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Sample records for shockwave treatment compared

  1. The TOPSHOCK study: Effectiveness of radial shockwave therapy compared to focused shockwave therapy for treating patellar tendinopath - design of a randomised controlled trial

    PubMed Central

    2011-01-01

    Background Patellar tendinopathy is a chronic overuse injury of the patellar tendon that is especially prevalent in people who are involved in jumping activities. Extracorporeal Shockwave Therapy is a relatively new treatment modality for tendinopathies. It seems to be a safe and promising part of the rehabilitation program for patellar tendinopathy. Extracorporeal Shockwave Therapy originally used focused shockwaves. Several years ago a new kind of shockwave therapy was introduced: radial shockwave therapy. Studies that investigate the effectiveness of radial shockwave therapy as treatment for patellar tendinopathy are scarce. Therefore the aim of this study is to compare the effectiveness of focussed shockwave therapy and radial shockwave therapy as treatments for patellar tendinopathy. Methods/design The TOPSHOCK study (Tendinopathy Of Patella SHOCKwave) is a two-armed randomised controlled trial in which the effectiveness of focussed shockwave therapy and radial shockwave therapy are directly compared. Outcome assessors and patients are blinded as to which treatment is given. Patients undergo three sessions of either focused shockwave therapy or radial shockwave therapy at 1-week intervals, both in combination with eccentric decline squat training. Follow-up measurements are scheduled just before treatments 2 and 3, and 1, 4, 7 and 12 weeks after the final treatment. The main outcome measure is the Dutch VISA-P questionnaire, which asks for pain, function and sports participation in subjects with patellar tendinopathy. Secondary outcome measures are pain determined with a VAS during ADL, sports and decline squats, rating of subjective improvement and overall satisfaction with the treatment. Patients will also record their sports activities, pain during and after these activities, and concurrent medical treatment on a weekly basis in a web-based diary. Results will be analysed according to the intention-to-treat principle. Discussion The TOPSHOCK study is the

  2. Molecular and Cellular Effects of In Vitro Shockwave Treatment on Lymphatic Endothelial Cells

    PubMed Central

    Hackl, Matthias; Weihs, Anna M.; Rünzler, Dominik; Skalicky, Susanna; Karbiener, Michael; Scheideler, Marcel; Pröll, Johannes; Gabriel, Christian; Schweighofer, Bernhard; Gröger, Marion; Spittler, Andreas; Grillari, Johannes; Redl, Heinz

    2014-01-01

    Extracorporeal shockwave treatment was shown to improve orthopaedic diseases and wound healing and to stimulate lymphangiogenesis in vivo. The aim of this study was to investigate in vitro shockwave treatment (IVSWT) effects on lymphatic endothelial cell (LEC) behavior and lymphangiogenesis. We analyzed migration, proliferation, vascular tube forming capability and marker expression changes of LECs after IVSWT compared with HUVECs. Finally, transcriptome- and miRNA analyses were conducted to gain deeper insight into the IVSWT-induced molecular mechanisms in LECs. The results indicate that IVSWT-mediated proliferation changes of LECs are highly energy flux density-dependent and LEC 2D as well as 3D migration was enhanced through IVSWT. IVSWT suppressed HUVEC 3D migration but enhanced vasculogenesis. Furthermore, we identified podoplaninhigh and podoplaninlow cell subpopulations, whose ratios changed upon IVSWT treatment. Transcriptome- and miRNA analyses on these populations showed differences in genes specific for signaling and vascular tissue. Our findings help to understand the cellular and molecular mechanisms underlying shockwave-induced lymphangiogenesis in vivo. PMID:25502694

  3. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature.

    PubMed

    Kertzman, Paulo; Lenza, Mario; Pedrinelli, André; Ejnisman, Benno

    2015-01-01

    Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the effectiveness of shockwave treatment for lateral epicondylitis, shoulder tendinopathy, knee osteoarthrosis, femoral head osteonecrosis and trochanteric bursitis reported inconsistent results for most of their patients. Those that evaluated patients with calcifying tendinopathy, plantar fasciitis, Achilles tendinopathy, patellar tendinopathy and pseudarthrosis showed benefits. Shockwave treatment is a safe and non-invasive method for chronic cases in which conventional techniques have been unsatisfactory and should be used in association with other treatment methods for tendinopathy. Further quality studies are needed. PMID:26229889

  4. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature☆

    PubMed Central

    Kertzman, Paulo; Lenza, Mario; Pedrinelli, André; Ejnisman, Benno

    2015-01-01

    Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the effectiveness of shockwave treatment for lateral epicondylitis, shoulder tendinopathy, knee osteoarthrosis, femoral head osteonecrosis and trochanteric bursitis reported inconsistent results for most of their patients. Those that evaluated patients with calcifying tendinopathy, plantar fasciitis, Achilles tendinopathy, patellar tendinopathy and pseudarthrosis showed benefits. Shockwave treatment is a safe and non-invasive method for chronic cases in which conventional techniques have been unsatisfactory and should be used in association with other treatment methods for tendinopathy. Further quality studies are needed. PMID:26229889

  5. Previous shock-wave lithotripsy treatment does not impact the outcomes of flexible ureterorenoscopy

    PubMed Central

    Yürük, Emrah; Binbay, Murat; Akman, Tolga; Özgör, Faruk; Berberoğlu, Yalçın; Müslümanoğlu, Ahmet Yaser

    2014-01-01

    Objective: Shock-wave lithotripsy (SWL) is the first-line treatment for the active removal of small and medium-sized kidney stones. Flexible ureterorenoscopy (fURS) is recommended after failed SWL treatment. The aim of this retrospective analysis is to evaluate whether prior unsuccessful SWL treatments affect the outcomes of fURS. Material and methods: Data from 206 patients who underwent fURS for the treatment of renal stones between September 2009 and January 2011 were collected, and the patients were divided into two groups according to their previous SWL treatment. The patient demographics, stone characteristics, operation and fluoroscopy times, stone-free rates and complications were compared. Results: Of the patients, 114 (55.3%) did not undergo SWL prior to fURS (Group 1), whereas 92 (44.6%) completed a minimum of 3 sessions of SWL and waited at least 2 weeks before the fURS operation (Group 2). Although the mean stone number was higher in Group 2, this difference was not significant (p=0.06). The mean operation (p=0.12) and fluoroscopy times (p=0.69) were similar between the groups. The mean operation time per mm2 stone and fluoroscopy time per mm2 stone were not significantly different (p=0.64 and p=0.76, respectively). The length of the hospitalization and the overall complication rates were similar. After the third postoperative month, the stone-free rates were not different between the groups (82.5% and 86.9%, respectively, p=0.38). Conclusion: The stone-free and complication rates of fURS were not affected by previous SWL therapy. PMID:26328180

  6. Safety and efficacy of low intensity shockwave (LISW) treatment in patients with erectile dysfunction

    PubMed Central

    Ruffo, A.; Capece, M.; Prezioso, D.; Romeo, G.; Illiano, E.; Romis, L.; Lauro, G. Di; Iacono, F.

    2015-01-01

    ABSTRACT The primary goal in the management strategy of a patient with ED would be to determine its etiology and cure it when possible, and not just to treat the symptoms alone. One of the new therapeutic strategies is the use of low intensity extracorporeal shockwave (LISW) therapy. The mechanism of shockwave therapy is not completely clear. It is suggested that LISW induces neovascularization and improvement of cavernosal arterial flow which can lead to an improvement of erectile function by releasing NO, VEGF and PCNA. Materials and Methods: 31 patients between February and June 2013 with mild to severe ED and non-Phosphodiesterase 5 inhibitors responders were enrolled. Patients underwent four weekly treatment sessions. During each session 3600 shocks at 0.09mJ/ mm2 were given, 900 shocks at each anatomical area (right and left corpus cavernosum, right and left crus). Improvement of the erectile function was evaluated using the International Index of Erectile Function (IIEF-EF), the Sexual Encounter Profile (SEP) diaries (SEP-Questions 2 and 3) and Global Assessment Questions (GAQ-Q1 and GAQ-Q2). Results: At 3-month follow-up IIEF-EF scores improved from 16.54±6.35 at baseline to 21.03±6.38. Patients answering ‘yes’ to the SEP-Q2 elevated from 61% to 89% and from 32% to 62% in the SEP-Q3. A statistically significant improvement was reported to the Global Assessment Questions (GAQ-Q1 and GAQ-Q2). Conclusion: In conclusion, we can affirm that LISW is a confirmed therapeutic approach to erectile dysfunction that definitely needs more long-term trials to be clarified and further verified. PMID:26689523

  7. Slightly focused high-energy shockwave therapy: a potential adjuvant treatment for osteoporotic fracture

    PubMed Central

    Chen, Xiao-Feng; Huang, Hai-Ming; Li, Xiao-Lin; Liu, Ge-Jun; Zhang, Hui

    2015-01-01

    Slightly focused high-energy shockwave (HESW) therapy is characterized by a wide focal area, a large therapy zone, easy positioning and less pain during treatment. The objective of this study was to perform for the first time an in vivo test of the slightly focused HESWs for osteoporotic fractures. Bilateral proximal tibial osteotomies were made in 30 ovariectomized (OVX) Sprague-Dawley rats and secured with internal fixation. The osteotomy site in the left tibia was subsequently treated with slightly focused HESWs with the energy flux density of 0.26 mj/mm2, shock repetition frequency of 1 Hz and 2000 shocks (OVX + HESW group). The contralateral right tibia was not treated and served as the control (OVX group). Roentgenographic examination 2, 4, 6, and 8 weeks after osteotomy showed that HESW treatment accelerated tibia fracture healing in osteoporotic rats. Histological examination 2, 4, and 8 weeks after HESW treatment showed a greater inflammatory reaction in the OVX + HESW group, with more mature collagen and trabeculae than in the OVX group. Micro computer tomography (Micro-CT) scanning after 4 and 8 weeks showed that bone volume (BV), bone volume/tissue volume (BV/TV), mean trabecular thickness (Tb.Th), and mean trabecular number (Tb.N) were about 45.0% and 33.1%, 18.4% and 20.1%, 38.2% and 20.9%, 26.7% and 28.4%, respectively, higher in the treatment group than in the control group (P < 0.05); and the mean trabecular separation (Tb.Sp) was about 16.7% and 27.3% lower in the treatment group (P < 0.05). Four and eight weeks after HESW treatment, the maximum compressive callus endurance was about 72.3% and 25.5%, respectively, higher in the treatment group than in the control group (P < 0.05). These results show that slightly focused HESW therapy has a beneficial effect on osteoporotic tibial fracture healing. Slightly focused HESWs could increase callus endurance, induce bone formation, and improve trabecular bone microarchitecture and biomechanical

  8. Extracorporeal shock-wave lithotripsy with MPL9000 for the treatment of urinary stones in pediatric patients.

    PubMed

    Zanetti, G; Montanari, E; Guarneri, A; Seveso, M; Trinchieri, A; Rovera, F; Austoni, E; Pisani, E

    1993-12-01

    Extracorporeal shock-wave lithotripsy (ESWL) is now applied as the treatment of choice in most cases of urinary stones. Its acceptance in pediatry, however has been only gradual despite numerous positive studies. We report on fourteen young patients (mean age: 9.7 years) who were all treated by ESWL with the MPL9000 lithotriptor for renal stones. Each patient received an average of 1440 shocks with generator energy set at 14.4 Kv. Six of these patients required either analgosedation or anesthesia. No observable complications of treatment occurred. At one-month follow up, the kidneys of twelve patients were found to be stone-free, while two still presented fragments that could pass spontaneously. At three-month follow-up, thirteen patients were stone-free and a single patient retained some fragments. From this data we infer that ESWL with the MPL9000 lithotriptor may be used safety and efficiently to treat urolithiasis in younger patients. PMID:8312950

  9. Halide based shock-wave treatment of fluid-rich natural phases

    NASA Astrophysics Data System (ADS)

    Schlothauer, T.; Schimpf, C.; Brendler, E.; Keller, K.; Kroke, E.; Heide, G.

    2015-11-01

    For the synthesis of high pressure phases from natural minerals and the shock wave treatment of fluid bearing phases a halide based method was developed. The experiments were performed in the pressure range between 25 and 162 GPa with a success rate for the new method of 100% for the new method. Based on the Impedance Corrected Sample Recovery Capsule under avoiding the adiabatic decompression a direct comparison between different loading paths and sample holder geometries is possible. The recovered samples show neither indications of melting in the case of kaolinite and very limited degassing in the case of carbonates. The recovery of amorphous water bearing Al-Si-phases with Aluminum in four-, five- and six-fold coordination was possible. The samples were analyzed with scanning electron microscopy, x-ray diffraction, nuclear-magnetic-resonance- and infra-red-spectroscopy and the results were directly compared.

  10. The treatment of the reno-ureteral calculi by extracorporeal shockwave lithotripsy (ESWL)

    PubMed Central

    Ceban, E

    2012-01-01

    Urolithiasis has an important role in the structure of urological pathology, due to its high incidence, frequency of recurrence and complications it might cause. There are many methods of treatment for kidney stones described in the scientific literature as conservative, surgical, laparoscopic, endoscopic, and ESWL. In this study, we have analyzed the ESWL method of treatment of reno-ureteral stones. There are still many controversies about the effectiveness of different models of lithotripters but the lithotripter type Modulith SLK Storz Medical (Germany) used in our clinic has proved to be very effective. ESWL is currently the first-line treatment for the majority of kidney and ureteral stones, which are up to 20 mm in diameter. PMID:22802877

  11. [Extracorporeal shockwave lithotripsy in the treatment of distal ureteral stones larger than 10 mm in diameter].

    PubMed

    Ishii, Nobuyuki; Yoshinaga, Atsushi; Ohno, Rena; Chiba, Koji; Hayashi, Tetsuo; Kamata, Shigeyoshi; Watanabe, Toru; Yamada, Takumi

    2004-06-01

    Optimal treatment for distal ureteral stones remains controversial. During a period of 10 years, from December 1992 to December 2002, 103 distal ureteral stones larger than 10 mm in diameter were treated at our institution with extracorporeal shock wave lithotripsy (ESWL) using the Siemens Lithostar. Only 2 patients had a ureteral stent in place at the time of treatment. The overall stone-free rate was 98% with 1-12 session and 3-month stone-free rate was 95.1%. These data reveal that a high success rate was achieved in multisession ESWL. Therefore, ESWL is considered to be acceptable as first-line therapy for fragmentation of distal ureteral stones larger than 10 mm in diameter. PMID:15293734

  12. Improving the antioxidant functionality of Citrus junos Tanaka (yuzu) fruit juice by underwater shockwave pretreatment.

    PubMed

    Kuraya, Eisuke; Nakada, Shina; Touyama, Akiko; Itoh, Shigeru

    2017-02-01

    Citrus junos Tanaka (yuzu) has a strong characteristic aroma, and hence, yuzu juice is used in a number of Japanese foods. We herein evaluated the functional compounds of yuzu juice to investigate whether underwater shockwave pretreatment affects its functionality. Employing the shockwave pretreatment at an increased discharge and energy of 3.5kV and 4.9kJ, respectively, resulted in an increase in the flavanone glycoside content and oxygen radical absorbance capacity (ORAC). The ORAC value of yuzu juice cultivated in Rikuzentakata increased approximately 1.7 times upon underwater shockwave pretreatment. The treatment method proposed herein exhibited reliable and good performance for the extraction of functional and antioxidant chemicals in yuzu fruits, and was comparable with traditional squeezing methods. The high applicability and reliability of this technique for improving the antioxidant functionality of yuzu fruit juice was demonstrated, confirming the potential for application to a wide range of food extraction processes. PMID:27596400

  13. Stepwise shockwave velocity determinator

    NASA Technical Reports Server (NTRS)

    Roth, Timothy E.; Beeson, Harold

    1992-01-01

    To provide an uncomplicated and inexpensive method for measuring the far-field velocity of a surface shockwave produced by an explosion, a stepwise shockwave velocity determinator (SSVD) was developed. The velocity determinator is constructed of readily available materials and works on the principle of breaking discrete sensors composed of aluminum foil contacts. The discrete sensors have an average breaking threshold of approximately 7 kPa. An incremental output step of 250 mV is created with each foil contact breakage and is logged by analog-to-digital instrumentation. Velocity data obtained from the SSVD is within approximately 11 percent of the calculated surface shockwave velocity of a muzzle blast from a 30.06 rifle.

  14. The Chelyabinsk airburst shockwave

    NASA Astrophysics Data System (ADS)

    Popova, O.; Shuvalov, V.; Rybnov, Y.; Jenniskens, P.; Kharlamov, V.; Usoltseva, O.; Glazachev, D.; Podobnaya, E.; Dyagilev, R.; Trubetskaya, I.

    2014-07-01

    The Chelyabinsk airburst of 15 February 2013 was exceptional because of the large kinetic energy of the impacting body and because the airburst that was generated created significant damage and injuries in a densely populated area. The butterfly-shape of the damaged area (Popova et al., 2013) is explained from the fact that the energy was deposited over a range of altitudes. Some uncertainty remains about the source energy of the airburst, because it is not known precisely at what pressure glass is expected to break. Reasonable results were obtained for energies of 300--520 kt TNT and over pressures of 500--1000 Pa, assuming that the time dependence of the energy release followed the meteor lightcurve (Popova et al. 2013). Additional information about the airburst characteristics may be extracted from the arrival times of the shockwave at various locations and from pressure records. Arrival times of the shock wave were derived from video observations. From the analysis of these shock wave arrival times, a range of altitudes of energy deposition was derived (Popova et al. 2013). The observed arrival times were compared with model estimates, taking into account the real wind and atmospheric conditions. Results of the numerical simulations were compared with recorded sound signals, which were often quite complex. Borovicka et al. (2013) suggested that subsequent acoustic arrivals corresponded to separate fragmentation events. This hypothesis is tested. There were no instrumental records of overpressure in the damaged area. However, seismic records exist from locations surrounding a coal mine at Korkino, situated in the damage area close to the meteoroid trajectory, almost immediately below the region of highest energy deposition. Its seismic control system to monitor land slides recorded the blast wave from the meteoroid entry indirectly due to coupling to the ground. This is the only instrumental record of the airburst close to the meteoroid trajectory. An analysis

  15. Quantitative Assessment of Shockwave Lithotripsy Accuracy and the Effect of Respiratory Motion*

    PubMed Central

    Bailey, Michael R.; Shah, Anup R.; Hsi, Ryan S.; Paun, Marla; Harper, Jonathan D.

    2012-01-01

    Abstract Background and Purpose Effective stone comminution during shockwave lithotripsy (SWL) is dependent on precise three-dimensional targeting of the shockwave. Respiratory motion, imprecise targeting or shockwave alignment, and stone movement may compromise treatment efficacy. The purpose of this study was to evaluate the accuracy of shockwave targeting during SWL treatment and the effect of motion from respiration. Patients and Methods Ten patients underwent SWL for the treatment of 13 renal stones. Stones were targeted fluoroscopically using a Healthtronics Lithotron (five cases) or Dornier Compact Delta II (five cases) shockwave lithotripter. Shocks were delivered at a rate of 1 to 2 Hz with ramping shockwave energy settings of 14 to 26 kV or level 1 to 5. After the low energy pretreatment and protective pause, a commercial diagnostic ultrasound (US) imaging system was used to record images of the stone during active SWL treatment. Shockwave accuracy, defined as the proportion of shockwaves that resulted in stone motion with shockwave delivery, and respiratory stone motion were determined by two independent observers who reviewed the ultrasonographic videos. Results Mean age was 51±15 years with 60% men, and mean stone size was 10.5±3.7 mm (range 5–18 mm). A mean of 2675±303 shocks was delivered. Shockwave-induced stone motion was observed with every stone. Accurate targeting of the stone occurred in 60%±15% of shockwaves. Conclusions US imaging during SWL revealed that 40% of shockwaves miss the stone and contribute solely to tissue injury, primarily from movement with respiration. These data support the need for a device to deliver shockwaves only when the stone is in target. US imaging provides real-time assessment of stone targeting and accuracy of shockwave delivery. PMID:22471349

  16. Analysis of flexible substrates for clinical translation of laser-generated shockwave therapy

    PubMed Central

    Francis, Nathan C.; Kassam, Imara; Nowroozi, Bryan; Grundfest, Warren S.; Taylor, Zach D.

    2015-01-01

    Bacteria biofilms in chronically infected wounds significantly increase the burden of healthcare costs and resources for patients and clinics. Because biofilms are such an effective barrier to standard antibiotic treatment, new methods of therapy need to be developed to combat these infections. Our group has demonstrated the potential of using Laser Generated Shockwaves as a potential therapy to mechanically disrupt the bacterial biofilms covering the wound. Previous studies have used rigid silica glass as the shockwave propagation medium, which is not compatible with the intended clinical application. This paper describes the exploration of five candidate flexible plastic films to replace the glass substrate. Each material measured 0.254 mm thick and was used to generate shockwaves of varying intensities. Shockwave characterization was performed using a high-speed Michelson displacement interferometer and peak stress values obtained in the flexible substrates were compared to glass using one-way nested Analysis of Variance and Tukey HSD post-hoc analysis. Results demonstrate statistically significant differences between substrate material and indicate that polycarbonate achieves the highest peak stress for a given laser fluence suggesting that it is optimal for clinical applications. PMID:25798307

  17. International Shock-Wave Database: Current Status

    NASA Astrophysics Data System (ADS)

    Levashov, Pavel

    2013-06-01

    speed in the Hugoniot state, and time-dependent free-surface or window-interface velocity profiles. Users are able to search the information in the database and obtain the experimental points in tabular or plain text formats directly via the Internet using common browsers. It is also possible to plot the experimental points for comparison with different approximations and results of equation-of-state calculations. The user can present the results of calculations in text or graphical forms and compare them with any experimental data available in the database. A short history of the shock-wave database will be presented and current possibilities of ISWdb will be demonstrated. Web-site of the project: http://iswdb.info. This work is supported by SNL contracts # 1143875, 1196352.

  18. A Supernova's Shockwaves

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Supernovae are the explosive deaths of the universe's most massive stars. In death, these volatile creatures blast tons of energetic waves into the cosmos, destroying much of the dust surrounding them.

    This false-color composite from NASA's Spitzer Space Telescope and NASA's Chandra X-ray Observatory shows the remnant of one such explosion. The remnant, called N132D, is the wispy pink shell of gas at the center of this image. The pinkish color reveals a clash between the explosion's high-energy shockwaves and surrounding dust grains.

    In the background, small organic molecules called polycyclic aromatic hydrocarbons are shown as tints of green. The blue spots represent stars in our galaxy along this line of sight.

    N132D is located 163,000 light-years away in a neighboring galaxy called, the Large Magellanic Cloud.

    In this image, infrared light at 4.5 microns is mapped to blue, 8.0 microns to green and 24 microns to red. Broadband X-ray light is mapped purple. The infrared data were taken by Spitzer's infrared array camera and multiband imaging photometer, while the X-ray data were captured by Chandra.

  19. [The endoscopic treatment of large calculi in the choledochus. The preliminary results with intracorporeal electrohydraulic shock-wave lithotripsy].

    PubMed

    Vladimirov, B

    1990-01-01

    Results are reported of endoscopic treatment of: 236 patients with common bile duct calculi treated by endoscopic sphincterotomy with or without hydrostatic balloon extraction and extraction of the calculi, mechanical lithotripsy and endoprosthesis; preliminary results in 12 patients treated by intracorporeal electrohydraulic lithotripsy. Complete removal of calculi from the common bile duct was achieved in 171 of 236 sphincterotomized patients (72 per cent). Complications were observed in 11 per cent of the patients. Mechanical cracking of common bile duct calculi was realized in 60 of 65 patients (92 per cent) with complications observed in 3 per cent. Thus, with the use of mechanical lithotripsy the success of endoscopic treatment rose to 98 per cent, without increase in the incidence of complications. Seven patients had endoprostheses placed because of failure to extract the calculi. Intracorporeal electrohydraulic lithotripsy was performed in 12 patients with common bile duct lithiasis (4 with single and 8 with numerous stones with diameter 20-40 mm. In one patient transient acute pancreatitis was observed. A rise in serum amylase content was recorded in 9 patients. The stones in the common bile duct were effectively broken to pieces and removed in 8 patients. Lithotripsy was unsuccessful in 4 patients, two of whom had solid calcium depositions. In the common bile duct of the other two MTBE gas applied. The patients were subjected to repeated lithotripsy with positive effect. It is pointed out in conclusion that crushing stones in the common bile duct allows real improvement of the results of endoscopic sphincterotomy in common bile duct calculosis. Endoscopic treatment of larger calculi became also feasible which until a few years ago were contraindication for endoscopic treatment. PMID:2102523

  20. Shock-wave surfing

    SciTech Connect

    Laurence, Stuart J; Deiterding, Ralf

    2011-01-01

    A phenomenon referred to as shock-wave surfing , in which a body moves in such a way as to follow the shock wave generated by another upstream body, is investigated numerically and theoretically. This process can lead to the downstream body accumulating a significantly higher lateral velocity than would otherwise be possible, and thus is of importance in situations such as meteoroid fragmentation, in which the fragment separation behaviour following disruption is determined to a large extent by aerodynamic effects. The surfing effect is first investigated in the context of interactions between a sphere and a planar oblique shock. Numerical simulations are performed and a simple theoretical model is developed to determine the forces acting on the sphere. A phase-plane description is employed to elucidate features of the system dynamics. The theoretical model is then generalised to the more complex situation of aerodynamic interactions between two spheres, and, through comparisons with further computations, is shown to adequately predict, in particular, the final separation velocity of the surfing sphere in initially touching configurations. Both numerical simulations and theory indicate a strong influence of the body radius ratio on the separation process and predict a critical radius ratio for initially touching fragments that delineates entrainment of the smaller fragment within the larger fragment s shock from expulsion; this critical ratio also results in the most extended surfing. Further, these results show that an earlier prediction for the separation velocity to scale with the square root of the radius ratio does not accurately describe the separation behaviour. The theoretical model is then employed to investigate initial configurations with varying relative sphere positions and initial velocities. A phase-space description is also shown to be useful in elucidating the dynamics of the sphere-sphere system. With regard to meteoroid fragmentation, it is shown

  1. Interaction of lithotripter shockwaves with single inertial cavitation bubbles.

    PubMed

    Klaseboer, Evert; Fong, Siew Wan; Turangan, Cary K; Khoo, Boo Cheong; Szeri, Andrew J; Calvisi, Michael L; Sankin, Georgy N; Zhong, Pei

    2007-01-01

    The dynamic interaction of a shockwave (modelled as a pressure pulse) with an initially spherically oscillating bubble is investigated. Upon the shockwave impact, the bubble deforms non-spherically and the flow field surrounding the bubble is determined with potential flow theory using the boundary-element method (BEM). The primary advantage of this method is its computational efficiency. The simulation process is repeated until the two opposite sides of the bubble surface collide with each other (i.e. the formation of a jet along the shockwave propagation direction). The collapse time of the bubble, its shape and the velocity of the jet are calculated. Moreover, the impact pressure is estimated based on water-hammer pressure theory. The Kelvin impulse, kinetic energy and bubble displacement (all at the moment of jet impact) are also determined. Overall, the simulated results compare favourably with experimental observations of lithotripter shockwave interaction with single bubbles (using laser-induced bubbles at various oscillation stages). The simulations confirm the experimental observation that the most intense collapse, with the highest jet velocity and impact pressure, occurs for bubbles with intermediate size during the contraction phase when the collapse time of the bubble is approximately equal to the compressive pulse duration of the shock wave. Under this condition, the maximum amount of energy of the incident shockwave is transferred to the collapsing bubble. Further, the effect of the bubble contents (ideal gas with different initial pressures) and the initial conditions of the bubble (initially oscillating vs. non-oscillating) on the dynamics of the shockwave-bubble interaction are discussed. PMID:19018296

  2. Developing Multimedia Courseware for the Internet's Java versus Shockwave.

    ERIC Educational Resources Information Center

    Majchrzak, Tina L.

    1996-01-01

    Describes and compares two methods for developing multimedia courseware for use on the Internet: an authoring tool called Shockwave, and an object-oriented language called Java. Topics include vector graphics, browsers, interaction with network protocols, data security, multithreading, and computer languages versus development environments. (LRW)

  3. Some aspects of shock-wave research

    NASA Astrophysics Data System (ADS)

    Glass, I. I.

    1986-01-01

    The major portion of the paper is devoted to a specific shock-wave research problem, namely, pseudostationary oblique shock-wave reflections in perfect and imperfect gases. Consideration is given to what has been achieved to date by using two- and three-shock theory to predict what type of reflection results when a planar shock wave M(S), in a shock tube, collides with a sharp compressive wedge of angle, theta(W). Expermental (interferometric and other optical) data are presented in (M(S), theta(W))-plots for argon, nitrogen, oxygen, air, carbon-dioxide, Freon-12 and sulfurhexafluoride, in order to check the validity of the analytically predicted regions and transition lines of the four types of reflection. Some disagreements are noted and discussed. The present interferometric isopycnic data are also compared with state-of-the-art computational results from a solution of the inviscid Euler equations using a CRAY I computer. Good agreement was obtained; it would be important, however, to obtain new data by solving the Navier-Stokes equations, as well as the rate equations for imperfect-gas excitations, in order to judge the improvement obtained with real-flow interferograms.

  4. Extracorporeal shockwave therapy for avascular necrosis of femoral head.

    PubMed

    Wang, Ching-Jen; Cheng, Jai-Hong; Huang, Chung-Cheng; Yip, Han-Kan; Russo, Sergio

    2015-12-01

    The etiology of osteonecrosis of the femoral head (ONFH) is multifactorial. Treatment of ONFH is disease stage dependent. For early stages, femoral head preservation procedures are preferred including core decompression, muscle pedicle grafting and de-rotational osteotomy. Core decompression with bone grafting is considered the gold standard. However, the results are inconsistence and unpredictable. An effective non-invasive method of treatment is imperative. Recently, extracorporeal shockwave therapy (ESWT) has shown beneficial effects in ONFH. ESWT improves pain and function of the hip and regression of the ONFH lesion. ESWT is more effective than core decompression with or without bone grafting, cocktail therapy that combined HBO, ESWT and oral alendronate is shown effective for patients with early osteonecrosis. The purpose of the article is to review, update and summarize the clinical treatment of ONFH using shockwave therapy. PMID:26188081

  5. Interaction of lithotripter shockwaves with single inertial cavitation bubbles

    PubMed Central

    Klaseboer, Evert; Fong, Siew Wan; Turangan, Cary K.; Khoo, Boo Cheong; Szeri, Andrew J.; Calvisi, Michael L.; Sankin, Georgy N.; Zhong, Pei

    2008-01-01

    The dynamic interaction of a shockwave (modelled as a pressure pulse) with an initially spherically oscillating bubble is investigated. Upon the shockwave impact, the bubble deforms non-spherically and the flow field surrounding the bubble is determined with potential flow theory using the boundary-element method (BEM). The primary advantage of this method is its computational efficiency. The simulation process is repeated until the two opposite sides of the bubble surface collide with each other (i.e. the formation of a jet along the shockwave propagation direction). The collapse time of the bubble, its shape and the velocity of the jet are calculated. Moreover, the impact pressure is estimated based on water-hammer pressure theory. The Kelvin impulse, kinetic energy and bubble displacement (all at the moment of jet impact) are also determined. Overall, the simulated results compare favourably with experimental observations of lithotripter shockwave interaction with single bubbles (using laser-induced bubbles at various oscillation stages). The simulations confirm the experimental observation that the most intense collapse, with the highest jet velocity and impact pressure, occurs for bubbles with intermediate size during the contraction phase when the collapse time of the bubble is approximately equal to the compressive pulse duration of the shock wave. Under this condition, the maximum amount of energy of the incident shockwave is transferred to the collapsing bubble. Further, the effect of the bubble contents (ideal gas with different initial pressures) and the initial conditions of the bubble (initially oscillating vs. non-oscillating) on the dynamics of the shockwave–bubble interaction are discussed. PMID:19018296

  6. Shock-wave measurement using a calibrated interferometric fiber-tip sensor.

    PubMed

    Koch, C; Molkenstruck, W; Reibold, R

    1997-01-01

    The results of shock-wave measurements using a calibrated fiber-tip sensor based on a Michelson interferometer are presented. A transfer function, obtained by an independent experiment that describes the properties of the sensor system, was used to correct the measured shock-wave data in the Fourier frequency domain. The phase of the transfer function was determined from its amplitude by a fitting procedure using minimum-phase terms. As an example of application, the acoustic output field of an electromagnetic lithotriptor was investigated, and the shock-wave source was reliably characterized. The measured data provide a basis for estimating the hazard to which a patient is exposed during shock-wave treatment and for optimizing a lithotriptor system to produce a sharply localized and effective acoustic field. PMID:9372574

  7. Shockwave Engine: Wave Disk Engine

    SciTech Connect

    2010-01-14

    Broad Funding Opportunity Announcement Project: MSU is developing a new engine for use in hybrid automobiles that could significantly reduce fuel waste and improve engine efficiency. In a traditional internal combustion engine, air and fuel are ignited, creating high-temperature and high-pressure gases which expand rapidly. This expansion of gases forces the engine’s pistons to pump and powers the car. MSU’s engine has no pistons. It uses the combustion of air and fuel to build up pressure within the engine, generating a shockwave that blasts hot gas exhaust into the blades of the engine’s rotors causing them to turn, which generates electricity. MSU’s redesigned engine would be the size of a cooking pot and contain fewer moving parts—reducing the weight of the engine by 30%. It would also enable a vehicle that could use 60% of its fuel for propulsion.

  8. Efficacy of Extracorporeal Shockwave Therapy in Frozen Shoulder

    PubMed Central

    Vahdatpour, Babak; Taheri, Parisa; Zade, Abolghasem Zare; Moradian, Saeed

    2014-01-01

    Background: Frozen shoulder has always been considered important because of the impact on the quality-of-life and long period of illness. Therefore, the use of noninvasive and safe techniques that can speed up the healing process of the disease is important. Methods: This study was a randomized clinical trial study on patients suffering from frozen shoulder who were referred to Isfahan University of Medical Sciences hospitals in 2011 and 2012. A total of 36 patients were enrolled in the study. Eligible patients were allocated into two groups. Intervention group received extracorporeal shockwave therapy (ESWT) once a week for 4 weeks. The control group received sham shockwave therapy once a week for 4 weeks. On the follow-up period, changes in individual performance and the amount of pain and disability were assessed by the Shoulder Pain and Disability Index (SPADI) questionnaire and the range of motion changes were assessed by a goniometer. Data obtained were analyzed using SPSS software. Results: Variance analysis revealed a difference in the mean pain and disability score of the SPADI questionnaire, flexion, extension, and abduction, external rotation of involved shoulder between two groups before and after the shockwave therapy (P < 0.05). Improvement was more satisfactory in the intervention group, but the mean internal rotation did not differ significantly in two groups (P > 0.05). Conclusions: The use of ESWT seems to have positive effects on treatment, quicker return to daily activities, and quality-of-life improvement on frozen shoulder. PMID:25104999

  9. Shockwave Consolidation of Nanostructured Thermoelectric Materials

    NASA Technical Reports Server (NTRS)

    Prasad, Narasimha S.; Taylor, Patrick; Nemir, David

    2014-01-01

    Nanotechnology based thermoelectric materials are considered attractive for developing highly efficient thermoelectric devices. Nano-structured thermoelectric materials are predicted to offer higher ZT over bulk materials by reducing thermal conductivity and increasing electrical conductivity. Consolidation of nano-structured powders into dense materials without losing nanostructure is essential towards practical device development. Using the gas atomization process, amorphous nano-structured powders were produced. Shockwave consolidation is accomplished by surrounding the nanopowder-containing tube with explosives and then detonating. The resulting shock wave causes rapid fusing of the powders without the melt and subsequent grain growth. We have been successful in generating consolidated nano-structured bismuth telluride alloy powders by using the shockwave technique. Using these consolidated materials, several types of thermoelectric power generating devices have been developed. Shockwave consolidation is anticipated to generate large quantities of nanostructred materials expeditiously and cost effectively. In this paper, the technique of shockwave consolidation will be presented followed by Seebeck Coefficient and thermal conductivity measurements of consolidated materials. Preliminary results indicate a substantial increase in electrical conductivity due to shockwave consolidation technique.

  10. 1D GAS-DYNAMIC SIMULATION OF SHOCK-WAVE PROCESSES VIA INTERNET

    SciTech Connect

    Khishchenko, K. V.; Levashov, P. R.; Povarnitsyn, M. E.; Zakharenkov, A. S.

    2009-12-28

    We present a Web-interface for 1D simulation of different shock-wave experiments. The choosing of initial parameters, the modeling itself and output data treatment can be made directly via the Internet. The interface is based upon the expert system on shock-wave data and equations of state and contains both the Eulerian and Lagrangian Godunov hydrocodes. The availability of equations of state for a broad set of substances makes this system a useful tool for planning and interpretation of shock-wave experiments. As an example of simulation with the system, results of modeling of multistep shock loading of potassium between polytetrafluoroethylene and stainless steel plates are presented in comparison with experimental data from Shakhray et al.(2005).

  11. D Gas-Dynamic Simulation of Shock-Wave Processes via Internet

    NASA Astrophysics Data System (ADS)

    Khishchenko, K. V.; Levashov, P. R.; Povarnitsyn, M. E.; Zakharenkov, A. S.

    2009-12-01

    We present a Web-interface for 1D simulation of different shock-wave experiments. The choosing of initial parameters, the modeling itself and output data treatment can be made directly via the Internet. The interface is based upon the expert system on shock-wave data and equations of state and contains both the Eulerian and Lagrangian Godunov hydrocodes. The availability of equations of state for a broad set of substances makes this system a useful tool for planning and interpretation of shock-wave experiments. As an example of simulation with the system, results of modeling of multistep shock loading of potassium between polytetrafluoroethylene and stainless steel plates are presented in comparison with experimental data from Shakhray et al. (2005).

  12. Extracorporeal shockwave lithotripsy of gallstones. Possibilities and limitations.

    PubMed Central

    Vergunst, H; Terpstra, O T; Brakel, K; Laméris, J S; van Blankenstein, M; Schröder, F H

    1989-01-01

    Recently extracorporeal shockwave lithotripsy (ESWL) has been introduced as a nonoperative treatment for gallstone disease. Except for lung damage, no significant adverse effects of ESWL of gallbladder stones have been observed in animals. In clinical use ESWL of gallbladder stones is now confined to 15% to 30% of symptomatic patients. To achieve complete stone clearance, ESWL of gallbladder stones must be supplemented by an adjuvant therapy. ESWL of bile duct stones is highly effective and can be considered in patients in whom primary endoscopic or surgical stone removal fails. Second generation lithotriptors allow anesthesia-free (outpatient) treatments, but the clinical experience with most of these ESWL devices is still limited. The likelihood of gallbladder stone recurrence is a major disadvantage of ESWL treatment, which raises the issue of cost-effectiveness. ESWL for cholelithiasis is a promising treatment modality with good short-term and unknown long-term results. PMID:2684058

  13. Use of shock-wave heating for faster and safer ablation of tissue volumes in high intensity focused ultrasound therapy

    NASA Astrophysics Data System (ADS)

    Khokhlova, V.; Yuldashev, P.; Sinilshchikov, I.; Partanen, A.; Khokhlova, T.; Farr, N.; Kreider, W.; Maxwell, A.; Sapozhnikov, O.

    2015-10-01

    Simulation of enhanced heating of clinically relevant tissue volumes using nonlinear ultrasound waves generated by a multi-element HIFU phased array were conducted based on the combined Westervelt and bio-heat equations. A spatial spectral approach using the fast Fourier transform algorithm and a corresponding analytic solution to the bioheat equation were used to optimize temperature modeling in tissue. Localized shock-wave heating within a much larger treated tissue volume and short, single HIFU pulses within a much longer overall exposure time were accounted for in the algorithm. Separation of processes with different time and spatial scales made the calculations faster and more accurate. With the proposed method it was shown that for the same time-average power, the use of high peak power pulsing schemes that produce high-amplitude shocks at the focus result in faster tissue heating compared to harmonic, continuous-wave sonications. Nonlinear effects can significantly accelerate volumetric heating while also permitting greater spatial control to reduce the impact on surrounding tissues. Such studies can be further used to test and optimize various steering trajectories of shock-wave sonications for faster and more controlled treatment of tissue volumes.

  14. Three lectures: NEMD, SPAM, and shockwaves

    NASA Astrophysics Data System (ADS)

    Hoover, Wm. G.; Hoover, Carol G.

    2011-03-01

    We discuss three related subjects well suited to graduate research. The first, Nonequilibrium molecular dynamics or "NEMD", makes possible the simulation of atomistic systems driven by external fields, subject to dynamic constraints, and thermostated so as to yield stationary nonequilibrium states. The second subject, Smooth Particle Applied Mechanics or "SPAM", provides a particle method, resembling molecular dynamics, but designed to solve continuum problems. The numerical work is simplified because the SPAM particles obey ordinary, rather than partial, differential equations. The interpolation method used with SPAM is a powerful interpretive tool converting point particle variables to twice-differentiable field variables. This interpolation method is vital to the study and understanding of the third research topic we discuss, strong shockwaves in dense fluids. Such shockwaves exhibit stationary far-from-equilibrium states obtained with purely reversible Hamiltonian mechanics. The SPAM interpolation method, applied to this molecular dynamics problem, clearly demonstrates both the tensor character of kinetic temperature and the time-delayed response of stress and heat flux to the strain rate and temperature gradients. The dynamic Lyapunov instability of the shockwave problem can be analyzed in a variety of ways, both with and without symmetry in time. These three subjects suggest many topics suitable for graduate research in nonlinear nonequilibrium problems.

  15. Causality violation, gravitational shockwaves and UV completion

    NASA Astrophysics Data System (ADS)

    Hollowood, Timothy J.; Shore, Graham M.

    2016-03-01

    The effective actions describing the low-energy dynamics of QFTs involving gravity generically exhibit causality violations. These may take the form of superluminal propagation or Shapiro time advances and allow the construction of "time machines", i.e. spacetimes admitting closed non-spacelike curves. Here, we discuss critically whether such causality violations may be used as a criterion to identify unphysical effective actions or whether, and how, causality problems may be resolved by embedding the action in a fundamental, UV complete QFT. We study in detail the case of photon scattering in an Aichelburg-Sexl gravitational shockwave background and calculate the phase shifts in QED for all energies, demonstrating their smooth interpolation from the causality-violating effective action values at low-energy to their manifestly causal high-energy limits. At low energies, these phase shifts may be interpreted as backwards-in-time coordinate jumps as the photon encounters the shock wavefront, and we illustrate how the resulting causality problems emerge and are resolved in a two-shockwave time machine scenario. The implications of our results for ultra-high (Planck) energy scattering, in which graviton exchange is modelled by the shockwave background, are highlighted.

  16. Radial extracorporeal shock-wave therapy in rotator cuff calcific tendinosis

    PubMed Central

    Mangone, Giuseppe; Veliaj, Altin; Postiglione, Marco; Viliani, Tamara; Pasquetti, Pietro

    2010-01-01

    The objective of the study is to evaluate the effectiveness of Radial Extracorporeal Shock-wave Therapy (RESWT) compared with High Power LASER Therapy (HPLT) for the treatment of patients with Rotator Cuff Calcific Tendinosis (RCCT). RCCT is widely diffused, it is painful and invalidating. It is an important public health problem with social and economic implications. The most common therapeutic approach is a physiotherapic one. Both HPLT and RESWT give positive results. There is a debate on which is to be preferred. Therefore there is need to obtain scientific evidence to support either case. An observational study was carried out in the period between October 2008 and September 2009 in our outpatient clinic with 62 patients, divided into 3 groups: group A 36 patients treated only with RESWT, group B 26 patients treated only with HPLT and group C 16 patients with only short term improvement with HPLT retreated with RESWT. Patients were evaluated with Constant-Murley scale before and after treatment (immediately, 1 month and 3 months) for mean constant score, pain and range of movement. Data were examined statistically with SPSS. Criteria for inclusion and exclusion were defined. Patients treated with HPLT have shown good clinical results but have returned to original syndrome 1 month after treatment. RESWT has given improvement after treatment extended in time (3 months) in terms of pain and recover of functionality with a limited number of applications. The evidence collected indicates that RESWT is the method of choice. PMID:22460011

  17. Minimizing masses in explosively driven two-shockwave physics applications

    NASA Astrophysics Data System (ADS)

    Buttler, William; Cherne, Frank; Furlanetto, Michael; Payton, Jeremy; Stone, Joseph; Tabaka, Leonard; Vincent, Samuel

    2015-06-01

    We have experimentally investigated different two-shockwave high-explosives (HE) physics package designs to maximize the variability of the second shockwave peak stress, while minimizing the total HE load of the physics tool. A critical requirement is to also have a large radial diameter of the second shockwave to maintain its value as an HE driven two-shockwave drive. We have previously shown that we could vary the peak-stress of the second-shockwave with a 76 mm diameter HE lens driving different composite boosters of PBX 9501 and TNT. Here we report on our results with a 56- and 50-mm diameter HE lens driving Baritol. The results indicate that the 56-mm diameter HE lens works well, as does the Baritol, giving total HE loads of about 250 mg TNT equivalent explosives.

  18. Abruptly changing patterns of diffusion and use of extracorporeal shock-wave renal lithotripsy.

    PubMed

    Bloom, B S; Hillman, A L; Schwartz, J S

    1991-07-01

    Early diffusion and use of extracorporeal shock-wave lithotripsy (ESWL) was found by a 1986 survey of the first 84 operational renal lithotripters in the United States to be similar to that of other equipment-embodied technologies. Resurvey in 1988 of this cohort of units found that clinical indications for ESWL treatment--stone size and location--expanded greatly. Professional fees for ESWL services remained essentially constant, while technical component charges increased 21.0%. Volume of procedures declined by 19.8% among the most productive units, and by 34.4% among the least productive study units; the previously noted approximate fourfold difference remained unchanged between most and least productive units. ESWL patterns of diffusion were comparable to other equipment-embodied diagnostic technology (magnetic resonance imaging [MRI] and computed tomography [CT]) during the first few years of clinical availability. ESWL growth slowed sooner than that of CT and MRI following their introduction into clinical practice, declining in the fourth to fifth year of use following rapid expansion in the first 2 years of availability. While clinical indications for both ESWL and imaging technologies expanded over time, CT and MRI experienced continued growth beyond that of ESWL at the same points of their respective life cycles. In the market areas of the 84 study units, the use of ESWL declined even with expanded indications for treatment, perhaps due to faster expansion of number of units than growth of clinical indications for treatment. PMID:2063841

  19. Developing A Laser Shockwave Model For Characterizing Diffusion Bonded Interfaces

    SciTech Connect

    James A. Smith; Jeffrey M. Lacy; Barry H. Rabin

    2014-07-01

    12. Other advances in QNDE and related topics: Preferred Session Laser-ultrasonics Developing A Laser Shockwave Model For Characterizing Diffusion Bonded Interfaces 41st Annual Review of Progress in Quantitative Nondestructive Evaluation Conference QNDE Conference July 20-25, 2014 Boise Centre 850 West Front Street Boise, Idaho 83702 James A. Smith, Jeffrey M. Lacy, Barry H. Rabin, Idaho National Laboratory, Idaho Falls, ID ABSTRACT: The US National Nuclear Security Agency has a Global Threat Reduction Initiative (GTRI) which is assigned with reducing the worldwide use of high-enriched uranium (HEU). A salient component of that initiative is the conversion of research reactors from HEU to low enriched uranium (LEU) fuels. An innovative fuel is being developed to replace HEU. The new LEU fuel is based on a monolithic fuel made from a U-Mo alloy foil encapsulated in Al-6061 cladding. In order to complete the fuel qualification process, the laser shock technique is being developed to characterize the clad-clad and fuel-clad interface strengths in fresh and irradiated fuel plates. The Laser Shockwave Technique (LST) is being investigated to characterize interface strength in fuel plates. LST is a non-contact method that uses lasers for the generation and detection of large amplitude acoustic waves to characterize interfaces in nuclear fuel plates. However the deposition of laser energy into the containment layer on specimen’s surface is intractably complex. The shock wave energy is inferred from the velocity on the backside and the depth of the impression left on the surface from the high pressure plasma pulse created by the shock laser. To help quantify the stresses and strengths at the interface, a finite element model is being developed and validated by comparing numerical and experimental results for back face velocities and front face depressions with experimental results. This paper will report on initial efforts to develop a finite element model for laser

  20. Impact of ureteric stent on outcome of extracorporeal shockwave lithotripsy: A propensity score analysis

    PubMed Central

    Gołąb, Adam; Słojewski, Marcin

    2016-01-01

    Introduction Extracorporeal shockwave lithotripsy (SWL) is one of the most frequently performed procedures in patients with urolithiasis. For ureter-localized stones, SWL is often preceded by a double J stent insertion. However, fear of serious complications, including sepsis associated with stents, is often expressed. The following study assessed the impact of stent insertions on the results of SWL in patients with ureteric stones. Material and methods The study group consisted of 411 ureteric stone patients who were treated with SWL from January 2010 to December 2014. In 60 cases, treatment was preceded by ureteric stent insertion. A propensity scoring system was used to pair non-stented patients with the stented group. Success rates were assessed and compared using the chi-squared test. Multivariate logistic regression analysis was used to evaluate the influence of particular variables on the stone-free rate. Results The overall success rate was 82.2%. After matching, the success rate of the stented group was not significantly different from the control group (85.0% vs. 83.3% respectively, p = 0.80). The mean number of sessions was higher in the stented group (1.88 per patient). Stones located in the lower part of the ureter have the greatest chance of being successfully treated. Conclusions The double J stent has no influence on the outcome of SWL treatment. In view of the greater likelihood of having additional sessions, this approach should be reserved for selected cases. PMID:27551556

  1. New developments in shockwave technology intended for meat tenderization: Opportunities and challenges. A review.

    PubMed

    Bolumar, Tomas; Enneking, Mathias; Toepfl, Stefan; Heinz, Volker

    2013-12-01

    Meat tenderness is an important quality parameter determining consumer acceptance and price. Meat tenderness is difficult to ensure in the global meat chain because the production systems are not always aiming at this purpose (ex.: cattle derived from milk production) and by the existence within the carcass of "tough" primals. Different methods can be used by the meat industry to improve meat tenderness each with its advantages and drawbacks. The application of hydrodynamic pressure or shockwaves has showed outstanding improvements by reducing the Warner Bratzler Shear Force by 25% or more. However, the technology has not penetrated into the market as first systems were based on the use of explosives and further developments seemed to lack the robustness to fulfill industrial requirements. The present paper describes the main challenges to construct a prototype for the continuous treatment of meat by shockwaves based on electrical discharges under water. Finally, improvements on the tenderness of meat by using the novel prototype are presented. PMID:23660173

  2. New treatments compared to established treatments in randomized trials

    PubMed Central

    Djulbegovic, Benjamin; Kumar, Ambuj; Glasziou, Paul P; Perera, Rafael; Reljic, Tea; Dent, Louise; Raftery, James; Johansen, Marit; Di Tanna, Gian Luca; Miladinovic, Branko; Soares, Heloisa P; Vist, Gunn E; Chalmers, Iain

    2012-01-01

    Background The proportion of proposed new treatments that are ’successful’ is of ethical, scientific, and public importance. We investigated how often new, experimental treatments evaluated in randomized controlled trials (RCTs) are superior to established treatments. Objectives Our main question was: “On average how often are new treatments more effective, equally effective or less effective than established treatments?” Additionally, we wanted to explain the observed results, i.e. whether the observed distribution of outcomes is consistent with the ’uncertainty requirement’ for enrollment in RCTs. We also investigated the effect of choice of comparator (active versus no treatment/placebo) on the observed results. Search methods We searched the Cochrane Methodology Register (CMR) 2010, Issue 1 in The Cochrane Library (searched 31 March 2010); MEDLINE Ovid 1950 to March Week 2 2010 (searched 24 March 2010); and EMBASE Ovid 1980 to 2010 Week 11 (searched 24 March 2010). Selection criteria Cohorts of studies were eligible for the analysis if they met all of the following criteria: (i) consecutive series of RCTs, (ii) registered at or before study onset, and (iii) compared new against established treatments in humans. Data collection and analysis RCTs from four cohorts of RCTs met all inclusion criteria and provided data from 743 RCTs involving 297,744 patients. All four cohorts consisted of publicly funded trials. Two cohorts involved evaluations of new treatments in cancer, one in neurological disorders, and one for mixed types of diseases. We employed kernel density estimation, meta-analysis and meta-regression to assess the probability of new treatments being superior to established treatments in their effect on primary outcomes and overall survival. Main results The distribution of effects seen was generally symmetrical in the size of difference between new versus established treatments. Meta-analytic pooling indicated that, on average, new treatments

  3. [A 10-month experience with extracorporeal shockwave therapy of urolithiasis].

    PubMed

    García Sisamón, F; Ferrer Roda, J; Tudela Bañuls, O; Ferrer Bosch, L

    1990-01-01

    From November 1987 treatment of urinary lithiasis regardless location was initiated in our Service of extracorporal renal lithofragmentation using shockwaves. Up until August 1988 (10 months), 411 patients have been treated representing a total of 590 lithiasis and 699 sessions on which the present communication is based; treatment included calculus of various chemical composition, as well as different sizes and locations. Also the relationship between sex, age, number of waves, use of analgesia, hospital stay, etc, has been considered. Results obtained after a 2.5 months follow-up are: 60.34% fragments-free and 39.41% in expulsion stage. Monotherapy was chosen in 98% cases and multiple drug therapy in the remaining 2%. There has been no case of complementary open surgical therapy. Thus, we consider extracorporal renal lithofragmentation as the ideal treatment for urinary lithiasis, as long as the indication is correct. And we believe it to be the ideal treatment since it is a simple procedure, highly effective and with few complications. PMID:2239390

  4. Influence of shockwave profile on ejecta

    SciTech Connect

    Zellner, Michael B; Dimonte, Guy; Germann, Tim C; Hammerberg, James E; Rigg, Paulo A; Buttler, William T; Stevens, Gerald D; Turley, William D

    2009-01-01

    This effort investigates the relation between shock-pulse shape and the amount of micron-scale fragments ejected (ejecta) upon shock release at the metal/vacuum interface of shocked Sn targets. Two shock-pulse shapes are considered: a supported shock created by impacting a Sn target with a sabot that was accelerated using a powder gun; and an unsupported or Taylor shockwave, created by detonation of high explosive that was press-fit to the front-side of the Sn target. Ejecta production at the back-side or free-side of the Sn coupons were characterized through use of piezoelectric pins. Assay foils, optical shadowgraphy, and x-ray attenuation.

  5. Shock-wave properties of brittle solids

    SciTech Connect

    Grady, D.E.

    1995-10-01

    Extensive experimental investigation in the form of large-amplitude, nonlinear wave-profile measurements which manifest the shock strength and equation-of-state properties of brittle solids has been performed. Brittle materials for which a base of dynamic property data is available include Al{sub 2}O{sub 3}, AlN, B{sub 4}C, CaCO{sub 3}, SiC, Si{sub 3}N{sub 4}, SiO{sub 2} (quartz and glass), TiB{sub 2}, WC and ZrO{sub 2}. Planar impact methods and velocity interferometry diagnostics have been used exclusively to provide the high-resolution shock-profile data. These wave-profile data are providing engineering dynamic strength and equation-of-state properties as well as controlled, shock-induced motion histories for the validation of theoretical and Computational models. Of equal importance, such data are providing a window into the physics of a newly emerging understanding of the compression and deformation behavior of high-strength brittle solids. When considered along with a rich assortment of strength and deformation data in the literature, a systematic assessment of this shock-wave data lends strong support for failure waves and concomitant high-confinement dilatancy as a general mechanism of inelastic deformation in the shock compression of ceramics. Phase transformation in selected brittle solids appears to be a critical state phenomenon strongly controlled by kinetics. The risetime and structure of deformation shock waves in brittle solids are controlled by viscous effects which at present are still poorly understood. The shockwave data also suggest that both crystalline plasticity and brittle fracture may play important and interconnected roles in the dynamic failure process.

  6. Shock-wave boundary layer interactions

    NASA Technical Reports Server (NTRS)

    Delery, J.; Marvin, J. G.; Reshotko, E.

    1986-01-01

    Presented is a comprehensive, up-to-date review of the shock-wave boundary-layer interaction problem. A detailed physical description of the phenomena for transonic and supersonic speed regimes is given based on experimental observations, correlations, and theoretical concepts. Approaches for solving the problem are then reviewed in depth. Specifically, these include: global methods developed to predict sudden changes in boundary-layer properties; integral or finite-difference methods developed to predict the continuous evolution of a boundary-layer encountering a pressure field induced by a shock wave; coupling methods to predict entire flow fields; analytical methods such as multi-deck techniques; and finite-difference methods for solving the time-dependent Reynolds-averaged Navier-Stokes equations used to predict the development of entire flow fields. Examples are presented to illustrate the status of the various methods and some discussion is devoted to delineating their advantages and shortcomings. Reference citations for the wide variety of subject material are provided for readers interested in further study.

  7. Comparing compliance patterns between randomized treatments.

    PubMed

    Vrijens, B; Goetghebeur, E

    1997-06-01

    When two equally efficacious drugs enter the market, the one with the better compliance is likely to be more widely used. Special management of the delivery may produce increased compliance. In this paper we analyze a trial of a single drug dosing prescription with patients randomized to either daily self monitoring of the outcome (blood pressure) or not. The study used Medication Event Monitoring Systems (MEMS) to record each exact time and date when a patient opened the pill container. No established method is available for comparing these high-dimensional compliance patterns between groups. This paper investigates several summary measures that highlight different dimensions of the pattern and the drug context in which they may be meaningful. Further, we examine conditional and marginal models that enable comparisons of the full pattern of daily dosing indicators for subjects between the groups. We found no simple difference in average compliance levels, but we found an interesting interaction between treatment and time: similar compliance existed initially among patients in both randomized groups, with a stronger decline over time for patients who did not monitor their blood pressure. We discuss how a balance between simplicity of interpretation and efficiency of data use may be sought in this case. PMID:9204220

  8. Shockwave Absorption using Network-forming Ionic glass

    NASA Astrophysics Data System (ADS)

    Lee, Jaejun; Yang, Ke; Moore, Jeffrey; Sottos, Nancy; MURI SWED Collaboration

    2015-06-01

    Network-forming ionic glasses composed of di-ammonium cations and citrate anions exhibit significant potential for dissipation of shock wave energy. The long alkyl side chains in the di-ammonium cation form a soft matrix, while the negatively charged heads of anions segregate into hard nanophase domains. Similar to polyurea, which has microphase separation of soft and hard domains, we hypothesize that shock wave dissipation of the ionic glass occurs by bond breaking in the hard domains and/or pressure-induced phase transition. By employing size-tunable alkyl side chains in the cations, we examine the effect of the relative soft domain size on energy dissipation. A series of thin film (ca. 50 μm) ionic glass specimens are subjected to laser-induced compressive stress waves and the transmitted response measured interferometrically. Structural changes of the ionic glass due to shock wave impact are characterized by x-ray diffraction. When compared directly to polyurea films of identical thickness and geometry, the ionic glass showed superior shock-wave mitigating performance. ONR MURI program.

  9. Developing a laser shockwave model for characterizing diffusion bonded interfaces

    SciTech Connect

    Lacy, Jeffrey M. Smith, James A. Rabin, Barry H.

    2015-03-31

    The US National Nuclear Security Agency has a Global Threat Reduction Initiative (GTRI) with the goal of reducing the worldwide use of high-enriched uranium (HEU). A salient component of that initiative is the conversion of research reactors from HEU to low enriched uranium (LEU) fuels. An innovative fuel is being developed to replace HEU in high-power research reactors. The new LEU fuel is a monolithic fuel made from a U-Mo alloy foil encapsulated in Al-6061 cladding. In order to support the fuel qualification process, the Laser Shockwave Technique (LST) is being developed to characterize the clad-clad and fuel-clad interface strengths in fresh and irradiated fuel plates. LST is a non-contact method that uses lasers for the generation and detection of large amplitude acoustic waves to characterize interfaces in nuclear fuel plates. However, because the deposition of laser energy into the containment layer on a specimen's surface is intractably complex, the shock wave energy is inferred from the surface velocity measured on the backside of the fuel plate and the depth of the impression left on the surface by the high pressure plasma pulse created by the shock laser. To help quantify the stresses generated at the interfaces, a finite element method (FEM) model is being utilized. This paper will report on initial efforts to develop and validate the model by comparing numerical and experimental results for back surface velocities and front surface depressions in a single aluminum plate representative of the fuel cladding.

  10. Developing a laser shockwave model for characterizing diffusion bonded interfaces

    NASA Astrophysics Data System (ADS)

    Lacy, Jeffrey M.; Smith, James A.; Rabin, Barry H.

    2015-03-01

    The US National Nuclear Security Agency has a Global Threat Reduction Initiative (GTRI) with the goal of reducing the worldwide use of high-enriched uranium (HEU). A salient component of that initiative is the conversion of research reactors from HEU to low enriched uranium (LEU) fuels. An innovative fuel is being developed to replace HEU in high-power research reactors. The new LEU fuel is a monolithic fuel made from a U-Mo alloy foil encapsulated in Al-6061 cladding. In order to support the fuel qualification process, the Laser Shockwave Technique (LST) is being developed to characterize the clad-clad and fuel-clad interface strengths in fresh and irradiated fuel plates. LST is a non-contact method that uses lasers for the generation and detection of large amplitude acoustic waves to characterize interfaces in nuclear fuel plates. However, because the deposition of laser energy into the containment layer on a specimen's surface is intractably complex, the shock wave energy is inferred from the surface velocity measured on the backside of the fuel plate and the depth of the impression left on the surface by the high pressure plasma pulse created by the shock laser. To help quantify the stresses generated at the interfaces, a finite element method (FEM) model is being utilized. This paper will report on initial efforts to develop and validate the model by comparing numerical and experimental results for back surface velocities and front surface depressions in a single aluminum plate representative of the fuel cladding.

  11. Unsteady relativistic shock-wave diffraction by cylinders and spheres.

    PubMed

    Tsai, I-Nan; Huang, Juan-Chen; Tsai, Shang-Shi; Yang, J Y

    2012-02-01

    The unsteady relativistic shock-wave diffraction patterns generated by a relativistic blast wave impinging on a circular cylinder and a sphere are numerically simulated using some high-resolution relativistic kinetic beam schemes in a general coordinate system for solving the relativistic Euler equations of gas dynamics. The diffraction patterns are followed through about 6 radii of travel of the incident shock past the body. The complete diffraction patterns, including regular reflection, transition from regular to Mach reflection, slip lines, and the complex shock-on-shock interaction at the wake region resulting from the Mach shocks collision behind the body are reported in detail. Computational results of several incident shock Mach numbers covering the near ultrarelativistic limit are studied. Various contours of flow properties including the Lorentz factor and velocity streamline plots are also presented to add a better understanding of the complex diffraction phenomena. The three-dimensional relieving effects of the sphere cases are evident and can be quantitatively evaluated as compared with the corresponding cylinder cases. PMID:22463327

  12. High-efficiency shock-wave generator for extracorporeal lithotripsy.

    PubMed

    Broyer, P; Cathignol, D; Theillère, Y; Mestas, J L

    1996-09-01

    In extracorporeal lithotripsy, the electro-acoustic efficiency of electrohydraulic generators is limited by the inductance of the electrical discharge circuit. A new shock-wave generator is described that uses a coaxial discharge line enabling electro-acoustic efficiency to be greatly increased. The line is built using a para-electric ceramic with a relative dielectric constant of 1700, manufactured for use in high-voltage impulse mode. A coaxial spark gap, with minimal inductance, has been developed to obtain the triggered breakdown of the discharge line. Shock waves are created with a coaxial electrode plugged directly into the spark gap and immersed in an electrolyte of degassed saline. Electrode gap and electrolyte resistivity are adjusted to match the resistivity of the electrolyte volume between the underwater electrodes to the characteristic impedance of the line. The discharge line generates in the medium a rectangular current pulse with an amplitude of about 6000 A and a rise time of 50 ns. Compared with conventional generators, measurements of the expansive peak pressure pulse show an increase of 105% at 10 kV, 86.5% at 12 kV and 34.5% at 14 kV charging voltage. Electro-acoustic efficiency is found to be 11% instead of 5.5% for a conventional discharge circuit. PMID:8945854

  13. Unsteady relativistic shock-wave diffraction by cylinders and spheres

    NASA Astrophysics Data System (ADS)

    Tsai, I.-Nan; Huang, Juan-Chen; Tsai, Shang-Shi; Yang, J. Y.

    2012-02-01

    The unsteady relativistic shock-wave diffraction patterns generated by a relativistic blast wave impinging on a circular cylinder and a sphere are numerically simulated using some high-resolution relativistic kinetic beam schemes in a general coordinate system for solving the relativistic Euler equations of gas dynamics. The diffraction patterns are followed through about 6 radii of travel of the incident shock past the body. The complete diffraction patterns, including regular reflection, transition from regular to Mach reflection, slip lines, and the complex shock-on-shock interaction at the wake region resulting from the Mach shocks collision behind the body are reported in detail. Computational results of several incident shock Mach numbers covering the near ultrarelativistic limit are studied. Various contours of flow properties including the Lorentz factor and velocity streamline plots are also presented to add a better understanding of the complex diffraction phenomena. The three-dimensional relieving effects of the sphere cases are evident and can be quantitatively evaluated as compared with the corresponding cylinder cases.

  14. Time Resolved Shadowgraph Images of Silicon during Laser Ablation:Shockwaves and Particle Generation

    SciTech Connect

    Liu, C.Y.; Mao, X.L.; Greif, R.; Russo, R.E.

    2006-05-06

    Time resolved shadowgraph images were recorded of shockwaves and particle ejection from silicon during laser ablation. Particle ejection and expansion were correlated to an internal shockwave resonating between the shockwave front and the target surface. The number of particles ablated increased with laser energy and was related to the crater volume.

  15. Al 1s-2p Absorption Spectroscopy of Shock-Wave Heating and Compression in Laser-Driven Planar Foil

    SciTech Connect

    Sawada, H.; Regan, S.P.; Radha, P.B.; Epstein, R.; Li, D.; Goncharov, V.N.; Hu, S.X.; Meyerhofer, D.D.; Delettrez, J.A.; Jaanimagi, P.A.; Smalyuk, V.A.; Boehly, T.R.; Sangster, T.C.; Yaakobi, B.; Mancini, R.C.

    2009-05-19

    Time-resolved Al 1s-2p absorption spectroscopy is used to diagnose direct-drive, shock-wave heating and compression of planar targets having nearly Fermi-degenerate plasma conditions (Te ~ 10–40 eV, rho ~ 3–11 g/cm^3) on the OMEGA Laser System [T. R. Boehly et al., Opt. Commun. 133, 495 (1997)]. A planar plastic foil with a buried Al tracer layer was irradiated with peak intensities of 10^14–10^15 W/cm^2 and probed with the pseudocontinuum M-band emission from a point-source Sm backlighter in the range of 1.4–1.7 keV. The laser ablation process launches 10–70 Mbar shock waves into the CH/Al/CH target. The Al 1s-2p absorption spectra were analyzed using the atomic physic code PRISMSPECT to infer Te and rho in the Al layer, assuming uniform plasma conditions during shock-wave heating, and to determine when the heat front penetrated the Al layer. The drive foils were simulated with the one-dimensional hydrodynamics code LILAC using a flux-limited (f =0.06 and f =0.1) and nonlocal thermal-transport model [V. N. Goncharov et al., Phys. Plasmas 13, 012702 (2006)]. The predictions of simulated shock-wave heating and the timing of heat-front penetration are compared to the observations. The experimental results for a wide variety of laser-drive conditions and buried depths have shown that the LILAC predictions using f = 0.06 and the nonlocal model accurately model the shock-wave heating and timing of the heat-front penetration while the shock is transiting the target. The observed discrepancy between the measured and simulated shock-wave heating at late times of the drive can be explained by the reduced radiative heating due to lateral heat flow in the corona.

  16. Systemic treatment: maintenance compared with holiday.

    PubMed

    Punt, Cornelis J A; Simkens, Lieke H J; Koopman, Miriam

    2015-01-01

    With the currently available cytotoxic and targeted drugs, metastatic colorectal cancer (mCRC) may be controlled by systemic treatment for a substantial period of time. However, many questions remain about the optimal use of drugs and duration of treatment. The feasibility of chemotherapy-free intervals has been studied in patients with mCRC treated with chemotherapy alone, but the results are conflicting. Current data show that oxaliplatin may be safely interrupted, but they do not allow a firm conclusion on the safety of a full treatment break of chemotherapy. For targeted therapy, continuous inhibition of intracellular signaling by prolonged administration would theoretically be beneficial for efficacy of treatment. Recent data support the use of maintenance treatment with chemotherapy and bevacizumab. No data on the optimal duration of treatment with anti-epidermal growth factor receptor (EGFR) agents are currently available. PMID:25993146

  17. Cavitation in ultrasound and shockwave therapy

    NASA Astrophysics Data System (ADS)

    Colonius, Tim

    2014-11-01

    Acoustic waves, especially high-intensity ultrasound and shock waves, are used for medical imaging and intra- and extra-corporeal manipulation of cells, tissue, and urinary calculi. Waves are currently used to treat kidney stone disease, plantar fasciitis, and bone nonunion, and they are being investigated as a technique to ablate cancer tumors and mediate drug delivery. In many applications, acoustic waves induce the expansion and collapse of preexisting or newly cavitating bubbles whose presence can either mediate the generation of localized stresses or lead to collateral damage, depending on how effectively they can be controlled. We describe efforts aimed at simulating the collapse of bubbles, both individually and in clusters, with the aim to characterize the induced mechanical stresses and strains. To simulate collapse of one or a few bubbles, compressible Euler and Navier-Stokes simulations of multi-component materials are performed with WENO-based shock and interface capturing schemes. Repetitive insonification generates numerous bubbles that are difficult to resolve numerically. Such clouds are also important in traditional engineering applications such as caveating hydrofoils. Models that incorporate the dynamics of an unresolved dispersed phase consisting of the bubble cloud are also developed. The results of several model problems including bubble collapse near rigid surfaces, bubble collapse near compliant surfaces and in small capillaries are analyzed. The results are processed to determine the potential for micron-sized preexisting gas bubbles to damage capillaries. The translation of the fundamental fluid dynamics into improvements in the design and clinical application of shockwave lithotripters will be discussed. NIH Grant PO1-DK043881.

  18. Numerical Simulation of Low-Density Shock-Wave Interactions

    NASA Technical Reports Server (NTRS)

    Glass, Christopher E.

    1999-01-01

    Computational Fluid Dynamics (CFD) numerical simulations of low-density shock-wave interactions for an incident shock impinging on a cylinder have been performed. Flow-field density gradient and surface pressure and heating define the type of interference pattern and corresponding perturbations. The maximum pressure and heat transfer level and location for various interaction types (i.e., shock-wave incidence with respect to the cylinder) are presented. A time-accurate solution of the Type IV interference is employed to demonstrate the establishment and the steadiness of the low-density flow interaction.

  19. Molecular changes after shockwave therapy in osteoarthritic knee in rats

    NASA Astrophysics Data System (ADS)

    Wang, C.-J.; Sun, Y.-C.; Wu, C.-T.; Weng, L.-H.; Wang, F.-S.

    2016-01-01

    This study investigated the molecular changes of DKK-1, MMP13, Wnt-5a and \\upbeta -catenin after extracorporeal shockwave therapy (ESWT) in anterior cruciate ligament transected (ACLT) osteoarthritic (OA) knee in rats. 27 male Spraque-Dawley rats were divided into three groups. Group I was the control one and received sham knee arthrotomy but no ACLT or ESWT. Group II underwent ACLT, but no ESWT. Group III underwent ACLT and received ESWT. The animals were killed at 12 weeks, and the harvested knee specimens were subjected to histopathological examination and immunohistochemical analysis. Radiographs of the knees were obtained at 0 and 12 weeks. At 12 weeks, radiographs of group II showed more arthritic changes with formation of osteochondral fragments, whereas very subtle arthritis was noted in groups I and III. In histopathological examination, group II showed a significant increase of Mankin score and a decrease of subchondral bone as compared to groups I and III. Group III showed a significant decrease of Mankin score and an increase of subchondral bone, with the data comparable to group I. In immunohistochemical analysis, group II showed significant increases of DKK-1 and MMP13 and decreases of Wnt-5a and \\upbeta -catenin in articular cartilage and subchondral bone as compared to groups I and III. Group III showed significant decreases of DKK-1 and MMP13 and increases of Wnt-5a and \\upbeta -catenin, with the data comparable to group I. In conclusion, the application of ESWT causes molecular changes that are consistent with the improvement in subchondral bone remodeling and chondroprotective effect in ACLT OA knees in rats.

  20. Large-Eddy Simulation of Shock-Wave Boundary Layer Interaction and its Control Using Sparkjet

    NASA Astrophysics Data System (ADS)

    Yang, Guang; Yao, Yufeng; Fang, Jian; Gan, Tian; Lu, Lipeng

    2016-06-01

    Large-eddy simulation (LES) of an oblique shock-wave generated by an 8° sharp wedge impinging onto a spatially-developing Mach 2.3 turbulent boundary layer and their interactions has been carried out in this study. The Reynolds number based on the incoming flow property and the boundary layer displacement thickness at the impinging point without shock-wave is 20,000. The detailed numerical approaches are described and the inflow turbulence is generated using the digital filter method to avoid artificial temporal or streamwise periodicity. Numerical results are compared with the available wind tunnel PIV measurements of the same flow conditions. Further LES study on the control of flow separation due to the strong shock-viscous interaction is also conducted by using an active control actuator “SparkJet” concept. The single-pulsed characteristics of the control device are obtained and compared with the experiments. Instantaneous flowfield shows that the “SparkJet” promotes the flow mixing in the boundary layer and enhances its ability to resist the flow separation. The time and spanwise averaged skin friction coefficient distribution demonstrates that the separation bubble length is reduced by maximum 35% with the control exerted.

  1. Working mechanism of extracorporeal shockwave therapy in non-urological disciplines

    NASA Astrophysics Data System (ADS)

    Schaden, Wolfgang

    2005-04-01

    For 32 years of extracorporeal shockwave lithotripsy (ESWL) only the mechanical strength of shockwaves were of clinical interest. For use in orthopaedics, the absence of dangerous long term effects (malignant degeneration, etc.) is the only important message. The mechanical model tries to explain the effect of shock waves by the provocation of microleasions in the tissue stimulating repairing processes. First doubts on this mechanical model came up when Schaden (2001) could show, that less energy is more efficient in the treatment of non-unions. Due to the basic research of the last years knowledge increased about the microbiological effects. Under the influence of shock waves the change of permeability of cell membranes and the liberation of free radicals was reported. Also the production of nitric oxide (NO) and different growth factors like vascular endothelial growth factor (VEGF), bone morphogenetic proteins (BMP), transforming growth factor-beta 1 (TGF-b1), insulin-like growth factor-I (IGF-I) etc. was observed. The biological model tries to explain the effect of shock waves by stimulating the ingrowth of blood vessels and liberation of growth factors. Under the influence of shock waves, biological tissues seem to be able to produce important substances to initiate healing processes.

  2. Vlasov-Fokker-Planck Simulation of a Collisional Ion-Electron Shockwave

    NASA Astrophysics Data System (ADS)

    Taitano, William; Knoll, Dana; Prinja, Anil

    2012-10-01

    There has been recent increased interest in a range of kinetic plasma physics phenomena which may be important in simulating ICF pellet performance. [1] have numerically demonstrated the limitations of the classic Spitzer, Braginski fluid closures in collisional plasmas for shockwave problems. [1] has shown the importance of modeling kinetic effects for scale lengths of shockwave much larger than the ion collision mean free path. In [1], the ions were modeled kinetically using the Fokker-Planck approximation while the electrons were modeled as a fluid. An investigation of a full kinetic treatment of electron with collision is computationally intractable with standard explicit schemes due to collision CFL limitation that requires resolving the electron-electron collision timescale. [2] has developed a new, fully implicit and discretely consistent moment based accelerator method to solve the full ion-electron kinetic Vlasov-Ampere system. A similar moment based accelerator will be extended to a collisionless shock problem in order to accelerate the Fokker-Planck collision source in the kinetic equations. In the presentation, we provide some preliminary results. [4pt] [1] M. Casanova and O. Larroche, Phys. Rev. Let. 67-(16), 1991. [0pt] [2] W.T. Taitano et al. SISC in review.

  3. Extracorporeal shockwave therapy for Peyronie's disease does not correct penile deformity.

    PubMed

    Strebel, R T; Suter, S; Sautter, T; Hauri, D

    2004-10-01

    To evaluate whether extracorporeal shockwave therapy (ESWT) offers an effective treatment for the main complications of Peyronie's disease (PD), that is, penile deformity and angulation, painful erection and most importantly unsatisfied sexual intercourse. From September 1999 to January 2001, 52 patients with PD were treated with ESWT. Pain during erection was assessed with a visual analogue scale. Penile deviation was determined by photographs with a goniometer. Five treatment sessions were performed at weekly intervals. Each consisted of 3000 shockwaves with an emission frequency of 120 shockwaves/min and a mean intensity of 0.17 mJ/mm(2). A Storz Minilith SL 1 with integrated inline ultrasound probe was used. In all, 52 patients were evaluated 6 weeks after ESWT for early follow-up. Before ESWT intercourse was difficult or impossible for 40 men; 29 patients suffered mainly from penile deformity, 14 from painful erection and eight mainly from loss of distal rigidity. A total of 30 patients mentioned painful erection before treatment. In 28 patients (93%) pain reduction was achieved. A total relief of pain was observed in 19 patients (63%). Mean pain score dropped from 4.2 to 1.3 in patients who suffered predominantly from painful erections. Intercourse satisfaction improved in 11 patients after therapy. Mean angulation before (40 degrees ) and after (37 degrees ) ESWT did not change significantly. Late follow-up after 11.1 months (4-17 months) could be completed in 36 patients. In total, 19 men reported that ESWT improved their PD. Of these, 16 noted no change. Only one of the patients noticed a worsening of his disease during or after treatment. Complication rate was low with only minor side effects such as minimal skin bruising; one urethral bleeding occurred. ESWT did reduce pain during erection in patients suffering mainly from painful erection due to PD. However, penile angulation did not improve significantly in our setup and thus intercourse difficulties

  4. International Shock-Wave Database: Systematization of Experimental Data

    NASA Astrophysics Data System (ADS)

    Levashov, Pavel R.; Khishchenko, Konstantin V.; Lomonosov, Igor V.; Minakov, Dmitry V.; Zakharenkov, Alexey S.

    2011-06-01

    In this work, we announce the creation of the International Shock-Wave Database (ISWDB). Shock-wave and related dynamic material response data serve for calibrating, validating, and improving material models over very broad regions of the pressure-temperature-density phase space. Our objectives are (i) to develop a database on thermodynamic and mechanical properties of materials under conditions of shock wave and other dynamic loadings, selected related quantities of interest, and the meta-data that describes the provenance of the measurements and material models, and (ii) to make this database available internationally thru the Internet, in an interactive form. The development and operation of the ISWDB will be guided by input from a steering committee. The database will be installed on two mirrored web-servers, one in Russia and the other in USA. The database will provide access to original experimental data on shock compression, non-shock dynamic loadings, isentropic expansion, measurements of sound speed in the Hugoniot state, and time-dependent free-surface or window-interface velocity profiles. We believe that the ISWDB will be a useful tool for the shock-wave community.

  5. Percutaneous nephrolithotomy vs. extracorporeal shockwave lithotripsy for treating a 20–30 mm single renal pelvic stone

    PubMed Central

    Hassan, Mohammed; El-Nahas, Ahmed R.; Sheir, Khaled Z.; El-Tabey, Nasr A.; El-Assmy, Ahmed M.; Elshal, Ahmed M.; Shokeir, Ahmed A.

    2015-01-01

    Objective To compare the efficacy, safety and cost of extracorporeal shockwave lithotripsy (ESWL) and percutaneous nephrolithotomy (PNL) for treating a 20–30 mm single renal pelvic stone. Patients and methods The computerised records of patients who underwent PNL or ESWL for a 20–30 mm single renal pelvic stone between January 2006 and December 2012 were reviewed retrospectively. Patients aged <18 years who had a branched stone, advanced hydronephrosis, a solitary kidney, anatomical renal abnormality, or had a surgical intervention within the past 6 months were excluded. The study included 337 patients with a mean (SD, range) age of 49.3 (12.2, 20–81) years. The patients’ criteria (age, sex, body mass index) and the stone characteristics (side, stone length, surface area, attenuation value and skin-to-stone distance) were compared between the groups. The re-treatment rate, the need for secondary procedures, success rate, complications and the total costs were calculated and compared. Results In all, 167 patients were treated by ESWL and 170 by PNL. The re-treatment rate (75% vs. 5%), the need for secondary procedures (25% vs. 4.7%) and total number of procedures (three vs. one) were significantly higher in the ESWL group (P < 0.001). The success rate was significantly higher in the PNL group (95% vs. 75%, P < 0.001), as was the complication rate (13% vs. 6.6%, P = 0.050). The total costs of primary and secondary procedures were significantly higher for PNL (US$ 1120 vs. 490; P < 0.001). Conclusions PNL was more effective than ESWL for treating a single renal pelvic stone of 20–30 mm. However, ESWL was associated with fewer complications and a lower cost. PMID:26413350

  6. Al 1s-2p absorption spectroscopy of shock-wave heating and compression in laser-driven planar foil

    SciTech Connect

    Sawada, H.; Regan, S. P.; Radha, P. B.; Epstein, R.; Li, D.; Goncharov, V. N.; Hu, S. X.; Meyerhofer, D. D.; Delettrez, J. A.; Jaanimagi, P. A.; Smalyuk, V. A.; Boehly, T. R.; Sangster, T. C.; Yaakobi, B.; Mancini, R. C.

    2009-05-15

    Time-resolved Al 1s-2p absorption spectroscopy is used to diagnose direct-drive, shock-wave heating and compression of planar targets having nearly Fermi-degenerate plasma conditions (T{sub e}{approx}10-40 eV, {rho}{approx}3-11 g/cm{sup 3}) on the OMEGA Laser System [T. R. Boehly et al., Opt. Commun. 133, 495 (1997)]. A planar plastic foil with a buried Al tracer layer was irradiated with peak intensities of 10{sup 14}-10{sup 15} W/cm{sup 2} and probed with the pseudocontinuum M-band emission from a point-source Sm backlighter in the range of 1.4-1.7 keV. The laser ablation process launches 10-70 Mbar shock waves into the CH/Al/CH target. The Al 1s-2p absorption spectra were analyzed using the atomic physic code PRISMSPECT to infer T{sub e} and {rho} in the Al layer, assuming uniform plasma conditions during shock-wave heating, and to determine when the heat front penetrated the Al layer. The drive foils were simulated with the one-dimensional hydrodynamics code LILAC using a flux-limited (f=0.06 and f=0.1) and nonlocal thermal-transport model [V. N. Goncharov et al., Phys. Plasmas 13, 012702 (2006)]. The predictions of simulated shock-wave heating and the timing of heat-front penetration are compared to the observations. The experimental results for a wide variety of laser-drive conditions and buried depths have shown that the LILAC predictions using f=0.06 and the nonlocal model accurately model the shock-wave heating and timing of the heat-front penetration while the shock is transiting the target. The observed discrepancy between the measured and simulated shock-wave heating at late times of the drive can be explained by the reduced radiative heating due to lateral heat flow in the corona.

  7. Extracorporeal shockwave therapy (ESWT) ameliorates healing of tibial fracture non-union unresponsive to conventional therapy.

    PubMed

    Haffner, Nicolas; Antonic, Vlado; Smolen, Daniel; Slezak, Paul; Schaden, Wolfgang; Mittermayr, Rainer; Stojadinovic, Alexander

    2016-07-01

    Tibial non-unions are common cause of demanding revision surgeries and are associated with a significant impact on patients' quality of life and health care costs. Extracorporeal shockwave therapy (ESWT) has been shown to improve osseous healing in vitro and in vivo. The main objective of present study was to evaluate the efficacy of ESWT in healing of tibial non-unions unresponsive to previous surgical and non-surgical measures. A retrospective multivariant analysis of a prospective open, single-centre, clinical trial of tibia non-union was conducted. 56 patients with 58 eligible fractures who met the FDA criteria were included. All patients received 3000-4000 impulses of electrohydraulic shockwaves at an energy flux density of 0.4mJ/mm(2) (-6dB). On average patients underwent 1.9 times (±1.3SD) surgical interventions prior to ESWT displaying the rather negatively selected cohort and its limited therapy responsiveness. In 88.5% of patients receiving ESWT complete bone healing was observed after six months irrespective of underlying pathology. The multivariant analysis showed that time of application is important for therapy success. Patients achieving healing received ESWT earlier: mean number of days between last surgical intervention and ESWT (healed - 355.1 days±167.4SD vs. not healed - 836.7 days±383.0SD; p<0.0001). ESWT proved to be a safe, effective and non-invasive treatment modality in tibial non-unions recalcitrant to standard therapies. The procedure is well tolerated, time-saving, lacking side effects, with potential to significantly decrease health care costs. Thus, in our view, ESWT should be considered the treatment of first choice in established tibial non-unions. PMID:27158008

  8. Comparing Outcomes for Youth Served in Treatment Foster Care and Treatment Group Care

    ERIC Educational Resources Information Center

    Robst, John; Armstrong, Mary; Dollard, Norin

    2011-01-01

    This study compared youth in the Florida Medicaid system prior to entry into treatment foster care or treatment group care, and compared outcomes in the 6 months after treatment. Florida Medicaid data from FY2003/04 through 2006/2007 along with Department of Juvenile Justice, Department of Law Enforcement, and involuntary examination data were…

  9. Renal milk of calcium: contraindication to extracorporeal shockwave lithotripsy.

    PubMed

    Heidenreich, A; Vorreuther, R; Krug, B; Moul, J W; Engelmann, U H

    1996-01-01

    Renal milk-of-calcium (MOC) cysts are rare findings, with only approximately 60 cases reported in the literature. The diagnosis depends on the demonstration of the typical "half-moon" configuration on horizontal beam radiography; classical ultrasound finding is a gravity-dependent, echogenic shadowy material in a renal cyst. The importance of the MOC syndrome lies in its recognition and differentiation from a renal stone in order to avoid unwarranted surgery or extracorporeal shock-wave lithotripsy (ESWL). We have encountered five patients with renal MOC and present the typical clinical and radiological features in order to facilitate differential diagnosis. PMID:9118405

  10. Shock-wave studies: modeling the giant planets

    SciTech Connect

    Ross, M.

    1981-07-20

    The giant planets - Jupiter, Saturn, Uranus, and Neptune - differ markedly from the inner, or terrestrial, planets. Observations of their average density, gravitational moments, and atmospheric composition have enabled astrophysicists to draw some conclusions as to their structure, but efforts have been hampered by a lack of accurate data on the chemical, physical, and thermodynamic properties of constituent materials at the extremely high temperatures and pressures characteristic of planetary interiors. Shock-wave experiments conducted recently at LLNL have provided more accurate equations of state and electrical conductivities for many of these materials, and these have led to improved structural models of the giant planets.

  11. Constitutive model used in computer simulation of time-resolved, shock-wave data

    NASA Astrophysics Data System (ADS)

    Steinberg, D. J.

    1986-10-01

    A constitutive model was designed for use with high-speed, hydrodynamic computer codes. The model, valid at high-deformation rates, accounts for pressure and temperature dependence of the yield strength and shear modulus, work hardening, pressure-dependent melting, Bauschinger and strain-rate effects, and spall. There are a minimum number of parameters needed to implement the model, and most can be determined without recourse to shock-wave data. At Lawrence Livermore National Laboratory, we assembled a library of these material properties for 44 metals, alloys, mixtures, and compounds. Shock and release data from plate-impact experiments for Be, U, Ta, Cu, 1100-0, and 6061-T6 al, with peak stresses from 6.4 to 230 GPa, are successfully compared against calculations.

  12. Shockwave Processing of Composite Boron and Titanium Nitride Powders

    NASA Astrophysics Data System (ADS)

    Beason, Matthew T.; Gunduz, I. Emre; Mukasyan, Alexander S.; Son, Steven F.

    2015-06-01

    Shockwave processing of powders has been shown to initiate reactions between condensed phase reactants. It has been observed that these reactions can occur at very short timescales, resulting in chemical reactions occurring at a high pressure state. These reactions have the potential to produce metastable phases. Kinetic limitations prevent gaseous reactants from being used in this type of synthesis reaction. To overcome this limitation, a solid source of gaseous reactants must be used. An example of this type of reaction is the nitrogen exchange reaction (e.g. B + TiN, B + Si3N4 etc.). In these reactions nitrogen is ``carried'' by a material that can be then reduced by the second reactant. This work explores the possibility of using nitrogen exchange reactions to synthesize the cubic phase of boron nitride (c-BN) through shockwave processing of ball milled mixtures of boron and titanium nitride. The heating from the passage of the shock wave (pore collapse, plastic work, etc.) combined with thermochemical energy from the reaction may provide a means to synthesize c-BN. This material is based upon work supported by the Department of Energy, National Nuclear Security Administration, under Award Number(s) DE-NA0002377. National Defense Science & Engineering Graduate Fellowship (NDSEG), 32 CFR 168a.

  13. Noise transmission along shock-waves

    NASA Astrophysics Data System (ADS)

    Amur Varadarajan, Prasanna

    Shocks at the inlet of scramjet engines are subject to perturbations from their interaction with turbulent boundary layer. DNS results for this interaction indicate the presence of discrete vortices that interact with the shock at its foot. These studies reveal that the vortices cause oscillations of the shock. In this work we examine the propagation of disturbances along a stationary oblique shock following interaction with a two-dimensional vortex. We study the decay of disturbances along a normal shock as measured from Euler computations and compare these with the predictions of Geometrical Shock Dynamics (GSD) for long range propagation. We have incorporated two improvements into the GSD model to tackle the shock-vortex interaction problem. The wave structure of the disturbance resembles N waves, the decay of which follows a power law profile. An extension of the GSD model to predict shock surface propagation in 3-D flows is presented along with the numerical implementation.

  14. Treatment of Conduct Disorders in Childhood: A Comparative Study.

    ERIC Educational Resources Information Center

    Robinson, Elizabeth A.

    Children evidencing conduct disorders comprise the bulk of clinical referrals. Longitudinal studies have found that the prognosis for these children is poor in that the majority exhibit antisocial behavior in adulthood. In order to compare two methods of treatment, relationship-based and contingency management, 53 children (33 boys, 20 girls),…

  15. Shock-wave heating model for chondrule formation: Hydrodynamic simulation of molten droplets exposed to gas flows

    NASA Astrophysics Data System (ADS)

    Miura, Hitoshi; Nakamoto, Taishi

    2007-05-01

    Millimeter-sized, spherical silicate grains abundant in chondritic meteorites, which are called as chondrules, are considered to be a strong evidence of the melting event of the dust particles in the protoplanetary disk. One of the most plausible scenarios is that the chondrule precursor dust particles are heated and melt in the high-velocity gas flow (shock-wave heating model). We developed the non-linear, time-dependent, and three-dimensional hydrodynamic simulation code for analyzing the dynamics of molten droplets exposed to the gas flow. We confirmed that our simulation results showed a good agreement in a linear regime with the linear solution analytically derived by Sekyia et al. [Sekyia, M., Uesugi, M., Nakamoto, T., 2003. Prog. Theor. Phys. 109, 717-728]. We found that the non-linear terms in the hydrodynamical equations neglected by Sekiya et al. [Sekiya, M., Uesugi, M., Nakamoto, T., 2003. Prog. Theor. Phys. 109, 717-728] can cause the cavitation by producing negative pressure in the droplets. We discussed that the fragmentation through the cavitation is a new mechanism to determine the upper limit of chondrule sizes. We also succeeded to reproduce the fragmentation of droplets when the gas ram pressure is stronger than the effect of the surface tension. Finally, we compared the deformation of droplets in the shock-wave heating with the measured data of chondrules and suggested the importance of other effects to deform droplets, for example, the rotation of droplets. We believe that our new code is a very powerful tool to investigate the hydrodynamics of molten droplets in the framework of the shock-wave heating model and has many potentials to be applied to various problems.

  16. Laser Shockwave Technique For Characterization Of Nuclear Fuel Plate Interfaces

    SciTech Connect

    James A. Smith; Barry H. Rabin; Mathieu Perton; Daniel Lévesque; Jean-Pierre Monchalin; Martin Lord

    2012-07-01

    The US National Nuclear Security Agency is tasked with minimizing the worldwide use of high-enriched uranium. One aspect of that effort is the conversion of research reactors to monolithic fuel plates of low-enriched uranium. The manufacturing process includes hot isostatic press bonding of an aluminum cladding to the fuel foil. The Laser Shockwave Technique (LST) is here evaluated for characterizing the interface strength of fuel plates using depleted Uranium/Mo foils. LST is a non-contact method that uses lasers for the generation and detection of large amplitude acoustic waves and is therefore well adapted to the quality assurance of this process. Preliminary results show a clear signature of well-bonded and debonded interfaces and the method is able to classify/rank the bond strength of fuel plates prepared under different HIP conditions.

  17. Laser shockwave technique for characterization of nuclear fuel plate interfaces

    SciTech Connect

    Perton, M.; Levesque, D.; Monchalin, J.-P.; Lord, M.; Smith, J. A.; Rabin, B. H.

    2013-01-25

    The US National Nuclear Security Agency is tasked with minimizing the worldwide use of high-enriched uranium. One aspect of that effort is the conversion of research reactors to monolithic fuel plates of low-enriched uranium. The manufacturing process includes hot isostatic press bonding of an aluminum cladding to the fuel foil. The Laser Shockwave Technique (LST) is here evaluated for characterizing the interface strength of fuel plates using depleted Uranium/Mo foils. LST is a non-contact method that uses lasers for the generation and detection of large amplitude acoustic waves and is therefore well adapted to the quality assurance of this process. Preliminary results show a clear signature of well-bonded and debonded interfaces and the method is able to classify/rank the bond strength of fuel plates prepared under different HIP conditions.

  18. Clobetasone treatment of allergic conjunctivitis: a comparative double blind study.

    PubMed

    Cerqueti, P M; Prosio, P E; Bosia, S; Buscaglia, S; Ciprandi, G

    1993-01-01

    Glucocorticosteroids are often included in the treatment of allergic conjunctivitis. The present study compares the efficacy on clinical and cytological parameters and safety of topical clobetasone butyrate compared to placebo. The trial, designed as double blind, randomized and parallel group treatment, was carried out in 30 patients, suffering from seasonal allergic conjunctivitis due to Grass pollen, during the pollen season (June 1992). Patients received clobetasone butyrate 0.1% eye drops or placebo eye drops, two drops each eye, t.i.d. for 10 days. The clinical and cytological evidences were investigated on admission and at the end of treatment by clinicians and by patients on a dairy card. The steroid group showed a rapid and significant clinical improvement and at the end of the trial a statistically significant difference was evidenced between the active drug treated group and placebo treated group. No serious side effects were observed. The results show the clinical efficacy of clobetasone butyrate in the treatment of pollen-induced allergic conjunctivitis. PMID:8337991

  19. Comparing Treatment Plan in All Locations of Esophageal Cancer

    PubMed Central

    Lin, Jang-Chun; Tsai, Jo-Ting; Chang, Chih-Chieh; Jen, Yee-Min; Li, Ming-Hsien; Liu, Wei-Hsiu

    2015-01-01

    Abstract The aim of this study was to compare treatment plans of volumetric modulated arc therapy (VMAT) with intensity-modulated radiotherapy (IMRT) for all esophageal cancer (EC) tumor locations. This retrospective study from July 2009 to June 2014 included 20 patients with EC who received definitive concurrent chemoradiotherapy with radiation doses >50.4 Gy. Version 9.2 of Pinnacle3 with SmartArc was used for treatment planning. Dosimetric quality was evaluated based on doses to several organs at risk, including the spinal cord, heart, and lung, over the same coverage of gross tumor volume. In upper thoracic EC, the IMRT treatment plan had a lower lung mean dose (P = 0.0126) and lung V5 (P = 0.0037) compared with VMAT; both techniques had similar coverage of the planning target volumes (PTVs) (P = 0.3575). In middle thoracic EC, a lower lung mean dose (P = 0.0010) and V5 (P = 0.0145), but higher lung V20 (P = 0.0034), spinal cord Dmax (P = 0.0262), and heart mean dose (P = 0.0054), were observed for IMRT compared with VMAT; IMRT provided better PTV coverage. Patients with lower thoracic ECs had a lower lung mean dose (P = 0.0469) and V5 (P = 0.0039), but higher spinal cord Dmax (P = 0.0301) and heart mean dose (P = 0.0020), with IMRT compared with VMAT. PTV coverage was similar (P = 0.0858) for the 2 techniques. IMRT provided a lower mean dose and lung V5 in upper thoracic EC compared with VMAT, but exhibited different advantages and disadvantages in patients with middle or lower thoracic ECs. Thus, choosing different techniques for different EC locations is warranted. PMID:25929910

  20. Development of a new diagnostic sensor for extra-corporeal shock-wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Fedele, F.; Coleman, A. J.; Leighton, T. G.; White, P. R.; Hurrell, A. M.

    2004-01-01

    Extracorporeal shock-wave lithotripsy is the leading technique used in urology for the non-invasive treatment of kidney and ureteric stones. The stone is comminuted by thousands of ultrasound shocks, into fragments small enough to be naturally passed. Since the technique was introduced in the 1980 different generations of lithotripters have been developed. Nevertheless the alignment systems (x-ray, ultrasound) still have some limitations (indeed, the tighter focusing of newer lithotripter reduces the tolerance for misalignment) and there is no capability for on-line monitoring of the degree of fragmentation of the stone. There is 50% incidence of re-treatments, possibly due to these deficiencies. The objective of this research is to design a new passive acoustic sensor, exploiting the secondary acoustic emission generated during the treatment, which could be used as a diagnostic device for lithotripsy. With a passive cylindrical cavitation detector, developed by the National Physical Laboratory, it was possible to detect these emissions in a laboratory lithotripter, and it was shown that they contain information on the degree of stone fragmentation and stone location. This information could be used to perform the desired monitoring and to improve the stone targeting. In collaboration with Precision Acoustic Ltd, some clinical prototypes were developed and tested to verify the relevance of these preliminary results. Clinical results are presented.

  1. Comparative analysis of bio fouling microorganisms after treatment with glidarc

    NASA Astrophysics Data System (ADS)

    Hnatiuc, M.; Sabau, A.; Hnatiuc, B.; Ghita, S.

    2015-11-01

    The biofouling of the surfaces immersed in water is one of the most important problems which must be solved in the naval field. This phenomenon is amplified during the harbor operations, when the ships are stationary and there is a high density of microorganisms in the neritic area, developing the biofouling. For this reason, in order to prevent or delay the deposition of the first layers of biofouling, different methods have been used [1]. This paper presents the comparative analysis of microorganisms’ behavior obtained by using GlidArc technology for the treatment of the naval metallic surfaces [2, 3]. The main parameters identified for data processing were: the number of microorganisms shared from the point of view of sensibility to the used technology found on the metallic surfaces, the type of the naval paint and the treatment methods. For analysis it was used the epifluorescence microscopy method with. The comparative analysis follows the data processing which has the same input characteristics. Finally it was observed the microorganism's lifetime after the surface treatment.

  2. Comparing Biofouling Control Treatments for Use on Aquaculture Nets

    PubMed Central

    Swain, Geoffrey; Shinjo, Nagahiko

    2014-01-01

    Test panels comprised of uncoated, copper coated and silicone coated 7/8'' (22 mm) mesh knitted nylon net were evaluated to compare their properties and the effectiveness to prevent biofouling. This paper describes test procedures that were developed to quantify the performance in terms of antifouling, cleanability, drag and cost. The copper treatment was the most effective at controlling fouling, however, the silicone treated nets were the easiest to clean. The drag forces on the net were a function of twine diameter, twine roughness and fouling. After immersion, the uncoated nets had the most drag followed by the silicone and copper treatments. The cost of applying silicone to nets is high; however, improved formulations may provide a non-toxic alternative to control fouling. PMID:25474085

  3. The comparative bioavailability of cimetidine-alginate treatments.

    PubMed

    Britton, A M; Nichols, J D; Draper, P R

    1991-02-01

    The comparative bioavailability of cimetidine in cimetidine-alginate combinations has been investigated in twelve healthy volunteers in an open crossover study. Each volunteer received a single oral dose of a commercially available alginate-cimetidine combination tablet (Algitec) or cimetidine tablets (Tagamet), co-administered with a commercially available alginate reflux suppressant liquid or tablet (Gaviscon). No significant differences were observed between treatments for Cmax, tmax, AUC0-12 or AUC0- infinity. The study demonstrated equivalent bioavailability of cimetidine when administered separately with alginate products and as a fixed dose combination product. PMID:1672897

  4. Topical treatment of interdigital tinea pedis: terbinafine compared with clotrimazole.

    PubMed

    Patel, A; Brookman, S D; Bullen, M U; Marley, J; Ellis, D H; Williams, T; Barnetson, R S

    1999-11-01

    A multicentre, prospective, randomized, double-blind, parallel group study was undertaken to compare the efficacy and tolerability of topical terbinafine with topical clotrimazole in the treatment of interdigital tinea pedis. Patients were randomized to receive either terbinafine 1% cream twice daily for 1 week, followed by a similar placebo cream for 5 weeks, or clotrimazole 1% cream twice daily for 4 weeks. Outcome measures were: (i) mycological cure (negative culture); (ii) effective treatment (negative culture plus a symptom score of 2 or less out of a maximum score of 18); and (iii) complete cure (negative culture and a symptom score of 0); measured at 1, 4, 8 and 12 weeks after the commencement of the study. One hundred and four of the 217 patients randomized had a culture-confirmed dermatophyte infection at baseline. In these patients, 84.6% in the terbinafine group were culture negative after 1 week, compared with only 55.8% in the clotrimazole group. Both agents were well tolerated. The study showed that terbinafine achieves mycological cure more rapidly than clotrimazole. This may result in improved compliance and better control over transmission of infection. PMID:10570555

  5. Cost-effectiveness of trachoma control measures: comparing targeted household treatment and mass treatment of children.

    PubMed Central

    Frick, K. D.; Lietman, T. M.; Holm, S. O.; Jha, H. C.; Chaudhary, J. S.; Bhatta, R. C.

    2001-01-01

    OBJECTIVE: The present study compares the cost-effectiveness of targeted household treatment and mass treatment of children in the most westerly part of Nepal. METHODS: Effectiveness was measured as the percentage point change in the prevalence of trachoma. Resource measures included personnel time required for treatment, transportation, the time that study subjects had to wait to receive treatment, and the quantity of azithromycin used. The costs of the programme were calculated from the perspectives of the public health programme sponsor, the study subjects, and the society as a whole. FINDINGS: Previous studies have indicated no statistically significant differences in effectiveness, and the present work showed no significant differences in total personnel and transportation costs per child aged 1-10 years, the total time that adults spent waiting, or the quantity of azithromycin per child. However, the mass treatment of children was slightly more effective and used less of each resource per child aged 1-10 years than the targeted treatment of households. CONCLUSION: From all perspectives, the mass treatment of children is at least as effective and no more expensive than targeted household treatment, notwithstanding the absence of statistically significant differences. Less expensive targeting methods are required in order to make targeted household treatment more cost-effective. PMID:11285663

  6. Effect of shockwave curvature on run distance observed with a modified wedge test

    NASA Astrophysics Data System (ADS)

    Lee, Richard; Dorgan, Robert J.; Sutherland, Gerrit; Benedetta, Ashley; Milby, Christopher

    2012-03-01

    The effect of wave curvature on shock initiation in PBXN-110 was investigated using a modified wedge test configuration. Various widths of PBXN-110 donor slabs were used to define the shockwave curvature introduced to wedge samples of the same explosive. The donor slabs were initiated with line-wave generators so that the shock from the donor would be the same shape, magnitude and duration across the entire input surface of the wedge. The shock parameters were varied for a given donor with PMMA spacers placed between the donor and the wedge sample. A high-speed electronic framing camera was used to observe where initiation occurred along the face of the wedge. Initiation always occurred at the center of the shock front instead of along the sides like that reported by others using a much smaller test format. Results were compared to CTH calculations to indicate if there were effects associated with highly curved shock fronts that could not be adequately predicted. The run distance predicted in CTH for a 50.8 mm wide donor slab (low curvature) compared favorably with experimental results. However, results from thinner donor slabs (higher curvature) indicate a more sensitive behavior than the simulations predicted.

  7. Effect of Shockwave Curvature on Run Distance Observed with a Modified Wedge Test

    NASA Astrophysics Data System (ADS)

    Lee, Richard; Dorgan, Robert; Sutherland, Gerrit; Benedetta, Ashley; Milby, Christopher

    2011-06-01

    The effect of wave curvature on shock initiation in PBXN-110 was investigated using a modified wedge test configuration. Various thicknesses of PBXN-110 donor slabs were used to define the shockwave curvature introduced to wedge samples of the same explosive. The donor slabs were initiated with line-wave generators so that the introduced shock would be the same shape, magnitude and duration across the entire input surface of the wedge. The shock parameters were varied for a given donor thickness via different widths of PMMA spacers placed between the donor and the wedge. A framing camera was used to observe where initiation occurred along the face of the wedge. Initiation always occurred at the center of the shock front instead of the sides like that reported by others using a much smaller test format. Results were compared to CTH calculations to indicate if there were effects associated with highly curved shock fronts that could not be adequately predicted. The run distance predicted in CTH for a 50.8 mm thick donor slab (low curvature) compared favorably with experimental results. However, results from thinner donor slabs (higher curvature) indicate a more sensitive behavior than the simulations predicted.

  8. Shock-Wave Acceleration of Protons on OMEGA EP

    NASA Astrophysics Data System (ADS)

    Haberberger, D.; Froula, D. H.; Pak, A.; Link, A.; Patel, P.; Fiuza, F.; Tochitsky, S.; Joshi, C.

    2015-11-01

    Recent experimental results using shock-wave acceleration (SWA) driven by a CO2 laser in a H2 gas-jet plasma have shown the possibility of producing proton beams with energy spreads <10% and with energies of up to 20 MeV using a modest peak laser power of 4 TW. Here we propose the investigation of the scaling of the SWA mechanism to higher laser powers using the 1- μm OMEGA EP Laser System at the Laboratory for Laser Energetics. The required tailored plasma profile is created by expanding a CH target using the thermal x-ray emission from a UV ablated material. The desired characteristics optimal for SWA are met: (a) peak plasma density is overcritical for the 1- μm main pulse and (b) the plasma profile exponentially decays over a long scale length on the rear side. Results will be shown using a 4 ω probe to experimentally characterize the plasma density profile. Scaling from simulations of the SWA mechanism shows that ion energies in the range of 100 MeV/amu are achievable with a focused a0 of 5 from the OMEGA EP Laser System. This material is based upon work supported by the Department of Energy National Nuclear Security Administration under Award Number DE-NA0001944.

  9. Exact black holes and gravitational shockwaves on codimension-2 branes

    NASA Astrophysics Data System (ADS)

    Kaloper, Nemanja; Kiley, Derrick

    2006-03-01

    We derive exact gravitational fields of a black hole and a relativistic particle stuck on a codimension-2 brane in D dimensions when gravity is ruled by the bulk D-dimensional Einstein-Hilbert action. The black hole is locally the higher-dimensional Schwarzschild solution, which is threaded by a tensional brane yielding a deficit angle and includes the first explicit example of a `small' black hole on a tensional 3-brane. The shockwaves allow us to study the large distance limits of gravity on codimension-2 branes. In an infinite locally flat bulk, they extinguish as 1/rD-4, i.e. as 1/r2 on a 3-brane in 6D, manifestly displaying the full dimensionality of spacetime. We check that when we compactify the bulk, this special case correctly reduces to the 4D Aichelburg-Sexl solution at large distances. Our examples show that gravity does not really obstruct having general matter stress-energy on codimension-2 branes, although its mathematical description may be more involved.

  10. Laser-induced shock-wave lithotripsy of canine urocystoliths and nephroliths

    NASA Astrophysics Data System (ADS)

    Woods, J. P.; Bartels, Kenneth E.; Stair, Ernest L.; Schafer, Steven A.; Nordquist, Robert E.

    1997-05-01

    Urolithiasis is a common disease affecting dogs which can sometimes be treated with dietary and medical protocols. In many cases, however, medical management cannot be employed because the dietary restrictions are contraindicated, effective medical dissolution protocols for the calculi (uroliths) do not exist, or obstruction by the calculi may result in deterioration of renal function during the time required for medical dissolution. At present, the management of medically untreatable calculi has been surgical removal which may result in temporary but dramatic decrease in renal function, irreversible loss of damaged nephrons, and significant risk, particularly for bilateral or recurrent nephroliths. An innovative technique for the removal of these uroliths would involve laser lithotripsy which transforms light energy into acoustical energy generating a shock wave sufficient to fragment stones (photoacoustic ablation). The laser is transmitted via quartz fibers which are small and flexible and can be used under direct vision through endoscopes resulting in effective fragmentation with little surrounding tissue damage. Lasers are becoming increasingly more utilized in veterinary medicine, in contrast to the limited availability of other non-invasive methods of treatment of nephroliths (i.e. extracorporeal shock-wave lithotripsy).

  11. Prostaglandin E2 and Connexin 43 crosstalk in the osteogenesis induced by extracorporeal shockwave.

    PubMed

    Chen, Youbin; Xu, Jiankun; Liao, Haojie; Ma, Zebin; Zhang, Yuantao; Chen, Hongjiang; Huang, Zhonglian; Hu, Jun

    2016-09-01

    As a type of mechanical stimulation, extracorporeal shockwave (ESW) has been widely used in the clinic to treat bone fracture delayed union and non-unions. A large number of studies have shown beneficial effects of ESW in promoting fracture healing by inducing bone regeneration; however, the underlying mechanisms remain unclear. ESW has been shown to induce the production of prostaglandin E2 (PGE2), which is essential for gap junction intercellular communication in response to mechanical stress. Among the 19 known gap junction subunits, connexin43 (Cx43) is the most prevalent for mediating the response of mechanical stress. However, to our knowledge, the effect of ESW on Cx43 expression has not been reported before. Herein, we propose that a crosstalk between PGE2 and Cx43 is involved in the enhancement of osteogenesis induced by ESW. We review the currently available data to propose an unrevealed, but important mechanism via which ESW treatment affects osteogenic differentiation of bone marrow stromal cells. PMID:27515217

  12. Extended asymmetric hot region formation due to shockwave interactions following void collapse in shocked high explosive

    DOE PAGESBeta

    Shan, Tzu -Ray; Wixom, Ryan R.; Thompson, Aidan P.

    2016-08-11

    In both continuum hydrodynamics simulations and also multimillion atom reactive molecular dynamics simulations of shockwave propagation in single crystal pentaerythritol tetranitrate (PETN) containing a cylindrical void, we observed the formation of an initial radially symmetric hot spot. By extending the simulation time to the nanosecond scale, however, we observed the transformation of the small symmetric hot spot into a longitudinally asymmetric hot region extending over a much larger volume. Performing reactive molecular dynamics shock simulations using the reactive force field (ReaxFF) as implemented in the LAMMPS molecular dynamics package, we showed that the longitudinally asymmetric hot region was formed bymore » coalescence of the primary radially symmetric hot spot with a secondary triangular hot zone. We showed that the triangular hot zone coincided with a double-shocked region where the primary planar shockwave was overtaken by a secondary cylindrical shockwave. The secondary cylindrical shockwave originated in void collapse after the primary planar shockwave had passed over the void. A similar phenomenon was observed in continuum hydrodynamics shock simulations using the CTH hydrodynamics package. Furthermore, the formation and growth of extended asymmetric hot regions on nanosecond timescales has important implications for shock initiation thresholds in energetic materials.« less

  13. Extended asymmetric hot region formation due to shockwave interactions following void collapse in shocked high explosive

    NASA Astrophysics Data System (ADS)

    Shan, Tzu-Ray; Wixom, Ryan R.; Thompson, Aidan P.

    2016-08-01

    In both continuum hydrodynamics simulations and also multimillion atom reactive molecular dynamics simulations of shockwave propagation in single crystal pentaerythritol tetranitrate (PETN) containing a cylindrical void, we observed the formation of an initial radially symmetric hot spot. By extending the simulation time to the nanosecond scale, however, we observed the transformation of the small symmetric hot spot into a longitudinally asymmetric hot region extending over a much larger volume. Performing reactive molecular dynamics shock simulations using the reactive force field (ReaxFF) as implemented in the LAMMPS molecular dynamics package, we showed that the longitudinally asymmetric hot region was formed by coalescence of the primary radially symmetric hot spot with a secondary triangular hot zone. We showed that the triangular hot zone coincided with a double-shocked region where the primary planar shockwave was overtaken by a secondary cylindrical shockwave. The secondary cylindrical shockwave originated in void collapse after the primary planar shockwave had passed over the void. A similar phenomenon was observed in continuum hydrodynamics shock simulations using the CTH hydrodynamics package. The formation and growth of extended asymmetric hot regions on nanosecond timescales has important implications for shock initiation thresholds in energetic materials.

  14. Dynamics of plasma expansion and shockwave formation in femtosecond laser-ablated aluminum plumes in argon gas at atmospheric pressures

    SciTech Connect

    Miloshevsky, Alexander; Harilal, Sivanandan S.; Miloshevsky, Gennady Hassanein, Ahmed

    2014-04-15

    Plasma expansion with shockwave formation during laser ablation of materials in a background gasses is a complex process. The spatial and temporal evolution of pressure, temperature, density, and velocity fields is needed for its complete understanding. We have studied the expansion of femtosecond (fs) laser-ablated aluminum (Al) plumes in Argon (Ar) gas at 0.5 and 1 atmosphere (atm). The expansion of the plume is investigated experimentally using shadowgraphy and fast-gated imaging. The computational fluid dynamics (CFD) modeling is also carried out. The position of the shock front measured by shadowgraphy and fast-gated imaging is then compared to that obtained from the CFD modeling. The results from the three methods are found to be in good agreement, especially during the initial stage of plasma expansion. The computed time- and space-resolved fields of gas-dynamic parameters have provided valuable insights into the dynamics of plasma expansion and shockwave formation in fs-pulse ablated Al plumes in Ar gas at 0.5 and 1 atm. These results are compared to our previous data on nanosecond (ns) laser ablation of Al [S. S. Harilal et al., Phys. Plasmas 19, 083504 (2012)]. It is observed that both fs and ns plumes acquire a nearly spherical shape at the end of expansion in Ar gas at 1 atm. However, due to significantly lower pulse energy of the fs laser (5 mJ) compared to pulse energy of the ns laser (100 mJ) used in our studies, the values of pressure, temperature, mass density, and velocity are found to be smaller in the fs laser plume, and their time evolution occurs much faster on the same time scale. The oscillatory shock waves clearly visible in the ns plume are not observed in the internal region of the fs plume. These experimental and computational results provide a quantitative understanding of plasma expansion and shockwave formation in fs-pulse and ns-pulse laser ablated Al plumes in an ambient gas at atmospheric pressures.

  15. Dynamics of plasma expansion and shockwave formation in femtosecond laser-ablated aluminum plumes in argon gas at atmospheric pressures

    NASA Astrophysics Data System (ADS)

    Miloshevsky, Alexander; Harilal, Sivanandan S.; Miloshevsky, Gennady; Hassanein, Ahmed

    2014-04-01

    Plasma expansion with shockwave formation during laser ablation of materials in a background gasses is a complex process. The spatial and temporal evolution of pressure, temperature, density, and velocity fields is needed for its complete understanding. We have studied the expansion of femtosecond (fs) laser-ablated aluminum (Al) plumes in Argon (Ar) gas at 0.5 and 1 atmosphere (atm). The expansion of the plume is investigated experimentally using shadowgraphy and fast-gated imaging. The computational fluid dynamics (CFD) modeling is also carried out. The position of the shock front measured by shadowgraphy and fast-gated imaging is then compared to that obtained from the CFD modeling. The results from the three methods are found to be in good agreement, especially during the initial stage of plasma expansion. The computed time- and space-resolved fields of gas-dynamic parameters have provided valuable insights into the dynamics of plasma expansion and shockwave formation in fs-pulse ablated Al plumes in Ar gas at 0.5 and 1 atm. These results are compared to our previous data on nanosecond (ns) laser ablation of Al [S. S. Harilal et al., Phys. Plasmas 19, 083504 (2012)]. It is observed that both fs and ns plumes acquire a nearly spherical shape at the end of expansion in Ar gas at 1 atm. However, due to significantly lower pulse energy of the fs laser (5 mJ) compared to pulse energy of the ns laser (100 mJ) used in our studies, the values of pressure, temperature, mass density, and velocity are found to be smaller in the fs laser plume, and their time evolution occurs much faster on the same time scale. The oscillatory shock waves clearly visible in the ns plume are not observed in the internal region of the fs plume. These experimental and computational results provide a quantitative understanding of plasma expansion and shockwave formation in fs-pulse and ns-pulse laser ablated Al plumes in an ambient gas at atmospheric pressures.

  16. Use of the Hugoniot elastic limit in laser shockwave experiments to relate velocity measurements

    NASA Astrophysics Data System (ADS)

    Smith, James A.; Lacy, Jeffrey M.; Lévesque, Daniel; Monchalin, Jean-Pierre; Lord, Martin

    2016-02-01

    The US National Nuclear Security Agency has a Global Threat Reduction Initiative (GTRI) with the goal of reducing the worldwide use of high-enriched uranium (HEU). A salient component of that initiative is the conversion of research reactors from HEU to low enriched uranium (LEU) fuels. An innovative fuel is being developed to replace HEU in high-power research reactors. The new LEU fuel is a monolithic fuel made from a U-Mo alloy foil encapsulated in Al-6061 cladding. In order to support the fuel qualification process, the Laser Shockwave Technique (LST) is being developed to characterize the clad-clad and fuel-clad interface strengths in fresh and irradiated fuel plates. This fuel-cladding interface qualification will ensure the survivability of the fuel plates in the harsh reactor environment even under abnormal operating conditions. One of the concerns of the project is the difficulty of calibrating and standardizing the laser shock technique. An analytical study under development and experimental testing supports the hypothesis that the Hugoniot Elastic Limit (HEL) in materials can be a robust and simple benchmark to compare stresses generated by different laser shock systems.

  17. Shockwave-induced plasticity via large-scale nonequilibrium molecular dynamics

    SciTech Connect

    Holian, B.L.

    1998-07-01

    Nonequilibrium molecular-dynamics (MD) simulations of shock waves in single crystals have shown that, above a threshold strength, strongly shocked crystals deform in a very simple way. Rather than experiencing massive deformation, a simple slippage occurs at the shock front, relieving the peak shear stress, and leaving behind a stacking fault. Later calculations quantified the apparent threshold strength, namely the yield strength of the perfect crystal. Subsequently, pulsed x-ray experiments on shocked single crystals showed relative shifts in diffraction peaks, confirming our MD observations of stacking faults produced by shockwave passage. With the advent of massively parallel computers, we have been able to simulate shock waves in 10-million atom crystals with cross-sectional dimensions of 100{times}100 fcc unit cells (compared to earlier 6{times}6 systems). We have seen that the increased cross-section allows the system to slip along all of the available {l_brace}111{r_brace} slip planes, in different places along the now non-planar shock front. These simulations conclusively eliminate the worry that the kind of slippage we have observed is somehow an artifact of transverse periodic boundary conditions. Thus, future simulations are much more likely to show that weak-shock plasticity is nucleated by pre-existing extended defects embedded in the sample. {copyright} {ital 1998 American Institute of Physics.}

  18. Spectroscopic diagnostics of plume rebound and shockwave dynamics of confined aluminum laser plasma plumes

    SciTech Connect

    Yeates, P.; Kennedy, E. T.

    2011-06-15

    Generation and expansion dynamics of aluminum laser plasma plumes generated between parallel plates of varying separation ({Delta}Z = 2.0, 3.2, 4.0, and 5.6 mm), which confined plume expansion normal to the ablation surface, were diagnosed. Space and time resolved visible emission spectroscopy in the spectral range {lambda} = 355-470 nm and time gated visible imaging were employed to record emission spectra and plume dynamics. Space and time resolved profiles of N{sub e} (the electron density), T{sub e} (the electron temperature), and T{sub ionz} (the ionization temperature) were compared for different positions in the plasma plume. Significant modifications of the profiles of the above parameters were observed for plasma-surface collisions at the inner surface of the front plate, which formed a barrier to the free expansion of the plasma plume generated by the laser light on the surface of the back plate. Shockwave generation at the collision interface resulted in delayed compression of the low-density plasma plume near the inner ablation surface, at late stages in the plasma history. Upon exiting the cavity formed by the two plates, through an aperture in the front plate, the plasma plume underwent a second phase of free expansion.

  19. Shock-induced bubble collapse in a vessel: Implications for vascular injury in shockwave lithotripsy

    NASA Astrophysics Data System (ADS)

    Coralic, Vedran; Colonius, Tim

    2014-11-01

    In shockwave lithotripsy, shocks are repeatedly focused on kidney stones so to break them. The process leads to cavitation in tissue, which leads to hemorrhage. We hypothesize that shock-induced collapse (SIC) of preexisting bubbles is a potential mechanism for vascular injury. We study it numerically with an idealized problem consisting of the three-dimensional SIC of an air bubble immersed in a cylindrical water column embedded in gelatin. The gelatin is a tissue simulant and can be treated as a fluid due to fast time scales and small spatial scales of collapse. We thus model the problem as a compressible multicomponent flow and simulate it with a shock- and interface-capturing numerical method. The method is high-order, conservative and non-oscillatory. Fifth-order WENO is used for spatial reconstruction and an HLLC Riemann solver upwinds the fluxes. A third-order TVD-RK scheme evolves the solution. We evaluate the potential for injury in SIC for a range of pressures, bubble and vessel sizes, and tissue properties. We assess the potential for injury by comparing the finite strains in tissue, obtained by particle tracking, to ultimate strains from experiments. We conclude that SIC may contribute to vascular rupture and discuss the smallest bubble sizes needed for injury. This research was supported by NIH Grant No. 2PO1DK043881 and utilized XSEDE, which is supported by NSF Grant No. OCI-1053575.

  20. Comparative study of novel endovascular treatment techniques for intracranial aneurysms

    NASA Astrophysics Data System (ADS)

    Cantón, Gádor; Lasheras, Juan C.; Levy, David I.; Sparks, Steven R.

    2002-11-01

    Intracranial aneurysms are life-threatening vascular lesions, which are potentially treatable to avoid the consequences of their rupture. Current treatments, either surgical or endovascular, are all guided to reduce the hemodynamic forces acting on the aneurysm wall in an effort to minimize the risk of rupture. Surgical clipping is still the most used technique to treat this type of aneurysm but there is a continued demand for less invasive approaches. This has led to the development of several endovascular techniques. We report here a comparative study of the reduction in the hemodynamic stresses and the modification of the flow in the parent vessel resulting from the use of three different techniques. The first one consists of endosaccular packing with platinum coils (GDC, Target Therapeutics), which is already widely used but its long-term efficacy has not yet been determined. The second one consists of the embolization of the aneurismal sac with Onyx, a polymer which hardens when in contact with the blood (being developed by Micro Therapeutics, Inc.). The third one involves the packing of the sac with hydrocoils, platinum wires coated with a gel which quickly hydrates when in contact with blood (developed by MicroVention). A Digital Particle Image Velocimetry (DPIV) system is used to measure in vitro the velocity field inside a model of an ACOM aneurysm (an aneurysm forming in the anterior communicating artery). Physiological accurate pulsatile flow conditions are input to the arterial model through a programmable pump. The measurements show that although all treatment techniques lead to a reduction in both normal and tangential shear stresses on the aneurismal sac, each one of them also leads to different modifications of the flow in the parent vessel which may have consequences related to potential for clotting. Comparison of the untreated aneurysm with the above three treated cases also showed that the characteristics of the wall shear stresses on the parent

  1. Effect of High Shock Number on Acute Complication Development After Extracorporeal Shockwave Lithotripsy

    PubMed Central

    Hadj-Moussa, Miriam

    2013-01-01

    Abstract Purpose We assessed whether high shock number is associated with higher rates of acute complication development after extracorporeal shockwave lithotripsy (SWL). Patients and Methods A retrospective chart review of 372 patients who underwent 436 SWL procedures at 24 kV using a Medstone STS-T lithotripter (Medstone International Inc., Aliso Viejo, CA) was conducted. Complications occurred within 4 weeks of SWL. Treatments were split into three cohorts based on shock number (<2400, 2401–4000, and >4000). Postoperative sequelae of patients who were stone free and those with residual stone were studied separately. Chi-square tests were used to evaluate the relationship between shock number cohort and postoperative complication development. Results SWL treatments recorded for each cohort were 158 (37.4%), 145 (34.4%), and 119 (28.2%), respectively. The short-term complication rate when SWL was successful was 8.3% overall. Complication rate for each cohort was 9.5% (11), 7.8% (5), and 7.2% (7), respectively. When SWL was successful, statistical analysis revealed no significant difference between complication rates and shock number cohort (P=0.63). Complications in patients with a residual stone occurred after 41.4% of treatments and trended upward with shock number cohort, but did not reach statistical significance (P=0.84). Conclusions At high voltage, high shock number was not shown to cause higher rates of short-term postoperative complications, as experienced by patients, when SWL was successful or resulted in a residual stone, yet complication rates associated with residual stone burden were approximately five times as common. Forgoing a higher shock number in the presence of a residual stone may therefore increase the risks of sequelae immediately after SWL. PMID:23537270

  2. Treatment Acceptability of Alternative Marital Therapies: A Comparative Analysis.

    ERIC Educational Resources Information Center

    Bornstein, Philip H.; And Others

    1983-01-01

    Examined the acceptability of four therapeutic models (i.e., behavioral, psychoanalytic, systems, and eclectic) used in treatment of marital discord. Subjects (N=88) evaluated four treatment sequences as they applied to a marital case history. Results showed that, among varying treatments, behavioral and systems approaches were rated more…

  3. [THE BONE DEFECT HEALING UNDER THE INFLUENCE OF RADIAL EXTRACORPOREAL SHOCK-WAVE THERAPY IN EXPERIMENT].

    PubMed

    Gertsen, G I; Se-Fey; Ostapchuk, R M; Lesovoy, A V; Zherebchuk, V V

    2016-03-01

    In experiment on 24 rabbits the processes of reparative osteogenesis in perforated defect of proximal tibial metaphysis under the influence of extracorporeal shock-wave therapy were studied. In accordance to data of clinical, roentgenological and morphological investiagations, conducted in terms 5, 15, 30 and 45 days of observation, there was established, that under the influence of extracorporeal shock-wave therapy in the bone marrow in the traumatic region a vasodilatation, as well as the blood cells exit from capillaries and sinusoid vessels with creation of massive regions of osseous endostal regenerate, guaranteeing the tibial integrity restoration, occurs. PMID:27514097

  4. Experimental studies of hypersonic shock-wave boundary-layer interactions

    NASA Technical Reports Server (NTRS)

    Lu, Frank K.

    1992-01-01

    Two classes of shock-wave boundary-layer interactions were studied experimentally in a shock tunnel in which a low Reynolds number, turbulent flow at Mach 8 was developed on a cold, flat test surface. The two classes of interactions were: (1) a swept interaction generated by a wedge ('fin') mounted perpendicularly on the flat plate; and (2) a two-dimensional, unseparated interaction induced by a shock impinging near an expansion corner. The swept interaction, with wedge angles of 5-20 degrees, was separated and there was also indication that the strongest interactions prossessed secondary separation zones. The interaction spread out extensively from the inviscid shock location although no indication of quasi-conical symmetry was evident. The surface pressure from the upstream influence to the inviscid shock was relatively low compared to the inviscid downstream value but it rose rapidly past the inviscid shock location. However, the surface pressure did not reach the downstream inviscid value and reasons were proposed for this anomalous behavior compared to strongly separated, supersonic interactions. The second class of interactions involved weak shocks impinging near small expansion corners. As a prelude to studying this interaction, a hypersonic similarity parameter was identified for the pure, expansion corner flow. The expansion corner severely damped out surface pressure fluctuations. When a shock impinged upstream of the corner, no significant changes to the surface pressure were found as compared to the case when the shock impinged on a flat plate. But, when the shock impinged downstream of the corner, a close coupling existed between the two wave systems, unlike the supersonic case. This close coupling modified the upstream influence. Regardless of whether the shock impinged ahead or behind the corner, the downstream region was affected by the close coupling between the shock and the expansion. Not only was the mean pressure distribution modified but the

  5. Can stone density on plain radiography predict the outcome of extracorporeal shockwave lithotripsy for ureteral stones?

    PubMed Central

    Lim, Ki Hong; Jung, Jin-Hee; Kwon, Jae Hyun; Lee, Yong Seok; Bae, Jungbum; Cho, Min Chul; Lee, Kwang Soo

    2015-01-01

    Purpose The objective was to determine whether stone density on plain radiography (kidney-ureter-bladder, KUB) could predict the outcome of extracorporeal shockwave lithotripsy (ESWL) for ureteral stones. Materials and Methods A total of 223 patients treated by ESWL for radio-opaque ureteral stones of 5 to 20 mm were included in this retrospective study. All patients underwent routine blood and urine analyses, plain radiography (KUB), and noncontrast computed tomography (NCCT) before ESWL. Demographic, stone, and radiological characteristics on KUB and NCCT were analyzed. The patients were categorized into two groups: lower-density (LD) group (radiodensity less than or equal to that of the 12th rib, n=163) and higher-density (HD) group (radiodensity greater than that of the 12th rib, n=60). Stone-free status was assessed by KUB every week after ESWL. A successful outcome was defined as stone free within 1 month after ESWL. Results Mean stone size in the LD group was significantly smaller than that in the HD group (7.5±1.4 mm compared with 9.9±2.9 mm, p=0.002). The overall success rates in the LD and HD groups were 82.1% and 60.0%, respectively (p=0.007). The mean duration of stone-free status and average number of SWL sessions required for success in the two groups were 21.7 compared with 39.2 days and 1.8 compared with 2.3, respectively (p<0.05). On multivariate logistic analysis, stone size and time to ESWL since colic and radiodensity of the stone on KUB were independent predictors of successful ESWL. Conclusions Our data suggest that larger stone size, longer time to ESWL, and ureteral stones with a radiodensity greater than that of the 12th rib may be at a relatively higher risk of ESWL failure 1 month after the procedure. PMID:25598937

  6. Comparative Effectiveness of Guided Mastery and Exposure Treatments for Intractable Phobias.

    ERIC Educational Resources Information Center

    Williams, S. Lloyd; And Others

    1984-01-01

    Compared two models of phobia treatment. Severe height and driving phobics (N=32) were assigned to either mastery-oriented treatment based on self-efficacy theory, exposure treatment, or no treatment. Mastery treatment proved to be significantly more effective. Results indicated that treatments effect behavioral change through their intervening…

  7. Comparative assessment of water treatment using polymeric and inorganic coagulants

    NASA Astrophysics Data System (ADS)

    Manda, Innocent K. M.; Chidya, Russel C. G.; Saka, John D. K.; Biswick, Timothy T.

    2016-06-01

    Portable water plays a vital role in improving human life, particularly in controlling the spread of diseases. However, problems associated with lack of potable water are still common especially in developing countries including Malawi. Until now little information exists on the effectiveness of available commercial coagulants used by national water boards in Malawi. Therefore, this study was undertaken in Southern Region Water Board (SRWB) to investigate the efficiency of polymeric coagulants (sufdfloc 3850 and algaefloc 19s) in turbidity reduction comparative with inorganic coagulant (aluminium sulphate) at Zomba, Liwonde, Mangochi, Chikwawa and Mulanje Treatment plants. The jar test method was used to determine the effectiveness of the water coagulants. The results revealed that sudfloc 3850 was most effective in reducing turbidity at Mangochi (99.4 ± 0.06%) and Liwonde (97.2 ± 0.04%) using 0.4 mg L-1 flocculant dose. The Zomba, Mulanje and Chikwawa plants gave 19.56 ± 0.03%, 29.23 ± 0.02% and 9.43 ± 0.02% total reductions respectively. Algaefloc 19s afforded the highest turbidity reduction at Liwonde and Mangochi plants (98.66 ± 0.06 and 97.48 ± 0.05% at a dose of 0.4 and 0.6 mg L-1 respectively), while Chikwawa provided the lowest (9.52 ± 0.01%). At the Zomba and Mulanje plants 20.5 ± 0.03% and 28.4 ± 0.04% reductions were obtained respectively. The inorganic flocculant, alum provided a 99.0 ± 0.05% and 98.6 ± 0.04% reduction at a dose of 4.0 mg L-1 and 6.0 mg L-1 at Zomba and Liwonde plants respectively. The lowest reductions in turbidity were achieved at Chikwawa (7.50 ± 0.01%), Mangochi (12.97 ± 0.02%) and Mulanje (25.00 ± 0.02). The best and optimum pH ranges for polymeric and inorganic coagulants were 7.20-7.80 and 7.35 to 7.57 respectively. The results further revealed that sudfloc 3850 and algaefloc 19s achieved faster formation of heavy flocs than alum. At 0.4 mg L-1 flocculant dosage sudfloc 3850 and algaefloc 19s required ten times

  8. Extracorporeal shockwave therapy promotes chondrogenesis in cartilage tissue engineering: A hypothesis based on previous evidence.

    PubMed

    Ji, Qiaodan; He, Chengqi

    2016-06-01

    The dearth of intrinsic regenerative capacity of articular cartilage makes it a challenge to deal with the cartilage defects. Among all the recommended clinical options, cartilage tissue engineering (CTE) which is highlighted of dominant features and less drawbacks for functional cartilage restoration, has been emphasized recently. Shock waves, a mode of therapeutic mechanical forces, utilized in extracorporeal shockwave therapy (ESWT), is hypothesized to enhance proliferation, chondrogenic differentiation, and cartilage extracellular matrix production of target cells seeded on bioactive scaffolds. The hypothesis is firstly based on cellular mechanotransduction by which cells convent the shockwave mechanical signals into biochemical responses via integrins, iron channels, cytoskeletal filaments, growth factor receptors and nuclei. Secondly, by modulating gene expression and up-regulating the release of various growth factors which are of vital importance in three-dimensional cartilage culture environment, ESWT holds a promising potential to favor the cell sources (e.g. chondrocytes and stem cells) to mimic the optimal functional cartilage. In all, on the basis of cellular mechanotransduction and previous evidence, the hypothesis is developed to support the beneficial effects of ESWT on chondrogenesis in CTE. If this hypothesis is confirmed, shockwaves may allow a better success in combination with other stimulating factors for cartilage repair. There is a paucity of studies investigating the assistant role of shockwave stimulation in CTE. Further research is required to elucidate the mechanisms, and explore effectiveness and appropriate protocols of this novel stimulative factor in cartilage tissue engineering. PMID:27142133

  9. Ultrafast Time Response Pressure-Sensitive Paint for Unsteady Shock-Wave Research

    NASA Astrophysics Data System (ADS)

    Numata, Daiju; Asai, Keisuke

    Pressure-Sensitive Paint (PSP) is an optical pressure measurement technique widely used in aerodynamic experiments, and has been applied to unsteady shock-wave phenomena [1, 2]. However, one of the largest problems to apply PSP to high-speed and unsteady phenomena is the response time of PSP.

  10. Shock-wave sensitivity of a TATB-based plasticized explosive

    SciTech Connect

    Aminov, Y.A.; Vershinin, A.V.; Es`kov, N.S.

    1995-07-01

    The results of numerical modelling of experiments on the investigation of shock-wave sensitivity of a TATB-based explosive are presented. A model for the macrokinetics of decomposition of the explosive has been constructed within the framework of a hypothesis of hot spots.

  11. Clinical experience with shock-wave lithotripsy using the Siemens Modularis Vario lithotripter

    PubMed Central

    Hassouna, Mohamed E.; Oraby, Samir; Sameh, Wael; El-Abbady, Ahmed

    2011-01-01

    Purpose To assess the effectiveness of a lithotripter (Modularis Vario; Siemens, AG Healthcare, Munich, Germany) in the management of renal and ureteric stones. Patients and methods In all, 1146 adult patients with renal or ureteric stones were treated at one urological centre using the latest model of the Modularis Vario lithotripter. The effectiveness of lithotripsy and re-treatment rate were assessed. Data were obtained on stone location, stone size, shock wave usage, success rate, and complications. Results Between May 2007 and November 2009, 698 patients with renal stones and 448 with ureteric stones underwent extracorporeal shock-wave lithotripsy (ESWL). The mean (SD) renal stone size was 12.8 (3.8) mm; a mean of 1.36 sessions was required, with a mean (SD) number of 3744 (1961) shocks delivered per renal stone. After 3 months, the success rate defined as the patient being stone-free or with residual fragments of <4 mm; for renal stones the rate was 91.1%, with a 6.9% complication rate in the form of steinstrasse and severe renal colic. The mean (SD) ureteric stone size was 10.4 (2.7) mm. A mean of 1.37 sessions was required, with a mean (SD) of 4551 (2467) shocks delivered for each ureteric stone. The success rate for ureteric stones was 89.5%, with a 5.6% complication rate. The overall efficiency quotient was 0.66. Conclusion The Siemens Modularis Vario lithotripter is a safe and effective machine for treating renal and ureteric stones. PMID:26579276

  12. Summary of comparative results integrated nonthermal treatment and integrated thermal treatment systems studies

    SciTech Connect

    1996-12-01

    In July 1994, the Idaho National Engineering Laboratory (INEL), under a contract from U.S. Department of Energy`s (DOE) Environment Management Office of Science and Technology (OST, EM-50) published a report entitled {open_quotes}Integrated Thermal Treatment System Study - Phase 1 Results{close_quotes} (EGG-MS-11211). This report was the culmination of over a year of analysis involving scientists and engineers within the DOE complex and from private industry. The purpose of that study was {open_quotes}to conduct a systematic engineering evaluation of a variety of mixed low level waste (MLLW) treatment system alternatives.{close_quotes} The study also {open_quotes}identified the research and development, demonstrations, and testing and evaluation needed to assure unit operability in the most promising alternative system.{close_quotes} This study evaluated ten primary thermal treatment technologies, organized into complete {open_quotes}cradle-to-grave{close_quotes} systems (including complete engineering flow sheets), to treat DOE MLLW and calculated mass balances and 20-year total life cycle costs (TLCC) for all systems. The waste input used was a representative heterogenous mixture of typical DOE MLLW. An additional study was conducted, and then, based on response to these studies, additional work was started to investigate and evaluate non-thermal treatment options on a footing comparable to the effort devoted to thermal options. This report attempts to present a summary overview of the thermal and non-thermal treatment technologies which were examined in detail in the process of the above mentioned reviews.

  13. Comparative efficacy and tolerability of drug treatments for bipolar disorder.

    PubMed

    Strakowski, S M; DelBello, M P; Adler, C M

    2001-01-01

    Lithium has been the backbone of treatment for bipolar disorder for several decades, although recent advances have identified a number of other medications that have efficacy in treating various phases of the illness. These include the antiepileptic drugs valproate semisodium (divalproex sodium) and carbamazepine and some new antiepileptic drugs (e.g. lamotrigine and topiramate), and the atypical antipsychotics (e.g. olanzapine, clozapine and risperidone). Conventional antipsychotics continue to be used frequently in bipolar disorder, although they may be somewhat less effective than other treatments. Otherwise, to date, none of these treatments have been shown to be consistently more effective than any other, so that drug adverse effects and tolerability often dictate which agents are used in an individual patient. Drugs commonly used for the treatment of bipolar disorder are generally tolerated by most patients in large samples. However, the unique adverse effect signature of a drug will often suggest that it will be less tolerable in some patients than in others. Identifying a specific treatment for a specific patient requires a careful individualised assessment of the risk of adverse effects for that patient's unique circumstances. PMID:11580309

  14. Atomoxetine Treatment for ADHD: Younger Adults Compared with Older Adults

    ERIC Educational Resources Information Center

    Durell, Todd; Adler, Lenard; Wilens, Timothy; Paczkowski, Martin; Schuh, Kory

    2010-01-01

    Objective: Atomoxetine is a nonstimulant medication for treating child, adolescent, and adult ADHD. This meta-analysis compared the effects in younger and older adults. Method: A post hoc analysis was conducted using data from two double-blind, placebo-controlled clinical trials. Data from patients aged 18-25 years were compared with data from…

  15. Criticality and characteristic neutronic analysis of a transient-state shockwave in a pulsed spherical gaseous uranium-hexafluoride reactor

    NASA Astrophysics Data System (ADS)

    Boles, Jeremiah Thomas

    The purpose of this study is to analyze the theoretical criticality of a spherical uranium-hexafluoride reactor with a transient, pulsed shockwave emanating from the center of the sphere in an outward-radial direction. This novel nuclear reactor design, based upon pulsed fission in a spherical enclosure is proposed for possible use in direct energy conversion, where the energy from fission products is captured through the use of electrostatic fields or through induction. An analysis of the dynamic behavior of the shockwave in this reactor is the subject of this thesis. As a shockwave travels through a fluid medium, the characteristics of the medium will change across the shockwave boundary. Pressure, temperature, and density are all affected by the shockwave. Changes in these parameters will affect the neutronic characteristics of a fissile medium. If the system is initially in a subcritical state, the increases in pressure, temperature, and density, all brought about by the introduction of the shockwave, will increase the reactivity of the nuclear system, creating a brief super critical state that will return to a subcritical state after the shockwave dissipates. Two major problems are required to be solved for this system. One is the effects of the shockwave on the gas, and the second is the resulting effects on system criticality. These problems are coupled due to the unique nature of the speed of the expanding shockwave in the uranium-hexafluoride medium and the energy imparted to the system by the shockwave with respect to the fissile uranium-hexafluoride. Using compressible flow and shockwave theories, this study determines the properties of the gaseous medium for reference points before, during, and behind the shockwave as it passes through the fissile medium. These properties include pressure changes, temperature changes, and density changes that occur to the system. Using the parameters calculated from the shockwave, the neutron transport equation is

  16. Comparing Active Pediatric Obesity Treatments Using Meta-Analysis

    ERIC Educational Resources Information Center

    Gilles, Allyson; Cassano, Michael; Shepherd, Elizabeth J.; Higgins, Diana; Hecker, Jeffrey E.; Nangle, Douglas W.

    2008-01-01

    The current meta-analysis reviews research on the treatment of pediatric obesity focusing on studies that have been published since 1994. Eleven studies (22 comparisons, 115 effect sizes, N = 447) were included in the present meta-analysis. Results indicated that comprehensive behavioral interventions may be improved in at least two ways:…

  17. Public and Private Management of Wastewater Treatment: A Comparative Study.

    ERIC Educational Resources Information Center

    O'Toole, Laurence J., Jr.

    1991-01-01

    The costs and performance of contract management of municipal wastewater treatment facilities are considered, using information from a nationwide empirical examination of evidence from individual plants, municipalities, and regulatory agencies. The broad issues arising in the evaluation are outlined as the specifics are discussed. (SLD)

  18. Extracorporeal shockwave therapy in osteoporotic osteoarthritis of the knee in rats: an experiment in animals

    PubMed Central

    2014-01-01

    Introduction This study investigated the effectiveness of extracorporeal shockwave therapy (ESWT) in osteoporotic (OP) osteoarthritis (OA) of rat knee. Methods Fifty-six rats were divided into seven groups including sham, OA, OP, OA + OP, OA + ESWT, OP + ESWT, and OA + OP + ESWT groups. The evaluations included gross pathology, bone mineral density (BMD), micro-computed tomography (micro-CT) scan, bone-strength test, histopathologic examination, and immunohistochemical analysis. Results On gross pathology, group OA + OP showed larger areas of osteoarthritic changes than did groups OA and OP, as compared with the sham group. BMD and bone strength significantly decreased in groups OA, OP, and OA + OP relative to the sham group, and ESWT significantly improved BMD and bone-strength changes. On micro-CT scan, the subchondral plate thickness significantly decreased, and the bone porosity increased in groups OA, OP, and OA + OP, and ESWT significantly improved the changes in subchondral-plate thickness and bone porosity. In histopathologic examination, Mankin score and safranin O score significantly increased in groups OA and group OA + OP, but not in group OP relative to the sham group, and ESWT significantly improved the changes. In immunohistochemical analysis, Dickkopf-1 (DKK-1) significantly increased, but vessel endothelial growth factor (VEGF), proliferating cell nuclear antigen (PCNA), and bone morphogenetic protein 2 (BMP-2) decreased in groups OA, OP, and OA + OP relative to the sham group, and ESWT significantly reversed the changes. Conclusions Osteoporosis increased the severity of cartilage damage in osteoarthritis of the knee. ESWT showed effectiveness in the reduction of osteoporotic osteoarthritis of the knee in rats. PMID:24994452

  19. A cumulative shear mechanism for tissue damage initiation in shock-wave lithotripsy

    PubMed Central

    Freund, Jonathan B.; Colonius, Tim; Evan, Andrew P.

    2007-01-01

    Evidence suggests that inertial cavitation plays an important role in the renal injury incurred during shock-wave lithotripsy. However, it is unclear how tissue damage is initiated, and significant injury typically occurs only after a sufficient dose of shock waves. While it has been suggested that shock-induced shearing might initiate injury, estimates indicate that individual shocks do not produce sufficient shear to do so. In this paper, we hypothesize that the cumulative shear of the many shocks is damaging. This mechanism depends upon whether there is sufficient time between shocks for tissue to relax to its unstrained state. We investigate the mechanism with a physics-based simulation model wherein the the basement membranes that define the tubules and vessels in the inner medulla are represented as elastic shells surrounded by viscous fluid. Material properties are estimated from in vitro tests of renal basement membranes and documented mechanical properties of cells and extracellular gels. Estimates for the net shear deformation from a typical lithotripter shock (~ 0.1%) are found from a separate dynamic shock simulation. The results suggest that the larger interstitial volume (~ 40%) near the papilla tip gives the tissue there a relaxation time comparable to clinical shock delivery rates (~ 1Hz), thus allowing shear to accumulate. Away from the papilla tip, where the interstitial volume is smaller (≲ 20%), the model tissue relaxes completely before the next shock would be delivered. Implications of the model are that slower delivery rates and broader focal zones should both decrease injury, consistent with some recent observations. PMID:17507147

  20. Quantification of the Range of Motion of Kidney and Ureteral Stones During Shockwave Lithotripsy in Conscious Patients.

    PubMed

    Harrogate, Suzanne R; Yick, L M Shirley; Williams, James C; Cleveland, Robin O; Turney, Benjamin W

    2016-04-01

    Effective shockwave lithotripsy requires accurate targeting of the stone throughout the course of treatment. Stone movement secondary to respiratory movement can make this more difficult. In vitro work has shown that stone motion outside the focal region reduces the efficacy of stone fragmentation; however, there are few clinical data on the degree of stone movement in patients during treatment. To investigate this, X-ray fluoroscopic images of the kidney and ureteral stones at the upper and lower limits of the normal respiratory cycle were acquired during shock wave lithotripsy of 58 conscious patients, and stone excursion was calculated from these images. In addition, the respiration rate and patient perceived pain were recorded during the course of the treatment. It was found that stone motion secondary to respiration was 7.7 ± 2.9 mm for kidney stones and 3.6 ± 2.1 mm for ureteral stones-less than has been reported in studies with anesthetized patients. There was no significant change of motion over the course of treatment although pain was found to increase. These data suggest that stone motion in conscious patients is less than in anesthetized patients. Furthermore, it suggests that lithotripters with focal regions of 8 mm or greater should not suffer from a marked drop in fragmentation efficiency due to stone motion. PMID:26756226

  1. Comparative environmental analysis of waste brominated plastic thermal treatments

    SciTech Connect

    Bientinesi, M. Petarca, L.

    2009-03-15

    The aim of this research activity is to investigate the environmental impact of different thermal treatments of waste electric and electronic equipment (WEEE), applying a life cycle assessment methodology. Two scenarios were assessed, which both allow the recovery of bromine: (A) the co-combustion of WEEE and green waste in a municipal solid waste combustion plant, and (B) the staged-gasification of WEEE and combustion of produced syngas in gas turbines. Mass and energy balances on the two scenarios were set and the analysis of the life cycle inventory and the life cycle impact assessment were conducted. Two impact assessment methods (Ecoindicator 99 and Impact 2002+) were slightly modified and then used with both scenarios. The results showed that scenario B (staged-gasification) had a potentially smaller environmental impact than scenario A (co-combustion). In particular, the thermal treatment of staged-gasification was more energy efficient than co-combustion, and therefore scenario B performed better than scenario A, mainly in the impact categories of 'fossil fuels' and 'climate change'. Moreover, the results showed that scenario B allows a higher recovery of bromine than scenario A; however, Br recovery leads to environmental benefits for both the scenarios. Finally the study demonstrates that WEEE thermal treatment for energy and matter recovery is an eco-efficient way to dispose of this kind of waste.

  2. Comparative environmental analysis of waste brominated plastic thermal treatments.

    PubMed

    Bientinesi, M; Petarca, L

    2009-03-01

    The aim of this research activity is to investigate the environmental impact of different thermal treatments of waste electric and electronic equipment (WEEE), applying a life cycle assessment methodology. Two scenarios were assessed, which both allow the recovery of bromine: (A) the co-combustion of WEEE and green waste in a municipal solid waste combustion plant, and (B) the staged-gasification of WEEE and combustion of produced syngas in gas turbines. Mass and energy balances on the two scenarios were set and the analysis of the life cycle inventory and the life cycle impact assessment were conducted. Two impact assessment methods (Ecoindicator 99 and Impact 2002+) were slightly modified and then used with both scenarios. The results showed that scenario B (staged-gasification) had a potentially smaller environmental impact than scenario A (co-combustion). In particular, the thermal treatment of staged-gasification was more energy efficient than co-combustion, and therefore scenario B performed better than scenario A, mainly in the impact categories of "fossil fuels" and "climate change". Moreover, the results showed that scenario B allows a higher recovery of bromine than scenario A; however, Br recovery leads to environmental benefits for both the scenarios. Finally the study demonstrates that WEEE thermal treatment for energy and matter recovery is an eco-efficient way to dispose of this kind of waste. PMID:18829288

  3. Posthospitalization Outcomes for Psychiatric Sex Offenders: Comparing Two Treatment Protocols.

    PubMed

    Stinson, Jill D; McVay, Lee Ann; Becker, Judith V

    2016-05-01

    This study evaluates the effectiveness of safe offender strategies (SOS) in comparison with relapse prevention (RP) in a sample of 91 inpatient males in a secure psychiatric setting. All men evidenced a history of violent sexual offending and were diagnosed with serious psychiatric disorders and/or intellectual disabilities. Participants who received SOS (n= 58) and RP (n= 33) were followed from 6 to 36 months post release. SOS clients were significantly less likely to be arrested (0%) or rehospitalized (5.2%) than RP clients (9% arrested; 54.5% rehospitalized). In addition, SOS clients were more likely to transition continuously to less restrictive alternatives, with no returns to high security, in comparison with RP clients. The authors discuss implications for use of SOS, a treatment that facilitates skills development and affects global self-regulatory functioning, particularly in sex offenders with serious mental illness or intellectual impairment, in promoting community reintegration and limiting returns to psychiatric settings. PMID:26205684

  4. A Treatment Study of Suicidal Adolescent with Personality Disorder or Traits: Mode Deactivation Therapy as Compared to Treatment as Usual

    ERIC Educational Resources Information Center

    Apsche, Jack A.; Bass, Christopher K.; Siv, Alexander M.

    2006-01-01

    This treatment research compares Mode Deactivation Therapy(MDT) to Treatment as Usual (TAU) with suicidal adolescents. This treatment research study examines the effects of MDT vs. TAU on adolescents who had co-morbid mental health issues as well as, personality disorders and traits. MDT was shown to be more effective in reducing suicidal thoughts…

  5. Secnidazole vs. paromomycin: comparative antiprotozoan treatment in captive primates.

    PubMed

    Gracenea, M; Gómez, M S; Fernández, J; Feliu, C

    1998-02-01

    The antiprotozoan activity of secnidazole was studied in Cercocebus t. torquatus, Cercopithecus campbelli, Erythrocebus patas (Cercopithecidae), and Gorilla gorilla (Pongidae) compared with that of paromomycin in Cercocebus t. lunulatus (Cercopithecidae), E. patas, and G. gorilla (Pongidae) by coprological analysis. The antiprotozoan activity of both drugs depended on the parasite species and the host species. The drugs acted in a similar way on Entamoeba coli parasitising C. t. torquatus, and E. patas. This activity was different from that observed on I. buestchlii from the same host species. Nevertheless, E. coli parasitising cercopithecids and pongids responded to drugs differently. PMID:9606042

  6. Shock-wave equation-of-state studies at Los Alamos

    SciTech Connect

    Morris, C.E.

    1990-01-01

    A history of the shock-wave equation-of-state (EOS) studies at Los Alamos is given. Particular emphasis is placed on the pioneering research in the 1950s where many of the experimental techniques and methods of analysis were developed, which we now take for granted. A brief review of shock-wave physics is given, which illustrates important hydrodynamic and thermodynamic concepts. Recent studies on the EOS of Ti are presented with emphasis on the {alpha}-to-{omega} phase transition. VISAR wave profiles on polycrystalline Ni and single-crystal Ni are presented to determine the strengths of these materials at pressure. Low-density polystyrene foam Hugoniot experiments are described and results analyzed. 21 refs., 14 figs.

  7. Investigation into low-temperatures influence on high explosive compounds sensitivity to shock-wave impacts

    SciTech Connect

    Averin, A.N.; Alekseev, A.V.; Batalov, S.V.; Loboiko, B.G.; Litvinov, B.V.; Sumin, V.D.; Filin, V.P.; Yagnakov, A.N.

    1996-05-01

    Study of shock-wave sensitivity of explosives under various temperatures is of great significance for correct analysis of safe application of different industrial processes, technologies, as well as for correct understanding of explosion initiation mechanism in (explosives). Currently, the influence of low, ({minus}100{degree}C{hor_ellipsis}{minus}200{degree}C) temperatures on explosive sensitivity to weak shock waves is poorly studied. This paper gives experimental results on the influence of low temperatures on the sensitivity of HMX{emdash}based explosives to weak shock-waves. In the present paper an attempt is made to experimentally determine dependence of HMX{emdash}based explosive sensitivity to weak shock waves on temperatures. The original technique of the experiment is presented in the report. {copyright} {ital 1996 American Institute of Physics.}

  8. Comparative tolerability of treatments for inflammatory bowel disease.

    PubMed

    Stein, R B; Hanauer, S B

    2000-11-01

    Despite limited understanding of therapeutic aetiopathogenesis of ulcerative colitis and Crohn's disease, there is a strong evidence base for the efficacy of pharmacological and biological therapies. It is equally important to recognise toxicity of the medical armamentarium for inflammatory bowel disease (IBD). Sulfasalazine consists of sulfapyridine linked to 5-aminosalicylic acid (5-ASA) via an azo bond. Common adverse effects related to sulfapyridine 'intolerance' include headache, nausea, anorexia, and malaise. Other allergic or toxic adverse effects include fever, rash, haemolytic anaemia, hepatitis, pancreatitis, paradoxical worsening of colitis, and reversible sperm abnormalities. The newer 5-ASA agents were developed to deliver the active ingredient of sulfasalazine while minimising adverse effects. Adverse effects are infrequent but may include nausea, dyspepsia and headache. Olsalazine may cause a secretory diarrhoea. Uncommon hypersensitivity reactions, including worsening of colitis, pancreatitis, pericarditis and nephritis, have also been reported. Corticosteroids are commonly prescribed for treatment of moderate to severe IBD. Despite short term efficacy, corticosteroids have numerous adverse effects that preclude their long term use. Adverse effects include acne, fluid retention, fat redistribution, hypertension, hyperglycaemia, psycho-neurological disturbances, cataracts, adrenal suppression, growth failure in children, and osteonecrosis. Newer corticosteroid preparations offer potential for targeted therapy and less corticosteroid-related adverse effects. Azathioprine and mercaptopurine are associated with pancreatitis in 3 to 15% of patients that resolves upon drug cessation. Bone marrow suppression is dose related and may be delayed. The adverse effects of methotrexate include nausea, leucopenia and, rarely, hypersensitivity pneumonia or hepatic fibrosis. Common adverse effects of cyclosporin include nephrotoxicity, hypertension, headache

  9. Shock-Wave and Plasma-Pinch Mechanisms of Galactic Cosmic-Ray Production

    SciTech Connect

    Trubnikov, B.A.

    2005-07-01

    Based on recent discoveries, we show that it is appropriate to complement the standard shock-wave model for the production of galactic cosmic rays by a plasma-pinch model. The latter describes well the production of high-energy cosmic rays, yields a simple formula for their intensity, and allows the threshold pattern of the knee-type kink in the secondary particle spectrum and a number of unusual phenomena observed above the threshold to be explained.

  10. Characterization of acoustic shockwaves generated by exposure to nanosecond electrical pulses

    NASA Astrophysics Data System (ADS)

    Roth, Caleb C.; Maswadi, Saher; Ibey, Bennett L.; Beier, Hope T.; Glickman, Randolph D.

    2014-03-01

    Despite 30 years of research, the mechanism behind the induced breakdown of plasma membranes by electrical pulses, termed electroporation, remains unknown. Current theories treat the interaction between the electrical field and the membrane as an entirely electrical event pointing to multiple plausible mechanisms. By investigating the biophysical interaction between plasma membranes and nanosecond electrical pulses (nsEP), we may have identified a non-electric field driven mechanism, previously unstudied in nsEP, which could be responsible for nanoporation of plasma membranes. In this investigation, we use a non-contact optical technique, termed probe beam deflection technique (PBDT), to characterize acoustic shockwaves generated by nsEP traveling through tungsten wire electrodes. We conclude these acoustic shockwaves are the result of the nsEP exposure imparting electrohydraulic forces on the buffer solution. When these acoustic shockwaves occur in close proximity to lipid bilayer membranes, it is possible that they impart a sufficient amount of mechanical stress to cause poration of that membrane. This research establishes for the first time that nsEP discharged in an aqueous medium generate measureable pressure waves of a magnitude capable of mechanical deformation and possibly damage to plasma membranes. These findings provide a new insight into the longunanswered question of how electric fields cause the breakdown of plasma membranes.

  11. Shockwaves and deep inelastic scattering within the gauge/gravity duality

    NASA Astrophysics Data System (ADS)

    Avsar, E.; Iancu, E.; McLerran, L.; Triantafyllopoulos, D. N.

    2009-11-01

    Within the gauge/gravity correspondence, we discuss the general formulation of the shockwave metric which is dual to a `nucleus' described by the strongly-coupled Script N = 4 SYM theory in the limit where the number of colors Nc is arbitrarily large. We emphasize that the `nucleus' must possess Nc2 degrees of freedom per unit volume, so like a finite-temperature plasma, in order for a supergravity description to exist. We critically reassess previous proposals for introducing transverse inhomogeneity in the shockwave and formulate a new proposal in that sense, which involves no external source but requires the introduction of an `infrared' cutoff which mimics confinement. This cutoff however plays no role when the shockwave is probed by a highly virtual projectile, so like in deep inelastic scattering. We consider two such projectiles, the dilaton and the Script R-current, and compute the respective structure functions including unitarity corrections. We find that there are no leading-twist contributions to the structure functions at high virtuality, meaning that there are no point-like constituents in the strongly coupled `nucleus'. In the black-disk regime at low virtuality, the structure functions are suggestive of parton saturation with occupation numbers of order one. The saturation momentum Qs grows with the energy like Qs2 ~ 1/x (with x the Bjorken variable), which is the hallmark of graviton exchanges and is also necessary for the fulfillment of the energy-momentum sum rules.

  12. International shock-wave database project : report of the requirements workshop.

    SciTech Connect

    Aidun, John Bahram; Lomonosov, Igor V.; Levashov, Pavel R.

    2012-03-01

    We report on the requirements workshop for a new project, the International Shock-Wave database (ISWdb), which was held October 31 - November 2, 2011, at GSI, Darmstadt, Germany. Participants considered the idea of this database, its structure, technical requirements, content, and principles of operation. This report presents the consensus conclusions from the workshop, key discussion points, and the goals and plan for near-term and intermediate-term development of the ISWdb. The main points of consensus from the workshop were: (1) This international database is of interest and of practical use for the shock-wave and high pressure physics communities; (2) Intermediate state information and off-Hugoniot information is important and should be included in ISWdb; (3) Other relevant high pressure and auxiliary data should be included to the database, in the future; (4) Information on the ISWdb needs to be communicated, broadly, to the research community; and (5) Operating structure will consist of an Advisory Board, subject-matter expert Moderators to vet submitted data, and the database Project Team. This brief report is intended to inform the shock-wave research community and interested funding agencies about the project, as its success, ultimately, depends on both of these groups finding sufficient value in the database to use it, contribute to it, and support it.

  13. Simulation of shock-induced bubble collapse with application to vascular injury in shockwave lithotripsy

    NASA Astrophysics Data System (ADS)

    Coralic, Vedran

    Shockwave lithotripsy is a noninvasive medical procedure wherein shockwaves are repeatedly focused at the location of kidney stones in order to pulverize them. Stone comminution is thought to be the product of two mechanisms: the propagation of stress waves within the stone and cavitation erosion. However, the latter mechanism has also been implicated in vascular injury. In the present work, shock-induced bubble collapse is studied in order to understand the role that it might play in inducing vascular injury. A high-order accurate, shock- and interface-capturing numerical scheme is developed to simulate the three-dimensional collapse of the bubble in both the free-field and inside a vessel phantom. The primary contributions of the numerical study are the characterization of the shock-bubble and shock-bubble-vessel interactions across a large parameter space that includes clinical shockwave lithotripsy pressure amplitudes, problem geometry and tissue viscoelasticity, and the subsequent correlation of these interactions to vascular injury. Specifically, measurements of the vessel wall pressures and displacements, as well as the finite strains in the fluid surrounding the bubble, are utilized with available experiments in tissue to evaluate damage potential. Estimates are made of the smallest injurious bubbles in the microvasculature during both the collapse and jetting phases of the bubble's life cycle. The present results suggest that bubbles larger than one micrometer in diameter could rupture blood vessels under clinical SWL conditions.

  14. A new electromagnetic shock-wave generator "SLX-F2" with user-selectable dual focus size: ex vivo evaluation of renal injury.

    PubMed

    Leistner, Rasmus; Wendt-Nordahl, Gunnar; Grobholz, Rainer; Michel, Maurice Stephan; Marlinghaus, Ernst; Köhrmann, Kai Uwe; Alken, Peter; Häcker, Axel

    2007-08-01

    Storz Medical AG (Kreutzlingen/Switzerland) has developed a new electromagnetic shockwave (SW) generator, the "SLX-F2", which allows the user to choose between a small-focus, high-pressure treatment regime or a wide-focus, low-pressure option. The aim of this study was to investigate, under standardized conditions, the impact of these two different treatment regimes on SW-induced renal injury. SW-induced renal injury was investigated by using the standardized model of the perfused ex vivo kidney. SWs were applied under ultrasound control in the parenchyma of a kidney pole. Different SW numbers (20, 50, 125, 250, 500, 1,000) were applied in three groups: group A was treated with a wider focus (80 MPa), groups B (60 MPa) and C (120 MPa) with a smaller focus (each parameter setting was repeated ten-fold). Disintegration capacity (measured by crater volume in cubes of plaster of Paris) was the same in groups A and C. After SW exposure, barium sulphate suspension was perfused through the renal artery. The maximum diameter (mm) of the extravasation in the cortex, representing the extent of vascular injury, was measured on X-ray mammography films. H&E staining was performed. In all three groups (A, B, C) a higher number of SWs caused the diameter of the extravasate to increase, with statistical significance appearing at 1,000 shots versus 20 shots (p < 0.05). Vascular injury was not influenced by the focal size and positive peak pressure at identical SW numbers applied. Histology of the focal area showed gap-like defects. Our ex vivo data show that renal vascular injury is independent of the focal diameter of the SW generator at the same peak positive pressure and disintegration power. This confirms the in vivo findings that show renal injury caused by SW as being related to the number of SWs administered. Clinical studies are needed to investigate whether there is any advantage to offering both treatment regimes in one SW machine-for example, by using the "wide

  15. Shock-wave lithotripsy in the elderly: Safety, efficacy and special considerations

    PubMed Central

    Philippou, Prodromos; Lamrani, D.; Moraitis, Konstantinos; Wazait, Hassan; Masood, Junaid; Buchholz, Noor

    2011-01-01

    Purpose Shock-wave lithotripsy (SWL) for elderly patients can be challenging. Patients often have a long-standing complex stone burden and significant comorbidities. We report a cohort of patients aged ⩾70 years who were treated by SWL, with special attention to treatment outcomes, complications and the need for adjuvant procedures. Patients and methods Over a period of 4 years, 2311 patients were treated with SWL in a tertiary referral centre. Among these patients, 137 were aged ⩾70 years (5.9%). Patient and stone data were obtained from an electronic database and the patients’ electronic medical records were reviewed. Results During the pre-procedural assessment, 29 patients (21.2%) were considered to be at high anaesthetic risk, due their comorbidities (American Society of Anesthesiology score 3+). In terms of stone burden, 16 stones (11.7%) were located in the distal ureter (mean stone diameter 7.9 mm) and 28 (20.4%) were in the proximal ureter (mean diameter 10.1 mm). In the kidney, 54 stones (39.4%) were in the renal pelvis, upper or mid calyx (mean diameter 10.6 mm), while 39 stones (28.5%) were in the lower calyx (mean diameter 10.1 mm). The median (range) number of SWL sessions per patient was 2.0 (1–3). The overall stone-free rate achieved by SWL alone was 63.5% (65.9% for ureteric stones and 62.4% for renal stones). In total, 38 patients (27.7%) had an adjuvant procedure to achieve stone clearance (ureteroscopy in 23, PCNL in 14 and laparoscopic ureterolithotomy in one case). Apart from six cases (4.3%) of ureteric obstruction due to steinstrasse, there were no severe complications noted. Conclusions The management of elderly patients presenting with urolithiasis is challenging, due to the presence of significant comorbidities. Careful assessment of an integrated management plan for geriatric patients with urolithiasis is essential, and SWL still remains a safe and efficient first-line tool in well-selected cases. PMID:26579264

  16. Advancement of Shock-wave Induced Spraying Process through the Study of Gas and Particle Flow Fields

    NASA Astrophysics Data System (ADS)

    Karimi Esfahani, Mohammad

    This research advances the knowledge of the working principles of the Shock-wave Induced Spraying Process (SISP), a thermal spray material deposition technique. Pulses created by a fast acting valve pass through a heated line increasing energy content and interacting with metered batches of heated or non-heated powder introduced into the line. The powder is accelerated to high velocities before bonding to the substrate upon impact. Advantages over other cold spray processes include cost savings and a more effective transfer of thermal energy to the powder. The shock-wave occurring near the substrate in other cold spray processes is avoided. The SISP flow field is resolved by using a computational model. The two-dimensional model accounts for the valve, gas heater, a tapered nozzle at the tip of the device, and preheating of the powder. It is implemented with a commercial computational fluid dynamics code. Comparisons are made with one-dimensional predictions, and measurements of pressure and temperature. Particle flow predictions are validated using particle velocity and adhesion measurements. A flow region of both high temperature and velocity gas, favorable to material deposition, forms which is not present in comparable steady-state cold spray processes. Increasing gas pressure increases the gas speed, while increasing temperature increases speed and temperature of this region. Using helium results in greater energy levels but for shorter periods of time. This indicates the need for a powder feeder which places particles in the flow at correct instants and durations of time. The effects of particle flow parameters on system performance are examined. It is found that the device must be operated at very high main heater and powder heater temperatures: 900 °C and 700 °C respectively to achieve a coating with stainless steel using nitrogen as the driving gas. It is also shown that a heater length range of 0.9 m to 1.4 m results in the greatest likelihood of

  17. Superiority of preventive antibiotic treatment compared with standard treatment of poststroke pneumonia in experimental stroke: a bed to bench approach

    PubMed Central

    Hetze, Susann; Engel, Odilo; Römer, Christine; Mueller, Susanne; Dirnagl, Ulrich; Meisel, Christian; Meisel, Andreas

    2013-01-01

    Stroke patients are prone to life-threatening bacterial pneumonia. Previous experimental stroke studies have demonstrated that preventive antibiotic treatment (PAT) improves outcome compared with placebo treatment, which however does not model the clinical setting properly. Here we investigate whether PAT is superior to the current clinical ‘gold standard' for treating poststroke infections. Therefore, we modeled stroke care according to the current stroke guidelines recommending early antibiotic treatment after diagnosing infections. To reliably diagnose pneumonia in living mice, we established a general health score and a magnetic resonance imaging protocol for radiologic confirmation. Compared with standard treatment after diagnosis by these methods, PAT not only abolished pneumonia successfully but also improved general medical outcome. Both, preventive and standard antibiotic treatment using enrofloxacin improved survival in a similar way compared with placebo treatment. However, in contrast to standard treatment, only PAT improved functional outcome assessed by gait analysis. In conclusion, standard and preventive treatment approach reduced poststroke mortality, however at the cost of a worse neurologic outcome compared with preventive approach. These data support the concept of PAT for treating patients at risk for poststroke infections and warrant phase III trials to prove this concept in clinical setting. PMID:23361393

  18. Incident shock-wave characteristics in air, argon, carbon dioxide, and helium in a shock tube with unheated helium driver

    NASA Technical Reports Server (NTRS)

    Miller, C. G., III; Jones, J. J.

    1975-01-01

    Incident shock-wave velocities were measured in the Langley 6-inch expansion tube, operated as a shock tube, with air, argon, carbon dioxide, and helium as test gases. Unheated helium was used as the driver gas and most data were obtained at pressures of approximately 34 and 54 MN/sq m. A range of pressure ratio across the diaphragm was obtained by varying the quiescent test-gas pressure, for a given driver pressure, from 0.0276 to 34.5 kN/sq m. Single- and double-diaphragm modes of operation were employed and diaphragms of various materials tested. Shock velocity was determined from microwave interferometer measurements, response of pressure transducers positioned along interferometer measurements, response of pressure transducers positioned along the driven section (time-of-arrival gages), and to a lesser extent, measured tube-wall pressure. Velocities obtained from these methods are compared and limitations of the methods discussed. The present results are compared with theory and the effects of diaphragm mode (single or double diaphragm), diaphragm material, heating of the driver gas upon pressurization of the driver section, diaphragm opening time, interface mixing, and two-dimensional (nonplanar) flow are discussed.

  19. The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification.

    PubMed

    Lin, Tz-Yan; Chen, Jing-Ting; Chen, Yu-Yu; Chen, Tien-Wen; Lee, Chia-Ling; Chen, Chia-Hsin; Huang, Mao-Hsiung

    2015-07-01

    We investigated the effects of extracorporeal shockwave therapy (ESWT) on the rehabilitation of cervical spondylosis with nuchal ligament (NL) calcification under X-ray and ultrasound guidance. Sixty patients with cervical spondylosis and calcification of NL were selected and randomly assigned to three groups: A, B, and C. Patients in Group A received rehabilitation with 20 minutes of hot packs and underwent 15 minutes of intermittent cervical traction three times/week for 6 weeks. Patients in Group B received the same rehabilitation as those in Group A and ESWT (2000 impulses, 0.27 mJ/mm(2)) over the calcified NL guided by X-ray image. Patients in Group C received the same treatment as those in Group B, but the ESWT was guided by musculoskeletal sonography. The therapeutic effects were evaluated by: changes in range of motion (ROM) of the cervical spine including flexion, extension, lateral bending, and rotation; visual analog pain scale; and Neck Disability Index before and after treatment and at follow up 3 months later. We found a significant reduction in pain in each treated group after treatment and at follow up. However, patients in Groups B and C showed more improvements in ROM and neck pain relief after treatment and a decrease in Neck Disability Index. Furthermore, patients in Group C showed better cervical ROM at follow up than Group B. ESWT is an adjuvant treatment in the management of cervical spondylosis with calcification of NL and ultrasound-guided ESWT results in more functional improvements. PMID:26162813

  20. Shock-induced bubble jetting into a viscous fluid with application to tissue injury in shock-wave lithotripsy

    PubMed Central

    Freund, J. B.; Shukla, R. K.; Evan, A. P.

    2009-01-01

    Shock waves in liquids are known to cause spherical gas bubbles to rapidly collapse and form strong re-entrant jets in the direction of the propagating shock. The interaction of these jets with an adjacent viscous liquid is investigated using finite-volume simulation methods. This configuration serves as a model for tissue injury during shock-wave lithotripsy, a medical procedure to remove kidney stones. In this case, the viscous fluid provides a crude model for the tissue. It is found that for viscosities comparable to what might be expected in tissue, the jet that forms upon collapse of a small bubble fails to penetrate deeply into the viscous fluid “tissue.” A simple model reproduces the penetration distance versus viscosity observed in the simulations and leads to a phenomenological model for the spreading of injury with multiple shocks. For a reasonable selection of a single efficiency parameter, this model is able to reproduce in vivo observations of an apparent 1000-shock threshold before wide-spread tissue injury occurs in targeted kidneys and the approximate extent of this injury after a typical clinical dose of 2000 shock waves. PMID:19894850

  1. Focal Adhesion Kinase Signaling Mediated the Enhancement of Osteogenesis of Human Mesenchymal Stem Cells Induced by Extracorporeal Shockwave

    PubMed Central

    Hu, Jun; Liao, Haojie; Ma, Zebin; Chen, Hongjiang; Huang, Zhonglian; Zhang, Yuantao; Yu, Menglei; Chen, Youbin; Xu, Jiankun

    2016-01-01

    Extracorporeal shockwave (ESW) has been shown of great potential in promoting the osteogenesis of bone marrow mesenchymal stem cells (BMSCs), but it is unknown whether this osteogenic promotion effect can also be achieved in other MSCs (i.e., tendon-derived stem cells (TDSCs) and adipose-derived stem cells (ADSCs)). In the current study, we aimed not only to compare the osteogenic effects of BMSCs induced by ESW to those of TDSCs and ADSCs; but also to investigate the underlying mechanisms. We show here that ESW (0.16 mj/mm2) significantly promoted the osteogenic differentiation in all the tested types of MSCs, accompanied with the downregulation of miR-138, but the activation of FAK, ERK1/2, and RUNX2. The enhancement of osteogenesis in these MSCs was consistently abolished when the cells were pretreated with one of the following conditions: overexpression of miR-138, FAK knockdown using specific siRNA, and U0126, implying that all of these elements are indispensable for mediating the effect of ESW. Moreover, our study provides converging genetic and molecular evidence that the miR-138-FAK-ERK1/2-RUNX2 machinery can be generally activated in ESW-preconditioned MSCs, suggesting that ESW may be a promising therapeutic strategy for the enhancement of osteogenesis of MSCs, regardless of their origins. PMID:26863924

  2. Focal Adhesion Kinase Signaling Mediated the Enhancement of Osteogenesis of Human Mesenchymal Stem Cells Induced by Extracorporeal Shockwave

    NASA Astrophysics Data System (ADS)

    Hu, Jun; Liao, Haojie; Ma, Zebin; Chen, Hongjiang; Huang, Zhonglian; Zhang, Yuantao; Yu, Menglei; Chen, Youbin; Xu, Jiankun

    2016-02-01

    Extracorporeal shockwave (ESW) has been shown of great potential in promoting the osteogenesis of bone marrow mesenchymal stem cells (BMSCs), but it is unknown whether this osteogenic promotion effect can also be achieved in other MSCs (i.e., tendon-derived stem cells (TDSCs) and adipose-derived stem cells (ADSCs)). In the current study, we aimed not only to compare the osteogenic effects of BMSCs induced by ESW to those of TDSCs and ADSCs; but also to investigate the underlying mechanisms. We show here that ESW (0.16 mj/mm2) significantly promoted the osteogenic differentiation in all the tested types of MSCs, accompanied with the downregulation of miR-138, but the activation of FAK, ERK1/2, and RUNX2. The enhancement of osteogenesis in these MSCs was consistently abolished when the cells were pretreated with one of the following conditions: overexpression of miR-138, FAK knockdown using specific siRNA, and U0126, implying that all of these elements are indispensable for mediating the effect of ESW. Moreover, our study provides converging genetic and molecular evidence that the miR-138-FAK-ERK1/2-RUNX2 machinery can be generally activated in ESW-preconditioned MSCs, suggesting that ESW may be a promising therapeutic strategy for the enhancement of osteogenesis of MSCs, regardless of their origins.

  3. Autologous platelet-rich plasma compared with whole blood for the treatment of chronic plantar fasciitis; a comparative clinical trial

    PubMed Central

    Vahdatpour, Babak; Kianimehr, Lida; Ahrar, Mohmmad Hossein

    2016-01-01

    Background: Intralesional injection of autologous blood-derived products has recently gained attention as a potential treatment for plantar fasciitis (PF). We compared platelet-rich plasma (PRP) and whole blood (WB) for the treatment of chronic PF. Materials and Methods: Patients with chronic PF received either an intralesional injection of 3 cc PRP prepared by double centrifuge technique or WB (n = 17 in each group). Overall, morning and walking pain severity were assessed by 11-point numerical rating scale, and function was assessed by the Roles and Maudsley score (RMS) at baseline and 1-month and 3 months after treatment. Ultrasonography was performed to measure plantar fascia thickness at baseline and 3 months after treatment. Results: Pain scores were reduced over the study in the PRP (mean change = −5.00 ± 1.17 to −5.47 ± 1.46) and WB groups (mean change = −5.29 ± 2.56 to −6.47 ± 2.83), with no difference between groups (P > 0.05). One month and 3 months after treatment, successful treatment (RMS of ≤ 2) was respectively observed in 29.4% and 82.3% of the PRP and in 47.1% and 76.4% of the WB groups (P > 0.05). Also, fascia thickness was decreased in both the PRP and WB groups (mean change = −1.74 ± 1.11 vs. −1.21 ± 0.73 mm, respectively, P = 0.115). Conclusions: Significant improvement in pain and function, as well as decrease in plantar fascia thickness, was observed by intralesional injection of the PRP and WB in patients with chronic PF. The study results indicate similar effectiveness between PRP and WB for the treatment of chronic PF in short-term. PMID:27274499

  4. EXTRACORPOREAL SHOCKWAVE TERAPY TO TREAT CHRONIC MUSCLE INJURY

    PubMed Central

    Astur, Diego Costa; Santos, Bruno; de Moraes, Eduardo Ramalho; Arliani, Gustavo Gonçalves; dos Santos, Paulo Roberto Dias; Pochini, Alberto de Castro

    2015-01-01

    ABSTRACT Objective: To evaluate the low energy extracorporeal shock waves therapy (ESWT) associated with physical therapy in the treatment of chronic muscle injuries classified as grades 2 and 3 in the lower limbs of amateur athletes. Methods: Eight athletes presenting with lower limb muscle injury for more than three weeks were treated with physiotherapy and ESWT. We evaluated the following parameters during treatment: palpable gap, muscle strength, pain, and Tegner score, as well as ultrasound image features and the ability to return to sports practice. Results: The average time of the first evaluation of the injury was 8.75 weeks. All patients presented muscle strength grade V after eight weeks. The pain score evolved from 5.75 to 0.5 points of the visual analogue scale (VAS), at the end of the treatment. The Tegner score after treatment was six points on average. Patients returned to sports practice after 8.14 weeks. Conclusion: ESWT associated with physical therapy proved to be effective to treat long-term muscle injury, with good performance and the ability to return to sport practice for all patients. Level of Evidence IV, Case Series, Prospective Study. PMID:26981031

  5. Laser-induced shockwave paired with FRET: a method to study cell signaling.

    PubMed

    Gomez-Godinez, Veronica; Preece, Daryl; Shi, Linda; Khatibzadeh, Nima; Rosales, Derrick; Pan, Yijia; Lei, Lie; Wang, Yingxiao; Berns, Michael W

    2015-03-01

    Cells within the body are subject to various forces; however, the details concerning the way in which cells respond to mechanical stimuli are not well understood. We demonstrate that laser-induced shockwaves (LIS) combined with biosensors based on fluorescence resonance energy transfer (FRET) is a promising new approach to study biological processes in single live cells. As "proof-of-concept," using a FRET biosensor, we show that in response to LIS, cells release intracellular calcium. With the parameters used, cells retain their morphology and remain viable. LIS combined with FRET permits observation of the cells immediate response to a sudden shear force. PMID:25639252

  6. How Often Do Comparative Randomised Controlled Trials in the Field of Eczema Fail to Directly Compare the Treatments Being Tested?

    PubMed Central

    Ratib, Sonia; Wilkes, Sally R.; Nankervis, Helen; Thomas, Kim S.; Williams, Hywel C.

    2015-01-01

    The objective of the study was to identify all parallel design randomised controlled trials (RCTs) comparing treatments for eczema in recent dermatology literature that have failed to report a between-group analysis. The GREAT database (www.greatdatabase.org.uk) was searched to identify parallel group RCTs comparing two or more interventions published in the English language in the last decade, 2004 to 2013. The primary outcome was the number of studies that had not reported a between-group analysis for any of the outcomes. Where possible we re-analysed the data to determine whether a between-group analysis would have given a different conclusion to that reported. Out of a total of 304 RCTs in the study period, 173 (56.9%) met the inclusion criteria. Of the 173 eligible studies, 12 (6.9%) had not conducted a between-group analysis for any of the reported outcomes. There was no clear improvement over time. Five of the eight studies that were re-analysed yielded non-significant between-group differences yet reported significant within-group comparisons. All but one of the 12 studies implied that the experimental intervention was successful despite not undertaking any between-group comparisons. Although the proportion of all RCTs that fail to report an appropriate between-group analysis is small, the fact that any scientist who purports to compare one treatment against another then chooses to omit the key comparison statistic is worrying. PMID:26239561

  7. Patient Perception of Treatment Burden is High in Celiac Disease Compared to Other Common Conditions

    PubMed Central

    Shah, Sveta; Akbari, Mona; Vanga, Rohini; Kelly, Ciaran P.; Hansen, Joshua; Theethira, Thimmaiah; Tariq, Sohaib; Dennis, Melinda; Leffler, Daniel A.

    2014-01-01

    Introduction The only treatment for celiac disease (CD) is life-long adherence to a gluten-free diet (GFD). Noncompliance is associated with signs and symptoms of celiac disease, yet long-term adherence rates are poor. It is not known how the burden of the GFD compares to other medical treatments, and there are limited data on the socio-economic factors influencing treatment adherence. In this study we compared treatment burden and health state in CD compared with other chronic illnesses and evaluated the relationship between treatment burden and adherence. Methods A survey was mailed to participants with: CD, gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), hypertension (HTN), diabetes mellitus (DM), congestive heart failure (CHF), and end stage renal disease on dialysis (ESRD). Surveys included demographic information and visual analog scales measuring treatment burden, importance of treatment, disease-specific and overall health status. Results We collected surveys from 341 celiac and 368 non-celiac participants. Celiac participants reported high treatment burden, greater than participants with GERD or HTN and comparable to ESRD. Conversely, patients with CD reported the highest health state of all groups. Factors associated with high treatment burden in CD included poor adherence, concern regarding food cost, eating outside the home, higher income, lack of college education and time limitations in preparing food. Poor adherence in CD was associated with increased symptoms, income, and low perceived importance of treatment. Discussion Participants with CD have high treatment burden but also excellent overall health status in comparison with other chronic medical conditions. The significant burden of dietary therapy for celiac disease argues for the need for safe adjuvant treatment as well as interventions designed to lower the perceived burden of the GFD. PMID:24980880

  8. Comparing Offenders against Women and Offenders against Children on Treatment Outcome in Offenders with Intellectual Disability

    ERIC Educational Resources Information Center

    Lindsay, William R.; Michie, Amanda M.; Steptoe, Lesley; Moore, Fhionna; Haut, Fabian

    2011-01-01

    Background: Several studies have shown the positive effects of sex offender treatment for men with intellectual disabilities who have perpetrated sex offences or inappropriate sexual behaviour. The present study investigates the process of treatment change and compares two groups of offenders against adults and offenders against children. Method:…

  9. Comparing drinking water treatment costs to source water protection costs using time series analysis.

    EPA Science Inventory

    We present a framework to compare water treatment costs to source water protection costs, an important knowledge gap for drinking water treatment plants (DWTPs). This trade-off helps to determine what incentives a DWTP has to invest in natural infrastructure or pollution reductio...

  10. A Comparative Evaluation of Minimal Therapist Contact and 15-Session Treatment for Female Orgasmic Dysfunction.

    ERIC Educational Resources Information Center

    Morokoff, Patricia J.; LoPiccolo, Joseph

    1986-01-01

    Compared a four-session minimal therapist contact (MTC) program for treatment of lifelong global orgasmic dysfunction in women to a 15-session full therapist contact (FTC) program. Both programs were effective in producing female orgasm and in improving satisfaction with the sexual relationship and, for women in MTC treatment, happiness in…

  11. Effects of extracorporeal shockwave therapy on nanostructural and biomechanical responses in the collagenase-induced Achilles tendinitis animal model.

    PubMed

    Yoo, Seung Don; Choi, Samjin; Lee, Gi-Ja; Chon, Jinmann; Jeong, Yong Seol; Park, Hun-Kuk; Kim, Hee-Sang

    2012-11-01

    The aim of this study was to quantitatively investigate the effects of extracorporeal shockwave therapy (ESWT) on the nanostructure and adhesion force of collagen fibrils in a rat model of collagenase-induced Achilles tendinitis (CIAT) using histology and atomic force microscopy. A total of 45 rats were divided into experimental groups of three rats each: a control group, 27 CIAT rats with nine time points, and 15 ESWT rats with five time points. Progressive changes in nanostructure including the fibrillary diameter and D-periodicity, and biomechanical properties including the fibrillary adhesion forces in each healing phase were investigated over a 5-week period after collagenase injection. On postoperative day 3, CIAT rats showed granulomatous tissue associated with subacute inflammation, and a deterioration in nanostructure and mechanical properties compared to controls. On postoperative day 12, the ESWT group showed increased vascularity, fibroblastic activity, lymphocyte and plasma cell infiltration, dense histocytes, and disorganization of the fibers compared to the CIAT group. The ESWT group showed and improvement in nanostructure and mechanical properties compared to controls, while the CIAT group showed a deterioration in nanostructure and mechanical properties compared to controls. On postoperative day 26, the ESWT group showed 30% inflamed tissue and 70% fibrotic tissue, while the CIAT group showed chronic inflammation. By the end of the experiments, in both groups the changes had reversed and the tissues were similar in appearance to those in the control group. Following ESWT the deformed and irregular collagen network returned to a well-aligned normal collagen network nanostructure. These results suggest that ESWT may promote the healing response in Achilles tendinitis. PMID:22274874

  12. Clinical Nomograms to Predict Stone-Free Rates after Shock-Wave Lithotripsy: Development and Internal-Validation

    PubMed Central

    Kim, Jung Kwon; Ha, Seung Beom; Jeon, Chan Hoo; Oh, Jong Jin; Cho, Sung Yong; Oh, Seung-June; Kim, Hyeon Hoe; Jeong, Chang Wook

    2016-01-01

    Purpose Shock-wave lithotripsy (SWL) is accepted as the first line treatment modality for uncomplicated upper urinary tract stones; however, validated prediction models with regards to stone-free rates (SFRs) are still needed. We aimed to develop nomograms predicting SFRs after the first and within the third session of SWL. Computed tomography (CT) information was also modeled for constructing nomograms. Materials and Methods From March 2006 to December 2013, 3028 patients were treated with SWL for ureter and renal stones at our three tertiary institutions. Four cohorts were constructed: Total-development, Total-validation, CT-development, and CT-validation cohorts. The nomograms were developed using multivariate logistic regression models with selected significant variables in a univariate logistic regression model. A C-index was used to assess the discrimination accuracy of nomograms and calibration plots were used to analyze the consistency of prediction. Results The SFR, after the first and within the third session, was 48.3% and 68.8%, respectively. Significant variables were sex, stone location, stone number, and maximal stone diameter in the Total-development cohort, and mean Hounsfield unit (HU) and grade of hydronephrosis (HN) were additional parameters in the CT-development cohort. The C-indices were 0.712 and 0.723 for after the first and within the third session of SWL in the Total-development cohort, and 0.755 and 0.756, in the CT-development cohort, respectively. The calibration plots showed good correspondences. Conclusions We constructed and validated nomograms to predict SFR after SWL. To the best of our knowledge, these are the first graphical nomograms to be modeled with CT information. These may be useful for patient counseling and treatment decision-making. PMID:26890006

  13. A model for traumatic brain injury using laser induced shockwaves

    NASA Astrophysics Data System (ADS)

    Selfridge, A.; Preece, D.; Gomez, V.; Shi, L. Z.; Berns, M. W.

    2015-08-01

    Traumatic brain injury (TBI) represents a major treatment challenge in both civilian and military medicine; on the cellular level, its mechanisms are poorly understood. As a method to study the dysfunctional repair mechanisms following injury, laser induced shock waves (LIS) are a useful way to create highly precise, well characterized mechanical forces. We present a simple model for TBI using laser induced shock waves as a model for damage. Our objective is to develop an understanding of the processes responsible for neuronal death, the ways in which we can manipulate these processes to improve cell survival and repair, and the importance of these processes at different levels of biological organization. The physics of shock wave creation has been modeled and can be used to calculate forces acting on individual neurons. By ensuring that the impulse is in the same regime as that occurring in practical TBI, the LIS model can ensure that in vitro conditions and damage are similar to those experienced in TBI. This model will allow for the study of the biochemical response of neurons to mechanical stresses, and can be combined with microfluidic systems for cell growth in order to better isolate areas of damage.

  14. Reduction of tissue injury in shock-wave lithotripsy by using an acoustic diode.

    PubMed

    Zhu, Songlin; Dreyer, Thomas; Liebler, Marko; Riedlinger, Rainer; Preminger, Glenn M; Zhong, Pei

    2004-05-01

    An acoustic diode (AD) was constructed of two acoustic transparent membranes with good initial contact to allow the transmission of the positive pressure of lithotripter shock wave at an almost unaltered level, yet attenuate significantly its negative pressure, was fabricated. It was evaluated systematically on a Dornier HM-3 lithotripter to assess its application potential to reduce vascular injury without compromising stone fragmentation efficiency during shock-wave lithotripsy. By inserting the AD, the maximum compressive pressure, maximum tensile pressure and tensile duration of the lithotripter shock wave were formed to drop from 49.7 to 47.8 MPa, -7.5 to -7.0 MPa and 6.0 to 5.1 micros, respectively. Damage of a 0.2-mm inner diameter vessel phantom (cellulose hollow fiber) was reduced from rupture after 31 +/- 11 shocks to no rupture after 100 shocks. Maximum bubble size in free-field, maximum dilation of the vessel phantom wall and bubble collapse time became smaller with the use of the AD. However, stone fragmentation showed similar results without a statistically significant difference between the case with and without the AD. All these evidences suggest that the use of an acoustic diode may be a feasible approach to reduce tissue injury without compromising stone comminution in shock-wave lithotripsy. PMID:15183234

  15. Generation of Shock-Wave Disturbances at Plasma-Vapor Bubble Oscillation

    NASA Astrophysics Data System (ADS)

    Kuznetsova, N. S.; Yudin, A. S.; Voitenko, N. V.

    2015-11-01

    The complex physical and mathematical model describing all steps of plasma-vapor bubble evolution in the system of the water-ground condensed media is presented. Discharge circuit operation, discharge plasma channel expansion, its transformation into the vapor-plasma bubble and its pulsation, pressure wave generation and propagation of the mechanical stress waves in the ground are self-consistently considered in the model. The model allows investigation of the basic laws of stored energy transformation into the discharge plasma channel, next to the plasma-vapor bubble and transformation of this energy to the energy of pressure wave compressing the surrounding ground. Power characteristics of wave disturbances generated by gas-vapor bubble oscillation in liquid depending on the circuit parameters are analyzed for the prediction of the ground boundary displacement. The dynamics of the shock-wave propagation in water-ground condensed media depending on the rate of the plasma channel energy release is investigated. Simulation of the shock-wave phenomena at a plasma-vapor bubble oscillation in condensed media consecutively describes the physical processes underlying technology for producing piles by electro-discharge stuffing. The quantitative model verified by physical experimental tests will allow optimization of pulse generator parameters and electrode system construction of high-voltage equipment.

  16. Shock-wave measurements of solids using the long-pulsed laser

    NASA Astrophysics Data System (ADS)

    Uchino, Mazakazu; Kaetsu, Masahide; Mashimo, Tsutomu

    1997-05-01

    The optical measurement system using long-pulsed lasers were constructed for shock-wave measurements and spectroscopy under shock compression of solids. We have produced two types of long-pulsed lasers with no Q-switch for such purposes: Nd:YAG frequency-double laser using an intracavity KTP crystal, and dye laser using a rhodamine 6G. They consisted of doubled-elliptical pump cavity, two zenon flash lamps, and a high-voltage electrical-pulse source. The former one can be used as a light source for a Fabry-Perot type Interferometer (FPI), and the latter one can be used as a constant light source for a luminescence or an absorption spectroscopy and for the inclined-mirror method. The inclined-mirror Hugoniot measurements of some materials were performed by using the long-pulsed dye laser and the mirror- rotating type streak camera. The time resolution was increased by using a narrow width slit and the laser. The velocity-interferometer system for shock-wave measurements using a FPI and the time-resolved optical spectroscopy system using a spectrometer were constructed combined with the Nd:YAG frequency-doubled laser and the dye laser, respectively, and with an image-converter streak camera.

  17. Experimental study of pulsed power driven radiative shockwaves in noble gases

    NASA Astrophysics Data System (ADS)

    Skidmore, J.; Lebedev, S.; Suzuki-Vidal, F.; Bland, S.; Swadling, G.; Burdiak, G.; Hall, G.; Patankar, S.; de Grouchy, P.; Suttle, L.; Bennett, M.; Pickworth, L.; Khoory, E.; Smith, R.; Rodriguez, R.; Gil, J.

    2013-10-01

    The use of plastic disks coated with a thin film of Aluminium has been investigated as a control mechanism for the shockwave formed from a radial foil z-pinch in the presence of an ambient medium. Experiments were carried out on the MAGPIE (1.4 MA, 250 ns rise time) facility at Imperial College London. The configuration produces a strong radiative shockwave driven with constant velocity (>25 km/s) for long time (>400 ns) and spatial scales (cm). Experimental results demonstrate scaling of shock compression opposite to that found in 1D radiation hydrodynamic simulations. Evidence of a thermal instability in the post-shock cooling region is linked to a decrease in compression for higher atomic masses due to increased radiative cooling. Increases in post-shock temperature and ionization have been measured with decreased radial distance from a strongly cooling hydrodynamic jet. Regions of observed thermal instability for Xenon and Krypton agree with those expected from evaluation of theoretical cooling functions. Institute of Shock Physics, Imperial College London.

  18. Results of a supersonic, single-mode, shockwave-driven Kelvin-Helmholtz instability experiment

    NASA Astrophysics Data System (ADS)

    Wan, W. C.; Malamud, G.; di Stefano, C. A.; Trantham, M. R.; Klein, S. R.; Shimony, A.; Shvarts, D.; Kuranz, C. C.; Drake, R. P.

    2014-10-01

    The Kelvin-Helmholtz instability is a hydrodynamic process that causes mixing at an interface with shear flow. It is prevalent in many high-energy-density systems such as fusion research, core-collapse supernovae, and protoplanetary disks. Although it is common to simplify the Euler equations by assuming incompressibility, this assumption does not account for the inhibited growth rate found in supersonic flows. Here, we present the first laboratory observations of single-mode, compressible Kelvin-Helmholtz instability growth. This experiment was performed at the OMEGA-EP facility using three beams stitched into a 28 ns square pulse to sustain a shockwave in low-density foam. The shockwave generated shear along the interface between the foam and a high-density plastic, seeded with a precisely machined single-mode sinusoidal perturbation. The system was diagnosed using radiography with a spherically bent crystal. This work is funded by the U.S. Department of Energy, through the NNSA-DS and SC-OFES Joint Program in High-Energy-Density Laboratory Plasmas, Grant Number DE-NA0001840, the National Laser User Facility Program, Grant Number DE-NA0000850, and the Laboratory for Laser Energetics, University of Rochester by the NNSA/OICF under Cooperative Agreement No. DE-FC52-08NA28302.

  19. Human experts' and a fuzzy model's predictions of outcomes of scoliosis treatment: a comparative analysis.

    PubMed

    Chalmers, Eric; Pedrycz, Witold; Lou, Edmond

    2015-03-01

    Brace treatment is the most commonly used nonsurgical treatment for adolescents with idiopathic scoliosis. However, brace treatment is not always successful and the factors influencing its success are not completely clear. This makes treatment outcome difficult to predict. A computer model which can accurately predict treatment outcomes could potentially provide valuable treatment recommendations. This paper describes a fuzzy system that includes a prediction model and a decision support engine. The model was constructed using conditional fuzzy c-means clustering to discover patterns in retrospective patient data. The model's ability to predict treatment outcome was compared to the ability of eight Scoliosis experts. The model and experts each predicted treatment outcome retrospectively for 28 braced patients, and these predictions were compared to the actual outcomes. The model outperformed all but one expert individually and performed similarly to the experts as a group. These results suggest that the fuzzy model is capable of providing meaningful treatment recommendations. This study offers the first model for this application whose performance has been shown to be at or above the human expert level. PMID:25494498

  20. A randomized trial comparing mebendazole and secnidazole for the treatment of giardiasis.

    PubMed

    Escobedo, A A; Cañete, R; Gonzalez, M E; Pareja, A; Cimerman, S; Almirall, P

    2003-07-01

    To compare the efficacy of the two drugs in the treatment of giardiasis, 146 children (aged 5-15 years) with confirmed Giardia lamblia infection were randomly allotted to treatment with mebendazole (200 mg three times daily for 3 days) or secnidazole (30 mg/kg, in a single dose). Parasitological response to treatment was evaluated in each child by the microscopical examination of faecal samples collected 3, 5 and 7 days after he or she had completed treatment. Although the frequency of cure was higher for secnidazole (79.4%) than for mebendazole (78.1%), the difference was not statistically significant (P > 0.05). Both treatment regimens were well tolerated, with only mild, transient and self-limiting side-effects reported. Mebendazole may be preferable to secnidazole in the treatment of giardiasis cases who have an history of intolerance to 5-nitromidazoles, and where infections with Giardia and soil-transmitted helminths frequently co-occur. PMID:12930613

  1. RANS Modeling of Benchmark Shockwave / Boundary Layer Interaction Experiments

    NASA Technical Reports Server (NTRS)

    Georgiadis, Nick; Vyas, Manan; Yoder, Dennis

    2010-01-01

    This presentation summarizes the computations of a set of shock wave / turbulent boundary layer interaction (SWTBLI) test cases using the Wind-US code, as part of the 2010 American Institute of Aeronautics and Astronautics (AIAA) shock / boundary layer interaction workshop. The experiments involve supersonic flows in wind tunnels with a shock generator that directs an oblique shock wave toward the boundary layer along one of the walls of the wind tunnel. The Wind-US calculations utilized structured grid computations performed in Reynolds-averaged Navier-Stokes mode. Three turbulence models were investigated: the Spalart-Allmaras one-equation model, the Menter Shear Stress Transport wavenumber-angular frequency two-equation model, and an explicit algebraic stress wavenumber-angular frequency formulation. Effects of grid resolution and upwinding scheme were also considered. The results from the CFD calculations are compared to particle image velocimetry (PIV) data from the experiments. As expected, turbulence model effects dominated the accuracy of the solutions with upwinding scheme selection indicating minimal effects.!

  2. Orthodontic treatment need among special health care needs school children in Dharwad, India: A comparative study

    PubMed Central

    Nayak, Prajna P; Prasad, KVV; Bhat, Y Manohar

    2015-01-01

    Objectives: The aim was to assess and compare the prevalence of orthodontic treatment need among various special health care needs (SHCN) schoolchildren and adolescents in Dharwad, India. Materials and Methods: This cross-sectional study was carried out among 492 subjects in age group of 12-19 years (mean age 14.02 ± 1.84 standard deviation [SD]) who were examined for occlusal anomalies using dental aesthetic index (DAI). They were classified into five groups as: Visual impairment, speech and hearing disability (SH), physical disability, mentally subnormal and multiple disabilities (MD). Chi-square test was used to compare the orthodontic treatment need among various SHCN groups. One-way ANOVA and ANCOVA were performed to test any significant differences in mean DAI scores among the SHCN groups. Results: None of the children were undergoing or had undergone orthodontic treatment for malocclusion. Mean DAI score was 28.81 ± 11.64 (SD). Orthodontic treatment was indicated in 50.2% of study population who had DAI scores of 26 and above. Mandatory orthodontic treatment (DAI >=36) was required in as high as 29% of MD individuals when compared to only 10% of SH individuals. Significant differences in DAI scores were found between the SHCN groups. Conclusions: The need for orthodontic treatment among SHCN individuals was found to be high. Yet, absence of any orthodontic treatment for any child points out to the fact that the dental services are highly needed in these individuals. PMID:26020038

  3. Ground Measurements of Airplane Shock-Wave Noise at Mach Numbers to 2.0 and at Altitudes to 60,000 Feet

    NASA Technical Reports Server (NTRS)

    Lina, Lindsay J.; Maglieri, Domenic J.

    1960-01-01

    The intensity of shock-wave noise at the ground resulting from flights at Mach numbers to 2.0 and altitudes to 60,000 feet was measured. Meagurements near the ground track for flights of a supersonic fighter and one flight of a supersonic bomber are presented. Level cruising flight at an altitude of 60,000 feet and a Mach number of 2.0 produced sonic booms which were considered to be tolerable, and it is reasonable t o expect that cruising flight at higher altitudes will produce booms of tolerable intensity for airplanes of the size and weight of the test airplanes. The measured variation of sonic-boom intensity with altitude was in good agreement with the variation calculated by an equation given in NASA Technical Note D-48. The effect of Mach number on the ground overpressure is small between Mach numbers of 1.4 and 2.0, a result in agreement with the theory. No amplification of the shock-wave overpressures due to refraction effects was apparent near the cutoff Mach number. A method for estimating the effect of fligh-path angle on cutoff Mach number is shown. Experimental results indicate agreement with the method, since a climb maneuver produced booms of a much decreased intensity as compared with the intensity of those measured in level flight at about the same altitude and Mach number. Comparison of sound pressure levels for the fighter and bomber airp lanes indicated little effect of either airplane size or weight at an altitude of 40,000 feet.

  4. Dissipation of Molecular Cloud Turbulence by Magnetohydrodynamic Shockwaves

    NASA Astrophysics Data System (ADS)

    Lehmann, Andrew; Wardle, Mark

    2015-08-01

    The character of star formation is intimately related to the supersonic magnetohydrodynamic (MHD) turbulent dynamics of the giant molecular clouds in which stars form. A significant amount of the turbulent energy dissipates in low velocity shock waves. These shocks cause molecular line cooling of the compressed and heated gas, and so their radiative signatures probe the nature of the turbulence. In MHD fluids the three distinct families of shocks—fast, intermediate and slow—differ in how they compress and heat the molecular gas, and so observational differences between them may also distinguish driving modes of turbulent regions.Here we use a two-fluid model to compare the characteristics of one-dimensional fast and slow MHD shocks. Fast MHD shocks are magnetically driven, forcing ion species to stream through the neutral gas ahead of the shock front. This magnetic precursor heats the gas sufficiently to create a large, warm transition zone where all the fluid variables only weakly change in the shock front. In contrast, slow MHD shocks are driven by gas pressure where neutral species collide with ion species in a thin hot slab that closely resembles an ordinary gas dynamic shock.We computed observational diagnostics for fast and slow shocks at velocities vs = 2-4 km/s and preshock Hydrogen nuclei densities n(H) = 102-4 cm-3. We followed the abundances of molecules relevant for a simple oxygen chemistry and include cooling by CO, H2 and H2O. Estimates of intensities of CO rotational lines show that high-J lines, above J = 6→5, are more strongly excited in slow MHD shocks. We discuss how these shocks could help interpret recently observed anomalously strong mid- and high-J CO lines emitted by warm gas in the Milky Way and external galaxies, and implications for simulations of MHD turbulence.

  5. Comparative analysis of effluent water quality from a municipal treatment plant and two on-site wastewater treatment systems.

    PubMed

    Garcia, Santos N; Clubbs, Rebekah L; Stanley, Jacob K; Scheffe, Brian; Yelderman, Joe C; Brooks, Bryan W

    2013-06-01

    Though decentralized on-site technologies are extensively employed for wastewater treatment around the globe, an understanding of effluent water quality impairments associated with these systems remain less understood than effluent discharges from centralized municipal wastewater treatment facilities. Using a unique experimental facility, a novel comparative analysis of effluent water quality was performed from model decentralized aerobic (ATS) and septic (STS) on-site wastewater treatment systems and a centralized municipal wastewater treatment plant (MTP). The ATS and STS units did not benefit from further soil treatment. Each system received common influent wastewater from the Waco, Texas, USA Metropolitan Area Regional Sewerage System. We tested the hypothesis that MTP effluent would exhibit higher water quality than on-site effluents, based on parameters selected for study. A tiered testing approach was employed to assess the three effluent discharges: select routine water quality parameters (Tier I), whole effluent toxicity (Tier II), and select endocrine-active compounds (Tier III). Contrary to our hypothesis, ATS effluent was not statistically different from MTP effluents, based on Tier I and III parameters, but reproductive responses of Daphnia magna were slightly more sensitive to ATS than MTP effluents. STS effluent water quality was identified as most degraded of the three wastewater treatment systems. Parameters used to assess centralized wastewater treatment plant effluent water quality such as whole effluent toxicity and endocrine active substances appear useful for water quality assessments of decentralized discharges. Aerobic on-site wastewater treatment systems may represent more robust options than traditional septic systems for on-site wastewater treatment in watersheds with appreciable groundwater - surface water exchange. PMID:23557723

  6. Explosively driven two-shockwave tools with application to ejecta formation at the Los Alamos National Laboratory Proton Radiography Facility

    NASA Astrophysics Data System (ADS)

    Buttler, William

    2013-06-01

    We present the development of an explosively driven physics tool to generate two mostly uniaxial shockwaves. The tool is being used to extend single shockwave ejecta models to a subsequent shockwave event separated by a time interval on the order of a few microseconds. We explore the possibility of varying the amplitude of both the first and second shockwaves, and we apply the tool in experimental geometries on Sn with a surface roughness of Ra = 0 . 8 μ m. We then evaluate the tool further at the Los Alamos National Laboratory Proton Radiography (pRad) Facility in an application to Sn with larger scale perturbations of wavelength 550 μ m, and various amplitudes that gave wave-number amplitude products of η0 2 π / λ = { 3 / 4 , 1 / 2 , 1 / 4 , 1 / 8 } , where the perturbation amplitude is η0, and the wave-number k = 2 π / λ . The pRad data and velocimetry imply it should be possible to develop a second shock ejecta model based on unstable Richtmyer-Meshkov physics. In collaboration with David Oro, Fesseha Mariam, Alexander Saunders, Malcolm Andrews, Frank Cherne, James Hammerberg. Robert Hixson, Christopher Morris, Russell Olson, Dean Preston, Joseph Stone, Dale Tupa, and Wendy Vogan-McNeil, Los Alamos National Laboratory,

  7. Dosimetric feasibility of cone-beam CT-based treatment planning compared to CT-based treatment planning

    SciTech Connect

    Yoo, Sua . E-mail: sua.yoo@duke.edu; Yin, F.-F.

    2006-12-01

    Purpose: Cone-beam computed tomography (CBCT) images are currently used for positioning verification. However, it is yet unknown whether CBCT could be used in dose calculation for replanning in adaptive radiation therapy. This study investigates the dosimetric feasibility of CBCT-based treatment planning. Methods and Materials: Hounsfield unit (HU) values and profiles of Catphan, homogeneous/inhomogeneous phantoms, and various tissue regions of patients in CBCT images were compared to those in CT. The dosimetric consequence of the HU variation was investigated by comparing CBCT-based treatment plans to conventional CT-based plans for both phantoms and patients. Results: The maximum HU difference between CBCT and CT of Catphan was 34 HU in the Teflon. The differences in other materials were less than 10 HU. The profiles for the homogeneous phantoms in CBCT displayed reduced HU values up to 150 HU in the peripheral regions compared to those in CT. The scatter and artifacts in CBCT became severe surrounding inhomogeneous tissues with reduced HU values up to 200 HU. The MU/cGy differences were less than 1% for most phantom cases. The isodose distributions between CBCT-based and CT-based plans agreed very well. However, the discrepancy was larger when CBCT was scanned without a bowtie filter than with bowtie filter. Also, up to 3% dosimetric error was observed in the plans for the inhomogeneous phantom. In the patient studies, the discrepancies of isodose lines between CT-based and CBCT-based plans, both 3D and IMRT, were less than 2 mm. Again, larger discrepancy occurred for the lung cancer patients. Conclusion: This study demonstrated the feasibility of CBCT-based treatment planning. CBCT-based treatment plans were dosimetrically comparable to CT-based treatment plans. Dosimetric data in the inhomogeneous tissue regions should be carefully validated.

  8. Additional treatment of wastewater reduces endocrine disruption in wild fish--a comparative study of tertiary and advanced treatments.

    PubMed

    Baynes, Alice; Green, Christopher; Nicol, Elizabeth; Beresford, Nicola; Kanda, Rakesh; Henshaw, Alan; Churchley, John; Jobling, Susan

    2012-05-15

    Steroid estrogens are thought to be the major cause of feminization (intersex) in wild fish. Widely used wastewater treatment technologies are not effective at removing these contaminants to concentrations thought to be required to protect aquatic wildlife. A number of advanced treatment processes have been proposed to reduce the concentrations of estrogens entering the environment. Before investment is made in such processes, it is imperative that we compare their efficacy in terms of removal of steroid estrogens and their feminizing effects with other treatment options. This study assessed both steroid removal and intersex induction in adult and early life stage fish (roach, Rutilus rutilus). Roach were exposed directly to either secondary (activated sludge process (ASP)), tertiary (sand filtrated (SF)), or advanced (chlorine dioxide (ClO(2)), granular activated charcoal (GAC)) treated effluents for six months. Surprisingly, both the advanced GAC and tertiary SF treatments (but not the ClO(2) treatment) significantly removed the intersex induction associated with the ASP effluent; this was not predicted by the steroid estrogen measurements, which were higher in the tertiary SF than either the GAC or the ClO(2). Therefore our study highlights the importance of using both biological and chemical analysis when assessing new treatment technologies. PMID:22500691

  9. Comparing drinking water treatment costs to source water protection costs using time series analysis

    NASA Astrophysics Data System (ADS)

    Heberling, Matthew T.; Nietch, Christopher T.; Thurston, Hale W.; Elovitz, Michael; Birkenhauer, Kelly H.; Panguluri, Srinivas; Ramakrishnan, Balaji; Heiser, Eric; Neyer, Tim

    2015-11-01

    We present a framework to compare water treatment costs to source water protection costs, an important knowledge gap for drinking water treatment plants (DWTPs). This trade-off helps to determine what incentives a DWTP has to invest in natural infrastructure or pollution reduction in the watershed rather than pay for treatment on site. To illustrate, we use daily observations from 2007 to 2011 for the Bob McEwen Water Treatment Plant, Clermont County, Ohio, to understand the relationship between treatment costs and water quality and operational variables (e.g., turbidity, total organic carbon [TOC], pool elevation, and production volume). Part of our contribution to understanding drinking water treatment costs is examining both long-run and short-run relationships using error correction models (ECMs). Treatment costs per 1000 gallons (per 3.79 m3) were based on chemical, pumping, and granular activated carbon costs. Results from the ECM suggest that a 1% decrease in turbidity decreases treatment costs by 0.02% immediately and an additional 0.1% over future days. Using mean values for the plant, a 1% decrease in turbidity leads to $1123/year decrease in treatment costs. To compare these costs with source water protection costs, we use a polynomial distributed lag model to link total phosphorus loads, a source water quality parameter affected by land use changes, to turbidity at the plant. We find the costs for source water protection to reduce loads much greater than the reduction in treatment costs during these years. Although we find no incentive to protect source water in our case study, this framework can help DWTPs quantify the trade-offs.

  10. Minimum radius of chondrules formed through the shock-wave heating events.

    NASA Astrophysics Data System (ADS)

    Miura, H.; Nakamoto, T.

    Most of chondritic meteorites that fall onto the Earth contain spherical igneous rocks, which have a typical size distribution between about ten microns to a few mm. These are named chondrules. They are considered to have formed through flash heating events in the solar nebula; precursor dust particles were heated and melted, and cooled again to solidify in a short period of time. The characteristic size distribution of chondrule is expected to have a relation to the chondrule formation mechanism. We report that chondrules formed through the shock-wave heating events have minimum size below which no chondrule exists. The shock wave heating is one of the most popular mechanisms for chondrule formation. For example, Iida et al. (2001) numerically simulated the postshock region taking into account many physical and chemical processes and showed that precursor particles can form chondrules if the shock meets a certain density and velocity conditions. They also showed that the formed chondrules in the postshock region are exposed by the hot gas in that region until the gas cools by emission of radiation. The duration of the phase is about a few hundreds seconds for a typical shock wave. In this phase, the temperature of the chondrule is kept very high (more than 1500 K) by the thermal conduction with the hot gas. Then, it is naturally expected that the evaporation from the surface of the chondrule should take place and the radius of the chondrule should shrink. Small chondrules may vanish in the postshock hot gas region. We performed numerical simulations of chondrule formation and evaporation with a shock-wave heating model. And we found that precursor particles with various radii can form chondrules once, but only large particles whose initial radii are larger than about 10 microns can survive in the postshock hot gas. Moreover, the final radii of survived particles are larger than about 10 microns for typical shock velocity vs and gas number density npre (vs = 5 - 30

  11. Patients’ experience compared to physicians’ recommendations for the treatment of fecal incontinence: A qualitative approach

    PubMed Central

    Cichowski, Sara B; Dunivan, Gena C; Rogers, Rebecca G; Komesu, Yuko M

    2015-01-01

    Introduction To compare physician-recommended treatment options for fecal incontinence to patients’ knowledge of treatment options using qualitative methods. Our hypothesis was that physician recommendations were not being communicated well to patients’ and that this impaired patients’ ability to cope with fecal incontinence. Methods Cognitive interviews were conducted with physicians who routinely care for women with fecal incontinence. Physicians were asked to describe their typical non-surgical treatment recommendations and counseling for fecal incontinence. Women with bothersome fecal incontinence were recruited to participate in focus groups and asked about personal experience with fecal incontinence symptoms and treatments. For both the physician interviews and patient focus groups, qualitative data analysis was performed using grounded theory methodology. Results Physicians identified several barriers patients face when seeking treatment: lack of physician interest towards fecal incontinence and patients’ embarrassment in discussing fecal incontinence. Physicians universally recommended fiber and pelvic floor exercise; they felt the majority (approximately 70–80%) of patients will improve with these therapies. Collectively, patients were able to identify all treatment recommendations given by physicians although many had discovered these treatments through personal experience. Three concepts emerged regarding treatment options that physicians did not identify but that patients felt were important in their treatment: hope for improvement, personal effort to control symptoms and encouragement to go on living life. Conclusions While physicians had treatment to offer women with fecal incontinence, women with fecal incontinence had found the best treatments through personal research and effort. Women want to hear a message of hope, encouragement and personal effort from providers. PMID:24573357

  12. Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

    PubMed Central

    Imani, Saeed; Atef Vahid, Mohammad Kazem; Gharraee, Banafsheh; Noroozi, Alireza; Habibi, Mojtaba; Bowen, Sarah

    2015-01-01

    Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT) compared to the usual opioid dependence treatment (TAU).Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS) were randomly assigned into experimental (Mindfulness-Based Group Therapy) and control groups (the Usual Treatment).The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program. Methods: The Five Factor Mindfulness Questionnaire (FFMQ) and the Addiction Sevier Index (ASI) were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results: The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion: The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders. PMID:26877751

  13. COMPARING RBF WITH BENCH-SCALE CONVENTIONAL TREATMENT FOR PRECURSOR REDUCTION

    EPA Science Inventory

    The reduction of disinfection by-product (DBP) precursors upon riverbank filtration (RBF) at three drinking water utilities in the mid-Western United States was compared with that obtained using a bench-scale conventional treatment train on the corresponding river waters. The riv...

  14. Delinquency and Crime Prevention: Overview of Research Comparing Treatment Foster Care and Group Care

    ERIC Educational Resources Information Center

    Osei, Gershon K.; Gorey, Kevin M.; Jozefowicz, Debra M. Hernandez

    2016-01-01

    Background: Evidence of treatment foster care (TFC) and group care's (GC) potential to prevent delinquency and crime has been developing. Objectives: We clarified the state of comparative knowledge with a historical overview. Then we explored the hypothesis that smaller, probably better resourced group homes with smaller staff/resident ratios have…

  15. Treatment Gain for Sexual Offenders against Children Predicts Reduced Recidivism: A Comparative Validity Study

    ERIC Educational Resources Information Center

    Beggs, Sarah M.; Grace, Randolph C.

    2011-01-01

    Objective: To determine whether pro-social treatment change in sexual offenders would predict reductions in recidivism beyond static and dynamic risk factors measured at pretreatment and whether different methods for assessing change based on self-reports and structured clinical rating systems would show convergent validity. Method: We compared 3…

  16. [The atraumatic restorative treatment approach in pediatric dental care: a comparative clinical study].

    PubMed

    Dmitrova, A G; Kulakov, A A

    2015-01-01

    The aim of this study was to assess and compare the discomfort levels during Atraumatic Restorative Treatment and Minimal Cavity Preparation using rotary instruments and Air abrasion method. The results of the study suggest that ART induces less discomfort, therefore this method can be recommended for children who have a fear of dental procedures as well as for children with intellectual disabilities. PMID:26145474

  17. Comparing Spoken Language Treatments for Minimally Verbal Preschoolers with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Paul, Rhea; Campbell, Daniel; Gilbert, Kimberly; Tsiouri, Ioanna

    2013-01-01

    Preschoolers with severe autism and minimal speech were assigned either a discrete trial or a naturalistic language treatment, and parents of all participants also received parent responsiveness training. After 12 weeks, both groups showed comparable improvement in number of spoken words produced, on average. Approximately half the children in…

  18. Comparing injection, feeding and topical application methods for treatment of honey bees with octopamine

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Entomologists have used a range of techniques to treat insects with neuroactive compounds, but like vertebrates, insects possess a blood-brain barrier and it is not clear how different treatment methods compare in delivering a compound to the brain. Here we used five different techniques to treat h...

  19. Comparing Cognitive Behavior Therapy, Problem Solving Therapy, and Treatment as Usual in a High Risk Population

    ERIC Educational Resources Information Center

    Stewart, Carment D.; Quinn, Andrea; Plever, Sally; Emmerson, Brett

    2009-01-01

    Cognitive behavior therapy (CBT), problem-solving therapy (PST), or treatment as usual (TAU) were compared in the management of suicide attempters. Participants completed the Beck Hopelessness Scale, Beck Scale for Suicidal Ideation, Social Problem-Solving Inventory, and Client Satisfaction Questionnaire at pre- and posttreatment. Both CBT and PST…

  20. Comparing the Effects of Four Instructional Treatments on EFL Students' Achievement in Writing Classified Ads

    ERIC Educational Resources Information Center

    Khodabandeh, Farzaneh

    2016-01-01

    The current study set out to compare the effect of traditional and non-traditional instructional treatments; i.e. explicit, implicit, task-based and no-instruction approaches on students' abilities to learn how to write classified ads. 72 junior students who have all taken a course in Reading Journalistic Texts at the Payame-Noor University…

  1. DUI/DWAI Offenders Compared to Clients Seen in an Outpatient Alcohol-Treatment Facility.

    ERIC Educational Resources Information Center

    Packard, Michele A.

    1987-01-01

    Examined client records to compare 50 subjects admitted to a drinking-driver program and 50 subjects admitted to an outpatient alcohol treatment clinic. Highly significant differences were found between groups on 10 of 12 drinking indices, suggesting that clients referred for alcohol-related traffic offenses represent a population different from…

  2. A mixed treatment comparison to compare the efficacy and safety of botulinum toxin treatments for cervical dystonia.

    PubMed

    Han, Yi; Stevens, Andrea L; Dashtipour, Khashayar; Hauser, Robert A; Mari, Zoltan

    2016-04-01

    A systematic pair-wise comparison of all available botulinum toxin serotype A and B treatments for cervical dystonia (CD) was conducted, as direct head-to-head clinical trial comparisons are lacking. Five botulinum toxin products: Dysport(®) (abobotulinumtoxinA), Botox(®) (onabotulinumtoxinA), Xeomin(®) (incobotulinumtoxinA), Prosigne(®) (Chinese botulinum toxin serotype A) and Myobloc(®) (rimabotulinumtoxinB) have demonstrated efficacy for managing CD. A pair-wise efficacy and safety comparison was performed for all toxins based on literature-reported clinical outcomes. Multi-armed randomized controlled trials (RCTs) were identified for inclusion using a systematic literature review, and assessed for comparability based on patient population and efficacy outcome measures. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was selected as the efficacy outcome measurement for assessment. A mixed treatment comparison (MTC) was conducted using a Bayesian hierarchical model allowing indirect comparison of the interventions. Due to the limitation of available clinical data, this study only investigated the main effect of toxin treatments without explicitly considering potential confounding factors such as gender and formulation differences. There was reasonable agreement between the number of unconstrained data points, residual deviance and pair-wise results. This research suggests that all botulinum toxin serotype A and serotype B treatments were effective compared to placebo in treating CD, with the exception of Prosigne. Based on this MTC analysis, there is no significant efficacy difference between Dysport, Botox, Xeomin and Myobloc at week four post injection. Of the adverse events measured, neither dysphagia nor injection site pain was significantly greater in the treatment or placebo groups. PMID:26914922

  3. Comparative effectiveness of imaging modalities to determine metastatic breast cancer treatment response.

    PubMed

    Lee, Christoph I; Gold, Laura S; Nelson, Heidi D; Chou, Roger; Ramsey, Scott D; Sullivan, Sean D

    2015-02-01

    We performed a systematic review to address the comparative effectiveness of different imaging modalities in evaluating treatment response among metastatic breast cancer patients. We searched seven multidisciplinary electronic databases for relevant publications (January 2003-December 2013) and performed dual abstraction of details and results for all clinical studies that involved stage IV breast cancer patients and evaluated imaging for detecting treatment response. Among 159 citations reviewed, 17 single-institution, non-randomized, observational studies met our inclusion criteria. Several studies demonstrate that changes in PET/CT standard uptake values are associated with changes in tumor volume as determined by bone scan, MRI, and/or CT. However, no studies evaluated comparative test performance between modalities or determined relationships between imaging findings and subsequent clinical decisions. Evidence for imaging's effectiveness in determining treatment response among metastatic breast cancer patients is limited. More rigorous research is needed to address imaging's value in this patient population. PMID:25479913

  4. Shock-wave compression of silica gel as a model material for comets

    NASA Astrophysics Data System (ADS)

    Arasuna, Akane; Okuno, Masayuki; Chen, Liliang; Mashimo, Tsutomu; Okudera, Hiroki; Mizukami, Tomoyuki; Arai, Shoji

    2016-03-01

    A shock-wave compression experiment using synthesized silica gel was investigated as a model for a comet impact event on the Earth's surface. The sample shocked at 20.7 GPa showed considerable structural changes, a release of water molecules, and the dehydration of silanol (Si-OH) that led to the formation of a new Si-O-Si network structure containing larger rings (e.g., six-membered ring of SiO4 tetrahedra). The high aftershock temperature at 20.7 GPa, which could be close to 800 °C, influenced the sample structure. However, some silanols, which were presumed to be the mutually hydrogen-bonded silanol group, remained at pressures >20.7 GPa. This type of silanol along with a small number of water molecules may remain even after shock compression at 30.9 GPa, although the intermediate structure of the sample recovered was similar to that of silica glass.

  5. Relationship among shock-wave velocity, particle velocity, and adiabatic exponent for dry air

    NASA Astrophysics Data System (ADS)

    Kim, In H.; Hong, Sang H.; Jhung, Kyu S.; Oh, Ki-Hwan; Yoon, Yo K.

    1991-07-01

    Using the results of the detailed numerical calculations, it is shown that the relationship between the shock-wave velocity U sub s and the particle velocity U sub p for shock-compressed dry air can be represented accurately by the linear relation U sub s = a(P0) + b(P0)U sub p in a wide range of U sub p (U sub p = 2 to 9 ) km/s and initial pressure P0 = 10 to the -6th to 1 atm, where a and b are given by the cubic polynomials of log10P0. Based on the linear U sub s - U sub p relation, an analytic expression has been obtained for the adiabatic exponent gamma as a function of particle velocity.

  6. Shock-wave compression of silica gel as a model material for comets

    NASA Astrophysics Data System (ADS)

    Arasuna, Akane; Okuno, Masayuki; Chen, Liliang; Mashimo, Tsutomu; Okudera, Hiroki; Mizukami, Tomoyuki; Arai, Shoji

    2016-07-01

    A shock-wave compression experiment using synthesized silica gel was investigated as a model for a comet impact event on the Earth's surface. The sample shocked at 20.7 GPa showed considerable structural changes, a release of water molecules, and the dehydration of silanol (Si-OH) that led to the formation of a new Si-O-Si network structure containing larger rings (e.g., six-membered ring of SiO4 tetrahedra). The high aftershock temperature at 20.7 GPa, which could be close to 800 °C, influenced the sample structure. However, some silanols, which were presumed to be the mutually hydrogen-bonded silanol group, remained at pressures >20.7 GPa. This type of silanol along with a small number of water molecules may remain even after shock compression at 30.9 GPa, although the intermediate structure of the sample recovered was similar to that of silica glass.

  7. CHARADE: A characteristic code for calculating rate-dependent shock-wave response

    SciTech Connect

    Johnson, J.N.; Tonks, D.L.

    1991-01-01

    In this report we apply spatially one-dimensional methods and simple shock-tracking techniques to the solution of rate-dependent material response under flat-plate-impact conditions. This method of solution eliminates potential confusion of material dissipation with artificial dissipative effects inherent in finite-difference codes, and thus lends itself to accurate calculation of elastic-plastic deformation, shock-to-detonation transition in solid explosives, and shock-induced structural phase transformation. Equations are presented for rate-dependent thermoelastic-plastic deformation for (100) planar shock-wave propagation in materials of cubic symmetry (or higher). Specific numerical calculations are presented for polycrystalline copper using the mechanical threshold stress model of Follansbee and Kocks with transition to dislocation drag. A listing of the CHARADE (for characteristic rate dependence) code and sample input deck are given. 26 refs., 11 figs.

  8. Study of shockwave method for diagnosing the radiation fields of laser-driven gold hohlraums

    NASA Astrophysics Data System (ADS)

    Li, Yongsheng; Lan, Ke; Huo, Wenyi; Lai, Dongxian; Gao, Yaoming; Pei, Wenbing

    2013-11-01

    Besides the routinely used broad-band x-ray spectrometer (Dante or SXS), ablative shock-wave method is often used to diagnose the radiation fields of laser-driven Hohlraums. The x-ray ablation process of Aluminum and Titanium is studied numerically with a 1-D radiation hydrodynamic code RDMG [F. Tinggui et al., Chin. J. Comput. Phys. 16, 199 (1999)], based on which a new scaling relation of the equivalent radiation temperature with the ablative shock velocity in Aluminum plates is proposed, and a novel method is developed for determining simultaneously the radiation temperature and the M-band (2-4 keV) fraction in laser-driven gold Hohlraums.

  9. Quantum molecular dynamics simulation of shock-wave experiments in aluminum

    SciTech Connect

    Minakov, D. V.; Khishchenko, K. V.; Fortov, V. E.; Levashov, P. R.

    2014-06-14

    We present quantum molecular dynamics calculations of principal, porous, and double shock Hugoniots, release isentropes, and sound velocity behind the shock front for aluminum. A comprehensive analysis of available shock-wave data is performed; the agreement and discrepancies of simulation results with measurements are discussed. Special attention is paid to the melting region of aluminum along the principal Hugoniot; the boundaries of the melting zone are estimated using the self-diffusion coefficient. Also, we make a comparison with a high-quality multiphase equation of state for aluminum. Independent semiempirical and first-principle models are very close to each other in caloric variables (pressure, density, particle velocity, etc.) but the equation of state gives higher temperature on the principal Hugoniot and release isentropes than ab initio calculations. Thus, the quantum molecular dynamics method can be used for calibration of semiempirical equations of state in case of lack of experimental data.

  10. Comparative Effects of Gamma Irradiation and Ozone Treatment on Hygienic Quality of Korean Red Ginseng Powder

    NASA Astrophysics Data System (ADS)

    Byun, Myung-Woo; Yook, Hong-Sun; Kang, Il-Jun; Chung, Cha-Kwon; Kwon, Joong-Ho; Choi, Kang-Ju

    1998-06-01

    For the purpose of improving hygienic quality of Korean red ginseng powder, the comparative effects of gamma irradiation and ozone treatment on the microbial and physicochemical properties were investigated. Gamma irradiation at 7.5 kGy resulted in sterilization of total aerobic bacteria, molds and coliforms below detective levels, while ozone treatment for 8 hours up to 18 ppm did not sufficiently eliminate the microorganisms of the red ginseng powder. Physicochemical properties including compositions of the red ginseng saponin (ginsenosides) and fatty acids, pH and hydrogen doanting activity were not significantly changed by gamma irradiation, whereas, ozone treatment caused significant changes in fatty acid compositions, TBA value, pH, acidity and hydrogen donating activity. The results from this study led us to conclude that gamma irradiation was more effective than ozone treatment both for the improvement of hygienic quality and for the maintenance of physicochemical quality of red ginseng powder.

  11. Shock-wave compression and release of aluminum/ceramic composites

    SciTech Connect

    Johnson, J.N.; Hixson, R.S.; Gray, G.T. III )

    1994-11-15

    Several composite materials consisting of ceramic particles embedded in a 6061-T6 aluminum matrix have been studied under conditions of shock-wave compression and release, including spallation. The 6061-T6 matrix represents a material for which high-rate shock-wave response has been extremely well characterized for thermoelastic-plastic deformation. The ceramic particles (alumina and mullite) are also well characterized, particularly in the elastic regime. Experimental tests consist of quasistatic, uniaxial-stress compression of both virgin and shock-recovered samples as well as time-resolved velocity interferometer measurements under conditions of flat-plate impact. The latter tests were performed with lithium fluoride windows for transmitted wave studies and free surfaces for spallation measurement. Theoretical analysis of the data is carried out with a pseudodissipation model originated by Barker [J. Composite Mat. [bold 5], 140 (1971)] for application to elastic deformation of layered composites and generalized here to include thermoelastic-plastic properties of the constituents. For a pseudodissipative model to apply to composite material response, significant geometrical randomization must be present in the composite structure; this is something that all commercially produced composites naturally possess. Randomization produces mechanical energy traps, which convert some fraction of regular, directed motion into random elastic vibrations behind the shock front. Within a few microseconds (depending on the pinned dislocation segment density) this macroscale, continuum vibrational energy is converted to heat by means of the anelastic properties of the metal matrix. The use of pseudodissipation as a means of representing dispersive composite material behavior is thus placed on a more secure physical foundation.

  12. Comparative efficacy and safety of mavacoxib and carprofen in the treatment of canine osteoarthritis

    PubMed Central

    Payne-Johnson, M; Becskei, C; Chaudhry, Y; Stegemann, M R

    2015-01-01

    A multi-site, masked, randomised parallel group study employing a double dummy treatment design was performed in canine veterinary patients to determine the comparative efficacy and safety of mavacoxib and carprofen in the treatment of pain and inflammation associated with osteoarthritis for a period of 134 days. Treatments were administered according to their respective summaries of product characteristics. Of 139 dogs screened, 124 were suitable for study participation: 62 of which were dosed with mavacoxib and 62 with carprofen. Both treatments resulted in a very similar pattern of considerable improvement as indicated in all parameters assessed by both owner and veterinarian. The primary efficacy endpoint ‘overall improvement’ was a composite score of owner assessments after approximately six weeks of treatment. Both drugs were remarkably effective, with 57/61 (93.4 per cent) of mavacoxib-treated dogs and 49/55 (89.1 per cent) of carprofen-treated dogs demonstrating overall improvement and with mavacoxib's efficacy being non-inferior to carprofen. The treatments had a similar safety profile as evidenced by documented adverse events and summaries of clinical pathology parameters. The positive clinical response to treatment along with the safety and dosing regimen of mavacoxib makes it an attractive therapy for canine osteoarthritis. PMID:25433056

  13. Assessing treatment integrity in cognitive-behavioral therapy: comparing session segments with entire sessions.

    PubMed

    Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Stangier, Ulrich

    2014-07-01

    The evaluation of treatment integrity (therapist adherence and competence) is a necessary condition to ensure the internal and external validity of psychotherapy research. However, the evaluation process is associated with high costs, because therapy sessions must be rated by experienced clinicians. It is debatable whether rating session segments is an adequate alternative to rating entire sessions. Four judges evaluated treatment integrity (i.e., therapist adherence and competence) in 84 randomly selected videotapes of cognitive-behavioral therapy for major depressive disorder, social anxiety disorder, and hypochondriasis (from three different treatment outcome studies). In each case, two judges provided ratings based on entire therapy sessions and two on session segments only (i.e., the middle third of the entire sessions). Interrater reliability of adherence and competence evaluations proved satisfactory for ratings based on segments and the level of reliability did not differ from ratings based on entire sessions. Ratings of treatment integrity that were based on entire sessions and session segments were strongly correlated (r=.62 for adherence and r=.73 for competence). The relationship between treatment integrity and outcome was comparable for ratings based on session segments and those based on entire sessions. However, significant relationships between therapist competence and therapy outcome were only found in the treatment of social anxiety disorder. Ratings based on segments proved to be adequate for the evaluation of treatment integrity. The findings demonstrate that session segments are an adequate and cost-effective alternative to entire sessions for the evaluation of therapist adherence and competence. PMID:24912466

  14. Barriers to accessing substance abuse treatment in Mexico: national comparative analysis by migration status

    PubMed Central

    2014-01-01

    Background We examined Mexican migrants’ perceived barriers to entering substance abuse treatment and potential differences by gender. Methods This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment. Results Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City. Conclusions Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico. PMID:25074067

  15. Comparing Chronic Pain Treatment Seekers in Primary Care versus Tertiary Care Settings

    PubMed Central

    Fink-Miller, Erin L.; Long, Dustin M.; Gross, Richard T.

    2015-01-01

    Background Patients frequently seek treatment for chronic nonmalignant pain in primary care settings. Compared with physicians who have completed extensive specialization (eg, fellowships) in pain management, primary care physicians receive much less formal training in managing chronic pain. While chronic pain represents a complicated condition in its own right, the recent increase in opioid prescriptions further muddles treatment. It is unknown whether patients with chronic pain seeking treatment in primary care differ from those seeking treatment in tertiary care settings. This study sought to determine whether patients with chronic pain in primary care reported less pain, fewer psychological variables related to pain, and lower risk of medication misuse/abuse compared with those in tertiary care. Methods Data collected from patients with chronic pain in primary care settings and tertiary care settings were analyzed for significant differences using Wilcoxon rank sum tests, Fisher exact tests, and linear regression. A host of variables among populations, including demographics, self-reported pain severity, psychological variables related to pain, and risk for opioid misuse and abuse, were compared. Results Findings suggest that primary care patients with chronic pain were similar to those in tertiary care on a host of indices and reported more severe pain. There were no significant group differences for risk of medication misuse or abuse. Conclusion It seems that primary care physicians care for a complicated group of patients with chronic pain that rivals the complexity of those seen in specialized tertiary care pain management facilities. PMID:25201929

  16. Comparative analysis of 11 different radioisotopes for palliative treatment of bone metastases by computational methods

    SciTech Connect

    Guerra Liberal, Francisco D. C. E-mail: adriana-tavares@msn.com; Tavares, Adriana Alexandre S. E-mail: adriana-tavares@msn.com; Tavares, João Manuel R. S.

    2014-11-01

    Purpose: Throughout the years, the palliative treatment of bone metastases using bone seeking radiotracers has been part of the therapeutic resources used in oncology, but the choice of which bone seeking agent to use is not consensual across sites and limited data are available comparing the characteristics of each radioisotope. Computational simulation is a simple and practical method to study and to compare a variety of radioisotopes for different medical applications, including the palliative treatment of bone metastases. This study aims to evaluate and compare 11 different radioisotopes currently in use or under research for the palliative treatment of bone metastases using computational methods. Methods: Computational models were used to estimate the percentage of deoxyribonucleic acid (DNA) damage (fast Monte Carlo damage algorithm), the probability of correct DNA repair (Monte Carlo excision repair algorithm), and the radiation-induced cellular effects (virtual cell radiobiology algorithm) post-irradiation with selected particles emitted by phosphorus-32 ({sup 32}P), strontium-89 ({sup 89}Sr), yttrium-90 ({sup 90}Y ), tin-117 ({sup 117m}Sn), samarium-153 ({sup 153}Sm), holmium-166 ({sup 166}Ho), thulium-170 ({sup 170}Tm), lutetium-177 ({sup 177}Lu), rhenium-186 ({sup 186}Re), rhenium-188 ({sup 188}Re), and radium-223 ({sup 223}Ra). Results: {sup 223}Ra alpha particles, {sup 177}Lu beta minus particles, and {sup 170}Tm beta minus particles induced the highest cell death of all investigated particles and radioisotopes. The cell survival fraction measured post-irradiation with beta minus particles emitted by {sup 89}Sr and {sup 153}Sm, two of the most frequently used radionuclides in the palliative treatment of bone metastases in clinical routine practice, was higher than {sup 177}Lu beta minus particles and {sup 223}Ra alpha particles. Conclusions: {sup 223}Ra and {sup 177}Lu hold the highest potential for palliative treatment of bone metastases of all

  17. Geriatric Small Bowel Obstruction: An Analysis of Treatment and Outcomes Compared to a Younger Cohort

    PubMed Central

    Krause, William R.; Webb, Travis P.

    2016-01-01

    Background Small bowel obstruction (SBO) is a common condition, but little is known about its presentation, management, and outcomes in geriatric patients. Methods A retrospective review was performed comparing geriatric (≥65 years of age) and non-geriatric patients admitted with SBO. Admission characteristics, treatment, and outcomes were compared. Data analysis included Student’s t test and chi-square test or Fisher exact test. Results Among 80 geriatric and 136 non-geriatric patients no difference was observed between admission characteristics, treatment, time to or type of surgery, length of post-op stay, or overall complications. Cardiac complications (15% vs 0%, p=0.0082) and sub-acute care facility discharge (29% vs 5%, p<0.001) were more common for geriatric patients. Conclusions Compared to younger adults, elderly patients with SBO have similar presentations and overall outcomes with the exception of cardiac morbidity and discharge disposition. Pre-operative attention to cardiac risk profile and discharge disposition discussion should be encouraged. Summary This study analyzes geriatric patients presenting with small bowel obstruction when cared for by an Acute Care Surgery service. Compared to younger adults, the presentation, treatment response, and outcomes are similar with the exception of cardiac complications and discharge destination. PMID:25048569

  18. Olive oil waste treatment: a comparative and critical presentation of methods, advantages & disadvantages.

    PubMed

    Arvanitoyannis, Ioannis S; Kassaveti, Aikaterini; Stefanatos, Stelios

    2007-01-01

    Since olive oil industries were considered responsible for a great amount of pollution there has been a strong need for optimization of olive oil waste treatment systems. The currently employed systems are numerous and fall in the following large categories; bioremediation (ex-situ, in-situ), thermal processes (incineration, pyrolysis, gasification), evaporation, membrance processes, electrolysis, ozonation, digestion, coagulation/flocculation/precipitation, and distillation. Both advantages and disadvantages in conjunction with respective methodology and explicit flow diagrams were presented per waste treatment method. Furthermore, most recent studies were reported and more than twenty-five figures showing mainly the effectiveness of the current waste treatment methods versus time or temperature were displayed. The comparative presentation of the various olive oil waste treatment methodologies showed that though bioremediation stands for the most enviromentally friendly technique, its required longer treatment time in conjuction with its weakness to deal with elemental contaminants makes imperative the employment of a second alternative technique which could either be a membrance process (low energy cost, reliability, reduced capital cost) or a coagulation/flocculation method because of its low cost and high effectiveness. Biogas production appears to be another promising and energy effective waste treatment method. On the other hand, methods like distillation and ozonation (high cost) and electrolysis (experimental level) are unlikely to dominate this field unless their high cost is substantially reduced in the near future. PMID:17453921

  19. Comparative Cost Analysis of Sequential, Adaptive, Behavioral, Pharmacological, and Combined Treatments for Childhood ADHD.

    PubMed

    Page, Timothy F; Pelham, William E; Fabiano, Gregory A; Greiner, Andrew R; Gnagy, Elizabeth M; Hart, Katie C; Coxe, Stefany; Waxmonsky, James G; Foster, E Michael; Pelham, William E

    2016-01-01

    We conducted a cost analysis of the behavioral, pharmacological, and combined interventions employed in a sequential, multiple assignment, randomized, and adaptive trial investigating the sequencing and enhancement of treatment for children with attention deficit hyperactivity disorder (ADHD; Pelham et al., 201X; N = 146, 76% male, 80% Caucasian). The quantity of resources expended on each child's treatment was determined from records that listed the type, date, location, persons present, and duration of all services provided. The inputs considered were the amount of physician time, clinician time, paraprofessional time, teacher time, parent time, medication, and gasoline. Quantities of these inputs were converted into costs in 2013 USD using national wage estimates from the Bureau of Labor Statistics, the prices of 30-day supplies of prescription drugs from the national Express Scripts service, and mean fuel prices from the Energy Information Administration. Beginning treatment with a low-dose/intensity regimen of behavior modification (large-group parent training) was less costly for a school year of treatment ($961) than beginning treatment with a low dose of stimulant medication ($1,669), regardless of whether the initial treatment was intensified with a higher "dose" or if the other modality was added. Outcome data from the parent study (Pelham et al., 201X) found equivalent or superior outcomes for treatments beginning with low-intensity behavior modification compared to intervention beginning with medication. Combined with the present analyses, these findings suggest that initiating treatment with behavior modification rather than medication is the more cost-effective option for children with ADHD. PMID:26808137

  20. Depression Treatment in Individuals with Cancer: A Comparative Analysis with Cardio-Metabolic Conditions

    PubMed Central

    Rane, Pallavi B.; Sambamoorthi, Usha; Madhavan, Suresh

    2013-01-01

    A clear picture of the current state of nation-wide depression treatment practices in individuals with cancer and depression does not exist in the United States (US). Therefore, the primary objective of this study was to examine rates of any depression treatment among individuals with cancer and depression in the US. To better understand the relationship between any treatment for depression and presence of cancer, we used a comparison group of individuals with cardio-metabolic conditions owing to the similar challenges faced in management of depression in individuals with these conditions. We used a retrospective cross-sectional design and data from multiple years of the Medical Expenditure Panel Survey, a nationally representative household-survey on healthcare utilization and expenditures. Study sample consisted of adults aged 21 or older with self-reported depression and cancer (n=528) or self-reported depression and diabetes, heart disease or hypertension (n=1643). Depression treatment comprised of any use of antidepressants and/or any use of mental health counseling services. Treatment rates for depression were 78.0% and 81.7% among individuals with cancer and cardio-metabolic conditions respectively. After controlling for socio-demographic, access-to-care, number of physician-visits, health-status, and lifestyle risk-factors related variables; individuals with cancer were less likely to report any treatment for depression (Adjusted Odds Ratio=0.67; 95% Confidence Interval=0.49, 0.92) compared to individuals with cardio-metabolic conditions (P≤0.01). Our findings highlight the possibility that competing demands may crowd out treatment for depression and that cancer diagnosis may be a barrier to depression treatment. PMID:26973891

  1. In Vitro Comparative Assessment of Mechanical Blood Damage Induced by Different Hemodialysis Treatments.

    PubMed

    Sakota, Ranko; Lodi, Carlo Alberto; Sconziano, Sara Antonia; Beck, Werner; Bosch, Juan P

    2015-12-01

    Gradual deterioration of red blood cells (RBCs) due to mechanical stress (chronic hemolysis) is unavoidable during treatments that involve extracorporeal blood circulation, such as hemodialysis (HD). This effect is generally undetectable and does not generate any acute symptoms, but it leads to an increase in plasma free hemoglobin (fHb). There are no absolute safety levels for fHb increase, indicating the need for an empirical evaluation using comparative testing. The increase in fHb levels was investigated in vitro by applying double-needle double-pump HD (HD-DNDP), a new modality in which arterial and venous pumps both run continuously. fHb was measured during typical and worst-case simulated dialysis treatments (double-needle single-pump HD [HD-DNSP], hemodiafiltration [HDF-DN], single-needle double-pump HD [HD-SNDP], and HD-DNDP) performed in vitro using bovine blood for 4 h. Hemolysis-related indices (fHb%; index of hemolysis, IH; and normalized IH) were calculated and used for comparison. The increase in fHb during either HDF-DN or HD-SNDP with Artis and AK200 dialysis machines was similar, while the fHb at the maximum real blood flow rate (Qbreal ) at the completion of the HD-DNDP treatment on Artis was higher than that for HD-DNSP using a Phoenix dialysis machine (fHb% = 1.24 ± 0.13 and 0.92 ± 0.12 for the Artis machine with HD-DNDP at Qbreal  = 450 mL/min and Phoenix with HD-DNSP at Qbreal  = 500 mL/min, respectively). However, the fHb levels increased linearly, and no steep changes were observed. The increases observed during HD-DNDP were the same order of magnitude as those for widely used bloodlines and treatment modes for delivering dialysis treatments. The observed results matched literature findings, and thus the measured fHb trends are not predicted to have clinical side effects. HD-DNDP treatment with Artis does not merit any additional concern regarding mechanical stress to RBCs compared with that observed for

  2. Comparative effectiveness of dynamic treatment regimes: an application of the parametric g-formula

    PubMed Central

    Young, Jessica G.; Cain, Lauren E.; Robins, James M.; O’Reilly, Eilis J.; Hernán, Miguel A.

    2013-01-01

    Ideally, randomized trials would be used to compare the long-term effectiveness of dynamic treatment regimes on clinically relevant outcomes. However, because randomized trials are not always feasible or timely, we often must rely on observational data to compare dynamic treatment regimes. An example of a dynamic treatment regime is “start combined antiretroviral therapy (cART) within 6 months of CD4 cell count first dropping below x cells/mm3 or diagnosis of an AIDS-defining illness, whichever happens first” where x can take values between 200 and 500. Recently, Cain et al (2011) used inverse probability (IP) weighting of dynamic marginal structural models to find the x that minimizes 5-year mortality risk under similar dynamic regimes using observational data. Unlike standard methods, IP weighting can appropriately adjust for measured time-varying confounders (e.g., CD4 cell count, viral load) that are affected by prior treatment. Here we describe an alternative method to IP weighting for comparing the effectiveness of dynamic cART regimes: the parametric g-formula. The parametric g-formula naturally handles dynamic regimes and, like IP weighting, can appropriately adjust for measured time-varying confounders. However, estimators based on the parametric g-formula are more efficient than IP weighted estimators. This is often at the expense of more parametric assumptions. Here we describe how to use the parametric g-formula to estimate risk by the end of a user-specified follow-up period under dynamic treatment regimes. We describe an application of this method to answer the “when to start” question using data from the HIV-CAUSAL Collaboration. PMID:24039638

  3. Network meta-analysis for comparing treatment effects of multiple interventions: an introduction.

    PubMed

    Catalá-López, Ferrán; Tobías, Aurelio; Cameron, Chris; Moher, David; Hutton, Brian

    2014-11-01

    Systematic reviews and meta-analyses of randomized trials have long been important synthesis tools for guiding evidence-based medicine. More recently, network meta-analyses, an extension of traditional meta-analyses enabling the comparison of multiple interventions, use new statistical methods to incorporate clinical evidence from both direct and indirect treatment comparisons in a network of treatments and associated trials. There is a need to provide education to ensure that core methodological considerations underlying network meta-analyses are well understood by readers and researchers to maximize their ability to appropriately interpret findings and appraise validity. Network meta-analyses are highly informative for assessing the comparative effects of multiple competing interventions in clinical practice and are a valuable tool for health technology assessment and comparative effectiveness research. PMID:24691560

  4. Treatment of enterocutaneous fistulas with TPN and somatostatin, compared with patients who received TPN only.

    PubMed

    Spiliotis, J; Vagenas, K; Panagopoulos, K; Kalfarentzos, F

    1990-12-01

    Eighteen patients with post-operative enterocutaneous fistulas were treated with total parenteral nutrition (TPN), skin care, infection control and intravenous somatostatin (SMS) 250 micrograms/h. This group was compared with 30 patients treated with standard medical treatment (total parenteral nutrition (TPN), skin care and infection control). In the SMS group the fistula output was reduced to 50% in three days and spontaneous closure was observed in 14 patients after a mean of 6.1 +/- 3.1 days of treatment with SMS, and in 18.2 +/- 6.3 days after the TPN administration. In the control group the fistula output was reduced by up to 50% after a week and spontaneous closure occurred in 20 patients in a mean of 27.4 +/- 8.7 days after the start of treatment. These results are statistically significant. There was one (5.5%) death in the SMS group compared with three (10%) deaths in the other, and glucose intolerance was observed in two (11%) patients in the SMS group. Somatostatin has been shown to be useful in the conservative treatment of enterocutaneous fistulas because of its ability to reduce output and accelerate closure. PMID:1983231

  5. Granular biochar compared with activated carbon for wastewater treatment and resource recovery.

    PubMed

    Huggins, Tyler M; Haeger, Alexander; Biffinger, Justin C; Ren, Zhiyong Jason

    2016-05-01

    Granular wood-derived biochar (BC) was compared to granular activated carbon (GAC) for the treatment and nutrient recovery of real wastewater in both batch and column studies. Batch adsorption studies showed that BC material had a greater adsorption capacity at the high initial concentrations of total chemical oxygen demand (COD-T) (1200 mg L(-1)), PO4 (18 mg L(-1)), and NH4 (50 mg L(-1)) compared to GAC. Conversely the BC material showed a lower adsorption capacity for all concentrations of dissolved chemical oxygen demand (COD-D) and the lower concentrations of PO4 (5 mg L(-1)) and NH4 (10 mg L(-1)). Packed bed column studies showed similar average COD-T removal rate for BC with 0.27 ± 0.01 kg m(-3) d(-1) and GAC with 0.24 ± 0.01 kg m(-3) d(-1), but BC had nearly twice the average removal rate (0.41 ± 0.08 kg m(-3) d(-3)) compared to GAC during high COD-T concentrations (>500 mg L(-1)). Elemental analysis showed that both materials accumulated phosphorous during wastewater treatment (2.6 ± 0.4 g kg(-1) and 1.9 ± 0.1 g kg(-1) for BC and GAC respectively). They also contained high concentrations of other macronutrients (K, Ca, and Mg) and low concentrations of metals (As, Cd, Cr, Pb, Zn, and Cu). The good performance of BC is attributed to its macroporous structure compared with the microporous GAC. These favorable treatment data for high strength wastewater, coupled with additional life-cycle benefits, helps support the use of BC in packed bed column filters for enhanced wastewater treatment and nutrient recovery. PMID:26954576

  6. Comparative effectiveness of long term drug treatment strategies to prevent asthma exacerbations: network meta-analysis

    PubMed Central

    Gemperli, Armin; Cohen, Judith; Rubinstein, Sidney M; Sterk, Peter J; Reddel, Helen K; Jüni, Peter; ter Riet, Gerben

    2014-01-01

    Objective To determine the comparative effectiveness and safety of current maintenance strategies in preventing exacerbations of asthma. Design Systematic review and network meta-analysis using Bayesian statistics. Data sources Cochrane systematic reviews on chronic asthma, complemented by an updated search when appropriate. Eligibility criteria Trials of adults with asthma randomised to maintenance treatments of at least 24 weeks duration and that reported on asthma exacerbations in full text. Low dose inhaled corticosteroid treatment was the comparator strategy. The primary effectiveness outcome was the rate of severe exacerbations. The secondary outcome was the composite of moderate or severe exacerbations. The rate of withdrawal was analysed as a safety outcome. Results 64 trials with 59 622 patient years of follow-up comparing 15 strategies and placebo were included. For prevention of severe exacerbations, combined inhaled corticosteroids and long acting β agonists as maintenance and reliever treatment and combined inhaled corticosteroids and long acting β agonists in a fixed daily dose performed equally well and were ranked first for effectiveness. The rate ratios compared with low dose inhaled corticosteroids were 0.44 (95% credible interval 0.29 to 0.66) and 0.51 (0.35 to 0.77), respectively. Other combined strategies were not superior to inhaled corticosteroids and all single drug treatments were inferior to single low dose inhaled corticosteroids. Safety was best for conventional best (guideline based) practice and combined maintenance and reliever therapy. Conclusions Strategies with combined inhaled corticosteroids and long acting β agonists are most effective and safe in preventing severe exacerbations of asthma, although some heterogeneity was observed in this network meta-analysis of full text reports. PMID:24919052

  7. Comparative efficacy, persistent effect, and treatment intervals of anthelmintic pastes in naturally infected horses.

    PubMed

    Mercier, P; Chick, B; Alves-Branco, F; White, C R

    2001-07-31

    Eighty horses were involved in a comparative, controlled, and randomised field study conducted in Australia and Brazil. This study was undertaken to address the duration of efficacy (by faecal egg count reduction) of four anthelmintic pastes and to measure the time required between treatments on horses naturally infected by gastrointestinal nematodes. The treatment interval was based on the egg reappearance period (ERP), defined as "the period after treatment when horses have reached a positive egg count equal or superior to 200 eggs per gram (epg) of faeces". Horses were ranked according to pre-treatment faecal egg counts and randomly allocated on Day 0 to one of the four treatment groups (n=16). Group A received a combination of ivermectin at 200 microg/kg and praziquantel at 1.5mg/kg, Group B received an ivermectin paste at 200 microg/kg, Group C received a reference product containing ivermectin at 200 microg/kg, Group D received a moxidectin paste at 400 microg/kg, and Group E received a placebo. Horses were individually faecal sampled at weekly interval from Days 0 to 70 after treatment and coprocultures were made on pooled samples at the pre-treatment time on D-7 in Brazil and D-6 in Australia. The nematode population was mainly composed of small strongyles (Cyathostominae, Gyalocephalus spp., Triodontophorus spp.). All products were efficient (>90% efficacy) until Day 42 with no statistical difference between groups. From Day 49 onwards, Group C reached the threshold, while Group B exceeded this threshold on Day 56. Groups A and D remained below 200 epg for the entire study period (70 days). The interval between two anthelmintic treatments can vary according to the threshold. The ERP was defined as the period after treatment while the output of eggs is negligible or considered as acceptable. The mean number of days calculated to recurrence of 200 epg and more was, respectively, 60 days for product A, 56 days for products B and C, and 64 days for product D

  8. An open comparative study of nail drilling as adjunctive treatment for toenail onychomycosis (.).

    PubMed

    Shemer, A; Gupta, A K; Amichai, B; Farhi, R; Baran, R; Daniel, C R; Daigle, D; Foley, K A

    2016-10-01

    Introduction Novel treatment regimens are being developed to improve drug penetration through the nail plate. This study investigated the efficacy of nail drilling regimens for the treatment of onychomycosis. Methods Participants were assigned to holes with combination (oral plus topical terbinafine) therapy (Group 1), holes with topical terbinafine (Group 2) or topical terbinafine only (Group 3). Measurement of clear nail and mycology was performed at baseline and at weeks 4, 10, 16, 22 and 28. Mixed linear models were used to compare mean percent clear nail. Mycological cure rates were also tabulated for each group. Tolerability and adverse events were documented. Results Ninety-eight participants were enrolled (106 nails). Both groups with holes had significantly higher percentage of clear nail compared with topical terbinafine alone. Although no significant difference between the two groups where holes were drilled in the nail plate, Group 1 demonstrated improvement over Group 3 earlier than Group 2 (visit 2 versus visit 4). Group 1 also had the highest mycological cure rates. Conclusion Treatment with holes plus topical terbinafine produces significantly greater improvement in toenails' appearance and higher mycological cure rates compared to treating the dorsal aspect of the nail plate with topical terbinafine alone. PMID:27032812

  9. Application systems for the intracorporal laser-induced shockwave lithotripsy using the Nd:YAG Q-switched laser

    NASA Astrophysics Data System (ADS)

    Frank, Klaus H.; Eichenlaub, M.; Hessel, Stefan F. F.; Wondrazek, Fritz

    1990-06-01

    For the laser-induced shockwave lithotripsy the electromagnetic energy of a laser light pulse is converted intracorporally into the acoustic energy of a shock wave. The lithotriptor is based on a specially developed, Q-switched Nd:YAG laser whose high power light pulses (70 mJ, 25 ns) are coupled into a flexible quartz fiber of 600 pim core diameter. Using focussing elements energy densities higher than 6 1O J m2 can be achieved resulting in an optical breakdown in water followed by a shock wave. As a result of different absorption mechanisms the breakdown threshold can be decreased by placing a metallic target into the laser beam. The different shockwave formations of such optomechanical transducers have been measured. First clinical applications have been performed.

  10. Structural Equation Analyses of Clinical Subpopulation Differences and Comparative Treatment Outcomes: Characterizing the Daily Lives of Drug Addicts.

    ERIC Educational Resources Information Center

    Aiken, Leona S.; And Others

    1994-01-01

    Used structural equation modeling for comparative treatment outcome research conducted with heterogeneous clinical subpopulations within large multimodality treatment settings. Evaluated effect of early period of treatment on daily lives of 486 clients in 2 drug abuse treatment modalities (methadone maintenance and outpatient counseling).…

  11. Withdrawing and withholding medical treatment: a comparative study between the Malaysian, English and Islamic law.

    PubMed

    Kassim, Puteri Nemie Jahn; Adeniyi, Omipidan Bashiru

    2010-09-01

    The permissibility and lawfulness of withdrawing and withholding medical treatment has attracted considerable debates and criticisms, as the legal issues are drawn into entering the slippery slope of euthanasia. Proponents of "sanctity of life" views that withdrawing and withholding medical treatment with knowledge that death would result is still within the sphere of euthanasia, whereas proponents of "quality of life" argue that it is not, as death is not intended. Their arguments maintain that for patients who are totally dependant on machines to ensure the work of some bodily functions, living may amount to little more than survival as dying is prolonged. Furthermore, the prolonging of life of the dying patient has profound implications on patients themselves, their relatives, dependants and medical providers. Thus, withdrawing and withholding medical treatment would not only respect a patient's right to self-determination, by allowing them to die in their underlying condition, but will ensure that medical providers are able to concentrate on more worthwhile treatments. This paper discusses the intractable difficulties with the moral distinction between withholding and withdrawing treatment and euthanasia, as well as makes a comparative study between the present state of law in Malaysia and England on this issue. The paper further highlights the differences between civil law and Islamic law in this controversial area. PMID:22145563

  12. Once-weekly treatment of anemia in patients with cancer: a comparative review of epoetins.

    PubMed

    Pujade-Lauraine, Eric; Topham, Clare

    2005-01-01

    Anemia is common in cancer patients, but its impact is often poorly appreciated. As well as the negative effect of anemia on the quality of life, there is strong evidence that it is associated with poor treatment outcome and reduced survival. The introduction of recombinant human erythropoietin (epoetin) has provided an effective treatment of anemia, without the risk associated with blood transfusion. A recent randomized study of patients with hematological malignancies showed that once-weekly epoetin beta has comparable efficacy at the same overall weekly dose as three-times-weekly treatment. This once-weekly regimen of epoetin beta (NeoRecormon) has been approved by European Regulatory Authorities for patients with lymphoproliferative malignancies and relative erythropoietin deficiency, who are receiving anti-tumor therapy. Darbepoetin alpha (Aranesp) has also recently been approved for once-weekly treatment of anemia in patients with nonmyeloid malignancies receiving chemotherapy. The improved convenience and reduced administration costs associated with a once-weekly treatment may result in more patients receiving the benefits of epoetin therapy. PMID:16015034

  13. Treatment of shoulder ulcers in sows – rubber mats and zinc ointment compared to chlortetracycline spray

    PubMed Central

    2013-01-01

    Background Shoulder ulcers can have a significant impact on the welfare of sows. In Denmark, rubber mats are used for treatment of shoulder ulcers. The objective of the study was to compare a treatment consisting of a combination of rubber mats and zinc ointment with the effect of local antibiotic spray (chlortetracycline) on shoulder ulcers. Methods A total of 304 sows with shoulder ulcers were observed shortly after farrowing (day 1) and on days 14 and 21 after the first observation. The sows were paired according to the grade of the shoulder ulcer using the official Danish scoring system. From each pair of sows, one sow was allocated to mat group (M) and the other to an antibiotic group (A) in a random way. In the M group, rubber mats were placed on the floor, and the ulcers were treated with zinc ointment once a day. In the A group, sows were treated with antibiotic spray daily. The size of the shoulder ulcer was measured manually on a continuous scale on days 1, 14 and 21. The data were analysed by use of two multivariable models where the response was the area of the shoulder ulcer on day 14 and day 21, respectively. Explanatory variables were treatment, herd, parity, body condition and size of ulcer on day 1. If a sow had an ulcer on both shoulders, the shoulder with the largest ulcer was selected. Results The treatment consisting of mats and zinc ointment had a statistical significant effect on the size of the shoulder ulcer on day 14 and day 21 compared to daily treatment with antibiotic spray. For lean sows that were kept on rubber mats and zinc ointment, the average shoulder ulcer was significantly smaller on day 14 (3.8 cm2 versus 9.5 cm2 when antibiotic spray was used) and day 21 (3.4 cm2 versus 6.6 cm2) compared to lean sows that were only treated with antibiotic spray. For fat sows this was also the case when using the lesion on day 21 as the response (2.0 cm2 versus 5.7 cm2) but not on day 14. Moreover, the size of the lesion on day 1 was

  14. Estimating the pressure of laser-induced plasma shockwave by stimulated Raman shift of lattice translational modes

    SciTech Connect

    Li Zhanlong; Shan Xiaoning; Li Zuowei; Zhou Mi; Men Zhiwei; Cao Junsheng; Wang Yiding; Sun Chenglin

    2012-07-09

    The current paper investigates stimulated Raman scattering (SRS) when laser-induced plasma is formed in heavy water by focusing an intense pulsed 532 nm Nd:YAG laser beam at room temperature. An unexpected low-frequency SRS line attributed to the lattice translational modes of ice-VII (D{sub 2}O) is observed. The pressure of the plasma shockwave is estimated using low-frequency SRS line shift.

  15. Evidence for effectiveness of Extracorporal Shock-Wave Therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis--a systematic review.

    PubMed

    Huisstede, Bionka M A; Gebremariam, Lukas; van der Sande, Renske; Hay, Elaine M; Koes, Bart W

    2011-10-01

    Extracorporeal shock-wave therapy (ESWT) is suggested as a treatment alternative for calcific and non-calcific rotator cuff tendinosis (RC-tendinosis), which may decrease the need for surgery. In this study we assessed the evidence for effectiveness of ESWT for these disorders. The Cochrane Library, PubMed, Embase, Pedro, and Cinahl were searched for relevant systematic reviews and RCTs. Two reviewers independently extracted data and assessed the methodological quality. Seventeen RCTs (11 calcific, 6 non-calcific) were included. For calcific RC-tendinosis, strong evidence was found for effectiveness in favour of high-ESWT versus low-ESWT in short-term. Moderate evidence was found in favour of high-ESWT versus placebo in short-, mid- and long-term and versus low-ESWT in mid- and long-term. Moreover, high-ESWT was more effective (moderate evidence) with focus on calcific deposit versus focus on tuberculum major in short- and long-term. RSWT was more effective (moderate evidence) than placebo in mid-term. For non-calcific RC-tendinosis, no strong or moderate evidence was found in favour of low-, mid- or high-ESWT versus placebo, each other, or other treatments. This review shows that only high-ESWT is effective for treating calcific RC-tendinosis. No evidence was found for the effectiveness of ESWT to treat non-calcific RC-tendinosis. PMID:21396877

  16. Meso-scale Computational Investigation of Shock-Wave Attenuation by Trailing Release Wave in Different Grades of Polyurea

    NASA Astrophysics Data System (ADS)

    Grujicic, Mica; Snipes, J. S.; Ramaswami, S.; Yavari, R.; Ramasubramanian, M. K.

    2014-01-01

    Over the past several years, considerable research efforts have been made toward investigating polyurea, a segmented thermoplastic elastomer, and particularly its shock-mitigation capacity, i.e., an ability to attenuate and disperse shock-waves. These research efforts have clearly established that the shock-mitigation capacity of polyurea is closely related to its chemistry, processing route, and the resulting microstructure. Polyurea typically possesses a nano-segregated microstructure consisting of (high glass transition temperature, T g) hydrogen-bonded discrete hard domains and a (low T g) contiguous soft matrix. While the effect of polyurea microstructure on its shock-mitigation capacity is well-established, it is not presently clear what microstructure-dependent phenomena and processes control its shock-mitigation capacity. To help identify these phenomena and processes, meso-scale simulations of the formation of nano-segregated microstructure and its interaction with a leading shock-wave and a trailing release-wave is analyzed in the present work. The results obtained revealed that shock-induced hard-domain densification makes an important contribution to the superior shock-mitigation capacity of polyurea, and that the extent of densification is a sensitive function of the polyurea soft-segment molecular weight. In particular, the ability of release-waves to capture and neutralize shock-waves has been found to depend strongly on the extent of shock-induced hard-domain densification and, thus, on the polyurea soft-segment molecular weight.

  17. Comparative Effectiveness of Tocilizumab with either Methotrexate or Leflunomide in the Treatment of Rheumatoid Arthritis

    PubMed Central

    Narváez, Javier; Díaz-Torné, César; Magallares, Berta; Hernández, Maria Victoria; Reina, Delia; Corominas, Héctor; Sanmartí, Raimon; de la Serna, Arturo Rodriguez; Llobet, Josep Maria; Nolla, Joan M.

    2015-01-01

    Objective In agreement with EULAR recommendations, a DMARD in combination with a biotherapy is the reference treatment because of the superior long-term clinical and radiographic outcomes. Methotrexate (MTX) is the cornerstone of combination therapy but is in some cases contra-indicated or poorly tolerated. This observational study aimed to compare the effectiveness and safety of TCZ in combination with either MTX or leflunomide (LEF) in the treatment of patients with active rheumatoid arthritis (RA) and an inadequate response to one or more DMARDs and/or biological agents in a real-world setting. Methods We performed an ambispective review of 91 patients with active RA who were routinely treated with TCZ plus MTX or LEF. A comparative study between the two combinations of treatment was performed at 6 months of follow-up considering 3 outcomes: improvement of RA disease activity, evolution of functional disability, and tolerability and side effect profile. Results Of the 91 patients, 62 received TCZ with MTX and 29 received TCZ with LEF. Eighty-one patients were followed for 6 months, and the remaining 10 patients discontinued treatment due to serious adverse events. At baseline, there were no significant differences between the groups in terms of the main clinical and laboratory data or in the number of previous DMARDs and biological agents used. At 6 months, there were no significant differences between the combinations in terms of disease activity and functional disability. Serious adverse events occurred in 11% and 10% of the patients treated in combination with MTX and LEF, respectively. Conclusion Our preliminary data support the argument that LEF is an effective and safe (equivalent) alternative to MTX for combination treatment with TCZ. PMID:25830224

  18. Comparative evaluation between hypericin (hypiran) and fluoxetine in treatment of companion dogs with tail chasing

    PubMed Central

    Mosallanejad, Bahman; Najafzadeh Varzi, Hossein; Avizeh, Reza; Pourmahdi, Mahdi; Khalili, Fatemeh

    2015-01-01

    The aim of the present study was to compare the effects of hypericin and fluoxetine in the treatment of companion dogs with tail chasing in Ahvaz district. In the present survey, eighteen dogs with tail chasing were assigned into three equal groups for a three-year period. The dogs were randomly classified based on different treatment groups. During 15 weeks, dogs of group A were given 0.05 mg kg-1 hypericin orally and dogs of group B received 1 mg kg-1 fluoxetine, orally. The group C was the control group. Changes in signs of tail chasing were weekly reported by the owners or a veterinarian. Treatment periods were assessed in five intervals: weeks 1-3, 4-6, 7-9, 10-12 and weeks 13-15, respectively. Hypericin (group A) was significantly more effective in the treatment of tail chasing compared with fluoxetine (group B), (p = 0.043). Statistical analysis revealed a significant difference in each group between weeks 1-3 (X2 = 8.8, p = 0.01), 4-6 (X2 = 9.1, p = 0.01), 7-9 (X2 = 7.4, p = 0.03), 10-12 (X2 = 10.4, p = 0.005) and 13-15 (X2 = 12.5, p = 0.002). Improvement of behavior in the dogs of group A was significant compared with group B, between weeks 10-12 (X2 = 5.4, p = 0.02) and 13-15 (X2 = 7.2, p = 0.007). In conclusion, our survey showed that hypericin was more effective than fluoxetine in controlling signs of tail chasing. PMID:26261714

  19. Comparative study of wastewater treatment and nutrient recycle via activated sludge, microalgae and combination systems.

    PubMed

    Wang, Liang; Liu, Jinli; Zhao, Quanyu; Wei, Wei; Sun, Yuhan

    2016-07-01

    Algal-bacterial synergistic cultivation could be an optional wastewater treatment technology in temperate areas. In this study, a locally screened vigorous Chlorella strain was characterized and then it was used in a comparative study of wastewater treatment and nutrient recycle assessment via activated sludge (AS), microalgae and their combination systems. Chlorella sp. cultured with AS in light showed the best performance, in which case the removal efficiencies of COD, NH3-N and TP were 87.3%, 99.2% and 83.9%, respectively, within a short period of 1day. Algal-bacterial combination in light had the best settleability. Chlorella sp. contained biomass, could be processed to feed, fertilizer or fuel due to the improved quality (higher C/H/N) compared with sludge. PCR-DGGE analysis shows that two types of rhizobacteria, namely, Pseudomonas putida and Flavobacterium hauense were enriched in sludge when cultured with algae in light, serving as the basics for artificial consortium construction for improved wastewater treatment. PMID:26995615

  20. Acupuncture as an Adjunct Treatment for Primary Dysmenorrhea: A Comparative Study

    PubMed Central

    Díaz-Toral, Livia Gabriela; Verdín-Terán, Silvia Leticia; Orozco-Suárez, Eunice Sonia; López-Ramírez, Patricia; Pineda-Carranza, Antonio; Basulto-Sosa, Patricio Guillermo; Reyes-Campos, Primo F.

    2013-01-01

    Abstract Background Primary dysmenorrhea occurs 40%–50% in women of reproductive age. Acupuncture may assist treatment of menstrual pain. Objective This study compared the effects of the acupuncture program Chongmai, or Thoroughfare Vessel (TV), to sham acupuncture on primary dysmenorrhea. Methods The current authors selected 3 groups of 10 patients each with primary dysmenorrhea for this comparative, prospective longitudinal study. The first group was treated at the TV points, the second group underwent sham acupuncture, and the third group (control) did not receive any kind of acupuncture. All groups were allowed to use steroidal anti-inflammatory drugs (NSAIDs). Menstrual pain was measured using a visual analogue scale (VAS). The results were analyzed using a Student's-t test in GraphPad Prism 5.0. Acupuncture needles were applied at the following TV acupuncture points: (1) Gongsun (SP 4); (2) Qichong (ST30); (3) Neiguan (PC 6); and (4) Baihuanshu (BL 30), the metameric action point of the pelvic area. Electrical stimulation was applied through each needle at 120 Hz for 40 minutes. Results TV acupuncture, sham acupuncture, and/or NSAIDs substantially reduced pain in all 10 patients in each respective group (100%). TV acupuncture treatment reduced the symptoms of primary dysmenorrhea, and symptoms were reduced for at least 6 months. Application of needles at simulated points away from the TV acupuncture program did not reduce pain significantly. Conclusions TV acupuncture treatment can reduce the symptoms of primary dysmenorrhea, and the effect can last for 6 months. PMID:24761179

  1. Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants: a meta-analysis.

    PubMed Central

    Anderson, I. M.; Tomenson, B. M.

    1995-01-01

    OBJECTIVE--To assess treatment discontinuation rates with selective serotonin reuptake inhibitors compared with tricyclic antidepressants. DESIGN--Meta-analysis of 62 randomised controlled trials. SUBJECTS--6029 patients with major unipolar depression. MAIN OUTCOME MEASURES--Pooled risk ratios for drop out rates with respect to all cases of discontinuation and those due to side effects and treatment failure. RESULTS--The total discontinuation rate was 10% lower with selective serotonin reuptake inhibitors than with tricyclic antidepressants (risk ratio 0.90; 95% confidence interval 0.84 to 0.97) and the drop out rate due to side effects was 25% lower (risk ratio 0.75; 0.66 to 0.84). There was no significant difference between drug classes in the drop out rates for treatment failure. The risk ratios for drop out did not differ significantly between individual selective serotonin reuptake inhibitors. CONCLUSIONS--Selective serotonin reuptake inhibitors are better tolerated than tricyclic antidepressants as measured by total numbers of drop outs. The definite advantage to selective serotonin reuptake inhibitors is explained by fewer drop outs due to side effects. The overall difference, however, is comparatively small and may not be clinically relevant. Analyses of cost effectiveness should not overestimate the advantage to selective serotonin reuptake inhibitors. PMID:7613276

  2. Shockwave-Induced Plasticity Via Large-Scale Nonequilibrium Molecular Dynamics

    NASA Astrophysics Data System (ADS)

    Holian, Brad Lee

    1997-07-01

    In nonequilibrium molecular-dynamics (MD) simulations of shock waves in single crystals, carried out in 1979 at Los Alamos,(B.L. Holian and G.K. Straub, Phys. Rev. Lett. 43), 1598 (1979). we discovered that, above a threshold strength, strongly shocked crystals deform in a very simple way. Rather than experiencing massive deformation, a simple slippage occurs at the shock front, relieving the peak shear stress, and leaving behind a stacking fault. We realized, of course, that real materials could yield at much lower thresholds, and speculated then that pre-existing defects could nucleate plastic flow at lower shock strengths than those characteristic of pure single crystals. (Historical note: at about the same time as our earliest dynamical shockwave simulations, Mogilevsky, working independently in the Soviet Union, carried out relaxation MD calculations under uniaxial strain, and observed spontaneous production of dislocations.(M.A. Mogilevsky, in Shock Waves and High Strain Rate Phenomena in Metals) (Plenum, New York, 1981), p.531.) Further Los Alamos calculations, carried out nearly a decade later in five-times larger systems (up to 10,000 atoms), confirmed this observation and quantified the threshold strength, namely the yield strength of the perfect crystal.(B.L. Holian, Phys. Rev. A 37), 2562 (1988); for a review, see B.L. Holian, Shock Waves 5, 149 (1995). Subsequently, Zaretskii and co-workers,(E.B. Zaretskii, G.I. Kanel, P.A. Mogilevskii, and V.E. Fortov, Sov. Phys. Dokl. 36), 76 (1991). using x-ray diffraction of shocked single crystals, confirmed our MD observations of stacking faults produced by shockwave passage. With the advent of massively parallel computers, we have recently studied systems with over six-times larger cross-sectional area and four-times longer distance of run to the steady state (approximately 270,000 atoms). We have seen that the increased cross-section allows the system to slip along both available forward slip systems, in

  3. Quinolones in treatment of human brucellosis: comparative trial of ofloxacin-rifampin versus doxycycline-rifampin.

    PubMed Central

    Akova, M; Uzun, O; Akalin, H E; Hayran, M; Unal, S; Gür, D

    1993-01-01

    Quinolones have been reported to be active against Brucella species in vitro. In this prospective randomized study, the efficacy and safety of the combination of ofloxacin plus rifampin were compared with the efficacy and safety of doxycycline plus rifampin, both combinations administered for a 6-week period in treatment of brucellosis. Sixty-one patients were enrolled in the study, and 49 had blood or bone marrow cultures positive for Brucella melitensis. Thirty patients received 200 mg of doxycycline plus 600 mg of rifampin once daily, and 31 patients were treated with 400 mg of ofloxacin plus 600 mg of rifampin once daily for 6 weeks. Nine patients in each group had complications of the disease. There was one therapeutic failure in the ofloxacin-rifampin treatment group, and one patient from each group relapsed (3.3% of those in the doxycycline-rifampin treatment group versus 3.2% of those in the ofloxacin-rifampin treatment group). Gastric discomfort was the major side effect observed in 13 patients (43.3%) who received doxycycline plus rifampin, whereas only 2 patients (6.5%) treated with ofloxacin plus rifampin complained of gastric irritation. These results suggest that the combination of ofloxacin plus rifampin administered for 6 weeks is as effective as doxycycline plus rifampin given for the same period, regardless of the presence of complications of the disease. PMID:8239591

  4. Comparative trial of permethrin 5% versus lindane 1% for the treatment of scabies.

    PubMed

    Goldust, Mohamad; Babae Nejad, Shahla; Rezaee, Elham; Raghifar, Ramin

    2013-01-20

    Objective: Treatment of scabies is an important issue in infectious dermatology. The aim of this study was to specify whether permethrin is effective for the treatment of human scabies and to compare its effectiveness with that of 1% lindane by topical application. Methods: 220 patients with scabies with the mean age of 44 ± 12/24 attended the study. Patients were divided into two groups randomly. The first group and their family contacts received 5% permethrin cream and the other received 1% lindane lotion. Treatment was evaluated at intervals of 2 and 4 weeks. Results: Of 254 patients, 220 completed the study. 110 in the group treated with lindane and 110 in the group treated with permethrin. Permethrin provided an improvement rate of 92 (83.6%) after 2 weeks, whereas lindane was effective only in 54 (49%) of patients. After 4 weeks improvement rate was 96.3% (106 of 110) in permethrin group since it was only 69.1% (76 of 110) in lindane group. Conclusion: Permethrin (5%) cream was found to be significantly more effective in the treatment of scabies in comparison with lindane in this study. There were no adverse effects with either permethrin or lindane. PMID:22905702

  5. [Parenteral S-adenosylmethionine compared to placebos in the treatment of alcoholic liver diseases].

    PubMed

    Diaz Belmont, A; Dominguez Henkel, R; Uribe Ancira, F

    1996-01-01

    The improvements in the knowledge of the action of ethanol over the hepatic cell, its direct action over the cell, and the intracytoplasmatic structures membranes, point out the possibilities of use of sulfo-adenosil-L-metionina (SAMe); as an util drug inn the treatment of the altered metilation reactions, that take place in those membranes, facilitating their physiological functions. The primary end point in this study was to demonstrate the therapeutic worth os SAMe, by parenteral route in 45 patients with alcoholic liver disease, which were determined by clinical laboratory and hepatic function test, label qith 32 points or more of the discriminatory function index. Divided into two groups, placebo-SAMe, randomized, double blind. As well as total plasmatic and reduced glutation and lipoperoxidation index, indirect form as malondehaldehyde. Were determined at the first visit anf after 8 and 15 days of treatment. Comparing the results of both groups there were a significative favorable results for the group treatment with SAMe and this confirms the utility of this drug in the treatment of patients with alcoholic liver disease with a discriminatory function index (Maddrey index), of 32 points or more. PMID:8679834

  6. A Comparative Systematic Review of the Optimal CD4 Cell Count Threshold for HIV Treatment Initiation

    PubMed Central

    Mitchell-Fearon, Kathryn

    2014-01-01

    HIV infection is no longer characterized by high morbidity, rapid progression to AIDS, and death as when the infection was first identified. While anti-retroviral drugs have improved the outcome of AIDS patients, clinical research on the appropriate time to initiate therapy continues to evolve. Optimal therapy initiation would maximize the benefits of these drugs, while minimizing side effects and drug resistance. Recent 2013 WHO guidelines changed HIV therapy initiation from 350 cells/μL to 500 cells/μL. This systematic review provides an evidence-based comparison of starting treatment at >500 cells/μL with starting treatment at the range between 350 cells/μL and 500 cells/μL. An 11% increase in risk was detected from initiation therapy at the 350–500 cells/μL range (0.37 [0.26, 0.53]), when compared with starting treatment before 500 cells/μL (0.33 [0.22, 0.48]). Most individual study comparisons showed a benefit for starting treatment at 500 cells/μL in comparison with starting at the 350–500 cells/μL range with risks ranging from 19% to 300%, though a number of comparisons were not statistically significant. Overall, the study provides evidence based support for initiating anti retroviral therapy at cell counts >500 cells/μL wherever possible to prevent AIDS mortality and morbidity. PMID:24778646

  7. Comparative trial of five antimicrobial compounds in the treatment of cholera in adults.

    PubMed

    Khan, W A; Begum, M; Salam, M A; Bardhan, P K; Islam, M R; Mahalanabis, D

    1995-01-01

    To compare the efficacy of ciprofloxacin, erythromycin, nalidixic acid and pivmecillinam in the treatment of tetracycline-resistant strains of Vibrio cholerae O1 in adults, a randomized, open, clinical trial was conducted. A tetracycline group was used for comparison. Seventy-five adult men infected with V. cholerae O1 were randomly assigned to receive either 400 mg pivmecillinam or 500 mg of one of each of the other drugs. Ciprofloxacin was given every 12 h and the others every 6 h for 3 d. The mean total stool volume per kg was 155 mL for the ciprofloxacin group, 212 mL for the erythromycin and pivmecillinam groups, 246 mL for nalidixic acid, and 293 mL for tetracycline. The difference between ciprofloxacin and tetracycline was significant (P = 0.045). After 72 h, diarrhoea had stopped in 14 patients (93%) in the ciprofloxacin group and 12 (80%) in the erythromycin group, compared to 5 (42%) of those receiving tetracycline (P = 0.006 and 0.049, respectively). Bacteriological clearance was 100% at 24 h in patients treated with ciprofloxacin compared to 20% and 8.3% (P < 0.001 for both comparisons) in the erythromycin and tetracycline groups. Ciprofloxacin in conjunction with appropriate fluid therapy was the most effective treatment for cholera in adults; erythromycin was the next best. PMID:7747291

  8. Radiofrequency Ablation Compared to Surgery for the Treatment of Benign Thyroid Nodules

    PubMed Central

    Bernardi, Stella; Dobrinja, Chiara; Fabris, Bruno; Bazzocchi, Gabriele; Sabato, Nicoletta; Ulcigrai, Veronica; Giacca, Massimo; Barro, Enrica; De Manzini, Nicolò; Stacul, Fulvio

    2014-01-01

    Objective. Benign thyroid nodules are a common occurrence whose only remedy, in case of symptoms, has always been surgery until the advent of new techniques, such as radiofrequency ablation (RFA). This study aimed at evaluating RFA efficacy, tolerability, and costs and comparing them to hemithyroidectomy for the treatment of benign thyroid nodules. Design and Methods. 37 patients who underwent RFA were retrospectively compared to 74 patients surgically treated, either in a standard inpatient or in a short-stay surgical regimen. Efficacy, tolerability, and costs were compared. The contribution of final pathology was also taken into account. Results. RFA reduced nodular volume by 70% after 12 months and it was an effective method for treating nodule-related clinical problems, but it was not as effective as surgery for the treatment of hot nodules. RFA and surgery were both safe, although RFA had less complications and pain was rare. RFA costed €1,661.50, surgery costed €4,556.30, and short-stay surgery costed €4,139.40 per patient. RFA, however, did not allow for any pathologic analysis of the nodules, which, in 6 patients who had undergone surgery (8%), revealed that the nodules harboured malignant cells. Conclusions. RFA might transform our approach to benign thyroid nodules. PMID:25045352

  9. Levocloperastine in the treatment of chronic nonproductive cough: comparative efficacy versus standard antitussive agents.

    PubMed

    Aliprandi, P; Castelli, C; Bernorio, S; Dell'Abate, E; Carrara, M

    2004-01-01

    The medical and social impact of cough is substantial. Current antitussive agents at effective doses have adverse events such as drowsiness, nausea and constipation that limit their use. There is also recent evidence that standard antitussive agents, such as codeine, may not reduce cough during upper respiratory infections. Therefore, there is a need for more effective and better-tolerated agents. The efficacy of levocloperastine, a novel antitussive, which acts both centrally on the cough center and on peripheral receptors in the tracheobronchial tree in treating chronic cough, was compared with that of other standard antitussive agents (codeine, levodropropizine and DL-cloperastine) in six open clinical trials. The studies enrolled patients of all ages with cough associated with various respiratory disorders including bronchitis, asthma, pneumonia and chronic obstructive pulmonary disease. Levocloperastine significantly improved cough symptoms (intensity and frequency of cough) in all trials, and improvements were observed after the first day of treatment. In children, levocloperastine reduced nighttime awakenings and irritability, and in adults it was effective in treating cough induced by angiotensin-converting enzyme inhibitors. When compared with other antitussive agents, levocloperastine had improved or comparable efficacy, with a more rapid onset of action. Importantly, no evidence of central adverse events was recorded with levocloperastine, whereas drowsiness was reported by a significant number of patients receiving codeine. Levocloperastine is an effective antitussive agent for the treatment of cough in patients of all ages. It has a more rapid onset of action than standard agents with an improved tolerability profile. PMID:15553659

  10. New Alternatives for Autoimmune Disease Treatments: Physicochemical and Clinical Comparability of Biosimilar Etanercept

    PubMed Central

    Miranda-Hernández, Mariana P.; López-Morales, Carlos A.; Perdomo-Abúndez, Francisco C.; Salazar-Flores, Rodolfo D.; Ramírez-Ibanez, Nancy D.; Pérez, Nestor O.; Molina-Pérez, Aarón; Revilla-Beltri, Jorge; Flores-Ortiz, Luis F.; Medina-Rivero, Emilio

    2016-01-01

    Etanercept is a recombinant fusion protein approved for the treatment of TNF-α mediated diseases such as rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, and ankylosing spondylitis. Herein, we present an evaluation of the physicochemical and biological properties of a biosimilar etanercept and its reference product followed by a clinical study in patients diagnosed with RA intended to demonstrate comparability of their immunomodulatory activity. Identity analyses showed a total correspondence of the primary and higher-order structure between the two products. In regard to intrinsic heterogeneity, both products showed to be highly heterogenous; however the biosimilar etanercept exhibited similar charge and glycan heterogeneity intervals compared to the reference product. Apoptosis inhibition assay also showed that, despite the high degree of heterogeneity exhibited by both products, no significant differences exist in their in vitro activity. Finally, the clinical assessment conducted in RA-diagnosed patients did not show significant differences in the evaluated pharmacodynamic markers of both products. Collectively, the results from the comparability exercise provide convincing evidence that the evaluated biosimilar etanercept can be considered an effective alternative for the treatment of RA. PMID:27382576

  11. Stigma, Discrimination, Treatment Effectiveness and Policy Support: Comparing Public Views about Drug Addiction with Mental Illness

    PubMed Central

    Barry, Colleen L; McGinty, Emma Elizabeth; Pescosolido, Bernice; Goldman, Howard H.

    2014-01-01

    Objective This study compares current public attitudes about drug addiction with attitudes about mental illness. Methods A web-based national public opinion survey (N=709) was conducted to compare attitudes about stigma, discrimination, treatment effectiveness, and policy support. Results Respondents hold significantly more negative views toward persons with drug addiction compared to those with mental illness. More respondents were unwilling to have a person with drug addiction marry into their family or work closely with them on a job. Respondents were more willing to accept discriminatory practices, more skeptical about the effectiveness of available treatments, and more likely to oppose public policies aimed at helping persons with drug addiction. Conclusions Drug addiction is often treated as a sub-category of mental illness, and health insurance benefits group these conditions together under the rubric of behavioral health. Given starkly different public views about drug addiction and mental illness, advocates may need to adopt differing approaches for advancing stigma reduction and public policy. PMID:25270497

  12. Comparative LCA of decentralized wastewater treatment alternatives for non-potable urban reuse.

    PubMed

    Opher, Tamar; Friedler, Eran

    2016-11-01

    Municipal wastewater (WW) effluent represents a reliable and significant source for reclaimed water, very much needed nowadays. Water reclamation and reuse has become an attractive option for conserving and extending available water sources. The decentralized approach to domestic WW treatment benefits from the advantages of source separation, which makes available simple small-scale systems and on-site reuse, which can be constructed on a short time schedule and occasionally upgraded with new technological developments. In this study we perform a Life Cycle Assessment to compare between the environmental impacts of four alternatives for a hypothetical city's water-wastewater service system. The baseline alternative is the most common, centralized approach for WW treatment, in which WW is conveyed to and treated in a large wastewater treatment plant (WWTP) and is then discharged to a stream. The three alternatives represent different scales of distribution of the WW treatment phase, along with urban irrigation and domestic non-potable water reuse (toilet flushing). The first alternative includes centralized treatment at a WWTP, with part of the reclaimed WW (RWW) supplied back to the urban consumers. The second and third alternatives implement de-centralized greywater (GW) treatment with local reuse, one at cluster level (320 households) and one at building level (40 households). Life cycle impact assessment results show a consistent disadvantage of the prevailing centralized approach under local conditions in Israel, where seawater desalination is the marginal source of water supply. The alternative of source separation and GW reuse at cluster level seems to be the most preferable one, though its environmental performance is only slightly better than GW reuse at building level. Centralized WW treatment with urban reuse of WWTP effluents is not advantageous over decentralized treatment of GW because the supply of RWW back to consumers is very costly in materials and

  13. Energy implications of mechanical and mechanical–biological treatment compared to direct waste-to-energy

    SciTech Connect

    Cimpan, Ciprian Wenzel, Henrik

    2013-07-15

    Highlights: • Compared systems achieve primary energy savings between 34 and 140 MJ{sub primary}/100 MJ{sub input} {sub waste.} • Savings magnitude is foremost determined by chosen primary energy and materials production. • Energy consumption and process losses can be upset by increased technology efficiency. • Material recovery accounts for significant shares of primary energy savings. • Direct waste-to-energy is highly efficient if cogeneration (CHP) is possible. - Abstract: Primary energy savings potential is used to compare five residual municipal solid waste treatment systems, including configurations with mechanical (MT) and mechanical–biological (MBT) pre-treatment, which produce waste-derived fuels (RDF and SRF), biogas and/or recover additional materials for recycling, alongside a system based on conventional mass burn waste-to-energy and ash treatment. To examine the magnitude of potential savings we consider two energy efficiency levels (state-of-the-art and best available technology), the inclusion/exclusion of heat recovery (CHP vs. PP) and three different background end-use energy production systems (coal condensing electricity and natural gas heat, Nordic electricity mix and natural gas heat, and coal CHP energy quality allocation). The systems achieved net primary energy savings in a range between 34 and 140 MJ{sub primary}/100 MJ{sub input} {sub waste}, in the different scenario settings. The energy footprint of transportation needs, pre-treatment and reprocessing of recyclable materials was 3–9.5%, 1–18% and 1–8% respectively, relative to total energy savings. Mass combustion WtE achieved the highest savings in scenarios with CHP production, nonetheless, MBT-based systems had similarly high performance if SRF streams were co-combusted with coal. When RDF and SRF was only used in dedicated WtE plants, MBT-based systems totalled lower savings due to inherent system losses and additional energy costs. In scenarios without heat

  14. Essential elements of treatment: a comparative study between European and American therapeutic communities for addiction.

    PubMed

    Goethals, Ilse; Soyez, Veerle; Melnick, Gerald; De Leon, George; Broekaert, Eric

    2011-01-01

    The purpose of this study was to investigate whether European and American therapeutic communities (TCs) for addiction, both traditional and modified, share a common perspective on what is essential in treatment using the Survey of Essential Elements Questionnaire (SEEQ). The European sample (N = 19) was gathered in 2009. For the American sample (N = 19), we used previously published research data. Despite comparable perspectives, European traditional TCs (N = 11) scored significantly higher than their American predecessors (N = 11) on four SEEQ domains. Cluster differences were more pronounced in Europe than in America. PMID:21235341

  15. Comparative study of actinic keratosis treatment with 3% diclofenac sodium and 5% 5-fluorouracil*

    PubMed Central

    Segatto, Majoriê Mergen; Dornelles, Sérgio Ivan Torres; Silveira, Vera Bauer; Frantz, Gabriela de Oliveira

    2013-01-01

    BACKGROUND Actinic keratosis is a frequent lesion which occurs in sunlight exposed areas. Diclofenac sodium and 5-Fluorouracil are effective, non-invasive and easy-to-apply topical treatment options. OBJECTIVES To assess and compare the effectiveness of 3% diclofenac sodium associated with 2.5% hyaluronic acid and of 5% 5-Fluorouracil for the treatment of actinic keratosis, as well as the patient's degree of satisfaction and tolerability. METHODS 28 patients with a clinical diagnosis of actinic keratosis were randomized to receive diclofenac sodium or 5-Fluorouracil and were clinically assessed before and after treatment as well as 8 weeks after the end of treatment. Modified versions of the Investigator and Patient Global Improvement Scores were used. RESULTS The average number of lesions in the diclofenac sodium group before and after treatment was 13.6 and 6.6 (p<0,001), respectively, while it was 17.4 and 3.15 (p<0.001) in the 5-Fluorouracil group. There was a significant reduction in the number of lesions in the 5-Fluorouracil group in relation to the diclofenac sodium group (p<0.001). To the non-blinded physician, there was a higher satisfactory therapeutic response in the 5-Fluorouracil group (p<0.001); to the blinded physician, there was a higher satisfactory response in this same group, although not statistically significant (p=0.09). There was a high degree of satisfaction in both groups (73% in the diclofenac sodium group and 77% in the 5-Fluorouracil group; p=0.827). Regarding adverse effects, the diclofenac sodium group presented a higher degree of satisfaction (93.3% vs 38.4%; p=0.008). Erythema, edema, crusts and itching were significantly higher in the 5-Fluorouracil group. CONCLUSION We concluded that 5-Fluorouracil was more effective; however, it showed lower tolerability than diclofenac sodium. PMID:24173178

  16. A randomized trial comparing levothyroxine with radioactive iodine in the treatment of sporadic nontoxic goiter.

    PubMed

    Wesche, M F; Tiel-V Buul, M M; Lips, P; Smits, N J; Wiersinga, W M

    2001-03-01

    A randomized clinical trial was performed in consecutive patients with sporadic nontoxic nodular goiter to compare efficacy and side effects of iodine-131 ((131)I) therapy with suppressive levothyroxine (L-thyroxine) treatment. Sixty-four patients were randomized after stratification for sex and menopausal age to receive (131)I (4.44 MBq/g thyroid; group A) or suppressive L-thyroxine treatment aiming at TSH values between 0.01 and 0.1 mU/L (group B). The main outcome measurements after 2 yr were goiter size by ultrasound, serum thyroid function tests, markers of bone turnover, and bone mineral density (BMD). Fifty-seven patients completed the trial. Goiter size was reduced after 2 yr by 44% in group A and by 1% in group B (P< 0.001). Nonresponders (goiter reduction <13%) were 1 of 29 patients in group A and 16 of 28 patients in group B (P = 0.00001). In responders, goiter reduction in group A (46%) was greater than in group B (22%; P< 0.005). In group A, 45% of patients developed hypothyroidism. In group B, 10 patients experienced thyrotoxic symptoms, requiring discontinuation of treatment in 2 (in 1 because of atrial fibrillation). Markers of bone formation and bone resorption increased significantly in group B, related to a mean decrease of 3.6% of BMD at the lumbar spine after 2 yr (from 1.09 +/- 0.22 to 1.05 +/- 0.23 g/cm(2); P< 0.001), both in pre- and postmenopausal women. No changes in BMD were observed in group A. In conclusion, (131)I therapy is more effective and better tolerated than L-thyroxine treatment in patients with sporadic nontoxic goiter. Suppressive L-thyroxine treatment results in significant bone loss. PMID:11238476

  17. Comparative dosimetry study of three UK centres implementing total skin electron treatment through external audit

    PubMed Central

    Gonzalez, R; McGovern, M; Greener, A

    2015-01-01

    Objective: This article describes the external audit measurements conducted in two UK centres implementing total skin electron beam therapy (TSEBT) and the results obtained. Methods: Measurements of output, energy, beam flatness and symmetry at a standard distance (95 or 100 cm SSD) were performed using a parallel plate chamber in solid water. Similarly, output and energy measurements were also performed at the treatment plane for single and dual fields. Clinical simulations were carried out using thermoluminescent dosemeters (TLDs) and Gafchromic® film (International Specialty Products, Wayne, NJ) on an anthropomorphic phantom. Results: Extended distance measurements confirmed that local values for the beam dosimetry at Centres A and B were within 2% for outputs and 1-mm agreement of the expected depth at which the dose is 50% of the maximum for the depth–dose curve in water (R50,D) value. Clinical simulation using TLDs) showed an agreement of −1.6% and −6.7% compared with the expected mean trunk dose for each centre, respectively, and a variation within 10% (±1 standard deviation) across the trunk. The film results confirmed that the delivery of the treatment technique at each audited centre complies with the European Organisation for Research and Treatment of Cancer recommendations. Conclusion: This audit methodology has proven to be a successful way to confirm the agreement of dosimetric parameters for TSEBT treatments at both audited centres and could serve as the basis for an audit template to be used by other audit groups. Advances in knowledge: TSEBT audits are not established in the UK owing to a limited number of centres carrying out the treatment technique. This article describes the audits performed at two UK centres prior to their clinical implementation. PMID:25761213

  18. Comparative analyses of linac and Gamma Knife radiosurgery for trigeminal neuralgia treatments

    NASA Astrophysics Data System (ADS)

    Ma, L.; Kwok, Y.; Chin, L. S.; Yu, C.; Regine, W. F.

    2005-11-01

    Dedicated linac-based radiosurgery has been reported for trigeminal neuralgia treatments. In this study, we investigated the dose fall-off characteristics and setup error tolerance of linac-based radiosurgery as compared with standard Gamma Knife radiosurgery. In order to minimize the errors from different treatment planning calculations, consistent imaging registration, dose calculation and dose volume analysis methods were developed and implemented for both Gamma Knife and linac-based treatments. Intra-arc setup errors were incorporated into the treatment planning process of linac-based deliveries. The effects of intra-arc setup errors with increasing number of arcs were studied and benchmarked against Gamma Knife deliveries with and without plugging patterns. Our studies found equivalent dose fall-off properties between Gamma Knife and linac-based radiosurgery given a sufficient number of arcs (>7) and small intra-arc errors (<0.5 mm) were satisfied for linac-based deliveries. Increasing the number of arcs significantly decreased the variations in the dose fall-off curve at the low isodose region (e.g. from 40% to 10%) and also improved dose uniformity at the high isodose region (e.g. from 70% to 90%). As the number of arcs increased, the effects of intra-arc setup errors on the dose fall-off curves decreased. Increasing the number of arcs also reduced the integral dose to the distal normal brain tissues. In conclusion, linac-based radiosurgery produces equivalent dose fall-off characteristics to Gamma Knife radiosurgery with a high number of arcs. However, one must note the increased treatment time for a large number of arcs and isocentre accuracies.

  19. Comparing treatments for age-related macular degeneration: safety, effectiveness and cost.

    PubMed

    Maguire, Maureen G

    2012-06-01

    Comparative effectiveness research (CER) has received widespread attention and federal funding because of its potential to inform and improve treatment decisions. Since 2005, patients and their ophthalmologists have faced a dilemma in treating age-related macular degeneration (AMD)--the leading cause of blindness in the United States. Two closely related drugs have produced dramatic improvements in vision; one has been rigorously tested for use in AMD patients, while the other has been rigorously tested for use in cancer patients, but is now widely used to treat AMD. One drug costs 40 times as much as the other. This Issue Brief summarizes a CER study comparing these drugs head-to-head, and provides the most definitive evidence to date about the safety and effectiveness of the two alternatives. PMID:22754971

  20. Dislocation-kinetic analysis of FCC and BCC crystal spallation under shock-wave loading

    NASA Astrophysics Data System (ADS)

    Malygin, G. A.; Ogarkov, S. L.; Andriyash, A. V.

    2015-09-01

    Within the dislocation-kinetic model of the formation and propagation of shock waves in crystals under their intense shock-wave loading, the crystal spallation mechanism at micro- and macrolevels has been discussed taking into account published empirical data. It has been shown that the spallation time t f for Cu, Ni, α-Fe, and Ta crystals in the time interval of 10-6-10-9 s at the macroscopic level changes with variations in the wave pressure σ as , where = is the plastic strain rate according to the Swegle-Grady relation; K f , K σ, and ɛ f = K f K σ ≈ 3-5% are the pressure-independent spallation coefficients and strain, respectively; and E is the Young's modulus. At the microlevel, the dislocation-kinetic calculation of plastic zones around pore nuclei as stress concentrators and plastic strain localization regions at the shock wave front has been performed. It has been shown that the pore coalescence and spall fracture formation result from the superposition of shear stresses and plastic deformations in interpore spacings when the latter decrease to a size of the order of two pore sizes.

  1. Shockwave-Driven, Supersonic Kelvin-Helmholtz Instability Experiment on OMEGA-EP

    NASA Astrophysics Data System (ADS)

    Wan, Wesley; Malamud, Guy; di Stefano, Carlos; Kuranz, Carolyn; Drake, R. Paul

    2013-10-01

    Hydrodynamic instabilities are commonly encountered in a variety of high-energy-density systems, including fusion experiments and various astrophysical processes. Shear flow at a fluid interface gives rise to the Kelvin-Helmholtz instability, which then results in mixing between the layers. This talk will cover a recent experiment performed at the OMEGA-EP facility that studied the dampening of the Kelvin-Helmholtz instability as a result of compressibility effects in a high convective Mach number regime. A laser-driven shockwave was used to create shear flow between a low-density foam and high-density plastic. The instability growth was assisted by seeded, single-mode perturbations of varied wavelengths. Our primary diagnostic was x-ray radiography. This work is funded by the NNSA-DS and SC-OFES Joint Program in High-Energy-Density Laboratory Plasmas, grant number DE-FG52-09NA29548, and by the National Laser User Facility Program, grant number DE-NA0000850, with additional support provided under Cooperative Agreement No. DE-FC52-08NA28302 through the Laboratory for Laser Energetics, University of Rochester.

  2. Shooter position estimation with muzzle blast and shockwave measurements from separate locations

    NASA Astrophysics Data System (ADS)

    Grasing, David

    2016-05-01

    There are two acoustical events associated with small arms fire: the muzzle blast (created by bullets being expelled from the barrel of the weapon), and the shockwave (created by bullets which exceed the speed of sound). Assuming the ballistics of a round are known, the times and directions of arrival of the acoustic events furnish sufficient information to determine the origin of the shot. Existing methods tacitly assume that it is a single sensor which makes measurements of the times and direction of arrival. If the sensor is located past the point where the bullet goes transonic or if the sensor is far off the axis of the shot line a single sensor localization become highly inaccurate due to the ill-conditioning of the localization problem. In this paper, a more general approach is taken which allows for localizations from measurements made at separate locations. There are considerable advantages to this approach, the most noteworthy of which is the improvement in localization accuracy due to the improvement in the conditioning of the problem. Additional benefits include: the potential to locate in cases where a single sensor has insufficient information, furnishing high quality initialization to data fusion algorithms, and the potential to identify the round from a set of possible rounds.

  3. In vitro sonoluminescence and sonochemistry studies with an electrohydraulic shock-wave lithotripter.

    PubMed

    Matula, Thomas J; Hilmo, Paul R; Bailey, Michael R; Crum, Lawrence A

    2002-09-01

    Sonoluminescence and sonochemistry from a cavitation field generated by an electrohydraulic shock-wave lithotripter were investigated as functions of spark discharge voltage (13 to 21 kV) and pulse-repetition frequency (PRF) (0.5 to 2.0 Hz). Sonochemical activity, measured with an iodide dosimeter, increased with both voltage and PRF. Sonoluminescence was measured in an acoustically matched light-tight box. The envelope of the light intensity was measured in a temporally gated region extending from the initial arrival of the shock wave (resulting in bubble compression) to the final inertial collapse of the bubble cloud, which follows hundreds of micros after passage of the shock wave. The initial compression resulted in greater sonoluminescence emissions, suggesting that the initial bubble compression due to the leading positive pressure spike from the lithotripter generated higher temperatures than the inertial collapse of the bubble. These unexpected results are consistent with some recent calculations in which the vapor pressure of the liquid limits compressional heating. PMID:12401391

  4. Calibration of Wire-Like Manganin Gauges for Use in Planar Shock-Wave Experiments

    NASA Astrophysics Data System (ADS)

    Chapman, David; Proud, William

    2009-06-01

    Peizoresistive gauges have been used extensively for many decades as in-material stress transducers during shock wave experiments. Manganin demonstrates a high piezoresistive response which is relatively temperature independent. As such manganin gauges have been widely calibrated by many authors for use during shock-wave experiments. The precise calibration has been demonstrated to depend on both the chemical composition and mechanical history of the manganin, and on the geometry of the gauge. The research presented in this paper refers to the calibration of a commercially available manganin gauge, Micro-measurements J2M-SS-580SF-025, generally referred to as the T-gauge owing to its geometry. The T-gauge has seen widespread use as a pressure transducer to measure lateral stress during plate-impact experiments. It has been previously proposed that T-gauges have a similar response to the grid foil-like manganin gauges extensively calibrated by Rosenberg et. al.. However, recently it has been suggested that they in fact behave in a wire-like manner. The results presented here demonstrate that the gauges behaviour is wire-like when mounted to measure longitudinal stress. A modified calibration can be applied successfully to convert the relative resistance change to the stress normal to the gauge element. These results have important ramifications for the reduction of lateral stress measurements previously made using the T-gauge.

  5. Calibration of Wire-Like Manganin Gauges for Use in Planar Shock-Wave Experiments

    NASA Astrophysics Data System (ADS)

    Chapman, David J.; Braithwaite, Christopher H.; Proud, William G.

    2009-12-01

    Piezoresistive gauges have been used extensively for many decades as in-material stress transducers during shock wave experiments. Manganin demonstrates a high piezoresistive response which is relatively temperature independent. As such manganin gauges have been widely calibrated by many authors for use during shock-wave experiments. The precise calibration has been demonstrated to depend on both the chemical composition and mechanical history of the manganin, and on the geometry of the gauge. The research presented in this paper refers to the calibration of a commercially available manganin gauge, Micro-measurements J2M-SS-580SF-025, generally referred to as the T-gauge owing to its geometry. The T-gauge has seen widespread use as a pressure transducer to measure lateral stress during plate-impact experiments. It has been previously proposed that T-gauges have a similar response to the grid foil-like manganin gauges extensively calibrated by Rosenberg et al. However, recently it has been suggested that they in fact behave in a wire-like manner. The results presented here demonstrate that the gauges' behaviour is wire-like when mounted to measure longitudinal stress. A modified calibration can be applied successfully to convert the relative resistance change to the stress normal to the gauge element. These results have important ramifications for the reduction of lateral stress measurements previously made using the T-gauge.

  6. Cardiac shockwave therapy improves myocardial function in patients with refractory coronary artery disease by promoting VEGF and IL-8 secretion to mediate the proliferation of endothelial progenitor cells

    PubMed Central

    CAI, HONG-YAN; LI, LIN; GUO, TAO; WANG, YU; MA, TIE-KUN; XIAO, JIAN-MING; ZHAO, LING; FANG, YIN; YANG, PING; ZHAO, HU

    2015-01-01

    Cardiac shockwave therapy (CSWT) is a potential and effective remedy to promote revascularization in the ischemic myocardium of patients with refractory coronary heart disease (CHD). The technique is both safe and non-invasive; however, the underlying molecular mechanism remains unclear. The aim of this study was to evaluate the efficacy of CSWT in treating CHD patients and investigate a potential mechanism. A total of 26 patients with CHD were enrolled in the study, and CSWT was performed over a 3-month period. The efficacy of CSWT was assessed using several clinical parameters. Peripheral blood (PB) was collected prior to and following treatment. The number of circulating endothelial progenitor cells (EPCs) in the PB was counted using a flow cytometer, and the levels of vascular endothelial growth factor (VEGF), interleukin-8 (IL-8), stromal cell-derived factor 1 and matrix metalloproteinase 9 in the PB were analyzed. Mononuclear cells were isolated from the PB and cultured in vitro. The EPCs and EPC-colony forming units (EPC-CFUs) in the PB mononuclear cell culture were counted using an inverted phase contrast microscope. Following CSWT, the tested clinical parameters were significantly improved. The levels of circulating EPCs, VEGF and IL-8 in the PB were significantly increased, as were the EPCs and EPC-CFUs from the PB mononuclear cell culture. We suggest that EPC proliferation, mediated by VEGF and IL-8 secretion, may be among the potential mechanisms associated with CSWT. PMID:26668649

  7. A comparative study on thermomechanical pulping pressate treatment using thermophilic and mesophilic sequencing batch reactors.

    PubMed

    Zheng, Meiru; Liao, B Q

    2014-01-01

    A comparative study on the treatment of thermomechanical pulping (TMP) pressate was conducted under thermophilic (55 degrees C) and mesophilic (30 degrees C) temperatures to explore in-mill biological treatment, with the intention to operate under heat-efficient conditions. The experimental study involved sequencing batch reactors (SBRs) operated over 114 days. Receiving a total influent chemical oxygen demand (COD) of 3700-4100 mg L(-1), the COD removal efficiencies of 80-90% and 75-85% were achieved for the mesophilic and thermophilic SBRs, respectively, at a hydraulic retention time (HRT) of 12 and 24h. Excellent sludge settleability (sludge volume index < 100 mL g(-1) mixed liquor suspended solids) was obtained at both thermophilic and mesophilic SBRs. A higher level of effluent suspended solids was observed under thermophilic conditions. The results support the feasibility of applying thermophilic biological treatment of TMP pressate. The treated effluent has the potential for subsequent reuse as process water after polishing, thus addressing the long-standing desire to develop water system closure for the pulp and paper mill operation. PMID:24701939

  8. Comparing dynamic treatment regimes using repeated-measures outcomes: modeling considerations in SMART studies.

    PubMed

    Lu, Xi; Nahum-Shani, Inbal; Kasari, Connie; Lynch, Kevin G; Oslin, David W; Pelham, William E; Fabiano, Gregory; Almirall, Daniel

    2016-05-10

    A dynamic treatment regime (DTR) is a sequence of decision rules, each of which recommends a treatment based on a patient's past and current health status. Sequential, multiple assignment, randomized trials (SMARTs) are multi-stage trial designs that yield data specifically for building effective DTRs. Modeling the marginal mean trajectories of a repeated-measures outcome arising from a SMART presents challenges, because traditional longitudinal models used for randomized clinical trials do not take into account the unique design features of SMART. We discuss modeling considerations for various forms of SMART designs, emphasizing the importance of considering the timing of repeated measures in relation to the treatment stages in a SMART. For illustration, we use data from three SMART case studies with increasing level of complexity, in autism, child attention deficit hyperactivity disorder, and adult alcoholism. In all three SMARTs, we illustrate how to accommodate the design features along with the timing of the repeated measures when comparing DTRs based on mean trajectories of the repeated-measures outcome. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26638988

  9. Four alginate dressings in the treatment of partial thickness wounds: a comparative experimental study.

    PubMed

    Agren, M S

    1996-03-01

    Alginate-based absorption materials for wound treatment are meeting with increasing clinical acceptance. The purpose of this study was to compare four different calcium alginate dressings (Algosteril, Comfeel Alginate, Kaltostat and Sorbsan) with respect to wound fluid retaining ability, adherence, dressing residues, epithelialisation and inflammatory cell infiltration using a standardised partial-thickness wound model in domestic pigs. Wound fluid spread laterally onto surrounding normal skin by about 40% more with Sorbsan than with the other alginate dressings after 24 h of treatment (P = 0.026). The corresponding figure after 66 h of treatment was 20% (P = 0.030). Algosteril (mean 1.7 [sem 0.3]) adhered significantly (P = 0.014) more to the wounds than Comfeel Alginate (mean 0.2 [0.2]). Kaltostat (mean 1.8 [0.3]) left significantly (P = 0.038) more dressing residues on the wound surface at dressing removal than the Comfeel Alginate dressing (mean 0.8 [0.2]). In the effect on epithelialisation or dermal inflammation there was no statistically significant difference at significance level 5% among the four alginate dressings, as assessed by light microscopy. In summary, the four alginate dressings showed significant differences in important handling characteristics and did not differ significantly in their effect on epithelialisation. PMID:8733355

  10. Mixed-waste treatment -- What about the residuals? A comparative analysis of MSO and incineration

    SciTech Connect

    1993-06-01

    This report examines the issues concerning final waste forms, or residuals, that result from the treatment of mixed waste in molten salt oxidation (MSO) and incinerator systems. MSO is a technology with the potential to treat a certain segment of the waste streams at US Department of Energy (DOE) sites. MSO was compared with incineration because incineration is the best demonstrated available technology (BDAT) for the same waste streams. The Grand Junction Projects Office (GJPO) and Oak Ridge National Laboratory (ORNL) prepared this report for the DOE Office of Environmental Restoration (OER). The goals of this study are to objectively evaluate the anticipated residuals from MSO and incineration, examine regulatory issues for these final waste forms, and determine secondary treatment options. This report, developed to address concerns that MSO residuals present unique disposal difficulties, is part of a larger effort to successfully implement MSO as a treatment technology for mixed and hazardous waste. A Peer Review Panel reviewed the MSO technology in November 1991, and the implementation effort is ongoing under the guidance of the MSO Task Force.