (ADS). The first stage is a sodium-cooled FR fuel cycle starting with low-enriched uranium (LEU) fuel; at the equilibrium cycle, the FR is operated using the recovered Pu and natural uranium without supporting LEU. Pu and uranium (U) are co-extracted from the dischargedmore » fuel and recycled in the first stage, and the recovered MAs are sent to the second stage. The second stage is a sodium-cooled ADS in which MAs are burned in an inert matrix fuel form. The discharged fuel of ADS is reprocessed, and all the recovered heavy metals (HMs) are recycled into the ADS. The other is a two-stage FR/ADS fuel cycle option with MA targets loaded in the FR. The recovered MAs are not directly sent to ADS, but partially incinerated in the FR in order to reduce the amount of MAs to be sent to the ADS. This is a heterogeneous recycling option of transuranic (TRU) elements« less

Runway Operations Planning: A Two-Stage Heuristic Algorithm

NASA Technical Reports Server (NTRS)

Anagnostakis, Ioannis; Clarke, John-Paul

2003-01-01

The airport runway is a scarce resource that must be shared by different runway operations (arrivals, departures and runway crossings). Given the possible sequences of runway events, careful Runway Operations Planning (ROP) is required if runway utilization is to be maximized. From the perspective of departures, ROP solutions are aircraft departure schedules developed by optimally allocating runway time for departures given the time required for arrivals and crossings. In addition to the obvious objective of maximizing throughput, other objectives, such as guaranteeing fairness and minimizing environmental impact, can also be incorporated into the ROP solution subject to constraints introduced by Air Traffic Control (ATC) procedures. This paper introduces a two stage heuristic algorithm for solving the Runway Operations Planning (ROP) problem. In the first stage, sequences of departure class slots and runway crossings slots are generated and ranked based on departure runway throughput under stochastic conditions. In the second stage, the departure class slots are populated with specific flights from the pool of available aircraft, by solving an integer program with a Branch & Bound algorithm implementation. Preliminary results from this implementation of the two-stage algorithm on real-world traffic data are presented.

Management of untreated advanced stage follicular lymphoma: Role of patient discernment.

PubMed

Umakanthan, Jayadev Manikkam; Lunning, Mathew A

2018-03-01

Follicular lymphoma is the most common indolent non-Hodgkin lymphoma. Advanced stage disease is common at diagnosis. The timing of treatment for follicular lymphoma is best approached by considering the combination of presence or absence of symptoms along with estimation of tumor burden. Upfront treatment strategies should take into initial presentation variables, pace of disease progression and goals of care after discussion with the patient. Treatment approaches remain diverse and patient discernment is paramount. Copyright © 2017 Elsevier Ltd. All rights reserved.

Long-term outcome of cochlear implant in patients with chronic otitis media: one-stage surgery is equivalent to two-stage surgery.

PubMed

Jang, Jeong Hun; Park, Min-Hyun; Song, Jae-Jin; Lee, Jun Ho; Oh, Seung Ha; Kim, Chong-Sun; Chang, Sun O

2015-01-01

This study compared long-term speech performance after cochlear implantation (CI) between surgical strategies in patients with chronic otitis media (COM). Thirty patients with available open-set sentence scores measured more than 2 yr postoperatively were included: 17 who received one-stage surgeries (One-stage group), and the other 13 underwent two-stage surgeries (Two-stage group). Preoperative inflammatory status, intraoperative procedures, postoperative outcomes were compared. Among 17 patients in One-stage group, 12 underwent CI accompanied with the eradication of inflammation; CI without eradicating inflammation was performed on 3 patients; 2 underwent CIs via the transcanal approach. Thirteen patients in Two-stage group received the complete eradication of inflammation as first-stage surgery, and CI was performed as second-stage surgery after a mean interval of 8.2 months. Additional control of inflammation was performed in 2 patients at second-stage surgery for cavity problem and cholesteatoma, respectively. There were 2 cases of electrode exposure as postoperative complication in the two-stage group; new electrode arrays were inserted and covered by local flaps. The open-set sentence scores of Two-stage group were not significantly higher than those of One-stage group at 1, 2, 3, and 5 yr postoperatively. Postoperative long-term speech performance is equivalent when either of two surgical strategies is used to treat appropriately selected candidates.

Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts.

PubMed

Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

2009-01-27

The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts. We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments. Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%. The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future.

Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts

PubMed Central

Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

2009-01-01

Objective: The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts. Methods: We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments. Results: Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%. Conclusion: The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future. PMID:21197345

Cryogenic Pressure Control Modeling for Ellipsoidal Space Tanks in Reduced Gravity

NASA Technical Reports Server (NTRS)

Hedayat, Ali; Lopez, Alfredo; Grayson, Gary D.; Chandler, Frank O.; Hastings, Leon J.

2008-01-01

A computational fluid dynamics (CFD) model is developed to simulate pressure control of an ellipsoidal-shaped liquid hydrogen tank under external heating in low gravity. Pressure control is provided by an axial jet thermodynamic vent system (TVS) centered within the vessel that injects cooler liquid into the tank, mixing the contents and reducing tank pressure. The two-phase cryogenic tank model considers liquid hydrogen in its own vapor with liquid density varying with temperature only and a fully compressible ullage. The axisymmetric model is developed using a custom version of the commercially available FLOW-3D software and simulates low gravity extrapolations of engineering checkout tests performed at Marshall Space Flight Center in 1999 in support of the Solar Thermal Upper Stage Technology Demonstrator (STUSTD) program. Model results illustrate that stable low gravity liquid-gas interfaces are maintained during all phases of the pressure control cycle. Steady and relatively smooth ullage pressurization rates are predicted. This work advances current low gravity CFD modeling capabilities for cryogenic pressure control and aids the development of a low cost CFD-based design process for space hardware.

Laser velocimeter measurements of the flow downstream of the Space Shuttle Main Engine high pressure oxidizer turbopump first-stage turbine nozzle

NASA Technical Reports Server (NTRS)

Ferguson, T. V.; Havskjold, G. L.; Rojas, L.

1988-01-01

A laser two-focus velocimeter was used in an open-loop water test facility in order to map the flowfield downstream of the SSME's high-pressure oxidizer turbopump first-stage turbine nozzle; attention was given to the effects of the upstream strut-downstream nozzle configuration on the flow at the rotor inlet, in order to estimate dynamic loads on the first-stage rotor blades. Velocity and flow angles were plotted as a function of circumferential position, and were found to clearly display the periodic behavior of the wake flow field. The influence of the upstream centerbody-supporting struts on the vane nozzle wake pattern was evident.

Bevacizumab, Carboplatin and Paclitaxel Combination Treatment in Advanced Stage Ovarian Cancer: The First Experience in Thammasat University Hospital, Thailand: A Case Report.

PubMed

Suwannarurk, Komsun; Thaweekul, Yudthadej; Mairaing, Karicha; Poomtavorn, Yenrudee; Tangtiang, Kaan; Piyawang, Wichet; Bhamarapravatana, Kornkarn

2015-04-01

Bevacizumab, a humanized monoclonal antibody targeting vascular endothelial growthfactor (VEGF), has been approvedfor concurrent treatment with first line chemotherapy in advanced epithelial ovarian cancer. A case of an advanced stage epithelial ovarian cancer (EOC) receiving a combination of bevacizumab, carboplatin andpaclitaxel chemotherapy was reported. A 44-year-old woman was presented with abdominal discomfort and distention for 4 months. Bilateral 12 cm diameter ovarian tumors were diagnosed as FIGO stage IIIc after surgical staging operation. Histopathology report showed the mixed type of serous and endometriod adenocarcinoma. The patient was then started on carboplatin/paclitaxel combination chemotherapy for 6 cycles after surgery every 3 weeks. Bevacizumab (7.5 mg/ m2) was concurrently administered with chemotherapy every 3 weeks startingfrom the 2nd cycle. A complete remission was achieved after the end of the chemotherapy treatment. Bevacizumab was continued for one year after the completion of the standard chemotherapy. Bone marrow suppression, hypertension and proteinuria were not found during Bevacizumab treatment. At bevacizumab treatment completion, a platinum-sensitive recurrent ovarian cancer was diagnosed at the two weeks postprogram routine check-up. The patient was counseled to start second line chemotherapy treatment and has yet to come back with her decision. Combination of bevacizumab, carboplatin and paclitaxelfor first line chemotherapy in advanced EOC in this case had no serious side effects and need further study.

The two-stage origin of bright rings in extended radio lobes

NASA Astrophysics Data System (ADS)

Morrison, P.; Sadun, A.

1996-01-01

A few strong radio sources show unusual large-intensity features (up to 100- or 200-kpc scale) within their extended lobes. These appear in the plane of the sky as nearly circular rings, but physically they are actually spherical shells. Two such sources, HerA (3C348) and 3C310, are analysed in terms of their similarly uniform kinematics. Such objects do not easily fit into the Fanaroff-Riley scheme for jet and lobe sources. We model these sources by a two-stage account of their dynamics. Long ago, acoustic waves (or weak shocks) were excited again and again to form sphere after sphere in the pre-existing thermal galactic wind. They all arose at one spot along the jet axis at the edge of the galaxy, to drift with the wind, expanding uniformly at the speed of sound in the near-isothermal gas. The wind flows out supersonically at about Mach 5. In a much later second stage, a new and much faster flow of relativistic plasma is energized by the active nucleus deep within the galaxy. That plasma jet swiftly forms the radio lobe and infuses it with radio electrons. The new plasma fills in locally the low-pressure portions of each drifting acoustic shell. The shells then appear as a procession of radio rings, with modest intensity contrast and an understandable polarization. Both of these radio ring sources appear to have optically double active nuclei. Perhaps periodic tidal forces determine the density modulations during the older outflow that gave rise to the several drifting shells.

An Empirical Comparison of Two-Stage and Pyramidal Adaptive Ability Testing.

ERIC Educational Resources Information Center

Larkin, Kevin C.; Weiss, David J.

A 15-stage pyramidal test and a 40-item two-stage test were constructed and administered by computer to 111 college undergraduates. The two-stage test was found to utilize a smaller proportion of its potential score range than the pyramidal test. Score distributions for both tests were positively skewed but not significantly different from the…

The Two-Word Stage: Motivated by Linguistic or Cognitive Constraints?

ERIC Educational Resources Information Center

Berk, Stephanie; Lillo-Martin, Diane

2012-01-01

Child development researchers often discuss a "two-word" stage during language acquisition. However, there is still debate over whether the existence of this stage reflects primarily cognitive or linguistic constraints. Analyses of longitudinal data from two Deaf children, Mei and Cal, not exposed to an accessible first language (American Sign…

Prediction of the characteristics of two types of pressure waves in the cochlea: Theoretical considerations

NASA Astrophysics Data System (ADS)

Andoh, Masayoshi; Wada, Hiroshi

2004-07-01

The aim of this study was to predict the characteristics of two types of cochlear pressure waves, so-called fast and slow waves. A two-dimensional finite-element model of the organ of Corti (OC), including fluid-structure interaction with the surrounding lymph fluid, was constructed. The geometry of the OC at the basal turn was determined from morphological measurements of others in the gerbil hemicochlea. As far as mechanical properties of the materials within the OC are concerned, previously determined mechanical properties of portions within the OC were adopted, and unknown mechanical features were determined from the published measurements of static stiffness. Time advance of the fluid-structure scheme was achieved by a staggered approach. Using the model, the magnitude and phase of the fast and slow waves were predicted so as to fit the numerically obtained pressure distribution in the scala tympani with what is known about intracochlear pressure measurement. When the predicted pressure waves were applied to the model, the numerical result of the velocity of the basilar membrane showed good agreement with the experimentally obtained velocity of the basilar membrane documented by others. Thus, the predicted pressure waves appeared to be reliable. Moreover, it was found that the fluid-structure interaction considerably influences the dynamic behavior of the OC at frequencies near the characteristic frequency.

A two-stage heating scheme for heat assisted magnetic recording

NASA Astrophysics Data System (ADS)

Xiong, Shaomin; Kim, Jeongmin; Wang, Yuan; Zhang, Xiang; Bogy, David

2014-05-01

Heat Assisted Magnetic Recording (HAMR) has been proposed to extend the storage areal density beyond 1 Tb/in.2 for the next generation magnetic storage. A near field transducer (NFT) is widely used in HAMR systems to locally heat the magnetic disk during the writing process. However, much of the laser power is absorbed around the NFT, which causes overheating of the NFT and reduces its reliability. In this work, a two-stage heating scheme is proposed to reduce the thermal load by separating the NFT heating process into two individual heating stages from an optical waveguide and a NFT, respectively. As the first stage, the optical waveguide is placed in front of the NFT and delivers part of laser energy directly onto the disk surface to heat it up to a peak temperature somewhat lower than the Curie temperature of the magnetic material. Then, the NFT works as the second heating stage to heat a smaller area inside the waveguide heated area further to reach the Curie point. The energy applied to the NFT in the second heating stage is reduced compared with a typical single stage NFT heating system. With this reduced thermal load to the NFT by the two-stage heating scheme, the lifetime of the NFT can be extended orders longer under the cyclic load condition.

Single-stage experimental evaluation of tandem-airfoil rotor and stator blading for compressors. Part 2: Data and performance for stage A

NASA Technical Reports Server (NTRS)

Brent, J. A.

1972-01-01

Stage A, comprised of a conventional rotor and stator, was designed and tested to establish a performance baseline for comparison with the results of subsequent tests planned for two tandem-blade stages. The rotor had an inlet hub/tip ratio of 0.8 and a design tip velocity of 757 ft/sec. At design equivalent rotor speed, rotor A achieved a maximum adiabatic efficiency of 85.1 percent at a pressure ratio of 1.29. The stage maximum adiabatic efficiency was 78.6 percent at a pressure ratio of 1.27.

SU-E-J-87: Ventilation Weighting Effect On Mean Doses of Both Side Lungs for Patients with Advanced Stage Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qu, H; Xia, P; Yu, N

Purpose: To study ventilation weighting effect on radiation doses to both side lungs for patients with advanced stage lung cancer. Methods: Fourteen patients with advanced stage lung cancer were included in this retrospective study. Proprietary software was developed to calculate the lung ventilation map based on 4DCT images acquired for radiation therapy. Two phases of inhale (0%) and exhale (50%) were used for the lung ventilation calculations. For each patient, the CT images were resampled to the same dose calculation resolution of 3mmx3mmx3mm. The ventilation distribution was then normalized by the mean value of the ventilation. The ventilation weighted dosemore » was calculated by applying linearly weighted ventilation to the dose of each pixel. The lung contours were automatically delineated from patient CT image with lung window, excluding the tumor and high density tissues. For contralateral and ipsilateral lungs, the mean lung doses from the original plan and ventilation weighted mean lung doses were compared using two tail t-Test. Results: The average of mean dose was 6.1 ±3.8Gy for the contralateral lungs, and 26.2 ± 14.0Gy for the ipsilateral lungs. The average of ventilation weighted dose was 6.3± 3.8Gy for the contralateral lungs and 24.6 ± 13.1Gy for the ipsilateral lungs. The statistics analysis shows the significance of the mean dose increase (p<0.015) for the contralateral lungs and decrease (p<0.005) for the ipsilateral lungs. Conclusion: Ventilation weighted doses were greater than the un-weighted doses for contralateral lungs and smaller for ipsilateral lungs. This Result may be helpful to understand the radiation dosimetric effect on the lung function and provide planning guidance for patients with advance stage lung cancer.« less

Heat transfer and pressure measurements for the SSME fuel turbine

NASA Technical Reports Server (NTRS)

Dunn, Michael G.; Kim, Jungho

1991-01-01

A measurement program is underway using the Rocketdyne two-stage Space Shuttle Main Engine (SSME) fuel turbine. The measurements use a very large shock tunnel to produce a short-duration source of heated and pressurized gas which is subsequently passed through the turbine. Within this environment, the turbine is operated at the design values of flow function, stage pressure ratio, stage temperature ratio, and corrected speed. The first stage vane row and the first stage blade row are instrumented in both the spanwise and chordwise directions with pressure transducers and heat flux gages. The specific measurements to be taken include time averaged surface pressure and heat flux distributions on the vane and blade, flow passage static pressure, flow passage total pressure and total temperature distributions, and phase resolved surface pressure and heat flux on the blade.

Behavioral variant frontotemporal dementia: advanced disease stages and death. A step to palliative care.

PubMed

Diehl-Schmid, J; Richard-Devantoy, S; Grimmer, T; Förstl, H; Jox, R

2017-08-01

The aim of the present study was to gain insight into the living and care situation in advanced behavioral variant frontotemporal dementia (bvFTD), to describe symptoms and findings in advanced bvFTD, and to evaluate somatic comorbidities and circumstances of death. Standardized interviews were conducted with family caregivers of 83 patients with bvFTD. Forty-four percent of the patients were already deceased at the time of the interview. At the time of the interview or death, respectively, 47% of the patients lived in a nursing home. The median time between symptom onset and nursing home admission was 5.0 ± 5.5 years. In moderate and severe dementia stages almost all patients suffered from severe disabilities including impairment of language, gait, swallowing, and of the ability to care for themselves. Sixteen percent of the patients had got enteral tube feeding. Comorbid somatic diseases were diagnosed in 46% of the patients. Twenty-three percent of the deceased patients had been admitted into a hospital before death. Cardiovascular disease and respiratory disease, mostly pneumonia, were the most frequent causes of death. Advanced bvFTD is characterized by severe cognitive impairment and physical disabilities. BvFTD leads to a premature death. Our findings stress the importance of strategies that maximize patient comfort in advanced disease stages and allow for a peaceful death. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Occipital pressure sores in two neonates.

PubMed

Liu, Yi; Xiao, Bin; Zhang, Cheng; Su, Zhihong

2015-01-01

The preference for a specific head shape can be influenced by people's culture, religious beliefs and race. Modern Chinese people prefer a "talented" head shape, which is rounded and has a long profile. To obtain their preferred head shape, some parents try to change their neonates' sleeping position. Due to these forced sleeping positions, positional skull deformities, such as plagiocephaly, may be present during the first few months of life. In this article, we report two neonatal cases, of Hui nationality and Dongxiang nationality, with occipital pressure sores that were caused by using hard objects as pillows with the intention of obtaining a flattened occiput. The pressure sores were deep to the occipital bone and needed surgical management. These pressure sores caused wounds that were repaired by local skin flaps, after debridement, and the use of external constraints from a dense sponge-made head frame for approximately two weeks. One case recovered with primary healing after surgical operation. The other case suffered from a disruption of the sutured wound, and a secondary operation was performed to cover the wound. These occipital pressure sores are avoidable by providing guidance to the parents in ethnic minorities' area regarding the prevention, diagnosis and management of positional skull deformity.

Acetylcysteine reduces plasma homocysteine concentration and improves pulse pressure and endothelial function in patients with end-stage renal failure.

PubMed

Scholze, Alexandra; Rinder, Christiane; Beige, Joachim; Riezler, Reiner; Zidek, Walter; Tepel, Martin

2004-01-27

Increased oxidative stress, elevated plasma homocysteine concentration, increased pulse pressure, and impaired endothelial function constitute risk factors for increased mortality in patients with end-stage renal failure. We investigated the metabolic and hemodynamic effects of intravenous administration of acetylcysteine, a thiol-containing antioxidant, during a hemodialysis session in a prospective, randomized, placebo-controlled crossover study in 20 patients with end-stage renal failure. Under control conditions, a hemodialysis session reduced plasma homocysteine concentration to 58+/-22% predialysis (mean+/-SD), whereas in the presence of acetylcysteine, the plasma homocysteine concentration was significantly more reduced to 12+/-7% predialysis (P<0.01). The reduction of plasma homocysteine concentration was significantly correlated with a reduction of pulse pressure. A 10% decrease in plasma homocysteine concentration was associated with a decrease of pulse pressure by 2.5 mm Hg. Analysis of the second derivative of photoplethysmogram waveform showed changes of arterial wave reflectance during hemodialysis in the presence of acetylcysteine, indicating improved endothelial function. Acetylcysteine-dependent increase of homocysteine removal during a hemodialysis session improves plasma homocysteine concentration, pulse pressure, and endothelial function in patients with end-stage renal failure.

The role of ontogeny in physiological tolerance: decreasing hydrostatic pressure tolerance with development in the northern stone crab Lithodes maja.

PubMed

Munro, Catriona; Morris, James P; Brown, Alastair; Hauton, Chris; Thatje, Sven

2015-06-22

Extant deep-sea invertebrate fauna represent both ancient and recent invasions from shallow-water habitats. Hydrostatic pressure may present a significant physiological challenge to organisms seeking to colonize deeper waters or migrate ontogenetically. Pressure may be a key factor contributing to bottlenecks in the radiation of taxa and potentially drive speciation. Here, we assess shifts in the tolerance of hydrostatic pressure through early ontogeny of the northern stone crab Lithodes maja, which occupies a depth range of 4-790 m in the North Atlantic. The zoea I, megalopa and crab I stages were exposed to hydrostatic pressures up to 30.0 MPa (equivalent of 3000 m depth), and the relative fold change of genes putatively coding for the N-methyl-D-aspartate receptor-regulated protein 1 (narg gene), two heat-shock protein 70 kDa (HSP70) isoforms and mitochondrial Citrate Synthase (CS gene) were measured. This study finds a significant increase in the relative expression of the CS and hsp70a genes with increased hydrostatic pressure in the zoea I stage, and an increase in the relative expression of all genes with increased hydrostatic pressure in the megalopa and crab I stages. Transcriptional responses are corroborated by patterns in respiratory rates in response to hydrostatic pressure in all stages. These results suggest a decrease in the acute high-pressure tolerance limit as ontogeny advances, as reflected by a shift in the hydrostatic pressure at which significant differences are observed. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Two stage sorption of sulfur compounds

DOEpatents

Moore, William E.

1992-01-01

A two stage method for reducing the sulfur content of exhaust gases is disclosed. Alkali- or alkaline-earth-based sorbent is totally or partially vaporized and introduced into a sulfur-containing gas stream. The activated sorbent can be introduced in the reaction zone or the exhaust gases of a combustor or a gasifier. High efficiencies of sulfur removal can be achieved.

Additively Manufactured Low Cost Upper Stage Combustion Chamber

NASA Technical Reports Server (NTRS)

Protz, Christopher; Cooper, Ken; Ellis, David; Fikes, John; Jones, Zachary; Kim, Tony; Medina, Cory; Taminger, Karen; Willingham, Derek

2016-01-01

Over the past two years NASA's Low Cost Upper Stage Propulsion (LCUSP) project has developed Additive Manufacturing (AM) technologies and design tools aimed at reducing the costs and manufacturing time of regeneratively cooled rocket engine components. High pressure/high temperature combustion chambers and nozzles must be regeneratively cooled to survive their operating environment, causing their design fabrication to be costly and time consuming due to the number of individual steps and different processes required. Under LCUSP, AM technologies in Sintered Laser Melting (SLM) GRCop-84 and Electron Beam Freeform Fabrication (EBF3) Inconel 625 have been significantly advanced, allowing the team to successfully fabricate a 25k-class regenerative chamber. Estimates of the costs and schedule of future builds indicate cost reductions and significant schedule reductions will be enabled by this technology. Characterization of the microstructural and mechanical properties of the SLM-produced GRCop-84, EBF3 Inconel 625 and the interface layer between the two has been performed and indicates the properties will meet the design requirements. The LCUSP chamber is to be tested with a previously demonstrated SLM injector in order to advance the Technology Readiness Level (TRL) and demonstrate the capability of the application of these processes. NASA is advancing these technologies to reduce cost and schedule for future engine applications and commercial needs.

The Pacman Perforator-Based V-Y Advancement Flap for Reconstruction of Pressure Sores at Different Locations.

PubMed

Bonomi, Stefano; Salval, André; Brenta, Federica; Rapisarda, Vincenzo; Settembrini, Fernanda

2016-09-01

Many procedures have been proposed for the treatment of pressure sores, and V-Y advancement flaps are widely used to repair a defect. Unfortunately, the degree of mobility of a V-Y advancement flap is dependent on the laxity of the underlying subcutaneous tissue. This is an important disadvantage of traditional V-Y advancement flap and limits its use.We used V-Y advancement flaps as perforator-based to overcome mobility restriction problem, with a further modification (Pacman-like shape) to improve the covering surface area of the flap. Between January 2012 and December 2014, the authors used 37 V-Y Pacman perforator-based flaps in 33 consecutive patients for coverage of defects located at sacral (n = 21), ischial (n = 13), trochanter (n = 1) regions. There were 27 male and 6 female patients with a mean age of 49.9 years (range, 15-74 years). All flaps survived completely (92.3%) except 3 in which one of them had undergone total necrosis due to hematoma and the other 2 had partial necrosis. No venous congestion was observed. The mean follow-up period was 14.9 months (range, 2-38 months). No flap surgery-related mortality or recurrence of pressure sores was noted. The V-Y Pacman perforator-based advancement flaps are safe and very effective for reconstruction of pressure sores at various regions. The advantage of our modification procedure include shorter operative time, lesser pedicle dissection, low donor site morbidity, good preservation of muscle, and offers remarkable excursion to the V-Y flap, which make the V-Y Pacman perforator-based flaps an excellent choice for large pressure sore coverage.

Downstream processing of antibodies: single-stage versus multi-stage aqueous two-phase extraction.

PubMed

Rosa, P A J; Azevedo, A M; Ferreira, I F; Sommerfeld, S; Bäcker, W; Aires-Barros, M R

2009-12-11

Single-stage and multi-stage strategies have been evaluated and compared for the purification of human antibodies using liquid-liquid extraction in aqueous two-phase systems (ATPSs) composed of polyethylene glycol 3350 (PEG 3350), dextran, and triethylene glycol diglutaric acid (TEG-COOH). The performance of single-stage extraction systems was firstly investigated by studying the effect of pH, TEG-COOH concentration and volume ratio on the partitioning of the different components of a Chinese hamster ovary (CHO) cells supernatant. It was observed that lower pH values and high TEG-COOH concentrations favoured the selective extraction of human immunoglobulin G (IgG) to the PEG-rich phase. Higher recovery yields, purities and percentage of contaminants removal were always achieved in the presence of the ligand, TEG-COOH. The extraction of IgG could be enhanced using higher volume ratios, however with a significant decrease in both purity and percentage of contaminants removal. The best single-stage extraction conditions were achieved for an ATPS containing 1.3% (w/w) TEG-COOH with a volume ratio of 2.2, which allowed the recovery of 96% of IgG in the PEG-rich phase with a final IgG concentration of 0.21mg/mL, a protein purity of 87% and a total purity of 43%. In order to enhance simultaneously both recovery yield and purity, a four stage cross-current operation was simulated and the corresponding liquid-liquid equilibrium (LLE) data determined. A predicted optimised scheme of a counter-current multi-stage aqueous two-phase extraction was hence described. IgG can be purified in the PEG-rich top phase with a final recovery yield of 95%, a final concentration of 1.04mg/mL and a protein purity of 93%, if a PEG/dextran ATPS containing 1.3% (w/w) TEG-COOH, 5 stages and volume ratio of 0.4 are used. Moreover, according to the LLE data of all CHO cells supernatant components, it was possible to observe that most of the cells supernatant contaminants can be removed during this

Effect of Silica Fume on two-stage Concrete Strength

NASA Astrophysics Data System (ADS)

Abdelgader, H. S.; El-Baden, A. S.

2015-11-01

Two-stage concrete (TSC) is an innovative concrete that does not require vibration for placing and compaction. TSC is a simple concept; it is made using the same basic constituents as traditional concrete: cement, coarse aggregate, sand and water as well as mineral and chemical admixtures. As its name suggests, it is produced through a two-stage process. Firstly washed coarse aggregate is placed into the formwork in-situ. Later a specifically designed self compacting grout is introduced into the form from the lowest point under gravity pressure to fill the voids, cementing the aggregate into a monolith. The hardened concrete is dense, homogeneous and has in general improved engineering properties and durability. This paper presents the results from a research work attempt to study the effect of silica fume (SF) and superplasticizers admixtures (SP) on compressive and tensile strength of TSC using various combinations of water to cement ratio (w/c) and cement to sand ratio (c/s). Thirty six concrete mixes with different grout constituents were tested. From each mix twenty four standard cylinder samples of size (150mm×300mm) of concrete containing crushed aggregate were produced. The tested samples were made from combinations of w/c equal to: 0.45, 0.55 and 0.85, and three c/s of values: 0.5, 1 and 1.5. Silica fume was added at a dosage of 6% of weight of cement, while superplasticizer was added at a dosage of 2% of cement weight. Results indicated that both tensile and compressive strength of TSC can be statistically derived as a function of w/c and c/s with good correlation coefficients. The basic principle of traditional concrete, which says that an increase in water/cement ratio will lead to a reduction in compressive strength, was shown to hold true for TSC specimens tested. Using a combination of both silica fume and superplasticisers caused a significant increase in strength relative to control mixes.

Spectroscopic detection of the blanch response at the heel of the foot: a possible diagnostic for stage I pressure ulcers

NASA Astrophysics Data System (ADS)

Kohlenberg, Elicia M.; Zanca, Jeanne; Brienza, David M.; Levasseur, Michelle A.; Sowa, Michael G.

2005-09-01

Pressure ulcers (sores) can occur when there is constant pressure being applied to tissue for extended periods of time. Immobile people are particularly prone to this problem. Ideally, pressure damage is detected at an early stage, pressure relief is applied and the pressure ulcer is averted. One of the hallmarks of pressure damaged skin is an obliterated blanch response due to compromised microcirculation near the surface of the skin. Visible reflectance spectroscopy can noninvasively probe the blood circulation of the upper layers of skin by measuring the electronic transitions arising from hemoglobin, the primary oxygen carrying protein in blood. A spectroscopic test was developed on a mixed population of 30 subjects to determine if the blanch response could be detected in healthy skin with high sensitivity and specificity regardless of the pigmentation of the skin. Our results suggest that a spectroscopic based blanch response test can accurately detect the blanching of healthy tissue and has the potential to be developed into a screening test for early stage I pressure ulcers.

HIV-infection has no prognostic impact on advanced-stage Hodgkin lymphoma.

PubMed

Sorigué, Marc; García, Olga; Tapia, Gustavo; Baptista, Maria-Joao; Moreno, Miriam; Mate, José-Luis; Sancho, Juan M; Feliu, Evarist; Ribera, Josep-Maria; Navarro, José-Tomás

2017-06-19

Classical Hodgkin lymphoma (cHL) is a non-AIDS-defining cancer with a good response to chemotherapy in the combined antiretroviral therapy (cART) era. The aim of the present study was to compare the characteristics, the response to treatment and the survival of advanced-stage cHL treated with adriamycin, bleomycin, vinblastine and dacarbazine (ABVD) between cART-treated HIV-positive and HIV-negative patients. We retrospectively analyzed advanced-stage cHL patients from a single institution, uniformly treated with ABVD. All HIV-positive patients received cART concomitantly with ABVD. A total of 69 patients were included in the study: 21 were HIV-positive and 48 were HIV-negative. HIV-positive patients had more aggressive features at cHL diagnosis, such as worse performance status, more frequent bone marrow involvement and mixed cellularity histologic subtype. There were no differences in complete response rate (89% in HIV-positive vs. 91% in HIV-negative), P = 1; disease-free survival (DFS) [10-year DFS probability (95% CI) 70% (41-99%) vs. 74% (57-91%)], P = 0.907 and overall survival (OS) [10-year OS probability (95% CI) 73% (52-94%) vs. 68% (51-85%)], P = 0.904. On multivariate analysis, HIV infection did not correlate with worse OS. Although HIV-positive patients with cHL had more aggressive baseline features in this series, there were no differences in response rate or survival between HIV-positive and HIV-negative patients.

Liquid Oxygen/Liquid Methane Propulsion and Cryogenic Advanced Development

NASA Technical Reports Server (NTRS)

Klem, Mark D.; Smith, Timothy D.; Wadel, Mary F.; Meyer, Michael L.; Free, James M.; Cikanek, Harry A., III

2011-01-01

Exploration Systems Architecture Study conducted by NASA in 2005 identified the liquid oxygen (LOx)/liquid methane (LCH4) propellant combination as a prime candidate for the Crew Exploration Vehicle Service Module propulsion and for later use for ascent stage propulsion of the lunar lander. Both the Crew Exploration Vehicle and Lunar Lander were part the Constellation architecture, which had the objective to provide global sustained lunar human exploration capability. From late 2005 through the end of 2010, NASA and industry matured advanced development designs for many components that could be employed in relatively high thrust, high delta velocity, pressure fed propulsion systems for these two applications. The major investments were in main engines, reaction control engines, and the devices needed for cryogenic fluid management such as screens, propellant management devices, thermodynamic vents, and mass gauges. Engine and thruster developments also included advanced high reliability low mass igniters. Extensive tests were successfully conducted for all of these elements. For the thrusters and engines, testing included sea level and altitude conditions. This advanced development provides a mature technology base for future liquid oxygen/liquid methane pressure fed space propulsion systems. This paper documents the design and test efforts along with resulting hardware and test results.

Relations Among River Stage, Rainfall, Ground-Water Levels, and Stage at Two Missouri River Flood-Plain Wetlands

USGS Publications Warehouse

Kelly, Brian P.

2001-01-01

The source of water is important to the ecological function of Missouri River flood-plain wetlands. There are four potential sources of water to flood-plain wetlands: direct flow from the river channel during high river stage, ground-water movement into the wetlands in response to river-stage changes and aquifer recharge, direct precipitation, and runoff from surrounding uplands. Concurrent measurements of river stage, rainfall, ground-water level, and wetland stage were compared for two Missouri River flood-plain wetlands located near Rocheport, Missouri, to characterize the spatial and temporal relations between river stage, rainfall, ground-water levels and wetland stage, determine the source of water to each wetland, and compare measured and estimated stage and ground-water levels at each site. The two sites chosen for this study were wetland NC-5, a non-connected, 50 feet deep scour constantly filled with water, formed during the flood of 1993, and wetland TC-1, a shallow, temporary wetland intermittently filled with water. Because these two wetlands bracket a range of wetland types of the Missouri River flood plain, the responses of other Missouri River wetlands to changes in river stage, rainfall, and runoff should be similar to the responses exhibited by wetlands NC-5 and TC-1. For wetlands deep enough to intersect the ground-water table in the alluvial aquifer, such as wetland NC-5, the ground-water response factor can estimate flood-plain wetland stage changes in response to known river-stage changes. Measured maximum stage and ground-water-level changes at NC-5 fall within the range of estimated changes using the ground-water response factor. Measured maximum ground-water-level changes at TC-1 are similar to, but consistently greater than the estimated values, and are most likely the result of alluvial deposits with higher than average hydraulic conductivity located between wetland TC-1 and the Missouri River. Similarity between ground-water level and

Study of blade aspect ratio on a compressor front stage aerodynamic and mechanical design report

NASA Technical Reports Server (NTRS)

Burger, G. D.; Lee, D.; Snow, D. W.

1979-01-01

A single stage compressor was designed with the intent of demonstrating that, for a tip speed and hub-tip ratio typical of an advanced core compressor front stage, the use of low aspect ratio can permit high levels of blade loading to be achieved at an acceptable level of efficiency. The design pressure ratio is 1.8 at an adiabatic efficiency of 88.5 percent. Both rotor and stator have multiple-circular-arc airfoil sections. Variable IGV and stator vanes permit low speed matching adjustments. The design incorporates an inlet duct representative of an engine transition duct between fan and high pressure compressor.

High-pressure Experimental Studies on Geo-liquids Using Synchrotron Radiation at the Advanced Photon Source

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Yanbin; Shen, Guoyin

2014-12-23

Here, we review recent progress in studying silicate, carbonate, and metallic liquids of geological and geophysical importance at high pressure and temperature, using the large-volume high-pressure devices at the third-generation synchrotron facility of the Advanced Photon Source, Argonne National Laboratory. These integrated high-pressure facilities now offer a unique combination of experimental techniques that allow researchers to investigate structure, density, elasticity, viscosity, and interfacial tension of geo-liquids under high pressure, in a coordinated and systematic fashion. Moreover, we describe experimental techniques, along with scientific highlights. Future developments are also discussed.

Risk factors for competing noncancer mortality after definitive treatment for advanced-stage head and neck cancer.

PubMed

Kim, Yong Han; Roh, Jong-Lyel; Kim, Sung-Bae; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon

2018-05-27

Patients with head and neck cancer (HNC) can die of index tumor progression and second tumor or noncancer causes. Here, we investigated the risk factors for competing noncancer mortality (NCM) in a prospective cohort of patients with advanced-stage HNC. A prospective observational study was conducted with 604 patients who underwent definitive treatment for advanced-stage HNC between 2010 and 2015. Main outcomes were NCM and cancer mortality (CM) defined as death from noncancer causes and HNC or second cancers, respectively. Cumulative incidence and cause-specific hazard functions were used to analyze the risk factors of NCM and CM. Age, smoking, Charlson comorbidity index (CCI), performance status, body mass index, rural residence, education and hemoglobin level at diagnosis, and chemotherapy were significantly associated with NCM (all P<0.05). Multivariate analyses showed that age, CCI, and hemoglobin were independent factors of NCM. Age (≥65 years), CCI (≥2), and hemoglobin (<11 g/dL) were related to 4.5-, 3.2-, and 2.7-fold increased adjusted risk of NCM, respectively. Old age, comorbidity, and hemoglobin at diagnosis were independent predictors of NCM. The risk factors could be used to predict noncancer death after definitive treatment for advanced-stage HNC. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Anterior Urethral Advancement as a Single-Stage Technique for Repair of Anterior Hypospadias: Our Experience.

PubMed

Gite, Venkat A; Nikose, Jayant V; Bote, Sachin M; Patil, Saurabh R

2017-07-02

Many techniques have been described to correct anterior hypospadias with variable results. Anterior urethral advancement as one stage technique was first described by Ti Chang Shing in 1984. It was also used for the repair of strictures and urethrocutaneous fistulae involving distal urethra. We report our experience of using this technique with some modification for the repair of anterior hypospadias. In the period between 2013-2015, 20 cases with anterior hypospadias including 2 cases of glanular, 3 cases of coronal, 12 cases of subcoronal and 3 cases of distal penile hypospadias were treated with anterior urethral advancement technique. Patients' age groups ranged from 18 months to 10 years. Postoperatively, patients were passing urine from tip of neomeatus with satisfactory stream during follow up period of 6 months to 2 years. There were no major complications in any of our patients except in one patient who developed meatal stenosis which was treated by periodic dilatation. Three fold urethral mobilization was sufficient in all cases. Anterior urethral advancement technique is a single-stage procedure with good cosmetic results and least complications for anterior hypospadias repair in properly selected cases.

Perioperative BRAF inhibitors in locally advanced stage III melanoma.

PubMed

Zippel, Douglas; Markel, Gal; Shapira-Frommer, Roni; Ben-Betzalel, Guy; Goitein, David; Ben-Ami, Eytan; Nissan, Aviram; Schachter, Jacob; Schneebaum, Schlomo

2017-12-01

Stage III malignant melanoma is a heterogeneous disease where those cases deemed marginally resectable or irresecatble are frequently incurable by surgery alone. Targeted therapy takes advantage of the high incidence of BRAF mutations in melanomas, most notably the V600E mutation. These agents have rarely been used in a neoadjuvant setting prior to surgery. Thirteen consecutive patients with confirmed BRAF V600E regionally advanced melanoma deemed marginally resectable or irrresectable, were treated with BRAF inhibiting agents, prior to undergoing surgery. The primary outcome measures were a successful resection and pathological response. Disease-free survival was a secondary outcome measure. Overall, 12/13 patients showed a marked clinical responsiveness to medical treatment, enabling a macroscopically successful resection in all cases. Four patients had a complete pathological response with no viable tumor evident in the resected specimens and eight patients showed evidence of minimally residual tumor with extensive tumoral necrosis and fibrosis. One patient progressed and died before surgery. At a median follow up of 20 months, 10 patients remain free of disease. Perioperative treatment with BRAF inhibiting agents in BRAFV600E mutated Stage III melanoma patients facilitates surgical resection and affords satisfactory disease free survival. © 2017 Wiley Periodicals, Inc.

EVALUATION OF A TWO-STAGE PASSIVE TREATMENT APPROACH FOR MINING INFLUENCE WATERS

EPA Science Inventory

A two-stage passive treatment approach was assessed at bench-scale using two Colorado Mining Influenced Waters (MIWs). The first-stage was a limestone drain with the purpose of removing iron and aluminum and mitigating the potential effects of mineral acidity. The second stage w...

Development and validation of a clinically applicable score to classify cachexia stages in advanced cancer patients

PubMed Central

Zhou, Ting; Wang, Bangyan; Liu, Huiquan; Yang, Kaixiang; Thapa, Sudip; Zhang, Haowen; Li, Lu

2018-01-01

Abstract Background Cachexia is a multifactorial syndrome that is highly prevalent in advanced cancer patients and leads to progressive functional impairments. The classification of cachexia stages is essential for diagnosing and treating cachexia. However, there is a lack of simple tools with good discrimination for classifying cachexia stages. Therefore, our study aimed to develop a clinically applicable cachexia staging score (CSS) and validate its discrimination of clinical outcomes for different cachexia stages. Methods Advanced cancer patients were enrolled in our study. A CSS comprising the following five components was developed: weight loss, a simple questionnaire of sarcopenia (SARC‐F), Eastern Cooperative Oncology Group, appetite loss, and abnormal biochemistry. According to the CSS, patients were classified into non‐cachexia, pre‐cachexia, cachexia, and refractory cachexia stages, and clinical outcomes were compared among the four groups. Results Of the 297 participating patients, data from 259 patients were ultimately included. Based on the CSS, patients were classified into non‐cachexia (n = 69), pre‐cachexia (n = 68), cachexia (n = 103), and refractory cachexia (n = 19) stages. Patients with more severe cachexia stages had lower skeletal muscle indexes (P = 0.002 and P = 0.004 in male and female patients, respectively), higher prevalence of sarcopenia (P = 0.017 and P = 0.027 in male and female patients, respectively), more severe symptom burden (P < 0.001), poorer quality of life (P < 0.001 for all subscales except social well‐being), and shorter survival times (P < 0.001). Conclusions The CSS is a simple and clinically applicable tool with excellent discrimination for classifying cachexia stages. This score is extremely useful for the clinical treatment and prognosis of cachexia and for designing clinical trials. PMID:29372594

Method and apparatus for removing coarse unentrained char particles from the second stage of a two-stage coal gasifier

DOEpatents

Donath, Ernest E.

1976-01-01

A method and apparatus for removing oversized, unentrained char particles from a two-stage coal gasification process so as to prevent clogging or plugging of the communicating passage between the two gasification stages. In the first stage of the process, recycled process char passes upwardly while reacting with steam and oxygen to yield a first stage synthesis gas containing hydrogen and oxides of carbon. In the second stage, the synthesis gas passes upwardly with coal and steam which react to yield partially gasified char entrained in a second stage product gas containing methane, hydrogen, and oxides of carbon. Agglomerated char particles, which result from caking coal particles in the second stage and are too heavy to be entrained in the second stage product gas, are removed through an outlet in the bottom of the second stage, the particles being separated from smaller char particles by a counter-current of steam injected into the outlet.

Preoperative tumour staging with multidisciplinary team assessment improves the outcome in locally advanced primary rectal cancer.

PubMed

Palmer, G; Martling, A; Cedermark, B; Holm, T

2011-12-01

Multidisciplinary team meetings have been introduced as a result of developments in preoperative radiological tumour staging and neoadjuvant treatment. Multidisciplinary team recommendations will influence treatment decisions but their effect on patient outcome is unknown. The aim of this study was to assess outcome in relation to preoperative local and distant staging, with or without multidisciplinary team assessment. A population-based registry of all patients with rectal cancer, treated in the Stockholm region from 1995 to 2004, identified 303 patients with locally advanced primary rectal cancer. The patients were classified into three groups: group 1, preoperative local and distant radiological tumour staging with discussion at a multidisciplinary team meeting; group 2, preoperative staging but no multidisciplinary team assessment; and group 3, no proper preoperative radiological staging. Neoadjuvant treatment was more prevalent in groups 1 and 2 than in group 3. The incidence of R0 resection differed significantly between the groups (52% in group 1, 43% in group 2 and 21% in group 3; P < 0.001). Local tumour control was achieved in 57%, 36%, and 19% of patients in groups 1, 2 and 3, respectively (P < 0.001). The estimated overall 5-year survival of patients was 30%, 28% and 12% in groups 1, 2 and 3, respectively. Preoperative radiological tumour staging in patients with locally advanced primary rectal cancer and discussion at a multidisciplinary team meeting increases the proportion of patients receiving neoadjuvant treatment and cancer-specific end-points. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study

PubMed Central

Zietsman, Annelle; Galukande, Moses; Anele, Angelica; Adisa, Charles; Parham, Groesbeck; Pinder, Leeya; Cubasch, Herbert; Joffe, Maureen; Kidaaga, Frederick; Lukande, Robert; Offiah, Awa U.; Egejuru, Ralph O.; Shibemba, Aaron; Schuz, Joachim; Anderson, Benjamin O.; dos Santos Silva, Isabel; McCormack, Valerie

2017-01-01

Breast cancer (BC) survival rates in sub‐Saharan Africa (SSA) are low in part due to advanced stage at diagnosis. As one component of a study of the entire journey of SSA women with BC, we aimed to identify shared and setting‐specific drivers of advanced stage BC. Women newly diagnosed in the multicountry African Breast Cancer–Disparities in Outcomes (ABC‐DO) study completed a baseline interview and their stage information was extracted from medical records. Ordinal logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for advanced stage (I, II, III, IV) in relation to individual woman‐level, referral and biological factors. A total of 1795 women were included from Nigeria, Uganda, Zambia, and the multiracial populations of Namibia and South Africa, 1091 of whom (61%) were stage III/IV. Stage was lower in women with greater BC knowledge (OR 0.77 (95% CI: 0.70, 0.85) per point on a 6 point scale). More advanced stage was associated with being black (4.00 (2.79, 5.74)), having attended stage BC in SSA is largely attributed to modifiable factors and strategies to improve BC education and awareness in women and the health system should be intensified. PMID:29197068

Online two-stage association method for robust multiple people tracking

NASA Astrophysics Data System (ADS)

Lv, Jingqin; Fang, Jiangxiong; Yang, Jie

2011-07-01

Robust multiple people tracking is very important for many applications. It is a challenging problem due to occlusion and interaction in crowded scenarios. This paper proposes an online two-stage association method for robust multiple people tracking. In the first stage, short tracklets generated by linking people detection responses grow longer by particle filter based tracking, with detection confidence embedded into the observation model. And, an examining scheme runs at each frame for the reliability of tracking. In the second stage, multiple people tracking is achieved by linking tracklets to generate trajectories. An online tracklet association method is proposed to solve the linking problem, which allows applications in time-critical scenarios. This method is evaluated on the popular CAVIAR dataset. The experimental results show that our two-stage method is robust.

Two technicians apply insulation to S-II second stage

NASA Technical Reports Server (NTRS)

1964-01-01

Two technicians apply insulation to the outer surface of the S-II second stage booster for the Saturn V moon rocket. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

The effects of RN staffing hours on nursing home quality: a two-stage model.

PubMed

Lee, Hyang Yuol; Blegen, Mary A; Harrington, Charlene

2014-03-01

Based on structure-process-outcome approach, this study examined the association of registered nurse (RN) staffing hours and five quality indicators, including two process measures (catheter use and antipsychotic drug use) and three outcome measures (pressure ulcers, urinary tract infections, and weight loss). We used data on resident assessments, RN staffing, organizational characteristics, and market factors to examine the quality of 195 nursing homes operating in a rural state of United States - Colorado. Two-stage least squares regression models were performed to address the endogenous relationships between RN staffing and the outcome-related quality indicators, and ordinary least squares regression was used for the process-related ones. This analysis focused on the relationship of RN staffing to nursing home quality indicators, controlling for organizational characteristics, resources, resident casemix, and market factors with clustering to control for geographical differences. Higher RN hours were associated with fewer pressure ulcers, but RN hours were not related to the other quality indicators. The study finding shows the importance of understanding the role of 'nurse staffing' under nursing home care, as well as the significance of associated/contextual factors with nursing home quality even in a small rural state. Copyright © 2013 Elsevier Ltd. All rights reserved.

Two-stage color palettization for error diffusion

NASA Astrophysics Data System (ADS)

Mitra, Niloy J.; Gupta, Maya R.

2002-06-01

Image-adaptive color palettization chooses a decreased number of colors to represent an image. Palettization is one way to decrease storage and memory requirements for low-end displays. Palettization is generally approached as a clustering problem, where one attempts to find the k palette colors that minimize the average distortion for all the colors in an image. This would be the optimal approach if the image was to be displayed with each pixel quantized to the closest palette color. However, to improve the image quality the palettization may be followed by error diffusion. In this work, we propose a two-stage palettization where the first stage finds some m << k clusters, and the second stage chooses palette points that cover the spread of each of the M clusters. After error diffusion, this method leads to better image quality at less computational cost and with faster display speed than full k-means palettization.

Development of a two-stage light gas gun to accelerate hydrogen pellets to high speeds for plasma fueling applications

NASA Astrophysics Data System (ADS)

Combs, S. K.; Milora, S. L.; Foust, C. R.; Gouge, M. J.; Fehling, D. T.; Sparks, D. O.

1988-08-01

The development of a two-stage light gas gun to accelerate hydrogen isotope pellets to high speeds is under way at Oak Ridge National Laboratory. High velocities are desirable for plasma fueling applications, since the faster pellets can penetrate more deeply into large, hot plasmas and deposit atoms of fuel directly in a larger fraction of the plasma volume. In the initial configuration of the two-stage device, a 2.2-l volume provides the gas to accelerate a 25.4-mm-diam piston in a 1-m-long pump tube; a burst disk or a fast valve initiates the acceleration process in the first stage. As the piston travels the length of the pump tube, the downstream gas is compressed (to pressures up to 2600 bar) and thus is driven to high temperature (approx. 5000 K). This provides the driving force for acceleration of a 4-mm pellet in a 1-m-long gun barrel. In preliminary tests using helium as the driver in both stages, 35-mg plastic pellets have been accelerated to speeds as high as 3.8 km/s. Projectiles composed of hydrogen ice will have a mass in the range from 5 to 20 mg. However, the use of sabots to encase and protect the cryogenic pellets from the high peak pressures will probably be required to realize speeds of approx. 3 km/s or greater. The experimental plan includes acceleration of hydrogen isotopes as soon as the gun geometry and operating parameters are optimized; theoretical models are being used to aid in this process. The hardware is being designed to accommodate repetitive operation, which is the objective of this research and is required for future applications.

Advanced Launch Vehicle Upper Stages Using Liquid Propulsion and Metallized Propellants

NASA Technical Reports Server (NTRS)

Palaszewski, Bryan A.

1990-01-01

Metallized propellants are liquid propellants with a metal additive suspended in a gelled fuel or oxidizer. Typically, aluminum (Al) particles are the metal additive. These propellants provide increase in the density and/or the specific impulse of the propulsion system. Using metallized propellant for volume-and mass-constrained upper stages can deliver modest increases in performance for low earth orbit to geosynchronous earth orbit (LEO-GEO) and other earth orbital transfer missions. Metallized propellants, however, can enable very fast planetary missions with a single-stage upper stage system. Trade studies comparing metallized propellant stage performance with non-metallized upper stages and the Inertial Upper Stage (IUS) are presented. These upper stages are both one- and two-stage vehicles that provide the added energy to send payloads to altitudes and onto trajectories that are unattainable with only the launch vehicle. The stage designs are controlled by the volume and the mass constraints of the Space Transportation System (STS) and Space Transportation System-Cargo (STS-C) launch vehicles. The influences of the density and specific impulse increases enabled by metallized propellants are examined for a variety of different stage and propellant combinations.

Initial stages of oxide formation on the Zr surface at low oxygen pressure: An in situ FIM and XPS study

PubMed Central

Bespalov, I.; Datler, M.; Buhr, S.; Drachsel, W.; Rupprechter, G.; Suchorski, Y.

2015-01-01

An improved methodology of the Zr specimen preparation was developed which allows fabrication of stable Zr nanotips suitable for FIM and AP applications. Initial oxidation of the Zr surface was studied on a Zr nanotip by FIM and on a polycrystalline Zr foil by XPS, both at low oxygen pressure (10−8–10−7 mbar). The XPS data reveal that in a first, fast stage of oxidation, a Zr suboxide interlayer is formed which contains three suboxide components (Zr+1, Zr+2 and Zr+3) and is located between the Zr surface and a stoichiometric ZrO2 overlayer that grows in a second, slow oxidation stage. The sole suboxide layer has been observed for the first time at very early states of the oxidation (oxygen exposure ≤4 L). The Ne+ FIM observations are in accord with a two stage process of Zr oxide formation. PMID:25766998

Palliative management of pressure ulcers and malignant wounds in patients with advanced illness.

PubMed

McDonald, Amy; Lesage, Pauline

2006-04-01

Pressure ulcers and malignant wounds are prevalent in populations with advanced illness. In these populations, the goals of care may shift from a primary focus on healing to a focus on wound management, palliation and comfort. Many complications associated with these wounds must be palliated. This review explores the palliative approach to managing pressure ulcers and malignant wounds in patients with advanced illness. A comprehensive search of MEDLINE, CINAHL, and Cochrane Databases for articles addressing wound management and palliation was performed. We also reviewed online wound care resources and textbooks related to the field. The key to good wound care is prevention if possible, ongoing wound assessment, correct choice of dressing and use of available adjuvant therapies. The ultimate goals of palliative wound care are to control pain, to manage infection, odor, bleeding, and exudate, and to maintain a good quality of life for the patient and caregiver.

Numerical simulation and analysis of the flow in a two-staged axial fan

NASA Astrophysics Data System (ADS)

Xu, J. Q.; Dou, H. S.; Jia, H. X.; Chen, X. P.; Wei, Y. K.; Dong, M. W.

2016-05-01

In this paper, numerical simulation was performed for the internal three-dimensional turbulent flow field in the two-stage axial fan using steady three-dimensional in-compressible Navier-Stokes equations coupled with the Realizable turbulent model. The numerical simulation results of the steady analysis were combined with the flow characteristics of two- staged axial fan, the influence of the mutual effect between the blade and the vane on the flow of the two inter-stages was analyzed emphatically. This paper studied how the flow field distribution in inter-stage is influenced by the wake interaction and potential flow interaction of mutual effect in the impeller-vane inter-stage and the vane-impeller inter-stage. The results showed that: Relatively, wake interaction has an advantage over potential flow interaction in the impeller-vane inter-stage; potential flow interaction has an advantage over wake interaction in the vane-impeller inter-stage. In other words, distribution of flow field in the two interstages is determined by the rotating component.

Two-stage plasma gun based on a gas discharge with a self-heating hollow emitter.

PubMed

Vizir, A V; Tyunkov, A V; Shandrikov, M V; Oks, E M

2010-02-01

The paper presents the results of tests of a new compact two-stage bulk gas plasma gun. The plasma gun is based on a nonself-sustained gas discharge with an electron emitter based on a discharge with a self-heating hollow cathode. The operating characteristics of the plasma gun are investigated. The discharge system makes it possible to produce uniform and stable gas plasma in the dc mode with a plasma density up to 3x10(9) cm(-3) at an operating gas pressure in the vacuum chamber of less than 2x10(-2) Pa. The device features high power efficiency, design simplicity, and compactness.

Functional Impairment of Myeloid Dendritic Cells during Advanced Stage of HIV-1 Infection: Role of Factors Regulating Cytokine Signaling.

PubMed

Sachdeva, Meenakshi; Sharma, Aman; Arora, Sunil K

2015-01-01

Severely immunocompromised state during advanced stage of HIV-1 infection has been linked to functionally defective antigen presentation by dendritic cells (DCs). The molecular mechanisms behind DC impairment are still obscure. We investigated changes in DC function and association of key regulators of cytokine signaling during different stages of HIV-1 infection and following antiretroviral therapy (ART). Phenotypic and functional characteristics of circulating myeloid DCs (mDCs) in 56 ART-naive patients (23 in early and 33 in advanced stage of disease), 36 on ART and 24 healthy controls were evaluated. Sixteen patients were studied longitudinally prior-to and 6 months after the start of ART. For functional studies, monocyte-derived DCs (Mo-DCs) were evaluated for endocytosis, allo-stimulation and cytokine secretion. The expression of suppressor of cytokine signaling (SOCS)-1 and other regulators of cytokine signaling was evaluated by real-time RT-PCR. The ability to respond to an antigenic stimulation was severely impaired in patients in advanced HIV-1 disease which showed partial recovery in the treated group. Mo-DCs from patients with advanced HIV-disease remained immature with low allo-stimulation and reduced cytokine secretion even after TLR-4 mediated stimulation ex-vivo. The cells had an increased expression of negative regulatory factors like SOCS-1, SOCS-3, SH2-containing phosphatase (SHP)-1 and a reduced expression of positive regulators like Janus kinase (JAK)2 and Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB)1. A functional recovery after siRNA mediated silencing of SOCS-1 in these mo-DCs confirms the role of negative regulatory factors in functional impairment of these cells. Functionally defective DCs in advanced stage of HIV-1 infection seems to be due to imbalanced state of negative and positive regulatory gene expression. Whether this is a cause or effect of increased viral replication at this stage of disease, needs

The Role of Free-Stream Turbulence on High Pressure Turbine Aero-Thermal Stage Interaction

NASA Astrophysics Data System (ADS)

Kopriva, James Earl

Turbulence plays an important role on the aero-thermal performance of modern aircraft engine High Pressure Turbines (HPT). The role of the vane wake and passage turbulence on the downstream blade flow field is an important consideration for both performance and durability. Obtaining measurements to fully characterize the flow field can be challenging and costly in an experimental facility. Advances in computational Fluid Dynamic (CFD) modeling and High Performance Computing (HPC) are providing opportunity to close these measurement gaps. In order for CFD to be adopted, methods need to be both accurate and efficient. Meshing approaches must also be able to resolve complex HPT geometry while maintaining quality adequate for scale-resolved simulations. Therefore, the accuracy of executing scale-resolved simulations with a second-order code on a mesh of prisms and tetrahedrals in Fluent is considered. Before execution of the HPT computational study, a building block approach is taken to gain quantified predictive performance in the modeling approach as well as understanding limitations in lower computational cost modeling approaches. The predictive capability for Reynolds Averaged Navier Stokes (RANS), Hybrid Large Eddy Simulation (LES), and wall-resolved LES turbulence modeling approaches are first assessed for a cylinder in cross-flow at a Reynolds number of 2580. The flow condition and simple geometry facilitate a quick turn-around for modeling assessment before moving the HPT vane study at high Reynolds and Mach number conditions. Modeling approaches are then assessed relative to the experimental measurements of Arts and Rouvroit (1992) on a pitch-line HPT uncooled vane at high Mach and Reynolds numbers conditions with low (0-6%) free-stream turbulence. The current unstructured second-order LES approach agrees with experimental data and is found to be within the equivalent experimental uncertainty when compared to the structured high-ordered solver FDL3DI. The

[Modified two-stage surgery for total auriculoplasty with autogenous rib cartilage].

PubMed

Zhang, Zheng-wen; Kang, Shen-song; Xie, Feng; Ma, Teng-xiao; Li, Lei; Zhai, Hong-feng; Chou, Hai-yan; Li, Hao; Zhong, Ai-mei; Zhang, Dong-yi

2011-09-01

To introduce a modified surgery for total auriculoplasty and the experience in one hundred and forty-six cases (155 ears). The procedure was a two-stage operation. The first stage involved fabrication and grafting of a costal cartilage framework. A U-shaped skin incision was made on the posterior edge of the lobule and the remnant ear cartilage was removed completely. The area for the insertion of the cartilage framework was undermined. Skin flaps were sutured after insertion of the cartilage framework. The second-stage surgery was usually performed six months after the first-stage operation. The reconstructed auricle was elevated, and a costal cartilage block was fixed to the posterior part of the auricle. A temporoparietal fascia flap was then used to cover the costal cartilage block. Finally, the posterior aspect of the projected auricle was covered with a spit-thickness skin graft. The incisions healed in one hundred and forty-one patients (150 ears) after the first stage operation. Partial necrosis of the postauricular flap was observed in five cases (5 ears) after the first stage operation, but no exposure or absorption of the cartilage took place. The skin grafts survived in one hundred and thirty-nine cases (147 ears) after the second-stage surgery. Partial necrosis of the skin graft was observed in seven cases (8 ears), but healed after one-week of dressing changes. Ninety-four cases (97 ears) were followed up, but fifty-two cases (58 ears) were lost to follow up. The follow-up at six months to two years showed satisfactory contour and projection of the constructed ears. This two-stage surgery is simple and ideal for auricloplasty with few complications.

A Randomized Trial Comparing Two Tongue-Pressure Resistance Training Protocols for Post-Stroke Dysphagia.

PubMed

Steele, Catriona M; Bayley, Mark T; Peladeau-Pigeon, Melanie; Nagy, Ahmed; Namasivayam, Ashwini M; Stokely, Shauna L; Wolkin, Talia

2016-06-01

The objective of this study was to compare the outcomes of two tongue resistance training protocols. One protocol ("tongue-pressure profile training") emphasized the pressure-timing patterns that are typically seen in healthy swallows by focusing on gradual pressure release and saliva swallowing tasks. The second protocol ("tongue-pressure strength and accuracy training") emphasized strength and accuracy in tongue-palate pressure generation and did not include swallowing tasks. A prospective, randomized, parallel allocation trial was conducted. Of 26 participants who were screened for eligibility, 14 received up to 24 sessions of treatment. Outcome measures of posterior tongue strength, oral bolus control, penetration-aspiration and vallecular residue were made based on videofluoroscopy analysis by blinded raters. Complete data were available for 11 participants. Significant improvements were seen in tongue strength and post-swallow vallecular residue with thin liquids, regardless of treatment condition. Stage transition duration (a measure of the duration of the bolus presence in the pharynx prior to swallow initiation, which had been chosen to capture impairments in oral bolus control) showed no significant differences. Similarly, significant improvements were not seen in median scores on the penetration-aspiration scale. This trial suggests that tongue strength can be improved with resistance training for individuals with tongue weakness following stroke. We conclude that improved penetration-aspiration does not necessarily accompany improvements in tongue strength; however, tongue-pressure resistance training does appear to be effective for reducing thin liquid vallecular residue.

An adaptive two-stage sequential design for sampling rare and clustered populations

USGS Publications Warehouse

Brown, J.A.; Salehi, M.M.; Moradi, M.; Bell, G.; Smith, D.R.

2008-01-01

How to design an efficient large-area survey continues to be an interesting question for ecologists. In sampling large areas, as is common in environmental studies, adaptive sampling can be efficient because it ensures survey effort is targeted to subareas of high interest. In two-stage sampling, higher density primary sample units are usually of more interest than lower density primary units when populations are rare and clustered. Two-stage sequential sampling has been suggested as a method for allocating second stage sample effort among primary units. Here, we suggest a modification: adaptive two-stage sequential sampling. In this method, the adaptive part of the allocation process means the design is more flexible in how much extra effort can be directed to higher-abundance primary units. We discuss how best to design an adaptive two-stage sequential sample. ?? 2008 The Society of Population Ecology and Springer.

MRI helps depict clinically undetectable risk factors in advanced stage retinoblastomas.

PubMed

Galluzzi, Paolo; Hadjistilianou, Theodora; Cerase, Alfonso; Toti, Paolo; Leonini, Sara; Bracco, Sandra; de Francesco, Sonia; Galimberti, Daniela; Balducci, Donatella; Piu, Pietro; Monti, Lucia; Bellini, Matteo; Caini, Mauro; Rossi, Alessandro

2015-02-01

This study compared high-resolution MRI with histology in advanced stage retinoblastomas in which ophthalmoscopy and ultrasonography did not give an exhaustive depiction of the tumour and/or its extension. MRI of orbits and head in 28 retinoblastoma patients (28 eyes) treated with primary enucleation were evaluated. Iris neoangiogenesis, infiltrations of optic nerve, choroid, anterior segment and sclera suspected at MR and histology were compared. Abnormal anterior segment enhancement (AASE) was also correlated with histologically proven infiltrations. Brain images were also evaluated. Significant values were obtained for: prelaminar optic nerve (ON) sensitivity (0.88), positive predictive value (PPV) (0.75) and negative predictive value (NPV) (0.71); post-laminar ON sensitivity (0.50), specificity (0.83), PPV (0.50) and NPV (0.83); overall choroid sensitivity (0.82), and massive choroid NPV (0.69); scleral specificity (1), and NPV (1). AASE correlated with iris neoangiogenesis in 14 out of 19 eyes, and showed significant values for: overall ON PPV (0.65), prelaminar ON sensitivity (0.65), and PPV (0.61), post-laminar ON NPV (0.64); overall choroid sensitivity (0.77), PPV (0.59) and NPV (0.73); scleral NPV (0.83); anterior segment sensitivity (1), and NPV (1). Odds ratios (OR) and accuracy were significant in scleral and prelaminar optic nerve infiltration. Brain examination was unremarkable in all cases. High-resolution MRI may add important findings to clinical evaluation of advanced stage retinoblastomas. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

Advanced Computational Modeling of Vapor Deposition in a High-Pressure Reactor

NASA Technical Reports Server (NTRS)

Cardelino, Beatriz H.; Moore, Craig E.; McCall, Sonya D.; Cardelino, Carlos A.; Dietz, Nikolaus; Bachmann, Klaus

2004-01-01

In search of novel approaches to produce new materials for electro-optic technologies, advances have been achieved in the development of computer models for vapor deposition reactors in space. Numerical simulations are invaluable tools for costly and difficult processes, such as those experiments designed for high pressures and microgravity conditions. Indium nitride is a candidate compound for high-speed laser and photo diodes for optical communication system, as well as for semiconductor lasers operating into the blue and ultraviolet regions. But InN and other nitride compounds exhibit large thermal decomposition at its optimum growth temperature. In addition, epitaxy at lower temperatures and subatmospheric pressures incorporates indium droplets into the InN films. However, surface stabilization data indicate that InN could be grown at 900 K in high nitrogen pressures, and microgravity could provide laminar flow conditions. Numerical models for chemical vapor deposition have been developed, coupling complex chemical kinetics with fluid dynamic properties.

Advanced Computational Modeling of Vapor Deposition in a High-pressure Reactor

NASA Technical Reports Server (NTRS)

Cardelino, Beatriz H.; Moore, Craig E.; McCall, Sonya D.; Cardelino, Carlos A.; Dietz, Nikolaus; Bachmann, Klaus

2004-01-01

In search of novel approaches to produce new materials for electro-optic technologies, advances have been achieved in the development of computer models for vapor deposition reactors in space. Numerical simulations are invaluable tools for costly and difficult processes, such as those experiments designed for high pressures and microgravity conditions. Indium nitride is a candidate compound for high-speed laser and photo diodes for optical communication system, as well as for semiconductor lasers operating into the blue and ultraviolet regions. But InN and other nitride compounds exhibit large thermal decomposition at its optimum growth temperature. In addition, epitaxy at lower temperatures and subatmospheric pressures incorporates indium droplets into the InN films. However, surface stabilization data indicate that InN could be grown at 900 K in high nitrogen pressures, and microgravity could provide laminar flow conditions. Numerical models for chemical vapor deposition have been developed, coupling complex chemical kinetics with fluid dynamic properties.

On the possibility to develop an advanced non-equilibrium model of depressurisation in two-phase fluids

NASA Astrophysics Data System (ADS)

Duc, Linh Do; Horák, Vladimír; Kulish, Vladimir; Lukáč, Tomáš

2017-01-01

Carbon dioxide is widely used as the power gas in the gas guns community due to its ease of handling, storability at room temperature, and high vapor pressure depending only upon temperature, but not a tank size, as long as some liquid carbon dioxide remains in the tank. This high vapor pressure can be used as the pressurant, making it what is referred to as a self-pressurising propellant. However, as a two-phase substance, carbon dioxide does have its drawbacks: (1) vaporization of liquefied CO2 inside a tank when shooting rapidly or a lot causes the tank to get cool, resulting in pressure fluctuations that makes the gun's performance and accuracy worse, (2) solid carbon dioxide that is also known as dry ice can appear on the output valve of the tank while shooting and it can cause damage or slow the gun's performance down, if it works its way into some control components, including the barrel of the gun. Hence, it is crucial to obtain a scientific understanding of carbon dioxide behavior and further the discharge characteristics of a wide range of pressure-tank configurations. For the purpose of satisfying this goal, a comprehensive discharge mathematical model for carbon dioxide tank dynamics is required. In this paper, the possibility to develop an advanced non-equilibrium model of depressurization in two-phase fluids is discussed.

Locally advanced breast cancer in Saudi Arabia: high frequency of stage III in a young population.

PubMed

Ezzat, A A; Ibrahim, E M; Raja, M A; Al-Sobhi, S; Rostom, A; Stuart, R K

1999-07-01

In the Kingdom of Saudi Arabia (KSA), breast cancer constitutes 18% of all cancers in Saudi women. Whilst locally advanced breast cancer disease is unusual in Western countries, it constitutes more than 40% of all non-metastatic breast cancer in KSA. The relative frequency of locally advanced disease among our breast cancer population and the lack of a uniform consensus in the literature about its optimal management have prompted this retrospective analysis of the medical records of patients with Stage III breast cancer patients seen at King Faisal Specialist Hospital and Research Center between 1981 and 1991. In all, 315 patients were identified. Their median age +/- SD was 46 +/- 11.6 years which is distinctly different from the 60-65 years median age in industrial Western nations. Most patients were younger than 50 years (64%) and premenopausal (62%). Patients were approximately equally divided between Stage IIIA and Stage III B. Patients received multimodality treatment, including surgery, adjuvant chemotherapy, tamoxifen, and adjuvant radiotherapy. Sixty-one patients were excluded from survival analysis as they were considered lost to follow-up. Of the remaining 254 patients, 73 (29%) were alive and disease free, and 18 patients (7%) were alive but with evidence of the disease. The remaining 163 (64%) had died from breast cancer or its related complications. Their median overall survival (OS) was 54 months, (95% CI, 27 to 121 months) and the median progression-free survival (PFS) was 28.8 months (95% CI, 14.2 to 113 months). Cox proportional hazard model identified Stage III B and the number of positive axillary lymph nodes as poor predictors of OS and PFS. Radiotherapy was the only adjuvant modality that affected survival favourably. The prognosis of patients with Stage III disease remains poor despite the use of a multimodality approach. The overall young age of our patients may have contributed to the poor outcome. Moreover, the adverse effect of Stage III

A two-stage linear discriminant analysis via QR-decomposition.

PubMed

Ye, Jieping; Li, Qi

2005-06-01

Linear Discriminant Analysis (LDA) is a well-known method for feature extraction and dimension reduction. It has been used widely in many applications involving high-dimensional data, such as image and text classification. An intrinsic limitation of classical LDA is the so-called singularity problems; that is, it fails when all scatter matrices are singular. Many LDA extensions were proposed in the past to overcome the singularity problems. Among these extensions, PCA+LDA, a two-stage method, received relatively more attention. In PCA+LDA, the LDA stage is preceded by an intermediate dimension reduction stage using Principal Component Analysis (PCA). Most previous LDA extensions are computationally expensive, and not scalable, due to the use of Singular Value Decomposition or Generalized Singular Value Decomposition. In this paper, we propose a two-stage LDA method, namely LDA/QR, which aims to overcome the singularity problems of classical LDA, while achieving efficiency and scalability simultaneously. The key difference between LDA/QR and PCA+LDA lies in the first stage, where LDA/QR applies QR decomposition to a small matrix involving the class centroids, while PCA+LDA applies PCA to the total scatter matrix involving all training data points. We further justify the proposed algorithm by showing the relationship among LDA/QR and previous LDA methods. Extensive experiments on face images and text documents are presented to show the effectiveness of the proposed algorithm.

Optimization of engines for a commercial Mach 0.98 transport using advanced turbine cooling methods

NASA Technical Reports Server (NTRS)

Kraft, G. A.; Whitlow, J. B., Jr.

1972-01-01

A study was made of an advanced technology airplane using supercritical aerodynamics. Cruise Mach number was 0.98 at 40,000 feet altitude with a payload of 60,000 pounds and a range of 3000 nautical miles. Separate-flow turbofans were examined parametrically to determine the effect of sea-level-static design turbine-inlet-temperature and noise on takeoff gross weight (TOGW) assuming full-film turbine cooling. The optimum turbine inlet temperature was 2650 F. Two-stage-fan engines, with cruise fan pressure ratio of 2.25, achieved a noise goal of 103.5 EPNdB with todays noise technology while one-stage-fan engines, achieved a noise goal of 98 EPNdB. The take-off gross weight penalty to use the one-stage fan was 6.2 percent.

Two stage treatment of dairy effluent using immobilized Chlorella pyrenoidosa

PubMed Central

2013-01-01

Background Dairy effluents contains high organic load and unscrupulous discharge of these effluents into aquatic bodies is a matter of serious concern besides deteriorating their water quality. Whilst physico-chemical treatment is the common mode of treatment, immobilized microalgae can be potentially employed to treat high organic content which offer numerous benefits along with waste water treatment. Methods A novel low cost two stage treatment was employed for the complete treatment of dairy effluent. The first stage consists of treating the diary effluent in a photobioreactor (1 L) using immobilized Chlorella pyrenoidosa while the second stage involves a two column sand bed filtration technique. Results Whilst NH4+-N was completely removed, a 98% removal of PO43--P was achieved within 96 h of two stage purification processes. The filtrate was tested for toxicity and no mortality was observed in the zebra fish which was used as a model at the end of 96 h bioassay. Moreover, a significant decrease in biological oxygen demand and chemical oxygen demand was achieved by this novel method. Also the biomass separated was tested as a biofertilizer to the rice seeds and a 30% increase in terms of length of root and shoot was observed after the addition of biomass to the rice plants. Conclusions We conclude that the two stage treatment of dairy effluent is highly effective in removal of BOD and COD besides nutrients like nitrates and phosphates. The treatment also helps in discharging treated waste water safely into the receiving water bodies since it is non toxic for aquatic life. Further, the algal biomass separated after first stage of treatment was highly capable of increasing the growth of rice plants because of nitrogen fixation ability of the green alga and offers a great potential as a biofertilizer. PMID:24355316

A two-stage model of fracture of rocks

USGS Publications Warehouse

Kuksenko, V.; Tomilin, N.; Damaskinskaya, E.; Lockner, D.

1996-01-01

In this paper we propose a two-stage model of rock fracture. In the first stage, cracks or local regions of failure are uncorrelated occur randomly throughout the rock in response to loading of pre-existing flaws. As damage accumulates in the rock, there is a gradual increase in the probability that large clusters of closely spaced cracks or local failure sites will develop. Based on statistical arguments, a critical density of damage will occur where clusters of flaws become large enough to lead to larger-scale failure of the rock (stage two). While crack interaction and cooperative failure is expected to occur within clusters of closely spaced cracks, the initial development of clusters is predicted based on the random variation in pre-existing Saw populations. Thus the onset of the unstable second stage in the model can be computed from the generation of random, uncorrelated damage. The proposed model incorporates notions of the kinetic (and therefore time-dependent) nature of the strength of solids as well as the discrete hierarchic structure of rocks and the flaw populations that lead to damage accumulation. The advantage offered by this model is that its salient features are valid for fracture processes occurring over a wide range of scales including earthquake processes. A notion of the rank of fracture (fracture size) is introduced, and criteria are presented for both fracture nucleation and the transition of the failure process from one scale to another.

Two-stage perceptual learning to break visual crowding.

PubMed

Zhu, Ziyun; Fan, Zhenzhi; Fang, Fang

2016-01-01

When a target is presented with nearby flankers in the peripheral visual field, it becomes harder to identify, which is referred to as crowding. Crowding sets a fundamental limit of object recognition in peripheral vision, preventing us from fully appreciating cluttered visual scenes. We trained adult human subjects on a crowded orientation discrimination task and investigated whether crowding could be completely eliminated by training. We discovered a two-stage learning process with this training task. In the early stage, when the target and flankers were separated beyond a certain distance, subjects acquired a relatively general ability to break crowding, as evidenced by the fact that the breaking of crowding could transfer to another crowded orientation, even a crowded motion stimulus, although the transfer to the opposite visual hemi-field was weak. In the late stage, like many classical perceptual learning effects, subjects' performance gradually improved and showed specificity to the trained orientation. We also found that, when the target and flankers were spaced too finely, training could only reduce, rather than completely eliminate, the crowding effect. This two-stage learning process illustrates a learning strategy for our brain to deal with the notoriously difficult problem of identifying peripheral objects in clutter. The brain first learned to solve the "easy and general" part of the problem (i.e., improving the processing resolution and segmenting the target and flankers) and then tackle the "difficult and specific" part (i.e., refining the representation of the target).

A Bayesian-frequentist two-stage single-arm phase II clinical trial design.

PubMed

Dong, Gaohong; Shih, Weichung Joe; Moore, Dirk; Quan, Hui; Marcella, Stephen

2012-08-30

It is well-known that both frequentist and Bayesian clinical trial designs have their own advantages and disadvantages. To have better properties inherited from these two types of designs, we developed a Bayesian-frequentist two-stage single-arm phase II clinical trial design. This design allows both early acceptance and rejection of the null hypothesis ( H(0) ). The measures (for example probability of trial early termination, expected sample size, etc.) of the design properties under both frequentist and Bayesian settings are derived. Moreover, under the Bayesian setting, the upper and lower boundaries are determined with predictive probability of trial success outcome. Given a beta prior and a sample size for stage I, based on the marginal distribution of the responses at stage I, we derived Bayesian Type I and Type II error rates. By controlling both frequentist and Bayesian error rates, the Bayesian-frequentist two-stage design has special features compared with other two-stage designs. Copyright © 2012 John Wiley & Sons, Ltd.

Outcome after associating liver partition and portal vein ligation for staged hepatectomy and conventional two-stage hepatectomy for colorectal liver metastases.

PubMed

Adam, R; Imai, K; Castro Benitez, C; Allard, M-A; Vibert, E; Sa Cunha, A; Cherqui, D; Baba, H; Castaing, D

2016-10-01

Although associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been increasingly adopted by many centres, the oncological outcome for colorectal liver metastases compared with that after two-stage hepatectomy is still unknown. Between January 2010 and June 2014, all consecutive patients who underwent either ALPPS or two-stage hepatectomy for colorectal liver metastases in a single institution were included in the study. Morbidity, mortality, disease recurrence and survival were compared. The two groups were comparable in terms of clinicopathological characteristics. ALPPS was completed in all 17 patients, whereas the second-stage hepatectomy could not be completed in 15 of 41 patients. Ninety-day mortality rates for ALPPS and two-stage resection were 0 per cent (0 of 17) versus 5 per cent (2 of 41) (P = 0·891). Major complication rates (Clavien grade at least III) were 41 per cent (7 of 17) and 39 per cent (16 of 41) respectively (P = 0·999). Overall survival was significantly lower after ALPPS than after two-stage hepatectomy: 2-year survival 42 versus 77 per cent respectively (P = 0·006). Recurrent disease was more often seen in the liver in the ALPPS group. Salvage surgery was less often performed after ALPPS (2 of 8 patients) than after two-stage hepatectomy (10 of 17). Although major complication and 90-day mortality rates of ALPPS were similar to those of two-stage hepatectomy, overall survival was significantly lower following ALPPS. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Laparoscopic common hepatic artery ligation and staging followed by distal pancreatectomy with en bloc resection of celiac artery for advanced pancreatic cancer.

PubMed

Raut, V; Takaori, K; Kawaguchi, Y; Mizumoto, M; Kawaguchi, M; Koizumi, M; Kodama, S; Kida, A; Uemoto, S

2011-11-01

Adeno-carcinomas of pancreatic body are usually asymptomatic and progress to advanced stage with involvement of major arteries. Resection of advanced cancer along with en bloc resection of a common hepatic artery and celiac trunk enables a "curative" resections and only possible treatment. However, the celiac axis resection always has a risk of compromising blood supply to liver, resulting in the hepatic insufficiency. We evaluated practicability of a two-stage procedure for the advanced pancreases body cancer, laparoscopic clamping of a common hepatic artery followed by open distal pancreatectomy with en bloc celiac arterial resection to prevent the hepatic insufficiency. Seventy-five-year-old woman diagnosed with a 50-mm pancreatic body mass, invading splenic artery, common hepatic artery, splenic vein, and portal vein at the confluence. STAGE-1: At laparoscopy, after confirming absence of the peritoneal, superficial liver metastases and negative peritoneal cytology; we approached the common hepatic artery through the lesser sac and ligated. STAGE-2: Her liver function tests were normal after 2 weeks, and CT angiography showed complete blockage of the common hepatic artery with sufficient collateral circulation to the liver through inferior pancreatico-duodenal artery and gastro-duodenal artery. We performed an open distal pancreatectomy with en bloc resection of celiac artery. Histopathology examination confirmed R0 resection. The celiac axis resection with distal pancreatectomy improves the chance of R0 resection and potentially, survival of the patient. Preoperative laparoscopic ligation of the common hepatic artery is a safe, effective, and in-expensive technique to prevent postoperative hepatic insufficiency and improves the safety of en bloc celiac artery resection with a distal pancreatectomy. Also these patients have high risk of peritoneal dissemination. Diagnostic laparoscopy is useful to detect occult metastasis, which are missed by per-operative CT

Advances of two-stage riser catalytic cracking of heavy oil for maximizing propylene yield (TMP) process.

PubMed

Chaohe, Yang; Xiaobo, Chen; Jinhong, Zhang; Chunyi, Li; Honghong, Shan

Two-stage riser catalytic cracking of heavy oil for maximizing propylene yield (TMP) process proposed by State Key Laboratory of Heavy oil Processing, China University of Petroleum, can remarkably enhance the propylene yield and minimize the dry gas and coke yields, and obtain high-quality light oils (gasoline and diesel). It has been commercialized since 2006. Up to now, three TMP commercial units have been put into production and other four commercial units are under design and construction. The commercial data showed that taking paraffinic based Daqing (China) atmospheric residue as the feedstock, the propylene yield reached 20.31 wt%, the liquid products yield (the total yield of liquefied petroleum gas, gasoline, and diesel) was 82.66 wt%, and the total yield of dry gas and coke was 14.28 wt%. Moreover, the research octane number of gasoline could be up to 96.

Design and analysis of axial aspirated compressor stages

NASA Astrophysics Data System (ADS)

Merchant, Ali A.

The pressure ratio of axial compressor stages can be significantly increased by controlling the development of blade and endwall boundary layers in regions of adverse pressure gradient by means of boundary layer suction. This concept is validated and demonstrated through the design and analysis of two unique aspirated compressor stages: a low-speed stage with a design pressure ratio of 1.6 at a tip speed of 750 ft/s, and a high-speed stage with a design pressure ratio of 3.5 at a tip speed of 1500 ft/s. The aspirated compressor stages were designed using a new procedure which is a synthesis of low speed and high speed blade design techniques combined with a flexible inverse design method which enabled precise independent control over the shape of the blade suction and pressure surfaces. Integration of the boundary layer suction calculation into the overall design process is an essential ingredient of the new procedure. The blade design system consists of two axisymmetric through-flow codes coupled with a quasi three-dimensional viscous cascade plane code with inverse design capability. Validation of the completed designs were carried out with three-dimensional Euler and Navier-Stokes calculations. A single spanwise slot on the blade suction surface is used to bleed the boundary layer. The suction mass flow requirement for the low-speed and high-speed stages are 1% and 4% of the inlet mass flow, respectively. Additional suction between 1-2% is also required on the compressor endwalls near shock impingement locations. The rotor is modeled with a tip shroud to eliminate tip clearance effects and to discharge the suction flow radially from the flowpath. Three-dimensional viscous evaluation of the designs showed good agreement with the quasi three-dimensional design intent, except in the endwall regions. The suction requirements predicted by the quasi three-dimensional calculation were confirmed by the three-dimensional viscous calculations. The three

Magnetic Gauge Instrumentation on the LANL Gas-Driven Two-Stage Gun

NASA Astrophysics Data System (ADS)

Alcon, R. R.; Sheffield, S. A.; Martinez, A. R.; Gustavsen, R. L.

1997-07-01

Our gas-driven two-stage gun was designed and built to do initiation studies on insensitive high explosives as well as other equation of state experiments on inert materials. Our preferred method of measuring initiation phenomena involves the use of in-situ magnetic particle velocity gauges. In order to provide the 1-D experimental area to accommodate this type of gauging in our two-stage gun, it has a 50-mm-diameter launch tube. We have used magnetic gauging on our 72-mm bore diameter single-stage gun for over 15 years and it has proven a very effective technique for all types of shock wave experiments, including those on high explosives. This technique has now been installed on our two-stage gun. We describe the experimental method, as well as some of the difficulties that arose during the installation. Several magnetic gauge experiments have been completed on plastic and high explosive materials. Waveforms obtained in some of the experiments will be discussed. Up to 10 in-situ particle velocity measurements can be made in a single experiment. This new technique is now working quite well, as is evidenced by the data. To our knowledge, this is the first time magnetic gauging has been used on a two-stage gun.

Magnetic gauge instrumentation on the LANL gas-driven two-stage gun

NASA Astrophysics Data System (ADS)

Alcon, R. R.; Sheffield, S. A.; Martinez, A. R.; Gustavsen, R. L.

1998-07-01

The LANL gas-driven two-stage gun was designed and built to do initiation studies on insensitive high explosives as well as equation of state and reaction experiments on other materials. The preferred method of measuring reaction phenomena involves the use of in-situ magnetic particle velocity gauges. In order to accommodate this type of gauging in our two-stage gun, it has a 50-mm-diameter launch tube. We have used magnetic gauging on our 72-mm bore diameter single-stage gun for over 15 years and it has proven a very effective technique for all types of shock wave experiments, including those on high explosives. This technique has now been installed on our gas-driven two-stage gun. We describe the method used, as well as some of the difficulties that arose during the installation. Several magnetic gauge experiments have been completed on plastic materials. Waveforms obtained in some of the experiments will be discussed. Up to 10 in-situ particle velocity measurements can be made in a single experiment. This new technique is now working quite well, as is evidenced by the data. To our knowledge, this is the first time magnetic gauging has been used on a two-stage gun.

An optimal stratified Simon two-stage design.

PubMed

Parashar, Deepak; Bowden, Jack; Starr, Colin; Wernisch, Lorenz; Mander, Adrian

2016-07-01

In Phase II oncology trials, therapies are increasingly being evaluated for their effectiveness in specific populations of interest. Such targeted trials require designs that allow for stratification based on the participants' molecular characterisation. A targeted design proposed by Jones and Holmgren (JH) Jones CL, Holmgren E: 'An adaptive Simon two-stage design for phase 2 studies of targeted therapies', Contemporary Clinical Trials 28 (2007) 654-661.determines whether a drug only has activity in a disease sub-population or in the wider disease population. Their adaptive design uses results from a single interim analysis to decide whether to enrich the study population with a subgroup or not; it is based on two parallel Simon two-stage designs. We study the JH design in detail and extend it by providing a few alternative ways to control the familywise error rate, in the weak sense as well as the strong sense. We also introduce a novel optimal design by minimising the expected sample size. Our extended design contributes to the much needed framework for conducting Phase II trials in stratified medicine. © 2016 The Authors Pharmaceutical Statistics Published by John Wiley & Sons Ltd. © 2016 The Authors Pharmaceutical Statistics Published by John Wiley & Sons Ltd.

Hypospadias repair: Byar's two stage operation revisited.

PubMed

Arshad, A R

2005-06-01

Hypospadias is a congenital deformity characterised by an abnormally located urethral opening, that could occur anywhere proximal to its normal location on the ventral surface of glans penis to the perineum. Many operations had been described for the management of this deformity. One hundred and fifteen patients with hypospadias were treated at the Department of Plastic Surgery, Hospital Kuala Lumpur, Malaysia between September 1987 and December 2002, of which 100 had Byar's procedure performed on them. The age of the patients ranged from neonates to 26 years old. Sixty-seven patients had penoscrotal (58%), 20 had proximal penile (18%), 13 had distal penile (11%) and 15 had subcoronal hypospadias (13%). Operations performed were Byar's two-staged (100), Bracka's two-staged (11), flip-flap (2) and MAGPI operation (2). The most common complication encountered following hypospadias surgery was urethral fistula at a rate of 18%. There is a higher incidence of proximal hypospadias in the Malaysian community. Byar's procedure is a very versatile technique and can be used for all types of hypospadias. Fistula rate is 18% in this series.

Structural design and stress analysis program for advanced composite filament-wound axisymmetric pressure vessels (COMTANK)

NASA Technical Reports Server (NTRS)

Knoell, A. C.

1972-01-01

Computer program has been specifically developed to handle, in an efficient and cost effective manner, planar wound pressure vessels fabricated of either boron-epoxy or graphite-epoxy advanced composite materials.

Sub-classification of Advanced-Stage Hepatocellular Carcinoma: A Cohort Study Including 612 Patients Treated with Sorafenib.

PubMed

Yoo, Jeong-Ju; Chung, Goh Eun; Lee, Jeong-Hoon; Nam, Joon Yeul; Chang, Young; Lee, Jeong Min; Lee, Dong Ho; Kim, Hwi Young; Cho, Eun Ju; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung-Hwan

2018-04-01

Advanced hepatocellular carcinoma (HCC) is associated with various clinical conditions including major vessel invasion, metastasis, and poor performance status. The aim of this study was to establish a prognostic scoring system and to propose a sub-classification of the Barcelona-Clinic Liver Cancer (BCLC) stage C. This retrospective study included consecutive patientswho received sorafenib for BCLC stage C HCC at a single tertiary hospital in Korea. A Cox proportional hazard model was used to develop a scoring system, and internal validationwas performed by a 5-fold cross-validation. The performance of the model in predicting risk was assessed by the area under the curve and the Hosmer-Lemeshow test. A total of 612 BCLC stage C HCC patients were sub- classified into strata depending on their performance status. Five independent prognostic factors (Child-Pugh score, α-fetoprotein, tumor type, extrahepatic metastasis, and portal vein invasion) were identified and used in the prognostic scoring system. This scoring system showed good discrimination (area under the receiver operating characteristic curve, 0.734 to 0.818) and calibration functions (both p < 0.05 by the Hosmer-Lemeshow test at 1 month and 12 months, respectively). The differences in survival among the different risk groups classified by the total score were significant (p < 0.001 by the log-rank test in both the Eastern Cooperative Oncology Group 0 and 1 strata). The heterogeneity of patientswith BCLC stage C HCC requires sub-classification of advanced HCC. A prognostic scoring system with five independent factors is useful in predicting the survival of patients with BCLC stage C HCC.

Analyses of pressure ulcer point prevalence at the first skin assessment in a Portuguese hospital.

PubMed

Garcez Sardo, Pedro Miguel; Simões, Cláudia Sofia Oliveira; Alvarelhão, José Joaquim Marques; de Oliveira e Costa, César Telmo; Simões, Carlos Jorge Cardoso; Figueira, Jorge Manuel Rodrigues; Simões, João Filipe Fernandes Lindo; Amado, Francisco Manuel Lemos; Amaro, António José Monteiro; Pinheiro de Melo, Elsa Maria Oliveira

2016-05-01

To analyze the first pressure ulcer risk and skin assessment records of hospitalized adult patients in medical and surgical areas of Aveiro Hospital during 2012 in association with their demographic and clinical characteristics. Retrospective cohort analysis of electronic health record database from 7132 adult patients admitted to medical and surgical areas in a Portuguese hospital during 2012. The presence of (at least) one pressure ulcer at the first skin assessment in inpatient setting was associated with age, gender, type of admission, specialty units, length of stay, patient discharge and ICD-9 diagnosis. Point prevalence of participants with pressure ulcer category/stage I-IV of 7.9% at the first skin assessment in inpatient setting. A total of 1455 pressure ulcers were documented, most of them category/stage I. The heels and the sacrum/coccyx were the most problematic areas. Participants with pressure ulcer commonly had two or more pressure ulcers. The point prevalence of participants with pressure ulcer of our study was similar international literature. The presence of a pressure ulcer at the first skin assessment could be an important measure of frailty and the participants with pressure ulcer commonly had more than one documented pressure ulcer. Advanced age or lower Braden Scale scores or Emergency Service admission were relevant variables for the presence of (at least) one pressure ulcer at the first skin assessment in inpatient setting as well as respiratory, infectious or genitourinary system diseases. Copyright © 2016 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Advanced launch system trajectory optimization using suboptimal control

NASA Technical Reports Server (NTRS)

Shaver, Douglas A.; Hull, David G.

1993-01-01

The maximum-final mass trajectory of a proposed configuration of the Advanced Launch System is presented. A model for the two-stage rocket is given; the optimal control problem is formulated as a parameter optimization problem; and the optimal trajectory is computed using a nonlinear programming code called VF02AD. Numerical results are presented for the controls (angle of attack and velocity roll angle) and the states. After the initial rotation, the angle of attack goes to a positive value to keep the trajectory as high as possible, returns to near zero to pass through the transonic regime and satisfy the dynamic pressure constraint, returns to a positive value to keep the trajectory high and to take advantage of minimum drag at positive angle of attack due to aerodynamic shading of the booster, and then rolls off to negative values to satisfy the constraints. Because the engines cannot be throttled, the maximum dynamic pressure occurs at a single point; there is no maximum dynamic pressure subarc. To test approximations for obtaining analytical solutions for guidance, two additional optimal trajectories are computed: one using untrimmed aerodynamics and one using no atmospheric effects except for the dynamic pressure constraint. It is concluded that untrimmed aerodynamics has a negligible effect on the optimal trajectory and that approximate optimal controls should be able to be obtained by treating atmospheric effects as perturbations.

Closing the loop: modelling of heart failure progression from health to end-stage using a meta-analysis of left ventricular pressure-volume loops.

PubMed

Warriner, David R; Brown, Alistair G; Varma, Susheel; Sheridan, Paul J; Lawford, Patricia; Hose, David R; Al-Mohammad, Abdallah; Shi, Yubing

2014-01-01

The American Heart Association (AHA)/American College of Cardiology (ACC) guidelines for the classification of heart failure (HF) are descriptive but lack precise and objective measures which would assist in categorising such patients. Our aim was two fold, firstly to demonstrate quantitatively the progression of HF through each stage using a meta-analysis of existing left ventricular (LV) pressure-volume (PV) loop data and secondly use the LV PV loop data to create stage specific HF models. A literature search yielded 31 papers with PV data, representing over 200 patients in different stages of HF. The raw pressure and volume data were extracted from the papers using a digitising software package and the means were calculated. The data demonstrated that, as HF progressed, stroke volume (SV), ejection fraction (EF%) decreased while LV volumes increased. A 2-element lumped parameter model was employed to model the mean loops and the error was calculated between the loops, demonstrating close fit between the loops. The only parameter that was consistently and statistically different across all the stages was the elastance (Emax). For the first time, the authors have created a visual and quantitative representation of the AHA/ACC stages of LVSD-HF, from normal to end-stage. The study demonstrates that robust, load-independent and reproducible parameters, such as elastance, can be used to categorise and model HF, complementing the existing classification. The modelled PV loops establish previously unknown physiological parameters for each AHA/ACC stage of LVSD-HF, such as LV elastance and highlight that it this parameter alone, in lumped parameter models, that determines the severity of HF. Such information will enable cardiovascular modellers with an interest in HF, to create more accurate models of the heart as it fails.

Optimal debulking targets in women with advanced stage ovarian cancer: a retrospective study of immediate versus interval debulking surgery.

PubMed

Altman, Alon D; Nelson, Gregg; Chu, Pamela; Nation, Jill; Ghatage, Prafull

2012-06-01

The objective of this study was to examine both overall and disease-free survival of patients with advanced stage ovarian cancer after immediate or interval debulking surgery based on residual disease. We performed a retrospective chart review at the Tom Baker Cancer Centre in Calgary, Alberta of patients with pathologically confirmed stage III or IV ovarian cancer, fallopian tube cancer, or primary peritoneal cancer between 2003 and 2007. We collected data on the dates of diagnosis, recurrence, and death; cancer stage and grade, patients' age, surgery performed, and residual disease. One hundred ninety-two patients were included in the final analysis. The optimal debulking rate with immediate surgery was 64.8%, and with interval surgery it was 85.9%. There were improved overall and disease-free survival rates for optimally debulked disease (< 1 cm) with both immediate and interval surgery (P < 0.001) compared to suboptimally debulked disease. Overall survival rates for optimally debulked disease were not significantly different in patients having immediate and interval surgery (P = 0.25). In the immediate surgery group, patients with microscopic residual disease had better disease-free survival (P = 0.015) and overall survival (P = 0.005) than patients with < 1 cm residual disease. In patients who had interval surgery, those who had microscopic residual disease had more improved disease-free survival than those with < 1 cm disease (P = 0.05), but they did not have more improved overall survival (P = 0.42). Patients with microscopic residual disease who had immediate surgery had a significantly better overall survival rate than those who had interval surgery (P = 0.034). In women with advanced stage ovarian cancer, the goal of surgery should be resection of disease to microscopic residual at the initial procedure. This results in improved overall survival than lesser degrees of resection. Further studies are required to determine optimal surgical management.

Solar Thermal Upper Stage Liquid Hydrogen Pressure Control Testing

NASA Technical Reports Server (NTRS)

Moore, J. D.; Otto, J. M.; Cody, J. C.; Hastings, L. J.; Bryant, C. B.; Gautney, T. T.

2015-01-01

High-energy cryogenic propellant is an essential element in future space exploration programs. Therefore, NASA and its industrial partners are committed to an advanced development/technology program that will broaden the experience base for the entire cryogenic fluid management community. Furthermore, the high cost of microgravity experiments has motivated NASA to establish government/aerospace industry teams to aggressively explore combinations of ground testing and analytical modeling to the greatest extent possible, thereby benefitting both industry and government entities. One such team consisting of ManTech SRS, Inc., Edwards Air Force Base, and Marshall Space Flight Center (MSFC) was formed to pursue a technology project designed to demonstrate technology readiness for an SRS liquid hydrogen (LH2) in-space propellant management concept. The subject testing was cooperatively performed June 21-30, 2000, through a partially reimbursable Space Act Agreement between SRS, MSFC, and the Air Force Research Laboratory. The joint statement of work used to guide the technical activity is presented in appendix A. The key elements of the SRS concept consisted of an LH2 storage and supply system that used all of the vented H2 for solar engine thrusting, accommodated pressure control without a thermodynamic vent system (TVS), and minimized or eliminated the need for a capillary liquid acquisition device (LAD). The strategy was to balance the LH2 storage tank pressure control requirements with the engine thrusting requirements to selectively provide either liquid or vapor H2 at a controlled rate to a solar thermal engine in the low-gravity environment of space operations. The overall test objective was to verify that the proposed concept could enable simultaneous control of LH2 tank pressure and feed system flow to the thruster without necessitating a TVS and a capillary LAD. The primary program objectives were designed to demonstrate technology readiness of the SRS concept

Combining evidence from multiple electronic health care databases: performances of one-stage and two-stage meta-analysis in matched case-control studies.

PubMed

La Gamba, Fabiola; Corrao, Giovanni; Romio, Silvana; Sturkenboom, Miriam; Trifirò, Gianluca; Schink, Tania; de Ridder, Maria

2017-10-01

Clustering of patients in databases is usually ignored in one-stage meta-analysis of multi-database studies using matched case-control data. The aim of this study was to compare bias and efficiency of such a one-stage meta-analysis with a two-stage meta-analysis. First, we compared the approaches by generating matched case-control data under 5 simulated scenarios, built by varying: (1) the exposure-outcome association; (2) its variability among databases; (3) the confounding strength of one covariate on this association; (4) its variability; and (5) the (heterogeneous) confounding strength of two covariates. Second, we made the same comparison using empirical data from the ARITMO project, a multiple database study investigating the risk of ventricular arrhythmia following the use of medications with arrhythmogenic potential. In our study, we specifically investigated the effect of current use of promethazine. Bias increased for one-stage meta-analysis with increasing (1) between-database variance of exposure effect and (2) heterogeneous confounding generated by two covariates. The efficiency of one-stage meta-analysis was slightly lower than that of two-stage meta-analysis for the majority of investigated scenarios. Based on ARITMO data, there were no evident differences between one-stage (OR = 1.50, CI = [1.08; 2.08]) and two-stage (OR = 1.55, CI = [1.12; 2.16]) approaches. When the effect of interest is heterogeneous, a one-stage meta-analysis ignoring clustering gives biased estimates. Two-stage meta-analysis generates estimates at least as accurate and precise as one-stage meta-analysis. However, in a study using small databases and rare exposures and/or outcomes, a correct one-stage meta-analysis becomes essential. Copyright © 2017 John Wiley & Sons, Ltd.

Staged regenerative sorption heat pump

NASA Technical Reports Server (NTRS)

Jones, Jack A. (Inventor)

1995-01-01

A regenerative adsorbent heat pump process and system for cooling and heating a space. A sorbent is confined in a plurality of compressors of which at least four are first stage and at least four are second stage. The first stage operates over a first pressure region and the second stage over a second pressure region which is higher than the first. Sorbate from the first stage enters the second stage. The sorbate loop includes a condenser, expansion valve, evaporator and the compressors. A single sorbate loop can be employed for single-temperature-control such as air conditioning and heating. Two sorbate loops can be used for two-temperature-control as in a refrigerator and freezer. The evaporator temperatures control the freezer and refrigerator temperatures. Alternatively the refrigerator temperature can be cooled by the freezer with one sorbate loop. A heat transfer fluid is circulated in a closed loop which includes a radiator and the compressors. Low temperature heat is exhausted by the radiator. High temperature heat is added to the heat transfer fluid entering the compressors which are desorbing vapor. Heat is transferred from compressors which are sorbing vapor to the heat transfer fluid, and from the heat transfer fluid to the compressors which are desorbing vapor. Each compressor is subjected to the following phases, heating to its highest temperature, cooling down from its highest temperature, cooling to its lowest temperature, and warming up from its lowest temperature. The phases are repeated to complete a cycle and regenerate heat.

Measurement of the steady surface pressure distribution on a single rotation large scale advanced prop-fan blade at Mach numbers from 0.03 to 0.78

NASA Technical Reports Server (NTRS)

Bushnell, Peter

1988-01-01

The aerodynamic pressure distribution was determined on a rotating Prop-Fan blade at the S1-MA wind tunnel facility operated by the Office National D'Etudes et de Recherches Aerospatiale (ONERA) in Modane, France. The pressure distributions were measured at thirteen radial stations on a single rotation Large Scale Advanced Prop-Fan (LAP/SR7) blade, for a sequence of operating conditions including inflow Mach numbers ranging from 0.03 to 0.78. Pressure distributions for more than one power coefficient and/or advanced ratio setting were measured for most of the inflow Mach numbers investigated. Due to facility power limitations the Prop-Fan test installation was a two bladed version of the eight design configuration. The power coefficient range investigated was therefore selected to cover typical power loading per blade conditions which occur within the Prop-Fan operating envelope. The experimental results provide an extensive source of information on the aerodynamic behavior of the swept Prop-Fan blade, including details which were elusive to current computational models and do not appear in the two-dimensional airfoil data.

Dual-Fuel Propulsion in Single-Stage Advanced Manned Launch System Vehicle

NASA Technical Reports Server (NTRS)

Lepsch, Roger A., Jr.; Stanley, Douglas O.; Unal, Resit

1995-01-01

As part of the United States Advanced Manned Launch System study to determine a follow-on, or complement, to the Space Shuttle, a reusable single-stage-to-orbit concept utilizing dual-fuel rocket propulsion has been examined. Several dual-fuel propulsion concepts were investigated. These include: a separate-engine concept combining Russian RD-170 kerosene-fueled engines with space shuttle main engine-derivative engines: the kerosene- and hydrogen-fueled Russian RD-701 engine; and a dual-fuel, dual-expander engine. Analysis to determine vehicle weight and size characteristics was performed using conceptual-level design techniques. A response-surface methodology for multidisciplinary design was utilized to optimize the dual-fuel vehicles with respect to several important propulsion-system and vehicle design parameters, in order to achieve minimum empty weight. The tools and methods employed in the analysis process are also summarized. In comparison with a reference hydrogen- fueled single-stage vehicle, results showed that the dual-fuel vehicles were from 10 to 30% lower in empty weight for the same payload capability, with the dual-expander engine types showing the greatest potential.

The influence of pressure ratio on the regenerator performance

NASA Astrophysics Data System (ADS)

Lin, Y.; Zhu, S.

2017-12-01

For a multi-stage pulse tube refrigerator with displacer, improving the regenerator efficiency is important. A displacer can get higher operating pressure ratio compared with inertance tube. The pressure ratio and porosity influence on the regenerator performance with is discussed, and CFD simulation is done on a two-stage pulse tube refrigerator with displacer to show that mass flow rate and pressure wave relation in the regenerator can be realized by a step-displacer.

Selection of the initial design for the two-stage continual reassessment method.

PubMed

Jia, Xiaoyu; Ivanova, Anastasia; Lee, Shing M

2017-01-01

In the two-stage continual reassessment method (CRM), model-based dose escalation is preceded by a pre-specified escalating sequence starting from the lowest dose level. This is appealing to clinicians because it allows a sufficient number of patients to be assigned to each of the lower dose levels before escalating to higher dose levels. While a theoretical framework to build the two-stage CRM has been proposed, the selection of the initial dose-escalating sequence, generally referred to as the initial design, remains arbitrary, either by specifying cohorts of three patients or by trial and error through extensive simulations. Motivated by a currently ongoing oncology dose-finding study for which clinicians explicitly stated their desire to assign at least one patient to each of the lower dose levels, we proposed a systematic approach for selecting the initial design for the two-stage CRM. The initial design obtained using the proposed algorithm yields better operating characteristics compared to using a cohort of three initial design with a calibrated CRM. The proposed algorithm simplifies the selection of initial design for the two-stage CRM. Moreover, initial designs to be used as reference for planning a two-stage CRM are provided.

Pressure Safety: Advanced Live 11459

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glass, George

Many Los Alamos National Laboratory (LANL) operations use pressure equipment and systems. Failure to follow proper procedures when designing or operating pressure systems can result in injuries to personnel and damage to equipment and/or the environment. This manual presents an overview of the requirements and recommendations that address the safe design and operation of pressure systems at LANL.

Using Advanced Tensiometers to Monitor Temporal Variations in Pore Pressure

NASA Astrophysics Data System (ADS)

Nichols, R. L.; Young, M. H.; Dixon, K. L.; Rossabi, J.; Hyde, W. K.; Holmes-Burns, H.

2002-12-01

The Savannah River Site has installed a comprehensive vadose zone monitoring system (VZMS) at it's low level radioactive waste disposal facility to collect the necessary information to calculate contaminant flux. The VZMS includes water content reflectometers, suction lysimeters, advanced tensiometers (ATs), water flux meters, access ports for neutron probes, and a tipping bucket rain gauge. Forty one ATs were installed from 1999 to 2001 at depths ranging from 2 to 60 feet and have been operated continuously. The installation depths were based on a hydrostatigraphic model developed from core logs, cone penetrometer logs, moisture content profiles, water retention curves model that were obtained during the phased installation of the VZMS. An AT consists of a porous cup installed at a prescribed depth with casing back to the surface and a pressure transducer that is lowered into the casing and connects with the porous cup. The pressure transducer transmits it's signal to a datalogger where the data is stored for future retrieval using a cellular phone communications package. Results from the 2 year operating period show that the AT calibrations are stable and t ATs are capable of extended monitoring of pore pressures in the 0 to 300 cm H2 O range. The ATs had sufficient resolution to detect the naturally occurring fluctuations in pore pressure (1 to 100 cm H2 O over 1 to 72 hours) that resulted from infiltration events at the site. The stable performance of the ATs combined with their ability to detect naturally occurring fluctuations in pore pressure make the ATs a useful tool in measuring temporal pore pressure variations for use in calibrating numerical models of fluid flow in variably saturated porous media.

Empirical study of classification process for two-stage turbo air classifier in series

NASA Astrophysics Data System (ADS)

Yu, Yuan; Liu, Jiaxiang; Li, Gang

2013-05-01

The suitable process parameters for a two-stage turbo air classifier are important for obtaining the ultrafine powder that has a narrow particle-size distribution, however little has been published internationally on the classification process for the two-stage turbo air classifier in series. The influence of the process parameters of a two-stage turbo air classifier in series on classification performance is empirically studied by using aluminum oxide powders as the experimental material. The experimental results show the following: 1) When the rotor cage rotary speed of the first-stage classifier is increased from 2 300 r/min to 2 500 r/min with a constant rotor cage rotary speed of the second-stage classifier, classification precision is increased from 0.64 to 0.67. However, in this case, the final ultrafine powder yield is decreased from 79% to 74%, which means the classification precision and the final ultrafine powder yield can be regulated through adjusting the rotor cage rotary speed of the first-stage classifier. 2) When the rotor cage rotary speed of the second-stage classifier is increased from 2 500 r/min to 3 100 r/min with a constant rotor cage rotary speed of the first-stage classifier, the cut size is decreased from 13.16 μm to 8.76 μm, which means the cut size of the ultrafine powder can be regulated through adjusting the rotor cage rotary speed of the second-stage classifier. 3) When the feeding speed is increased from 35 kg/h to 50 kg/h, the "fish-hook" effect is strengthened, which makes the ultrafine powder yield decrease. 4) To weaken the "fish-hook" effect, the equalization of the two-stage wind speeds or the combination of a high first-stage wind speed with a low second-stage wind speed should be selected. This empirical study provides a criterion of process parameter configurations for a two-stage or multi-stage classifier in series, which offers a theoretical basis for practical production.

Optimization Study of the Ames 0.5 Two-Stage Light Gas Gun

NASA Technical Reports Server (NTRS)

Bogdanoff, D. W.

1996-01-01

There is a need for more faithful simulation of space debris impacts on various space vehicles. Space debris impact velocities can range up to 14 km/sec and conventional two-stage light gas guns with moderately heavy saboted projectiles are limited to launch velocities of 7-8 km/sec. Any increases obtained in the launch velocities will result in more faithful simulations of debris impacts. It would also be valuable to reduce the maximum gun and projectile base pressures and the gun barrel erosion rate. In this paper, the results of a computational fluid dynamics (CFD) study designed to optimize the performance of the NASA Ames 0.5' gun by systematically varying seven gun operating parameters are reported. Particularly beneficial effects were predicted to occur if (1) the piston mass was decreased together with the powder mass and the hydrogen fill pressure and (2) the pump tube length was decreased. The optimum set of changes in gun operating conditions were predicted to produce an increase in muzzle velocity of 0.7-1.0 km/sec, simultaneously with a substantial decrease in gun erosion. Preliminary experimental data have validated the code predictions. Velocities of up to 8.2 km/sec with a 0.475 cm diameter saboted aluminum sphere have been obtained, along with large reductions in gun erosion rates.

Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial.

PubMed

Gallamini, Andrea; Tarella, Corrado; Viviani, Simonetta; Rossi, Andrea; Patti, Caterina; Mulé, Antonino; Picardi, Marco; Romano, Alessandra; Cantonetti, Maria; La Nasa, Giorgio; Trentin, Livio; Bolis, Silvia; Rapezzi, Davide; Battistini, Roberta; Gottardi, Daniela; Gavarotti, Paolo; Corradini, Paolo; Cimminiello, Michele; Schiavotto, Corrado; Parvis, Guido; Zanotti, Roberta; Gini, Guido; Ferreri, Andrés J M; Viero, Piera; Miglino, Maurizio; Billio, Atto; Avigdor, Abraham; Biggi, Alberto; Fallanca, Federico; Ficola, Umberto; Gregianin, Michele; Chiaravalloti, Agostino; Prosperini, Giuseppe; Bergesio, Fabrizio; Chauvie, Stephane; Pavoni, Chiara; Gianni, Alessandro Massimo; Rambaldi, Alessandro

2018-02-10

Purpose To investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2). Patients and Methods Patients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Patients with a positive PET2 were randomly assigned to four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) followed by four cycles of standard BEACOPP with or without rituximab. Patients with a negative PET2 continued ABVD, and those with a large nodal mass at diagnosis (≥ 5 cm) in complete remission with a negative PET at the end of chemotherapy were randomly assigned to radiotherapy or no further treatment. The primary end point was 3-year PFS. Results Of 782 enrolled patients, 150 (19%) had a positive and 630 (81%) a negative PET2. The 3-year PFS of all patients was 82%. The 3-year PFS of those with a positive and negative PET2 was 60% and 87%, respectively ( P < .001). The 3-year PFS of patients with a positive PET2 assigned to BEACOPP with or without rituximab was 63% versus 57% ( P = .53). In 296 patients with both interim and post-ABVD-negative PET who had a large nodal mass at diagnosis, radiotherapy was randomly added after chemotherapy without a significant PFS improvement (97% v 93%, respectively; P = .29). The 3-year overall survival of all 782 patients was 97% (99% and 89% for PET2 negative and positive, respectively). Conclusion The PET-driven switch from ABVD to escalated BEACOPP is feasible and effective in high-risk patients with advanced-stage HL.

Chondrocutaneous helix rim advancement flap: two classical and two new modifications for very large defects of the ear.

PubMed

Valesky, E M; Kaufmann, R; Meissner, M

2015-11-01

The plastic reconstruction of the ear after microscopically controlled tumor surgery is a particular challenge. The chondrocutaneous helix rim advancement flap (CHRAF) is perfectly suited for the repair of different defects of the helix and even defects beyond. Here, we describe two known and two new modifications of the CHRAF that enlarge the scope of application in tumor surgery of the ear. We demonstrate the different techniques and practical application of the repair and evaluate the benefits and limitations. The CHRAF and its modifications is an excellent method for repair of various defects of the helical region of the ear. The CHRAF and its modifications proves to be an good alternative to other methods of closure by preserving the anatomical contour and mechanical and acoustic functions in a single-staged procedure with excellent aesthetic results. The two new modifications we introduced here, enlarge the known armentarium for very large defects of the upper pole and the mid-helix of the ear. © 2014 European Academy of Dermatology and Venereology.

Centrifugal compressor surge detecting method based on wavelet analysis of unsteady pressure fluctuations in typical stages

NASA Astrophysics Data System (ADS)

Izmaylov, R.; Lebedev, A.

2015-08-01

Centrifugal compressors are complex energy equipment. Automotive control and protection system should meet the requirements: of operation reliability and durability. In turbocompressors there are at least two dangerous areas: surge and rotating stall. Antisurge protecting systems usually use parametric or feature methods. As a rule industrial system are parametric. The main disadvantages of anti-surge parametric systems are difficulties in mass flow measurements in natural gas pipeline compressor. The principal idea of feature method is based on the experimental fact: as a rule just before the onset of surge rotating or precursor stall established in compressor. In this case the problem consists in detecting of unsteady pressure or velocity fluctuations characteristic signals. Wavelet analysis is the best method for detecting onset of rotating stall in spite of high level of spurious signals (rotating wakes, turbulence, etc.). This method is compatible with state of the art DSP systems of industrial control. Examples of wavelet analysis application for detecting onset of rotating stall in typical stages centrifugal compressor are presented. Experimental investigations include unsteady pressure measurement and sophisticated data acquisition system. Wavelet transforms used biorthogonal wavelets in Mathlab systems.

Two-phase flows and heat transfer within systems with ambient pressure above the thermodynamic critical pressure

NASA Technical Reports Server (NTRS)

Hendricks, R. C.; Braun, M. J.; Mullen, R. L.

1986-01-01

In systems where the design inlet and outlet pressures P sub amb are maintained above the thermodynamic critical pressure P sub c, it is often assumed that heat and mass transfer are governed by single-phase relations and that two-phase flows cannot occur. This simple rule of thumb is adequate in many low-power designs but is inadequate for high-performance turbomachines, boilers, and other systems where two-phase regions can exist even though P sub amb P sub c. Heat and mass transfer and rotordynamic-fluid-mechanic restoring forces depend on momentum differences, and those for a two-phase zone can differ significantly from those for a single-phase zone. By using a laminar, variable-property bearing code and a rotating boiler code, pressure and temperature surfaces were determined that illustrate nesting of a two-phase region within a supercritical pressure region. The method of corresponding states is applied to bearings with reasonable rapport.

Two-phase flows and heat transfer within systems with ambient pressure above the thermodynamic critical pressure

NASA Technical Reports Server (NTRS)

Hendricks, R. C.; Braun, M. J.; Mullen, R. L.

1986-01-01

In systems where the design inlet and outlet pressure P sub amb are maintained above the thermodynamic critical pressure P sub c, it is often assumed that heat and mass transfer are governed by single-phase relations and that two-phase flows cannot occur. This simple rule of thumb is adequate in many low-power designs but is inadequate for high-performance turbomachines, boilers, and other systems where two-phase regions can exist even though P sub amb P sub c. Heat and mass transfer and rotordynamic-fluid-mechanic restoring forces depend on momentum differences, and those for a two-phase zone can differ significantly from those for a single-phase zone. By using a laminar, variable-property bearing code and a rotating boiler code, pressure and temperature surfaces were determined that illustrate nesting of a two-phase region within a supercritical pressure region. The method of corresponding states is applied to bearings with reasonable rapport.

Mechanisms to deploy the two-stage IUS from the shuttle cargo bay

NASA Technical Reports Server (NTRS)

Haynie, H. T.

1980-01-01

The Inertial Upper Stage (IUS) is a two-stage or three-stage booster used to transport spacecraft from the space shuttle orbit to synchronous orbit or on an interplanetary trajectory. The mechanisms which were designed specifically to perform the two-stage IUS required functions while contained within the cargo bay of the space shuttle during the boost phase and while in a low Earth orbit are discussed. The requirements, configuration, and operation of the mechanisms are described, with particular emphasis on the tilt actuator and the mechanism for decoupling the actuators during boost to eliminate redundant load paths.

Optimized ex-ovo culturing of chick embryos to advanced stages of development.

PubMed

Cloney, Kellie; Franz-Odendaal, Tamara Anne

2015-01-24

Research in anatomy, embryology, and developmental biology has largely relied on the use of model organisms. In order to study development in live embryos model organisms, such as the chicken, are often used. The chicken is an excellent model organism due to its low cost and minimal maintenance, however they present observational challenges because they are enclosed in an opaque eggshell. In order to properly view the embryo as it develops, the shell must be windowed or removed. Both windowing and ex ovo techniques have been developed to assist researchers in the study of embryonic development. However, each of the methods has limitations and challenges. Here, we present a simple, optimized ex ovo culture technique for chicken embryos that enables the observation of embryonic development from stage HH 19 into late stages of development (HH 40), when many organs have developed. This technique is easy to adopt in both undergraduate classes and more advanced research laboratories where embryo manipulations are conducted.

der(11)t(11;17): a distinct cytogenetic pathway of advanced stage neuroblastoma (NBL) - detected by spectral karyotyping (SKY).

PubMed

Stark, Batia; Jeison, Marta; Glaser-Gabay, Leticia; Bar-Am, Irit; Mardoukh, Jacques; Ash, Shifra; Atias, Dina; Stein, Jerry; Zaizov, Rina; Yaniv, Isaac

2003-07-18

Conventional cytogenetic, molecular cytogenic and genetic methods disclosed a broad spectrum of genetic abnormalities leading to gain and loss of chromosomal segments in advanced stage neuroblastoma (NBL). Specific correlation between the genetic findings could delineate distinct genetic pathways, of which the biology and prognostic significance is as yet undetermined. Using spectral karyotyping (SKY) and fluorescence in situ hybridization (FISH) on metaphases from 16 patients with advanced stage NBL, it was possible to explore the whole spectrum of rearrangement within complex karyotypes and to detect hidden recurrent translocations. All translocations were unbalanced. The most prevalent recurrent unbalanced translocations resulted in 17q gain in 12 patients (75%), 11q loss in nine patients (56%), and 1p deletion/imbalance in eight patients (50%). The most frequent recurrent translocation was der(11)t(11;17) in six patients. Three cytogenetic pathways could be delineated. The first, with six patients, was characterized by the unbalanced translocation der(11)t(11;17), detected only by SKY, resulting in the concomitant 17q gain and 11q loss. No MYCN amplification or 1p deletion (except one patient with 1p imbalance) were found, while 3p deletion, and complex karyotypes were common. The second subgroup, with four patients, had 17q gain and 1p deletion, and in two patients 11q loss, that was apparent only by FISH. 1p deletion occurred through der(1)t(1;17) or del(1p). The third subgroup of four patients was characterized by MYCN amplification with 17q gain and 1p deletion, very rarely with 11q loss (one patient) through a translocation with a non-17q partner. The SKY subclassifications were in accordance with the findings reported by molecular genetic techniques, and may indicate that distinct oncogenes and suppressor genes are involved in the der(11)t(11;17) pathway of advanced stage NBL.

A Rocket Powered Single-Stage-to-Orbit Launch Vehicle With U.S. and Soviet Engineers

NASA Technical Reports Server (NTRS)

MacConochie, Ian O.; Stnaley, Douglas O.

1991-01-01

A single-stage-to-orbit launch vehicle is used to assess the applicability of Soviet Energia high-pressure-hydrocarbon engine to advanced U.S. manned space transportation systems. Two of the Soviet engines are used with three Space Shuttle Main Engines. When applied to a baseline vehicle that utilized advanced hydrocarbon engines, the higher weight of the Soviet engines resulted in a 20 percent loss of payload capability and necessitated a change in the crew compartment size and location from mid-body to forebody in order to balance the vehicle. Various combinations of Soviet and Shuttle engines were evaluated for comparison purposes, including an all hydrogen system using all Space Shuttle Main Engines. Operational aspects of the baseline vehicle are also discussed. A new mass properties program entitles Weights and Moments of Inertia (WAMI) is used in the study.

A two-stage design for multiple testing in large-scale association studies.

PubMed

Wen, Shu-Hui; Tzeng, Jung-Ying; Kao, Jau-Tsuen; Hsiao, Chuhsing Kate

2006-01-01

Modern association studies often involve a large number of markers and hence may encounter the problem of testing multiple hypotheses. Traditional procedures are usually over-conservative and with low power to detect mild genetic effects. From the design perspective, we propose a two-stage selection procedure to address this concern. Our main principle is to reduce the total number of tests by removing clearly unassociated markers in the first-stage test. Next, conditional on the findings of the first stage, which uses a less stringent nominal level, a more conservative test is conducted in the second stage using the augmented data and the data from the first stage. Previous studies have suggested using independent samples to avoid inflated errors. However, we found that, after accounting for the dependence between these two samples, the true discovery rate increases substantially. In addition, the cost of genotyping can be greatly reduced via this approach. Results from a study of hypertriglyceridemia and simulations suggest the two-stage method has a higher overall true positive rate (TPR) with a controlled overall false positive rate (FPR) when compared with single-stage approaches. We also report the analytical form of its overall FPR, which may be useful in guiding study design to achieve a high TPR while retaining the desired FPR.

Development of Monozygotic Twin Mouse Embryos from the Time of Blastomere Separation at the Two-Cell Stage to Blastocyst1

PubMed Central

Katayama, Mika; Ellersieck, Mark R.; Roberts, R. Michael

2010-01-01

The development of blastomeres separated from two-cell stage murine embryos has been compared. Blastomeres were removed from the zona pellucida (ZP) and cultured individually; the twin embryos were compared during their progression to blastocyst in terms of development rate, cell number, morphology, conformation at the four-cell stage, and CDX2 and POU5F1 (also known as OCT4) expression. In general, twin embryos, whether obtained from superovulated or normally bred dams, displayed comparable cell numbers as they advanced. They formed morulae and blastocysts more or less synchronously with each other and with control embryos, although possessing about half of the latter's cell number. Despite this apparent synchrony, the majority of twin blastocysts differed in terms of their relative complements of POU5F1+/CDX2− cells, which represent inner cell mass (ICM), and POU5F1+/CDX2+ cells, which identify trophectoderm (TE). Many, but not all, exhibited a disproportionately small ICM. By contrast, demiembryos retained within their ZP and created by randomly damaging one of the two blastomeres in two-cell stage embryos exhibited a more normal ratio of ICM to TE cells at blastocyst and significantly less variance in ICM cell number. One possible explanation is that ZP-free demiembryos only infrequently adopt the same conformation as their partners, including the favorable tetrahedral form, at the four-cell stage, suggesting that such embryos exhibit a high degree of plasticity with regard to the orientation of their first two cleavage planes and that a significant number likely deviate from paths that provide an optimal geometric progression to blastocyst. These data could explain the difficulty of creating monozygotic twins from two-cell stage embryos. PMID:20181620

The ideas about advanced life support and affecting factors at the end-stage of life in a hospital in Turkey.

PubMed

Albayrak, Turgay; Şencan, İrfan; Akça, Ömer; Koç, Esra Meltem; Aksoy, Hilal; Ünsal, Selim; Bülbül, İskender; Bahadır, Adem; Kasım, İsmail; Kahveci, Rabia; Özkara, Adem

2017-01-01

The participation of the people in health decisions may be structured in various levels. One of these is participation in decisions for the treatment. "Advanced directives" is one of the examples for the participation in decisions for the treatment. We wanted to determine the decisions on advanced life support at the end-stage of life in case of a life-threatening illness for the people themselves and their first degree relatives and the factors effecting these decisions. The cross-sectional study was conducted with volunteers among patients and patient relatives who applied to all polyclinics of the Ankara Numune Training and Research Hospital except the emergency, oncology and psychiatry polyclinics between 15.12.2012 and 15.03.2013. A questionnaire, the Hospital Anxiety Depression (HAD) scale, and Templer's Death Anxiety Scale (TDA) were applied to all individuals. SPSS for Win. Ver. 17.0 and MS-Excel 2010 Starter software bundles were used for all statistical analysis and calculations. The participants want both themselves and their first degree relatives included in end-stage decision-making process. Therefore, the patients and their families should be informed adequately during decision making process and quality communication must be provided. Participants who have given their end-stage decisions previously want to be treated according to these decisions. This desire can just be possible by advanced directives.When moral and material loads of end-stage process are taken into consideration, countries, in which advanced directives are practiced, should be examined well and participants' desire should be evaluated in terms of practicability.

Interim Positron Emission Tomography Response-Adapted Therapy in Advanced-Stage Hodgkin Lymphoma: Final Results of the Phase II Part of the HD0801 Study.

PubMed

Zinzani, Pier Luigi; Broccoli, Alessandro; Gioia, Daniela Maria; Castagnoli, Antonio; Ciccone, Giovannino; Evangelista, Andrea; Santoro, Armando; Ricardi, Umberto; Bonfichi, Maurizio; Brusamolino, Ercole; Rossi, Giuseppe; Anastasia, Antonella; Zaja, Francesco; Vitolo, Umberto; Pavone, Vincenzo; Pulsoni, Alessandro; Rigacci, Luigi; Gaidano, Gianluca; Stelitano, Caterina; Salvi, Flavia; Rusconi, Chiara; Tani, Monica; Freilone, Roberto; Pregno, Patrizia; Borsatti, Eugenio; Sacchetti, Gian Mauro; Argnani, Lisa; Levis, Alessandro

2016-04-20

The clinical impact of positron emission tomography (PET) evaluation performed early during first-line therapy in patients with advanced-stage Hodgkin lymphoma, in terms of providing a rationale to shift patients who respond poorly onto a more intensive regimen (PET response-adapted therapy), remains to be confirmed. The phase II part of the multicenter HD0801 study involved 519 patients with advanced-stage de novo Hodgkin lymphoma who received an initial treatment with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and who underwent an early ifosfamide-containing salvage treatment followed by stem-cell transplantation if they showed a positive PET evaluation after two cycles of chemotherapy (PET2). The primary end point was 2-year progression-free survival calculated for both PET2-negative patients (who completed a full six cycles of ABVD treatment) and PET2-positive patients. Overall survival was a secondary end point. In all, 103 of the 512 evaluable patients were PET2 positive. Among them, 81 received the scheduled salvage regimen with transplantation, 15 remained on ABVD (physician's decision, mostly because of minimally positive PET2), five received an alternative treatment, and two were excluded because of diagnostic error. On intention-to-treat analysis, the 2-year progression-free survival was 76% for PET2-positive patients (regardless of the salvage treatment they received) and 81% for PET2-negative patients. Patients with advanced-stage Hodgkin lymphoma for whom treatment was at high risk of failing appear to benefit from early treatment intensification with autologous transplantation, as indicated by the possibility of successful salvage treatment in more than 70% of PET2-positive patients through obtaining the same 2-year progression-free survival as the PET2-negative subgroup. © 2016 by American Society of Clinical Oncology.

A two-stage broadcast message propagation model in social networks

NASA Astrophysics Data System (ADS)

Wang, Dan; Cheng, Shun-Jun

2016-11-01

Message propagation in social networks is becoming a popular topic in complex networks. One of the message types in social networks is called broadcast message. It refers to a type of message which has a unique and unknown destination for the publisher, such as 'lost and found'. Its propagation always has two stages. Due to this feature, rumor propagation model and epidemic propagation model have difficulty in describing this message's propagation accurately. In this paper, an improved two-stage susceptible-infected-removed model is proposed. We come up with the concept of the first forwarding probability and the second forwarding probability. Another part of our work is figuring out the influence to the successful message transmission chance in each level resulting from multiple reasons, including the topology of the network, the receiving probability, the first stage forwarding probability, the second stage forwarding probability as well as the length of the shortest path between the publisher and the relevant destination. The proposed model has been simulated on real networks and the results proved the model's effectiveness.

Complete response in 5 out of 38 patients with advanced hepatocellular carcinoma treated with stem cell differentiation stage factors: case reports from a single centre.

PubMed

Livraghi, Tito; Ceriani, R; Palmisano, A; Pedicini, V; Pich, M G; Tommasini, M A; Torzilli, G

2011-02-01

Hepatocellular carcinoma (HCC) represents the third cause of cancer-related death. Because HCC is multi-centric with time, excluding the few transplanted patients, sooner or later it becomes untreatable with loco-regional therapies and, until some years ago, it was not responsive to systemic therapies. In 2005 a randomized trial indicated the efficacy of a product containing stem cell differentiation stage factors (SCDSF) taken from zebra fish embryos during the stage in which the totipotent stem cells are differentiating into the pluripotent adult stem cells. In such a trial the patients, with "intermediate" and "advanced" HCC according to BCLC/AASLD guidelines, presented benefit in terms of performance status (PS) and objective tumoral response, with some cases (2.4%) of complete response (CR). The aim of this cohort study is to report the experience of a tertiary referral center on the evidence of cases of CR in patients with "advanced" stage HCC treated with SCDSF as supportive care. CR was regarded as sustained disappearance of the neoplastic areas or blood supply therein, accompanied by normalization of AFP levels. Out of 49 patients consecutively recruited and retrospectively evaluated, 38 had "advanced" stage and 11 "terminal" stage. In 5 patients with "advanced" stage a sustained CR was reported (13.1%). Improvement on PS was obtained in 17 patients (34.6%). No side effects occurred. SCDSF treatment confirmed its efficacy in patients with "advanced" HCC, in terms of PS and tumoral response.

Point estimation following two-stage adaptive threshold enrichment clinical trials.

PubMed

Kimani, Peter K; Todd, Susan; Renfro, Lindsay A; Stallard, Nigel

2018-05-31

Recently, several study designs incorporating treatment effect assessment in biomarker-based subpopulations have been proposed. Most statistical methodologies for such designs focus on the control of type I error rate and power. In this paper, we have developed point estimators for clinical trials that use the two-stage adaptive enrichment threshold design. The design consists of two stages, where in stage 1, patients are recruited in the full population. Stage 1 outcome data are then used to perform interim analysis to decide whether the trial continues to stage 2 with the full population or a subpopulation. The subpopulation is defined based on one of the candidate threshold values of a numerical predictive biomarker. To estimate treatment effect in the selected subpopulation, we have derived unbiased estimators, shrinkage estimators, and estimators that estimate bias and subtract it from the naive estimate. We have recommended one of the unbiased estimators. However, since none of the estimators dominated in all simulation scenarios based on both bias and mean squared error, an alternative strategy would be to use a hybrid estimator where the estimator used depends on the subpopulation selected. This would require a simulation study of plausible scenarios before the trial. © 2018 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

Incidence and risk factors associated with pressure ulcers among patients with HIV infection.

PubMed

Nicastri, Emanuele; Viale, Pierluigi; Lyder, Courtney H; Cristini, Francesco; Martini, Lorena; Preziosi, Gianni; Dodi, Ferdinando; Irato, Laura; Pan, Angelo; Petrosillo, Nicola

2004-06-01

To assess the incidence of and risk factors for pressure ulcers among patients with advanced human immunodeficiency virus type 1 (HIV-1) infection. Multicenter trial that included 1258 consecutive patients infected with HIV-1 who had 1815 admissions to 16 acute care infectious disease units in Italy. Data were collected for demographic, clinical, immunologic, and virologic parameters. The chi-square test was used to compare categorical variables, and the Student t test was used for continuous variables. Univariate analysis was performed to examine possible risk factors for pressure ulcers by computing odds ratios; a multiple logistic regression model was used to obtain adjusted estimates of odds ratios while accounting for all possible risk factors. The incidence of pressure ulcers was 2.31 per 100 admissions, 3.33 per 100 patients, and 1.06 per 1000 patient days. All stages of pressure ulcers were represented in the sample: 7 Stage I (15.9%), 24 Stage II (54.5%), 8 Stage III (18.2%), and 5 Stage IV (11.4%). Multivariate analyses showed that being female, length of hospitalization, and clinical markers of HIV infection were independently associated with pressure ulcers. Mortality rates were 50% among patients with pressure ulcers and 7.2% among patients without pressure ulcers (P <.0001), with an attributable mortality rate of 42.8% and an odds ratio of 12.96 (95% confidence interval 6.99-24.22). A higher incidence of pressure ulcers was found in patients infected with HIV-1 when compared with noninfected patients. Because a longer hospitalization may increase the risk of developing a pressure ulcer, practitioners should be aware of the clinical conditions that may prolong a patient's hospital stay. Aggressive preventive strategies should be implemented to decrease the complications associated with pressure ulcers among patients infected with HIV-1.

Advanced Chemical Propulsion

NASA Technical Reports Server (NTRS)

Alexander, Leslie, Jr.

2006-01-01

Advanced Chemical Propulsion (ACP) provides near-term incremental improvements in propulsion system performance and/or cost. It is an evolutionary approach to technology development that produces useful products along the way to meet increasingly more demanding mission requirements while focusing on improving payload mass fraction to yield greater science capability. Current activities are focused on two areas: chemical propulsion component, subsystem, and manufacturing technologies that offer measurable system level benefits; and the evaluation of high-energy storable propellants with enhanced performance for in-space application. To prioritize candidate propulsion technology alternatives, a variety of propulsion/mission analyses and trades have been conducted for SMD missions to yield sufficient data for investment planning. They include: the Advanced Chemical Propulsion Assessment; an Advanced Chemical Propulsion System Model; a LOx-LH2 small pumps conceptual design; a space storables propellant study; a spacecraft cryogenic propulsion study; an advanced pressurization and mixture ratio control study; and a pump-fed vs. pressure-fed study.

Evaluation of pelvic posterior exenteration in the management of advanced-stage ovarian cancer.

PubMed

Tixier, Hervé; Fraisse, Jean; Chauffert, Bruno; Mayer, Françoise; Causeret, Sylvain; Loustalot, Catherine; Deville, Coralie; Bonnetain, Franck; Sagot, Paul; Douvier, Serge; Cuisenier, Jean

2010-03-01

The main aim of this study was to show the interest of pelvic posterior exenteration to obtain complete resection of the tumor in case of invasion of the rectum by contiguity in advanced-stage ovarian cancer. The secondary aim was to determine the morbidity of this surgery. It is a multicentric, retrospective study of a series of 41 patients, who underwent posterior pelvectomy for advanced-stage ovarian cancer, over a period of 18 years, from July 1989 to July 2007. The surgery resulted in macroscopically complete resection in 19 patients (46.34%), a residual tumor <2 cm in 19 patients (46.34%) and >2 cm in 3 patients (7.32%). In 34 patients (34/41), digestive continuity with satisfactory anal sphincter function was restored immediately or in the short term. The mean delay to the start of complementary treatment was 36 days. Median overall survival was 33 months. The main aim of surgery for ovarian peritoneal carcinomatosis is to obtain a complete resection. In the case of direct invasion of the rectum by contiguity, when there is no cleavage plane between the uterus and the rectum, pelvic posterior exenteration is an effective method to achieve this objective. Morbidity is relatively high, but acceptable given the poor prognosis of this disease, the improved survival after surgery, and improvements in post-operative quality of life and functions.