WE-AB-202-03: Quantifying Ventilation Change Due to Radiation Therapy Using 4DCT Jacobian Calculations

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

Patton, T; Du, K; Bayouth, J

Purpose: Four-dimensional computed tomography (4DCT) and image registration can be used to determine regional lung ventilation changes after radiation therapy (RT). This study aimed to determine if lung ventilation change following radiation therapy was affected by the pre-RT ventilation of the lung. Methods: 13 subjects had three 4DCT scans: two repeat scans acquired before RT and one three months after RT. Regional ventilation was computed using Jacobian determinant calculations on the registered 4DCT images. The post-RT ventilation map was divided by the pre-RT ventilation map to get a voxel-by-voxel Jacobian ratio map depicting ventilation change over the course of RT.more » Jacobian ratio change was compared over the range of delivered doses. The first pre-RT ventilation image was divided by the second to establish a control for Jacobian ratio change without radiation delivered. The functional change between scans was assessed using histograms of the Jacobian ratios. Results: There were significantly (p < 0.05) more voxels that had a large decrease in Jacobian ratio in the post-RT divided by pre-RT map (15.6%) than the control (13.2%). There were also significantly (p < .01) more voxels that had a large increase in Jacobian ratio (16.2%) when compared to control (13.3%). Lung regions with low function (<10% expansion by Jacobian) showed a slight linear reduction in expansion (0.2%/10 Gy delivered), while high function regions (>10% expansion) showed a greater response (1.2% reduction/10 Gy). Contiguous high function regions > 1 liter occurred in 11 of 13 subjects. Conclusion: There is a significant change in regional ventilation following a course of radiation therapy. The change in Jacobian following RT is dependent both on the delivered dose and the initial ventilation of the lung tissue: high functioning lung has greater ventilation loss for equivalent radiation doses. Substantial regions of high function lung tissue are prevalent. Research support from NIH grants CA166119 and CA166703, a gift from Roger Koch, and a Pilot Grant from University of Iowa Carver College of Medicine.« less

A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators

PubMed Central

Thille, Arnaud W.; Lyazidi, Aissam; Richard, Jean-Christophe M.; Galia, Fabrice; Brochard, Laurent

2009-01-01

Objective To compare 13 commercially available, new-generation, intensive-care-unit (ICU) ventilators regarding trigger function, pressurization capacity during pressure-support ventilation (PSV), accuracy of pressure measurements and expiratory resistance. Design and Setting Bench study at a research laboratory in a university hospital. Material Four turbine-based ventilators and nine conventional servo-valve compressed-gas ventilators were tested using a two-compartment lung model. Results Three levels of effort were simulated. Each ventilator was evaluated at four PSV levels (5, 10, 15, and 20 cm H2O), with and without positive end-expiratory pressure (5 cm H2O, Trigger function was assessed as the time from effort onset to detectable pressurization. Pressurization capacity was evaluated using the airway pressure-time product computed as the net area under the pressure-time curve over the first 0.3 s after inspiratory effort onset. Expiratory resistance was evaluated by measuring trapped volume in controlled ventilation. Significant differences were found across the ventilators, with a range of triggering-delay from 42 ms to 88 ms for all conditions averaged (P<.001). Under difficult conditions, the triggering delay was longer than 100 ms and the pressurization was poor with five ventilators at PSV5 and three at PSV10, suggesting an inability to unload patient’s effort. On average, turbine-based ventilators performed better than conventional ventilators, which showed no improvement compared to a 2000 bench comparison. Conclusion Technical performances of trigger function, pressurization capacity and expiratory resistance vary considerably across new-generation ICU ventilators. ICU ventilators seem to have reached a technical ceiling in recent years, and some ventilators still perform inadequately. PMID:19352622

A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators.

PubMed

Thille, Arnaud W; Lyazidi, Aissam; Richard, Jean-Christophe M; Galia, Fabrice; Brochard, Laurent

2009-08-01

To compare 13 commercially available, new-generation, intensive-care-unit (ICU) ventilators in terms of trigger function, pressurization capacity during pressure-support ventilation (PSV), accuracy of pressure measurements, and expiratory resistance. Bench study at a research laboratory in a university hospital. Four turbine-based ventilators and nine conventional servo-valve compressed-gas ventilators were tested using a two-compartment lung model. Three levels of effort were simulated. Each ventilator was evaluated at four PSV levels (5, 10, 15, and 20 cm H2O), with and without positive end-expiratory pressure (5 cm H2O). Trigger function was assessed as the time from effort onset to detectable pressurization. Pressurization capacity was evaluated using the airway pressure-time product computed as the net area under the pressure-time curve over the first 0.3 s after inspiratory effort onset. Expiratory resistance was evaluated by measuring trapped volume in controlled ventilation. Significant differences were found across the ventilators, with a range of triggering delays from 42 to 88 ms for all conditions averaged (P < 0.001). Under difficult conditions, the triggering delay was longer than 100 ms and the pressurization was poor for five ventilators at PSV5 and three at PSV10, suggesting an inability to unload patient's effort. On average, turbine-based ventilators performed better than conventional ventilators, which showed no improvement compared to a bench comparison in 2000. Technical performance of trigger function, pressurization capacity, and expiratory resistance differs considerably across new-generation ICU ventilators. ICU ventilators seem to have reached a technical ceiling in recent years, and some ventilators still perform inadequately.

WE-FG-206-08: Pulmonary Functional Imaging Biomarkers of NSCLC to Guide and Optimize Functional Lung Avoidance Radiotherapy

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

Sheikh, Khadija; Capaldi, Dante PI; Parraga, Grace

Purpose: Functional lung avoidance radiotherapy promises optimized therapy planning by minimizing dose to well-functioning lung and maximizing dose to the rest of the lung. Patients with NSCLC commonly present with co-morbid COPD and heterogeneously distributed ventilation abnormalities stemming from emphysema, airways disease, and tumour burden. We hypothesized that pulmonary functional imaging methods may be used to optimize radiotherapy plans to avoid regions of well-functioning lung and significantly improve outcomes like quality-of-life and survival. To ascertain the utility of functional lung avoidance therapy in clinical practice, we measured COPD phenotypes in NSCLC patients enrolled in a randomized-controlled-clinical-trial prior to curative intentmore » therapy. Methods: Thirty stage IIIA/IIIB NSCLC patients provided written informed consent to a randomized-controlled-clinical-trial ( http://clinicaltrials.gov/ct2/show/NCT02002052 ) comparing outcomes in patients randomized to standard or image-guided radiotherapy. Hyperpolarized noble gas MRI ventilation-defect-percent (VDP) (Kirby et al, Acad Radiol, 2012) as well as CT-emphysema measurements were determined. Patients were stratified based on quantitative imaging evidence of ventilation-defects and emphysema into two subgroups: 1) tumour-specific ventilation defects only (TSD), and, 2) tumour-specific and other ventilation defects with and without emphysema (TSD{sub VE}). Receiver-operating-characteristic (ROC) curves were used to characterize the performance of clinical measures as predictors of the presence of non-tumour specific ventilation defects. Results: Twenty-one out of thirty subjects (70%) had non-tumour specific ventilation defects (TSD{sub VE}) and nine subjects had ONLY tumour-specific defects (TSD). Subjects in the TSD{sub VE} group had significantly greater smoking-history (p=.006) and airflow obstruction (FEV{sub 1}/FVC) (p=.001). ROC analysis demonstrated an 87% classification rate for smoking pack-years, 90% for FEV{sub 1}/FVC, and 56% for tumour RECIST measurements for identifying patients with non-tumour and tumour-specific ventilation abnormalities. Conclusion: 70% of NSCLC patients had ventilation abnormalities stemming from emphysema, airways disease and tumour burden. Smoking-history and airflow obstruction, but not RECIST, identified NSCLC patients with ventilation abnormalities appropriate for functional lung avoidance therapy.« less

PDF4LHC recommendations for LHC Run II

DOE PAGES

Butterworth, Jon; Carrazza, Stefano; Cooper-Sarkar, Amanda; ...

2016-01-06

We provide an updated recommendation for the usage of sets of parton distribution functions (PDFs) and the assessment of PDF and PDF+αs uncertainties suitable for applications at the LHC Run II. We review developments since the previous PDF4LHC recommendation, and discuss and compare the new generation of PDFs, which include substantial information from experimental data from the Run I of the LHC. We then propose a new prescription for the combination of a suitable subset of the available PDF sets, which is presented in terms of a single combined PDF set. Lastly, we finally discuss tools which allow for themore » delivery of this combined set in terms of optimized sets of Hessian eigenvectors or Monte Carlo replicas, and their usage, and provide some examples of their application to LHC phenomenology.« less

Continuous distributions of specific ventilation recovered from inert gas washout

NASA Technical Reports Server (NTRS)

Lewis, S. M.; Evans, J. W.; Jalowayski, A. A.

1978-01-01

A new technique is described for recovering continuous distributions of ventilation as a function of tidal ventilation/volume ratio from the nitrogen washout. The analysis yields a continuous distribution of ventilation as a function of tidal ventilation/volume ratio represented as fractional ventilations of 50 compartments plus dead space. The procedure was verified by recovering known distributions from data to which noise had been added. Using an apparatus to control the subject's tidal volume and FRC, mixed expired N2 data gave the following results: (a) the distributions of young, normal subjects were narrow and unimodal; (b) those of subjects over age 40 were broader with more poorly ventilated units; (c) patients with pulmonary disease of all descriptions showed enlarged dead space; (d) patients with cystic fibrosis showed multimodal distributions with the bulk of the ventilation going to overventilated units; and (e) patients with obstructive lung disease fell into several classes, three of which are illustrated.

Intermedin Stabilized Endothelial Barrier Function and Attenuated Ventilator-induced Lung Injury in Mice

PubMed Central

Müller-Redetzky, Holger Christian; Kummer, Wolfgang; Pfeil, Uwe; Hellwig, Katharina; Will, Daniel; Paddenberg, Renate; Tabeling, Christoph; Hippenstiel, Stefan; Suttorp, Norbert; Witzenrath, Martin

2012-01-01

Background Even protective ventilation may aggravate or induce lung failure, particularly in preinjured lungs. Thus, new adjuvant pharmacologic strategies are needed to minimize ventilator-induced lung injury (VILI). Intermedin/Adrenomedullin-2 (IMD) stabilized pulmonary endothelial barrier function in vitro. We hypothesized that IMD may attenuate VILI-associated lung permeability in vivo. Methodology/Principal Findings Human pulmonary microvascular endothelial cell (HPMVEC) monolayers were incubated with IMD, and transcellular electrical resistance was measured to quantify endothelial barrier function. Expression and localization of endogenous pulmonary IMD, and its receptor complexes composed of calcitonin receptor-like receptor (CRLR) and receptor activity-modifying proteins (RAMPs) 1–3 were analyzed by qRT-PCR and immunofluorescence in non ventilated mouse lungs and in lungs ventilated for 6 h. In untreated and IMD treated mice, lung permeability, pulmonary leukocyte recruitment and cytokine levels were assessed after mechanical ventilation. Further, the impact of IMD on pulmonary vasoconstriction was investigated in precision cut lung slices (PCLS) and in isolated perfused and ventilated mouse lungs. IMD stabilized endothelial barrier function in HPMVECs. Mechanical ventilation reduced the expression of RAMP3, but not of IMD, CRLR, and RAMP1 and 2. Mechanical ventilation induced lung hyperpermeability, which was ameliorated by IMD treatment. Oxygenation was not improved by IMD, which may be attributed to impaired hypoxic vasoconstriction due to IMD treatment. IMD had minor impact on pulmonary leukocyte recruitment and did not reduce cytokine levels in VILI. Conclusions/Significance IMD may possibly provide a new approach to attenuate VILI. PMID:22563471

WE-AB-202-04: Statistical Evaluation of Lung Function Using 4DCT Ventilation Imaging: Proton Therapy VS IMRT

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

Huang, Q; Zhang, M; Chen, T

Purpose: Variation in function of different lung regions has been ignored so far for conventional lung cancer treatment planning, which may lead to higher risk of radiation induced lung disease. 4DCT based lung ventilation imaging provides a novel yet convenient approach for lung functional imaging as 4DCT is taken as routine for lung cancer treatment. Our work aims to evaluate the impact of accounting for spatial heterogeneity in lung function using 4DCT based lung ventilation imaging for proton and IMRT plans. Methods: Six patients with advanced stage lung cancer of various tumor locations were retrospectively evaluated for the study. Protonmore » and IMRT plans were designed following identical planning objective and constrains for each patient. Ventilation images were calculated from patients’ 4DCT using deformable image registration implemented by Velocity AI software based on Jacobian-metrics. Lung was delineated into two function level regions based on ventilation (low and high functional area). High functional region was defined as lung ventilation greater than 30%. Dose distribution and statistics in different lung function area was calculated for patients. Results: Variation in dosimetric statistics of different function lung region was observed between proton and IMRT plans. In all proton plans, high function lung regions receive lower maximum dose (100.2%–108.9%), compared with IMRT plans (106.4%–119.7%). Interestingly, three out of six proton plans gave higher mean dose by up to 2.2% than IMRT to high function lung region. Lower mean dose (lower by up to 14.1%) and maximum dose (lower by up to 9%) were observed in low function lung for proton plans. Conclusion: A systematic approach was developed to generate function lung ventilation imaging and use it to evaluate plans. This method hold great promise in function analysis of lung during planning. We are currently studying more subjects to evaluate this tool.« less

Protective mechanical ventilation during general anesthesia for open abdominal surgery improves postoperative pulmonary function.

PubMed

Severgnini, Paolo; Selmo, Gabriele; Lanza, Christian; Chiesa, Alessandro; Frigerio, Alice; Bacuzzi, Alessandro; Dionigi, Gianlorenzo; Novario, Raffaele; Gregoretti, Cesare; de Abreu, Marcelo Gama; Schultz, Marcus J; Jaber, Samir; Futier, Emmanuel; Chiaranda, Maurizio; Pelosi, Paolo

2013-06-01

The impact of intraoperative ventilation on postoperative pulmonary complications is not defined. The authors aimed at determining the effectiveness of protective mechanical ventilation during open abdominal surgery on a modified Clinical Pulmonary Infection Score as primary outcome and postoperative pulmonary function. Prospective randomized, open-label, clinical trial performed in 56 patients scheduled to undergo elective open abdominal surgery lasting more than 2 h. Patients were assigned by envelopes to mechanical ventilation with tidal volume of 9 ml/kg ideal body weight and zero-positive end-expiratory pressure (standard ventilation strategy) or tidal volumes of 7 ml/kg ideal body weight, 10 cm H2O positive end-expiratory pressure, and recruitment maneuvers (protective ventilation strategy). Modified Clinical Pulmonary Infection Score, gas exchange, and pulmonary functional tests were measured preoperatively, as well as at days 1, 3, and 5 after surgery. Patients ventilated protectively showed better pulmonary functional tests up to day 5, fewer alterations on chest x-ray up to day 3 and higher arterial oxygenation in air at days 1, 3, and 5 (mmHg; mean ± SD): 77.1 ± 13.0 versus 64.9 ± 11.3 (P = 0.0006), 80.5 ± 10.1 versus 69.7 ± 9.3 (P = 0.0002), and 82.1 ± 10.7 versus 78.5 ± 21.7 (P = 0.44) respectively. The modified Clinical Pulmonary Infection Score was lower in the protective ventilation strategy at days 1 and 3. The percentage of patients in hospital at day 28 after surgery was not different between groups (7 vs. 15% respectively, P = 0.42). A protective ventilation strategy during abdominal surgery lasting more than 2 h improved respiratory function and reduced the modified Clinical Pulmonary Infection Score without affecting length of hospital stay.

Design, production and first commissioning results of the electrical feedboxes of the LHC

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

Perin, A.; Atieh, S.; Benda, V.

2007-12-01

A total of 44 CERN designed cryogenic electrical feedboxes are needed to power the LHC superconducting magnets. The feedboxes include more than 1000 superconducting circuits fed by high temperature superconductor and conventional current leads ranging from 120 A to 13 kA. In addition to providing the electrical current to the superconducting circuits, they also ensure specific mechanical and cryogenic functions for the LHC. The paper focuses on the main design aspects and related production operations and gives an overview of specific technologies employed. Results of the commissioning of the feedboxes of the first LHC sectors are presented.

Improving Survival and Promoting Respiratory Motor Function After Cervical Spinal Cord Injury

DTIC Science & Technology

2017-09-01

ventilator in order to survive. Use of the ventilator severely limits the quality of life of those injured and dramatically increases the demand for health...care for cervical SCI patients so as to lead to an improved quality of life , better-quality health care management, and improved functional outcomes...mechanical ventilator in order to survive. Use of the ventilator severely limits the quality of life of those injured and dramatically increases the

Xenon-enhanced CT using subtraction CT: Basic and preliminary clinical studies for comparison of its efficacy with that of dual-energy CT and ventilation SPECT/CT to assess regional ventilation and pulmonary functional loss in smokers.

PubMed

Ohno, Yoshiharu; Yoshikawa, Takeshi; Takenaka, Daisuke; Fujisawa, Yasuko; Sugihara, Naoki; Kishida, Yuji; Seki, Shinichiro; Koyama, Hisanobu; Sugimura, Kazuro

2017-01-01

To prospectively and directly compare the capability for assessments of regional ventilation and pulmonary functional loss in smokers of xenon-ventilation CT obtained with the dual-energy CT (DE-CT) and subtraction CT (Sub-CT) MATERIALS AND METHODS: Twenty-three consecutive smokers (15 men and 8 women, mean age: 69.7±8.7years) underwent prospective unenhanced and xenon-enhanced CTs, the latter by Sub-CT and DE-CT methods, ventilation SPECT and pulmonary function tests. Sub-CT was generated from unenhanced and xenon-enhanced CT, and all co-registered SPECT/CT data were produced from SPECT and unenhanced CT data. For each method, regional ventilation was assessed by using a 11-point scoring system on a per-lobe basis. To determine the functional lung volume by each method, it was also calculated for individual sublets with a previously reported method. To determine inter-observer agreement for each method, ventilation defect assessment was evaluated by using the χ2 test with weighted kappa statistics. For evaluation of the efficacy of each method for pulmonary functional loss assessment, functional lung volume was correlated with%FEV 1 . Each inter-observer agreement was rated as substantial (Sub-CT: κ=0.69, p<0.0001; DE-CT: κ=0.64, p<0.0001; SPECT/CT: κ=0.64, p<0.0001). Functional lung volume for each method showed significant to good correlation with%FEV 1 (Sub-CT: r=0.72, p=0.0001; DE-CT: r=0.74, p<0.0001; SPECT/CT: r=0.66, p=0.0006). Xenon-enhanced CT obtained by Sub-CT can be considered at least as efficacious as that obtained by DE-CT and SPECT/CT for assessment of ventilation abnormality and pulmonary functional loss in smokers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

SU-E-J-86: Lobar Lung Function Quantification by PET Galligas and CT Ventilation Imaging in Lung Cancer Patients

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

Eslick, E; Kipritidis, J; Keall, P

2014-06-01

Purpose: The purpose of this study was to quantify the lobar lung function using the novel PET Galligas ([68Ga]-carbon nanoparticle) ventilation imaging and the investigational CT ventilation imaging in lung cancer patients pre-treatment. Methods: We present results on our first three lung cancer patients (2 male, mean age 78 years) as part of an ongoing ethics approved study. For each patient a PET Galligas ventilation (PET-V) image and a pair of breath hold CT images (end-exhale and end-inhale tidal volumes) were acquired using a Siemens Biograph PET CT. CT-ventilation (CT-V) images were created from the pair of CT images usingmore » deformable image registration (DIR) algorithms and the Hounsfield Unit (HU) ventilation metric. A comparison of ventilation quantification from each modality was done on the lobar level and the voxel level. A Bland-Altman plot was used to assess the difference in mean percentage contribution of each lobe to the total lung function between the two modalities. For each patient, a voxel-wise Spearmans correlation was calculated for the whole lungs between the two modalities. Results: The Bland-Altman plot demonstrated strong agreement between PET-V and CT-V for assessment of lobar function (r=0.99, p<0.001; range mean difference: −5.5 to 3.0). The correlation between PET-V and CT-V at the voxel level was moderate(r=0.60, p<0.001). Conclusion: This preliminary study on the three patients data sets demonstrated strong agreement between PET and CT ventilation imaging for the assessment of pre-treatment lung function at the lobar level. Agreement was only moderate at the level of voxel correlations. These results indicate that CT ventilation imaging has potential for assessing pre-treatment lobar lung function in lung cancer patients.« less

Studies of QCD structure in high-energy collisions

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

Nadolsky, Pavel M.

2016-06-26

”Studies of QCD structure in high-energy collisions” is a research project in theoretical particle physics at Southern Methodist University funded by US DOE Award DE-SC0013681. The award furnished bridge funding for one year (2015/04/15-2016/03/31) between the periods funded by Nadolsky’s DOE Early Career Research Award DE-SC0003870 (in 2010-2015) and a DOE grant DE-SC0010129 for SMU Department of Physics (starting in April 2016). The primary objective of the research is to provide theoretical predictions for Run-2 of the CERN Large Hadron Collider (LHC). The LHC physics program relies on state-of-the-art predictions in the field of quantum chromodynamics. The main effort ofmore » our group went into the global analysis of parton distribution functions (PDFs) employed by the bulk of LHC computations. Parton distributions describe internal structure of protons during ultrarelivistic collisions. A new generation of CTEQ parton distribution functions (PDFs), CT14, was released in summer 2015 and quickly adopted by the HEP community. The new CT14 parametrizations of PDFs were obtained using benchmarked NNLO calculations and latest data from LHC and Tevatron experiments. The group developed advanced methods for the PDF analysis and estimation of uncertainties in LHC predictions associated with the PDFs. We invented and refined a new ’meta-parametrization’ technique that streamlines usage of PDFs in Higgs boson production and other numerous LHC processes, by combining PDFs from various groups using multivariate stochastic sampling. In 2015, the PDF4LHC working group recommended to LHC experimental collaborations to use ’meta-parametrizations’ as a standard technique for computing PDF uncertainties. Finally, to include new QCD processes into the global fits, our group worked on several (N)NNLO calculations.« less

Design of FPGA-based radiation tolerant quench detectors for LHC

NASA Astrophysics Data System (ADS)

Steckert, J.; Skoczen, A.

2017-04-01

The Large Hadron Collider (LHC) comprises many superconducting circuits. Most elements of these circuits require active protection. The functionality of the quench detectors was initially implemented as microcontroller based equipment. After the initial stage of the LHC operation with beams the introduction of a new type of quench detector began. This article presents briefly the main ideas and architectures applied to the design and the validation of FPGA-based quench detectors.

Pulmonary function recovery demonstrated by ventilation-perfusion scan after posterior vertebral column resection for severe adolescent idiopathic scoliosis: a case report.

PubMed

Fujii, Takeshi; Watanabe, Kota; Toyama, Yoshiaki; Matsumoto, Morio

2014-09-01

Case report. To describe a case in which a patient regained pulmonary function, assessed by ventilation-perfusion scans, after undergoing posterior vertebral column resection (VCR) to correct severe adolescent idiopathic scoliosis (AIS) with associated pulmonary dysfunction. Pulmonary improvement after corrective surgery for AIS has been reported. Ventilation-perfusion scans are useful for assessing pulmonary function. However, these scans have not been used to examine the recovery of pulmonary function after VCR for severe AIS with pulmonary dysfunction. A patient was described in whom ventilation-perfusion scans were used to examine improvements in impaired air ventilation and blood perfusion after VCR surgery for severe AIS. The relevant literature was reviewed. An 18-year-old male came to Keio University Hospital with exertional dyspnea associated with severe AIS. Radiographs showed severe scoliosis of 91° at T6-T12, and hypokyphosis of 6° at T5-T12. Computed tomographic scans showed narrowing of the thoracic cage on the convex side of the main thoracic curve, with the vertebral bodies at the apex of the curve obstructing the right main bronchus. Pulmonary function tests revealed a percent vital capacity of 44% and percent forced expiratory volume in 1 second of 76%. A ventilation-perfusion scan showed decreased air ventilation and blood perfusion in the right lung. The patient underwent posterior correction surgery, which used segmental pedicle screws with a VCR at T9. The scoliosis was corrected to 28°, and the kyphosis to 14°. Postoperative computed tomographic scans showed expansion of the right main bronchus. A ventilation-perfusion scan conducted 1 year after surgery showed clear improvement in both ventilation and blood perfusion in the right lung. The patient's forced expiratory volume in 1 second had increased to 91%. This is the first report in which ventilation-perfusion scans were used to examine improvements in impaired air ventilation and blood perfusion after VCR surgery in a patient with severe AIS. N/A.

Comparison between conventional and protective one-lung ventilation for ventilator-assisted thoracic surgery.

PubMed

Ahn, H J; Kim, J A; Yang, M; Shim, W S; Park, K J; Lee, J J

2012-09-01

Recent papers suggest protective ventilation (PV) as a primary ventilation strategy during one-lung ventilation (OLV) to reduce postoperative pulmonary morbidity. However, data regarding the advantage of the PV strategy in patients with normal preoperative pulmonary function are inconsistent, especially in the case of minimally invasive thoracic surgery. Therefore we compared conventional OLV (VT 10 ml/kg, FiO2 1.0, zero PEEP) to protective OLV (VT 6 ml/kg, FiO2 0.5, PEEP 5 cmH2O) in patients with normal preoperative pulmonary function tests undergoing video-assisted thoracic surgery. Oxygenation, respiratory mechanics, plasma interleukin-6 and malondialdehyde levels were measured at baseline, 15 and 60 minutes after OLV and 15 minutes after restoration of two-lung ventilation. PaO2 and PaO2/FiO2 were higher in conventional OLV than in protective OLV (P<0.001). Interleukin-6 and malondialdehyde increased over time in both groups (P<0.05); however, the magnitudes of increase were not different between the groups. Postoperatively there were no differences in the number of patients with PaO2/FiO2<300 mmHg or abnormalities on chest radiography. Protective ventilation did not provide advantages over conventional ventilation for video-assisted thoracic surgery in this group of patients with normal lung function.

TU-G-BRA-04: Changes in Regional Lung Function Measured by 4D-CT Ventilation Imaging for Thoracic Radiotherapy

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

Nakajima, Y; Kadoya, N; Kabus, S

Purpose: To test the hypothesis: 4D-CT ventilation imaging can show the known effects of radiotherapy on lung function: (1) radiation-induced ventilation reductions, and (2) ventilation increases caused by tumor regression. Methods: Repeat 4D-CT scans (pre-, mid- and/or post-treatment) were acquired prospectively for 11 thoracic cancer patients in an IRB-approved clinical trial. A ventilation image for each time point was created using deformable image registration and the Hounsfield unit (HU)-based or Jacobian-based metric. The 11 patients were divided into two subgroups based on tumor volume reduction using a threshold of 5 cm{sup 3}. To quantify radiation-induced ventilation reduction, six patients whomore » showed a small tumor volume reduction (<5 cm{sup 3}) were analyzed for dose-response relationships. To investigate ventilation increase caused by tumor regression, two of the other five patients were analyzed to compare ventilation changes in the lung lobes affected and unaffected by the tumor. The remaining three patients were excluded because there were no unaffected lobes. Results: Dose-dependent reductions of HU-based ventilation were observed in a majority of the patient-specific dose-response curves and in the population-based dose-response curve, whereas no clear relationship was seen for Jacobian-based ventilation. The post-treatment population-based dose-response curve of HU-based ventilation demonstrated the average ventilation reductions of 20.9±7.0% at 35–40 Gy (equivalent dose in 2-Gy fractions, EQD2), and 40.6±22.9% at 75–80 Gy EQD2. Remarkable ventilation increases in the affected lobes were observed for the two patients who showed an average tumor volume reduction of 37.1 cm{sup 3} and re-opening airways. The mid-treatment increase in HU-based ventilation of patient 3 was 100.4% in the affected lobes, which was considerably greater than 7.8% in the unaffected lobes. Conclusion: This study has demonstrated that 4D-CT ventilation imaging shows the known effects of radiotherapy on lung function: radiation-induced ventilation reduction and ventilation increase caused by tumor regression, providing validation for 4D-CT ventilation imaging. This study was supported in part by a National Lung Cancer Partnership Young Investigator Research grant.« less

Gluon Shadowing Effects on J / ψ and Υ Production in p + P b Collisions at s N N = 115 GeV and P b + p Collisions at s N N = 72 GeV at AFTER@LHC

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

Vogt, R.

We exploremore » the effects of shadowing on inclusive J / ψ and Υ ( 1 S ) production at AFTER@LHC. We also present the rates as a function of p T and rapidity for p + Pb and Pb + p collisions in the proposed AFTER@LHC rapidity acceptance.« less

Gluon Shadowing Effects on J / ψ and Υ Production in p + P b Collisions at s N N = 115 GeV and P b + p Collisions at s N N = 72 GeV at AFTER@LHC

DOE PAGES

Vogt, R.

2015-01-01

We exploremore » the effects of shadowing on inclusive J / ψ and Υ ( 1 S ) production at AFTER@LHC. We also present the rates as a function of p T and rapidity for p + Pb and Pb + p collisions in the proposed AFTER@LHC rapidity acceptance.« less

Worsening respiratory function in mechanically ventilated intensive care patients: feasibility and value of xenon-enhanced dual energy CT.

PubMed

Hoegl, Sandra; Meinel, Felix G; Thieme, Sven F; Johnson, Thorsten R C; Eickelberg, Oliver; Zwissler, Bernhard; Nikolaou, Konstantin

2013-03-01

To evaluate the feasibility and incremental diagnostic value of xenon-enhanced dual-energy CT in mechanically ventilated intensive care patients with worsening respiratory function. The study was performed in 13 mechanically ventilated patients with severe pulmonary conditions (acute respiratory distress syndrome (ARDS), n=5; status post lung transplantation, n=5; other, n=3) and declining respiratory function. CT scans were performed using a dual-source CT scanner at an expiratory xenon concentration of 30%. Both ventilation images (Xe-DECT) and standard CT images were reconstructed from a single CT scan. Findings were recorded for Xe-DECT and standard CT images separately. Ventilation defects on xenon images were matched to morphological findings on standard CT images and incremental diagnostic information of xenon ventilation images was recorded if present. Mean xenon consumption was 2.95 l per patient. No adverse events occurred under xenon inhalation. In the visual CT analysis, the Xe-DECT ventilation defects matched with pathologic changes in lung parenchyma seen in the standard CT images in all patients. Xe-DECT provided additional diagnostic findings in 4/13 patients. These included preserved ventilation despite early pneumonia (n=1), more confident discrimination between a large bulla and pneumothorax (n=1), detection of an airway-to-pneumothorax fistula (n=1) and exclusion of a suspected airway-to-mediastinum fistula (n=1). In all 4 patients, the additional findings had a substantial impact on patients' management. Xenon-enhanced DECT is safely feasible and can add relevant diagnostic information in mechanically ventilated intensive care patients with worsening respiratory function. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Impact of whole-body rehabilitation in patients receiving chronic mechanical ventilation.

PubMed

Martin, Ubaldo J; Hincapie, Luis; Nimchuk, Mark; Gaughan, John; Criner, Gerard J

2005-10-01

To evaluate the prevalence and magnitude of weakness in patients receiving chronic mechanical ventilation and the impact of providing aggressive whole-body rehabilitation on conventional weaning variables, muscle strength, and overall functional status. Retrospective analysis of 49 consecutive patients. Multidisciplinary ventilatory rehabilitation unit in an academic medical center. Forty-nine consecutive chronic ventilator-dependent patients referred to a tertiary care hospital ventilator rehabilitation unit. None. Patients were 58 +/- 7 yrs old with multiple etiologies for respiratory failure. On admission, all patients were bedridden and had severe weakness of upper and lower extremities measured by a 5-point muscle strength score and a 7-point Functional Independence Measurement. Postrehabilitation, patients had increases in upper and lower extremity strength (p < .05) and were able to stand and ambulate. All weaned from mechanical ventilation, but three required subsequent intermittent support. Six patients died before hospital discharge. Upper extremity strength on admission inversely correlated with time to wean from mechanical ventilation (R = .72, p < .001). : Patients receiving chronic ventilation are weak and deconditioned but respond to aggressive whole-body and respiratory muscle training with an improvement in strength, weaning outcome, and functional status. Whole-body rehabilitation should be considered a significant component of their therapy.

Changes in Regional Ventilation During Treatment and Dosimetric Advantages of CT Ventilation Image Guided Radiation Therapy for Locally Advanced Lung Cancer.

PubMed

Yamamoto, Tokihiro; Kabus, Sven; Bal, Matthieu; Bzdusek, Karl; Keall, Paul J; Wright, Cari; Benedict, Stanley H; Daly, Megan E

2018-05-04

Lung functional image guided radiation therapy (RT) that avoids irradiating highly functional regions has potential to reduce pulmonary toxicity following RT. Tumor regression during RT is common, leading to recovery of lung function. We hypothesized that computed tomography (CT) ventilation image-guided treatment planning reduces the functional lung dose compared to standard anatomic image-guided planning in 2 different scenarios with or without plan adaptation. CT scans were acquired before RT and during RT at 2 time points (16-20 Gy and 30-34 Gy) for 14 patients with locally advanced lung cancer. Ventilation images were calculated by deformable image registration of four-dimensional CT image data sets and image analysis. We created 4 treatment plans at each time point for each patient: functional adapted, anatomic adapted, functional unadapted, and anatomic unadapted plans. Adaptation was performed at 2 time points. Deformable image registration was used for accumulating dose and calculating a composite of dose-weighted ventilation used to quantify the lung accumulated dose-function metrics. The functional plans were compared with the anatomic plans for each scenario separately to investigate the hypothesis at a significance level of 0.05. Tumor volume was significantly reduced by 20% after 16 to 20 Gy (P = .02) and by 32% after 30 to 34 Gy (P < .01) on average. In both scenarios, the lung accumulated dose-function metrics were significantly lower in the functional plans than in the anatomic plans without compromising target volume coverage and adherence to constraints to critical structures. For example, functional planning significantly reduced the functional mean lung dose by 5.0% (P < .01) compared to anatomic planning in the adapted scenario and by 3.6% (P = .03) in the unadapted scenario. This study demonstrated significant reductions in the accumulated dose to the functional lung with CT ventilation image-guided planning compared to anatomic image-guided planning for patients showing tumor regression and changes in regional ventilation during RT. Copyright © 2018 Elsevier Inc. All rights reserved.

Higher levels of spontaneous breathing reduce lung injury in experimental moderate acute respiratory distress syndrome.

PubMed

Carvalho, Nadja C; Güldner, Andreas; Beda, Alessandro; Rentzsch, Ines; Uhlig, Christopher; Dittrich, Susanne; Spieth, Peter M; Wiedemann, Bärbel; Kasper, Michael; Koch, Thea; Richter, Torsten; Rocco, Patricia R; Pelosi, Paolo; de Abreu, Marcelo Gama

2014-11-01

To assess the effects of different levels of spontaneous breathing during biphasic positive airway pressure/airway pressure release ventilation on lung function and injury in an experimental model of moderate acute respiratory distress syndrome. Multiple-arm randomized experimental study. University hospital research facility. Thirty-six juvenile pigs. Pigs were anesthetized, intubated, and mechanically ventilated. Moderate acute respiratory distress syndrome was induced by repetitive saline lung lavage. Biphasic positive airway pressure/airway pressure release ventilation was conducted using the airway pressure release ventilation mode with an inspiratory/expiratory ratio of 1:1. Animals were randomly assigned to one of four levels of spontaneous breath in total minute ventilation (n = 9 per group, 6 hr each): 1) biphasic positive airway pressure/airway pressure release ventilation, 0%; 2) biphasic positive airway pressure/airway pressure release ventilation, > 0-30%; 3) biphasic positive airway pressure/airway pressure release ventilation, > 30-60%, and 4) biphasic positive airway pressure/airway pressure release ventilation, > 60%. The inspiratory effort measured by the esophageal pressure time product increased proportionally to the amount of spontaneous breath and was accompanied by improvements in oxygenation and respiratory system elastance. Compared with biphasic positive airway pressure/airway pressure release ventilation of 0%, biphasic positive airway pressure/airway pressure release ventilation more than 60% resulted in lowest venous admixture, as well as peak and mean airway and transpulmonary pressures, redistributed ventilation to dependent lung regions, reduced the cumulative diffuse alveolar damage score across lungs (median [interquartile range], 11 [3-40] vs 18 [2-69]; p < 0.05), and decreased the level of tumor necrosis factor-α in ventral lung tissue (median [interquartile range], 17.7 pg/mg [8.4-19.8] vs 34.5 pg/mg [29.9-42.7]; p < 0.05). Biphasic positive airway pressure/airway pressure release ventilation more than 0-30% and more than 30-60% showed a less consistent pattern of improvement in lung function, inflammation, and damage compared with biphasic positive airway pressure/airway pressure release ventilation more than 60%. In this model of moderate acute respiratory distress syndrome in pigs, biphasic positive airway pressure/airway pressure release ventilation with levels of spontaneous breath higher than usually seen in clinical practice, that is, more than 30% of total minute ventilation, reduced lung injury with improved respiratory function, as compared with protective controlled mechanical ventilation.

The PDF4LHC report on PDFs and LHC data: Results from Run I and preparation for Run II

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

Rojo, Juan; Accardi, Alberto; Ball, Richard D.

2015-09-16

The accurate determination of Parton Distribution Functions (PDFs) of the proton is an essential ingredient of the Large Hadron Collider (LHC) program. PDF uncertainties impact a wide range of processes, from Higgs boson characterization and precision Standard Model measurements to New Physics searches. A major recent development in modern PDF analyses has been to exploit the wealth of new information contained in precision measurements from the LHC Run I, as well as progress in tools and methods to include these data in PDF fits. In this report we summarize the information that PDF-sensitive measurements at the LHC have provided somore » far, and review the prospects for further constraining PDFs with data from the recently started Run II. As a result, this document aims to provide useful input to the LHC collaborations to prioritize their PDF-sensitive measurements at Run II, as well as a comprehensive reference for the PDF-fitting collaborations.« less

Controlled invasive mechanical ventilation strategies in obese patients undergoing surgery.

PubMed

Maia, Lígia de Albuquerque; Silva, Pedro Leme; Pelosi, Paolo; Rocco, Patricia Rieken Macedo

2017-06-01

The obesity prevalence is increasing in surgical population. As the number of obese surgical patients increases, so does the demand for mechanical ventilation. Nevertheless, ventilatory strategies in this population are challenging, since obesity results in pathophysiological changes in respiratory function. Areas covered: We reviewed the impact of obesity on respiratory system and the effects of controlled invasive mechanical ventilation strategies in obese patients undergoing surgery. To date, there is no consensus regarding the optimal invasive mechanical ventilation strategy for obese surgical patients, and no evidence that possible intraoperative beneficial effects on oxygenation and mechanics translate into better postoperative pulmonary function or improved outcomes. Expert commentary: Before determining the ideal intraoperative ventilation strategy, it is important to analyze the pathophysiology and comorbidities of each obese patient. Protective ventilation with low tidal volume, driving pressure, energy, and mechanical power should be employed during surgery; however, further studies are required to clarify the most effective ventilation strategies, such as the optimal positive end-expiratory pressure and whether recruitment maneuvers minimize lung injury. In this context, an ongoing trial of intraoperative ventilation in obese patients (PROBESE) should help determine the mechanical ventilation strategy that best improves clinical outcome in patients with body mass index≥35kg/m 2 .

FiO2 delivered by a turbine portable ventilator with an oxygen concentrator in an Austere environment.

PubMed

Bordes, Julien; Erwan d'Aranda; Savoie, Pierre-Henry; Montcriol, Ambroise; Goutorbe, Philippe; Kaiser, Eric

2014-09-01

Management of critically ill patients in austere environments is a logistic challenge. Availability of oxygen cylinders for the mechanically ventilated patient may be difficult in such a context. A solution is to use a ventilator able to function with an oxygen concentrator. We tested the SeQual Integra™ (SeQual, San Diego, CA) 10-OM oxygen concentrator paired with the Pulmonetic System(®) LTV 1000 ventilator (Pulmonetic Systems, Minneapolis, MN) and evaluated the delivered fraction of inspired oxygen (FiO2) across a range of minute volumes and combinations of ventilator settings. Two LTV 1000 ventilators were tested. The ventilators were attached to a test lung and FiO2 was measured by a gas analyzer. Continuous-flow oxygen was generated by the OC from 0.5 L/min to 10 L/min and injected into the oxygen inlet port of the LTV 1000. Several combinations of ventilator settings were evaluated to determine the factors affecting the delivered FiO2. The LTV 1000 ventilator is a turbine ventilator that is able to deliver high FiO2 when functioning with an oxygen concentrator. However, modifications of the ventilator settings such as increase in minute ventilation affect delivered FiO2 even if oxygen flow is constant on the oxygen concentrator. The ability of an oxygen concentrator to deliver high FiO2 when used with a turbine ventilator makes this method of oxygen delivery a viable alternative to cylinders in austere environments when used with a turbine ventilator. However, FiO2 has to be monitored continuously because delivered FiO2 decreases when minute ventilation is increased. Copyright © 2014 Elsevier Inc. All rights reserved.

The landscape of W± and Z bosons produced in pp collisions up to LHC energies

NASA Astrophysics Data System (ADS)

Basso, Eduardo; Bourrely, Claude; Pasechnik, Roman; Soffer, Jacques

2017-10-01

We consider a selection of recent experimental results on electroweak W± , Z gauge boson production in pp collisions at BNL RHIC and CERN LHC energies in comparison to prediction of perturbative QCD calculations based on different sets of NLO parton distribution functions including the statistical PDF model known from fits to the DIS data. We show that the current statistical PDF parametrization (fitted to the DIS data only) underestimates the LHC data on W± , Z gauge boson production cross sections at the NLO by about 20%. This suggests that there is a need to refit the parameters of the statistical PDF including the latest LHC data.

Basic principles of respiratory function monitoring in ventilated newborns: A review.

PubMed

Schmalisch, Gerd

2016-09-01

Respiratory monitoring during mechanical ventilation provides a real-time picture of patient-ventilator interaction and is a prerequisite for lung-protective ventilation. Nowadays, measurements of airflow, tidal volume and applied pressures are standard in neonatal ventilators. The measurement of lung volume during mechanical ventilation by tracer gas washout techniques is still under development. The clinical use of capnography, although well established in adults, has not been embraced by neonatologists because of technical and methodological problems in very small infants. While the ventilatory parameters are well defined, the calculation of other physiological parameters are based upon specific assumptions which are difficult to verify. Incomplete knowledge of the theoretical background of these calculations and their limitations can lead to incorrect interpretations with clinical consequences. Therefore, the aim of this review was to describe the basic principles and the underlying assumptions of currently used methods for respiratory function monitoring in ventilated newborns and to highlight methodological limitations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Daytime Mouthpiece for Continuous Noninvasive Ventilation in Individuals With Amyotrophic Lateral Sclerosis.

PubMed

Bédard, Marie-Eve; McKim, Douglas A

2016-10-01

Noninvasive ventilation (NIV) is commonly used to provide ventilatory support for individuals with amyotrophic lateral sclerosis (ALS). Once 24-h ventilation is required, the decision between invasive tracheostomy ventilation and palliation is often faced. This study describes the use and outcomes of daytime mouthpiece ventilation added to nighttime mask ventilation for continuous NIV in subjects with ALS as an effective alternative. This was a retrospective study of 39 subjects with ALS using daytime mouthpiece ventilation over a 17-y period. Thirty-one subjects were successful with mouthpiece ventilation, 2 were excluded, 2 stopped because of lack of motivation, and 4 with bulbar subscores of the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (b-ALSFRS-R) between 0 and 3 physically failed to use it consistently. No subject in the successful group had a b-ALSFRS-R score of <6. Thirty of the successful subjects were able to generate a maximum insufflation capacity - vital capacity difference with lung volume recruitment. The median (range) survival to tracheostomy or death from initiation of nocturnal NIV and mouthpiece ventilation were 648 (176-2,188) and 286 (41-1,769) d, respectively. Peak cough flow with lung-volume recruitment >180 L/min at initiation of mouthpiece ventilation was associated with a longer survival (637 ± 468 vs 240 ± 158 d (P = .01). Mouthpiece ventilation provides effective ventilation and prolonged survival for individuals with ALS requiring full-time ventilatory support and maintaining adequate bulbar function. Copyright © 2016 by Daedalus Enterprises.

Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy

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

Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu; Schubert, Leah; Diot, Quentin

2016-07-15

Purpose: The development of clinical trials is underway to use 4-dimensional computed tomography (4DCT) ventilation imaging to preferentially spare functional lung in patients undergoing radiation therapy. The purpose of this work was to generate data to aide with clinical trial design by retrospectively characterizing dosimetric and functional profiles for patients with different stages of lung cancer. Methods and Materials: A total of 118 lung cancer patients (36% stage I and 64% stage III) from 2 institutions were used for the study. A 4DCT-ventilation map was calculated using the patient's 4DCT imaging, deformable image registration, and a density-change–based algorithm. To assessmore » each patient's spatial ventilation profile both quantitative and qualitative metrics were developed, including an observer-based defect observation and metrics based on the ventilation in each lung third. For each patient we used the clinical doses to calculate functionally weighted mean lung doses and metrics that assessed the interplay between the spatial location of the dose and high-functioning lung. Results: Both qualitative and quantitative metrics revealed a significant difference in functional profiles between the 2 stage groups (P<.01). We determined that 65% of stage III and 28% of stage I patients had ventilation defects. Average functionally weighted mean lung dose was 19.6 Gy and 5.4 Gy for stage III and I patients, respectively, with both groups containing patients with large spatial overlap between dose and high-function regions. Conclusion: Our 118-patient retrospective study found that 65% of stage III patients have regionally variant ventilation profiles that are suitable for functional avoidance. Our results suggest that regardless of disease stage, it is possible to have unique spatial interplay between dose and high-functional lung, highlighting the importance of evaluating the function of each patient and developing a personalized functional avoidance treatment approach.« less

Improving Patient Safety with X-Ray and Anesthesia Machine Ventilator Synchronization: A Medical Device Interoperability Case Study

NASA Astrophysics Data System (ADS)

Arney, David; Goldman, Julian M.; Whitehead, Susan F.; Lee, Insup

When a x-ray image is needed during surgery, clinicians may stop the anesthesia machine ventilator while the exposure is made. If the ventilator is not restarted promptly, the patient may experience severe complications. This paper explores the interconnection of a ventilator and simulated x-ray into a prototype plug-and-play medical device system. This work assists ongoing interoperability framework development standards efforts to develop functional and non-functional requirements and illustrates the potential patient safety benefits of interoperable medical device systems by implementing a solution to a clinical use case requiring interoperability.

Chlamydomonas reinhardtii PsbS Protein Is Functional and Accumulates Rapidly and Transiently under High Light.

PubMed

Tibiletti, Tania; Auroy, Pascaline; Peltier, Gilles; Caffarri, Stefano

2016-08-01

Photosynthetic organisms must respond to excess light in order to avoid photo-oxidative stress. In plants and green algae the fastest response to high light is non-photochemical quenching (NPQ), a process that allows the safe dissipation of the excess energy as heat. This phenomenon is triggered by the low luminal pH generated by photosynthetic electron transport. In vascular plants the main sensor of the low pH is the PsbS protein, while in the green alga Chlamydomonas reinhardtii LhcSR proteins appear to be exclusively responsible for this role. Interestingly, Chlamydomonas also possesses two PsbS genes, but so far the PsbS protein has not been detected and its biological function is unknown. Here, we reinvestigated the kinetics of gene expression and PsbS and LhcSR3 accumulation in Chlamydomonas during high light stress. We found that, unlike LhcSR3, PsbS accumulates very rapidly but only transiently. In order to determine the role of PsbS in NPQ and photoprotection in Chlamydomonas, we generated transplastomic strains expressing the algal or the Arabidopsis psbS gene optimized for plastid expression. Both PsbS proteins showed the ability to increase NPQ in Chlamydomonas wild-type and npq4 (lacking LhcSR3) backgrounds, but no clear photoprotection activity was observed. Quantification of PsbS and LhcSR3 in vivo indicates that PsbS is much less abundant than LhcSR3 during high light stress. Moreover, LhcSR3, unlike PsbS, also accumulates during other stress conditions. The possible role of PsbS in photoprotection is discussed. © 2016 American Society of Plant Biologists. All Rights Reserved.

Chlamydomonas reinhardtii PsbS Protein Is Functional and Accumulates Rapidly and Transiently under High Light1

PubMed Central

Tibiletti, Tania; Auroy, Pascaline; Peltier, Gilles; Caffarri, Stefano

2016-01-01

Photosynthetic organisms must respond to excess light in order to avoid photo-oxidative stress. In plants and green algae the fastest response to high light is non-photochemical quenching (NPQ), a process that allows the safe dissipation of the excess energy as heat. This phenomenon is triggered by the low luminal pH generated by photosynthetic electron transport. In vascular plants the main sensor of the low pH is the PsbS protein, while in the green alga Chlamydomonas reinhardtii LhcSR proteins appear to be exclusively responsible for this role. Interestingly, Chlamydomonas also possesses two PsbS genes, but so far the PsbS protein has not been detected and its biological function is unknown. Here, we reinvestigated the kinetics of gene expression and PsbS and LhcSR3 accumulation in Chlamydomonas during high light stress. We found that, unlike LhcSR3, PsbS accumulates very rapidly but only transiently. In order to determine the role of PsbS in NPQ and photoprotection in Chlamydomonas, we generated transplastomic strains expressing the algal or the Arabidopsis psbS gene optimized for plastid expression. Both PsbS proteins showed the ability to increase NPQ in Chlamydomonas wild-type and npq4 (lacking LhcSR3) backgrounds, but no clear photoprotection activity was observed. Quantification of PsbS and LhcSR3 in vivo indicates that PsbS is much less abundant than LhcSR3 during high light stress. Moreover, LhcSR3, unlike PsbS, also accumulates during other stress conditions. The possible role of PsbS in photoprotection is discussed. PMID:27329221

A critical appraisal and evaluation of modern PDFs

DOE PAGES

Accardi, A.; Alekhin, S.; Blumlein, J.; ...

2016-08-23

Here, we review the present status in the determination of parton distribution functions (PDFs) in the light of the precision requirements for the LHC in Run 2 as well as other future colliders. We provide brief descriptions of all currently available PDF sets and use them to compute cross sections for a number of benchmark processes including the Higgs boson production in gluon-gluon fusion at the LHC. We show that the differences in the predictions obtained with the various PDFs are due to particular theory assumptions such as the heavy-flavor schemes used in the PDF fits, the account of powermore » corrections and others. We comment on PDF uncertainties in the kinematic region covered by the LHC and on averaging procedures for PDFs, such as realized by the PDF4LHC15 sets. As a result, we provide recommendations for the usage of sets of PDFs for theory predictions at the LHC.« less

Hyperdiversity of Genes Encoding Integral Light-Harvesting Proteins in the Dinoflagellate Symbiodinium sp

PubMed Central

Boldt, Lynda; Yellowlees, David; Leggat, William

2012-01-01

The superfamily of light-harvesting complex (LHC) proteins is comprised of proteins with diverse functions in light-harvesting and photoprotection. LHC proteins bind chlorophyll (Chl) and carotenoids and include a family of LHCs that bind Chl a and c. Dinophytes (dinoflagellates) are predominantly Chl c binding algal taxa, bind peridinin or fucoxanthin as the primary carotenoid, and can possess a number of LHC subfamilies. Here we report 11 LHC sequences for the chlorophyll a-chlorophyll c 2-peridinin protein complex (acpPC) subfamily isolated from Symbiodinium sp. C3, an ecologically important peridinin binding dinoflagellate taxa. Phylogenetic analysis of these proteins suggests the acpPC subfamily forms at least three clades within the Chl a/c binding LHC family; Clade 1 clusters with rhodophyte, cryptophyte and peridinin binding dinoflagellate sequences, Clade 2 with peridinin binding dinoflagellate sequences only and Clades 3 with heterokontophytes, fucoxanthin and peridinin binding dinoflagellate sequences. PMID:23112815

Variable mechanical ventilation

PubMed Central

Fontela, Paula Caitano; Prestes, Renata Bernardy; Forgiarini Jr., Luiz Alberto; Friedman, Gilberto

2017-01-01

Objective To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. Methods Search, selection, and analysis of all original articles on variable ventilation, without restriction on the period of publication and language, available in the electronic databases LILACS, MEDLINE®, and PubMed, by searching the terms "variable ventilation" OR "noisy ventilation" OR "biologically variable ventilation". Results A total of 36 studies were selected. Of these, 24 were original studies, including 21 experimental studies and three clinical studies. Conclusion Several experimental studies reported the beneficial effects of distinct variable ventilation strategies on lung function using different models of lung injury and healthy lungs. Variable ventilation seems to be a viable strategy for improving gas exchange and respiratory mechanics and preventing lung injury associated with mechanical ventilation. However, further clinical studies are necessary to assess the potential of variable ventilation strategies for the clinical improvement of patients undergoing mechanical ventilation. PMID:28444076

Outcome-based ventilation: A framework for assessing performance, health, and energy impacts to inform office building ventilation decisions.

PubMed

Rackes, A; Ben-David, T; Waring, M S

2018-07-01

This article presents an outcome-based ventilation (OBV) framework, which combines competing ventilation impacts into a monetized loss function ($/occ/h) used to inform ventilation rate decisions. The OBV framework, developed for U.S. offices, considers six outcomes of increasing ventilation: profitable outcomes realized from improvements in occupant work performance and sick leave absenteeism; health outcomes from occupant exposure to outdoor fine particles and ozone; and energy outcomes from electricity and natural gas usage. We used the literature to set low, medium, and high reference values for OBV loss function parameters, and evaluated the framework and outcome-based ventilation rates using a simulated U.S. office stock dataset and a case study in New York City. With parameters for all outcomes set at medium values derived from literature-based central estimates, higher ventilation rates' profitable benefits dominated negative health and energy impacts, and the OBV framework suggested ventilation should be ≥45 L/s/occ, much higher than the baseline ~8.5 L/s/occ rate prescribed by ASHRAE 62.1. Only when combining very low parameter estimates for profitable impacts with very high ones for health and energy impacts were all outcomes on the same order. Even then, however, outcome-based ventilation rates were often twice the baseline rate or more. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

WE-AB-202-01: Evaluating the Toxicity Reduction with CT-Ventilation Functional Avoidance Radiation Therapy

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

Vinogradskiy, Y; Miyasaka, Y; Kadoya, N

Purpose: CT-ventilation is an exciting new imaging modality that uses 4DCTs to calculate lung ventilation. Studies have proposed to use 4DCT-ventilation imaging for functional avoidance radiotherapy which implies designing treatment plans to spare functional portions of the lung. Although retrospective studies have been performed to evaluate the dosimetric gains to functional lung; no work has been done to translate the dosimetric gains to an improvement in pulmonary toxicity. The purpose of our work was to evaluate the potential reduction in toxicity for 4DCT-ventilation based functional avoidance. Methods: 70 lung cancer patients with 4DCT imaging were used for the study. CT-ventilationmore » maps were calculated using the patient’s 4DCT, deformable image registrations, and a density-change-based algorithm. Radiation pneumonitis was graded using imaging and clinical information. Log-likelihood methods were used to fit a normal-tissue-complication-probability (NTCP) model predicting grade 2+ radiation pneumonitis as a function of doses (mean and V20) to functional lung (>15% ventilation). For 20 patients a functional plan was generated that reduced dose to functional lung while meeting RTOG 0617-based constraints. The NTCP model was applied to the functional plan to determine the reduction in toxicity with functional planning Results: The mean dose to functional lung was 16.8 and 17.7 Gy with the functional and clinical plans respectively. The corresponding grade 2+ pneumonitis probability was 26.9% with the clinically-used plan and 24.6% with the functional plan (8.5% reduction). The V20-based grade 2+ pneumonitis probability was 23.7% with the clinically-used plan and reduced to 19.6% with the functional plan (20.9% reduction). Conclusion: Our results revealed a reduction of 9–20% in complication probability with functional planning. To our knowledge this is the first study to apply complication probability to convert dosimetric results to toxicity improvement. The results presented in the current work provide seminal data for prospective clinical trials in functional avoidance. YV discloses funding from State of Colorado. TY discloses National Lung Cancer Partnership; Young Investigator Research grant.« less

Comparison of Xenon-Enhanced Area-Detector CT and Krypton Ventilation SPECT/CT for Assessment of Pulmonary Functional Loss and Disease Severity in Smokers.

PubMed

Ohno, Yoshiharu; Fujisawa, Yasuko; Takenaka, Daisuke; Kaminaga, Shigeo; Seki, Shinichiro; Sugihara, Naoki; Yoshikawa, Takeshi

2018-02-01

The objective of this study was to compare the capability of xenon-enhanced area-detector CT (ADCT) performed with a subtraction technique and coregistered 81m Kr-ventilation SPECT/CT for the assessment of pulmonary functional loss and disease severity in smokers. Forty-six consecutive smokers (32 men and 14 women; mean age, 67.0 years) underwent prospective unenhanced and xenon-enhanced ADCT, 81m Kr-ventilation SPECT/CT, and pulmonary function tests. Disease severity was evaluated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. CT-based functional lung volume (FLV), the percentage of wall area to total airway area (WA%), and ventilated FLV on xenon-enhanced ADCT and SPECT/CT were calculated for each smoker. All indexes were correlated with percentage of forced expiratory volume in 1 second (%FEV 1 ) using step-wise regression analyses, and univariate and multivariate logistic regression analyses were performed. In addition, the diagnostic accuracy of the proposed model was compared with that of each radiologic index by means of McNemar analysis. Multivariate logistic regression showed that %FEV 1 was significantly affected (r = 0.77, r 2 = 0.59) by two factors: the first factor, ventilated FLV on xenon-enhanced ADCT (p < 0.0001); and the second factor, WA% (p = 0.004). Univariate logistic regression analyses indicated that all indexes significantly affected GOLD classification (p < 0.05). Multivariate logistic regression analyses revealed that ventilated FLV on xenon-enhanced ADCT and CT-based FLV significantly influenced GOLD classification (p < 0.0001). The diagnostic accuracy of the proposed model was significantly higher than that of ventilated FLV on SPECT/CT (p = 0.03) and WA% (p = 0.008). Xenon-enhanced ADCT is more effective than 81m Kr-ventilation SPECT/CT for the assessment of pulmonary functional loss and disease severity.

Linking lung function to structural damage of alveolar epithelium in ventilator-induced lung injury.

PubMed

Hamlington, Katharine L; Smith, Bradford J; Dunn, Celia M; Charlebois, Chantel M; Roy, Gregory S; Bates, Jason H T

2018-05-06

Understanding how the mechanisms of ventilator-induced lung injury (VILI), namely atelectrauma and volutrauma, contribute to the failure of the blood-gas barrier and subsequent intrusion of edematous fluid into the airspace is essential for the design of mechanical ventilation strategies that minimize VILI. We ventilated mice with different combinations of tidal volume and positive end-expiratory pressure (PEEP) and linked degradation in lung function measurements to injury of the alveolar epithelium observed via scanning electron microscopy. Ventilating with both high inspiratory plateau pressure and zero PEEP was necessary to cause derangements in lung function as well as visually apparent physical damage to the alveolar epithelium of initially healthy mice. In particular, the epithelial injury was tightly associated with indicators of alveolar collapse. These results support the hypothesis that mechanical damage to the epithelium during VILI is at least partially attributed to atelectrauma-induced damage of alveolar type I epithelial cells. Copyright © 2018. Published by Elsevier B.V.

Cardiopulmonary function and oxygen delivery during total liquid ventilation.

PubMed

Tsagogiorgas, Charalambos; Alb, Markus; Herrmann, Peter; Quintel, Michael; Meinhardt, Juergen P

2011-10-01

Total liquid ventilation (TLV) with perfluorocarbons has shown to improve cardiopulmonary function in the injured and immature lung; however there remains controversy over the normal lung. Hemodynamic effects of TLV in the normal lung currently remain undetermined. This study compared changes in cardiopulmonary and circulatory function caused by either liquid or gas tidal volume ventilation. In a prospective, controlled study, 12 non-injured anesthetized, adult New Zealand rabbits were primarily conventionally gas-ventilated (CGV). After instrumentation for continuous recording of arterial (AP), central venous (CVP), left artrial (LAP), pulmonary arterial pressures (PAP), and cardiac output (CO) animals were randomized into (1) CGV group and (2) TLV group. In the TLV group partial liquid ventilation was initiated with instillation of perfluoroctylbromide (12 ml/kg). After 15 min, TLV was established for 3 hr applying a volume-controlled, pressure-limited, time-cycled ventilation mode using a double-piston configured TLV. Controls (CGV) remained gas-ventilated throughout the experiment. During TLV, heart rate, CO, PAP, MAP, CVP, and LAP as well as derived hemodynamic variables, arterial and mixed venous blood gases, oxygen delivery, PVR, and SVR did not differ significantly compared to CGV. Liquid tidal volumes suitable for long-term TLV in non-injured rabbits do not significantly impair CO, blood pressure, and oxygen dynamics when compared to CGV. Copyright © 2011 Wiley-Liss, Inc.

Physiological Effects of Positive Pressure Ventilation.

DTIC Science & Technology

1992-05-01

function in the patient with respiratory failure . In R. R. Kirby, M. J. Banner, & J. B. Downs (Eds.), Clinical Applications of Ventilatory Su2Rort (pp. 301...G., Blehschmidt, N. G., & Linder, W. J. (1990). Positive-pressure ventilation with positive end-expiratory pressure and atrial natriuretic peptide ...Acute Resniratorv Failure . New York: Churchill Livingstone. Ventilation 1 Physiological Effects of Positive Pressure Ventilation Dennis L. Oakes, RN, BSN

Scintigraphy at 3 months after single lung transplantation and observations of primary graft dysfunction and lung function.

PubMed

Belmaati, Esther Okeke; Iversen, Martin; Kofoed, Klaus F; Nielsen, Michael B; Mortensen, Jann

2012-06-01

Scintigraphy has been used as a tool to detect dysfunction of the lung before and after transplantation. The aims of this study were to evaluate the development of the ventilation-perfusion relationships in single lung transplant recipients in the first year, at 3 months after transplantation, and to investigate whether scintigraphic findings at 3 months were predictive for the outcome at 12 months in relation to primary graft dysfunction (PGD) and lung function. A retrospective study was carried out on all patients who prospectively and consecutively were referred for a routine lung scintigraphy procedure 3 months after single lung transplantation (SLTX). A total of 41 patients were included in the study: 20 women and 21 men with the age span of patients at transplantation being 38-66 years (mean ± SD: 54.2 ± 6.0). Patient records also included lung function tests and chest X-ray images. We found no significant correlation between lung function distribution at 3 months and PGD at 72 h. There was also no significant correlation between PGD scores at 72 h and lung function at 6 and 12 months. The same applied to scintigraphic scores for heterogeneity at 3 months compared with lung function at 6 and 12 months. Fifty-five percent of all patients had decreased ventilation function measured in the period from 6 to 12 months. Forty-nine percent of the patients had normal perfusion evaluations, and 51% had abnormal perfusion evaluations at 3 months. For ventilation evaluations, 72% were normal and 28% were abnormal. There was a significant difference in the normal versus abnormal perfusion and ventilation scintigraphic images evaluated from the same patients. Ventilation was distributed more homogenously in the transplanted lung than perfusion in the same lung. The relative distribution of perfusion and ventilation to the transplanted lung of patients with and without a primary diagnosis of fibrosis did not differ significantly from each other. We conclude that PGD defined at 72 h does not lead to recognizable changes in ventilation-perfusion scintigrapy at 3 months, and scintigraphic findings do not correlate with development in lung function in the first 12 months.

Predicting the response of the injured lung to the mechanical breath profile

PubMed Central

Smith, Bradford J.; Lundblad, Lennart K. A.; Kollisch-Singule, Michaela; Satalin, Joshua; Nieman, Gary; Habashi, Nader

2015-01-01

Mechanical ventilation is a crucial component of the supportive care provided to patients with acute respiratory distress syndrome. Current practice stipulates the use of a low tidal volume (Vt) of 6 ml/kg ideal body weight, the presumptive notion being that this limits overdistension of the tissues and thus reduces volutrauma. We have recently found, however, that airway pressure release ventilation (APRV) is efficacious at preventing ventilator-induced lung injury, yet APRV has a very different mechanical breath profile compared with conventional low-Vt ventilation. To gain insight into the relative merits of these two ventilation modes, we measured lung mechanics and derecruitability in rats before and following Tween lavage. We fit to these lung mechanics measurements a computational model of the lung that accounts for both the degree of tissue distension of the open lung and the amount of lung derecruitment that takes place as a function of time. Using this model, we predicted how tissue distension, open lung fraction, and intratidal recruitment vary as a function of ventilator settings both for conventional low-Vt ventilation and for APRV. Our predictions indicate that APRV is more effective at recruiting the lung than low-Vt ventilation, but without causing more overdistension of the tissues. On the other hand, low-Vt ventilation generally produces less intratidal recruitment than APRV. Predictions such as these may be useful for deciding on the relative benefits of different ventilation modes and thus may serve as a means for determining how to ventilate a given lung in the least injurious fashion. PMID:25635004

Effect of leak and breathing pattern on the accuracy of tidal volume estimation by commercial home ventilators: a bench study.

PubMed

Luján, Manel; Sogo, Ana; Pomares, Xavier; Monsó, Eduard; Sales, Bernat; Blanch, Lluís

2013-05-01

New home ventilators are able to provide clinicians data of interest through built-in software. Monitoring of tidal volume (VT) is a key point in the assessment of the efficacy of home mechanical ventilation. To assess the reliability of the VT provided by 5 ventilators in a bench test. Five commercial ventilators from 4 different manufacturers were tested in pressure support mode with the help of a breathing simulator under different conditions of mechanical respiratory pattern, inflation pressure, and intentional leakage. Values provided by the built-in software of each ventilator were compared breath to breath with the VT monitored through an external pneumotachograph. Ten breaths for each condition were compared for every tested situation. All tested ventilators underestimated VT (ranges of -21.7 mL to -83.5 mL, which corresponded to -3.6% to -14.7% of the externally measured VT). A direct relationship between leak and underestimation was found in 4 ventilators, with higher underestimations of the VT when the leakage increased, ranging between -2.27% and -5.42% for each 10 L/min increase in the leakage. A ventilator that included an algorithm that computes the pressure loss through the tube as a function of the flow exiting the ventilator had the minimal effect of leaks on the estimation of VT (0.3%). In 3 ventilators the underestimation was also influenced by mechanical pattern (lower underestimation with restrictive, and higher with obstructive). The inclusion of algorithms that calculate the pressure loss as a function of the flow exiting the ventilator in commercial models may increase the reliability of VT estimation.

WE-AB-202-06: Correlating Lung CT HU with Transformation-Based and Xe-CT Derived Ventilation

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

Du, K; Patton, T; Bayouth, J

Purpose: Regional lung ventilation is useful to reduce radiation-induced function damage during lung cancer radiation therapy. Recently a new direct HU (Hounsfield unit)-based method was proposed to estimate the ventilation potential without image registration. The purpose of this study is to examine if there is a functional dependence between HU values and transformation-based or Xe-CT derived ventilation. Methods: 4DCT images acquired from 13 patients prior to radiation therapy and 4 mechanically ventilated sheep subjects which also have associated Xe-CT images were used for this analysis. Transformation-based ventilation was computed using Jacobian determinant of the transformation field between peak-exhale and peak-inhalemore » 4DCT images. Both transformation and Xe-CT derived ventilation was computed for each HU bin. Color scatter plot and cumulative histogram were used to compare and validate the direct HU-based method. Results: There was little change of the center and shape of the HU histograms between free breathing CT and 4DCT average, with or without smoothing, and between the repeated 4DCT scans. HU of −750 and −630 were found to have the greatest transformation-based ventilation for human and sheep subjects, respectively. Maximum Xe-CT derived ventilation was found to locate at HU of −600 in sheep subjects. The curve between Xe-CT ventilation and HU was noisy for tissue above HU −400, possibly due to less intensity change of Xe gas during wash-out and wash-in phases. Conclusion: Both transformation-based and Xe-CT ventilation demonstrated that lung tissues with HU values in the range of (-750, −600) HU have the maximum ventilation potential. The correlation between HU and ventilation suggests that HU might be used to help guide the ventilation calculation and make it more robust to noise and image registration errors. Research support from NIH grants CA166703 and CA166119 and a gift from Roger Koch.« less

Effect on lung function of mounthpiece ventilation in Steinert disease. A case report.

PubMed

Annunziata, Anna; Fiorentino, Giuseppe; Esquinas, Antonio

2017-03-01

In patients with muscular dystrophies both muscle length tension relationship changes and muscle elasticity and plasticity are decreased, resulting in impaired inspiratory muscle function and decreased vital capacity. Furthermore, the loss of deep breathing further increases the risk of alveolar collapse, hypoventilation and atelectasias. In this case report, a stable improvement of vital capacity after treatment with mounthpiece ventilation (MPV), was observed, suggesting that not invasive ventilation (NIV) might help to maintai lung and chest wall compliance, prevent hypoventilation and atelectasias which in turn may slow down the development of the restrictive respiratory pattern. The improvement of vital capacity may have a positive impact on alveolar ventilation by reducing the time with SaO2 values below 90%. This case illustrates that MPV is an effective method to improve respiratory function in patients non-tolerant of nasal mask and a valid alternative option for those who need NIV support for the most part of the day. Furthermore, the use of MPV, alone or combined with other interfaces, improves the quality of life of the neuromuscular patients and promotes a greater adherence to mechanical ventilation.

Effect of prophylactic non-invasive mechanical ventilation on functional capacity after heart valve replacement: a clinical trial

PubMed Central

de Araújo-Filho, Amaro Afrânio; de Cerqueira-Neto, Manoel Luiz; de Assis Pereira Cacau, Lucas; Oliveira, Géssica Uruga; Cerqueira, Telma Cristina Fontes; de Santana-Filho, Valter Joviniano

2017-01-01

OBJECTIVE: During cardiac surgery, several factors contribute to the development of postoperative pulmonary complications. Non-invasive ventilation is a promising therapeutic tool for improving the functionality of this type of patient. The aim of this study is to evaluate the functional capacity and length of stay of patients in a nosocomial intensive care unit who underwent prophylactic non-invasive ventilation after heart valve replacement. METHOD: The study was a controlled clinical trial, comprising 50 individuals of both sexes who were allocated by randomization into two groups with 25 patients in each group: the control group and experimental group. After surgery, the patients were transferred to the intensive care unit and then participated in standard physical therapy, which was provided to the experimental group after 3 applications of non-invasive ventilation within the first 26 hours after extubation. For non-invasive ventilation, the positive pressure was 10 cm H2O, with a duration of 1 hour. The evaluation was performed on the 7th postoperative day/discharge and included a 6-minute walk test. The intensive care unit and hospitalization times were monitored in both groups. Brazilian Registry of Clinical Trials (REBeC): RBR number 8bxdd3. RESULTS: Analysis of the 6-minute walk test showed that the control group walked an average distance of 264.34±76 meters and the experimental group walked an average distance of 334.07±71 meters (p=0.002). The intensive care unit and hospitalization times did not differ between the groups. CONCLUSION: Non-invasive ventilation as a therapeutic resource was effective toward improving functionality; however, non-invasive ventilation did not influence the intensive care unit or hospitalization times of the studied cardiac patients. PMID:29160424

Intra-aortic balloon pump combined with mechanical ventilation for treating patients aged > 60 years in cardiogenic shock: Retrospective analysis

PubMed Central

Liu, Hongwei; Wu, Xueping; Zhao, Xiaoning; Zhu, Ping

2016-01-01

Objective To examine if mechanical ventilation with positive end-expiratory pressure (PEEP) combined with intra-aortic balloon pump (IABP) provided a better outcome than IABP alone for the treatment of cardiogenic shock after acute myocardial infarction in patients aged > 60 years. Methods This was a retrospective analysis of data from patients in cardiogenic shock, refractory to pharmacological therapy and treated at a geriatric coronary care unit. Results Sixty-two patients were eligible for study inclusion: 33 received IABP alone; 29 received IABP combined with mechanical ventilation. Patients in the IABP + mechanical ventilation group had lower mean arterial blood pressure (BP), systolic BP and partial pressure of oxygen compared with the IABP group, indicating worse cardiac and pulmonary function. In addition, higher rates of pulmonary infection and renal insufficiency were observed in the IABP + mechanical ventilation group than in the IABP group. A statistically significant improvement of left ventricular function before and after treatment was observed in the IABP + mechanical ventilation group, but not in the IABP group. Pulmonary infection and renal insufficiency were risk factors for all-cause in-hospital mortality; successful revascularization was a negative risk factor. There was no between-group difference in survival. Conclusion Mechanical ventilation with an appropriate level of PEEP appears to enhance the beneficial effects of IABP on left ventricular function for patients in cardiogenic shock. PMID:27020597

Modes of mechanical ventilation for the operating room.

PubMed

Ball, Lorenzo; Dameri, Maddalena; Pelosi, Paolo

2015-09-01

Most patients undergoing surgical procedures need to be mechanically ventilated, because of the impact of several drugs administered at induction and during maintenance of general anaesthesia on respiratory function. Optimization of intraoperative mechanical ventilation can reduce the incidence of post-operative pulmonary complications and improve the patient's outcome. Preoxygenation at induction of general anaesthesia prolongs the time window for safe intubation, reducing the risk of hypoxia and overweighs the potential risk of reabsorption atelectasis. Non-invasive positive pressure ventilation delivered through different interfaces should be considered at the induction of anaesthesia morbidly obese patients. Anaesthesia ventilators are becoming increasingly sophisticated, integrating many functions that were once exclusive to intensive care. Modern anaesthesia machines provide high performances in delivering the desired volumes and pressures accurately and precisely, including assisted ventilation modes. Therefore, the physicians should be familiar with the potential and pitfalls of the most commonly used intraoperative ventilation modes: volume-controlled, pressure-controlled, dual-controlled and assisted ventilation. Although there is no clear evidence to support the advantage of any one of these ventilation modes over the others, protective mechanical ventilation with low tidal volume and low levels of positive end-expiratory pressure (PEEP) should be considered in patients undergoing surgery. The target tidal volume should be calculated based on the predicted or ideal body weight rather than on the actual body weight. To optimize ventilation monitoring, anaesthesia machines should include end-inspiratory and end-expiratory pause as well as flow-volume loop curves. The routine administration of high PEEP levels should be avoided, as this may lead to haemodynamic impairment and fluid overload. Higher PEEP might be considered during surgery longer than 3 h, laparoscopy in the Trendelenburg position and in patients with body mass index >35 kg/m(2). Large randomized trials are warranted to identify subgroups of patients and the type of surgery that can potentially benefit from specific ventilation modes or ventilation settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Biogenesis of light harvesting proteins.

PubMed

Dall'Osto, Luca; Bressan, Mauro; Bassi, Roberto

2015-09-01

The LHC family includes nuclear-encoded, integral thylakoid membrane proteins, most of which coordinate chlorophyll and xanthophyll chromophores. By assembling with the core complexes of both photosystems, LHCs form a flexible peripheral moiety for enhancing light-harvesting cross-section, regulating its efficiency and providing protection against photo-oxidative stress. Upon its first appearance, LHC proteins underwent evolutionary diversification into a large protein family with a complex genetic redundancy. Such differentiation appears as a crucial event in the adaptation of photosynthetic organisms to changing environmental conditions and land colonization. The structure of photosystems, including nuclear- and chloroplast-encoded subunits, presented the cell with a number of challenges for the control of the light harvesting function. Indeed, LHC-encoding messages are translated in the cytosol, and pre-proteins imported into the chloroplast, processed to their mature size and targeted to the thylakoids where are assembled with chromophores. Thus, a tight coordination between nuclear and plastid gene expression, in response to environmental stimuli, is required to adjust LHC composition during photoacclimation. In recent years, remarkable progress has been achieved in elucidating structure, function and regulatory pathways involving LHCs; however, a number of molecular details still await elucidation. In this review, we will provide an overview on the current knowledge on LHC biogenesis, ranging from organization of pigment-protein complexes to the modulation of gene expression, import and targeting to the photosynthetic membranes, and regulation of LHC assembly and turnover. Genes controlling these events are potential candidate for biotechnological applications aimed at optimizing light use efficiency of photosynthetic organisms. This article is part of a Special Issue entitled: Chloroplast biogenesis. Copyright © 2015 Elsevier B.V. All rights reserved.

Handbook of LHC Higgs Cross Sections: 4. Deciphering the Nature of the Higgs Sector

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

de Florian, D.

This Report summarizes the results of the activities of the LHC Higgs Cross Section Working Group in the period 2014-2016. The main goal of the working group was to present the state-of-the-art of Higgs physics at the LHC, integrating all new results that have appeared in the last few years. The first part compiles the most up-to-date predictions of Higgs boson production cross sections and decay branching ratios, parton distribution functions, and off-shell Higgs boson production and interference effects. The second part discusses the recent progress in Higgs effective field theory predictions, followed by the third part on pseudo-observables, simplifiedmore » template cross section and fiducial cross section measurements, which give the baseline framework for Higgs boson property measurements. The fourth part deals with the beyond the Standard Model predictions of various benchmark scenarios of Minimal Supersymmetric Standard Model, extended scalar sector, Next-to-Minimal Supersymmetric Standard Model and exotic Higgs boson decays. This report follows three previous working-group reports: Handbook of LHC Higgs Cross Sections: 1. Inclusive Observables (CERN-2011-002), Handbook of LHC Higgs Cross Sections: 2. Differential Distributions (CERN-2012-002), and Handbook of LHC Higgs Cross Sections: 3. Higgs properties (CERN-2013-004). The current report serves as the baseline reference for Higgs physics in LHC Run 2 and beyond.« less

Intravenous superoxide dismutase as a protective agent to prevent impairment of lung function induced by high tidal volume ventilation.

PubMed

Wu, Nan-Chun; Liao, Fan-Ting; Cheng, Hao-Min; Sung, Shih-Hsien; Yang, Yu-Chun; Wang, Jiun-Jr

2017-07-26

Positive-pressure mechanical ventilation is essential in assisting patients with respiratory failure in the intensive care unit and facilitating oxygenation in the operating room. However, it was also recognized as a primary factor leading to hospital-acquired pulmonary dysfunction, in which pulmonary oxidative stress and lung inflammation had been known to play important roles. Cu/Zn superoxide dismutase (SOD) is an important antioxidant, and possesses anti-inflammatory capacity. In this study, we aimed to study the efficacy of Cu/Zn SOD, administered intravenously during high tidal volume (HTV) ventilation, to prevent impairment of lung function. Thirty-eight male Sprague-Dawley rats were divided into 3 groups: 5 h ventilation with (A) low tidal volume (LTV; 8 mL/kg; n = 10), (B) high tidal volume (HTV; 18 mL/kg; n = 14), or (C) HTV and intravenous treatment of Cu/Zn SOD at a dose of 1000 U/kg/h (HTV + SOD; n = 14). Lung function was evaluated both at baseline and after 5-h ventilation. Lung injury was assessed by histological examination, lung water and protein contents in the bronchoalveolar lavage fluid (BALF). Pulmonary oxidative stress was examined by concentrations of methylguanidine (MG) and malondialdehyde (MDA) in BALF, and antioxidative activity by protein expression of glutathione peroxidase-1 (GPx-1) in the lung. Severity of lung inflammation was evaluated by white blood cell and differential count in BALF, and protein expression of inducible nitric oxide synthase (iNOS), intercellular adhesion molecule-1 (ICAM-1), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-9 (MMP-9), and mRNA expression of nuclear factor-κB (NF-κB) in the lung. We also examined protein expression of surfactant protein (SP)-A and D and we measured hourly changes in serum nitric oxide (NO) level. Five hours of LTV ventilation did not induce a major change in lung function, whereas 5 h of HTV ventilation induced apparent combined restrictive and obstructive lung disorder, together with increased pulmonary oxidative stress, decreased anti-oxidative activity and increased lung inflammation (P < 0.05). HTV ventilation also decreased SP-A and SP-D expression and suppressed serum NO level during the time course of ventilation. Cu/Zn SOD administered intravenously during HTV ventilation effectively reversed associated pulmonary oxidative stress and lung inflammation (P < 0.05); moreover, it preserved SP-A and SP-D expressions in the lung and increased serum nitric oxide (NO) level, enhancing vascular NO bioavailability. HTV ventilation can induce combined restrictive and obstructive lung disorders. Intravenous administration of Cu/Zn SOD during HTV ventilation can prevent lung function impairment and lung injury via reducing pulmonary oxidative stress and lung inflammation, preserving pulmonary surfactant expression, and enhancing vascular NO bioavailability.

Early mobilization and recovery in mechanically ventilated patients in the ICU: a bi-national, multi-centre, prospective cohort study.

PubMed

Hodgson, Carol; Bellomo, Rinaldo; Berney, Susan; Bailey, Michael; Buhr, Heidi; Denehy, Linda; Harrold, Megan; Higgins, Alisa; Presneill, Jeff; Saxena, Manoj; Skinner, Elizabeth; Young, Paul; Webb, Steven

2015-02-26

The aim of this study was to investigate current mobilization practice, strength at ICU discharge and functional recovery at 6 months among mechanically ventilated ICU patients. This was a prospective, multi-centre, cohort study conducted in twelve ICUs in Australia and New Zealand. Patients were previously functionally independent and expected to be ventilated for >48 hours. We measured mobilization during invasive ventilation, sedation depth using the Richmond Agitation and Sedation Scale (RASS), co-interventions, duration of mechanical ventilation, ICU-acquired weakness (ICUAW) at ICU discharge, mortality at day 90, and 6-month functional recovery including return to work. We studied 192 patients (mean age 58.1 ± 15.8 years; mean Acute Physiology and Chronic Health Evaluation (APACHE) (IQR) II score, 18.0 (14 to 24)). Mortality at day 90 was 26.6% (51/192). Over 1,351 study days, we collected information during 1,288 planned early mobilization episodes in patients on mechanical ventilation for the first 14 days or until extubation (whichever occurred first). We recorded the highest level of early mobilization. Despite the presence of dedicated physical therapy staff, no mobilization occurred in 1,079 (84%) of these episodes. Where mobilization occurred, the maximum levels of mobilization were exercises in bed (N = 94, 7%), standing at the bed side (N = 11, 0.9%) or walking (N = 26, 2%). On day three, all patients who were mobilized were mechanically ventilated via an endotracheal tube (N = 10), whereas by day five 50% of the patients mobilized were mechanically ventilated via a tracheostomy tube (N = 18). Early mobilization of patients receiving mechanical ventilation was uncommon. More than 50% of patients discharged from the ICU had developed ICU-acquired weakness, which was associated with death between ICU discharge and day-90. ClinicalTrials.gov NCT01674608. Registered 14 August 2012.

Muon Physics at Run-I and its upgrade plan

NASA Astrophysics Data System (ADS)

Benekos, Nektarios Chr.

2015-05-01

The Large Hadron Collider (LHC) and its multi-purpose Detector, ATLAS, has been operated successfully at record centre-of-mass energies of 7 and TeV. After this successful LHC Run-1, plans are actively advancing for a series of upgrades, culminating roughly 10 years from now in the high luminosity LHC (HL-LHC) project, delivering of order five times the LHC nominal instantaneous luminosity along with luminosity leveling. The final goal is to extend the data set from about few hundred fb-1 expected for LHC running to 3000 fb-1 by around 2030. To cope with the corresponding rate increase, the ATLAS detector needs to be upgraded. The upgrade will proceed in two steps: Phase I in the LHC shutdown 2018/19 and Phase II in 2023-25. The largest of the ATLAS Phase-1 upgrades concerns the replacement of the first muon station of the highrapidity region, the so called New Small Wheel. This configuration copes with the highest rates expected in Phase II and considerably enhances the performance of the forward muon system by adding triggering functionality to the first muon station. Prospects for the ongoing and future data taking are presented. This article presents the main muon physics results from LHC Run-1 based on a total luminosity of 30 fb^-1. Prospects for the ongoing and future data taking are also presented. We will conclude with an update of the status of the project and the steps towards a complete operational system, ready to be installed in ATLAS in 2018/19.

Detector Developments for the High Luminosity LHC Era (2/4)

ScienceCinema

Straessner, Arno

2018-04-16

Calorimetry and Muon Spectromers - Part II: When upgrading the LHC to higher luminosities, the detector and trigger performance shall be preserved - if not improved - with respect to the nominal performance. The ongoing R&D; for new radiation tolerant front-end electronics for calorimeters with higher read-out bandwidth are summarized and new possibilities for the trigger systems are presented. Similar developments are foreseen for the muon spectrometers, where also radiation tolerance of the muon detectors and functioning at high background rates is important. The corresponding plans and research work for the calorimeter and muon detectors at a LHC with highest luminsity are presented.

Pulmonary Ventilation Imaging Based on 4-Dimensional Computed Tomography: Comparison With Pulmonary Function Tests and SPECT Ventilation Images

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

Yamamoto, Tokihiro, E-mail: toyamamoto@ucdavis.edu; Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, California; Kabus, Sven

Purpose: 4-dimensional computed tomography (4D-CT)-based pulmonary ventilation imaging is an emerging functional imaging modality. The purpose of this study was to investigate the physiological significance of 4D-CT ventilation imaging by comparison with pulmonary function test (PFT) measurements and single-photon emission CT (SPECT) ventilation images, which are the clinical references for global and regional lung function, respectively. Methods and Materials: In an institutional review board–approved prospective clinical trial, 4D-CT imaging and PFT and/or SPECT ventilation imaging were performed in thoracic cancer patients. Regional ventilation (V{sub 4DCT}) was calculated by deformable image registration of 4D-CT images and quantitative analysis for regional volumemore » change. V{sub 4DCT} defect parameters were compared with the PFT measurements (forced expiratory volume in 1 second (FEV{sub 1}; % predicted) and FEV{sub 1}/forced vital capacity (FVC; %). V{sub 4DCT} was also compared with SPECT ventilation (V{sub SPECT}) to (1) test whether V{sub 4DCT} in V{sub SPECT} defect regions is significantly lower than in nondefect regions by using the 2-tailed t test; (2) to quantify the spatial overlap between V{sub 4DCT} and V{sub SPECT} defect regions with Dice similarity coefficient (DSC); and (3) to test ventral-to-dorsal gradients by using the 2-tailed t test. Results: Of 21 patients enrolled in the study, 18 patients for whom 4D-CT and either PFT or SPECT were acquired were included in the analysis. V{sub 4DCT} defect parameters were found to have significant, moderate correlations with PFT measurements. For example, V{sub 4DCT}{sup HU} defect volume increased significantly with decreasing FEV{sub 1}/FVC (R=−0.65, P<.01). V{sub 4DCT} in V{sub SPECT} defect regions was significantly lower than in nondefect regions (mean V{sub 4DCT}{sup HU} 0.049 vs 0.076, P<.01). The average DSCs for the spatial overlap with SPECT ventilation defect regions were only moderate (V{sub 4DCT}{sup HU}0.39 ± 0.11). Furthermore, ventral-to-dorsal gradients of V{sub 4DCT} were strong (V{sub 4DCT}{sup HU} R{sup 2} = 0.69, P=.08), which was similar to V{sub SPECT} (R{sup 2} = 0.96, P<.01). Conclusions: An 18-patient study demonstrated significant correlations between 4D-CT ventilation and PFT measurements as well as SPECT ventilation, providing evidence toward the validation of 4D-CT ventilation imaging.« less

Tracheostomy and invasive mechanical ventilation in amyotrophic lateral sclerosis: decision-making factors and survival analysis.

PubMed

Kimura, Fumiharu

2016-04-28

Invasive and/or non-invasive mechanical ventilation are most important options of respiratory management in amyotrophic lateral sclerosis. We evaluated the frequency, clinical characteristics, decision-making factors about ventilation and survival analysis of 190 people with amyotrophic lateral sclerosis patients from 1990 until 2013. Thirty-one percentage of patients underwent tracheostomy invasive ventilation with the rate increasing more than the past 20 years. The ratio of tracheostomy invasive ventilation in patients >65 years old was significantly increased after 2000 (25%) as compared to before (10%). After 2010, the standard use of non-invasive ventilation showed a tendency to reduce the frequency of tracheostomy invasive ventilation. Mechanical ventilation prolonged median survival (75 months in tracheostomy invasive ventilation, 43 months in non-invasive ventilation vs natural course, 32 months). The life-extending effects by tracheostomy invasive ventilation were longer in younger patients ≤65 years old at the time of ventilation support than in older patients. Presence of partners and care at home were associated with better survival. Following factors related to the decision to perform tracheostomy invasive ventilation: patients ≤65 years old: greater use of non-invasive ventilation: presence of a spouse: faster tracheostomy: higher progression rate; and preserved motor functions. No patients who underwent tracheostomy invasive ventilation died from a decision to withdraw mechanical ventilation. The present study provides factors related to decision-making process and survival after tracheostomy and help clinicians and family members to expand the knowledge about ventilation.

TU-A-12A-02: Novel Lung Ventilation Imaging with Single Energy CT After Single Inhalation of Xenon: Comparison with SPECT Ventilation Images

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

Negahdar, M; Yamamoto, T; Shultz, D

Purpose: We propose a novel lung functional imaging method to determine the spatial distribution of xenon (Xe) gas in a single inhalation as a measure of regional ventilation. We compare Xe-CT ventilation to single-photon emission CT (SPECT) ventilation, which is the current clinical reference. Regional lung ventilation information may be useful for the diagnosis and monitoring of pulmonary diseases such as COPD, radiotherapy planning, and assessing the progression of toxicity after radiation therapy. Methods: In an IRB-approved clinical study, Xe-CT and SPECT ventilation scans were acquired for three patients including one patient with severe emphysema and two lung cancer patientsmore » treated with radiotherapy. For Xe- CT, we acquired two breath-hold single energy CT images of the entire lung with inspiration of 100% O2 and a mixture of 70% Xe and 30% O2, respectively. A video biofeedback system was used to achieve reproducible breath-holds. We used deformable image registration to align the breathhold images with each other to accurately subtract them, producing a map of the distribution of Xe as a surrogate of lung ventilation. We divided each lung into twelve parts and correlated the Hounsfield unit (HU) enhancement at each part with the SPECT ventilation count of the corresponding part of the lung. Results: The mean of the Pearson linear correlation coefficient values between the Xe-CT and ventilation SPECT count for all three patients were 0.62 (p<0.01). The Xe-CT image had a higher resolution than SPECT, and did not show central airway deposition artifacts that were present in the SPECT image. Conclusion: We developed a rapid, safe, clinically practical, and potentially widely accessible method for regional lung functional imaging. We demonstrated strong correlations between the Xe-CT ventilation image and SPECT ventilation image as the clinical reference. This ongoing study will investigate more patients to confirm this finding.« less

Field Tolerances for the Triplet Quadrupoles of the LHC High Luminosity Lattice

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

Nosochkov, Yuri; Cai, Y.; Jiao, Y.

2012-06-25

It has been proposed to implement the so-called Achromatic Telescopic Squeezing (ATS) scheme in the LHC high luminosity (HL) lattice to reduce beta functions at the Interaction Points (IP) up to a factor of 8. As a result, the nominal 4.5 km peak beta functions reached in the Inner Triplets (IT) at collision will be increased by the same factor. This, therefore, justifies the installation of new, larger aperture, superconducting IT quadrupoles. The higher beta functions will enhance the effects of the triplet quadrupole field errors leading to smaller beam dynamic aperture (DA). To maintain the acceptable DA, the effectsmore » of the triplet field errors must be re-evaluated, thus specifying new tolerances. Such a study has been performed for the so-called '4444' collision option of the HL-LHC layout version SLHCV3.01, where the IP beta functions are reduced by a factor of 4 in both planes with respect to a pre-squeezed value of 60 cm at two collision points. The dynamic aperture calculations were performed using SixTrack. The impact on the triplet field quality is presented.« less

Investigation of turbine ventilator performance after added wind cup for room exhaust air applications

NASA Astrophysics Data System (ADS)

Harun, D.; Zulfadhli; Akhyar, H.

2018-05-01

The turbine ventilator is a wind turbine with a vertical axis that has a combined function of the wind turbine and a suction fan. In this study, the turbine ventilator modified by adding a wind cup on the top (cap) turbine ventilator. The purpose of this experiment is to investigated the effect of the addition of wind cup on the turbine ventilator. Turbine ventilator used is type v30 and wind cup with diameter 77 mm. The experiment was conducted using a triangular pentagon model space chamber which was cut off to place the ventilator turbine ventilation cup with a volume of 0.983 m3 (equivalent to 1 mm3). The results of this study indicate that at an average wind speed of 1.8 m/s, the rotation of the turbine produced without a wind cup is 60.6 rpm while with the addition of a wind cup in the turbine ventilator is 69 rpm. The average increase of rotation turbine after added win cup is 8.4 rpm and the efficiency improvement of turbine ventilator is 1.7 %.

CT14 intrinsic charm parton distribution functions from CTEQ-TEA global analysis

NASA Astrophysics Data System (ADS)

Hou, Tie-Jiun; Dulat, Sayipjamal; Gao, Jun; Guzzi, Marco; Huston, Joey; Nadolsky, Pavel; Schmidt, Carl; Winter, Jan; Xie, Keping; Yuan, C.-P.

2018-02-01

We investigate the possibility of a (sizable) nonperturbative contribution to the charm parton distribution function (PDF) in a nucleon, theoretical issues arising in its interpretation, and its potential impact on LHC scattering processes. The "fitted charm" PDF obtained in various QCD analyses contains a process-dependent component that is partly traced to power-suppressed radiative contributions in DIS and is generally different at the LHC. We discuss separation of the universal component of the nonperturbative charm from the rest of the radiative contributions and estimate its magnitude in the CT14 global QCD analysis at the next-to-next-to leading order in the QCD coupling strength, including the latest experimental data from HERA and the Large Hadron Collider. Models for the nonperturbative charm PDF are examined as a function of the charm quark mass and other parameters. The prospects for testing these models in the associated production of a Z boson and a charm jet at the LHC are studied under realistic assumptions, including effects of the final-state parton showering.

High energy beam impact tests on a LHC tertiary collimator at the CERN high-radiation to materials facility

NASA Astrophysics Data System (ADS)

Cauchi, Marija; Aberle, O.; Assmann, R. W.; Bertarelli, A.; Carra, F.; Cornelis, K.; Dallocchio, A.; Deboy, D.; Lari, L.; Redaelli, S.; Rossi, A.; Salvachua, B.; Mollicone, P.; Sammut, N.

2014-02-01

The correct functioning of a collimation system is crucial to safely operate highly energetic particle accelerators, such as the Large Hadron Collider (LHC). The requirements to handle high intensity beams can be demanding. In this respect, investigating the consequences of LHC particle beams hitting tertiary collimators (TCTs) in the experimental regions is a fundamental issue for machine protection. An experimental test was designed to investigate the robustness and effects of beam accidents on a fully assembled collimator, based on accident scenarios in the LHC. This experiment, carried out at the CERN High-Radiation to Materials (HiRadMat) facility, involved 440 GeV proton beam impacts of different intensities on the jaws of a horizontal TCT. This paper presents the experimental setup and the preliminary results obtained, together with some first outcomes from visual inspection and a comparison of such results with numerical simulations.

Technology for noninvasive mechanical ventilation: looking into the black box

PubMed Central

Navajas, Daniel; Montserrat, Josep M.

2016-01-01

Current devices for providing noninvasive respiratory support contain sensors and built-in intelligence for automatically modifying ventilation according to the patient's needs. These devices, including automatic continuous positive airway pressure devices and noninvasive ventilators, are technologically complex and offer a considerable number of different modes of ventilation and setting options, the details of which are sometimes difficult to capture by the user. Therefore, better predicting and interpreting the actual performance of these ventilation devices in clinical application requires understanding their functioning principles and assessing their performance under well controlled bench test conditions with simulated patients. This concise review presents an updated perspective of the theoretical basis of intelligent continuous positive airway pressure and noninvasive ventilation devices, and of the tools available for assessing how these devices respond under specific ventilation phenotypes in patients requiring breathing support. PMID:27730162

Mechanical ventilation in abdominal surgery.

PubMed

Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

2014-01-01

One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

Right ventricular function during one-lung ventilation: effects of pressure-controlled and volume-controlled ventilation.

PubMed

Al Shehri, Abdullah M; El-Tahan, Mohamed R; Al Metwally, Roshdi; Qutub, Hatem; El Ghoneimy, Yasser F; Regal, Mohamed A; Zien, Haytham

2014-08-01

To test the effects of pressure-controlled (PCV) and volume-controlled (VCV) ventilation during one-lung ventilation (OLV) for thoracic surgery on right ventricular (RV) function. A prospective, randomized, double-blind, controlled, crossover study. A single university hospital. Fourteen pairs of consecutive patients scheduled for elective thoracotomy. Patients were assigned randomly to ventilate the dependent lung with PCV or VCV mode, each in a randomized crossover order using tidal volume of 6 mL/kg, I: E ratio 1: 2.5, positive end-expiratory pressure (PEEP) of 5 cm H2O and respiratory rate adjusted to maintain normocapnia. Intraoperative changes in RV function (systolic and early diastolic tricuspid annular velocity (TAV), end-systolic volume (ESV), end-diastolic volume (EDV) and fractional area changes (FAC)), airway pressures, compliance and oxygenation index were recorded. The use of PCV during OLV resulted in faster systolic (10.1±2.39 vs. 5.8±1.67 cm/s, respectively), diastolic TAV (9.2±1.99 vs. 4.6±1.42 cm/s, respectively) (p<0.001) and compliance and lower ESV, EDV and airway pressures (p<0.05) than during the use of VCV. Oxygenation indices were similar during the use of VCV and PCV. The use of PCV offers more improved RV function than the use of VCV during OLV for open thoracotomy. These results apply specifically to younger patients with good ventricular and pulmonary functions. © 2014 Elsevier Inc. All rights reserved.

Ultrasonographic Assessment of Diaphragm Function in Critically Ill Subjects.

PubMed

Umbrello, Michele; Formenti, Paolo

2016-04-01

The majority of patients admitted to the ICU require mechanical ventilation as a part of their process of care. However, mechanical ventilation itself or the underlying disease can lead to dysfunction of the diaphragm, a condition that may contribute to the failure of weaning from mechanical ventilation. However, extended time on the ventilator increases health-care costs and greatly increases patient morbidity and mortality. Nevertheless, symptoms and signs of muscle disease in a bedridden (or bed rest-only) ICU patient are often difficult to assess because of concomitant confounding factors. Conventional assessment of diaphragm function lacks specific, noninvasive, time-saving, and easily performed bedside tools or requires patient cooperation. Recently, the use of ultrasound has raised great interest as a simple, noninvasive method of quantification of diaphragm contractile activity. In this review, we discuss the physiology and the relevant pathophysiology of diaphragm function, and we summarize the recent findings concerning the evaluation of its (dys)function in critically ill patients, with a special focus on the role of ultrasounds. We describe how to assess diaphragm excursion and diaphragm thickening during breathing and the meaning of these measurements under spontaneous or mechanical ventilation as well as the reference values in health and disease. The spread of ultrasonographic assessment of diaphragm function may possibly result in timely identification of patients with diaphragm dysfunction and to a potential improvement in the assessment of recovery from diaphragm weakness. Copyright © 2016 by Daedalus Enterprises.

Hyperpolarized (3)He magnetic resonance imaging: comparison with four-dimensional x-ray computed tomography imaging in lung cancer.

PubMed

Mathew, Lindsay; Wheatley, Andrew; Castillo, Richard; Castillo, Edward; Rodrigues, George; Guerrero, Thomas; Parraga, Grace

2012-12-01

Pulmonary functional imaging using four-dimensional x-ray computed tomographic (4DCT) imaging and hyperpolarized (3)He magnetic resonance imaging (MRI) provides regional lung function estimates in patients with lung cancer in whom pulmonary function measurements are typically dominated by tumor burden. The aim of this study was to evaluate the quantitative spatial relationship between 4DCT and hyperpolarized (3)He MRI ventilation maps. Eleven patients with lung cancer provided written informed consent to 4DCT imaging and MRI performed within 11 ± 14 days. Hyperpolarized (3)He MRI was acquired in breath-hold after inhalation from functional residual capacity of 1 L hyperpolarized (3)He, whereas 4DCT imaging was acquired over a single tidal breath of room air. For hyperpolarized (3)He MRI, the percentage ventilated volume was generated using semiautomated segmentation; for 4DCT imaging, pulmonary function maps were generated using the correspondence between identical tissue elements at inspiratory and expiratory phases to generate percentage ventilated volume. After accounting for differences in image acquisition lung volumes ((3)He MRI: 1.9 ± 0.5 L ipsilateral, 2.3 ± 0.7 L contralateral; 4DCT imaging: 1.2 ± 0.3 L ipsilateral, 1.3 ± 0.4 L contralateral), there was no significant difference in percentage ventilated volume between hyperpolarized (3)He MRI (72 ± 11% ipsilateral, 79 ± 12% contralateral) and 4DCT imaging (74 ± 3% ipsilateral, 75 ± 4% contralateral). Spatial correspondence between 4DCT and (3)He MRI ventilation was evaluated using the Dice similarity coefficient index (ipsilateral, 86 ± 12%; contralateral, 88 ± 12%). Despite rather large differences in image acquisition breathing maneuvers, good spatial and significant quantitative agreement was observed for ventilation maps on hyperpolarized (3)He MRI and 4DCT imaging, suggesting that pulmonary regions with good lung function are similar between modalities in this small group of patients with lung cancer. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

WE-AB-BRA-06: 4DCT-Ventilation: A Novel Imaging Modality for Thoracic Surgical Evaluation

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

Vinogradskiy, Y; Jackson, M; Schubert, L

Purpose: The current standard-of-care imaging used to evaluate lung cancer patients for surgical resection is nuclear-medicine ventilation. Surgeons use nuclear-medicine images along with pulmonary function tests (PFT) to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung that would be lost with surgery. 4DCT-ventilation is an emerging imaging modality developed in radiation oncology that uses 4DCT data to calculate lung ventilation maps. We perform the first retrospective study to assess the use of 4DCT-ventilation for pre-operative surgical evaluation. The purpose of this work was to compare %PPO-PFT values calculated with 4DCT-ventilation and nuclear-medicine imaging. Methods:more » 16 lung cancer patients retrospectively reviewed had undergone 4DCTs, nuclear-medicine imaging, and had Forced Expiratory Volume in 1 second (FEV1) acquired as part of a standard PFT. For each patient, 4DCT data sets, spatial registration, and a density-change based model were used to compute 4DCT-ventilation maps. Both 4DCT and nuclear-medicine images were used to calculate %PPO-FEV1 using %PPO-FEV1=pre-operative FEV1*(1-fraction of total ventilation of resected lung). Fraction of ventilation resected was calculated assuming lobectomy and pneumonectomy. The %PPO-FEV1 values were compared between the 4DCT-ventilation-based calculations and the nuclear-medicine-based calculations using correlation coefficients and average differences. Results: The correlation between %PPO-FEV1 values calculated with 4DCT-ventilation and nuclear-medicine were 0.81 (p<0.01) and 0.99 (p<0.01) for pneumonectomy and lobectomy respectively. The average difference between the 4DCT-ventilation based and the nuclear-medicine-based %PPO-FEV1 values were small, 4.1±8.5% and 2.9±3.0% for pneumonectomy and lobectomy respectively. Conclusion: The high correlation results provide a strong rationale for a clinical trial translating 4DCT-ventilation to the surgical domain. Compared to nuclear-medicine, 4DCT-ventilation is cheaper, does not require a radioactive contrast agent, provides a faster imaging procedure, and has improved spatial resolution. 4DCT-ventilation can reduce the cost and imaging time for patients while providing improved spatial accuracy and quantitative results for surgeons. YV discloses grant from State of Colorado.« less

Lung volume, breathing pattern and ventilation inhomogeneity in preterm and term infants.

PubMed

Latzin, Philipp; Roth, Stefan; Thamrin, Cindy; Hutten, Gerard J; Pramana, Isabelle; Kuehni, Claudia E; Casaulta, Carmen; Nelle, Matthias; Riedel, Thomas; Frey, Urs

2009-01-01

Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD) have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants, conflicting results exist possibly due to differences in sedation and measurement techniques. We studied 127 infants with BPD, 58 preterm infants without BPD and 239 healthy term-born infants, at a matched post-conceptional age of 44 weeks during quiet natural sleep according to ATS/ERS standards. Lung function parameters measured were functional residual capacity (FRC) and ventilation inhomogeneity by multiple breath washout as well as tidal breathing parameters. Preterm infants with BPD had only marginally lower FRC (21.4 mL/kg) than preterm infants without BPD (23.4 mL/kg) and term-born infants (22.6 mL/kg), though there was no trend with disease severity. They also showed higher respiratory rates and lower ratios of time to peak expiratory flow and expiratory time (t(PTEF)/t(E)) than healthy preterm and term controls. These changes were related to disease severity. No differences were found for ventilation inhomogeneity. Our results suggest that preterm infants with BPD have a high capacity to maintain functional lung volume during natural sleep. The alterations in breathing pattern with disease severity may reflect presence of adaptive mechanisms to cope with the disease process.

Characterisation of ionisation chambers for a mixed radiation field and investigation of their suitability as radiation monitors for the LHC.

PubMed

Theis, C; Forkel-Wirth, D; Perrin, D; Roesler, S; Vincke, H

2005-01-01

Monitoring of the radiation environment is one of the key tasks in operating a high-energy accelerator such as the Large Hadron Collider (LHC). The radiation fields consist of neutrons, charged hadrons as well as photons and electrons with energy spectra extending from those of thermal neutrons up to several hundreds of GeV. The requirements for measuring the dose equivalent in such a field are different from standard uses and it is thus necessary to investigate the response of monitoring devices thoroughly before the implementation of a monitoring system can be conducted. For the LHC, it is currently foreseen to install argon- and hydrogen-filled high-pressure ionisation chambers as radiation monitors of mixed fields. So far their response to these fields was poorly understood and, therefore, further investigation was necessary to prove that they can serve their function well enough. In this study, ionisation chambers of type IG5 (Centronic Ltd) were characterised by simulating their response functions by means of detailed FLUKA calculations as well as by calibration measurements for photons and neutrons at fixed energies. The latter results were used to obtain a better understanding and validation of the FLUKA simulations. Tests were also conducted at the CERF facility at CERN in order to compare the results with simulations of the response in a mixed radiation field. It is demonstrated that these detectors can be characterised sufficiently enough to serve their function as radiation monitors for the LHC.

Normal Physiological Values for Conscious Pigs Used in Biomedical Research

DTIC Science & Technology

1989-05-01

6. Cardiovascular and Pulmonary Functions........... 18 TABLE 7. Bioenergetics..................................... 19 TABLE 8. Renal Function...procedure developed in our laboratory. Plasma concentrations of aldosterone, cortisol, total T3, total T4, free T4, insulin and glucagon were...pulmonary vascular resistance , alveolar ventilation, alveolar ventilation/perfusion ratio, arterial 02 transport, tissue 02 extraction ratio, pulmonary

Insight into the Structure of Light Harvesting Complex II and its Stabilization in Detergent Solution

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

Cardoso, Mateus B; Smolensky, Dmitriy; Heller, William T

2009-01-01

The structure of spinach light-harvesting complex II (LHC II), stabilized in a solution of the detergent n-octyl-{beta}-d-glucoside (BOG), was investigated by small-angle neutron scattering (SANS). Physicochemical characterization of the isolated complex indicated that it was pure (>95%) and also in its native trimeric state. SANS with contrast variation was used to investigate the properties of the protein-detergent complex at three different H{sub 2}O/D{sub 2}O contrast match points, enabling the scattering properties of the protein and detergent to be investigated independently. The topological shape of LHC II, determined using ab initio shape restoration methods from the SANS data at the contrastmore » match point of BOG, was consistent with the X-ray crystallographic structure of LHC II (Liu et al. Nature 2004 428, 287-292). The interactions of the protein and detergent were investigated at the contrast match point for the protein and also in 100% D{sub 2}O. The data suggested that BOG micelle structure was altered by its interaction with LHC II, but large aggregate structures were not formed. Indirect Fourier transform analysis of the LHC II/BOG scattering curves showed that the increase in the maximum dimension of the protein-detergent complex was consistent with the presence of a monolayer of detergent surrounding the protein. A model of the LHC II/BOG complex was generated to interpret the measurements made in 100% D{sub 2}O. This model adequately reproduced the overall size of the LHC II/BOG complex, but demonstrated that the detergent does not have a highly regular shape that surrounds the hydrophobic periphery of LHC II. In addition to demonstrating that natively structured LHC II can be produced for functional characterization and for use in artificial solar energy applications, the analysis and modeling approaches described here can be used for characterizing detergent-associated {alpha}-helical transmembrane proteins.« less

CPAP of 4 cm H(2)O Has no short-term benefit at term in infants with BPD.

PubMed

Sandberg, Kenneth L; Hjalmarson, Ola

2012-01-01

Lung development and function is compromised at term in infants with bronchopulmonary dysplasia (BPD), characterized by reduced functional residual capacity (FRC) and impaired gas-mixing efficiency in distal airways. To determine whether continuous positive airway pressure (CPAP) improves FRC, ventilation, distal airway function, and gas exchange in spontaneously breathing infants with BPD. Twenty-one infants with BPD (median birth weight 0.72 kg (range 0.50-1.27) and median gestational age 26 weeks (range 23-28)) were studied before and after CPAP of 4 cm H(2)O was applied by a facemask system. A multiple-breath nitrogen washout method was used to assess FRC, ventilation, and gas-mixing efficiency. Moment analysis and lung clearance index was calculated from the nitrogen-decay curve for assessment of gas-mixing efficiency. Transcutaneous (Tc) PO(2)/PCO(2) was monitored during stable infant conditions before each washout test. When CPAP was raised from 0 to 4 cm H(2)O, FRC increased significantly together with a significant increase in moment ratios (M(1)/M(0) and M(2)/M(0)). Tc PO(2) decreased significantly and the breathing pattern changed, with significantly reduced respiratory rate, minute ventilation, and alveolar ventilation. There was also an increase in tidal volume and dead space. CPAP of 4 cm H(2)O applied with a facemask at term to infants with BPD did not improve ventilation, gas-mixing efficiency in distal airways, or oxygenation despite an increase in FRC. We speculate that instead of promoting recruitment of unventilated lung volumes, increasing the end-expiratory pressure in infants with BPD may lead to an overexpansion of already ventilated parts of the lung, causing further compromise of lung function. Copyright © 2012 S. Karger AG, Basel.

Feasibility of quantitative regional ventilation and perfusion mapping with phase-resolved functional lung (PREFUL) MRI in healthy volunteers and COPD, CTEPH, and CF patients.

PubMed

Voskrebenzev, Andreas; Gutberlet, Marcel; Klimeš, Filip; Kaireit, Till F; Schönfeld, Christian; Rotärmel, Alexander; Wacker, Frank; Vogel-Claussen, Jens

2018-04-01

In this feasibility study, a phase-resolved functional lung imaging postprocessing method for extraction of dynamic perfusion (Q) and ventilation (V) parameters using a conventional 1H lung MRI Fourier decomposition acquisition is introduced. Time series of coronal gradient-echo MR images with a temporal resolution of 288 to 324 ms of two healthy volunteers, one patient with chronic thromboembolic hypertension, one patient with cystic fibrosis, and one patient with chronic obstructive pulmonary disease were acquired at 1.5 T. Using a sine model to estimate cardiac and respiratory phases of each image, all images were sorted to reconstruct full cardiac and respiratory cycles. Time to peak (TTP), V/Q maps, and fractional ventilation flow-volume loops were calculated. For the volunteers, homogenous ventilation and perfusion TTP maps (V-TTP, Q-TTP) were obtained. The chronic thromboembolic hypertension patient showed increased perfusion TTP in hypoperfused regions in visual agreement with dynamic contrast-enhanced MRI, which improved postpulmonary endaterectomy surgery. Cystic fibrosis and chronic obstructive pulmonary disease patients showed a pattern of increased V-TTP and Q-TTP in regions of hypoventilation and decreased perfusion. Fractional ventilation flow-volume loops of the chronic obstructive pulmonary disease patient were smaller in comparison with the healthy volunteer, and showed regional differences in visual agreement with functional small airways disease and emphysema on CT. This study shows the feasibility of phase-resolved functional lung imaging to gain quantitative information regarding regional lung perfusion and ventilation without the need for ultrafast imaging, which will be advantageous for future clinical translation. Magn Reson Med 79:2306-2314, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Successful Reinnervation of the Diaphragm After Intercostal to Phrenic Nerve Neurotization in Patients With High Spinal Cord Injury.

PubMed

Nandra, Kulvir S; Harari, Martin; Price, Thea P; Greaney, Patrick J; Weinstein, Michael S

2017-08-01

Our objective in this study was to extend diaphragmatic pacing therapy to include paraplegic patients with high cervical spinal cord injuries between C3 and C5. Diaphragmatic pacing has been used in patients experiencing ventilator-dependent respiratory failure due to spinal cord injury as a means to reduce or eliminate the need for mechanical ventilation. However, this technique relies on intact phrenic nerve function. Recently, phrenic nerve reconstruction with intercostal nerve grafting has expanded the indications for diaphragmatic pacing. Our study aimed to evaluate early outcomes and efficacy of intercostal nerve transfer in diaphragmatic pacing. Four ventilator-dependent patients with high cervical spinal cord injuries were selected for this study. Each patient demonstrated absence of phrenic nerve function via external neck stimulation and laparoscopic diaphragm mapping. Each patient underwent intercostal to phrenic nerve grafting with implantation of a phrenic nerve pacer. The patients were followed, and ventilator dependence was reassessed at 1 year postoperatively. Our primary outcome was measured by the amount of time our patients tolerated off the ventilator per day. We found that all 4 patients have tolerated paced breathing independent of mechanical ventilation, with 1 patient achieving 24 hours of tracheostomy collar. From this study, intercostal to phrenic nerve transfer seems to be a promising approach in reducing or eliminating ventilator support in patients with C3 to C5 high spinal cord injury.

Validating and improving CT ventilation imaging by correlating with ventilation 4D-PET/CT using {sup 68}Ga-labeled nanoparticles

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

Kipritidis, John, E-mail: john.kipritidis@sydney.edu.au; Keall, Paul J.; Siva, Shankar

Purpose: CT ventilation imaging is a novel functional lung imaging modality based on deformable image registration. The authors present the first validation study of CT ventilation using positron emission tomography with{sup 68}Ga-labeled nanoparticles (PET-Galligas). The authors quantify this agreement for different CT ventilation metrics and PET reconstruction parameters. Methods: PET-Galligas ventilation scans were acquired for 12 lung cancer patients using a four-dimensional (4D) PET/CT scanner. CT ventilation images were then produced by applying B-spline deformable image registration between the respiratory correlated phases of the 4D-CT. The authors test four ventilation metrics, two existing and two modified. The two existing metricsmore » model mechanical ventilation (alveolar air-flow) based on Hounsfield unit (HU) change (V{sub HU}) or Jacobian determinant of deformation (V{sub Jac}). The two modified metrics incorporate a voxel-wise tissue-density scaling (ρV{sub HU} and ρV{sub Jac}) and were hypothesized to better model the physiological ventilation. In order to assess the impact of PET image quality, comparisons were performed using both standard and respiratory-gated PET images with the former exhibiting better signal. Different median filtering kernels (σ{sub m} = 0 or 3 mm) were also applied to all images. As in previous studies, similarity metrics included the Spearman correlation coefficient r within the segmented lung volumes, and Dice coefficient d{sub 20} for the (0 − 20)th functional percentile volumes. Results: The best agreement between CT and PET ventilation was obtained comparing standard PET images to the density-scaled HU metric (ρV{sub HU}) with σ{sub m} = 3 mm. This leads to correlation values in the ranges 0.22 ⩽ r ⩽ 0.76 and 0.38 ⩽ d{sub 20} ⩽ 0.68, with r{sup ¯}=0.42±0.16 and d{sup ¯}{sub 20}=0.52±0.09 averaged over the 12 patients. Compared to Jacobian-based metrics, HU-based metrics lead to statistically significant improvements in r{sup ¯} and d{sup ¯}{sub 20} (p < 0.05), with density scaled metrics also showing higher r{sup ¯} than for unscaled versions (p < 0.02). r{sup ¯} and d{sup ¯}{sub 20} were also sensitive to image quality, with statistically significant improvements using standard (as opposed to gated) PET images and with application of median filtering. Conclusions: The use of modified CT ventilation metrics, in conjunction with PET-Galligas and careful application of image filtering has resulted in improved correlation compared to earlier studies using nuclear medicine ventilation. However, CT ventilation and PET-Galligas do not always provide the same functional information. The authors have demonstrated that the agreement can improve for CT ventilation metrics incorporating a tissue density scaling, and also with increasing PET image quality. CT ventilation imaging has clear potential for imaging regional air volume change in the lung, and further development is warranted.« less

Photoprotection and triplet energy transfer in higher plants: the role of electronic and nuclear fluctuations.

PubMed

Cupellini, Lorenzo; Jurinovich, Sandro; Prandi, Ingrid G; Caprasecca, Stefano; Mennucci, Benedetta

2016-04-28

Photosynthetic organisms employ several photoprotection strategies to avoid damage due to the excess energy in high light conditions. Among these, quenching of triplet chlorophylls by neighboring carotenoids (Cars) is fundamental in preventing the formation of singlet oxygen. Cars are able to accept the triplets from chlorophylls by triplet energy transfer (TET). We have here studied TET rates in CP29, a minor light-harvesting complex (LHC) of the Photosystem II in plants. A fully atomistic strategy combining classical molecular dynamics of the LHC in its natural environment with a hybrid time-dependent density functional theory/polarizable MM description of the TET is used. We find that the structural fluctuations of the pigment-protein complex can largely enhance the transfer rates with respect to those predicted using the crystal structure, reducing the triplet quenching times in the subnanosecond scale. These findings add a new perspective for the interpretation of the photoprotection function and its relation with structural motions of the LHC.

Differences in one-year health outcomes and resource utilization by definition of prolonged mechanical ventilation: a prospective cohort study.

PubMed

Cox, Christopher E; Carson, Shannon S; Lindquist, Jennifer H; Olsen, Maren K; Govert, Joseph A; Chelluri, Lakshmipathi

2007-01-01

The outcomes of patients ventilated for longer than average are unclear, in part because of the lack of an accepted definition of prolonged mechanical ventilation (PMV). To better understand the implications of PMV provision, we compared one-year health outcomes between two common definitions of PMV as well as between PMV patients and those ventilated for shorter periods of time. We conducted a secondary analysis of prospectively collected data from medical and surgical intensive care units at an academic tertiary care medical center. The study included 817 critically ill patients ventilated for > or = 48 hours, 267 (33%) of whom received PMV based on receipt of a tracheostomy and ventilation for > or = 96 hours. A total of 114 (14%) patients met the alternate definition of PMV by being ventilated for > or = 21 days. Survival, functional status, and costs were measured at baseline and at 2, 6, and 12 months after discharge. Of one-year survivors, 71 (17%) were lost to follow up. PMV patients ventilated for > or = 21 days had greater costs ($140,409 versus $143,389) and higher one-year mortality (58% versus 48%) than did PMV patients with tracheostomies who were ventilated for > or = 96 hours. The majority of PMV deaths (58%) occurred after hospital discharge whereas 67% of PMV patients aged 65 years or older had died by one year. At one year PMV patients on average had limitations in two basic and five instrumental elements of functional status that exceeded both their pre-admission status and the one-year disability of those ventilated for < 96 hours. Costs per one-year survivor were $423,596, $266,105, and $165,075 for patients ventilated > or = 21 days, > or = 96 hours with a tracheostomy, and < 96 hours, respectively. Contrasting definitions of PMV capture significantly different patient populations, with > or = 21 days of ventilation specifying the most resource-intensive recipients of critical care. PMV patients, particularly the elderly, suffer from a significant burden of costly, chronic critical illness and are at high risk for death throughout the first year after intensive care.

TH-CD-202-09: Free-Breathing Proton MRI Functional Lung Avoidance Maps to Guide Radiation Therapy

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

Capaldi, D; Sheikh, K; Parraga, G

Purpose: Pulmonary functional MRI using inhaled gas contrast agents was previously investigated as a way to identify well-functioning lung in patients with NSCLC who are clinical candidates for radiotherapy. Hyperpolarized noble-gas ({sup 3}He and {sup 129}Xe) MRI has also been optimized to measure functional lung information, but for a number of reasons, the clinical translation of this approach to guide radiotherapy planning has been limited. As an alternative, free-breathing pulmonary 1H MRI using clinically available MRI systems and pulse sequences provides a non-contrast-enhanced method to generate both ventilation and perfusion maps. Free-breathing {sup 1}H MRI exploits non-rigid registration and Fouriermore » decomposition of MRI signal intensity differences (Bauman et al., MRM, 2009) that may be generated during normal tidal breathing. Here, our objective was to generate free-breathing {sup 1}H MRI ventilation and lung function avoidance maps in patients with NSCLC as a way to guide radiation therapy planning. Methods: Stage IIIA/IIIB NSCLC patients (n=8, 68±9yr) provided written informed consent to a randomized controlled clinical trial ( https://clinicaltrials.gov/ct2/show/NCT02002052 ) that aimed to compare outcomes related to image-guided versus conventional radiation therapy planning. Hyperpolarized {sup 3}He/{sup 129}Xe and dynamic free tidal-breathing {sup 1}H MRI were acquired as previously described (Capaldi et al., Acad Radiol, 2015). Non-rigid registration was performed using the modality-independent-neighbourhood-descriptor (MIND) deformable approach (Heinrich et al., Med Image Anal, 2012). Ventilation-defect-percent ({sup 3}He:VDP{sub He}, {sup 129}Xe:VDP{sub Xe}, Free-breathing-{sup 1}H:VDP{sub FB}) and the corresponding ventilation maps were compared using Pearson correlation coefficients (r) and the Dice similarity coefficient (DSC). Results: VDP{sub FB} was significantly related to VDP{sub He} (r=.71; p=.04) and VDP{sub Xe} (r=.80; p=.01) and there were also strong spatial relationships (DSC{sub He}/DSC{sub Xe}=89±3%/77±11%). Conclusion: In this proof of concept study in NSCLC patients, free-breathing {sup 1}H MRI ventilation defects were quantitatively and spatially related to inhaled-noble-gas MRI ventilation defects. Free-breathing {sup 1}H MRI measures lung function/ventilation that can be used to optimize radiotherapy planning in NSCLC patients.« less

Light Stress-Induced One-Helix Protein of the Chlorophyll a/b-Binding Family Associated with Photosystem I1

PubMed Central

Andersson, Ulrica; Heddad, Mounia; Adamska, Iwona

2003-01-01

The superfamily of light-harvesting chlorophyll a/b-binding (Lhc) proteins in higher plants and green algae is composed of more than 20 different antenna proteins associated either with photosystem I (PSI) or photosystem II (PSII). Several distant relatives of this family with conserved chlorophyll-binding residues and proposed photoprotective functions are induced transiently under various stress conditions. Whereas “classical” Lhc proteins contain three-transmembrane α-helices, their distant relatives span the membrane with between one and four transmembrane segments. Here, we report the identification and isolation of a novel member of the Lhc family from Arabidopsis with one predicted transmembrane α-helix closely related to helix I of Lhc protein from PSI (Lhca4) that we named Ohp2 (for a second one-helix protein of Lhc family described from higher plants). We showed that the Ohp2 gene expression is triggered by light stress and that the Ohp2 transcript and protein accumulated in a light intensity-dependent manner. Other stress conditions did not up-regulate the expression of the Ohp2 gene. Localization studies revealed that Ohp2 is associated with PSI under low- or high-light conditions. Because all stress-induced Lhc relatives reported so far were found in PSII, we propose that the accumulation of Ohp2 might represent a novel photoprotective strategy induced within PSI in response to light stress. PMID:12805611

Dynamical scales for multi-TeV top-pair production at the LHC

NASA Astrophysics Data System (ADS)

Czakon, Michał; Heymes, David; Mitov, Alexander

2017-04-01

We calculate all major differential distributions with stable top-quarks at the LHC. The calculation covers the multi-TeV range that will be explored during LHC Run II and beyond. Our results are in the form of high-quality binned distributions. We offer predictions based on three different parton distribution function (pdf) sets. In the near future we will make our results available also in the more flexible fastNLO format that allows fast re-computation with any other pdf set. In order to be able to extend our calculation into the multi-TeV range we have had to derive a set of dynamic scales. Such scales are selected based on the principle of fastest perturbative convergence applied to the differential and inclusive cross-section. Many observations from our study are likely to be applicable and useful to other precision processes at the LHC. With scale uncertainty now under good control, pdfs arise as the leading source of uncertainty for TeV top production. Based on our findings, true precision in the boosted regime will likely only be possible after new and improved pdf sets appear. We expect that LHC top-quark data will play an important role in this process.

Dosimetric feasibility of 4DCT-ventilation imaging guided proton therapy for locally advanced non-small-cell lung cancer.

PubMed

Huang, Qijie; Jabbour, Salma K; Xiao, Zhiyan; Yue, Ning; Wang, Xiao; Cao, Hongbin; Kuang, Yu; Zhang, Yin; Nie, Ke

2018-04-25

The principle aim of this study is to incorporate 4DCT ventilation imaging into functional treatment planning that preserves high-functioning lung with both double scattering and scanning beam techniques in proton therapy. Eight patients with locally advanced non-small-cell lung cancer were included in this study. Deformable image registration was performed for each patient on their planning 4DCTs and the resultant displacement vector field with Jacobian analysis was used to identify the high-, medium- and low-functional lung regions. Five plans were designed for each patient: a regular photon IMRT vs. anatomic proton plans without consideration of functional ventilation information using double scattering proton therapy (DSPT) and intensity modulated proton therapy (IMPT) vs. functional proton plans with avoidance of high-functional lung using both DSPT and IMPT. Dosimetric parameters were compared in terms of tumor coverage, plan heterogeneity, and avoidance of normal tissues. Our results showed that both DSPT and IMPT plans gave superior dose advantage to photon IMRTs in sparing low dose regions of the total lung in terms of V5 (volume receiving 5Gy). The functional DSPT only showed marginal benefit in sparing high-functioning lung in terms of V5 or V20 (volume receiving 20Gy) compared to anatomical plans. Yet, the functional planning in IMPT delivery, can further reduce the low dose in high-functioning lung without degrading the PTV dosimetric coverages, compared to anatomical proton planning. Although the doses to some critical organs might increase during functional planning, the necessary constraints were all met. Incorporating 4DCT ventilation imaging into functional proton therapy is feasible. The functional proton plans, in intensity modulated proton delivery, are effective to further preserve high-functioning lung regions without degrading the PTV coverage.

Xenon ventilation computed tomography and the management of asthma in the elderly.

PubMed

Park, Heung-Woo; Jung, Jae-Woo; Kim, Kyung-Mook; Kim, Tae-Wan; Lee, So-Hee; Lee, Chang Hyun; Goo, Jin Mo; Min, Kyung-Up; Cho, Sang-Heon

2014-04-01

Xenon ventilation computed tomography (CT) has shown potential in assessing the regional ventilation status in subjects with asthma. The purpose of this study was to evaluate the usefulness of xenon ventilation CT in the management of asthma in the elderly. Treatment-naïve asthmatics aged 65 years or older were recruited. Before initiation of medication, spirometry with bronchodilator (BD) reversibility, questionnaires to assess the severity of symptoms including a visual analogue scale (VAS), tests to evaluate cognitive function and mood, and xenon ventilation CT were performed. Xenon gas trapping (XT) on xenon ventilation CT represents an area where inhaled xenon gas was not expired and was trapped. Symptoms and lung functions were measured again after the 12-week treatment. A total of 30 elderly asthmatics were enrolled. The severity of dyspnoea measured by the VAS showed a significant correlation with the total number of areas of XT on the xenon ventilation CT taken in the pre-BD wash-out phase (r = -0.723, P < 0.001). The total number of areas of XT significantly decreased after BD inhalation, and differences in the total number of areas of XT (between the pre- and post-BD wash-out phases) at baseline showed significant correlations with the per cent increases in forced expiratory volume in 1 s after subsequent anti-asthma treatment (r = -0.775, P < 0.001). Xenon ventilation CT may be an objective and promising tool in the measurement of dyspnoea and prediction of the treatment response in elderly asthmatics. © 2014 The Authors. Respirology © 2014 Asian Pacific Society of Respirology.

Status of nuclear PDFs after the first LHC p-Pb run

NASA Astrophysics Data System (ADS)

Paukkunen, Hannu

2017-11-01

In this talk, I overview the recent progress on the global analysis of nuclear parton distribution functions (nuclear PDFs). After first introducing the contemporary fits, the analysis procedures are quickly recalled and the ambiguities in the use of experimental data outlined. Various nuclear-PDF parametrizations are compared and the main differences explained. The effects of nuclear PDFs in the LHC p-Pb hard-process observables are discussed and some future prospects sketched.

Adaptive support ventilation may deliver unwanted respiratory rate-tidal volume combinations in patients with acute lung injury ventilated according to an open lung concept.

PubMed

Dongelmans, Dave A; Paulus, Frederique; Veelo, Denise P; Binnekade, Jan M; Vroom, Margreeth B; Schultz, Marcus J

2011-05-01

With adaptive support ventilation, respiratory rate and tidal volume (V(T)) are a function of the Otis least work of breathing formula. We hypothesized that adaptive support ventilation in an open lung ventilator strategy would deliver higher V(T)s to patients with acute lung injury. Patients with acute lung injury were ventilated according to a local guideline advising the use of lower V(T) (6-8 ml/kg predicted body weight), high concentrations of positive end-expiratory pressure, and recruitment maneuvers. Ventilation parameters were recorded when the ventilator was switched to adaptive support ventilation, and after recruitment maneuvers. If V(T) increased more than 8 ml/kg predicted body weight, airway pressure was limited to correct for the rise of V(T). Ten patients with a mean (±SD) Pao(2)/Fio(2) of 171 ± 86 mmHg were included. After a switch from pressure-controlled ventilation to adaptive support ventilation, respiratory rate declined (from 31 ± 5 to 21 ± 6 breaths/min; difference = 10 breaths/min, 95% CI 3-17 breaths/min, P = 0.008) and V(T) increased (from 6.5 ± 0.8 to 9.0 ± 1.6 ml/kg predicted body weight; difference = 2.5 ml, 95% CI 0.4-4.6 ml/kg predicted body weight, P = 0.02). Pressure limitation corrected for the rise of V(T), but minute ventilation declined, forcing the user to switch back to pressure-controlled ventilation. Adaptive support ventilation, compared with pressure-controlled ventilation in an open lung strategy setting, delivers a lower respiratory rate-higher V(T) combination. Pressure limitation does correct for the rise of V(T), but leads to a decline in minute ventilation.

[Implementation of modern trends in the methods of the ventilation support in the new apparatus for artificial lung ventilation Avenir-221 P].

PubMed

Gal'perin, Iu Sh; Alkhimova, L R; Dmitriev, N D; Kozlova, I A; Nemirovskiĭ, S B; Makarov, M V; Safronov, A Iu

2005-01-01

In the new ventilator Avenir-221 P modern lines of development of ventilation support in intensive therapy of adults and children are implemented. The capacities of the ventilator are successfully combined with its technical decisions which include microprocessor parametrical controlling, programming-controlled electric drive, an information saturation, intuitively clear control system, protection against interruption of power supply sources and oxygen feeding falls. A set of functional characteristics (modes VCV, PCV, Ass/Contr, PSV, SIMV, PEEP, Sigh, etc.) in combination with an original design make the device the most accessible and promising for application in intensive care and resuscitation units of a wide network of Russian hospitals and clinics. The ventilator Avenir-221 P has passed all required tests and is presently commercially available.

Effects of mechanical ventilation on gene expression profiles in renal allografts from brain dead rats.

PubMed

Hottenrott, Maximilia C; Krebs, Joerg; Pelosi, Paolo; Luecke, Thomas; Rocco, Patricia R M; Sticht, Carsten; Breedijk, Annette; Yard, Benito; Tsagogiorgas, Charalambos

2017-12-01

Pathophysiological changes of brain death (BD) are impairing distal organ function and harming potential renal allografts. Whether ventilation strategies influence the quality of renal allografts from BD donors has not been thoroughly studied. 28 adult male Wistar rats were randomly assigned to four groups: 1) no brain death (NBD) with low tidal volume/low positive endexpiratory pressure (PEEP) titrated to minimal static elastance of the respiratory system (LVT/OLPEEP); 2) NBD with high tidal volume/low PEEP (HVT/LPEEP); 3) brain death (BD) with LVT/OLPEEP; and 4) BD with HVT/LPEEP. We hypothesized that HVT/LPEEP in BD leads to increased interleukin 6 (IL-6) gene expression and impairs potential renal allografts after six hours of mechanical ventilation. We assessed inflammatory cytokines in serum, genome wide gene expression profiles and quantitative PCR (qPCR) in kidney tissue. The influence of BD on renal gene-expression profiles was greater than the influence of the ventilation strategy. In BD, LVT ventilation did not influence the inflammatory parameters or kidney function in our experimental model. Copyright © 2017. Published by Elsevier B.V.

Streamlined calibrations of the ATLAS precision muon chambers for initial LHC running

NASA Astrophysics Data System (ADS)

Amram, N.; Ball, R.; Benhammou, Y.; Ben Moshe, M.; Dai, T.; Diehl, E. B.; Dubbert, J.; Etzion, E.; Ferretti, C.; Gregory, J.; Haider, S.; Hindes, J.; Levin, D. S.; Manilow, E.; Thun, R.; Wilson, A.; Weaverdyck, C.; Wu, Y.; Yang, H.; Zhou, B.; Zimmermann, S.

2012-04-01

The ATLAS Muon Spectrometer is designed to measure the momentum of muons with a resolution of dp/p=3% at 100 GeV and 10% at 1 TeV. For this task, the spectrometer employs 355,000 Monitored Drift Tubes (MDTs) arrayed in 1200 chambers. Calibration (RT) functions convert drift time measurements into tube-centered impact parameters for track segment reconstruction. RT functions depend on MDT environmental parameters and so must be appropriately calibrated for local chamber conditions. We report on the creation and application of a gas monitor system based calibration program for muon track reconstruction in the LHC startup phase.

Late outcomes of a randomized trial of high-frequency oscillation in neonates.

PubMed

Zivanovic, Sanja; Peacock, Janet; Alcazar-Paris, Mireia; Lo, Jessica W; Lunt, Alan; Marlow, Neil; Calvert, Sandy; Greenough, Anne

2014-03-20

Results from an observational study involving neonates suggested that high-frequency oscillatory ventilation (HFOV), as compared with conventional ventilation, was associated with superior small-airway function at follow-up. Data from randomized trials are needed to confirm this finding. We studied 319 adolescents who had been born before 29 weeks of gestation and had been enrolled in a multicenter, randomized trial that compared HFOV with conventional ventilation immediately after birth. The trial involved 797 neonates, of whom 592 survived to hospital discharge. We compared follow-up data from adolescents who had been randomly assigned to HFOV with follow-up data from those who had been randomly assigned to conventional ventilation, with respect to lung function and respiratory health, health-related quality of life, and functional status, as assessed with the use of questionnaires completed when the participants were 11 to 14 years of age. The primary outcome was forced expiratory flow at 75% of the expired vital capacity (FEF75). The HFOV group had superior results on a test of small-airway function (z score for FEF75, -0.97 with HFOV vs. -1.19 with conventional therapy; adjusted difference, 0.23 [95% confidence interval, 0.02 to 0.45]). There were significant differences in favor of HFOV in several other measures of respiratory function, including forced expiratory volume in 1 second, forced vital capacity, peak expiratory flow, diffusing capacity, and impulse-oscillometric findings. As compared with the conventional-therapy group, the HFOV group had significantly higher ratings from teachers in three of eight school subjects assessed, but there were no other significant differences in functional outcomes. In a randomized trial involving children who had been born extremely prematurely, those who had undergone HFOV, as compared with those who had received conventional ventilation, had superior lung function at 11 to 14 years of age, with no evidence of poorer functional outcomes. (Funded by the National Institute for Health Research Health Technology Assessment Programme and others.).

Processing LHC data in the UK

PubMed Central

Colling, D.; Britton, D.; Gordon, J.; Lloyd, S.; Doyle, A.; Gronbech, P.; Coles, J.; Sansum, A.; Patrick, G.; Jones, R.; Middleton, R.; Kelsey, D.; Cass, A.; Geddes, N.; Clark, P.; Barnby, L.

2013-01-01

The Large Hadron Collider (LHC) is one of the greatest scientific endeavours to date. The construction of the collider itself and the experiments that collect data from it represent a huge investment, both financially and in terms of human effort, in our hope to understand the way the Universe works at a deeper level. Yet the volumes of data produced are so large that they cannot be analysed at any single computing centre. Instead, the experiments have all adopted distributed computing models based on the LHC Computing Grid. Without the correct functioning of this grid infrastructure the experiments would not be able to understand the data that they have collected. Within the UK, the Grid infrastructure needed by the experiments is provided by the GridPP project. We report on the operations, performance and contributions made to the experiments by the GridPP project during the years of 2010 and 2011—the first two significant years of the running of the LHC. PMID:23230163

Insights into colour-tuning of chlorophyll optical response in green plants.

PubMed

Jornet-Somoza, Joaquim; Alberdi-Rodriguez, Joseba; Milne, Bruce F; Andrade, Xavier; Marques, Miguel A L; Nogueira, Fernando; Oliveira, Micael J T; Stewart, James J P; Rubio, Angel

2015-10-28

First-principles calculations within the framework of real-space time-dependent density functional theory have been performed for the complete chlorophyll (Chl) network of the light-harvesting complex from green plants, LHC-II. A local-dipole analysis method developed for this work has made possible the studies of the optical response of individual Chl molecules subjected to the influence of the remainder of the chromophore network. The spectra calculated using our real-space TDDFT method agree with previous suggestions that weak interaction with the protein microenvironment should produce only minor changes in the absorption spectrum of Chl chromophores in LHC-II. In addition, relative shifting of Chl absorption energies leads the stromal and lumenal sides of LHC-II to absorb in slightly different parts of the visible spectrum providing greater coverage of the available light frequencies. The site-specific alterations in Chl excitation energies support the existence of intrinsic energy transfer pathways within the LHC-II complex.

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

Aaboud, Morad; et al.

This paper presents combinations of inclusive and differential measurements of the charge asymmetry (more » $$A_{\\mathrm{C}}$$) in top quark pair ($$\\mathrm{t}\\overline{\\mathrm{t}}$$) events with a lepton+jets signature by the ATLAS and CMS Collaborations, using data from LHC proton-proton collisions at centre-of-mass energies of 7 and 8 TeV corresponding to integrated luminosities of about 5 and 20 fb$$^{-1}$$ for each experiment, respectively. The resulting combined LHC measurements of the inclusive charge asymmetry are $$A_{\\mathrm{C}}^{\\mathrm{LHC7}} = 0.005 \\pm0.007 \\text{ (stat)}\\pm0.006 \\text{ (syst)}$$ at 7 TeV and $$A_{\\mathrm{C}}^{\\mathrm{LHC8}} = 0.0055 \\pm0.0023\\text{ (stat)}\\pm0.0025\\text{ (syst)}$$ at 8 TeV. These values, as well as the combination of $$A_{\\mathrm{C}}$$ measurements as a function of the invariant mass of the $$\\mathrm{t}\\overline{\\mathrm{t}}$$ system at 8 TeV, are consistent with the respective standard model predictions.« less

Insights into colour-tuning of chlorophyll optical response in green plants

DOE PAGES

Jornet-Somoza, Joaquim; Alberdi-Rodriguez, Joseba; Milne, Bruce F.; ...

2015-07-17

Here, we performed first-principles calculations within the framework of real-space time-dependent density functional theory for the complete chlorophyll (Chl) network of the light-harvesting complex from green plants, LHC-II. A local-dipole analysis method developed for this work has made possible the studies of the optical response of individual Chl molecules subjected to the influence of the remainder of the chromophore network. The spectra calculated using our real-space TDDFT method agree with previous suggestions that weak interaction with the protein microenvironment should produce only minor changes in the absorption spectrum of Chl chromophores in LHC-II. In addition, relative shifting of Chl absorptionmore » energies leads the stromal and lumenal sides of LHC-II to absorb in slightly different parts of the visible spectrum providing greater coverage of the available light frequencies. The site-specific alterations in Chl excitation energies support the existence of intrinsic energy transfer pathways within the LHC-II complex.« less

Precision Luminosity of LHC Proton-Proton Collisions at 13 TeV Using Hit Counting With TPX Pixel Devices

NASA Astrophysics Data System (ADS)

Sopczak, André; Ali, Babar; Asawatavonvanich, Thanawat; Begera, Jakub; Bergmann, Benedikt; Billoud, Thomas; Burian, Petr; Caicedo, Ivan; Caforio, Davide; Heijne, Erik; Janeček, Josef; Leroy, Claude; Mánek, Petr; Mochizuki, Kazuya; Mora, Yesid; Pacík, Josef; Papadatos, Costa; Platkevič, Michal; Polanský, Štěpán; Pospíšil, Stanislav; Suk, Michal; Svoboda, Zdeněk

2017-03-01

A network of Timepix (TPX) devices installed in the ATLAS cavern measures the LHC luminosity as a function of time as a stand-alone system. The data were recorded from 13-TeV proton-proton collisions in 2015. Using two TPX devices, the number of hits created by particles passing the pixel matrices was counted. A van der Meer scan of the LHC beams was analyzed using bunch-integrated luminosity averages over the different bunch profiles for an approximate absolute luminosity normalization. It is demonstrated that the TPX network has the capability to measure the reduction of LHC luminosity with precision. Comparative studies were performed among four sensors (two sensors in each TPX device) and the relative short-term precision of the luminosity measurement was determined to be 0.1% for 10-s time intervals. The internal long-term time stability of the measurements was below 0.5% for the data-taking period.

Houses need to breathe--right?

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

Sherman, Max H.

2004-10-01

Houses need to breathe, but we can no longer leave the important functions associated with ventilation to be met accidentally. A designed ventilation system must be considered as much a part of a home as its heating system. Windows are a key part of that system because they allow a quick increase in ventilation for unusual events, but neither they nor a leaky building shell can be counted on to provide minimum levels.

Absolute electrical impedance tomography (aEIT) guided ventilation therapy in critical care patients: simulations and future trends.

PubMed

Denaï, Mouloud A; Mahfouf, Mahdi; Mohamad-Samuri, Suzani; Panoutsos, George; Brown, Brian H; Mills, Gary H

2010-05-01

Thoracic electrical impedance tomography (EIT) is a noninvasive, radiation-free monitoring technique whose aim is to reconstruct a cross-sectional image of the internal spatial distribution of conductivity from electrical measurements made by injecting small alternating currents via an electrode array placed on the surface of the thorax. The purpose of this paper is to discuss the fundamentals of EIT and demonstrate the principles of mechanical ventilation, lung recruitment, and EIT imaging on a comprehensive physiological model, which combines a model of respiratory mechanics, a model of the human lung absolute resistivity as a function of air content, and a 2-D finite-element mesh of the thorax to simulate EIT image reconstruction during mechanical ventilation. The overall model gives a good understanding of respiratory physiology and EIT monitoring techniques in mechanically ventilated patients. The model proposed here was able to reproduce consistent images of ventilation distribution in simulated acutely injured and collapsed lung conditions. A new advisory system architecture integrating a previously developed data-driven physiological model for continuous and noninvasive predictions of blood gas parameters with the regional lung function data/information generated from absolute EIT (aEIT) is proposed for monitoring and ventilator therapy management of critical care patients.

Ventilator-associated pneumonia: the influence of bacterial resistance, prescription errors, and de-escalation of antimicrobial therapy on mortality rates.

PubMed

Souza-Oliveira, Ana Carolina; Cunha, Thúlio Marquez; Passos, Liliane Barbosa da Silva; Lopes, Gustavo Camargo; Gomes, Fabiola Alves; Röder, Denise Von Dolinger de Brito

2016-01-01

Ventilator-associated pneumonia is the most prevalent nosocomial infection in intensive care units and is associated with high mortality rates (14-70%). This study evaluated factors influencing mortality of patients with Ventilator-associated pneumonia (VAP), including bacterial resistance, prescription errors, and de-escalation of antibiotic therapy. This retrospective study included 120 cases of Ventilator-associated pneumonia admitted to the adult adult intensive care unit of the Federal University of Uberlândia. The chi-square test was used to compare qualitative variables. Student's t-test was used for quantitative variables and multiple logistic regression analysis to identify independent predictors of mortality. De-escalation of antibiotic therapy and resistant bacteria did not influence mortality. Mortality was 4 times and 3 times higher, respectively, in patients who received an inappropriate antibiotic loading dose and in patients whose antibiotic dose was not adjusted for renal function. Multiple logistic regression analysis revealed the incorrect adjustment for renal function was the only independent factor associated with increased mortality. Prescription errors influenced mortality of patients with Ventilator-associated pneumonia, underscoring the challenge of proper Ventilator-associated pneumonia treatment, which requires continuous reevaluation to ensure that clinical response to therapy meets expectations. Copyright © 2016. Published by Elsevier Editora Ltda.

The effect of donor treatment with hydrogen on lung allograft function in rats.

PubMed

Kawamura, Tomohiro; Huang, Chien-Sheng; Peng, Ximei; Masutani, Kosuke; Shigemura, Norihisa; Billiar, Timothy R; Okumura, Meinoshin; Toyoda, Yoshiya; Nakao, Atsunori

2011-08-01

Because inhaled hydrogen provides potent anti-inflammatory and antiapoptotic effects against acute lung injury, we hypothesized that treatment of organ donors with inhaled hydrogen during mechanical ventilation would decrease graft injury after lung transplantation. Orthotopic left lung transplants were performed using a fully allogeneic Lewis to Brown Norway rat model. The donors were exposed to mechanical ventilation with 98% oxygen plus 2% nitrogen or 2% hydrogen for 3 h prior to harvest, and the lung grafts underwent 4 h of cold storage in Perfadex (Vitrolife, Göteborg, Sweden). The graft function, histomorphologic changes, and inflammatory reactions were assessed. The combination of mechanical ventilation and prolonged cold ischemia resulted in marked deterioration of gas exchange when the donors were ventilated with 2% nitrogen/98% oxygen, which was accompanied by upregulation of proinflammatory cytokines and proapoptotic molecules. These lung injuries were attenuated significantly by ventilation with 2% hydrogen. Inhaled hydrogen induced heme oxygenase-1, an antioxidant enzyme, in the lung grafts prior to implantation, which might contribute to protective effects afforded by hydrogen. Preloaded hydrogen gas during ventilation prior to organ procurement protected lung grafts effectively from ischemia/reperfusion-induced injury in a rat lung transplantation model. Copyright © 2011 Mosby, Inc. All rights reserved.

High-precision QCD at hadron colliders:electroweak gauge boson rapidity distributions at NNLO

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

Anastasiou, C.

2004-01-05

We compute the rapidity distributions of W and Z bosons produced at the Tevatron and the LHC through next-to-next-to leading order in QCD. Our results demonstrate remarkable stability with respect to variations of the factorization and renormalization scales for all values of rapidity accessible in current and future experiments. These processes are therefore ''gold-plated'': current theoretical knowledge yields QCD predictions accurate to better than one percent. These results strengthen the proposal to use $W$ and $Z$ production to determine parton-parton luminosities and constrain parton distribution functions at the LHC. For example, LHC data should easily be able to distinguish themore » central parton distribution fit obtained by MRST from that obtained by Alekhin.« less

[Therapeutic effect of the association between pulmonary ventilation and aerosol--inhalation with sulphureous mineral water in the chronic bronchopneumopathies].

PubMed

Lopalco, M; Proia, A R; Fraioli, A; Serio, A; Cammarella, I; Petraccia, L; Grassi, M

2004-04-01

Our research evaluates the efficacy of the inalation therapy by mineral sulphureous water in patients suffering from cronic bronchopneumopathy. From August to October 2002, two groups of patients, randomly selected, suffering from cronic bronchopneumonopathy, were studied at spa center "Pompeo" in Ferentino (FR). Every patient was treated daily during a cycle of twelve days. The first group was treated by pneumonic mechanical ventilation associated to sulphureous water aerosolinalation, the second by mechanical pulmonary ventilation associated to sulphureous water aerosol-inalation medicated with flunisolide. Every patient carried out spirometry, before and after treatment, and the measurement of FEV1 was considered a good parameter to evaluate the respiratory function. All patients reported an improvement in symptoms as dyspnea and cough. Results obtained show a significant functional improvement of respiratory function in both groups, evaluated by FEV1. Equal efficacy treating the patients by medicated and not medicated treatments stress the therapeutic role of mineral sulphureous waters in chronic bronchopneumopathies. Our research points out the usefullness of pneumonic ventilation associated with sulphureous water aerosol-inalation in patients suffering from chronic bronchopneumopathies.

New modes of assisted mechanical ventilation.

PubMed

Suarez-Sipmann, F

2014-05-01

Recent major advances in mechanical ventilation have resulted in new exciting modes of assisted ventilation. Compared to traditional ventilation modes such as assisted-controlled ventilation or pressure support ventilation, these new modes offer a number of physiological advantages derived from the improved patient control over the ventilator. By implementing advanced closed-loop control systems and using information on lung mechanics, respiratory muscle function and respiratory drive, these modes are specifically designed to improve patient-ventilator synchrony and reduce the work of breathing. Depending on their specific operational characteristics, these modes can assist spontaneous breathing efforts synchronically in time and magnitude, adapt to changing patient demands, implement automated weaning protocols, and introduce a more physiological variability in the breathing pattern. Clinicians have now the possibility to individualize and optimize ventilatory assistance during the complex transition from fully controlled to spontaneous assisted ventilation. The growing evidence of the physiological and clinical benefits of these new modes is favoring their progressive introduction into clinical practice. Future clinical trials should improve our understanding of these modes and help determine whether the claimed benefits result in better outcomes. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Lung-protective ventilation in abdominal surgery.

PubMed

Futier, Emmanuel; Jaber, Samir

2014-08-01

To provide the most recent and relevant clinical evidence regarding the use of prophylactic lung-protective mechanical ventilation in abdominal surgery. Evidence is accumulating, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary complications in patients undergoing abdominal surgery. Nonprotective ventilator settings, especially high tidal volume (>10-12 ml/kg), very low level of positive end-expiratory pressure (PEEP, <5 cm H2O), or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by the previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung-protective mechanical ventilation. Recent data provide compelling evidence that prophylactic lung-protective mechanical ventilation using lower tidal volume (6-8 ml/kg of predicted body weight), moderate PEEP (6-8 cm H2O), and recruitment maneuvers is associated with improved functional or physiological and clinical postoperative outcome in patients undergoing abdominal surgery. The use of prophylactic lung-protective ventilation can help in improving the postoperative outcome.

Applications and interpretation of krypton 81m ventilation/technetium 99m macroaggregate perfusion lung scanning in childhood

NASA Astrophysics Data System (ADS)

Davies, Hugh Trevor Frimston

Radionuclide ventilation perfusion lung scans now play an important part in the investigation of paediatric lung disease, providing a safe, noninvasive assessment of regional lung function in children with suspected pulmonary disease. In paediatric practice the most suitable radionuclides are Krypton 81m (Kr81m) and Technetium 99m (Tc99m), which are jointly used in the Kr81m ventilation/Tc99m macroaggregate perfusion lung scan (V/Q lung scan). The Kr81m ventilation scan involves a low radiation dose, requires little or no subject cooperation and because of the very short half life of Kr81m (13 seconds) the steady state image acquired during continuous inhalation of the radionuclide is considered to reflect regional distribution of ventilation. It is now the most important noninvasive method available for the investigation of the regional abnormalities of ventilation characteristic of many congenital and acquired paediatric respiratory diseases, such as diaphragmatic hernia, pulmonary sequestration, bronchopulmonary dysplasia, foreign body inhalation and bronchiectasis. It improves diagnostic accuracy, aids clinical decision making and is used to monitor the progress of disease and response to therapy. Theoretical analysis of the steady state Kr81m ventilation image suggests that it may only reflect regional ventilation when specific ventilation (ventilation per unit volume of lung) is within or below the normal adult range (1-3 L/L/min). At higher values such as those seen in neonates and infants (8-15 L/L/min) Kr81m activity may reflect regional lung volume rather than ventilation, a conclusion supported by the studies of Ciofetta et al. There is some controversy on this issue as animal studies have demonstrated that the Kr81m image reflects ventilation over a much wider range of specific ventilation (up to 13 L/L/min). A clinical study of sick infants and very young children is in agreement with this animal work and suggests that the steady state Kr81m image still reflects regional ventilation in this age group. The doubt cast on the interpretation of the Kr81m steady state image could limit the value of V/Q lung scans in following regional lung function through childhood, a period when specific ventilation is falling rapidly as the child grows. Therefore the first aim of this study was to examine the application of this theoretical model to children and determine whether the changing specific ventilation seen through childhood significantly alters the interpretation of the steady state Kr81m image. This is a necessary first step before conducting longitudinal studies of regional ventilation and perfusion in children. The effect of posture on regional ventilation and perfusion in the adult human lung has been extensively studied. Radiotracer studies have consistently shown that both ventilation and perfusion are preferentially distributed to dependent lung regions during tidal breathing regardless of posture. There is little published information concerning the pattern in children yet there are many differences in lung and chest wall mechanics of children and adults which, along with clinical observation, have led to the hypothesis that the pattern of regional ventilation observed in adults may not be seen in children. Recent reports of regional ventilation in infants and very young children have provided support for this theory. The paper of Heaf et al demonstrated that these differences may in certain circumstances be clinically important. It is not clear however at what age children adopt the "adult pattern of ventilation". In addition to the problems referred to above, attenuation of Kr81m activity as it passes through the chest wall and the changing geometry of the chest during tidal breathing have made quantitative analysis of the image difficult although fractional ventilation and perfusion to each lung can be calculated from the steady state image. In clinical practise, therefore, ventilation and perfusion are usually assessed by inspection of the steady state image. The aims of the present study were therefore: 1. To critically assess Kr81m ventilation and Tc99m MAA perfusion images in children. 2. To derive fractional ventilation and perfusion to each lung in children with normal chest radiography and homogeneous distribution of the radionuclides. 3. To conduct further studies into the effects of gravity on regional lung function. 4. To apply the technique in clinical practise. 5. To attempt to improve quantitation of the Kr81m ventilation image.

Automated pulmonary lobar ventilation measurements using volume-matched thoracic CT and MRI

NASA Astrophysics Data System (ADS)

Guo, F.; Svenningsen, S.; Bluemke, E.; Rajchl, M.; Yuan, J.; Fenster, A.; Parraga, G.

2015-03-01

Objectives: To develop and evaluate an automated registration and segmentation pipeline for regional lobar pulmonary structure-function measurements, using volume-matched thoracic CT and MRI in order to guide therapy. Methods: Ten subjects underwent pulmonary function tests and volume-matched 1H and 3He MRI and thoracic CT during a single 2-hr visit. CT was registered to 1H MRI using an affine method that incorporated block-matching and this was followed by a deformable step using free-form deformation. The resultant deformation field was used to deform the associated CT lobe mask that was generated using commercial software. 3He-1H image registration used the same two-step registration method and 3He ventilation was segmented using hierarchical k-means clustering. Whole lung and lobar 3He ventilation and ventilation defect percent (VDP) were generated by mapping ventilation defects to CT-defined whole lung and lobe volumes. Target CT-3He registration accuracy was evaluated using region- , surface distance- and volume-based metrics. Automated whole lung and lobar VDP was compared with semi-automated and manual results using paired t-tests. Results: The proposed pipeline yielded regional spatial agreement of 88.0+/-0.9% and surface distance error of 3.9+/-0.5 mm. Automated and manual whole lung and lobar ventilation and VDP were not significantly different and they were significantly correlated (r = 0.77, p < 0.0001). Conclusion: The proposed automated pipeline can be used to generate regional pulmonary structural-functional maps with high accuracy and robustness, providing an important tool for image-guided pulmonary interventions.

Vocal Ergonomics in the Workplace: Heating, Ventilation, and Air-Conditioning Method Influences on Vocal Comfort and Function

ERIC Educational Resources Information Center

Sandage, Mary J.; Rahn, Keith A.; Smith, Audrey G.

2017-01-01

Purpose: The purpose of this study was to examine the influence of the heating, ventilation, and air-conditioning method on voice function following a voicing task using ecologically valid offices, one with radiant HVAC and one with forced air. Method: A total of 12 consented participants (6 women, 6 men) narrated a video in each of 4…

[Non-invasive mechanical ventilation in the pre- and intraoperative period and difficult airway].

PubMed

Esquinas, A M; Jover, J L; Úbeda, A; Belda, F J

2015-11-01

Non-invasive mechanical ventilation is a method of ventilatory assistance aimed at increasing alveolar ventilation, thus achieving, in selected subjects, the avoidance of endotracheal intubation and invasive mechanical ventilation, with the consequent improvement in survival. There has been a systematic review and study of the technical, clinical experiences, and recommendations concerning the application of non-invasive mechanical ventilation in the pre- and intraoperative period. The use of prophylactic non-invasive mechanical ventilation before surgery that involves significant alterations in the ventilatory function may decrease the incidence of postoperative respiratory complications. Its intraoperative use will mainly depend on the type of surgery, type of anaesthetic technique, and the clinical status of the patient. Its use allows greater anaesthetic depth without deterioration of oxygenation and ventilation of patients. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Measuring interfraction and intrafraction lung function changes during radiation therapy using four-dimensional cone beam CT ventilation imaging

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

Kipritidis, John, E-mail: john.kipritidis@sydney.edu.au; Keall, Paul J.; Hugo, Geoffrey

Purpose: Adaptive ventilation guided radiation therapy could minimize the irradiation of healthy lung based on repeat lung ventilation imaging (VI) during treatment. However the efficacy of adaptive ventilation guidance requires that interfraction (e.g., week-to-week), ventilation changes are not washed out by intrafraction (e.g., pre- and postfraction) changes, for example, due to patient breathing variability. The authors hypothesize that patients undergoing lung cancer radiation therapy exhibit larger interfraction ventilation changes compared to intrafraction function changes. To test this, the authors perform the first comparison of interfraction and intrafraction lung VI pairs using four-dimensional cone beam CT ventilation imaging (4D-CBCT VI), amore » novel technique for functional lung imaging. Methods: The authors analyzed a total of 215 4D-CBCT scans acquired for 19 locally advanced non-small cell lung cancer (LA-NSCLC) patients over 4–6 weeks of radiation therapy. This set of 215 scans was sorted into 56 interfraction pairs (including first day scans and each of treatment weeks 2, 4, and 6) and 78 intrafraction pairs (including pre/postfraction scans on the same-day), with some scans appearing in both sets. VIs were obtained from the Jacobian determinant of the transform between the 4D-CBCT end-exhale and end-inhale images after deformable image registration. All VIs were deformably registered to their corresponding planning CT and normalized to account for differences in breathing effort, thus facilitating image comparison in terms of (i) voxelwise Spearman correlations, (ii) mean image differences, and (iii) gamma pass rates for all interfraction and intrafraction VI pairs. For the side of the lung ipsilateral to the tumor, we applied two-sided t-tests to determine whether interfraction VI pairs were more different than intrafraction VI pairs. Results: The (mean ± standard deviation) Spearman correlation for interfraction VI pairs was r{sup -}{sub Inter}=0.52±0.25, which was significantly lower than for intrafraction pairs (r{sup -}{sub Intra}=0.67±0.20, p = 0.0002). Conversely, mean absolute ventilation differences were larger for interfraction pairs than for intrafraction pairs, with |ΔV{sup -}{sub Inter}|=0.42±0.65 and |ΔV{sup -}{sub Intra}|=0.32±0.53, respectively (p < 10{sup −15}). Applying a gamma analysis with ventilation/distance tolerance of 25%/10 mm, we observed mean pass rate of (69% ± 20%) for interfraction VIs, which was significantly lower compared to intrafraction pairs (80% ± 15%, with p ∼ 0.0003). Compared to the first day scans, all patients experienced at least one subsequent change in median ipsilateral ventilation ≥10%. Patients experienced both positive and negative ventilation changes throughout treatment, with the maximum change occurring at different weeks for different patients. Conclusions: The authors’ data support the hypothesis that interfraction ventilation changes are larger than intrafraction ventilation changes for LA-NSCLC patients over a course of conventional lung cancer radiation therapy. Longitudinal ventilation changes are observed to be highly patient-dependent, supporting a possible role for adaptive ventilation guidance based on repeat 4D-CBCT VIs. We anticipate that future improvement of 4D-CBCT image reconstruction algorithms will improve the capability of 4D-CBCT VI to resolve interfraction ventilation changes.« less

Measuring interfraction and intrafraction lung function changes during radiation therapy using four-dimensional cone beam CT ventilation imaging.

PubMed

Kipritidis, John; Hugo, Geoffrey; Weiss, Elisabeth; Williamson, Jeffrey; Keall, Paul J

2015-03-01

Adaptive ventilation guided radiation therapy could minimize the irradiation of healthy lung based on repeat lung ventilation imaging (VI) during treatment. However the efficacy of adaptive ventilation guidance requires that interfraction (e.g., week-to-week), ventilation changes are not washed out by intrafraction (e.g., pre- and postfraction) changes, for example, due to patient breathing variability. The authors hypothesize that patients undergoing lung cancer radiation therapy exhibit larger interfraction ventilation changes compared to intrafraction function changes. To test this, the authors perform the first comparison of interfraction and intrafraction lung VI pairs using four-dimensional cone beam CT ventilation imaging (4D-CBCT VI), a novel technique for functional lung imaging. The authors analyzed a total of 215 4D-CBCT scans acquired for 19 locally advanced non-small cell lung cancer (LA-NSCLC) patients over 4-6 weeks of radiation therapy. This set of 215 scans was sorted into 56 interfraction pairs (including first day scans and each of treatment weeks 2, 4, and 6) and 78 intrafraction pairs (including pre/postfraction scans on the same-day), with some scans appearing in both sets. VIs were obtained from the Jacobian determinant of the transform between the 4D-CBCT end-exhale and end-inhale images after deformable image registration. All VIs were deformably registered to their corresponding planning CT and normalized to account for differences in breathing effort, thus facilitating image comparison in terms of (i) voxelwise Spearman correlations, (ii) mean image differences, and (iii) gamma pass rates for all interfraction and intrafraction VI pairs. For the side of the lung ipsilateral to the tumor, we applied two-sided t-tests to determine whether interfraction VI pairs were more different than intrafraction VI pairs. The (mean ± standard deviation) Spearman correlation for interfraction VI pairs was r̄(Inter)=0.52±0.25, which was significantly lower than for intrafraction pairs (r̄(Intra)=0.67±0.20, p = 0.0002). Conversely, mean absolute ventilation differences were larger for interfraction pairs than for intrafraction pairs, with |ΔV̄(Inter)|=0.42±0.65 and |ΔV̄(Intra)|=0.32±0.53, respectively (p < 10(-15)). Applying a gamma analysis with ventilation/distance tolerance of 25%/10 mm, we observed mean pass rate of (69% ± 20%) for interfraction VIs, which was significantly lower compared to intrafraction pairs (80% ± 15%, with p ∼ 0.0003). Compared to the first day scans, all patients experienced at least one subsequent change in median ipsilateral ventilation ≥10%. Patients experienced both positive and negative ventilation changes throughout treatment, with the maximum change occurring at different weeks for different patients. The authors' data support the hypothesis that interfraction ventilation changes are larger than intrafraction ventilation changes for LA-NSCLC patients over a course of conventional lung cancer radiation therapy. Longitudinal ventilation changes are observed to be highly patient-dependent, supporting a possible role for adaptive ventilation guidance based on repeat 4D-CBCT VIs. We anticipate that future improvement of 4D-CBCT image reconstruction algorithms will improve the capability of 4D-CBCT VI to resolve interfraction ventilation changes.

Comparison of 4-Dimensional Computed Tomography Ventilation With Nuclear Medicine Ventilation-Perfusion Imaging: A Clinical Validation Study

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

Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu; Koo, Phillip J.; Castillo, Richard

Purpose: Four-dimensional computed tomography (4DCT) ventilation imaging provides lung function information for lung cancer patients undergoing radiation therapy. Before 4DCT-ventilation can be implemented clinically it needs to be validated against an established imaging modality. The purpose of this work was to compare 4DCT-ventilation to nuclear medicine ventilation, using clinically relevant global metrics and radiologist observations. Methods and Materials: Fifteen lung cancer patients with 16 sets of 4DCT and nuclear medicine ventilation-perfusion (VQ) images were used for the study. The VQ-ventilation images were acquired in planar mode using Tc-99m-labeled diethylenetriamine-pentaacetic acid aerosol inhalation. 4DCT data, spatial registration, and a density-change-based modelmore » were used to compute a 4DCT-based ventilation map for each patient. The percent ventilation was calculated in each lung and each lung third for both the 4DCT and VQ-ventilation scans. A nuclear medicine radiologist assessed the VQ and 4DCT scans for the presence of ventilation defects. The VQ and 4DCT-based images were compared using regional percent ventilation and radiologist clinical observations. Results: Individual patient examples demonstrate good qualitative agreement between the 4DCT and VQ-ventilation scans. The correlation coefficients were 0.68 and 0.45, using the percent ventilation in each individual lung and lung third, respectively. Using radiologist-noted presence of ventilation defects and receiver operating characteristic analysis, the sensitivity, specificity, and accuracy of the 4DCT-ventilation were 90%, 64%, and 81%, respectively. Conclusions: The current work compared 4DCT with VQ-based ventilation using clinically relevant global metrics and radiologist observations. We found good agreement between the radiologist's assessment of the 4DCT and VQ-ventilation images as well as the percent ventilation in each lung. The agreement lessened when the data were analyzed on a regional level. Our study presents an important step for the integration of 4DCT-ventilation into thoracic clinical practice.« less

Reaching record-low β* at the CERN Large Hadron Collider using a novel scheme of collimator settings and optics

NASA Astrophysics Data System (ADS)

Bruce, R.; Bracco, C.; De Maria, R.; Giovannozzi, M.; Mereghetti, A.; Mirarchi, D.; Redaelli, S.; Quaranta, E.; Salvachua, B.

2017-03-01

The Large Hadron Collider (LHC) at CERN is built to collide intense proton beams with an unprecedented energy of 7 TeV. The design stored energy per beam of 362 MJ makes the LHC beams highly destructive, so that any beam losses risk to cause quenches of superconducting magnets or damage to accelerator components. Collimators are installed to protect the machine and they define a minimum normalized aperture, below which no other element is allowed. This imposes a limit on the achievable luminosity, since when squeezing β* (the β-function at the collision point) to smaller values for increased luminosity, the β-function in the final focusing system increases. This leads to a smaller normalized aperture that risks to go below the allowed collimation aperture. In the first run of the LHC, this was the main limitation on β*, which was constrained to values above the design specification. In this article, we show through theoretical and experimental studies how tighter collimator openings and a new optics with specific phase-advance constraints allows a β* as small as 40 cm, a factor 2 smaller than β*=80 cm used in 2015 and significantly below the design value β*=55 cm, in spite of a lower beam energy. The proposed configuration with β*=40 cm has been successfully put into operation and has been used throughout 2016 as the LHC baseline. The decrease in β* compared to 2015 has been an essential contribution to reaching and surpassing, in 2016, the LHC design luminosity for the first time, and to accumulating a record-high integrated luminosity of around 40 fb-1 in one year, in spite of using less bunches than in the design.

B-meson production at Tevatron and the LHC in the Regge limit of quantum chromodynamics

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

Karpishkov, A. V., E-mail: karpishkov@rambler.ru; Nefedov, M. A., E-mail: nefedovma@gmail.com; Saleev, V. A., E-mail: saleev@samsu.ru

2016-03-15

We study the inclusive hadroproduction of B{sup 0}, B{sup +}, and B{sub s}{sup 0} mesons in the leading order in the parton Reggeization approach. We have described B-meson transverse momentumdistributionsmeasured in the central region of rapidity by the CDF Collaboration at Fermilab Tevatron and CMS Collaboration at LHC within uncertainties and without free parameters, applying Kimber–Martin–Ryskin unintegrated gluon distribution function in a proton.

The effect of helium on ventilator performance: study of five ventilators and a bedside Pitot tube spirometer.

PubMed

Oppenheim-Eden, A; Cohen, Y; Weissman, C; Pizov, R

2001-08-01

To assess in vitro the performance of five mechanical ventilators-Siemens 300 and 900C (Siemens-Elma; Solna, Sweden), Puritan Bennett 7200 (Nellcor Puritan Bennett; Pleasanton, CA), Evita 4 (Dragerwerk; Lubeck, Germany), and Bear 1000 (Bear Medical Systems; Riverside CA)-and a bedside sidestream spirometer (Datex CS3 Respiratory Module; Datex-Ohmeda; Helsinki, Finland) during ventilation with helium-oxygen mixtures. In vitro study. ICUs of two university-affiliated hospitals. Each ventilator was connected to 100% helium through compressed air inlets and then tested at three to six different tidal volume (VT) settings using various helium-oxygen concentrations (fraction of inspired oxygen [FIO(2)] of 0.2 to 1.0). FIO(2) and VT were measured with the Datex CS3 spirometer, and VT was validated with a water-displacement spirometer. The Puritan Bennett 7200 ventilator did not function with helium. With the other four ventilators, delivered FIO(2) was lower than the set FIO(2). For the Siemens 300 and 900C ventilators, this difference could be explained by the lack of 21% oxygen when helium was connected to the air supply port, while for the other two ventilators, a nonlinear relation was found. The VT of the Siemens 300 ventilator was independent of helium concentration, while for the other three ventilators, delivered VT was greater than the set VT and was dependent on helium concentration. During ventilation with 80% helium and 20% oxygen, VT increased to 125% of set VT for the Siemens 900C ventilator, and more than doubled for the Evita 4 and Bear 1000 ventilators. Under the same conditions, the Datex CS3 spirometer underestimated the delivered VT by about 33%. At present, no mechanical ventilator is calibrated for use with helium. This investigation offers correction factors for four ventilators for ventilation with helium.

Cognitive Function Before and After Left Heart Catheterization.

PubMed

Scott, David A; Evered, Lisbeth; Maruff, Paul; MacIsaac, Andrew; Maher, Sarah; Silbert, Brendan S

2018-03-10

Hospital procedures have been associated with cognitive change in older patients. This study aimed to document the prevalence of mild cognitive impairment in individuals undergoing left heart catheterization (LHC) before the procedure and the incidence of cognitive decline to 3 months afterwards. We conducted a prospective, observational, clinical investigation of elderly participants undergoing elective LHC. Cognition was assessed using a battery of written tests and a computerized cognitive battery before the LHC and then at 3 months afterwards. The computerized tests were also administered at 24 hours (or discharge) and 7 days after LHC. A control group of 51 community participants was recruited to calculate cognitive decline using the Reliable Change Index. Of 437 participants, mild cognitive impairment was identified in 226 (51.7%) before the procedure. Computerized tests detected an incidence of cognitive decline of 10.0% at 24 hours and 7.5% at 7 days. At 3 months, written tests detected an incidence of cognitive decline of 13.1% and computerized tests detected an incidence of 8.5%. Cognitive decline at 3 months using written tests was associated with increasing age, whereas computerized tests showed cognitive decline was associated with baseline amnestic mild cognitive impairment, diabetes mellitus, and prior coronary stenting. More than half the patients aged >60 years presenting for LHC have mild cognitive impairment. LHC is followed by cognitive decline in 8% to 13% of individuals at 3 months after the procedure. Subtle cognitive decline both before and after LHC is common and may have important clinical implications. URL: www.anzctr.org.au. Unique identifier: ACTRN12607000051448. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Predictors of need for noninvasive ventilation during respiratory tract infections in medically stable, non-ventilated subjects with amyotrophic lateral sclerosis.

PubMed

Sancho, Jesus; Servera, Emilio; Bañuls, Pilar; Marin, Julio

2015-04-01

Acute lower respiratory infections can impair muscle strength in patients with amyotrophic lateral sclerosis (ALS). When associated with an increase in load on the respiratory system, this situation may precipitate hypercapnic respiratory failure in non-ventilated patients with ALS. The aim of this study was to determine whether a clinical or functional parameter can predict the need for noninvasive ventilation (NIV) during an acute respiratory infection for medically stable, non-ventilated patients with ALS. This was a prospective study involving all non-ventilated subjects with ALS admitted due to an acute respiratory infection to a respiratory care unit from a tertiary hospital. Thirty-two non-ventilated subjects with ALS were admitted to our respiratory care unit due to an acute respiratory infection: 60.72 ± 10.54 y, 13 males, 23 with spinal onset, FVC of 1.58 ± 0.83 L, FVC of 56.21 ± 23.15% of predicted, peak cough flow of 3.41 ± 1.77 L/s, maximum insufflation capacity of 1.87 ± 0.94 L, revised Amyotrophic Lateral Sclerosis Functional Rating Scale score of 22.80 ± 8.83, and Norris bulbar score of 23.48 ± 12.14. Fifteen subjects required NIV during the episode. Logistic regression analysis showed that the only predictors of need for NIV were percent-of-predicted FVC (odds ratio of 1.06, 95% CI 1.01-1.11, P = .02) and peak cough flow (odds ratio of 2.57, 95% CI 1.18-5.59, P = .02). In medically stable, non-ventilated patients with ALS, measurement of percent-of-predicted FVC and peak cough flow can predict the need for NIV during an acute lower respiratory tract infection. Copyright © 2015 by Daedalus Enterprises.

Inspiratory capacity at inflation hold in ventilated newborns: a surrogate measure for static compliance of the respiratory system.

PubMed

Hentschel, Roland; Semar, Nicole; Guttmann, Josef

2012-09-01

To study appropriateness of respiratory system compliance calculation using an inflation hold and compare it with ventilator readouts of pressure and tidal volume as well as with measurement of compliance of the respiratory system with the single-breath-single-occlusion technique gained with a standard lung function measurement. Prospective clinical trial. Level III neonatal unit of a university hospital. Sixty-seven newborns, born prematurely or at term, ventilated for a variety of pathologic conditions. A standardized sigh maneuver with a predefined peak inspiratory pressure of 30 cm H2O, termed inspiratory capacity at inflation hold, was applied. Using tidal volume, exhaled from inspiratory pause down to ambient pressure, as displayed by the ventilator, and predefined peak inspiratory pressure, compliance at inspiratory capacity at inflation hold conditions could be calculated as well as ratio of tidal volume and ventilator pressure using tidal volume and differential pressure at baseline ventilator settings: peak inspiratory pressure minus positive end-expiratory pressure. For the whole cohort, the equation for the regression between tidal volume at inspiratory capacity at inflation hold and compliance of the respiratory system was: compliance of the respiratory system = 0.052 * tidal volume at inspiratory capacity at inflation hold - 0.113, and compliance at inspiratory capacity at inflation hold conditions was closely related to the standard lung function measurement method of compliance of the respiratory system (R = 0.958). In contrast, ratio of tidal volume and ventilator pressure per kilogram calculated from the ventilator readouts and displayed against compliance of the respiratory system per kilogram yielded a broad scatter throughout the whole range of compliance; both were only weakly correlated (R = 0.309) and also the regression line was significantly different from the line of identity (p < .05). Peak inspiratory pressure at study entry did not affect the correlation between compliance at inspiratory capacity at inflation hold conditions and compliance of the respiratory system. After a standard sigh maneuver, inspiratory capacity at inflation hold and the derived quantity compliance at inspiratory capacity at inflation hold conditions can be regarded as a valid, accurate, and reliable surrogate measure for standard compliance of the respiratory system in contrast to ratio of tidal volume and ventilator pressure calculated from the ventilator readouts during ongoing mechanical ventilation at respective ventilator settings.

Ventilation heterogeneity measured by multiple breath inert gas testing is not affected by inspired oxygen concentration in healthy humans

PubMed Central

Elliott, Ann R.; Prisk, G. Kim; Darquenne, Chantal

2017-01-01

Multiple breath washout (MBW) and oxygen-enhanced MRI techniques use acute exposure to 100% oxygen to measure ventilation heterogeneity. Implicit is the assumption that breathing 100% oxygen does not induce changes in ventilation heterogeneity; however, this is untested. We hypothesized that ventilation heterogeneity decreases with increasing inspired oxygen concentration in healthy subjects. We performed MBW in 8 healthy subjects (4 women, 4 men; age = 43 ± 15 yr) with normal pulmonary function (FEV1 = 98 ± 6% predicted) using 10% argon as a tracer gas and oxygen concentrations of 12.5%, 21%, or 90%. MBW was performed in accordance with ERS-ATS guidelines. Subjects initially inspired air followed by a wash-in of test gas. Tests were performed in balanced order in triplicate. Gas concentrations were measured at the mouth, and argon signals rescaled to mimic a N2 washout, and analyzed to determine the distribution of specific ventilation (SV). Heterogeneity was characterized by the width of a log-Gaussian fit of the SV distribution and from Sacin and Scond indexes derived from the phase III slope. There were no significant differences in the ventilation heterogeneity due to altered inspired oxygen: histogram width (hypoxia 0.57 ± 0.11, normoxia 0.60 ± 0.08, hyperoxia 0.59 ± 0.09, P = 0.51), Scond (hypoxia 0.014 ± 0.011, normoxia 0.012 ± 0.015, hyperoxia 0.010 ± 0.011, P = 0.34), or Sacin (hypoxia 0.11 ± 0.04, normoxia 0.10 ± 0.03, hyperoxia 0.12 ± 0.03, P = 0.23). Functional residual capacity was increased in hypoxia (P = 0.04) and dead space increased in hyperoxia (P = 0.0001) compared with the other conditions. The acute use of 100% oxygen in MBW or MRI is unlikely to affect ventilation heterogeneity. NEW & NOTEWORTHY Hyperoxia is used to measure the distribution of ventilation in imaging and MBW but may alter the underlying ventilation distribution. We used MBW to evaluate the effect of inspired oxygen concentration on the ventilation distribution using 10% argon as a tracer. Short-duration exposure to hypoxia (12.5% oxygen) and hyperoxia (90% oxygen) during MBW had no significant effect on ventilation heterogeneity, suggesting that hyperoxia can be used to assess the ventilation distribution. PMID:28280107

Ventilation heterogeneity measured by multiple breath inert gas testing is not affected by inspired oxygen concentration in healthy humans.

PubMed

Hopkins, Susan R; Elliott, Ann R; Prisk, G Kim; Darquenne, Chantal

2017-06-01

Multiple breath washout (MBW) and oxygen-enhanced MRI techniques use acute exposure to 100% oxygen to measure ventilation heterogeneity. Implicit is the assumption that breathing 100% oxygen does not induce changes in ventilation heterogeneity; however, this is untested. We hypothesized that ventilation heterogeneity decreases with increasing inspired oxygen concentration in healthy subjects. We performed MBW in 8 healthy subjects (4 women, 4 men; age = 43 ± 15 yr) with normal pulmonary function (FEV 1 = 98 ± 6% predicted) using 10% argon as a tracer gas and oxygen concentrations of 12.5%, 21%, or 90%. MBW was performed in accordance with ERS-ATS guidelines. Subjects initially inspired air followed by a wash-in of test gas. Tests were performed in balanced order in triplicate. Gas concentrations were measured at the mouth, and argon signals rescaled to mimic a N 2 washout, and analyzed to determine the distribution of specific ventilation (SV). Heterogeneity was characterized by the width of a log-Gaussian fit of the SV distribution and from S acin and S cond indexes derived from the phase III slope. There were no significant differences in the ventilation heterogeneity due to altered inspired oxygen: histogram width (hypoxia 0.57 ± 0.11, normoxia 0.60 ± 0.08, hyperoxia 0.59 ± 0.09, P = 0.51), S cond (hypoxia 0.014 ± 0.011, normoxia 0.012 ± 0.015, hyperoxia 0.010 ± 0.011, P = 0.34), or S acin (hypoxia 0.11 ± 0.04, normoxia 0.10 ± 0.03, hyperoxia 0.12 ± 0.03, P = 0.23). Functional residual capacity was increased in hypoxia ( P = 0.04) and dead space increased in hyperoxia ( P = 0.0001) compared with the other conditions. The acute use of 100% oxygen in MBW or MRI is unlikely to affect ventilation heterogeneity. NEW & NOTEWORTHY Hyperoxia is used to measure the distribution of ventilation in imaging and MBW but may alter the underlying ventilation distribution. We used MBW to evaluate the effect of inspired oxygen concentration on the ventilation distribution using 10% argon as a tracer. Short-duration exposure to hypoxia (12.5% oxygen) and hyperoxia (90% oxygen) during MBW had no significant effect on ventilation heterogeneity, suggesting that hyperoxia can be used to assess the ventilation distribution. Copyright © 2017 the American Physiological Society.

Comparison of quantitative regional ventilation-weighted fourier decomposition MRI with dynamic fluorinated gas washout MRI and lung function testing in COPD patients.

PubMed

Kaireit, Till F; Gutberlet, Marcel; Voskrebenzev, Andreas; Freise, Julia; Welte, Tobias; Hohlfeld, Jens M; Wacker, Frank; Vogel-Claussen, Jens

2018-06-01

Ventilation-weighted Fourier decomposition-MRI (FD-MRI) has matured as a reliable technique for quantitative measures of regional lung ventilation in recent years, but has yet not been validated in COPD patients. To compare regional fractional lung ventilation obtained by ventilation-weighted FD-MRI with dynamic fluorinated gas washout MRI ( 19 F-MRI) and lung function test parameters. Prospective study. Twenty-seven patients with chronic obstructive pulmonary disease (COPD, median age 61 [54-67] years) were included. For FD-MRI and for 19 F-MRI a spoiled gradient echo sequence was used at 1.5T. FD-MRI coronal slices were acquired in free breathing. Dynamic 19 F-MRI was performed after inhalation of 25-30 L of a mixture of 79% fluorinated gas (C 3 F 8 ) and 21% oxygen via a closed face mask tubing using a dedicated coil tuned to 59.9 MHz. 19 F washout times in numbers of breaths ( 19 F-n breaths ) as well as fractional ventilation maps for both methods (FD-FV, 19 F-FV) were calculated. Slices were matched using a landmark driven algorithm, and only corresponding slices with an overlap of >90% were coregistered for evaluation. The obtained parameters were correlated with each other using Spearman's correlation coefficient (r). FD-FV strongly correlated with 19 F-n breaths on a global (r = -0.72, P < 0.0001) as well as on a lobar level and with lung function test parameters (FD-FV vs. FEV1, r = 0.76, P < 0.0001). There was a small systematic overestimation of FD-FV compared to 19 F-FV (mean difference -0.03 (95% confidence interval [CI]: -0.097; -0.045). Regional ventilation-weighted Fourier decomposition-MRI is a promising noninvasive, radiation-free tool for quantification of regional ventilation in COPD patients. 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1534-1541. © 2017 International Society for Magnetic Resonance in Medicine.

Analysis of LhcSR3, a Protein Essential for Feedback De-Excitation in the Green Alga Chlamydomonas reinhardtii

PubMed Central

Bonente, Giulia; Ballottari, Matteo; Truong, Thuy B.; Morosinotto, Tomas; Ahn, Tae K.; Fleming, Graham R.; Niyogi, Krishna K.; Bassi, Roberto

2011-01-01

In photosynthetic organisms, feedback dissipation of excess absorbed light energy balances harvesting of light with metabolic energy consumption. This mechanism prevents photodamage caused by reactive oxygen species produced by the reaction of chlorophyll (Chl) triplet states with O2. Plants have been found to perform the heat dissipation in specific proteins, binding Chls and carotenoids (Cars), that belong to the Lhc family, while triggering of the process is performed by the PsbS subunit, needed for lumenal pH detection. PsbS is not found in algae, suggesting important differences in energy-dependent quenching (qE) machinery. Consistent with this suggestion, a different Lhc-like gene product, called LhcSR3 (formerly known as LI818) has been found to be essential for qE in Chlamydomonas reinhardtii. In this work, we report the production of two recombinant LhcSR isoforms from C. reinhardtii and their biochemical and spectroscopic characterization. We found the following: (i) LhcSR isoforms are Chl a/b– and xanthophyll-binding proteins, contrary to higher plant PsbS; (ii) the LhcSR3 isoform, accumulating in high light, is a strong quencher of Chl excited states, exhibiting a very fast fluorescence decay, with lifetimes below 100 ps, capable of dissipating excitation energy from neighbor antenna proteins; (iii) the LhcSR3 isoform is highly active in the transient formation of Car radical cation, a species proposed to act as a quencher in the heat dissipation process. Remarkably, the radical cation signal is detected at wavelengths corresponding to the Car lutein, rather than to zeaxanthin, implying that the latter, predominant in plants, is not essential; (iv) LhcSR3 is responsive to low pH, the trigger of non-photochemical quenching, since it binds the non-photochemical quenching inhibitor dicyclohexylcarbodiimide, and increases its energy dissipation properties upon acidification. This is the first report of an isolated Lhc protein constitutively active in energy dissipation in its purified form, opening the way to detailed molecular analysis. Owing to its protonatable residues and constitutive excitation energy dissipation, this protein appears to merge both pH-sensing and energy-quenching functions, accomplished respectively by PsbS and monomeric Lhcb proteins in plants. PMID:21267060

Using integral dispersion relations to extend the LHC reach for new physics

NASA Astrophysics Data System (ADS)

Denton, Peter B.; Weiler, Thomas J.

2014-02-01

Many models of electroweak symmetry breaking predict new particles with masses at or just beyond LHC energies. Even if these particles are too massive to be produced on-shell at the LHC, it may be possible to see evidence of their existence through the use of integral dispersion relations (IDRs). Making use of Cauchy's integral formula and the analyticity of the scattering amplitude, IDRs are sensitive in principle to changes in the cross section at arbitrarily large energies. We investigate some models of new physics. We find that a sudden, order-one increase in the cross section above new particle mass thresholds can be inferred well below the threshold energy. On the other hand, for two more physical models of particle production, we show that the reach in energy and the signal strength of the IDR technique is greatly reduced. The peak sensitivity for the IDR technique is shown to occur when the new particle masses are near the machine energy, an energy where direct production of new particles is kinematically disallowed, phase-space suppressed, or, if applicable, suppressed by the soft parton distribution functions. Thus, IDRs do extend the reach of the LHC, but only to a window around Mχ˜√sLHC .

Light-Harvesting Complex Protein LHCBM9 Is Critical for Photosystem II Activity and Hydrogen Production in Chlamydomonas reinhardtii[C][W

PubMed Central

Grewe, Sabrina; Ballottari, Matteo; Alcocer, Marcelo; D’Andrea, Cosimo; Blifernez-Klassen, Olga; Hankamer, Ben; Mussgnug, Jan H.; Bassi, Roberto; Kruse, Olaf

2014-01-01

Photosynthetic organisms developed multiple strategies for balancing light-harvesting versus intracellular energy utilization to survive ever-changing environmental conditions. The light-harvesting complex (LHC) protein family is of paramount importance for this function and can form light-harvesting pigment protein complexes. In this work, we describe detailed analyses of the photosystem II (PSII) LHC protein LHCBM9 of the microalga Chlamydomonas reinhardtii in terms of expression kinetics, localization, and function. In contrast to most LHC members described before, LHCBM9 expression was determined to be very low during standard cell cultivation but strongly increased as a response to specific stress conditions, e.g., when nutrient availability was limited. LHCBM9 was localized as part of PSII supercomplexes but was not found in association with photosystem I complexes. Knockdown cell lines with 50 to 70% reduced amounts of LHCBM9 showed reduced photosynthetic activity upon illumination and severe perturbation of hydrogen production activity. Functional analysis, performed on isolated PSII supercomplexes and recombinant LHCBM9 proteins, demonstrated that presence of LHCBM9 resulted in faster chlorophyll fluorescence decay and reduced production of singlet oxygen, indicating upgraded photoprotection. We conclude that LHCBM9 has a special role within the family of LHCII proteins and serves an important protective function during stress conditions by promoting efficient light energy dissipation and stabilizing PSII supercomplexes. PMID:24706511

SU-F-J-219: Predicting Ventilation Change Due to Radiation Therapy: Dependency On Pre-RT Ventilation and Effort Correction

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

Patton, T; Du, K; Bayouth, J

Purpose: Ventilation change caused by radiation therapy (RT) can be predicted using four-dimensional computed tomography (4DCT) and image registration. This study tested the dependency of predicted post-RT ventilation on effort correction and pre-RT lung function. Methods: Pre-RT and 3 month post-RT 4DCT images were obtained for 13 patients. The 4DCT images were used to create ventilation maps using a deformable image registration based Jacobian expansion calculation. The post-RT ventilation maps were predicted in four different ways using the dose delivered, pre-RT ventilation, and effort correction. The pre-RT ventilation and effort correction were toggled to determine dependency. The four different predictedmore » ventilation maps were compared to the post-RT ventilation map calculated from image registration to establish the best prediction method. Gamma pass rates were used to compare the different maps with the criteria of 2mm distance-to-agreement and 6% ventilation difference. Paired t-tests of gamma pass rates were used to determine significant differences between the maps. Additional gamma pass rates were calculated using only voxels receiving over 20 Gy. Results: The predicted post-RT ventilation maps were in agreement with the actual post-RT maps in the following percentage of voxels averaged over all subjects: 71% with pre-RT ventilation and effort correction, 69% with no pre-RT ventilation and effort correction, 60% with pre-RT ventilation and no effort correction, and 58% with no pre-RT ventilation and no effort correction. When analyzing only voxels receiving over 20 Gy, the gamma pass rates were respectively 74%, 69%, 65%, and 55%. The prediction including both pre- RT ventilation and effort correction was the only prediction with significant improvement over using no prediction (p<0.02). Conclusion: Post-RT ventilation is best predicted using both pre-RT ventilation and effort correction. This is the only prediction that provided a significant improvement on agreement. Research support from NIH grants CA166119 and CA166703, a gift from Roger Koch, and a Pilot Grant from University of Iowa Carver College of Medicine.« less

A Chemical-Biological-Radio-Nuclear (CBRN) Filter can be Added to the Air-Outflow Port of a Ventilator to Protect a Home Ventilated Patient From Inhalation of Toxic Industrial Compounds.

PubMed

Be'eri, Eliezer; Owen, Simon; Beeri, Maurit; Millis, Scott R; Eisenkraft, Arik

2018-02-21

Chemical-biological-radio-nuclear (CBRN) gas masks are the standard means for protecting the general population from inhalation of toxic industrial compounds (TICs), for example after industrial accidents or terrorist attacks. However, such gas masks would not protect patients on home mechanical ventilation, as ventilator airflow would bypass the CBRN filter. We therefore evaluated in vivo the safety of adding a standard-issue CBRN filter to the air-outflow port of a home ventilator, as a method for providing TIC protection to such patients. Eight adult patients were included in the study. All had been on stable, chronic ventilation via a tracheostomy for at least 3 months before the study. Each patient was ventilated for a period of 1 hour with a standard-issue CBRN filter canister attached to the air-outflow port of their ventilator. Physiological and airflow measurements were made before, during, and after using the filter, and the patients reported their subjective sensation of ventilation continuously during the trial. For all patients, and throughout the entire study, no deterioration in any of the measured physiological parameters and no changes in measured airflow parameters were detected. All patients felt no subjective difference in the sensation of ventilation with the CBRN filter canister in situ, as compared with ventilation without it. This was true even for those patients who were breathing spontaneously and thus activating the ventilator's trigger/sensitivity function. No technical malfunctions of the ventilators occurred after addition of the CBRN filter canister to the air-outflow ports of the ventilators. A CBRN filter canister can be added to the air-outflow port of chronically ventilated patients, without causing an objective or subjective deterioration in the quality of the patients' mechanical ventilation. (Disaster Med Public Health Preparedness. 2018;page 1 of 5).

Distribution of pulmonary ventilation and perfusion during short periods of weightlessness

NASA Technical Reports Server (NTRS)

Michels, D. B.; West, J. B.

1978-01-01

Airborne experiments were conducted on four trained normal male subjects (28-40 yr) to study pulmonary function during short periods (22-27 sec) of zero gravity obtained by flying a jet aircraft through appropriate parabolic trajectories. The cabin was always pressurized to a sea-level altitude. The discussion is limited to pulmonary ventilation and perfusion. The results clearly demonstrate that gravity is the major factor causing nonuniformity in the topographical distribution of pulmonary ventilation. More importantly, the results suggest that virtually all the topographical nonuniformity of ventilation, blood flow, and lung volume observed under 1-G conditions are eliminated during short periods of zero gravity.

Parton distributions in the LHC era: MMHT 2014 PDFs.

PubMed

Harland-Lang, L A; Martin, A D; Motylinski, P; Thorne, R S

We present LO, NLO and NNLO sets of parton distribution functions (PDFs) of the proton determined from global analyses of the available hard scattering data. These MMHT2014 PDFs supersede the 'MSTW2008' parton sets, but they are obtained within the same basic framework. We include a variety of new data sets, from the LHC, updated Tevatron data and the HERA combined H1 and ZEUS data on the total and charm structure functions. We also improve the theoretical framework of the previous analysis. These new PDFs are compared to the 'MSTW2008' parton sets. In most cases the PDFs, and the predictions, are within one standard deviation of those of MSTW2008. The major changes are the [Formula: see text] valence quark difference at small [Formula: see text] due to an improved parameterisation and, to a lesser extent, the strange quark PDF due to the effect of certain LHC data and a better treatment of the [Formula: see text] branching ratio. We compare our MMHT PDF sets with those of other collaborations; in particular with the NNPDF3.0 sets, which are contemporary with the present analysis.

[Pulmonary ventilation indices of patients following the surgical correction of mitral stenosis].

PubMed

Gafurov, F Kh; Smolievskaia, G G; Azimov, A A; Amanov, A A

1986-02-01

The method of spiroveloergometry was used in 97 patients after operation of mitral commissurotomy for studying reserves of pulmonary ventilation and its relation to the level of physical working capacity. The results obtained have shown that in patients of worse functional classes the ventilation potency of the lungs deteriorated which resulted in the restricted physical working capacity. It should be necessarily taken into consideration when making programs for the rehabilitation of cardiosurgical patients.

Protective mechanical ventilation does not exacerbate lung function impairment or lung inflammation following influenza A infection.

PubMed

Zosky, Graeme R; Cannizzaro, Vincenzo; Hantos, Zoltan; Sly, Peter D

2009-11-01

The degree to which mechanical ventilation induces ventilator-associated lung injury is dependent on the initial acute lung injury (ALI). Viral-induced ALI is poorly studied, and this study aimed to determine whether ALI induced by a clinically relevant infection is exacerbated by protective mechanical ventilation. Adult female BALB/c mice were inoculated with 10(4.5) plaque-forming units of influenza A/Mem/1/71 in 50 microl of medium or medium alone. This study used a protective ventilation strategy, whereby mice were anesthetized, tracheostomized, and mechanically ventilated for 2 h. Lung mechanics were measured periodically throughout the ventilation period using a modification of the forced oscillation technique to obtain measures of airway resistance and coefficients of tissue damping and tissue elastance. Thoracic gas volume was measured and used to obtain specific airway resistance, tissue damping, and tissue elastance. At the end of the ventilation period, a bronchoalveolar lavage sample was collected to measure inflammatory cells, macrophage inflammatory protein-2, IL-6, TNF-alpha, and protein leak. Influenza infection caused significant increases in inflammatory cells, protein leak, and deterioration in lung mechanics that were not exacerbated by mechanical ventilation, in contrast to previous studies using bacterial and mouse-specific viral infection. This study highlighted the importance of type and severity of lung injury in determining outcome following mechanical ventilation.

Clinical characteristics and course of dying in patients with amyotrophic lateral sclerosis withdrawing from long-term ventilation.

PubMed

Kettemann, Dagmar; Funke, Andreas; Maier, André; Rosseau, Simone; Meyer, Robert; Spittel, Susanne; Münch, Christoph; Meyer, Thomas

2017-02-01

Non-invasive ventilation (NIV) or tracheotomy with invasive ventilation (TIV) are treatment options in ALS. However, a proportion of patients receiving long-term ventilation decide to have it withdrawn. The objective of this study was to analyse the clinical characteristics and palliative approaches in ALS patients withdrawing from long-term ventilation (WLTV). In a cohort study, two different palliative concepts in WLTV were studied: (1) augmented symptom control (ASC; sedation not intended) in patients with ventilator-free tolerance; (2) continuous deep sedation (CDS; sedation intended) in patients without ventilator-free tolerance. Results showed that WLTV was realised in 49 ALS patients (NIV = 13; TIV = 36). Mean daily ventilation was 23.4 h. The ALS Functional Rating Scale (ALSFRS-R) was low (5.6 of 48). Forty-one per cent of patients (n = 20) presented with ophthalmoplegia. ASC was performed in 20 patients, CDS in 29 patients. The mean time to death following disconnection was 32 (0.3-164) h during ASC and 0.3 (0.2-0.6) h in CDS. In conclusion, a low ALSFRS-R, high incidence of ophthalmoplegia and extended ventilator dependency were found before WLTV. The presence or absence of ventilator-free tolerance determined the approach to the management of symptoms, the setting for immediate end-of-life care and the course of dying in WLTV.

Utilizing a Suited Manikin Test Apparatus and Spacesuit Ventilation Loop to Evaluate Carbon Dioxide Washout

NASA Technical Reports Server (NTRS)

Chullen, Cinda; Conger, Bruce; Korona, Adam; Kanne, Bryan; McMillin, Summer; Norcross, Jason; Jeng, Frank; Swickrath, Mike

2014-01-01

NASA is pursuing technology development of an Advanced Extravehicular Mobility Unit (AEMU) which is an integrated assembly made up of primarily a pressure garment system and a Portable Life Support System (PLSS). The PLSS is further composed of an oxygen subsystem, a ventilation subsystem, and a thermal subsystem. One of the key functions of the ventilation system is to remove and control the carbon dioxide delivered to the crewmember. Carbon dioxide washout is the mechanism by which CO2 levels are controlled within the spacesuit helmet to limit the concentration of CO2 inhaled by the crew member. CO2 washout performance is a critical parameter needed to ensure proper and robust designs that are insensitive to human variabilities in a spacesuit. A Suited Manikin Test Apparatus (SMTA) is being developed to augment testing of the PLSS ventilation loop in order to provide a lower cost and more controlled alternative to human testing. The CO2 removal function is performed by the regenerative Rapid Cycle Amine (RCA) within the PLSS ventilation loop and its performance is evaluated within the integrated SMTA and Ventilation Loop test system. This paper will provide a detailed description of the schematics, test configurations, and hardware components of this integrated system. Results and analysis of testing performed with this integrated system will be presented within this paper.

Radionuclide assessment of the effects of chest physical therapy on ventilation in cystic fibrosis

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

DeCesare, J.A.; Babchyck, B.M.; Colten, H.R.

1982-06-01

This study assesses the use of /sup 81m/Kr scintigraphy as a measurement tool in evaluating the effectiveness of bronchial drainage with percussion and vibration on peripheral ventilation in patients with cystic fibrosis. Ten patients with cystic fibrosis participated. Each patient underwent a /sup 81m/Kr ventilation study and traditional pulmonary function tests. Forty-five minutes later, these studies were repeated before and after a chest physical therapy treatment. Each patient acted as his own control. All /sup 81m/Kr scintiscans were recorded and analyzed visually and numerically using a digital computer to assess distribution of ventilation. Visual analysis of the scintiscans indicated individualmore » variation in treatment response: in some patients ventilation improved with therapy; in others, no change was noted; still others had changes independent of treatment. Numerical data derived from the scintiscans and pulmonary function tests showed no important differences among the three studies of each patient. Airway abnormalities characteristic of cystic fibrosis, progression of the disease, sputum production, or a combination of these factors may account for the individual variation in response to treatment. /sup 81m/Kr scintigraphy is a reliable measure of regional ventilation and should be useful for assessing the efficacy of chest physical therapy because of the consistent, high quality visual data retrieved.« less

Utilizing a Suited Manikin Test Apparatus and Space Suit Ventilation Loop to Evaluate Carbon Dioxide Washout

NASA Technical Reports Server (NTRS)

Chullen, Cinda; Conger, Bruce; Korona, Adam; Kanne, Bryan; McMillin, Summer; Paul, Thomas; Norcross, Jason; Alonso, Jesus Delgado; Swickrath, Mike

2015-01-01

NASA is pursuing technology development of an Advanced Extravehicular Mobility Unit (AEMU) which is an integrated assembly made up of primarily a pressure garment system and a portable life support subsystem (PLSS). The PLSS is further composed of an oxygen subsystem, a ventilation subsystem, and a thermal subsystem. One of the key functions of the ventilation system is to remove and control the carbon dioxide (CO2) delivered to the crewmember. Carbon dioxide washout is the mechanism by which CO2 levels are controlled within the space suit helmet to limit the concentration of CO2 inhaled by the crew member. CO2 washout performance is a critical parameter needed to ensure proper and robust designs that are insensitive to human variabilities in a space suit. A suited manikin test apparatus (SMTA) was developed to augment testing of the PLSS ventilation loop in order to provide a lower cost and more controlled alternative to human testing. The CO2 removal function is performed by the regenerative Rapid Cycle Amine (RCA) within the PLSS ventilation loop and its performance is evaluated within the integrated SMTA and Ventilation Loop test system. This paper will provide a detailed description of the schematics, test configurations, and hardware components of this integrated system. Results and analysis of testing performed with this integrated system will be presented within this paper.

Echocardiographic evaluation during weaning from mechanical ventilation.

PubMed

Schifelbain, Luciele Medianeira; Vieira, Silvia Regina Rios; Brauner, Janete Salles; Pacheco, Deise Mota; Naujorks, Alexandre Antonio

2011-01-01

Echocardiographic, electrocardiographic and other cardiorespiratory variables can change during weaning from mechanical ventilation. To analyze changes in cardiac function, using Doppler echocardiogram, in critical patients during weaning from mechanical ventilation, using two different weaning methods: pressure support ventilation and T-tube; and comparing patient subgroups: success vs. failure in weaning. Randomized crossover clinical trial including patients under mechanical ventilation for more than 48 h and considered ready for weaning. Cardiorespiratory variables, oxygenation, electrocardiogram and Doppler echocardiogram findings were analyzed at baseline and after 30 min in pressure support ventilation and T-tube. Pressure support ventilation vs. T-tube and weaning success vs. failure were compared using ANOVA and Student's t-test. The level of significance was p<0.05. Twenty-four adult patients were evaluated. Seven patients failed at the first weaning attempt. No echocardiographic or electrocardiographic differences were observed between pressure support ventilation and T-tube. Weaning failure patients presented increases in left atrium, intraventricular septum thickness, posterior wall thickness and diameter of left ventricle and shorter isovolumetric relaxation time. Successfully weaned patients had higher levels of oxygenation. No differences were observed between Doppler echocardiographic variables and electrocardiographic and other cardiorespiratory variables during pressure support ventilation and T-tube. However cardiac structures were smaller, isovolumetric relaxation time was larger, and oxygenation level was greater in successfully weaned patients.

Single Sustained Inflation followed by Ventilation Leads to Rapid Cardiorespiratory Recovery but Causes Cerebral Vascular Leakage in Asphyxiated Near-Term Lambs

PubMed Central

Sobotka, Kristina S.; Hooper, Stuart B.; Crossley, Kelly J.; Ong, Tracey; Schmölzer, Georg M.; Barton, Samantha K.; McDougall, Annie R. A.; Miller, Suzie L.; Tolcos, Mary; Klingenberg, Claus; Polglase, Graeme R.

2016-01-01

Background A sustained inflation (SI) rapidly restores cardiac function in asphyxic, bradycardic newborns but its effects on cerebral haemodynamics and brain injury are unknown. We determined the effect of different SI strategies on carotid blood flow (CaBF) and cerebral vascular integrity in asphyxiated near-term lambs. Methods Lambs were instrumented and delivered at 139 ± 2 d gestation and asphyxia was induced by delaying ventilation onset. Lambs were randomised to receive 5 consecutive 3 s SI (multiple SI; n = 6), a single 30 s SI (single SI; n = 6) or conventional ventilation (no SI; n = 6). Ventilation continued for 30 min in all lambs while CaBF and respiratory function parameters were recorded. Brains were assessed for gross histopathology and vascular leakage. Results CaBF increased more rapidly and to a greater extent during a single SI (p = 0.01), which then decreased below both other groups by 10 min, due to a higher cerebral oxygen delivery (p = 0.01). Blood brain barrier disruption was increased in single SI lambs as indicated by increased numbers of blood vessel profiles with plasma protein extravasation (p = 0.001) in the cerebral cortex. There were no differences in CaBF or cerebral oxygen delivery between the multiple SI and no SI lambs. Conclusions Ventilation with an initial single 30 s SI improves circulatory recovery, but is associated with greater disruption of blood brain barrier function, which may exacerbate brain injury suffered by asphyxiated newborns. This injury may occur as a direct result of the initial SI or to the higher tidal volumes delivered during subsequent ventilation. PMID:26765258

A prototype of volume-controlled tidal liquid ventilator using independent piston pumps.

PubMed

Robert, Raymond; Micheau, Philippe; Cyr, Stéphane; Lesur, Olivier; Praud, Jean-Paul; Walti, Hervé

2006-01-01

Liquid ventilation using perfluorochemicals (PFC) offers clear theoretical advantages over gas ventilation, such as decreased lung damage, recruitment of collapsed lung regions, and lavage of inflammatory debris. We present a total liquid ventilator designed to ventilate patients with completely filled lungs with a tidal volume of PFC liquid. The two independent piston pumps are volume controlled and pressure limited. Measurable pumping errors are corrected by a programmed supervisor module, which modifies the inserted or withdrawn volume. Pump independence also allows easy functional residual capacity modifications during ventilation. The bubble gas exchanger is divided into two sections such that the PFC exiting the lungs is not in contact with the PFC entering the lungs. The heating system is incorporated into the metallic base of the gas exchanger, and a heat-sink-type condenser is placed on top of the exchanger to retrieve PFC vapors. The prototype was tested on 5 healthy term newborn lambs (<5 days old). The results demonstrate the efficiency and safety of the prototype in maintaining adequate gas exchange, normal acido-basis equilibrium, and cardiovascular stability during a short, 2-hour total liquid ventilator. Airway pressure, lung volume, and ventilation scheme were maintained in the targeted range.

Functional differences in bi-level pressure preset ventilators.

PubMed

Highcock, M P; Shneerson, J M; Smith, I E

2001-02-01

The performance of four bilevel positive pressure preset ventilators was compared. The ventilators tested were; BiPAP ST30 (Respironics); Nippy2 (B + D Electrical); Quantum PSV (Healthdyne); and Sullivan VPAP H ST (Resmed). A patient simulator was used to determine the sensitivity of the triggering mechanisms and the responses to a leak within the patient circuit, and to changes in patient effort. Significant differences (p <0.05) between the devices were seen in the trigger delay time and inspiratory trigger pressure. When a leak was introduced into the patient circuit, the fall in tidal volume (VT) was less than ten per cent for each ventilator. The addition of patient effort produced a number of changes in the ventilation delivered. Patient efforts of 0.25 s induced a variable fall in VT. An increase in VT was seen with some ventilators with patient efforts of 1 s but the effect was variable. Trigger failures and subsequent falls in minute volume were seen with the BiPAP and the Nippy2 at the highest respiratory frequency. Differences in the responses of the ventilators are demonstrated that may influence the selection of a ventilator, particularly in the treatment of breathless patients with ventilatory failure.

Mine fire experiments and simulation with MFIRE

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

Laage, L.W.; Yang, Hang

1995-12-31

A major concern of mine fires is the heat generated ventilation disturbances which can move products of combustion (POC) through unexpected passageways. Fire emergency planning requires simulation of the interaction of the fire and ventilation system to predict the state of the ventilation system and the subsequent distribution of temperatures and POC. Several computer models were developed by the U.S. Bureau of Mines (USBM) to perform this simulation. The most recent, MFIRE, simulates a mine`s ventilation system and its response to altered ventilation parameters such as the development of new mine workings or changes in ventilation control structures, external influencemore » such as varying outside temperatures, and internal influences such as fires. Extensive output allows quantitative analysis of the effects of the proposed alteration to die ventilation system. This paper describes recent USBM research to validate MFIRE`s calculation of temperature distribution in an airway due to a mine fire, as temperatures are the most significant source of ventilation disturbances. Fire tests were conducted at the Waldo Mine near Magdalena, NM. From these experiments, temperature profiles were developed as functions of time and distance from the fire and compared with simulations from MFIRE.« less

Ventilation-perfusion distribution in normal subjects.

PubMed

Beck, Kenneth C; Johnson, Bruce D; Olson, Thomas P; Wilson, Theodore A

2012-09-01

Functional values of LogSD of the ventilation distribution (σ(V)) have been reported previously, but functional values of LogSD of the perfusion distribution (σ(q)) and the coefficient of correlation between ventilation and perfusion (ρ) have not been measured in humans. Here, we report values for σ(V), σ(q), and ρ obtained from wash-in data for three gases, helium and two soluble gases, acetylene and dimethyl ether. Normal subjects inspired gas containing the test gases, and the concentrations of the gases at end-expiration during the first 10 breaths were measured with the subjects at rest and at increasing levels of exercise. The regional distribution of ventilation and perfusion was described by a bivariate log-normal distribution with parameters σ(V), σ(q), and ρ, and these parameters were evaluated by matching the values of expired gas concentrations calculated for this distribution to the measured values. Values of cardiac output and LogSD ventilation/perfusion (Va/Q) were obtained. At rest, σ(q) is high (1.08 ± 0.12). With the onset of ventilation, σ(q) decreases to 0.85 ± 0.09 but remains higher than σ(V) (0.43 ± 0.09) at all exercise levels. Rho increases to 0.87 ± 0.07, and the value of LogSD Va/Q for light and moderate exercise is primarily the result of the difference between the magnitudes of σ(q) and σ(V). With known values for the parameters, the bivariate distribution describes the comprehensive distribution of ventilation and perfusion that underlies the distribution of the Va/Q ratio.

Impact of High-Intensity-NIV on the heart in stable COPD: a randomised cross-over pilot study.

PubMed

Duiverman, Marieke Leontine; Maagh, Petra; Magnet, Friederike Sophie; Schmoor, Claudia; Arellano-Maric, Maria Paola; Meissner, Axel; Storre, Jan Hendrik; Wijkstra, Peter Jan; Windisch, Wolfram; Callegari, Jens

2017-05-02

Although high-intensity non-invasive ventilation has been shown to improve outcomes in stable COPD, it may adversely affect cardiac performance. Therefore, the aims of the present pilot study were to compare cardiac and pulmonary effects of 6 weeks of low-intensity non-invasive ventilation and 6 weeks of high-intensity non-invasive ventilation in stable COPD patients. In a randomised crossover pilot feasibility study, the change in cardiac output after 6 weeks of each NIV mode compared to baseline was assessed with echocardiography in 14 severe stable COPD patients. Furthermore, CO during NIV, gas exchange, lung function, and health-related quality of life were investigated. Three patients dropped out: two deteriorated on low-intensity non-invasive ventilation, and one presented with decompensated heart failure while on high-intensity non-invasive ventilation. Eleven patients were included in the analysis. In general, cardiac output and NTproBNP did not change, although individual effects were noticed, depending on the pressures applied and/or the co-existence of heart failure. High-intensity non-invasive ventilation tended to be more effective in improving gas exchange, but both modes improved lung function and the health-related quality of life. Long-term non-invasive ventilation with adequate pressure to improve gas exchange and health-related quality of life did not have an overall adverse effect on cardiac performance. Nevertheless, in patients with pre-existing heart failure, the application of very high inspiratory pressures might reduce cardiac output. The trial was registered in the Deutsches Register Klinischer Studien (DRKS-ID: DRKS00007977 ).

The use of chilled condensers for the recovery of perfluorocarbon liquid in an experimental model of perfluorocarbon vapour loss during neonatal partial liquid ventilation

PubMed Central

Dunster, Kimble R; Davies, Mark W; Fraser, John F

2007-01-01

Background Perfluorocarbon (PFC) vapour in the expired gases during partial liquid ventilation should be prevented from entering the atmosphere and recovered for potential reuse. This study aimed to determine how much PFC liquid could be recovered using a conventional humidified neonatal ventilator with chilled condensers in place of the usual expiratory ventilator circuit and whether PFC liquid could be recovered when using the chilled condensers at the ventilator exhaust outlet. Methods Using a model lung, perfluorocarbon vapour loss during humidified partial liquid ventilation of a 3.5 kg infant was approximated. For each test 30 mL of FC-77 was infused into the model lung. Condensers were placed in the expiratory limb of the ventilator circuit and the amounts of PFC (FC-77) and water recovered were measured five times. This was repeated with the condensers placed at the ventilator exhaust outlet. Results When the condensers were used as the expiratory limb, the mean (± SD) volume of FC77 recovered was 16.4 mL (± 0.18 mL). When the condensers were connected to the ventilator exhaust outlet the mean (± SD) volume of FC-77 recovered was 7.6 mL (± 1.14 mL). The volume of FC-77 recovered was significantly higher when the condenser was used as an expiratory limb. Conclusion Using two series connected condensers in the ventilator expiratory line 55% of PFC liquid (FC-77) can be recovered during partial liquid ventilation without altering the function of the of the ventilator circuit. This volume of PFC recovered was just over twice that recovered with the condensers connected to the ventilator exhaust outlet. PMID:17537270

Quantitative analysis of hyperpolarized 129Xe ventilation imaging in healthy volunteers and subjects with chronic obstructive pulmonary disease

PubMed Central

Virgincar, Rohan S.; Cleveland, Zackary I.; Kaushik, S. Sivaram; Freeman, Matthew S.; Nouls, John; Cofer, Gary P.; Martinez-Jimenez, Santiago; He, Mu; Kraft, Monica; Wolber, Jan; McAdams, H. Page; Driehuys, Bastiaan

2013-01-01

In this study, hyperpolarized (HP) 129Xe MR ventilation and 1H anatomical images were obtained from 3 subject groups: young healthy volunteers (HV), subjects with chronic obstructive pulmonary disease (COPD), and age-matched control subjects (AMC). Ventilation images were quantified by 2 methods: an expert reader-based ventilation defect score percentage (VDS%) and a semi-automatic segmentation-based ventilation defect percentage (VDP). Reader-based values were assigned by two experienced radiologists and resolved by consensus. In the semi-automatic analysis, 1H anatomical images and 129Xe ventilation images were both segmented following registration, to obtain the thoracic cavity volume (TCV) and ventilated volume (VV), respectively, which were then expressed as a ratio to obtain the VDP. Ventilation images were also characterized by generating signal intensity histograms from voxels within the TCV, and heterogeneity was analyzed using the coefficient of variation (CV). The reader-based VDS% correlated strongly with the semi-automatically generated VDP (r = 0.97, p < 0.0001), and with CV (r = 0.82, p < 0.0001). Both 129Xe ventilation defect scoring metrics readily separated the 3 groups from one another and correlated significantly with FEV1 (VDS%: r = -0.78, p = 0.0002; VDP: r = -0.79, p = 0.0003; CV: r = -0.66, p = 0.0059) and other pulmonary function tests. In the healthy subject groups (HV and AMC), the prevalence of ventilation defects also increased with age (VDS%: r = 0.61, p = 0.0002; VDP: r = 0.63, p = 0.0002). Moreover, ventilation histograms and their associated CVs distinguished between COPD subjects with similar ventilation defect scores but visibly different ventilation patterns. PMID:23065808

Economic, Environmental and Health Implications of Enhanced Ventilation in Office Buildings.

PubMed

MacNaughton, Piers; Pegues, James; Satish, Usha; Santanam, Suresh; Spengler, John; Allen, Joseph

2015-11-18

Current building ventilation standards are based on acceptable minimums. Three decades of research demonstrates the human health benefits of increased ventilation above these minimums. Recent research also shows the benefits on human decision-making performance in office workers, which translates to increased productivity. However, adoption of enhanced ventilation strategies is lagging. We sought to evaluate two of the perceived potential barriers to more widespread adoption-Economic and environmental costs. We estimated the energy consumption and associated per building occupant costs for office buildings in seven U.S. cities, representing different climate zones for three ventilation scenarios (standard practice (20 cfm/person), 30% enhanced ventilation, and 40 cfm/person) and four different heating, ventilation and air conditioning (HVAC) system strategies (Variable Air Volume (VAV) with reheat and a Fan Coil Unit (FCU), both with and without an energy recovery ventilator). We also estimated emissions of greenhouse gases associated with this increased energy usage, and, for comparison, converted this to the equivalent number of vehicles using greenhouse gas equivalencies. Lastly, we paired results from our previous research on cognitive function and ventilation with labor statistics to estimate the economic benefit of increased productivity associated with increasing ventilation rates. Doubling the ventilation rate from the American Society of Heating, Refrigeration and Air-Conditioning Engineers minimum cost less than $40 per person per year in all climate zones investigated. Using an energy recovery ventilation system significantly reduced energy costs, and in some scenarios led to a net savings. At the highest ventilation rate, adding an ERV essentially neutralized the environmental impact of enhanced ventilation (0.03 additional cars on the road per building across all cities). The same change in ventilation improved the performance of workers by 8%, equivalent to a $6500 increase in employee productivity each year. Reduced absenteeism and improved health are also seen with enhanced ventilation. The health benefits associated with enhanced ventilation rates far exceed the per-person energy costs relative to salary costs. Environmental impacts can be mitigated at regional, building, and individual-level scales through the transition to renewable energy sources, adoption of energy efficient systems and ventilation strategies, and promotion of other sustainable policies.

Economic, Environmental and Health Implications of Enhanced Ventilation in Office Buildings

PubMed Central

MacNaughton, Piers; Pegues, James; Satish, Usha; Santanam, Suresh; Spengler, John; Allen, Joseph

2015-01-01

Introduction: Current building ventilation standards are based on acceptable minimums. Three decades of research demonstrates the human health benefits of increased ventilation above these minimums. Recent research also shows the benefits on human decision-making performance in office workers, which translates to increased productivity. However, adoption of enhanced ventilation strategies is lagging. We sought to evaluate two of the perceived potential barriers to more widespread adoption—Economic and environmental costs. Methods: We estimated the energy consumption and associated per building occupant costs for office buildings in seven U.S. cities, representing different climate zones for three ventilation scenarios (standard practice (20 cfm/person), 30% enhanced ventilation, and 40 cfm/person) and four different heating, ventilation and air conditioning (HVAC) system strategies (Variable Air Volume (VAV) with reheat and a Fan Coil Unit (FCU), both with and without an energy recovery ventilator). We also estimated emissions of greenhouse gases associated with this increased energy usage, and, for comparison, converted this to the equivalent number of vehicles using greenhouse gas equivalencies. Lastly, we paired results from our previous research on cognitive function and ventilation with labor statistics to estimate the economic benefit of increased productivity associated with increasing ventilation rates. Results: Doubling the ventilation rate from the American Society of Heating, Refrigeration and Air-Conditioning Engineers minimum cost less than $40 per person per year in all climate zones investigated. Using an energy recovery ventilation system significantly reduced energy costs, and in some scenarios led to a net savings. At the highest ventilation rate, adding an ERV essentially neutralized the environmental impact of enhanced ventilation (0.03 additional cars on the road per building across all cities). The same change in ventilation improved the performance of workers by 8%, equivalent to a $6500 increase in employee productivity each year. Reduced absenteeism and improved health are also seen with enhanced ventilation. Conclusions: The health benefits associated with enhanced ventilation rates far exceed the per-person energy costs relative to salary costs. Environmental impacts can be mitigated at regional, building, and individual-level scales through the transition to renewable energy sources, adoption of energy efficient systems and ventilation strategies, and promotion of other sustainable policies. PMID:26593933

Mechanical ventilation and sepsis impair protein metabolism in the diaphragm of neonatal pigs

USDA-ARS?s Scientific Manuscript database

Mechanical ventilation (MV) impairs diaphragmatic function and diminishes the ability to wean from ventilatory support in adult humans. In normal neonatal pigs, animals that are highly anabolic, endotoxin (LPS) infusion induces sepsis, reduces peripheral skeletal muscle protein synthesis rates, but ...

Emptying patterns of the lung studied by multiple-breath N2 washout

NASA Technical Reports Server (NTRS)

Lewis, S. M.

1978-01-01

Changes in the nitrogen concentration seen during the single-breath nitrogen washout reflect changes in relative flow (ventilation) from units with differing ventilation/volume ratios. The multiple-breath washout provides sufficient data on ventilation for units with varying ventilation/volume ratios to be plotted as a function of the volume expired. Flow from the dead space may also be determined. In young normals the emptying patterns are narrow and unimodal throughout the alveolar plateau with little or no flow from the dead space at the end of the breath. Older normals show more flow from the dead space, particularly toward the end of the breath, and some show a high ventilation/volume ratio mode early in the breath. Patients with obstructive lung disease have a high flow from the dead space which is present throughout the breath. A well ventilated mode at the end of the breath is seen in some obstructed subjects. Patients with cystic fibrosis showed a poorly ventilated mode appearing at the end of the breath as well as a very high dead space.

Pectus excavatum in children: pulmonary scintigraphy before and after corrective surgery

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

Blickman, J.G.; Rosen, P.R.; Welch, K.J.

1985-09-01

Regional distribution of pulmonary function was evaluated preoperatively and postoperatively with xenon-133 perfusion and ventilation scintigraphy in 17 patients with pectus excavatum. Ventilatory preoperative studies were abnormal in 12 of 17 patients, resolving in seven of 12 postoperatively. Perfusion scans were abnormal in ten of 17 patients preoperatively; six of ten showed improvement postoperatively. Ventilation-perfusion ratios were abnormal in ten of 17 patients, normalizing postoperatively in six of ten. Symmetry of ventilation-perfusion ratio images improved in six out of nine in the latter group. The distribution of regional lung function in pectus excavatum can be evaluated preoperatively to support indicationsmore » for surgery. Postoperative improvement can be documented by physiological changes produced by the surgical correction.« less

Study of the Cooldown and Warmup for the Eight Sectors of the Large Hadron Collider

NASA Astrophysics Data System (ADS)

Liu, L.; Riddone, G.; Tavian, L.

2004-06-01

The LHC cryogenic system is based on a five-point feed scheme with eight refrigerators serving the eight sectors of the LHC machine. The paper presents the simplified flow scheme of the eight sectors and the mathematical methods including the program flowchart and the boundary conditions to simulate the cooldown and warmup of these sectors. The methods take into account the effect of the pressure drop across the valves as well as the pressure evolution in the different headers of the cryogenic distribution line. The simulated pressure and temperature profiles of headers of the LHC sector during the cooldown and warmup are given and the temperature evolutions of entire processes of cooldown and warmup are presented. As a conclusion, the functions of the input temperature for the normal and fast cooldown and warmup, the cooldown and warmup time of each sector and the distributions of mass flow rates in each sector are summarized. The results indicate that it is possible to cool down any of the LHC sector within 12.7 days in normal operation and 6.8 days in case of fast operation.

Probing medium-induced jet splitting and energy loss in heavy-ion collisions

NASA Astrophysics Data System (ADS)

Chang, Ning-Bo; Cao, Shanshan; Qin, Guang-You

2018-06-01

The nuclear modification of jet splitting in relativistic heavy-ion collisions at RHIC and the LHC energies is studied based on the higher twist formalism. Assuming coherent energy loss for the two splitted subjets, a non-monotonic jet energy dependence is found for the nuclear modification of jet splitting function: strongest modification at intermediate jet energies whereas weaker modification for larger or smaller jet energies. Combined with the smaller size and lower density of the QGP medium at RHIC than at the LHC, this helps to understand the groomed jet measurements from CMS and STAR Collaborations: strong modification of the momentum sharing zg distribution at the LHC and no obvious modification of zg distribution at RHIC. In addition, the observed nuclear modification pattern of the groomed jet zg distribution cannot be explained solely by independent energy loss of the two subjets. Our result may be tested in future measurements of groomed jets with lower jet energies at the LHC and larger jet energies at RHIC, for different angular separations between the two subjets.

Transfer factor, lung volumes, resistance and ventilation distribution in healthy adults.

PubMed

Verbanck, Sylvia; Van Muylem, Alain; Schuermans, Daniel; Bautmans, Ivan; Thompson, Bruce; Vincken, Walter

2016-01-01

Monitoring of chronic lung disease requires reference values of lung function indices, including putative markers of small airway function, spanning a wide age range.We measured spirometry, transfer factor of the lung for carbon monoxide (TLCO), static lung volume, resistance and ventilation distribution in a healthy population, studying at least 20 subjects per sex and per decade between the ages of 20 and 80 years.With respect to the Global Lung Function Initiative reference data, our subjects had average z-scores for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC of -0.12, 0.04 and -0.32, respectively. Reference equations were obtained which could account for a potential dependence of index variability on age and height. This was done for (but not limited to) indices that are pertinent to asthma and chronic obstructive pulmonary disease studies: forced expired volume in 6 s, forced expiratory flow, TLCO, specific airway conductance, residual volume (RV)/total lung capacity (TLC), and ventilation heterogeneity in acinar and conductive lung zones.Deterioration in acinar ventilation heterogeneity and lung clearance index with age were more marked beyond 60 years, and conductive ventilation heterogeneity showed the greatest increase in variability with age. The most clinically relevant deviation from published reference values concerned RV/TLC values, which were considerably smaller than American Thoracic Society/European Respiratory Society-endorsed reference values. Copyright ©ERS 2016.

Comfort parameters - Ventilation of a subway wagon

NASA Astrophysics Data System (ADS)

Petr, Pavlíček; Ladislav, Tříska

2017-09-01

Research and development of a ventilation system is being carried out as a part of project TA04030774 of the Technology Agency of the Czech Republic. Name of the project is "Research and Development of Mass-optimized Components for Rail Vehicles". Problems being solved are development and testing of a new concept for ventilation systems for public transport vehicles. The main improvements should be a reduction of the mass of the whole system, easy installation and reduction of the noise of the ventilation system. This article is focused on the comfort parameters in a subway wagon (measurement and evaluation carried out on a function sample in accordance with the regulations). The input to the project is a ventilator hybrid casing for a subway wagon, which was manufactured and tested during the Ministry of Industry and Trade project TIP FR-TI3/449.

Integrated analysis of particle interactions at hadron colliders Report of research activities in 2010-2015

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

Nadolsky, Pavel M.

2015-08-31

The report summarizes research activities of the project ”Integrated analysis of particle interactions” at Southern Methodist University, funded by 2010 DOE Early Career Research Award DE-SC0003870. The goal of the project is to provide state-of-the-art predictions in quantum chromodynamics in order to achieve objectives of the LHC program for studies of electroweak symmetry breaking and new physics searches. We published 19 journal papers focusing on in-depth studies of proton structure and integration of advanced calculations from different areas of particle phenomenology: multi-loop calculations, accurate long-distance hadronic functions, and precise numerical programs. Methods for factorization of QCD cross sections were advancedmore » in order to develop new generations of CTEQ parton distribution functions (PDFs), CT10 and CT14. These distributions provide the core theoretical input for multi-loop perturbative calculations by LHC experimental collaborations. A novel ”PDF meta-analysis” technique was invented to streamline applications of PDFs in numerous LHC simulations and to combine PDFs from various groups using multivariate stochastic sampling of PDF parameters. The meta-analysis will help to bring the LHC perturbative calculations to the new level of accuracy, while reducing computational efforts. The work on parton distributions was complemented by development of advanced perturbative techniques to predict observables dependent on several momentum scales, including production of massive quarks and transverse momentum resummation at the next-to-next-to-leading order in QCD.« less

Jets in d (p )-A collisions: Color transparency or energy conservation

NASA Astrophysics Data System (ADS)

Kordell, Michael; Majumder, Abhijit

2018-05-01

The production of jets, and high momentum hadrons from jets, produced in deuteron-Au (d -Au) collisions at the BNL Relativistic Heavy Ion Collider (RHIC) and proton-Pb (p -Pb) collisions at the CERN Large Hadron Collider (LHC) are studied as a function of centrality, a measure of the impact parameter of the collision. A modified version of the event generator pythia, widely used to simulate p -p collisions, is used in conjunction with a nuclear Monte Carlo event generator which simulates the locations of the nucleons within a large nucleus. We demonstrate how events with a hard jet may be simulated, in such a way that the parton distribution function of the projectile is "frozen" during its interaction with the extended nucleus. Using our approach, we demonstrate that the puzzling enhancement seen in peripheral events at RHIC and the LHC, as well as the suppression seen in central events at the LHC, are possibly due to mis-binning of central and semicentral events, containing a jet, as peripheral events. This occurs due to the suppression of soft particle production away from the jet, caused by the depletion of energy available in a nucleon of the deuteron (in d -Au at RHIC) or in the proton (in p -Pb at LHC), after the production of a hard jet. We conclude that partonic correlations built out of simple energy conservation are responsible for such an effect, though these are sampled at the hard scale of jet production and, as such, represent smaller states.

Role of multiparton interactions on J /ψ production in p +p collisions at LHC energies

NASA Astrophysics Data System (ADS)

Thakur, Dhananjaya; De, Sudipan; Sahoo, Raghunath; Dansana, Soumya

2018-05-01

The production mechanism of quarkonia states in hadronic collisions is still to be understood by the scientific community. In high-multiplicity p +p collisions, underlying event observables are of major interest. The multiparton interactions (MPIs) are underlying event observables, in which several interactions occur at the partonic level in a single p +p event. This leads to dependence of particle production on event multiplicity. If the MPI occurs in a harder scale, there will be a correlation between the yield of quarkonia and total charged-particle multiplicity. The ALICE experiment at the LHC in p +p collisions at √{s }=7 and 13 TeV has observed an approximate linear increase of relative J /ψ yield, (d/NJ /ψ/d y ⟨d NJ /ψ/d y ⟩ ), with relative charged-particle multiplicity density, (d/Nch/d y ⟨d Nch/d y ⟩ ). In our present work, we have performed a comprehensive study of the production of charmonia as a function of charged-particle multiplicity in p +p collisions at LHC energies using the perturbative QCD-inspired multiparton interaction model, pythia8 tune 4C, with and without the color reconnection scheme. A detailed multiplicity and energy-dependent study is performed to understand the effects of MPI on J /ψ production. The ratio of ψ (2 S ) to J /ψ is also studied as a function of charged-particle multiplicity at LHC energies.

Mechanical ventilation for amyotrophic lateral sclerosis/motor neuron disease.

PubMed

Radunovic, Aleksandar; Annane, Djillali; Rafiq, Muhammad K; Mustfa, Naveed

2013-03-28

Amyotrophic lateral sclerosis, also known as motor neuron disease, is a fatal neurodegenerative disease. Neuromuscular respiratory failure is the commonest cause of death, usually within two to five years of the disease onset. Supporting respiratory function with mechanical ventilation may improve survival and quality of life. This is the first update of a review first published in 2009. The primary objective of the review is to examine the efficacy of mechanical ventilation (tracheostomy and non-invasive ventilation) in improving survival in ALS. The secondary objectives are to examine the effect of mechanical ventilation on functional measures of disease progression and quality of life in people with ALS; and assess adverse events related to the intervention. We searched The Cochrane Neuromuscular Disease Group Specialized Register (1 May 2012), CENTRAL (2012, Issue 4), MEDLINE (January 1966 to April 2012), EMBASE (January 1980 to April 2012), CINAHL Plus (January 1937 to April 2012), and AMED (January 1985 to April 2012). We also searched for ongoing studies on ClinicalTrials.gov. Randomised and quasi-randomised controlled trials involving non-invasive or tracheostomy assisted ventilation in participants with a clinical diagnosis of amyotrophic lateral sclerosis, independent of the reported outcomes. We planned to include comparisons with no intervention or the best standard care. For the original review, four authors independently selected studies for assessment and two authors reviewed searches for this update. All authors extracted data independently from the full text of selected studies and assessed the risk of bias in studies that met the inclusion criteria. We attempted to obtain missing data where possible. We planned to collect adverse event data from included studies. For the original Cochrane review, the review authors identified and included two randomised controlled trials involving 54 participants with ALS receiving non-invasive ventilation. There were no new randomised or quasi-randomised controlled trials at this first update.Incomplete data were published for one study and we contacted the trial authors who were not able to provide the missing data. Therefore, the results of the review were based on a single study of 41 participants that compared non-invasive ventilation with standard care. It was a well conducted study with low risk of bias.The study showed that the overall median survival was significantly different between the group treated with non-invasive ventilation and the standard care group. The median survival in the non-invasive ventilation group was 48 days longer (219 days compared to 171 days for the standard care group (estimated 95% CI 12 to 91 days, P = 0.0062)). This survival benefit was accompanied by an enhanced quality of life. On subgroup analysis, the survival and quality of life benefit was much more in the subgroup with normal to moderately impaired bulbar function (20 participants); median survival was 205 days longer (216 days in NIV group versus 11 days in the standard care group, P = 0.0059). Non-invasive ventilation did not prolong survival in participants with poor bulbar function (21 participants), although it showed significant improvement in the mean symptoms domain of the Sleep Apnoea Quality of Life Index but not in the Short Form-36 Health Survey Mental Component Summary score. Neither trial reported clinical data on intervention related adverse effects. Evidence from a single randomised trial of non-invasive ventilation in 41 participants suggests that it significantly prolongs survival and improves or maintains quality of life in people with ALS. Survival and some measures of quality of life were significantly improved in the subgroup of people with better bulbar function, but not in those with severe bulbar impairment. Future studies should examine the health economics of NIV and factors influencing access to NIV. We need to understand the factors, personal and socioeconomic, that determine access to NIV.

Vibration analysis of the tympanic membrane with a ventilation tube and a perforation by holography

NASA Astrophysics Data System (ADS)

Maeta, Manabu; Kawakami, Shinichiro; Ogawara, Toshiaki; Masuda, Yu

1991-08-01

For severe otitis media with effusion, insertion of a ventilation tube is performed for the purpose of ventilation of the middle ear cavity and normalization of the eustachian tubular function and middle ear mucosa. The ventilation tube is left in place for as long as several months or even a few years. However, the influence of the indwelling tube on vibration of the tympanic membrane is unknown. Therefore, the authors observed the influence by means of time-averaged holography using human tympanic membranes. The following results were obtained. After insertion of a ventilation tube, vibration pattern of the tympanic membrane was not obviously changed, but the vibration amplitude of the tympanic membrane was decreased, especially at 500 Hz. Generally speaking, the change caused by insertion of a ventilation tube was very small. Also, the vibration pattern of perforated tympanic membrane was not changed, but the vibration amplitude of perforated tympanic membrane was decreased at the low frequency area.

WE-AB-202-02: Incorporating Regional Ventilation Function in Predicting Radiation Fibrosis After Concurrent Chemoradiotherapy for Lung Cancer

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

Lan, F; Jeudy, J; Tseng, H

Purpose: To investigate the incorporation of pre-therapy regional ventilation function in predicting radiation fibrosis (RF) in stage III non-small-cell lung cancer (NSCLC) patients treated with concurrent thoracic chemoradiotherapy. Methods: 37 stage III NSCLC patients were retrospectively studied. Patients received one cycle of cisplatin-gemcitabine, followed by two to three cycles of cisplatin-etoposide concurrently with involved-field thoracic radiotherapy between 46 and 66 Gy (2 Gy per fraction). Pre-therapy regional ventilation images of the lung were derived from 4DCT via a density-change-based image registration algorithm with mass correction. RF was evaluated at 6-months post-treatment using radiographic scoring based on airway dilation and volumemore » loss. Three types of ipsilateral lung metrics were studied: (1) conventional dose-volume metrics (V20, V30, V40, and mean-lung-dose (MLD)), (2) dose-function metrics (fV20, fV30, fV40, and functional mean-lung-dose (fMLD) generated by combining regional ventilation and dose), and (3) dose-subvolume metrics (sV20, sV30, sV40, and subvolume mean-lung-dose (sMLD) defined as the dose-volume metrics computed on the sub-volume of the lung with at least 60% of the quantified maximum ventilation status). Receiver operating characteristic (ROC) curve analysis and logistic regression analysis were used to evaluate the predictability of these metrics for RF. Results: In predicting airway dilation, the area under the ROC curve (AUC) values for (V20, MLD), (fV20, fMLD), and (sV20, and sMLD) were (0.76, 0.70), (0.80, 0.74) and (0.82, 0.80), respectively. The logistic regression p-values were (0.09, 0.18), (0.02, 0.05) and (0.004, 0.006), respectively. With regard to volume loss, the corresponding AUC values for these metrics were (0.66, 0.57), (0.67, 0.61) and (0.71, 0.69), and p-values were (0.95, 0.90), (0.43, 0.64) and (0.08, 0.12), respectively. Conclusion: The inclusion of regional ventilation function improved predictability of radiation fibrosis. Dose-subvolume metrics provided a promising method for incorporating functional information into the conventional dose-volume parameters for outcome assessment.« less

Variable versus conventional lung protective mechanical ventilation during open abdominal surgery (PROVAR): a randomised controlled trial.

PubMed

Spieth, P M; Güldner, A; Uhlig, C; Bluth, T; Kiss, T; Conrad, C; Bischlager, K; Braune, A; Huhle, R; Insorsi, A; Tarantino, F; Ball, L; Schultz, M J; Abolmaali, N; Koch, T; Pelosi, P; Gama de Abreu, M

2018-03-01

Experimental studies showed that controlled variable ventilation (CVV) yielded better pulmonary function compared to non-variable ventilation (CNV) in injured lungs. We hypothesized that CVV improves intraoperative and postoperative respiratory function in patients undergoing open abdominal surgery. Fifty patients planned for open abdominal surgery lasting >3 h were randomly assigned to receive either CVV or CNV. Mean tidal volumes and PEEP were set at 8 ml kg -1 (predicted body weight) and 5 cm H 2 O, respectively. In CVV, tidal volumes varied randomly, following a normal distribution, on a breath-by-breath basis. The primary endpoint was the forced vital capacity (FVC) on postoperative Day 1. Secondary endpoints were oxygenation, non-aerated lung volume, distribution of ventilation, and pulmonary and extrapulmonary complications until postoperative Day 5. FVC did not differ significantly between CVV and CNV on postoperative Day 1, 61.5 (standard deviation 22.1) % vs 61.9 (23.6) %, respectively; mean [95% confidence interval (CI)] difference, -0.4 (-13.2-14.0), P=0.95. Intraoperatively, CVV did not result in improved respiratory function, haemodynamics, or redistribution of ventilation compared to CNV. Postoperatively, FVC, forced expiratory volume at the first second (FEV 1 ), and FEV 1 /FVC deteriorated, while atelectasis volume and plasma levels of interleukin-6 and interleukin-8 increased, but values did not differ between groups. The incidence of postoperative pulmonary and extrapulmonary complications was comparable in CVV and CNV. In patients undergoing open abdominal surgery, CVV did not improve intraoperative and postoperative respiratory function compared with CNV. NCT 01683578. Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Imaging Lung Function in Mice Using SPECT/CT and Per-Voxel Analysis

PubMed Central

Jobse, Brian N.; Rhem, Rod G.; McCurry, Cory A. J. R.; Wang, Iris Q.; Labiris, N. Renée

2012-01-01

Chronic lung disease is a major worldwide health concern but better tools are required to understand the underlying pathologies. Ventilation/perfusion (V/Q) single photon emission computed tomography (SPECT) with per-voxel analysis allows for non-invasive measurement of regional lung function. A clinically adapted V/Q methodology was used in healthy mice to investigate V/Q relationships. Twelve week-old mice were imaged to describe normal lung function while 36 week-old mice were imaged to determine how age affects V/Q. Mice were ventilated with Technegas™ and injected with 99mTc-macroaggregated albumin to trace ventilation and perfusion, respectively. For both processes, SPECT and CT images were acquired, co-registered, and quantitatively analyzed. On a per-voxel basis, ventilation and perfusion were moderately correlated (R = 0.58±0.03) in 12 week old animals and a mean log(V/Q) ratio of −0.07±0.01 and standard deviation of 0.36±0.02 were found, defining the extent of V/Q matching. In contrast, 36 week old animals had significantly increased levels of V/Q mismatching throughout the periphery of the lung. Measures of V/Q were consistent across healthy animals and differences were observed with age demonstrating the capability of this technique in quantifying lung function. Per-voxel analysis and the ability to non-invasively assess lung function will aid in the investigation of chronic lung disease models and drug efficacy studies. PMID:22870297

Unilateral empyema impacts the assessment of regional lung ventilation by electrical impedance tomography.

PubMed

Bläser, D; Pulletz, S; Becher, T; Schädler, D; Elke, G; Weiler, N; Frerichs, I

2014-06-01

Several studies have shown the ability of electrical impedance tomography (EIT) to assess regional ventilation distribution in human lungs. Fluid accumulation in the pleural space as in empyema, typically occurring on one chest side, may influence the distribution of ventilation and the corresponding EIT findings. The aim of our study was to examine this effect on the assessment of regional ventilation by EIT. Six patients suffering from unilateral empyema and intubated with a double-lumen endotracheal tube were studied. EIT data were acquired during volume-controlled ventilation with bilateral (tidal volume (V(T)): 800 ml) and unilateral ventilation (V(T): 400 ml) of the right and left lungs. Mean tidal amplitudes of the EIT signal were calculated in all image pixels. The sums of these values, expressed as relative impedance change (rel. ΔZ), were then determined in whole images and functionally defined regions-of-interest (ROI). The sums of rel. ΔZ calculated during the two cases of one-lung ventilation either on the affected or unaffected side were significantly smaller than during bilateral ventilation. However, in contrast to previous findings in patients with no pleural pathology, very low values of rel. ΔZ were found when the lung on the affected side was ventilated. ROI-based analysis rendered higher values than the whole-image analysis in this case, nonetheless, the values were significantly smaller than when the unaffected side was ventilated in spite of identical VT. In conclusion, our results indicate that the presence of empyema may affect the quantitative evaluation of regional lung ventilation by EIT.

The effect of non-invasive positive pressure ventilation (NIPPV) on cognitive function in amyotrophic lateral sclerosis (ALS): a prospective study

PubMed Central

Newsom-Davis, I; Lyall, R; Leigh, P; Moxham, J; Goldstein, L

2001-01-01

OBJECTIVES—Neuropsychological investigations have shown a degree of cognitive dysfunction in a proportion of non-demented patients with ALS. Respiratory muscle weakness in ALS can lead to nocturnal hypoventilation, resulting in sleep disturbance and daytime somnolence. Sleep deprivation of this type may cause impairments in cognitive function, but this has not been formally evaluated in ALS.
METHODS—Cognitive functioning was evaluated in nine patients with ALS with sleep disturbance caused by nocturnal hypoventilation (NIPPV group), and in a comparison group of 10 similar patients without ventilation problems (control group). The NIPPV group then started non-invasive positive pressure ventilation (NIPPV) at night. After about 6 weeks, change in cognitive function was evaluated.
RESULTS—Statistically significant improvement in scores on two of the seven cognitive tests was demonstrated in the NIPPV group postventilation, and a trend towards significant improvement was found for two further tests. Scores in the control group did not improve significantly for these four tests, although an improvement was found on one other test.
CONCLUSIONS—Nocturnal hypoventilation and sleep disturbance may cause cognitive dysfunction in ALS. These deficits may be partially improved by NIPPV over a 6 week period. This has important implications for investigations of both cognitive dysfunction in non-demented patients with ALS, and the effect of ventilation on quality of life.

 PMID:11561031

Echocardiographic evaluation during weaning from mechanical ventilation

PubMed Central

Schifelbain, Luciele Medianeira; Vieira, Silvia Regina Rios; Brauner, Janete Salles; Pacheco, Deise Mota; Naujorks, Alexandre Antonio

2011-01-01

INTRODUCTION: Echocardiographic, electrocardiographic and other cardiorespiratory variables can change during weaning from mechanical ventilation. OBJECTIVES: To analyze changes in cardiac function, using Doppler echocardiogram, in critical patients during weaning from mechanical ventilation, using two different weaning methods: pressure support ventilation and T‐tube; and comparing patient subgroups: success vs. failure in weaning. METHODS: Randomized crossover clinical trial including patients under mechanical ventilation for more than 48 h and considered ready for weaning. Cardiorespiratory variables, oxygenation, electrocardiogram and Doppler echocardiogram findings were analyzed at baseline and after 30 min in pressure support ventilation and T‐tube. Pressure support ventilation vs. T‐tube and weaning success vs. failure were compared using ANOVA and Student's t‐test. The level of significance was p<0.05. RESULTS: Twenty‐four adult patients were evaluated. Seven patients failed at the first weaning attempt. No echocardiographic or electrocardiographic differences were observed between pressure support ventilation and T‐tube. Weaning failure patients presented increases in left atrium, intraventricular septum thickness, posterior wall thickness and diameter of left ventricle and shorter isovolumetric relaxation time. Successfully weaned patients had higher levels of oxygenation. CONCLUSION: No differences were observed between Doppler echocardiographic variables and electrocardiographic and other cardiorespiratory variables during pressure support ventilation and T‐tube. However cardiac structures were smaller, isovolumetric relaxation time was larger, and oxygenation level was greater in successfully weaned patients. PMID:21437445

Nebulized heparin is associated with fewer days of mechanical ventilation in critically ill patients: a randomized controlled trial.

PubMed

Dixon, Barry; Schultz, Marcus J; Smith, Roger; Fink, James B; Santamaria, John D; Campbell, Duncan J

2010-01-01

Prolonged mechanical ventilation has the potential to aggravate or initiate pulmonary inflammation and cause lung damage through fibrin deposition. Heparin may reduce pulmonary inflammation and fibrin deposition. We therefore assessed whether nebulized heparin improved lung function in patients expected to require prolonged mechanical ventilation. Fifty patients expected to require mechanical ventilation for more than 48 hours were enrolled in a double-blind randomized placebo-controlled trial of nebulized heparin (25,000 U) or placebo (normal saline) 4 or 6 hourly, depending on patient height. The study drug was continued while the patient remained ventilated to a maximum of 14 days from randomization. Nebulized heparin was not associated with a significant improvement in the primary end-point, the average daily partial pressure of oxygen to inspired fraction of oxygen ratio while mechanically ventilated, but was associated with improvement in the secondary end-point, ventilator-free days amongst survivors at day 28 (22.6 ± 4.0 versus 18.0 ± 7.1, treatment difference 4.6 days, 95% CI 0.9 to 8.3, P = 0.02). Heparin administration was not associated with any increase in adverse events. Nebulized heparin was associated with fewer days of mechanical ventilation in critically ill patients expected to require prolonged mechanical ventilation. Further trials are required to confirm these findings. The Australian Clinical Trials Registry (ACTR-12608000121369).

One-Lung Ventilation with Additional Ipsilateral Ventilation of Low Tidal Volume and High Frequency in Lung Lobectomy

PubMed Central

Feng, Yong; Wang, Jianyue; Zhang, Yang; Wang, Shiduan

2016-01-01

Background To investigate the protective effects of additional ipsilateral ventilation of low tidal volume and high frequency on lung functions in the patients receiving lobectomy. Material/Methods Sixty patients receiving lung lobectomy were randomized into the conventional one-lung ventilation (CV) group (n=30) and the ipsilateral low tidal volume high frequency ventilation (LV) group (n=30). In the CV group, patients received only contralateral OLV. In the LV group, patients received contralateral ventilation and additional ipsilateral ventilation of low tidal volume of 1–2 ml/kg and high frequency of 40 times/min. Normal lung tissues were biopsied for the analysis of lung injury. Lung injury was scored by evaluating interstitial edema, alveolar edema, neutrophil infiltration, and alveolar congestion. Results At 30 min and 60 min after the initiation of one-lung ventilation and after surgery, patients in the LV group showed significantly higher ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen than those in the CV group (P<0.001). Lung injury was significantly less severe (2.7±0.7) in the LV group than in the CV group (3.1±0.7) (P=0.006). Conclusions Additional ipsilateral ventilation of low tidal volume and high frequency can decrease the risk of hypoxemia and alleviate lung injury in patients receiving lobectomy. PMID:27166086

Multifaceted bench comparative evaluation of latest intensive care unit ventilators.

PubMed

Garnier, M; Quesnel, C; Fulgencio, J-P; Degrain, M; Carteaux, G; Bonnet, F; Similowski, T; Demoule, A

2015-07-01

Independent bench studies using specific ventilation scenarios allow testing of the performance of ventilators in conditions similar to clinical settings. The aims of this study were to determine the accuracy of the latest generation ventilators to deliver chosen parameters in various typical conditions and to provide clinicians with a comprehensive report on their performance. Thirteen modern intensive care unit ventilators were evaluated on the ASL5000 test lung with and without leakage for: (i) accuracy to deliver exact tidal volume (VT) and PEEP in assist-control ventilation (ACV); (ii) performance of trigger and pressurization in pressure support ventilation (PSV); and (iii) quality of non-invasive ventilation algorithms. In ACV, only six ventilators delivered an accurate VT and nine an accurate PEEP. Eleven devices failed to compensate VT and four the PEEP in leakage conditions. Inspiratory delays differed significantly among ventilators in invasive PSV (range 75-149 ms, P=0.03) and non-invasive PSV (range 78-165 ms, P<0.001). The percentage of the ideal curve (concomitantly evaluating the pressurization speed and the levels of pressure reached) also differed significantly (range 57-86% for invasive PSV, P=0.04; and 60-90% for non-invasive PSV, P<0.001). Non-invasive ventilation algorithms efficiently prevented the decrease in pressurization capacities and PEEP levels induced by leaks in, respectively, 10 and 12 out of the 13 ventilators. We observed real heterogeneity of performance amongst the latest generation of intensive care unit ventilators. Although non-invasive ventilation algorithms appear to maintain adequate pressurization efficiently in the case of leakage, basic functions, such as delivered VT in ACV and pressurization in PSV, are often less reliable than the values displayed by the device suggest. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

Alvioli, M.; Frankfurt, L.; Guzey, V.

Here, we model effects of color fluctuations (CFs) in the light-cone photon wave function and for the first time make predictions for the distribution over the number of wounded nucleons ν in the inelastic photon–nucleus scattering. We show that CFs lead to a dramatic enhancement of this distribution at ν=1 and large ν>10. We also study the implications of different scales and CFs in the photon wave function on the total transverse energy ΣE T and other observables in inelastic γA scattering with different triggers. Our predictions can be tested in proton–nucleus and nucleus–nucleus ultraperipheral collisions at the LHC andmore » will help to map CFs, whose first indications have already been observed at the LHC.« less

Phenomenology of single-inclusive jet production with jet radius and threshold resummation

NASA Astrophysics Data System (ADS)

Liu, Xiaohui; Moch, Sven-Olaf; Ringer, Felix

2018-03-01

We perform a detailed study of inclusive jet production cross sections at the LHC and compare the QCD theory predictions based on the recently developed formalism for threshold and jet radius joint resummation at next-to-leading logarithmic accuracy to inclusive jet data collected by the CMS Collaboration at √{S }=7 and 13 TeV. We compute the cross sections at next-to-leading order in QCD with and without the joint resummation for different choices of jet radii R and observe that the joint resummation leads to crucial improvements in the description of the data. Comprehensive studies with different parton distribution functions demonstrate the necessity of considering the joint resummation in fits of those functions based on the LHC jet data.

Mechanical ventilation alone, and in the presence of sepsis, impair protein metabolism in the diaphragm of neonatal pigs

USDA-ARS?s Scientific Manuscript database

Mechanical ventilation (MV) impairs diaphragmatic function and diminishes the ability to wean from ventilatory support in adult humans. In normal neonatal pigs, animals that are highly anabolic, endotoxin (LPS) infusion induces sepsis, reduces peripheral skeletal muscle protein synthesis rates, but ...

[USE OF PROTECTIVE LUNG VENTILATION REGIMEN IN CARDIAC SURGERY PATIENTS.

PubMed

Pshenichniy, T A; Akselrod, B A; Titova, I V; Trekova, N A; Khrustaleva, M V

2017-09-01

In cardiac surgery, protective lung ventilation and/or preventive brdnchoscopy (PB) are able to decrease lung injury effects of cardiopulmonary bypass (CPB) and mechanical ventilation. define lung complication risks, evaluate the effect ofprotective lung ventilation (PLV) on lung functioning, and investigate the feasibility ofpreventive PB in higher pulmonary risk (PR) patients. 66 patients participated in prospective randomized research. Allocation was based on PR and intraoperative mechanical ventilation type. PLV includedfollowing parameters: PCK PIP - up to 20 cm H20, Vt - 6 ml/ kg of PBW, PEEP - 5-10 cm H20, IE ratio - 1:1.5-1:1, EtCO2 - 35-42 mm Hg, FiO2 - 45-60%, lung ventilation during CPB, alveolar recruitment. Four groups were formed: A - higher PR plus PLV- B - higher PR plus conventional LV (CLV), C - lower PR plus PLV- D - lower PR plus CLV PIP PEEP dynamic compliance, p/f ratio and intrapulmonary shunt (Qs/Qt) were recorded. Seventeen patients of group A underwent PB. Advanced dynamic compliance, higher p/f ratio and lower Qs/Qt were seen in group A, in comparison with group B (p< 0.05). Lower Qs/Qt was seen in group C, in comparison with group D (p<0.05). Mucus obstruction of subsegmental bronchi was observed in 53.3% of higher PR patients. More than half ofpatients without PB sufferedfrom postoperative lung complications (70.4 vs. 34.2 7%, p

Detection of early subclinical lung disease in children with cystic fibrosis by lung ventilation imaging with hyperpolarised gas MRI.

PubMed

Marshall, Helen; Horsley, Alex; Taylor, Chris J; Smith, Laurie; Hughes, David; Horn, Felix C; Swift, Andrew J; Parra-Robles, Juan; Hughes, Paul J; Norquay, Graham; Stewart, Neil J; Collier, Guilhem J; Teare, Dawn; Cunningham, Steve; Aldag, Ina; Wild, Jim M

2017-08-01

Hyperpolarised 3 He ventilation-MRI, anatomical lung MRI, lung clearance index (LCI), low-dose CT and spirometry were performed on 19 children (6-16 years) with clinically stable mild cystic fibrosis (CF) (FEV 1 >-1.96), and 10 controls. All controls had normal spirometry, MRI and LCI. Ventilation-MRI was the most sensitive method of detecting abnormalities, present in 89% of patients with CF, compared with CT abnormalities in 68%, LCI 47% and conventional MRI 22%. Ventilation defects were present in the absence of CT abnormalities and in patients with normal physiology, including LCI. Ventilation-MRI is thus feasible in young children, highly sensitive and provides additional information about lung structure-function relationships. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Low-Flow Extracorporeal Carbon Dioxide Removal Using the Hemolung Respiratory Dialysis System® to Facilitate Lung-Protective Mechanical Ventilation in Acute Respiratory Distress Syndrome.

PubMed

Akkanti, Bindu; Rajagopal, Keshava; Patel, Kirti P; Aravind, Sangeeta; Nunez-Centanu, Emmanuel; Hussain, Rahat; Shabari, Farshad Raissi; Hofstetter, Wayne L; Vaporciyan, Ara A; Banjac, Igor S; Kar, Biswajit; Gregoric, Igor D; Loyalka, Pranav

2017-06-01

Extracorporeal carbon dioxide removal (ECCO 2 R) permits reductions in alveolar ventilation requirements that the lungs would otherwise have to provide. This concept was applied to a case of hypercapnia refractory to high-level invasive mechanical ventilator support. We present a case of an 18-year-old man who developed post-pneumonectomy acute respiratory distress syndrome (ARDS) after resection of a mediastinal germ cell tumor involving the left lung hilum. Hypercapnia and hypoxemia persisted despite ventilator support even at traumatic levels. ECCO 2 R using a miniaturized system was instituted and provided effective carbon dioxide elimination. This facilitated establishment of lung-protective ventilator settings and lung function recovery. Extracorporeal lung support increasingly is being applied to treat ARDS. However, conventional extracorporeal membrane oxygenation (ECMO) generally involves using large cannulae capable of carrying high flow rates. A subset of patients with ARDS has mixed hypercapnia and hypoxemia despite high-level ventilator support. In the absence of profound hypoxemia, ECCO 2 R may be used to reduce ventilator support requirements to lung-protective levels, while avoiding risks associated with conventional ECMO.

Evaluation of Fractional Regional Ventilation Using 4D-CT and Effects of Breathing Maneuvers on Ventilation

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

Mistry, Nilesh N., E-mail: nmistry@som.umaryland.edu; Diwanji, Tejan; Shi, Xiutao

2013-11-15

Purpose: Current implementations of methods based on Hounsfield units to evaluate regional lung ventilation do not directly incorporate tissue-based mass changes that occur over the respiratory cycle. To overcome this, we developed a 4-dimensional computed tomography (4D-CT)-based technique to evaluate fractional regional ventilation (FRV) that uses an individualized ratio of tidal volume to end-expiratory lung volume for each voxel. We further evaluated the effect of different breathing maneuvers on regional ventilation. The results from this work will help elucidate the relationship between global and regional lung function. Methods and Materials: Eight patients underwent 3 sets of 4D-CT scans during 1more » session using free-breathing, audiovisual guidance, and active breathing control. FRV was estimated using a density-based algorithm with mass correction. Internal validation between global and regional ventilation was performed by use of the imaging data collected during the use of active breathing control. The impact of breathing maneuvers on FRV was evaluated comparing the tidal volume from 3 breathing methods. Results: Internal validation through comparison between the global and regional changes in ventilation revealed a strong linear correlation (slope of 1.01, R{sup 2} of 0.97) between the measured global lung volume and the regional lung volume calculated by use of the “mass corrected” FRV. A linear relationship was established between the tidal volume measured with the automated breathing control system and FRV based on 4D-CT imaging. Consistently larger breathing volumes were observed when coached breathing techniques were used. Conclusions: The technique presented improves density-based evaluation of lung ventilation and establishes a link between global and regional lung ventilation volumes. Furthermore, the results obtained are comparable with those of other techniques of functional evaluation such as spirometry and hyperpolarized-gas magnetic resonance imaging. These results were demonstrated on retrospective analysis of patient data, and further research using prospective data is under way to validate this technique against established clinical tests.« less

Progressive ventilation inhomogeneity in infants with cystic fibrosis after pulmonary infection.

PubMed

Simpson, Shannon J; Ranganathan, Sarath; Park, Judy; Turkovic, Lidija; Robins-Browne, Roy M; Skoric, Billy; Ramsey, Kathryn A; Rosenow, Tim; Banton, Georgia L; Berry, Luke; Stick, Stephen M; Hall, Graham L

2015-12-01

Measures of ventilation distribution are promising for monitoring early lung disease in cystic fibrosis (CF). This study describes the cross-sectional and longitudinal impacts of pulmonary inflammation and infection on ventilation homogeneity in infants with CF.Infants diagnosed with CF underwent multiple breath washout (MBW) testing and bronchoalveolar lavage at three time points during the first 2 years of life.Measures were obtained for 108 infants on 156 occasions. Infants with a significant pulmonary infection at the time of MBW showed increases in lung clearance index (LCI) of 0.400 units (95% CI 0.150-0.648; p=0.002). The impact was long lasting, with previous pulmonary infection leading to increased ventilation inhomogeneity over time compared to those who remained free of infection (p<0.05). Infection with Haemophilus influenzae was particularly detrimental to the longitudinal lung function in young children with CF where LCI was increased by 1.069 units for each year of life (95% CI 0.484-1.612; p<0.001).Pulmonary infection during the first year of life is detrimental to later lung function. Therefore, strategies aimed at prevention, surveillance and eradication of pulmonary pathogens are paramount to preserve lung function in infants with CF. Copyright ©ERS 2015.

Using Hyperpolarized 129Xe MRI to Quantify the Pulmonary Ventilation Distribution

PubMed Central

He, Mu; Driehuys, Bastiaan; Que, Loretta G.; Huang, Yuh-Chin T.

2017-01-01

Background Ventilation heterogeneity is impossible to detect with spirometry. Alternatively, pulmonary ventilation can be imaged 3-dimensionally using inhaled 129Xe MRI. To date such images have been quantified primarily based on ventilation defects. Here, we introduce a robust means to transform 129Xe MRI scans such that the underlying ventilation distribution and its heterogeneity can be quantified. Methods Quantitative 129Xe ventilation MRI was conducted in 12 younger (24.7±5.2 yrs), and 10 older (62.2±7.2 yrs) healthy individuals, as well as 9 younger (25.9±6.4 yrs) and 10 older (63.2±6.1 yrs) asthmatics. The younger healthy population was used to establish a reference ventilation distribution and thresholds for 6 intensity bins. These were used to display and quantify regions of ventilation defect (VDR), low ventilation (LVR) and high ventilation (HVR). Results The ventilation distribution in young subjects was roughly Gaussian with a mean and SD of 0.52±0.18, resulting in VDR=2.1±1.3%, LVR=15.6±5.4% and HVR=17.4±3.1%. Older healthy volunteers exhibited a significantly right-skewed distribution (0.46±0.20, p=0.034), resulting in significantly increased VDR (7.0±4.8%, p=0.008) and LVR (24.5±11.5%, p=0.025). In the asthmatics, VDR and LVR increased in the older population, and HVR was significantly reduced (13.5±4.6% vs 18.9±4.5%, p=0.009). Quantitative 129Xe MRI also revealed different ventilation distribution patterns in response to albuterol in two asthmatics with normal FEV1. Conclusions Quantitative 129Xe MRI provides a robust and objective means to display and quantify the pulmonary ventilation distribution, even in subjects who have airway function impairment not appreciated by spirometry. PMID:27617823

Centralized Monitoring of the Microsoft Windows-based computers of the LHC Experiment Control Systems

NASA Astrophysics Data System (ADS)

Varela Rodriguez, F.

2011-12-01

The control system of each of the four major Experiments at the CERN Large Hadron Collider (LHC) is distributed over up to 160 computers running either Linux or Microsoft Windows. A quick response to abnormal situations of the computer infrastructure is crucial to maximize the physics usage. For this reason, a tool was developed to supervise, identify errors and troubleshoot such a large system. Although the monitoring of the performance of the Linux computers and their processes was available since the first versions of the tool, it is only recently that the software package has been extended to provide similar functionality for the nodes running Microsoft Windows as this platform is the most commonly used in the LHC detector control systems. In this paper, the architecture and the functionality of the Windows Management Instrumentation (WMI) client developed to provide centralized monitoring of the nodes running different flavour of the Microsoft platform, as well as the interface to the SCADA software of the control systems are presented. The tool is currently being commissioned by the Experiments and it has already proven to be very efficient optimize the running systems and to detect misbehaving processes or nodes.

Hadron Spectra in p+p Collisions at Rhic and Lhc Energies

NASA Astrophysics Data System (ADS)

Khandai, P. K.; Sett, P.; Shukla, P.; Singh, V.

2013-06-01

We present the systematic analysis of transverse momentum (pT) spectra of identified hadrons in p+p collisions at Relativistic Heavy Ion Collider (√ {s} = 62.4 and 200 GeV) and at Large Hadron Collider (LHC) energies (√ {s} = 0.9, 2.76 and 7.0 TeV) using phenomenological fit functions. We review various forms of Hagedorn and Tsallis distributions and show their equivalence. We use Tsallis distribution which successfully describes the spectra in p+p collisions using two parameters, Tsallis temperature T which governs the soft bulk spectra and power n which determines the initial production in partonic collisions. We obtain these parameters for pions, kaons and protons as a function of center-of-mass energy (√ {s}). It is found that the parameter T has a weak but decreasing trend with increasing √ {s}. The parameter n decreases with increasing √ {s} which shows that production of hadrons at higher energies are increasingly dominated by point like qq scatterings. Another important observation is with increasing √ {s}, the separation between the powers for protons and pions narrows down hinting that the baryons and mesons are governed by same production process as one moves to the highest LHC energy.

Advanced Hybrid Spacesuit Concept Featuring Integrated Open Loop and Closed Loop Ventilation Systems

NASA Technical Reports Server (NTRS)

Daniel, Brian A.; Fitzpatrick, Garret R.; Gohmert, Dustin M.; Ybarra, Rick M.; Dub, Mark O.

2013-01-01

A document discusses the design and prototype of an advanced spacesuit concept that integrates the capability to function seamlessly with multiple ventilation system approaches. Traditionally, spacesuits are designed to operate both dependently and independently of a host vehicle environment control and life support system (ECLSS). Spacesuits that operate independent of vehicle-provided ECLSS services must do so with equipment selfcontained within or on the spacesuit. Suits that are dependent on vehicle-provided consumables must remain physically connected to and integrated with the vehicle to operate properly. This innovation is the design and prototype of a hybrid spacesuit approach that configures the spacesuit to seamlessly interface and integrate with either type of vehicular systems, while still maintaining the ability to function completely independent of the vehicle. An existing Advanced Crew Escape Suit (ACES) was utilized as the platform from which to develop the innovation. The ACES was retrofitted with selected components and one-off items to achieve the objective. The ventilation system concept was developed and prototyped/retrofitted to an existing ACES. Components were selected to provide suit connectors, hoses/umbilicals, internal breathing system ducting/ conduits, etc. The concept utilizes a lowpressure- drop, high-flow ventilation system that serves as a conduit from the vehicle supply into the suit, up through a neck seal, into the breathing helmet cavity, back down through the neck seal, out of the suit, and returned to the vehicle. The concept also utilizes a modified demand-based breathing system configured to function seamlessly with the low-pressure-drop closed-loop ventilation system.

MO-A-BRD-05: Evaluation of Composed Lung Ventilation with 4DCT and Image Registration

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

Du, K; Bayouth, J; Reinhardt, J

Purpose: Regional pulmonary function can be derived using fourdimensional computed tomography (4DCT) combined with deformable image registration. However, only peak inhale and exhale phases have been used thus far while the lung ventilation during intermediate phases is not considered. In our previous work, we have investigated the spatiotemporal heterogeneity of lung ventilation and its dependence on respiration effort. In this study, composed ventilation is introduced using all inspiration phases and compared to direct ventilation. Both methods are evaluated against Xe-CT derived ventilation. Methods: Using an in-house tissue volume preserving deformable image registration, unlike the direct ventilation method, which computes frommore » end expiration to end inspiration, Jacobian ventilation maps were computed from one inhale phase to the next and then composed from all inspiration steps. The two methods were compared in both patients prior to RT and mechanically ventilated sheep subjects. In addition, they wereassessed for the correlation with Xe-CT derived ventilation in sheep subjects. Annotated lung landmarks were used to evaluate the accuracy of original and composed deformation field. Results: After registration, the landmark distance for composed deformation field was always higher than that for direct deformation field (0IN to 100IN average in human: 1.03 vs 1.53, p=0.001, and in sheep: 0.80 vs0.94, p=0.009), and both increased with longer phase interval. Direct and composed ventilation maps were similar in both sheep (gamma pass rate 87.6) and human subjects (gamma pass rate 71.9),and showed consistent pattern from ventral to dorsal when compared to Xe-CT derived ventilation. Correlation coefficient between Xe-CT and composed ventilation was slightly better than the direct method but not significant (average 0.89 vs 0.85, p=0.135). Conclusion: More strict breathing control in sheep subjects may explain higher similarity between direct and composed ventilation. When compared to Xe-CT ventilation, no significant difference was found for the composed method. NIH Grant: R01 CA166703.« less

Clinical review: Positive end-expiratory pressure and cardiac output

PubMed Central

Luecke, Thomas; Pelosi, Paolo

2005-01-01

In patients with acute lung injury, high levels of positive end-expiratory pressure (PEEP) may be necessary to maintain or restore oxygenation, despite the fact that 'aggressive' mechanical ventilation can markedly affect cardiac function in a complex and often unpredictable fashion. As heart rate usually does not change with PEEP, the entire fall in cardiac output is a consequence of a reduction in left ventricular stroke volume (SV). PEEP-induced changes in cardiac output are analyzed, therefore, in terms of changes in SV and its determinants (preload, afterload, contractility and ventricular compliance). Mechanical ventilation with PEEP, like any other active or passive ventilatory maneuver, primarily affects cardiac function by changing lung volume and intrathoracic pressure. In order to describe the direct cardiocirculatory consequences of respiratory failure necessitating mechanical ventilation and PEEP, this review will focus on the effects of changes in lung volume, factors controlling venous return, the diastolic interactions between the ventricles and the effects of intrathoracic pressure on cardiac function, specifically left ventricular function. Finally, the hemodynamic consequences of PEEP in patients with heart failure, chronic obstructive pulmonary disease and acute respiratory distress syndrome are discussed. PMID:16356246

SU-E-J-120: Comparing 4D CT Computed Ventilation to Lung Function Measured with Hyperpolarized Xenon-129 MRI

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

Neal, B; Chen, Q

2015-06-15

Purpose: To correlate ventilation parameters computed from 4D CT to ventilation, profusion, and gas exchange measured with hyperpolarized Xenon-129 MRI for a set of lung cancer patients. Methods: Hyperpolarized Xe-129 MRI lung scans were acquired for lung cancer patients, before and after radiation therapy, measuring ventilation, perfusion, and gas exchange. In the standard clinical workflow, these patients also received 4D CT scans before treatment. Ventilation was computed from 4D CT using deformable image registration (DIR). All phases of the 4D CT scan were registered using a B-spline deformable registration. Ventilation at the voxel level was then computed for each phasemore » based on a Jacobian volume expansion metric, yielding phase sorted ventilation images. Ventilation based upon 4D CT and Xe-129 MRI were co-registered, allowing qualitative visual comparison and qualitative comparison via the Pearson correlation coefficient. Results: Analysis shows a weak correlation between hyperpolarized Xe-129 MRI and 4D CT DIR ventilation, with a Pearson correlation coefficient of 0.17 to 0.22. Further work will refine the DIR parameters to optimize the correlation. The weak correlation could be due to the limitations of 4D CT, registration algorithms, or the Xe-129 MRI imaging. Continued development will refine parameters to optimize correlation. Conclusion: Current analysis yields a minimal correlation between 4D CT DIR and Xe-129 MRI ventilation. Funding provided by the 2014 George Amorino Pilot Grant in Radiation Oncology at the University of Virginia.« less

The gravitational distribution of ventilation-perfusion ratio is more uniform in prone than supine posture in the normal human lung

PubMed Central

Sá, Rui Carlos; Theilmann, Rebecca J.; Buxton, Richard B.; Prisk, G. Kim; Hopkins, Susan R.

2013-01-01

The gravitational gradient of intrapleural pressure is suggested to be less in prone posture than supine. Thus the gravitational distribution of ventilation is expected to be more uniform prone, potentially affecting regional ventilation-perfusion (V̇a/Q̇) ratio. Using a novel functional lung magnetic resonance imaging technique to measure regional V̇a/Q̇ ratio, the gravitational gradients in proton density, ventilation, perfusion, and V̇a/Q̇ ratio were measured in prone and supine posture. Data were acquired in seven healthy subjects in a single sagittal slice of the right lung at functional residual capacity. Regional specific ventilation images quantified using specific ventilation imaging and proton density images obtained using a fast gradient-echo sequence were registered and smoothed to calculate regional alveolar ventilation. Perfusion was measured using arterial spin labeling. Ventilation (ml·min−1·ml−1) images were combined on a voxel-by-voxel basis with smoothed perfusion (ml·min−1·ml−1) images to obtain regional V̇a/Q̇ ratio. Data were averaged for voxels within 1-cm gravitational planes, starting from the most gravitationally dependent lung. The slope of the relationship between alveolar ventilation and vertical height was less prone than supine (−0.17 ± 0.10 ml·min−1·ml−1·cm−1 supine, −0.040 ± 0.03 prone ml·min−1·ml−1·cm−1, P = 0.02) as was the slope of the perfusion-height relationship (−0.14 ± 0.05 ml·min−1·ml−1·cm−1 supine, −0.08 ± 0.09 prone ml·min−1·ml−1·cm−1, P = 0.02). There was a significant gravitational gradient in V̇a/Q̇ ratio in both postures (P < 0.05) that was less in prone (0.09 ± 0.08 cm−1 supine, 0.04 ± 0.03 cm−1 prone, P = 0.04). The gravitational gradients in ventilation, perfusion, and regional V̇a/Q̇ ratio were greater supine than prone, suggesting an interplay between thoracic cavity configuration, airway and vascular tree anatomy, and the effects of gravity on V̇a/Q̇ matching. PMID:23620488

WE-AB-202-08: Feasibility of Single-Inhalation/Single-Energy Xenon CT for High-Resolution Imaging of Regional Lung Ventilation in Humans

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

Pinkham, D; Schueler, E; Diehn, M

Purpose: To demonstrate the efficacy of a novel functional lung imaging method that utilizes single-inhalation, single-energy xenon CT (Xe-CT) lung ventilation scans, and to compare it against the current clinical standard, ventilation single-photon emission CT (V-SPECT). Methods: In an IRB-approved clinical study, 14 patients undergoing thoracic radiotherapy received two successive single inhalation, single energy (80keV) CT images of the entire lung using 100% oxygen and a 70%/30% xenon-oxygen mixture. A subset of ten patients also received concurrent SPECT ventilation scans. Anatomic reproducibility between the two scans was achieved using a custom video biofeedback apparatus. The CT images were registered tomore » each other by deformable registration, and a calculated difference image served as surrogate xenon ventilation map. Both lungs were partitioned into twelve sectors, and a sector-wise correlation was performed between the xenon and V-SPECT scans. A linear regression model was developed with forced expiratory volume (FEV) as a predictor and the coefficient of variation (CoV) as the outcome. Results: The ventilation comparison for five of the patients had either moderate to strong Pearson correlation coefficients (0.47 to 0.69, p<0.05). Of these, four also had moderate to strong Spearman correlation coefficients (0.46 to 0.80, p<0.03). The patients with the strongest correlation had clear regional ventilation deficits. The patient comparisons with the weakest correlations had more homogeneous ventilation distributions, and those patients also had diminished lung function as assessed by spirometry. Analysis of the relationship between CoV and FEV yielded a non-significant trend toward negative correlation (Pearson coefficient −0.60, p<0.15). Conclusion: Significant correlations were found between the Xe-CT and V-SPECT ventilation imagery. The results from this small cohort of patients indicate that single inhalation, single energy Xe-CT has the potential to quantify regional lung ventilation volumetrically with high resolution using widely accessible radiologic equipment. Bill Loo and Peter Maxim are founders of TibaRay, Inc. Bill Loo is also a board member. Bill Loo and Peter Maxim have received research grants from Varian Medical Systems, Inc. and RaySearch Laboratory.« less

Heating, Ventilation, Air Conditioning. Resource Manual for Custodial Training Course #3.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. School Plant Management Section.

Intended as a manual to provide school custodians with some understanding of basic functions of heating, ventilating, and air conditioning equipment for safe, efficient operation. Contains general rules and specifications for providing custodians with a more complete awareness of their equipment and the field of "Climate Control" within the…

Upgrade of the LHC magnet interconnections thermal shielding

NASA Astrophysics Data System (ADS)

Musso, Andrea; Barlow, Graeme; Bastard, Alain; Charrondiere, Maryline; Chrul, Anna; Damianoglou, Dimitrios; Deferne, Guy; Dib, Gaëlle; Duret, Max; Guinchard, Michael; Prin, Hervé; Strychalski, Michał; Craen, Arnaud Vande; Villiger, Gilles; Wright, Loren

2014-01-01

The about 1700 interconnections (ICs) between the Large Hadron Collider (LHC) superconducting magnets include thermal shielding at 50-75 K, providing continuity to the thermal shielding of the magnet cryostats to reduce the overall radiation heat loads to the 1.9 K helium bath of the magnets. The IC shield, made of aluminum, is conduction-cooled via a welded bridge to the thermal shield of the adjacent magnets which is actively cooled. TIG welding of these bridges made in the LHC tunnel at installation of the magnets induced a considerable risk of fire hazard due to the proximity of the multi-layer insulation of the magnet shields. A fire incident occurred in one of the machine sectors during machine installation, but fortunately with limited consequences thanks to prompt intervention of the operators. LHC is now undergoing a 2 years technical stop during which all magnet's ICs will have to be opened to consolidate the magnet electrical connections. The IC thermal shields will therefore have to be removed and re-installed after the work is completed. In order to eliminate the risk of fire hazard when re-welding, it has been decided to review the design of the IC shields, by replacing the welded bridges with a mechanical clamping which also preserves its thermal function. An additional advantage of this new solution is the ease in dismantling for maintenance, and eliminating weld-grinding operations at removal needing radioprotection measures because of material activation after long-term operation of the LHC. This paper describes the new design of the IC shields and in particular the theoretical and experimental validation of its thermal performance. Furthermore a status report of the on-going upgrade work in the LHC is given.

The surprisingly transparent sQGP at LHC

NASA Astrophysics Data System (ADS)

Horowitz, W. A.; Gyulassy, Miklos

2011-12-01

We present parameter-free predictions of the nuclear modification factor, RAAπ(p,s), of high p pions produced in Pb + Pb collisions at s=2.76 and 5.5 ATeV based on the WHDG/DGLV (radiative + elastic + geometric fluctuation) jet energy loss model. The initial quark gluon plasma (QGP) density at LHC is constrained from a rigorous statistical analysis of PHENIX/RHIC π quenching data at s=0.2 ATeV and the charged particle multiplicity at ALICE/LHC at 2.76 ATeV. Our perturbative QCD tomographic theory predicts significant differences between jet quenching at RHIC and LHC energies, which are qualitatively consistent with the p-dependence and normalization—within the large systematic uncertainty—of the first charged hadron nuclear modification factor, RAAch, data measured by ALICE. However, our constrained prediction of the central to peripheral pion modification, Rcpπ(p), for which large systematic uncertainties associated with unmeasured p + p reference data cancel, is found to be over-quenched relative to the charged hadron ALICE Rcpch data in the range 5

Hadronic production of Bs(*) at the Tevatron and LHC

NASA Astrophysics Data System (ADS)

Zhang, Jia-Wei; Fang, Zhen-Yun; Chang, Chao-Hsi; Wu, Xing-Gang; Zhong, Tao; Yu, Yao

2009-06-01

We study the hadronic production of Bs and Bs* mesons within the fixed-flavor-number scheme, in which the dominant gluon-gluon fusion mechanism is dealt with by using the complete αs4 approach. Main theoretical uncertainties for Bs and Bs* production at the Tevatron and LHC are presented. It is found that when ms increases by steps of 0.1 GeV, the integrated cross section of Bs(*) decreases by 80%-100%. When mb increases by steps of 0.1 GeV, it changes by ˜10%, while the uncertainties caused by the parton distribution function and the factorization scale vary within the region of (1)/(5) to (1)/(3). Considering a possible kinematic cut on the transverse momentum and the rapidity cut for the detectors at the Tevatron and LHC, we also make estimations on the Bs and Bs* production with various kinematic cuts.

Is Each Light-Harvesting Complex Protein Important for Plant Fitness?1[w

PubMed Central

Ganeteg, Ulrika; Külheim, Carsten; Andersson, Jenny; Jansson, Stefan

2004-01-01

Many of the photosynthetic genes are conserved among all higher plants, indicating that there is strong selective pressure to maintain the genes of each protein. However, mutants of these genes often lack visible growth phenotypes, suggesting that they are important only under certain conditions or have overlapping functions. To assess the importance of specific genes encoding the light-harvesting complex (LHC) proteins for the survival of the plant in the natural environment, we have combined two different scientific traditions by using an ecological fitness assay on a set of genetically modified Arabidopsis plants with differing LHC protein contents. The fitness of all of the LHC-deficient plants was reduced in some of the growth environments, supporting the hypothesis that each of the genes has been conserved because they provide ecological flexibility, which is of great adaptive value given the highly variable conditions encountered in nature. PMID:14730076

Mask leak increases and minute ventilation decreases when chest compressions are added to bag ventilation in a neonatal manikin model.

PubMed

Tracy, Mark B; Shah, Dharmesh; Hinder, Murray; Klimek, Jan; Marceau, James; Wright, Audrey

2014-05-01

To determine changes in respiratory mechanics when chest compressions are added to mask ventilation, as recommended by the International Liaison Committee on Resuscitation (ILCOR) guidelines for newborn infants. Using a Laerdal Advanced Life Support leak-free baby manikin and a 240-mL self-inflating bag, 58 neonatal staff members were randomly paired to provide mask ventilation, followed by mask ventilation with chest compressions with a 1:3 ratio, for two minutes each. A Florian respiratory function monitor was used to measure respiratory mechanics, including mask leak. The addition of chest compressions to mask ventilation led to a significant reduction in inflation rate, from 63.9 to 32.9 breaths per minute (p < 0.0001), mean airway pressure reduced from 7.6 to 4.9 cm H2 O (p < 0.001), minute ventilation reduced from 770 to 451 mL/kg/min (p < 0.0001), and there was a significant increase in paired mask leak of 6.8% (p < 0.0001). Adding chest compressions to mask ventilation, in accordance with the ILCOR guidelines, in a manikin model is associated with a significant reduction in delivered ventilation and increase in mask leak. If similar findings occur in human infants needing an escalation in resuscitation, there is a potential risk of either delay in recovery or inadequate response to resuscitation. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Energy and cost associated with ventilating office buildings in a tropical climate.

PubMed

Rim, Donghyun; Schiavon, Stefano; Nazaroff, William W

2015-01-01

Providing sufficient amounts of outdoor air to occupants is a critical building function for supporting occupant health, well-being and productivity. In tropical climates, high ventilation rates require substantial amounts of energy to cool and dehumidify supply air. This study evaluates the energy consumption and associated cost for thermally conditioning outdoor air provided for building ventilation in tropical climates, considering Singapore as an example locale. We investigated the influence on energy consumption and cost of the following factors: outdoor air temperature and humidity, ventilation rate (L/s per person), indoor air temperature and humidity, air conditioning system coefficient of performance (COP), and cost of electricity. Results show that dehumidification of outdoor air accounts for more than 80% of the energy needed for building ventilation in Singapore's tropical climate. Improved system performance and/or a small increase in the indoor temperature set point would permit relatively large ventilation rates (such as 25 L/s per person) at modest or no cost increment. Overall, even in a thermally demanding tropical climate, the energy cost associated with increasing ventilation rate up to 25 L/s per person is less than 1% of the wages of an office worker in an advanced economy like Singapore's. This result implies that the benefits of increasing outdoor air ventilation rate up to 25 L/s per person--which is suggested to provide for productivity increases, lower sick building syndrome symptom prevalence, and reduced sick leave--can be much larger than the incremental cost of ventilation.

WE-FG-206-07: Assessing the Lung Function of Patients with Non-Small Cell Lung Cancer Using Hyperpolarized Xenon-129 Dissolved-Phase MRI

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

Qing, K; Mugler, J; Chen, Q

Purpose: Hyperpolarized xenon-129 dissolved-phase MRI is the first imaging technique that allows 3-dimensional regional mapping of ventilation and gas uptake by tissue and blood the in human lung. Multiple outcome measures can be produced from this method. Existing studies in subjects with major lung diseases compared to healthy controls demonstrated high sensitivities of this method to pulmonary physiological factors including ventilation, alveolar tissue density, surface-to-volume ratio, pulmonary perfusion and gas-blood barrier thickness. The purpose of this study is to evaluate the utility of this new imaging tool to assess the lung function in patients with non-small cell lung cancer (NSCLC).more » Methods: Ten healthy controls (age: 63±10) and five patients (age: 62±13) with NSCLC underwent the xenon-129 dissolved-phase MRI, pulmonary function test (PFT) and CT for clinical purpose. Three outcome measures were produced from xenon-129 dissolved-phase MRI, including ventilation defect fraction (Vdef%) reflecting the airflow obstruction, tissue-to-gas ratio reflecting lung tissue density, and RBC-to-tissue ratio reflecting pulmonary perfusion and gas exchange. Results: Compared to healthy controls, patients with NSCLC showed more ventilation defects (NSCLC: 22±6%; control: 40±18%; P=0.01), lower tissue-to-gas (NSCLC: 0.82±0.31%; control: 1.07±0.13%; P=0.05) and RBC-to-tissue ratios (NSCLC: 0.82±0.31%; control: 1.07±0.13%; P=0.01). Maps for ventilation and gas uptake by tissue and blood were highly heterogeneous in the lungs of patients. Vdef% and RBC-to-tissue ratios in all 15 subjects correlated with corresponding global lung functional measures from PFT: FEV1/FVC (R=−0.91, P<0.001) and DLCO % predicted (R=0.54, P=0.03), respectively. The tissue-to-gas ratios correlated with tissue density (HU) measured by CT (R=0.88, P<0.001). Conclusion: With the unique ability to provide detailed information about lung function including ventilation, tissue density, perfusion and gas exchange with 3D resolution, hyperpolarized xenon-129 dissolved-phase MRI has high potential to be used as an important reference for radiotherapy treatment planning and for evaluating the side effects of the treatment. Receive research support and funding from Siemens.« less

Jet Substructure at the Large Hadron Collider : Experimental Review

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

Asquith, Lily; Campanelli, Mario; Delitzsch, Chris

Jet substructure has emerged to play a central role at the Large Hadron Collider (LHC), where it has provided numerous innovative new ways to search for new physics and to probe the Standard Model, particularly in extreme regions of phase space. In this article we focus on a review of the development and use of state-of-the-art jet substructure techniques by the ATLAS and CMS experiments. ALICE and LHCb have been probing fragmentation functions since the start of the LHC and have also recently started studying other jet substructure techniques. It is likely that in the near future all LHC collaborationsmore » will make significant use of jet substructure and grooming techniques. Much of the work in this field in recent years has been galvanized by the Boost Workshop Series, which continues to inspire fruitful collaborations between experimentalists and theorists. We hope that this review will prove a useful introduction and reference to experimental aspects of jet substructure at the LHC. A companion overview of recent progress in theory and machine learning approaches is given in 1709.04464, the complete review will be submitted to Reviews of Modern Physics.« less

Beam Loss Monitoring for LHC Machine Protection

NASA Astrophysics Data System (ADS)

Holzer, Eva Barbara; Dehning, Bernd; Effnger, Ewald; Emery, Jonathan; Grishin, Viatcheslav; Hajdu, Csaba; Jackson, Stephen; Kurfuerst, Christoph; Marsili, Aurelien; Misiowiec, Marek; Nagel, Markus; Busto, Eduardo Nebot Del; Nordt, Annika; Roderick, Chris; Sapinski, Mariusz; Zamantzas, Christos

The energy stored in the nominal LHC beams is two times 362 MJ, 100 times the energy of the Tevatron. As little as 1 mJ/cm3 deposited energy quenches a magnet at 7 TeV and 1 J/cm3 causes magnet damage. The beam dumps are the only places to safely dispose of this beam. One of the key systems for machine protection is the beam loss monitoring (BLM) system. About 3600 ionization chambers are installed at likely or critical loss locations around the LHC ring. The losses are integrated in 12 time intervals ranging from 40 μs to 84 s and compared to threshold values defined in 32 energy ranges. A beam abort is requested when potentially dangerous losses are detected or when any of the numerous internal system validation tests fails. In addition, loss data are used for machine set-up and operational verifications. The collimation system for example uses the loss data for set-up and regular performance verification. Commissioning and operational experience of the BLM are presented: The machine protection functionality of the BLM system has been fully reliable; the LHC availability has not been compromised by false beam aborts.

LHC interaction region quadrupole cryostat design

NASA Astrophysics Data System (ADS)

Nicol, T. H.; Darve, Ch.; Huang, Y.; Page, T. M.

2002-05-01

The cryostat of a Large Hadron Collider (LHC) Interaction Region (IR) quadrupole magnet consists of all components of the inner triplet except the magnet assembly itself. It serves to support the magnet accurately and reliably within the vacuum vessel, to house all required cryogenic piping, and to insulate the cold mass from heat radiated and conducted from the environment. It must function reliably during storage, shipping and handling, normal magnet operation, quenches, and seismic excitations, and must be able to be manufactured at low cost. The major components of the cryostat are the vacuum vessel, thermal shield, multi-layer insulation system, cryogenic piping, and suspension system. The overall design of a cryostat for superconducting accelerator magnets requires consideration of fluid flow, proper selection of materials for their thermal and structural performance at both ambient and operating temperature, and knowledge of the environment to which the magnets will be subjected over the course of their expected operating lifetime. This paper describes the current LHC IR inner triplet quadrupole magnet cryostats being designed and manufactured at Fermilab as part of the US-LHC collaboration, and includes discussions on the structural and thermal considerations involved in the development of each of the major systems.

Ventilation noise and its effects on annoyance and performance

NASA Astrophysics Data System (ADS)

Landstrom, Ulf

2004-05-01

In almost every room environment, ventilation acts as a more or less prominent part of the noise exposure. The contribution to the overall sound environment is a question not only of the way in which the ventilation system itself functions, but also a question of the prominence of other contemporary sound sources such as speech, equipment, machines, and external noises. Hazardous effects due to ventilation noise are most prominent in offices, hospitals, control rooms, classrooms, conference rooms, and other types of silent areas. The effects evoked by ventilation noise have also been found to be related to the type of activity being conducted. Annoyance and performance thus not only seemed to be linked to the physical character of exposure, i.e., noise level, frequency characteristics, and length of exposure, but also mental and manual activity, complexity, and monotony of the work. The effects can be described in terms of annoyance, discomfort, and fatigue, with consequences on performance and increased mental load. The silent areas where ventilation noise may be most frequently experienced are often synonymous with areas and activities most sensitive to the exposure.

Integrated Stress Response Mediates Epithelial Injury in Mechanical Ventilation.

PubMed

Dolinay, Tamas; Himes, Blanca E; Shumyatcher, Maya; Lawrence, Gladys Gray; Margulies, Susan S

2017-08-01

Ventilator-induced lung injury (VILI) is a severe complication of mechanical ventilation that can lead to acute respiratory distress syndrome. VILI is characterized by damage to the epithelial barrier with subsequent pulmonary edema and profound hypoxia. Available lung-protective ventilator strategies offer only a modest benefit in preventing VILI because they cannot impede alveolar overdistension and concomitant epithelial barrier dysfunction in the inflamed lung regions. There are currently no effective biochemical therapies to mitigate injury to the alveolar epithelium. We hypothesize that alveolar stretch activates the integrated stress response (ISR) pathway and that the chemical inhibition of this pathway mitigates alveolar barrier disruption during stretch and mechanical ventilation. Using our established rat primary type I-like alveolar epithelial cell monolayer stretch model and in vivo rat mechanical ventilation that mimics the alveolar overdistension seen in acute respiratory distress syndrome, we studied epithelial responses to mechanical stress. Our studies revealed that the ISR signaling pathway is a key modulator of epithelial permeability. We show that prolonged epithelial stretch and injurious mechanical ventilation activate the ISR, leading to increased alveolar permeability, cell death, and proinflammatory signaling. Chemical inhibition of protein kinase RNA-like endoplasmic reticulum kinase, an upstream regulator of the pathway, resulted in decreased injury signaling and improved barrier function after prolonged cyclic stretch and injurious mechanical ventilation. Our results provide new evidence that therapeutic targeting of the ISR can mitigate VILI.

HL-LHC and HE-LHC Upgrade Plans and Opportunities for US Participation

NASA Astrophysics Data System (ADS)

Apollinari, Giorgio

2017-01-01

The US HEP community has identified the exploitation of physics opportunities at the High Luminosity-LHC (HL-LHC) as the highest near-term priority. Thanks to multi-year R&D programs, US National Laboratories and Universities have taken the leadership in the development of technical solutions to increase the LHC luminosity, enabling the HL-LHC Project and uniquely positioning this country to make critical contributions to the LHC luminosity upgrade. This talk will describe the shaping of the US Program to contribute in the next decade to HL-LHC through newly developed technologies such as Nb3Sn focusing magnets or superconducting crab cavities. The experience gained through the execution of the HL-LHC Project in the US will constitute a pool of knowledge and capabilities allowing further developments in the future. Opportunities for US participations in proposed hadron colliders, such as a possible High Energy-LHC (HE-LHC), will be described as well.

Non-sedation versus sedation with a daily wake-up trial in critically ill patients receiving mechanical ventilation--effects on physical function: study protocol for a randomized controlled trial: a substudy of the NONSEDA trial.

PubMed

Nedergaard, Helene Korvenius; Jensen, Hanne Irene; Lauridsen, Jørgen T; Sjøgaard, Gisela; Toft, Palle

2015-07-23

Critically ill patients rapidly loose much of their muscle mass and strength. This can be attributed to prolonged admission, prolonged mechanical ventilation and increased mortality, and it can have a negative impact on the degree of independence and quality of life. In the NONSEDA trial we randomize critically ill patients to non-sedation or sedation with a daily wake-up trial during mechanical ventilation in the intensive care unit. It has never been assessed whether non-sedation affects physical function. The aim of this study is to assess the effects of non-sedation versus sedation with a daily wake-up trial on physical function after discharge from intensive care unit. Investigator-initiated, randomized, clinical, parallel-group, superiority trial, including 700 patients in total, with a substudy concerning 200 of these patients. Inclusion criteria will be intubated, mechanically ventilated patients with expected duration of mechanical ventilation >24 h. Exclusion criteria will be patients with severe head trauma, coma at admission or status epilepticus, patients treated with therapeutic hypothermia, patients with PaO2/FiO2<9 where sedation might be necessary to ensure sufficient oxygenation or placing the patient in a prone position. The experimental intervention will be non-sedation supplemented with pain management during mechanical ventilation. The control intervention will be sedation with a daily wake-up trial. The co-primary outcome will be quality of life regarding physical function (SF-36, physical component) and degree of independence in activities of daily living (Barthel Index), and this will be assessed for all 700 patients participating in the NONSEDA trial. The secondary outcomes, which will be assessed for the subpopulation of 200 NONSEDA patients in the trial site, Kolding, will be 6-min walking distance, handgrip strength, muscle size (ultrasonographic measurement of the rectus femoris muscle cross-sectional area) and biomechanical data on lower extremity function (maximal voluntary contraction, rate of force development and endurance). This study is the first to investigate the effect of no sedation during critical illness on physical function. If an effect is found, it will add important information on how to prevent muscle weakness following critical illness. The study has been approved by the relevant scientific ethics committee and is registered at ClinicalTrials.gov (ID: NCT02034942, 9 January 2014).

Comparison of different hadron production models for the study of π±, K±, protons and antiprotons production in proton-carbon interactions at 90 GeV/c

NASA Astrophysics Data System (ADS)

Ajaz, M.; Ali, Y.; Ullah, S.; Ali, Q.; Tabassam, U.

2018-05-01

In this research paper, comprehensive results on the double differential yield of π± and K± mesons, protons and antiprotons as a function of laboratory momentum in several polar angle ranges from 0-420 mrad for pions, 0-360 mrad for kaons, proton and antiproton are reported. EPOS 1.99, EPOS-LHC and QGSJETII-04 models are used to perform simulations. The predictions of these models at 90 GeV/c are plotted for comparison, which shows that QGSJETII-04 model gives overall higher yield for π+ mesons in the polar angle interval of 0-40 mrad but for the π‑ the yield is higher only up to 20 mrad. For π+ mesons after 40 mrad, EPOS-LHC predicts higher yield as compared to EPOS 1.99 and QGSJETII-04 while EPOS-LHC and EPOS 1.99 give similar behavior in these two intervals. However, for π‑ mesons EPOS-LHC and EPOS 1.99 give similar behavior in these two intervals. For of K± mesons, QGSJETII-04 model gives higher predictions in all cases from 0-300 mrad, while EPOS 1.99 and EPOS-LHC show similar distributions. In case of protons, all models give similar distribution but this is not true for antiproton. All models are in good agreement for p > 20 GeV/c. EPOS 1.99 produce lower yield compared to the other two models from 60-360 mrad polar angle interval.

Comparison of different functional EIT approaches to quantify tidal ventilation distribution.

PubMed

Zhao, Zhanqi; Yun, Po-Jen; Kuo, Yen-Liang; Fu, Feng; Dai, Meng; Frerichs, Inez; Möller, Knut

2018-01-30

The aim of the study was to examine the pros and cons of different types of functional EIT (fEIT) to quantify tidal ventilation distribution in a clinical setting. fEIT images were calculated with (1) standard deviation of pixel time curve, (2) regression coefficients of global and local impedance time curves, or (3) mean tidal variations. To characterize temporal heterogeneity of tidal ventilation distribution, another fEIT image of pixel inspiration times is also proposed. fEIT-regression is very robust to signals with different phase information. When the respiratory signal should be distinguished from the heart-beat related signal, or during high-frequency oscillatory ventilation, fEIT-regression is superior to other types. fEIT-tidal variation is the most stable image type regarding the baseline shift. We recommend using this type of fEIT image for preliminary evaluation of the acquired EIT data. However, all these fEITs would be misleading in their assessment of ventilation distribution in the presence of temporal heterogeneity. The analysis software provided by the currently available commercial EIT equipment only offers either fEIT of standard deviation or tidal variation. Considering the pros and cons of each fEIT type, we recommend embedding more types into the analysis software to allow the physicians dealing with more complex clinical applications with on-line EIT measurements.

Gas transfer model to design a ventilator for neonatal total liquid ventilation.

PubMed

Bonfanti, Mirko; Cammi, Antonio; Bagnoli, Paola

2015-12-01

The study was aimed to optimize the gas transfer in an innovative ventilator for neonatal Total Liquid Ventilation (TLV) that integrates the pumping and oxygenation functions in a non-volumetric pulsatile device made of parallel flat silicone membranes. A computational approach was adopted to evaluate oxygen (O2) and carbon dioxide (CO2) exchanges between the liquid perfluorocarbon (PFC) and the oxygenating gas, as a function of the geometrical parameter of the device. A 2D semi-empirical model was implemented to this purpose using Comsol Multiphysics to study both the fluid dynamics and the gas exchange in the ventilator. Experimental gas exchanges measured with a preliminary prototype were compared to the simulation outcomes to prove the model reliability. Different device configurations were modeled to identify the optimal design able to guarantee the desired gas transfer. Good agreement between experimental and simulation outcomes was obtained, validating the model. The optimal configuration, able to achieve the desired gas exchange (ΔpCO2 = 16.5 mmHg and ΔpO2 = 69 mmHg), is a device comprising 40 modules, 300 mm in length (total exchange area = 2.28 m(2)). With this configuration gas transfer performance is satisfactory for all the simulated settings, proving good adaptability of the device. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Impact of Fire Ventilation on General Ventilation in the Building

NASA Astrophysics Data System (ADS)

Zender-Świercz, Ewa; Telejko, Marek

2017-10-01

The fire of building is a threat to its users. The biggest threat is generation, during lifetime of fire, hot gases and smoke. The purpose of quick and efficient evacuation from the area covered by the fire, at first step the escape routes have to be secured from smokiness. The smoke ventilation systems are used for this purpose. The proper design and execution of smoke ventilation is important not only because of the safety, but also of the maintenance of comfort in the building at a time when there is no fire. The manuscript presents the effect of incorrectly realized smoke ventilation in the stairwell of the medium building. The analysis shows that the flaps of smoke ventilation located in the stairwell may have a significant impact on the proper functioning of mechanical ventilation in the period when there is no fire. The improperly installed or incorrect insulated components cause perturbation of air flow and they change pressure distribution in the building. The conclusion of the analysis is the need to include the entire technical equipment of the building during the design and realization of its individual elements. The impact of various installations at each other is very important, and the omission of any of them can cause disturbances in the proper work of another.

New insight into the assessment of asthma using xenon ventilation computed tomography.

PubMed

Jung, Jae-Woo; Kwon, Jae-Woo; Kim, Tae-Wan; Lee, So-Hee; Kim, Kyung-Mook; Kang, Hye-Ryun; Park, Heung-Woo; Lee, Chang-Hyun; Goo, Jin-Mo; Min, Kyung-Up; Cho, Sang-Heon

2013-08-01

Image analyses include computed tomography (CT), magnetic resonance imaging, and xenon ventilation CT, which is new modality to evaluate pulmonary functional imaging. To examine the usefulness of dual-energy xenon ventilation CT in asthmatic patients. A total of 43 patients 18 years or older who were nonsmokers were included in the study. Xenon CT images in wash-in and wash-out phases were obtained at baseline and after inhalation of methacholine and salbutamol. The degrees of ventilation defects and xenon trappings were evaluated through visual analysis. Ventilation defects and xenon trapping were significantly increased and decreased after methacholine challenge and salbutamol inhalation, respectively (P < .005). The ventilation abnormalities were not significantly related to the percentage of forced expiratory volume in 1 second (FEV1) or the ratio of FEV1 to forced vital capacity. Xenon trappings after salbutamol inhalation were negatively related to the scores of the asthma control test, wheezing, or night symptoms, with statistical significance (P < .05), whereas, FEV1 showed no significant correlation with symptom scores. Baseline FEV1 was significantly lower and dyspnea and wheezing were more severe in the non-full reversal group than in the full reversal group after salbutamol inhalation in xenon CT (P < .05). The degree of ventilation defects were positively correlated with FEV1 improvement after 3 months of treatment (P = .02). The results of this study suggest that xenon ventilation CT can be used as a new method to assess ventilation abnormalities in asthma, and these ventilation abnormalities can be used as novel parameters that reflect the status of asthma control and symptom severity. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Threshold and Jet Radius Joint Resummation for Single-Inclusive Jet Production

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

Liu, Xiaohui; Moch, Sven -Olaf; Ringer, Felix

Here, we present the first threshold and jet radius jointly resummed cross section for single-inclusive hadronic jet production. We work at next-to-leading logarithmic accuracy and our framework allows for a systematic extension beyond the currently achieved precision. Long-standing numerical issues are overcome by performing the resummation directly in momentum space within soft collinear effective theory. We present the first numerical results for the LHC and observe an improved description of the available data. Our results are of immediate relevance for LHC precision phenomenology including the extraction of parton distribution functions and the QCD strong coupling constant.

QCD Physics with the CMS Experiment

NASA Astrophysics Data System (ADS)

Cerci, S.

2017-12-01

Jets which are the signatures of quarks and gluons in the detector can be described by Quantum Chromodynamics (QCD) in terms of parton-parton scattering. Jets are abundantly produced at the LHC's high energy scales. Measurements of inclusive jets, dijets and multijets can be used to test perturbative QCD predictions and to constrain parton distribution functions (PDF), as well as to measure the strong coupling constant αS . The measurements use the samples of proton-proton collisions collected with the CMS detector at the LHC at various center-of-mass energies of 7, 8 and 13 TeV.

Diffractive heavy quark production in AA collisions at the LHC at NLO

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

Machado, M. M.; Ducati, M. B. Gay; Machado, M. V. T.

2011-07-15

The single and double diffractive cross sections for heavy quarks production are evaluated at NLO accuracy for hadronic and heavy ion collisions at the LHC. Diffractive charm and bottom production is the main subject of this work, providing predictions for CaCa, PbPb and pPb collisions. The hard diffraction formalism is considered using the Ingelman-Schlein model where a recent parametrization for the Pomeron structure function (DPDF) is applied. Absorptive corrections are taken into account as well. The diffractive ratios are estimated and theoretical uncertainties are discussed. Comparison with competing production channels is also presented.

Diffractive heavy quark production in AA collisions at the LHC at NLO

NASA Astrophysics Data System (ADS)

Machado, M. M.; Ducati, M. B. Gay; Machado, M. V. T.

2011-07-01

The single and double diffractive cross sections for heavy quarks production are evaluated at NLO accuracy for hadronic and heavy ion collisions at the LHC. Diffractive charm and bottom production is the main subject of this work, providing predictions for CaCa, PbPb and pPb collisions. The hard diffraction formalism is considered using the Ingelman-Schlein model where a recent parametrization for the Pomeron structure function (DPDF) is applied. Absorptive corrections are taken into account as well. The diffractive ratios are estimated and theoretical uncertainties are discussed. Comparison with competing production channels is also presented.

Threshold and Jet Radius Joint Resummation for Single-Inclusive Jet Production

DOE PAGES

Liu, Xiaohui; Moch, Sven -Olaf; Ringer, Felix

2017-11-20

Here, we present the first threshold and jet radius jointly resummed cross section for single-inclusive hadronic jet production. We work at next-to-leading logarithmic accuracy and our framework allows for a systematic extension beyond the currently achieved precision. Long-standing numerical issues are overcome by performing the resummation directly in momentum space within soft collinear effective theory. We present the first numerical results for the LHC and observe an improved description of the available data. Our results are of immediate relevance for LHC precision phenomenology including the extraction of parton distribution functions and the QCD strong coupling constant.

One-year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort study.

PubMed

Unroe, Mark; Kahn, Jeremy M; Carson, Shannon S; Govert, Joseph A; Martinu, Tereza; Sathy, Shailaja J; Clay, Alison S; Chia, Jessica; Gray, Alice; Tulsky, James A; Cox, Christopher E

2010-08-03

Growing numbers of critically ill patients receive prolonged mechanical ventilation. Little is known about the patterns of care as patients transition from acute care hospitals to postacute care facilities or about the associated resource utilization. To describe 1-year trajectories of care and resource utilization for patients receiving prolonged mechanical ventilation. 1-year prospective cohort study. 5 intensive care units at Duke University Medical Center, Durham, North Carolina. 126 patients receiving prolonged mechanical ventilation (defined as ventilation for >or=4 days with tracheostomy placement or ventilation for >or=21 days without tracheostomy), as well as their 126 surrogates and 54 intensive care unit physicians, enrolled consecutively over 1 year. Patients and surrogates were interviewed in the hospital, as well as 3 and 12 months after discharge, to determine patient survival, functional status, and facility type and duration of postdischarge care. Physicians were interviewed in the hospital to elicit prognoses. Institutional billing records were used to assign costs for acute care, outpatient care, and interfacility transportation. Medicare claims data were used to assign costs for postacute care. 103 (82%) hospital survivors had 457 separate transitions in postdischarge care location (median, 4 transitions [interquartile range, 3 to 5 transitions]), including 68 patients (67%) who were readmitted at least once. Patients spent an average of 74% (95% CI, 68% to 80%) of all days alive in a hospital or postacute care facility or receiving home health care. At 1 year, 11 patients (9%) had a good outcome (alive with no functional dependency), 33 (26%) had a fair outcome (alive with moderate dependency), and 82 (65%) had a poor outcome (either alive with complete functional dependency [4 patients; 21%] or dead [56 patients; 44%]). Patients with poor outcomes were older, had more comorbid conditions, and were more frequently discharged to a postacute care facility than patients with either fair or good outcomes (P < 0.05 for all). The mean cost per patient was $306,135 (SD, $285,467), and total cohort cost was $38.1 million, for an estimated $3.5 million per independently functioning survivor at 1 year. The results of this single-center study may not be applicable to other centers. Patients receiving prolonged mechanical ventilation have multiple transitions of care, resulting in substantial health care costs and persistent, profound disability. The optimism of surrogate decision makers should be balanced by discussions of these outcomes when considering a course of prolonged life support. None.

[Heat transfer analysis of liquid cooling garment used for extravehicular activity].

PubMed

Qiu, Y F; Yuan, X G; Mei, Z G; Jia, S G; Ouyang, H; Ren, Z S

2001-10-01

Brief description was given about the construction and function of the LCG (liquid cooling garment) used for EVA (extravehicular activity). The heat convection was analyzed between ventilating gas and LCG, the heat and mass transfer process was analyzed too, then a heat and mass transfer mathematical model of LCG was developed. Thermal physiological experimental study with human body wearing LVCG (liquid cooling and ventilation garment) used for EVA was carried out to verify this mathematical model. This study provided a basis for the design of liquid-cooling and ventilation system for the space suit.

[The prevention and treatment of suppurative-inflammatory complications in the bronchopulmonary system during prolonged artificial ventilation].

PubMed

Mozhaev, G A; Tikhonovskiĭ, I Iu

1992-01-01

The use of physical methods, namely low frequency magnetic field in critically ill patients under respiratory therapy made it possible to prevent and in case of their development to effectively treat pyoinflammatory bronchopulmonary complications that accompany prolonged controlled lung ventilation. The results obtained were due to the elimination of an unfavourable effect of controlled lung ventilation on natural resistance and immune response of the respiratory tract because of normalization of physicochemical properties of the tracheobronchial tree secretion, enhanced functional capacities of phagocytes, repaired bonds between cellular and humoral local immunity in the lungs.

Lung Function and Incidence of Chronic Obstructive Pulmonary Disease after Improved Cooking Fuels and Kitchen Ventilation: A 9-Year Prospective Cohort Study

PubMed Central

Zhou, Yumin; Zou, Yimin; Li, Xiaochen; Chen, Shuyun; Zhao, Zhuxiang; He, Fang; Zou, Weifeng; Luo, Qiuping; Li, Wenxi; Pan, Yiling; Deng, Xiaoliang; Wang, Xiaoping; Qiu, Rong; Liu, Shiliang; Zheng, Jingping; Zhong, Nanshan; Ran, Pixin

2014-01-01

Background Biomass smoke is associated with the risk of chronic obstructive pulmonary disease (COPD), but few studies have elaborated approaches to reduce the risk of COPD from biomass burning. The purpose of this study was to determine whether improved cooking fuels and ventilation have effects on pulmonary function and the incidence of COPD. Methods and Findings A 9-y prospective cohort study was conducted among 996 eligible participants aged at least 40 y from November 1, 2002, through November 30, 2011, in 12 villages in southern China. Interventions were implemented starting in 2002 to improve kitchen ventilation (by providing support and instruction for improving biomass stoves or installing exhaust fans) and to promote the use of clean fuels (i.e., biogas) instead of biomass for cooking (by providing support and instruction for installing household biogas digesters); questionnaire interviews and spirometry tests were performed in 2005, 2008, and 2011. That the interventions improved air quality was confirmed via measurements of indoor air pollutants (i.e., SO2, CO, CO2, NO2, and particulate matter with an aerodynamic diameter of 10 µm or less) in a randomly selected subset of the participants' homes. Annual declines in lung function and COPD incidence were compared between those who took up one, both, or neither of the interventions. Use of clean fuels and improved ventilation were associated with a reduced decline in forced expiratory volume in 1 s (FEV1): decline in FEV1 was reduced by 12 ml/y (95% CI, 4 to 20 ml/y) and 13 ml/y (95% CI, 4 to 23 ml/y) in those who used clean fuels and improved ventilation, respectively, compared to those who took up neither intervention, after adjustment for confounders. The combined improvements of use of clean fuels and improved ventilation had the greatest favorable effects on the decline in FEV1, with a slowing of 16 ml/y (95% CI, 9 to 23 ml/y). The longer the duration of improved fuel use and ventilation, the greater the benefits in slowing the decline of FEV1 (p<0.05). The reduction in the risk of COPD was unequivocal after the fuel and ventilation improvements, with an odds ratio of 0.28 (95% CI, 0.11 to 0.73) for both improvements. Conclusions Replacing biomass with biogas for cooking and improving kitchen ventilation are associated with a reduced decline in FEV1 and risk of COPD. Trial Registration Chinese Clinical Trial Register ChiCTR-OCH-12002398 Please see later in the article for the Editors' Summary PMID:24667834

Identifying the heterogeneity of COPD by V/P SPECT: a new tool for improving the diagnosis of parenchymal defects and grading the severity of small airways disease.

PubMed

Bajc, M; Chen, Y; Wang, J; Li, X Y; Shen, W M; Wang, C Z; Huang, H; Lindqvist, A; He, X Y

2017-01-01

Airway obstruction and possible concomitant pulmonary diseases in COPD cannot be identified conventionally with any single diagnostic tool. We aimed to diagnose and grade COPD severity and identify pulmonary comorbidities associated with COPD with ventilation/perfusion single-photon emission computed tomography (V/P SPECT) using Technegas as the functional ventilation imaging agent. 94 COPD patients (aged 43-86 years, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I-IV) were examined with V/P SPECT and spirometry. Ventilation and perfusion defects were analyzed blindly according to the European guidelines. Penetration grade of Technegas in V SPECT measured the degree of obstructive small airways disease. Total preserved lung function and penetration grade of Technegas in V SPECT were assessed by V/P SPECT and compared to GOLD stages and spirometry. Signs of small airway obstruction in the ventilation SPECT images were found in 92 patients. Emphysema was identified in 81 patients. Two patients had no signs of COPD, but both of them had a pulmonary embolism, and in one of them we also suspected a lung tumor. The penetration grade of Technegas in V SPECT and total preserved lung function correlated significantly to GOLD stages ( r =0.63 and -0.60, respectively, P <0.0001). V/P SPECT identified pulmonary embolism in 30 patients (32%). A pattern typical for heart failure was present in 26 patients (28%). Parenchymal changes typical for pneumonia or lung tumor were present in several cases. V/P SPECT, using Technegas as the functional ventilation imaging agent, is a new tool to diagnose COPD and to grade its severity. Additionally, it revealed heterogeneity of COPD caused by pulmonary comorbidities. The characteristics of these comorbidities suggest their significant impact in clarifying symptoms, and also their influence on the prognosis.

Noninvasive mechanical ventilation in patients with obesity hypoventilation syndrome. Long-term outcome and prognostic factors.

PubMed

Ojeda Castillejo, Elena; de Lucas Ramos, Pilar; López Martin, Soledad; Resano Barrios, Pilar; Rodríguez Rodríguez, Paula; Morán Caicedo, Liliana; Bellón Cano, José María; Rodriguez Gonzalez-Moro, José Miguel

2015-02-01

Obesity is associated with 2 closely related respiratory diseases: obesity hypoventilation syndrome (OHS) and obstructive sleep apnea-hypopnea syndrome (OSAHS). It has been shown that noninvasive ventilation during sleep produces clinical and functional improvement in these patients. The long-term survival rate with this treatment, and the difference in clinical progress in OHS patients with and without OSAHS are analyzed. Longitudinal, observational study with a cohort of patients diagnosed with OHS, included in a home ventilation program over a period of 12 years, divided into 2 groups: pure OHS and OSAHS-associated OHS. Bi-level positive airway pressure ventilation was administered. During the follow-up period, symptoms, exacerbations and hospitalizations, blood gas tests and pulmonary function tests, and survival rates were monitored and compared. Eighty-three patients were eligible for analysis, 60 women (72.3%) and 23 men (27.7%), with a mean survival time of 8.47 years. Fifty patients (60.2%) were included in the group without OSAHS (OHS) and 33 (39.8%) in the OSAHS-associated OHS group (OHS-OSAHS). PaCO₂ in the OHS group was significantly higher than in the OHS-OSAHS group (P<.01). OHS patients also had a higher hospitalization rate (P<.05). There was a significant improvement in both groups in FEV₁ and FVC, and no differences between groups in PaCO₂ and PaO₂ values. There were no differences in mortality between the 2 groups, but low FVC values were predictive of mortality. The use of mechanical ventilation in patients with OHS, with or without OSAHS, is an effective treatment for the correction of blood gases and functional alterations and can achieve prolonged survival rates. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Energy and Cost Associated with Ventilating Office Buildings in a Tropical Climate

PubMed Central

Rim, Donghyun; Schiavon, Stefano; Nazaroff, William W.

2015-01-01

Providing sufficient amounts of outdoor air to occupants is a critical building function for supporting occupant health, well-being and productivity. In tropical climates, high ventilation rates require substantial amounts of energy to cool and dehumidify supply air. This study evaluates the energy consumption and associated cost for thermally conditioning outdoor air provided for building ventilation in tropical climates, considering Singapore as an example locale. We investigated the influence on energy consumption and cost of the following factors: outdoor air temperature and humidity, ventilation rate (L/s per person), indoor air temperature and humidity, air conditioning system coefficient of performance (COP), and cost of electricity. Results show that dehumidification of outdoor air accounts for more than 80% of the energy needed for building ventilation in Singapore’s tropical climate. Improved system performance and/or a small increase in the indoor temperature set point would permit relatively large ventilation rates (such as 25 L/s per person) at modest or no cost increment. Overall, even in a thermally demanding tropical climate, the energy cost associated with increasing ventilation rate up to 25 L/s per person is less than 1% of the wages of an office worker in an advanced economy like Singapore’s. This result implies that the benefits of increasing outdoor air ventilation rate up to 25 L/s per person — which is suggested to provide for productivity increases, lower sick building syndrome symptom prevalence, and reduced sick leave — can be much larger than the incremental cost of ventilation. PMID:25822504

Novel analysis of 4DCT imaging quantifies progressive increases in anatomic dead space during mechanical ventilation in mice.

PubMed

Kim, Elizabeth H; Preissner, Melissa; Carnibella, Richard P; Samarage, Chaminda R; Bennett, Ellen; Diniz, Marcio A; Fouras, Andreas; Zosky, Graeme R; Jones, Heather D

2017-09-01

Increased dead space is an important prognostic marker in early acute respiratory distress syndrome (ARDS) that correlates with mortality. The cause of increased dead space in ARDS has largely been attributed to increased alveolar dead space due to ventilation/perfusion mismatching and shunt. We sought to determine whether anatomic dead space also increases in response to mechanical ventilation. Mice received intratracheal lipopolysaccharide (LPS) or saline and mechanical ventilation (MV). Four-dimensional computed tomography (4DCT) scans were performed at onset of MV and after 5 h of MV. Detailed measurements of airway volumes and lung tidal volumes were performed using image analysis software. The forced oscillation technique was used to obtain measures of airway resistance, tissue damping, and tissue elastance. The ratio of airway volumes to total tidal volume increased significantly in response to 5 h of mechanical ventilation, regardless of LPS exposure, and airways demonstrated significant variation in volumes over the respiratory cycle. These findings were associated with an increase in tissue elastance (decreased lung compliance) but without changes in tidal volumes. Airway volumes increased over time with exposure to mechanical ventilation without a concomitant increase in tidal volumes. These findings suggest that anatomic dead space fraction increases progressively with exposure to positive pressure ventilation and may represent a pathological process. NEW & NOTEWORTHY We demonstrate that anatomic dead space ventilation increases significantly over time in mice in response to mechanical ventilation. The novel functional lung-imaging techniques applied here yield sensitive measures of airway volumes that may have wide applications. Copyright © 2017 the American Physiological Society.

Efficiency index: a new parameter to define breathing patterns during dynamic Xe-127 ventilation studies

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

Slosman, D.; Susskind, H.; Bossuyt, A.

1986-03-01

Ventilation imaging can be improved by gating scintigraphic data with the respiratory cycle using temporal Fourier analysis (TFA) to quantify the temporal behavior of the ventilation. Sixteen consecutive images, representing equal-time increments of an average respiratory cycle, were produced by TFA in the posterior view on a pixel-by-pixel basis. An Efficiency Index (EFF), defined as the ratio of the summation of all the differences between maximum and minimum counts for each pixel to that for the entire lung during the respiratory cycle, was derived to describe the pattern of ventilation. The gated ventilation studies were carried out with Xe-127 inmore » 12 subjects: normal lung function (4), small airway disease (2), COPD (5), and restrictive disease (1). EFF for the first three harmonics correlated linearly with FEV1 (r = 0.701, p< 0.01). This approach is suggested as a very sensitive method to quantify the extent and regional distribution of airway obstruction.« less

The muscular basis of aerial ventilation of the primitive lung of Amia calva.

PubMed

Deyst, K A; Liem, K F

1985-02-01

Anatomical analysis, electromyography, pressure recordings, high-speed X-ray and light movies of the mechanism of air ventilation in Amia calva reveal that aerial ventilation proceeds by the action of a specialized pulse pump. The interhyoideus muscle is the dominant muscle being active during both the preparatory phase and the final, prolonged compressive phase during which new air is forced into the lung. Amia retains a relatively large residual volume in the lung and does not repeat inhalation. It often expels excess air from the buccal cavity after the lung has been fully reinflated. The pressure, kinematic and air flow patterns during air ventilation in Amia closely resemble those of the air breath in the lungfish Protopterus. We hypothesize that the basically similar electromyographic profiles of homologous muscles so characteristic for the air ventilation mechanism of Protopterus and Amia reflect a homologous anatomical as well as functional neuromuscular pattern, which has had a common and early evolutionary origin among the Teleostomi.

Mental health of mothers caring for ventilator-assisted children at home.

PubMed

Kuster, Patricia A; Badr, Lina K

2006-10-01

The complex management of ventilator-assisted children cared for in the home can place emotional and mental strain on parents, in particular, mothers. The purpose of this study was to explore the relationships among functional status of the child, impact of ventilator-assistance on the family, coping, social support, and depression in mothers caring for ventilator-assisted children at home. Thirty-eight mothers participated in the study. Almost half of the mothers experienced depressive mood symptoms. Impact on family was positively related to depression and social support was inversely related to depression. In addition, social support was a significant predictor of depression. The findings show that the high demands related to the care of ventilator-assisted children can be a significant risk factor for poor mental health outcomes of those mothers providing care at home. Interventions by mental health and pediatric nurses should focus on enhancing mothers' coping skills and assisting mothers in accessing a positive social network to help mediate the stress related to caring for their child.

The effects of L-glutamate, AMPA, quisqualate, and kainate on retinal horizontal cells depend on adaptational state: implications for rod-cone interactions.

PubMed

Krizaj, D; Akopian, A; Witkovsky, P

1994-09-01

We studied the responses of isolated and intact luminosity-type horizontal cells (L-HC) in the Xenopus retina to L-glutamate (L-glu) and its analogs. Isolated L-HCs studied with whole-cell patch clamp responded to L-glu, kainate (KA), AMPA, or quisqualate (quis) with inward currents from a holding potential of -60 mV, associated with a conductance increase. The current elicited by KA was relatively large and sustained, whereas AMPA or quis evoked a desensitizing current. Coapplication of quis and KA resulted in a smaller current and conductance change than that evoked by a pulse of either alone at the same concentration. This finding suggests that the L-HC has a single subtype of glutamate receptor that responds to both quis and KA. Prior exposure to dopamine enhanced the KA-evoked current about twofold. In the superfused eyecup we found that L-HC responses to quinoxalinediones (CNQX or DNQX) and to L-glu, KA, AMPA, and quis varied as a function of adaptational state. When driven exclusively by either cones or by rods, CNQX/DNQX hyperpolarized the L-HC and reduced its light response, without altering response kinetics, indicating that both rods and cones communicate with L-HCs at ionotropic glutamatergic synapses. Under mesopic conditions, however, as CNQX or DNQX reduced cone input, the rod input to the L-HC increased up to fivefold in magnitude and had slowed kinetics. The depolarizing response of the L-HC to L-glu, AMPA, or quis was relatively small and transient under photopic conditions, but was much larger and sustained when the eyecup was dark adapted. The D1 dopamine antagonist SCH 23390 potentiated the response to quis. In contrast, responses to KA were largest in light-adapted eyecups, were potentiated by a D1 dopamine agonist, SKF 38393, and were reduced by SCH 23390. We hypothesize that the segregated populations of glutamate receptors in the L-HC opposite cone and rod synaptic endings can be separately modulated to respond differentially to the native transmitter, glutamate. In photopic and mesopic states the dominant cone input tonically inhibits rod to L-HC communication. This inhibition appears to occur at the postsynaptic membrane and may be mediated by second messengers.

WE-AB-202-05: Validation of Lung Stress Maps for CT-Ventilation Imaging

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

Cazoulat, G; Jolly, S; Matuszak, M

Purpose: To date, lung CT-ventilation imaging has been based on quantification of local breathing-induced changes in Hounsfield Units (HU) or volume. This work investigates the use of a stress map resulting from a biomechanical deformable image registration (DIR) algorithm as a metric of the ventilation function. Method: Eight lung cancer patients presenting different kinds of ventilation defects were retrospectively analyzed. Additionally, to the 4DCT acquired for radiotherapy planning, five of them had PET and three had SPECT imaging following inhalation of Ga-68 and Tc-99m, respectively. For each patient, the inhale phase of the 4DCT was registered to the exhale phasemore » using Morfeus, a biomechanical DIR algorithm based on the determination of boundary conditions on the lung surfaces and vessel tree. To take into account the heterogeneity of the tissue stiffness in the stress map estimation, each tetrahedral element of the finite-element model was assigned a Young’s modulus ranging from 60kPa to 12MPa, as a function of the HU in the inhale CT. The node displacements and element stresses resulting from the numerical simulation were used to generate three CT-ventilation maps based on: (i) volume changes (Jacobian determinant), (ii) changes in HU, (iii) the maximum principal stress. The voxel-wise correlation between each CT-ventilation map and the PET or SPECT V image was computed in a lung mask. Results: For patients with PET, the mean (min-max) Spearman correlation coefficients r were: 0.33 (0.19–0.45), 0.36 (0.16–0.51) and 0.42 (0.21–0.59) considering the Jacobian, changes in HU and maximum principal stress, respectively. For patients with SPECT V, the mean r were: 0.12 (−0.12–0.43), 0.29 (0.22–0.45) and 0.33 (0.25–0.39). Conclusion: The maximum principal stress maps showed a stronger correlation with the ventilation images than the previously proposed Jacobian or change in HU maps. This metric thus appears promising for CT-ventilation imaging. This work was funded in part by NIH P01CA059827.« less

Postoperative respiratory muscle dysfunction: pathophysiology and preventive strategies.

PubMed

Sasaki, Nobuo; Meyer, Matthew J; Eikermann, Matthias

2013-04-01

Postoperative pulmonary complications are responsible for significant increases in hospital cost as well as patient morbidity and mortality; respiratory muscle dysfunction represents a contributing factor. Upper airway dilator muscles functionally resist the upper airway collapsing forces created by the respiratory pump muscles. Standard perioperative medications (anesthetics, sedatives, opioids, and neuromuscular blocking agents), interventions (patient positioning, mechanical ventilation, and surgical trauma), and diseases (lung hyperinflation, obesity, and obstructive sleep apnea) have differential effects on the respiratory muscle subgroups. These effects on the upper airway dilators and respiratory pump muscles impair their coordination and function and can result in respiratory failure. Perioperative management strategies can help decrease the incidence of postoperative respiratory muscle dysfunction. Such strategies include minimally invasive procedures rather than open surgery, early and optimal mobilizing of respiratory muscles while on mechanical ventilation, judicious use of respiratory depressant anesthetics and neuromuscular blocking agents, and noninvasive ventilation when possible.

Dynamic chest radiography: flat-panel detector (FPD) based functional X-ray imaging.

PubMed

Tanaka, Rie

2016-07-01

Dynamic chest radiography is a flat-panel detector (FPD)-based functional X-ray imaging, which is performed as an additional examination in chest radiography. The large field of view (FOV) of FPDs permits real-time observation of the entire lungs and simultaneous right-and-left evaluation of diaphragm kinetics. Most importantly, dynamic chest radiography provides pulmonary ventilation and circulation findings as slight changes in pixel value even without the use of contrast media; the interpretation is challenging and crucial for a better understanding of pulmonary function. The basic concept was proposed in the 1980s; however, it was not realized until the 2010s because of technical limitations. Dynamic FPDs and advanced digital image processing played a key role for clinical application of dynamic chest radiography. Pulmonary ventilation and circulation can be quantified and visualized for the diagnosis of pulmonary diseases. Dynamic chest radiography can be deployed as a simple and rapid means of functional imaging in both routine and emergency medicine. Here, we focus on the evaluation of pulmonary ventilation and circulation. This review article describes the basic mechanism of imaging findings according to pulmonary/circulation physiology, followed by imaging procedures, analysis method, and diagnostic performance of dynamic chest radiography.

Respiratory Mechanics and Plasma Levels of Tumor Necrosis Factor Alpha and Interleukin 6 Are Affected by Gas Humidification during Mechanical Ventilation in Dogs

PubMed Central

Hernández-Jiménez, Claudia; García-Torrentera, Rogelio; Olmos-Zúñiga, J. Raúl; Jasso-Victoria, Rogelio; Gaxiola-Gaxiola, Miguel O.; Baltazares-Lipp, Matilde; Gutiérrez-González, Luis H.

2014-01-01

The use of dry gases during mechanical ventilation has been associated with the risk of serious airway complications. The goal of the present study was to quantify the plasma levels of TNF-alpha and IL-6 and to determine the radiological, hemodynamic, gasometric, and microscopic changes in lung mechanics in dogs subjected to short-term mechanical ventilation with and without humidification of the inhaled gas. The experiment was conducted for 24 hours in 10 dogs divided into two groups: Group I (n = 5), mechanical ventilation with dry oxygen dispensation, and Group II (n = 5), mechanical ventilation with oxygen dispensation using a moisture chamber. Variance analysis was used. No changes in physiological, hemodynamic, or gasometric, and radiographic constants were observed. Plasma TNF-alpha levels increased in group I, reaching a maximum 24 hours after mechanical ventilation was initiated (ANOVA p = 0.77). This increase was correlated to changes in mechanical ventilation. Plasma IL-6 levels decreased at 12 hours and increased again towards the end of the study (ANOVA p>0.05). Both groups exhibited a decrease in lung compliance and functional residual capacity values, but this was more pronounced in group I. Pplat increased in group I (ANOVA p = 0.02). Inhalation of dry gas caused histological lesions in the entire respiratory tract, including pulmonary parenchyma, to a greater extent than humidified gas. Humidification of inspired gases can attenuate damage associated with mechanical ventilation. PMID:25036811

Respiratory mechanics and plasma levels of tumor necrosis factor alpha and interleukin 6 are affected by gas humidification during mechanical ventilation in dogs.

PubMed

Hernández-Jiménez, Claudia; García-Torrentera, Rogelio; Olmos-Zúñiga, J Raúl; Jasso-Victoria, Rogelio; Gaxiola-Gaxiola, Miguel O; Baltazares-Lipp, Matilde; Gutiérrez-González, Luis H

2014-01-01

The use of dry gases during mechanical ventilation has been associated with the risk of serious airway complications. The goal of the present study was to quantify the plasma levels of TNF-alpha and IL-6 and to determine the radiological, hemodynamic, gasometric, and microscopic changes in lung mechanics in dogs subjected to short-term mechanical ventilation with and without humidification of the inhaled gas. The experiment was conducted for 24 hours in 10 dogs divided into two groups: Group I (n = 5), mechanical ventilation with dry oxygen dispensation, and Group II (n = 5), mechanical ventilation with oxygen dispensation using a moisture chamber. Variance analysis was used. No changes in physiological, hemodynamic, or gasometric, and radiographic constants were observed. Plasma TNF-alpha levels increased in group I, reaching a maximum 24 hours after mechanical ventilation was initiated (ANOVA p = 0.77). This increase was correlated to changes in mechanical ventilation. Plasma IL-6 levels decreased at 12 hours and increased again towards the end of the study (ANOVA p>0.05). Both groups exhibited a decrease in lung compliance and functional residual capacity values, but this was more pronounced in group I. Pplat increased in group I (ANOVA p = 0.02). Inhalation of dry gas caused histological lesions in the entire respiratory tract, including pulmonary parenchyma, to a greater extent than humidified gas. Humidification of inspired gases can attenuate damage associated with mechanical ventilation.

Non-invasive ventilation effectiveness and the effect of ventilatory mode on survival in ALS patients.

PubMed

Sancho, Jesus; Servera, Emilio; Morelot-Panzini, Capucine; Salachas, François; Similowski, Thomas; Gonzalez-Bermejo, Jesus

2014-03-01

Non-invasive ventilation (NIV) prolongs survival in amyotrophic lateral sclerosis (ALS), but there are no data with which to compare the effectiveness of the different ventilator modes - volume (Vol-NIV) or pressure-cycled (Pres-NIV) ventilation - in ALS. We aimed to determine whether the ventilatory mode has an effect on ventilation effectiveness and survival of ALS patients using NIV. We used a retrospective study that included all ALS patients for whom NIV was indicated in two referral units: one using Vol-NIV and the other using Pres-NIV. Demographic, functional and nocturnal gas exchange parameters at NIV initiation were recorded. Eighty-two ALS patients ventilated using Pres-NIV and 62 using Vol-NIV were included. No differences were found in survival from NIV initiation between Vol-NIV (median 15.00 (7.48-22.41) months) and Pres-NIV (median 15.00 (10.25-19.75) months, p = 0.533) patients. Effective NIV was achieved in 72.41% Vol-NIV patients and in 48.78% Pres-NIV patients (p < 0.001). Ventilator mode (OR 12.066 (4.251-32.270), p < 0.001) and severity of bulbar dysfunction (OR 1.07 (1.011-1.133), p = 0.02) were the variables correlated with effective NIV. In conclusion, although Vol-NIV provides more effective ventilation, Vol-NIV and Pres-NIV present similar survival in ALS. Effectiveness of NIV is related to the severity of bulbar dysfunction.

Mapping color fluctuations in the photon in ultraperipheral heavy ion collisions at the Large Hadron Collider

DOE PAGES

Alvioli, M.; Frankfurt, L.; Guzey, V.; ...

2017-02-20

Here, we model effects of color fluctuations (CFs) in the light-cone photon wave function and for the first time make predictions for the distribution over the number of wounded nucleons ν in the inelastic photon–nucleus scattering. We show that CFs lead to a dramatic enhancement of this distribution at ν=1 and large ν>10. We also study the implications of different scales and CFs in the photon wave function on the total transverse energy ΣE T and other observables in inelastic γA scattering with different triggers. Our predictions can be tested in proton–nucleus and nucleus–nucleus ultraperipheral collisions at the LHC andmore » will help to map CFs, whose first indications have already been observed at the LHC.« less

Evolution of flexible non-photochemical quenching mechanisms that regulate light harvesting in oxygenic photosynthesis.

PubMed

Niyogi, Krishna K; Truong, Thuy B

2013-06-01

All photosynthetic organisms need to regulate light harvesting for photoprotection. Three types of flexible non-photochemical quenching (NPQ) mechanisms have been characterized in oxygenic photosynthetic cyanobacteria, algae, and plants: OCP-, LHCSR-, and PSBS-dependent NPQ. OCP-dependent NPQ likely evolved first, to quench excess excitation in the phycobilisome (PB) antenna of cyanobacteria. During evolution of eukaryotic algae, PBs were lost in the green and secondary red plastid lineages, while three-helix light-harvesting complex (LHC) antenna proteins diversified, including LHCSR proteins that function in dissipating excess energy rather than light harvesting. PSBS, an independently evolved member of the LHC protein superfamily, seems to have appeared exclusively in the green lineage, acquired a function as a pH sensor that turns on NPQ, and eventually replaced LHCSR in vascular plants. Copyright © 2013 Elsevier Ltd. All rights reserved.

Non-invasive ventilation with intelligent volume-assured pressure support versus pressure-controlled ventilation: effects on the respiratory event rate and sleep quality in COPD with chronic hypercapnia.

PubMed

Nilius, Georg; Katamadze, Nato; Domanski, Ulrike; Schroeder, Maik; Franke, Karl-Josef

2017-01-01

COPD patients who develop chronic hypercapnic respiratory failure have a poor prognosis. Treatment of choice, especially the best form of ventilation, is not well known. This study compared the effects of pressure-controlled (spontaneous timed [ST]) non-invasive ventilation (NIV) and NIV with intelligent volume-assured pressure support (IVAPS) in chronic hypercapnic COPD patients regarding the effects on alveolar ventilation, adverse patient/ventilator interactions and sleep quality. This prospective, single-center, crossover study randomized patients to one night of NIV using ST then one night with the IVAPS function activated, or vice versa. Patients were monitored using polysomnography (PSG) and transcutaneous carbon dioxide pressure (PtcCO 2 ) measurement. Patients rated their subjective experience (total score, 0-45; lower scores indicate better acceptability). Fourteen patients were included (4 females, age 59.4±8.9 years). The total number of respiratory events was low, and similar under pressure-controlled (5.4±6.7) and IVAPS (8.3±10.2) conditions ( P =0.064). There were also no clinically relevant differences in PtcCO 2 between pressure-controlled and IVAPS NIV (52.9±6.2 versus 49.1±6.4 mmHg). Respiratory rate was lower under IVAPS overall; between-group differences reached statistical significance during wakefulness and non-rapid eye movement sleep. Ventilation pressures were 2.6 cmH 2 O higher under IVAPS versus pressure-controlled ventilation, resulting in a 20.1 mL increase in breathing volume. Sleep efficiency was slightly higher under pressure-controlled ventilation versus IVAPS. Respiratory arousals were uncommon (24.4/h [pressure-controlled] versus 25.4/h [IVAPS]). Overall patient assessment scores were similar, although there was a trend toward less discomfort during IVAPS. Our results show that IVAPS NIV allows application of higher nocturnal ventilation pressures versus ST without affecting sleep quality or inducing ventilation- associated events.

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

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

Qu, H; Xia, P; Yu, N

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

Lung function in post-poliomyelitis syndrome: a cross-sectional study*

PubMed Central

de Lira, Claudio Andre Barbosa; Minozzo, Fábio Carderelli; Sousa, Bolivar Saldanha; Vancini, Rodrigo Luiz; Andrade, Marília dos Santos; Quadros, Abrahão Augusto Juviniano; Oliveira, Acary Souza Bulle; da Silva, Antonio Carlos

2013-01-01

OBJECTIVE: To compare lung function between patients with post-poliomyelitis syndrome and those with sequelae of paralytic poliomyelitis (without any signs or symptoms of post-poliomyelitis syndrome), as well as between patients with post-poliomyelitis syndrome and healthy controls. METHODS: Twenty-nine male participants were assigned to one of three groups: control; poliomyelitis (comprising patients who had had paralytic poliomyelitis but had not developed post-poliomyelitis syndrome); and post-poliomyelitis syndrome. Volunteers underwent lung function measurements (spirometry and respiratory muscle strength assessment). RESULTS: The results of the spirometric assessment revealed no significant differences among the groups except for an approximately 27% lower mean maximal voluntary ventilation in the post-poliomyelitis syndrome group when compared with the control group (p = 0.0127). Nevertheless, the maximal voluntary ventilation values for the post-poliomyelitis group were compared with those for the Brazilian population and were found to be normal. No significant differences were observed in respiratory muscle strength among the groups. CONCLUSIONS: With the exception of lower maximal voluntary ventilation, there was no significant lung function impairment in outpatients diagnosed with post-poliomyelitis syndrome when compared with healthy subjects and with patients with sequelae of poliomyelitis without post-poliomyelitis syndrome. This is an important clinical finding because it shows that patients with post-poliomyelitis syndrome can have preserved lung function. PMID:24068267

A compression algorithm for the combination of PDF sets.

PubMed

Carrazza, Stefano; Latorre, José I; Rojo, Juan; Watt, Graeme

The current PDF4LHC recommendation to estimate uncertainties due to parton distribution functions (PDFs) in theoretical predictions for LHC processes involves the combination of separate predictions computed using PDF sets from different groups, each of which comprises a relatively large number of either Hessian eigenvectors or Monte Carlo (MC) replicas. While many fixed-order and parton shower programs allow the evaluation of PDF uncertainties for a single PDF set at no additional CPU cost, this feature is not universal, and, moreover, the a posteriori combination of the predictions using at least three different PDF sets is still required. In this work, we present a strategy for the statistical combination of individual PDF sets, based on the MC representation of Hessian sets, followed by a compression algorithm for the reduction of the number of MC replicas. We illustrate our strategy with the combination and compression of the recent NNPDF3.0, CT14 and MMHT14 NNLO PDF sets. The resulting compressed Monte Carlo PDF sets are validated at the level of parton luminosities and LHC inclusive cross sections and differential distributions. We determine that around 100 replicas provide an adequate representation of the probability distribution for the original combined PDF set, suitable for general applications to LHC phenomenology.

EPPS16: nuclear parton distributions with LHC data.

PubMed

Eskola, Kari J; Paakkinen, Petja; Paukkunen, Hannu; Salgado, Carlos A

2017-01-01

We introduce a global analysis of collinearly factorized nuclear parton distribution functions (PDFs) including, for the first time, data constraints from LHC proton-lead collisions. In comparison to our previous analysis, EPS09, where data only from charged-lepton-nucleus deep inelastic scattering (DIS), Drell-Yan (DY) dilepton production in proton-nucleus collisions and inclusive pion production in deuteron-nucleus collisions were the input, we now increase the variety of data constraints to cover also neutrino-nucleus DIS and low-mass DY production in pion-nucleus collisions. The new LHC data significantly extend the kinematic reach of the data constraints. We now allow much more freedom for the flavor dependence of nuclear effects than in other currently available analyses. As a result, especially the uncertainty estimates are more objective flavor by flavor. The neutrino DIS plays a pivotal role in obtaining a mutually consistent behavior for both up and down valence quarks, and the LHC dijet data clearly constrain gluons at large momentum fraction. Mainly for insufficient statistics, the pion-nucleus DY and heavy-gauge-boson production in proton-lead collisions impose less visible constraints. The outcome - a new set of next-to-leading order nuclear PDFs called EPPS16 - is made available for applications in high-energy nuclear collisions.

Propagation of heavy baryons in heavy-ion collisions

NASA Astrophysics Data System (ADS)

Das, Santosh K.; Torres-Rincon, Juan M.; Tolos, Laura; Minissale, Vincenzo; Scardina, Francesco; Greco, Vincenzo

2016-12-01

The drag and diffusion coefficients of heavy baryons (Λc and Λb ) in the hadronic phase created in the latter stage of the heavy-ion collisions at RHIC and LHC energies have been evaluated recently. In this work we compute some experimental observables, such as the nuclear suppression factor RA A and the elliptic flow v2 of heavy baryons at RHIC and LHC energies, highlighting the role of the hadronic phase contribution to these observables, which are going to be measured at Run 3 of LHC. For the time evolution of the heavy quarks in the quark and gluon plasma (QGP) and heavy baryons in the hadronic phase, we use the Langevin dynamics. For the hadronization of the heavy quarks to heavy baryons we employ Peterson fragmentation functions. We observe a strong suppression of both the Λc and Λb . We find that the hadronic medium has a sizable impact on the heavy-baryon elliptic flow whereas the impact of hadronic medium rescattering is almost unnoticeable on the nuclear suppression factor. We evaluate the Λc/D ratio at RHIC and LHC. We find that the Λc/D ratio remains unaffected due to the hadronic phase rescattering which enables it as a nobel probe of QGP phase dynamics along with its hadronization.

Direct interaction of the major light-harvesting complex II and PsbS in nonphotochemical quenching

PubMed Central

Wilk, Laura; Grunwald, Matthias; Liao, Pen-Nan; Walla, Peter Jomo; Kühlbrandt, Werner

2013-01-01

The photosystem II (PSII) subunit S (PsbS) plays a key role in nonphotochemical quenching, a photoprotective mechanism for dissipation of excess excitation energy in plants. The precise function of PsbS in nonphotochemical quenching is unknown. By reconstituting PsbS together with the major light-harvesting complex of PSII (LHC-II) and the xanthophyll zeaxanthin (Zea) into proteoliposomes, we have tested the individual contributions of PSII complexes and Zea to chlorophyll (Chl) fluorescence quenching in a membrane environment. We demonstrate that PsbS is stable in the absence of pigments in vitro. Significant Chl fluorescence quenching of reconstituted LHC-II was observed in the presence of PsbS and Zea, although neither Zea nor PsbS alone was sufficient to induce the same quenching. Coreconstitution with PsbS resulted in the formation of LHC-II/PsbS heterodimers, indicating their direct interaction in the lipid bilayer. Two-photon excitation measurements on liposomes containing LHC-II, PsbS, and Zea showed an increase of electronic interactions between carotenoid S1 and Chl states, , that correlated directly with Chl fluorescence quenching. These findings are in agreement with a carotenoid-dependent Chl fluorescence quenching by direct interactions of LHCs of PSII with PsbS monomers. PMID:23509270

[Basic life support in pediatrics].

PubMed

Calvo Macías, A; Manrique Martínez, I; Rodríguez Núñez, A; López-Herce Cid, J

2006-09-01

Basic life support (BLS) is the combination of maneuvers that identifies the child in cardiopulmonary arrest and initiates the substitution of respiratory and circulatory function, without the use of technical adjuncts, until the child can receive more advanced treatment. BLS includes a sequence of steps or maneuvers that should be performed sequentially: ensuring the safety of rescuer and child, assessing unconsciousness, calling for help, positioning the victim, opening the airway, assessing breathing, ventilating, assessing signs of circulation and/or central arterial pulse, performing chest compressions, activating the emergency medical service system, and checking the results of resuscitation. The most important changes in the new guidelines are the compression: ventilation ratio and the algorithm for relieving foreign body airway obstruction. A compression/ ventilation ratio of 30:2 will be recommended for lay rescuers of infants, children and adults. Health professionals will use a compression: ventilation ratio of 15:2 for infants and children. If the health professional is alone, he/she may also use a ratio of 30:2 to avoid fatigue. In the algorithm for relieving foreign body airway obstruction, when the child becomes unconscious, the maneuvers will be similar to the BLS sequence with chest compressions (functioning as a deobstruction procedure) and ventilation, with reassessment of the mouth every 2 min to check for a foreign body, and evaluation of breathing and the presence of vital signs. BLS maneuvers are easy to learn and can be performed by anyone with adequate training. Therefore, BLS should be taught to all citizens.

Effects of staff training and electronic event monitoring on long-term adherence to lung-protective ventilation recommendations.

PubMed

Castellanos, Ixchel; Martin, Marcus; Kraus, Stefan; Bürkle, Thomas; Prokosch, Hans-Ulrich; Schüttler, Jürgen; Toddenroth, Dennis

2018-02-01

To investigate long-term effects of staff training and electronic clinical decision support (CDS) on adherence to lung-protective ventilation recommendations. In 2012, group instructions and workshops at two surgical intensive care units (ICUs) started, focusing on standardized protocols for mechanical ventilation and volutrauma prevention. Subsequently implemented CDS functions continuously monitor ventilation parameters, and from 2015 triggered graphical notifications when tidal volume (V T ) violated individual thresholds. To estimate the effects of these educational and technical interventions, we retrospectively analyzed nine years of V T records from routine care. As outcome measures, we calculated relative frequencies of settings that conform to recommendations, case-specific mean excess V T , and total ICU survival. Assessing 571,478 V T records from 10,241 ICU cases indicated that adherence during pressure-controlled ventilation improved significantly after both interventions; the share of conforming V T records increased from 61.6% to 83.0% and then 86.0%. Despite increasing case severity, ICU survival remained nearly constant over time. Staff training effectively improves adherence to lung-protective ventilation strategies. The observed CDS effect seemed less pronounced, although it can easily be adapted to new recommendations. Both interventions, which futures studies could deploy in combination, promise to improve the precision of mechanical ventilation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Regional Lung Ventilation Analysis Using Temporally Resolved Magnetic Resonance Imaging.

PubMed

Kolb, Christoph; Wetscherek, Andreas; Buzan, Maria Teodora; Werner, René; Rank, Christopher M; Kachelrie, Marc; Kreuter, Michael; Dinkel, Julien; Heuel, Claus Peter; Maier-Hein, Klaus

We propose a computer-aided method for regional ventilation analysis and observation of lung diseases in temporally resolved magnetic resonance imaging (4D MRI). A shape model-based segmentation and registration workflow was used to create an atlas-derived reference system in which regional tissue motion can be quantified and multimodal image data can be compared regionally. Model-based temporal registration of the lung surfaces in 4D MRI data was compared with the registration of 4D computed tomography (CT) images. A ventilation analysis was performed on 4D MR images of patients with lung fibrosis; 4D MR ventilation maps were compared with corresponding diagnostic 3D CT images of the patients and 4D CT maps of subjects without impaired lung function (serving as reference). Comparison between the computed patient-specific 4D MR regional ventilation maps and diagnostic CT images shows good correlation in conspicuous regions. Comparison to 4D CT-derived ventilation maps supports the plausibility of the 4D MR maps. Dynamic MRI-based flow-volume loops and spirograms further visualize the free-breathing behavior. The proposed methods allow for 4D MR-based regional analysis of tissue dynamics and ventilation in spontaneous breathing and comparison of patient data. The proposed atlas-based reference coordinate system provides an automated manner of annotating and comparing multimodal lung image data.

Amyotrophic lateral sclerosis and assisted ventilation: how patients decide.

PubMed

Lemoignan, Josée; Ells, Carolyn

2010-06-01

Throughout the course of their illness, people with amyotrophic lateral sclerosis (ALS) must make many treatment decisions; however, none has such a significant impact on quality of life and survival as decisions about assisted ventilation. The purpose of this study was to better understand the experience of decision-making about assisted ventilation for ALS patients. Using qualitative phenomenology methodology, 10 semi-structured interviews were conducted with persons with ALS and their caregivers to elicit factors that are pertinent to their decision-making process about assisted ventilation. Six main themes emerged from the interviews. (1) the meaning of the intervention - participants made a sharp distinction between non-invasive ventilation, which they viewed as a means to relieve symptoms of respiratory failure, and invasive ventilation, which they viewed as taking over their breathing and thereby saving their life when they otherwise would die, (2) the importance of context - including functional status, available supports, and financial implications, (3) the importance of values - with respect to communication, relationships, autonomy, life, and quality of life, (4) the effect of fears - particularly respiratory distress, chocking, running out of air, and the process of death itself, (5) the need for information - how use of assisted ventilation would impact daily life, how death from respiratory failure would occur, how caregivers and persons with ALS differ in their information needs and common misconceptions, and (6) adaptation to or acceptance of the intervention - a lengthy process that involved gradual familiarization with the equipment and its benefits. People with ALS and caregivers value autonomy in decision-making about assisted ventilation. Their decision-making process is neither wholly rational nor self-interested, and includes factors that health professionals should anticipate and address. Discussions about assisted ventilation and timing should be tailored to each individual and undertaken periodically.

Feasibility Studies for Single Transverse-Spin Asymmetry Measurements at a Fixed-Target Experiment Using the LHC Proton and Lead Beams (AFTER@LHC)

DOE PAGES

Kikoła, Daniel; Echevarria, Miguel García; Hadjidakis, Cynthia; ...

2017-05-17

Measurement of Single Transverse-Spin Asymmetrymore » $$A_N$$ for various quarkonia states and Drell-Yan lepton pairs can shed light on the orbital angular momentum of quarks and gluons, a fundamental ingredient of the spin puzzle of the proton. The AFTER@LHC experiment combines a unique kinematic coverage and large luminosities of the Large Hadron Collider beams to deliver precise measurements, complementary to the knowledge provided by collider experiments such as RHIC. Here, we report on sensitivity studies for $$J/\\Psi$$, $$\\Upsilon$$ and Drell-Yan $$A_N$$ done using the performance of a LHCb-like and ALICE-like detectors, combined with a polarised hydrogen and $^3$He target. Particularly, such research will provide new insights and knowledge about transverse-momentum-dependent parton distribution functions for quarks and gluons and on twist-3 collinear matrix elements in a proton and a neutron.« less

High-Precision Differential Predictions for Top-Quark Pairs at the LHC

NASA Astrophysics Data System (ADS)

Czakon, Michal; Heymes, David; Mitov, Alexander

2016-02-01

We present the first complete next-to-next-to-leading order (NNLO) QCD predictions for differential distributions in the top-quark pair production process at the LHC. Our results are derived from a fully differential partonic Monte Carlo calculation with stable top quarks which involves no approximations beyond the fixed-order truncation of the perturbation series. The NNLO corrections improve the agreement between existing LHC measurements [V. Khachatryan et al. (CMS Collaboration), Eur. Phys. J. C 75, 542 (2015)] and standard model predictions for the top-quark transverse momentum distribution, thus helping alleviate one long-standing discrepancy. The shape of the top-quark pair invariant mass distribution turns out to be stable with respect to radiative corrections beyond NLO which increases the value of this observable as a place to search for physics beyond the standard model. The results presented here provide essential input for parton distribution function fits, implementation of higher-order effects in Monte Carlo generators, as well as top-quark mass and strong coupling determination.

High-Precision Differential Predictions for Top-Quark Pairs at the LHC.

PubMed

Czakon, Michal; Heymes, David; Mitov, Alexander

2016-02-26

We present the first complete next-to-next-to-leading order (NNLO) QCD predictions for differential distributions in the top-quark pair production process at the LHC. Our results are derived from a fully differential partonic Monte Carlo calculation with stable top quarks which involves no approximations beyond the fixed-order truncation of the perturbation series. The NNLO corrections improve the agreement between existing LHC measurements [V. Khachatryan et al. (CMS Collaboration), Eur. Phys. J. C 75, 542 (2015)] and standard model predictions for the top-quark transverse momentum distribution, thus helping alleviate one long-standing discrepancy. The shape of the top-quark pair invariant mass distribution turns out to be stable with respect to radiative corrections beyond NLO which increases the value of this observable as a place to search for physics beyond the standard model. The results presented here provide essential input for parton distribution function fits, implementation of higher-order effects in Monte Carlo generators, as well as top-quark mass and strong coupling determination.

Luminosity determination in pp collisions at $$\\sqrt{s} = 7$$ TeV using the ATLAS detector at the LHC

DOE PAGES

Aad, G.; Abbott, B.; Abdallah, J.; ...

2011-04-27

Measurements of luminosity obtained using the ATLAS detector during early running of the Large Hadron Collider (LHC) at √s = 7 TeV are presented. The luminosity is independently determined using several detectors and multiple algorithms, each having different acceptances, systematic uncertainties and sensitivity to background. The ratios of the luminosities obtained from these methods are monitored as a function of time and of μ, the average number of inelastic interactions per bunch crossing. Residual time- and μ-dependence between the methods is less than 2% for 0 < μ < 2.5. Absolute luminosity calibrations, performed using beam separation scans, have amore » common systematic uncertainty of ±11%, dominated by the measurement of the LHC beam currents. After calibration, the luminosities obtained from the different methods differ by at most ±2%. The visible cross sections measured using the beam scans are compared to predictions obtained with the PYTHIA and PHOJET event generators and the ATLAS detector simulation.« less

Correlation of 68Ga Ventilation-Perfusion PET/CT with Pulmonary Function Test Indices for Assessing Lung Function.

PubMed

Le Roux, Pierre-Yves; Siva, Shankar; Steinfort, Daniel P; Callahan, Jason; Eu, Peter; Irving, Lou B; Hicks, Rodney J; Hofman, Michael S

2015-11-01

Pulmonary function tests (PFTs) are routinely used to assess lung function, but they do not provide information about regional pulmonary dysfunction. We aimed to assess correlation of quantitative ventilation-perfusion (V/Q) PET/CT with PFT indices. Thirty patients underwent V/Q PET/CT and PFT. Respiration-gated images were acquired after inhalation of (68)Ga-carbon nanoparticles and administration of (68)Ga-macroaggregated albumin. Functional volumes were calculated by dividing the volume of normal ventilated and perfused (%NVQ), unmatched and matched defects by the total lung volume. These functional volumes were correlated with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and diffusing capacity for carbon monoxide (DLCO). All functional volumes were significantly different in patients with chronic obstructive pulmonary disease (P < 0.05). FEV1/FVC and %NVQ had the highest correlation (r = 0.82). FEV1 was also best correlated with %NVQ (r = 0.64). DLCO was best correlated with the volume of unmatched defects (r = -0.55). Considering %NVQ only, a cutoff value of 90% correctly categorized 28 of 30 patients with or without significant pulmonary function impairment. Our study demonstrates strong correlations between V/Q PET/CT functional volumes and PFT parameters. Because V/Q PET/CT is able to assess regional lung function, these data support the feasibility of its use in radiation therapy and preoperative planning and assessing pulmonary dysfunction in a variety of respiratory diseases. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

SU-E-J-86: Functional Conformal Planning for Stereotactic Body Radiation Therapy with CT-Pulmonary Ventilation Imaging

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

Kurosawa, T; Moriya, S; Sato, M

2015-06-15

Purpose: To evaluate the functional planning using CT-pulmonary ventilation imaging for conformal SBRT. Methods: The CT-pulmonary ventilation image was generated using the Jacobian metric in the in-house program with the NiftyReg software package. Using the ventilation image, the normal lung was split into three lung regions for functionality (high, moderate and low). The anatomical plan (AP) and functional plan (FP) were made for ten lung SBRT patients. For the AP, the beam angles were optimized with the dose-volume constraints for the normal lung sparing and the PTV coverage. For the FP, the gantry angles were also optimized with the additionalmore » constraint for high functional lung. The MLC aperture shapes were adjusted to the PTV with the additional 5 mm margin. The dosimetric parameters for PTV, the functional volumes, spinal cord and so on were compared in both plans. Results: Compared to the AP, the FP showed better dose sparing for high- and moderate-functional lungs with similar PTV coverage while not taking care of the low functional lung (High:−12.9±9.26% Moderate: −2.0±7.09%, Low: +4.1±12.2%). For the other normal organs, the FP and AP showed similar dose sparing in the eight patients. However, the FP showed that the maximum doses for spinal cord were increased with the significant increment of 16.4Gy and 21.0Gy in other two patients, respectively. Because the beam direction optimizer chose the unexpected directions passing through the spinal cord. Conclusion: Even the functional conformal SBRT can selectively reduce high- and moderatefunctional lung while keeping the PTV coverage. However, it would be careful that the optimizer would choose unexpected beam angles and the dose sparing for the other normal organs can be worse. Therefore, the planner needs to control the dose-volume constraints and also limit the beam angles in order to achieve the expected dose sparing and coverage.« less

[A case report: inhaled nitric oxide improves respiratory function in an infant with pulmonary hypertension].

PubMed

Takeuchi, M; Ueno, T; Fukumitsu, K; Takada, K; Kinouchi, K; Kishimoto, H; Kitamura, S

1998-03-01

Nitric oxide (NO) was administered to an infant in a near fatal crisis of pulmonary hypertension after total correction of double outlet right ventricle. Inhaled NO of 4 parts per million reduced pulmonary arterial pressure (PAP) and increased tidal volume during pressure limit ventilation. Both respiratory system compliance and resistance were improved with NO inhalation. There was a significant negative correlation between mean PAP and respiratory system compliance. We speculated that a reduction in PAP with NO inhalation resulted in the improvement of respiratory function. He was successfully weaned from mechanical ventilation.

Incoherent vector mesons production in PbPb ultraperipheral collisions at the LHC

NASA Astrophysics Data System (ADS)

Xie, Ya-Ping; Chen, Xurong

2017-03-01

The incoherent rapidity distributions of vector mesons are computed in dipole model in PbPb ultraperipheral collisions at the CERN Large Hadron Collider (LHC). The IIM model fitted from newer data is employed in the dipole amplitude. The Boosted Gaussian and Gaus-LC wave functions for vector mesons are implemented in the calculations as well. Predictions for the J / ψ, ψ (2 s), ρ and ϕ incoherent rapidity distributions are evaluated and compared with experimental data and other theoretical predictions in this paper. We obtain closer predictions of the incoherent rapidity distributions for J / ψ than previous calculations in the IIM model.

Threshold region for Higgs boson production in gluon fusion.

PubMed

Bonvini, Marco; Forte, Stefano; Ridolfi, Giovanni

2012-09-07

We provide a quantitative determination of the effective partonic kinematics for Higgs boson production in gluon fusion in terms of the collider energy at the LHC. We use the result to assess, as a function of the Higgs boson mass, whether the large m(t) approximation is adequate and Sudakov resummation advantageous. We argue that our results hold to all perturbative orders. Based on our results, we conclude that the full inclusion of finite top mass corrections is likely to be important for accurate phenomenology for a light Higgs boson with m(H)~125 GeV at the LHC with √s=14 TeV.

Exclusive photoproduction of vector mesons in proton-lead ultraperipheral collisions at the LHC

NASA Astrophysics Data System (ADS)

Xie, Ya-Ping; Chen, Xurong

2018-02-01

Rapidity distributions of vector mesons are computed in dipole model proton-lead ultraperipheral collisions (UPCs) at the CERN Larger Hadron Collider (LHC). The dipole model framework is implemented in the calculations of cross sections in the photon-hadron interaction. The bCGC model and Boosted Gaussian wave functions are employed in the scattering amplitude. We obtain predictions of rapidity distributions of J / ψ meson proton-lead ultraperipheral collisions. The predictions give a good description to the experimental data of ALICE. The rapidity distributions of ϕ, ω and ψ (2 s) mesons in proton-lead ultraperipheral collisions are also presented in this paper.

Integrated analysis of numerical weather prediction and computational fluid dynamics for estimating cross-ventilation effects on inhaled air quality inside a factory

NASA Astrophysics Data System (ADS)

Murga, Alicia; Sano, Yusuke; Kawamoto, Yoichi; Ito, Kazuhide

2017-10-01

Mechanical and passive ventilation strategies directly impact indoor air quality. Passive ventilation has recently become widespread owing to its ability to reduce energy demand in buildings, such as the case of natural or cross ventilation. To understand the effect of natural ventilation on indoor environmental quality, outdoor-indoor flow paths need to be analyzed as functions of urban atmospheric conditions, topology of the built environment, and indoor conditions. Wind-driven natural ventilation (e.g., cross ventilation) can be calculated through the wind pressure coefficient distributions of outdoor wall surfaces and openings of a building, allowing the study of indoor air parameters and airborne contaminant concentrations. Variations in outside parameters will directly impact indoor air quality and residents' health. Numerical modeling can contribute to comprehend these various parameters because it allows full control of boundary conditions and sampling points. In this study, numerical weather prediction modeling was used to calculate wind profiles/distributions at the atmospheric scale, and computational fluid dynamics was used to model detailed urban and indoor flows, which were then integrated into a dynamic downscaling analysis to predict specific urban wind parameters from the atmospheric to built-environment scale. Wind velocity and contaminant concentration distributions inside a factory building were analyzed to assess the quality of the human working environment by using a computer simulated person. The impact of cross ventilation flows and its variations on local average contaminant concentration around a factory worker, and inhaled contaminant dose, were then discussed.

Exercise training improves characteristics of exercise oscillatory ventilation in chronic heart failure.

PubMed

Panagopoulou, Niki; Karatzanos, Eleftherios; Dimopoulos, Stavros; Tasoulis, Athanasios; Tachliabouris, Ioannis; Vakrou, Styliani; Sideris, Antonios; Gratziou, Christina; Nanas, Serafim

2017-05-01

Background Exercise oscillatory ventilation in chronic heart failure has been suggested as a factor related to adverse cardiac events, aggravated prognosis and higher mortality. Exercise training is well known to affect exercise capacity and mechanisms of pathophysiology beneficially in chronic heart failure. Little is known, however, about the exercise training effects on characteristics of exercise oscillatory ventilation in chronic heart failure patients. Design and methods Twenty (out of 38) stable chronic heart failure patients exhibited exercise oscillatory ventilation (age 54 ± 11 years, peak oxygen uptake 15.0 ± 5.0 ml/kg per minute). Patients attended 36 sessions of high intensity interval exercise. All patients underwent cardiopulmonary exercise testing before and after the programme. Assessment of exercise oscillatory ventilation was based on the amplitude of cyclic fluctuations in breathing during rest and exercise. All values are mean ± SD. Results Exercise training reduced ( P < 0.05) the percentage of exercise oscillatory ventilation duration (79.0 ± 13.0 to 50.0 ± 25.0%), while average amplitude (5.2 ± 2.0 to 4.9 ± 1.6 L/minute) and length (44.0 ± 10.9 to 41.0 ± 6.7 seconds) did not change ( P > 0.05). Exercise oscillatory ventilation patients also increased exercise capacity ( P < 0.05). Conclusions A rehabilitation programme based on high intensity interval training improved exercise oscillatory ventilation observed in chronic heart failure patients, as well as cardiopulmonary efficiency and functional capacity.

Evaluation of ventilators used during transport of critically ill patients: a bench study.

PubMed

Boussen, Salah; Gainnier, Marc; Michelet, Pierre

2013-11-01

To evaluate the most recent transport ventilators' operational performance regarding volume delivery in controlled mode, trigger function, and the quality of pressurization in pressure support mode. Eight recent transport ventilators were included in a bench study in order to evaluate their accuracy to deliver a set tidal volume under normal resistance and compliance conditions, ARDS conditions, and obstructive conditions. The performance of the triggering system was assessed by the measure of the decrease in pressure and the time delay required to open the inspiratory valve. The quality of pressurization was obtained by computing the integral of the pressure-time curve for the first 300 ms and 500 ms after the onset of inspiration. For the targeted tidal volumes of 300, 500, and 800 mL the errors ranged from -3% to 48%, -7% to 18%, and -5% to 25% in the normal conditions, -4% to 27%, -2% to 35%, and -3% to 35% in the ARDS conditions, and -4% to 53%, -6% to 30%, and -30% to 28% in the obstructive conditions. In pressure support mode the pressure drop range was 0.4-1.7 cm H2O, the trigger delay range was 68-198 ms, and the pressurization performance (percent of ideal pressurization, as measured by pressure-time product at 300 ms and 500 ms) ranges were -9% to 44% at 300 ms and 6%-66% at 500 ms (P < .01). There were important differences in the performance of the tested ventilators. The most recent turbine ventilators outperformed the pneumatic ventilators. The best performers among the turbine ventilators proved comparable to modern ICU ventilators.

Assessment of regional emphysema, air-trapping and Xenon-ventilation using dual-energy computed tomography in chronic obstructive pulmonary disease patients.

PubMed

Lee, Sang Min; Seo, Joon Beom; Hwang, Hye Jeon; Kim, Namkug; Oh, Sang Young; Lee, Jae Seung; Lee, Sei Won; Oh, Yeon-Mok; Kim, Tae Hoon

2017-07-01

To compare the parenchymal attenuation change between inspiration/expiration CTs with dynamic ventilation change between xenon wash-in (WI) inspiration and wash-out (WO) expiration CTs. 52 prospectively enrolled COPD patients underwent xenon ventilation dual-energy CT during WI and WO periods and pulmonary function tests (PFTs). The parenchymal attenuation parameters (emphysema index (EI), gas-trapping index (GTI) and air-trapping index (ATI)) and xenon ventilation parameters (xenon in WI (Xe-WI), xenon in WO (Xe-WO) and xenon dynamic (Xe-Dyna)) of whole lung and three divided areas (emphysema, hyperinflation and normal) were calculated on virtual non-contrast images and ventilation images. Pearson correlation, linear regression analysis and one-way ANOVA were performed. EI, GTI and ATI showed a significant correlation with Xe-WI, Xe-WO and Xe-Dyna (EI R = -.744, -.562, -.737; GTI R = -.621, -.442, -.629; ATI R = -.600, -.421, -.610, respectively, p < 0.01). All CT parameters showed significant correlation with PFTs except forced vital capacity (FVC). There was a significant difference in GTI, ATI and Xe-Dyna in each lung area (p < 0.01). The parenchymal attenuation change between inspiration/expiration CTs and xenon dynamic change between xenon WI- and WO-CTs correlate significantly. There are alterations in the dynamics of xenon ventilation between areas of emphysema. • The xenon ventilation change correlates with the parenchymal attenuation change. • The xenon ventilation change shows the difference between three lung areas. • The combination of attenuation and xenon can predict more accurate PFTs.

Implications of Natural Occlusion of Ventilated Racks on Ammonia and Sanitation Practices

PubMed Central

Creamer, Michelle A; Petty, Joann; Martin, Tara; Bergdall, Valerie; Hickman-Davis, Judy M

2014-01-01

Examination of ventilated rat racks prior to semiannual sanitation revealed silicone nozzles and ventilation ports that were partially or completely occluded with granular debris. We subsequently sought to document performance standards for rack sanitation and investigate the effect of ventilation port occlusion on rack function and animal husbandry practices. We hypothesized that individually ventilated cages with occluded airflow would require more frequent cage changes, comparable to those for static cages (that is, every 3 to 4 d). Sprague–Dawley rats were housed under one of 4 conditions: no airflow occlusion, occluded air-supply inlet, occluded air-exhaust outlet, and occlusion of both inlet and outlet. Cages were changed when daily ammonia concentration exceeded 20 ppm or after 14 d had elapsed. Most cages with unoccluded or partial airflow occlusion remained below the 20 ppm limit until day 12 or 13. Cages with occlusion of both inlet and outlet exceeded 20 ppm ammonia by as early as day 5. Airflow was significantly lower in cages with occlusion of both inlet and outlet airflow. Weekly inspection revealed that occlusion of ventilation ports was detectable by 3 mo after semiannual sanitation. This study demonstrates that silicone nozzles should be removed prior to rack sanitation to improve the effectiveness of cleaning ventilation ports and nozzles. While the rack is in use, silicone nozzles and ventilation ports should be inspected regularly to identify occlusion that is likely to diminish environmental quality in the cage. Intracage ammonia levels are significantly higher when both inlet and outlet airflow are occluded. PMID:24602544

Implications of natural occlusion of ventilated racks on ammonia and sanitation practices.

PubMed

Creamer, Michelle A; Petty, Joann; Martin, Tara; Bergdall, Valerie; Hickman-Davis, Judy M

2014-03-01

Examination of ventilated rat racks prior to semiannual sanitation revealed silicone nozzles and ventilation ports that were partially or completely occluded with granular debris. We subsequently sought to document performance standards for rack sanitation and investigate the effect of ventilation port occlusion on rack function and animal husbandry practices. We hypothesized that individually ventilated cages with occluded airflow would require more frequent cage changes, comparable to those for static cages (that is, every 3 to 4 d). Sprague-Dawley rats were housed under one of 4 conditions: no airflow occlusion, occluded air-supply inlet, occluded air-exhaust outlet, and occlusion of both inlet and outlet. Cages were changed when daily ammonia concentration exceeded 20 ppm or after 14 d had elapsed. Most cages with unoccluded or partial airflow occlusion remained below the 20 ppm limit until day 12 or 13. Cages with occlusion of both inlet and outlet exceeded 20 ppm ammonia by as early as day 5. Airflow was significantly lower in cages with occlusion of both inlet and outlet airflow. Weekly inspection revealed that occlusion of ventilation ports was detectable by 3 mo after semiannual sanitation. This study demonstrates that silicone nozzles should be removed prior to rack sanitation to improve the effectiveness of cleaning ventilation ports and nozzles. While the rack is in use, silicone nozzles and ventilation ports should be inspected regularly to identify occlusion that is likely to diminish environmental quality in the cage. Intracage ammonia levels are significantly higher when both inlet and outlet airflow are occluded.

Should regional ventilation function be considered during radiation treatment planning to prevent radiation-induced complications?

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

Lan, Fujun; Jeudy, Jean; D’Souza, Warren

Purpose: To investigate the incorporation of pretherapy regional ventilation function in predicting radiation fibrosis (RF) in stage III nonsmall cell lung cancer (NSCLC) patients treated with concurrent thoracic chemoradiotherapy. Methods: Thirty-seven patients with stage III NSCLC were retrospectively studied. Patients received one cycle of cisplatin–gemcitabine, followed by two to three cycles of cisplatin–etoposide concurrently with involved-field thoracic radiotherapy (46–66 Gy; 2 Gy/fraction). Pretherapy regional ventilation images of the lung were derived from 4D computed tomography via a density change–based algorithm with mass correction. In addition to the conventional dose–volume metrics (V{sub 20}, V{sub 30}, V{sub 40}, and mean lung dose),more » dose–function metrics (fV{sub 20}, fV{sub 30}, fV{sub 40}, and functional mean lung dose) were generated by combining regional ventilation and radiation dose. A new class of metrics was derived and referred to as dose–subvolume metrics (sV{sub 20}, sV{sub 30}, sV{sub 40}, and subvolume mean lung dose); these were defined as the conventional dose–volume metrics computed on the functional lung. Area under the receiver operating characteristic curve (AUC) values and logistic regression analyses were used to evaluate these metrics in predicting hallmark characteristics of RF (lung consolidation, volume loss, and airway dilation). Results: AUC values for the dose–volume metrics in predicting lung consolidation, volume loss, and airway dilation were 0.65–0.69, 0.57–0.70, and 0.69–0.76, respectively. The respective ranges for dose–function metrics were 0.63–0.66, 0.61–0.71, and 0.72–0.80 and for dose–subvolume metrics were 0.50–0.65, 0.65–0.75, and 0.73–0.85. Using an AUC value = 0.70 as cutoff value suggested that at least one of each type of metrics (dose–volume, dose–function, dose–subvolume) was predictive for volume loss and airway dilation, whereas lung consolidation cannot be accurately predicted by any of the metrics. Logistic regression analyses showed that dose–function and dose–subvolume metrics were significant (P values ≤ 0.02) in predicting volume airway dilation. Likelihood ratio test showed that when combining dose–function and/or dose–subvolume metrics with dose–volume metrics, the achieved improvements of prediction accuracy on volume loss and airway dilation were significant (P values ≤ 0.04). Conclusions: The authors’ results demonstrated that the inclusion of regional ventilation function improved accuracy in predicting RF. In particular, dose–subvolume metrics provided a promising method for preventing radiation-induced pulmonary complications.« less

Cardiorespiratory Interactions in Paediatrics: 'It's (almost always) the circulation stupid!'

PubMed

Rigby, M L; Rosenthal, M

2017-03-01

The interaction of the heart and lungs is probably the most important aspect of life and survival. Fortunately, it is not difficult to understand the fundamentals. The purpose of the lungs and their ventilation is to present oxygen to the circulation via the alveoli and to receive carbon dioxide from the circulation and then expel it. The relations of the heart and lungs and the matching of blood flow to the various organs with ventilation and lung perfusion may be disrupted by a variety of congenital or acquired heart malformations. They include those giving rise to an increased or reduced pulmonary blood flow, elevated pulmonary venous pressure or external physical pressure on the airways or lung parenchyma. Respiratory disorders which compromise cardiac function include states with reduced alveolar ventilation, those with a barrier to ventilation or perfusion, ventilation/perfusion mismatch and pulmonary vascular disease. There is also a fascinating group in which congenital disorders of the heart and lung co-exist to produce very particular modes of abnormal cardiopulmonary interaction. Copyright © 2016. Published by Elsevier Ltd.

Measurement of lung volume in mechanically ventilated monkeys with an ultrasonic flow meter and the nitrogen washout method.

PubMed

Schibler, Andreas; Hammer, Jürg; Isler, Ruedi; Buess, Christian; Newth, Christopher J L

2004-01-01

Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC. The bias flow nitrogen washout technique (FRC(N2MC)), the multiple breath nitrogen washout (FRC(MBNW)) and the multiple breath sulphur-hexafluoride washout using the molar mass signal of an ultrasonic flow meter (FRC(MBSF6)) were compared in six adult monkeys after endotracheal intubation and during spontaneous breathing and mechanical ventilation at three different positive end-expiratory pressure (PEEP) levels of 0, 5 and 10 cmH2O. Animal research laboratory. We found good agreement between all three methods and they all accurately measured changes in FRC when PEEP was increased. The coefficients of variance of the three measurement techniques were in the same range (1.3-9.2%). The measurement of the tracer gas concentration with the molar mass signal of the ultrasonic flow meter provides a good and simple alternative to respiratory mass spectrometer for FRC measurements in ventilated subjects.

[Experimental study on the influence of natural and artificial ventilation on indoor radon concentration].

PubMed

Remetti, R; Gigante, G E

2010-01-01

The study presents the results of a campaign of measurements on the daily radon concentration using a Genitron Alpha Guard spectrometer. All the measurements have been intended to highlight the radon concentration variability during the 24 hours of the day and trying to find correlations with other ambient parameters such as temperature and pressure or local conditions such as the presence or not of a forced ventilation system. The main part of the measurements have been carried in the area of the Nuclear Measurement Laboratory of the Department of Basic and Applied Sciences for Engineering of "Sapienza" University of Rome. Results show a rapid rise of radon concentration in the night, when the artificial ventilation system was off and with door and windows closed. In the morning, after the opening of door and windows, the concentration falls down abruptly. With artificial ventilation system in function concentration never reaches significant values.

[Bronchoscopy in ventilated patients: full narcosis or local anesthesia?].

PubMed

Konrad, F; Wiedeck, H; Winter, H; Kilian, J

1990-04-01

In a prospective, randomised trial bronchoscopy was performed either in local anaesthesia (LA) or general anaesthesia, each on 15 ventilated patients. LA was carried out with oxybuprocain-hydrochloride 1% in repeated doses injected into the trachea and main bronchi, general anaesthesia with midazolam, piritramide and vecuronium bromide. Measurements were performed before, 3 minutes after induction of anaesthesia, immediately after bronchoscopy and 15 and 60 minutes after bronchoscopy. There was no effect on cardiocirculatory function during bronchoscopy in both groups, but we found a decrease in paO2 from 97 to 80 mmHg (median) after application of LA. Subsequent bronchoscopy did not significantly influence paO2. The present study shows that in ventilation patients undergoing fibreoptic bronchoscopy, the application of LA will usually result in a decline of arterial oxygen tension. This procedure should therefore only be performed if general anaesthesia is undesirable, as e.g. in patients being weaned from ventilation.

The predictive value of respiratory function tests for non-invasive ventilation in amyotrophic lateral sclerosis.

PubMed

Tilanus, T B M; Groothuis, J T; TenBroek-Pastoor, J M C; Feuth, T B; Heijdra, Y F; Slenders, J P L; Doorduin, J; Van Engelen, B G; Kampelmacher, M J; Raaphorst, J

2017-07-25

Non-invasive ventilation (NIV) improves survival and quality of life in amyotrophic lateral sclerosis (ALS) patients. The timing of referral to a home ventilation service (HVS), which is in part based on respiratory function tests, has shown room for improvement. It is currently unknown which respiratory function test predicts an appropriate timing of the initiation of NIV. We analysed, retrospectively, serial data of five respiratory function tests: forced vital capacity (FVC), peak cough flow (PCF), maximum inspiratory and expiratory pressure (MIP and MEP) and sniff nasal inspiratory pressure (SNIP) in patients with ALS. Patients who had had at least one assessment of respiratory function and one visit at the HVS, were included. Our aim was to detect the test with the highest predictive value for the need for elective NIV in the following 3 months. We analysed time curves, currently used cut-off values for referral, and respiratory function test results between 'NIV indication' and 'no-NIV indication' patients. One hundred ten patients with ALS were included of whom 87 received an NIV indication; 11.5% had one assessment before receiving an NIV indication, 88.5% had two or more assessments. The NIV indication was based on complaints of hypoventilation and/or proven (nocturnal) hypercapnia. The five respiratory function tests showed a descending trend during disease progression, where SNIP showed the greatest decline within the latest 3 months before NIV indication (mean = -22%). PCF at the time of referral to the HVS significantly discriminated between the groups 'NIV-indication' and 'no NIV-indication yet' patients at the first HVS visit: 259 (±92) vs. 348 (±137) L/min, p = 0.019. PCF and SNIP showed the best predictive characteristics in terms of sensitivity. SNIP showed the greatest decline prior to NIV indication and PCF significantly differentiated 'NIV-indication' from 'no NIV-indication yet' patients with ALS. Currently used cut-off values might be adjusted and other respiratory function tests such as SNIP and PCF may become part of routine care in patients with ALS in order to avoid non-timely initiation of (non-invasive) ventilation.

Applied patent RFID systems for building reacting HEPA air ventilation system in hospital operation rooms.

PubMed

Lin, Jesun; Pai, Jar-Yuan; Chen, Chih-Cheng

2012-12-01

RFID technology, an automatic identification and data capture technology to provide identification, tracing, security and so on, was widely applied to healthcare industry in these years. Employing HEPA ventilation system in hospital is a way to ensure healthful indoor air quality to protect patients and healthcare workers against hospital-acquired infections. However, the system consumes lots of electricity which cost a lot. This study aims to apply the RFID technology to offer a unique medical staff and patient identification, and reacting HEPA air ventilation system in order to reduce the cost, save energy and prevent the prevalence of hospital-acquired infection. The system, reacting HEPA air ventilation system, contains RFID tags (for medical staffs and patients), sensor, and reacting system which receives the information regarding the number of medical staff and the status of the surgery, and controls the air volume of the HEPA air ventilation system accordingly. A pilot program was carried out in a unit of operation rooms of a medical center with 1,500 beds located in central Taiwan from Jan to Aug 2010. The results found the air ventilation system was able to function much more efficiently with less energy consumed. Furthermore, the indoor air quality could still keep qualified and hospital-acquired infection or other occupational diseases could be prevented.

Effect of dobutamine on extravascular lung water index, ventilator function, and perfusion parameters in acute respiratory distress syndrome associated with septic shock.

PubMed

Zhou, Min; Dai, Ji; Du, Min; Wang, Wei; Guo, Changxing; Wang, Yi; Tang, Rui; Xu, Fengling; Rao, Zhuqing; Sun, Gengyun

2016-08-01

The role of dobutamine in the relief of pulmonary edema during septic shock-induced acute respiratory distress syndrome (ARDS) remains undetermined, due to a lack of controllable and quantitative clinical studies. Our objective was to assess the potential effects of dobutamine on extravascular lung water index (ELWI) in septic shock-induced ARDS, reflecting its importance in pulmonary edema. At the same time, ventilator function and perfusion parameters were evaluated. We designed a prospective, non-randomized, non-blinded, controlled study to compare the differences in PiCCO parameters after 6 h of constant dobutamine infusion (15 μg/kg/min), in the baseline parameters in 26 septic shock-related ARDS patients with cardiac index ≥ 2.5I/min/m(2) and hyperlactatemia. These patients (12 survivors/14 non-survivors) were monitored using the PiCCO catheter system within 48 h of onset of septic shock. The dynamic changes in ELWI, which is typically used for quantifying the extent of pulmonary edema, were evaluated, and the corresponding ventilator function and tissue perfusion parameters were also measured. Decreasing ELWI (p = 0.0376) was accompanied by significantly decreased SVRI (p < 0.0001). Despite a significant increase in cardiac output (p < 0.0001), no differences were found in ITBI or GEDI. Moreover, the required dose of norepinephrine was decreased (p = 0.0389), and urine output was increased (p = 0.0358), accompanied by stabilized lactacidemia and MAP. Additionally, airway pressure was moderately improved. During the early stage of septic shock-induced ARDS, dobutamine treatment demonstrated a beneficial effect by relieving pulmonary edema in patients, without a negative elevation in preload or hemodynamics, which might account for the improvements in ventilator function and tissue hypoperfusion.

High indoor CO2 concentrations in an office environment increases the transcutaneous CO2 level and sleepiness during cognitive work.

PubMed

Vehviläinen, Tommi; Lindholm, Harri; Rintamäki, Hannu; Pääkkönen, Rauno; Hirvonen, Ari; Niemi, Olli; Vinha, Juha

2016-01-01

The purpose of this study is to perform a multiparametric analysis on the environmental factors, the physiological stress reactions in the body, the measured alertness, and the subjective symptoms during simulated office work. Volunteer male subjects were monitored during three 4-hr work meetings in an office room, both in a ventilated and a non-ventilated environment. The environmental parameters measured included CO(2), temperature, and relative humidity. The physiological test battery consisted of measuring autonomic nervous system functions, salivary stress hormones, blood's CO(2)- content and oxygen saturation, skin temperatures, thermal sensations, vigilance, and sleepiness. The study shows that we can see physiological changes caused by high CO(2) concentration. The findings support the view that low or moderate level increases in concentration of CO(2) in indoor air might cause elevation in the blood's transcutaneously assessed CO(2). The observed findings are higher CO(2) concentrations in tissues, changes in heart rate variation, and an increase of peripheral blood circulation during exposure to elevated CO(2) concentration. The subjective parameters and symptoms support the physiological findings. This study shows that a high concentration of CO(2) in indoor air seem to be one parameter causing physiological effects, which can decrease the facility user's functional ability. The correct amount of ventilation with relation to the number of people using the facility, functional air distribution, and regular breaks can counteract the decrease in functional ability. The findings of the study suggest that merely increasing ventilation is not necessarily a rational solution from a technical-economical viewpoint. Instead or in addition, more comprehensive, anthropocentric planning of space is needed as well as instructions and new kinds of reference values for the design and realization of office environments.

The operation of the LHC accelerator complex (2/2)

ScienceCinema

Redaelli, Stefano

2018-05-23

These lectures will give an overview of what happens when the LHC is in running mode. They are aimed at students working on the LHC experiments, but all those who are curious about what happens behind the scenes of the LHC are welcomed. You will learn all you always wanted to know about the LHC, and never had the courage to ask! The only pre-requisite is a basic, college-level, knowledge of EM and of the principles that allow to steer charged beams. Topics covered will include, among others: - the description of the injector chain, from the generation of the protons, to the delivery of bunches to the LHC. - the discussion of the steps required to accelerate the beams in the LHC, to bring them into collision, and to control the luminosity at the interaction points. - the description of the monitoring tools available to the LHC operators, and an explanation of the various plots and panels that can be found on the LHC web pages

The operation of the LHC accelerator complex (1/2)

ScienceCinema

Redaelli, Stefano

2018-05-23

These lectures will give an overview of what happens when the LHC is in running mode. They are aimed at students working on the LHC experiments, but all those who are curious about what happens behind the scenes of the LHC are welcomed. You will learn all you always wanted to know about the LHC, and never had the courage to ask! The only pre-requisite is a basic, college-level, knowledge of EM and of the principles that allow to steer charged beams. Topics covered will include, among others: - the description of the injector chain, from the generation of the protons, to the delivery of bunches to the LHC. - the discussion of the steps required to accelerate the beams in the LHC, to bring them into collision, and to control the luminosity at the interaction points. - the description of the monitoring tools available to the LHC operators, and an explanation of the various plots and panels that can be found on the LHC web pages.

Cardiopulmonary Laboratory AFSC 904X0

DTIC Science & Technology

1990-10-01

SET UP POSITIVE END EXPIRATORY PRESSURE (PEEP) DEVICES 100 J321 SET UP CONTINUOUS POSITIVE AIRWAY PRESSURE ( CPAP ) DEVICES 100 J298 ASSIST PHYSICIAN IN...PRESSURE VENTILATORS 61 COMPUTERIZED PULMONARY FUNCTION ANALYZERS 61 TREADMILLS 59 HOLTER MONITOR EQUIPMENT 57 CPAP EQUIPMENT 54 PRESSURE REGULATORS 48...SUCTIONING PROCEDURES 95 J321 SET UP CONTINUOUS POSITIVE AIRWAY PRESSURE ( CPAP ) DEVICES 95 J332 SET UP VOLUME VENTILATORS 93 F148 PERFORM ARTERIAL PUNCTURES 93

Adaptive servo ventilation improves cardiac dysfunction and prognosis in chronic heart failure patients with Cheyne-Stokes respiration.

PubMed

Yoshihisa, Akiomi; Shimizu, Takeshi; Owada, Takashi; Nakamura, Yuichi; Iwaya, Shoji; Yamauchi, Hiroyuki; Miyata, Makiko; Hoshino, Yasuto; Sato, Takamasa; Suzuki, Satoshi; Sugimoto, Koichi; Yamaki, Takayoshi; Kunii, Hiroyuki; Nakazato, Kazuhiko; Suzuki, Hitoshi; Saitoh, Shu-ichi; Takeishi, Yasuchika

2011-01-01

Cheyne-Stokes respiration (CSR) is often observed in patients with chronic heart failure (CHF). Although adaptive servo ventilation (ASV) is effective for CSR, it remains unclear whether ASV improves the cardiac function and prognosis of patients with CHF and CSR.Sixty patients with CHF and CSR (mean left ventricular ejection fraction 38.7%, mean apnea hypopnea index 36.8 times/hour, mean central apnea index 19.1 times/hour) were enrolled in this study. Patients were divided into two groups: 23 patients treated with ASV (ASV group) and 37 patients treated without ASV (Non-ASV group). Measurement of plasma B-type natriuretic peptide (BNP) levels and echocardiography were performed before, 3 and 6 months after treatments in each group. Patients were followed-up for cardiac events (cardiac death and re-hospitalization) after discharge. In the ASV group, NYHA functional class, BNP levels, cardiac systolic and diastolic function were significantly improved with ASV treatment for 6 months. In contrast, none of these parameters changed in the Non-ASV group. Importantly, Kaplan-Meier analysis clearly demonstrated that the event-free rate was significantly higher in the ASV group than in the Non-ASV group.Adaptive servo ventilation improves cardiac function and prognosis in patients with chronic heart failure and Cheyne-Stokes respiration.

Respirator triggering of electron beam computed tomography (EBCT): evaluation of dynamic changes during mechanical expiration in the traumatized patient

NASA Astrophysics Data System (ADS)

Recheis, Wolfgang A.; Kleinsasser, Axel; Hatschenberger, Robert; Knapp, Rudolf; zur Nedden, Dieter; Hoermann, Christoph

1999-05-01

The purpose of this project is to evaluate the dynamic changes during expiration at different levels of positive end- expiratory pressure (PEEP) in the ventilated patient. We wanted to discriminate between normal lung function and acute respiratory distress syndrome (ARDS). After approval by the local Ethic Committee we studied two ventilated patients: (1) with normal lung function; (2) ARDS). We used the 50 ms scan mode of the EBCT. The beam was positioned 1 cm above the diaphragm. The table position remained unchanged. An electronic trigger was developed, that utilizes the respirators synchronizing signal to start the EBCT at the onset of expiration. During controlled mechanical expiration at two levels of PEEP (0 and 15 cm H2O), pulmonary aeration was rated as: well-aerated (-900HU/-500HU), poorly- aerated (-500HU/-100HU) and non-aerated (-100HU/+100HU). Pathological and normal lung function showed different dynamic changes (FIG.4-12). The different PEEP levels resulted in a significant change of pulmonary aeration in the same patient. Although we studied only a very limited number of patients, respirator triggered EBCT may be accurate in discriminating pathological changes due to the abnormal lung function in the mechanically ventilated patient.

[Update on the respiratory management of patients with chronic neuromuscular disease].

PubMed

Priou, P; Trzepizur, W; Meslier, N; Gagnadoux, F

2017-12-01

Neuromuscular diseases include a wide range of conditions that may involve potentially life-threatening respiratory complications (infection, respiratory failure). For patients with neuromuscular diseases, clinical assessment of respiratory function and regular pulmonary function tests are needed to screen for nocturnal respiratory disorders, weakness of the diaphragm and potential restrictive disorders and/or chronic hypercapnic respiratory insufficiency, possibly with couch deficiency. MANAGEMENT OF NOCTURNAL RESPIRATORY DISORDERS AND CHRONIC RESPIRATORY FAILURE: Nocturnal respiratory assistance is an important phase of care for nocturnal respiratory disorders and chronic respiratory failure. This may involve continuous positive airway pressure, adaptative servo-ventilation or non-invasive ventilation with a facial or nasal mask. As needed, diurnal assistance may be proposed by mouthpiece ventilation. Should non-invasive ventilation prove insufficient, or if significant swallowing disorders or recurrent bronchial obstruction develop, or in case of prolonged intubation, tracheotomy may be required. In case of lower airway infection with ineffective cough, physical therapy, associated with air stacking, intermittent positive pressure breathing or mechanical in-exsufflation may be proposed. Care for swallowing disorders, nutritional counseling (cachexia, obesity), vaccinations and therapeutic education are integral elements of patient-centered management aiming to prevent the negative impact of infection and to manage respiratory failure of chronic neuromuscular disease. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Thermoregulation and ventilation of termite mounds.

PubMed

Korb, Judith

2003-05-01

Some of the most sophisticated of all animal-built structures are the mounds of African termites of the subfamily Macrotermitinae, the fungus-growing termites. They have long been studied as fascinating textbook examples of thermoregulation or ventilation of animal buildings. However, little research has been designed to provide critical tests of these paradigms, derived from a very small number of original papers. Here I review results from recent studies on Macrotermes bellicosus that considered the interdependence of ambient temperature, thermoregulation, ventilation and mound architecture, and that question some of the fundamental paradigms of termite mounds. M. bellicosus achieves thermal homeostasis within the mound, but ambient temperature has an influence too. In colonies in comparably cool habitats, mound architecture is adapted to reduce the loss of metabolically produced heat to the environment. While this has no negative consequences in small colonies, it produces a trade-off with gas exchange in large colonies, resulting in suboptimally low nest temperatures and increased CO(2) concentrations. Along with the alteration in mound architecture, the gas exchange/ventilation mechanism also changes. While mounds in the thermally appropriate savannah have a very efficient circular ventilation during the day, the ventilation in the cooler forest is a less efficient upward movement of air, with gas exchange restricted by reduced surface exchange area. These results, together with other recent findings, question entrenched ideas such as the thermosiphon-ventilation mechanism or the assumption that mounds function to dissipate internally produced heat. Models trying to explain the proximate mechanisms of mound building, or building elements, are discussed.

Thermoregulation and ventilation of termite mounds

NASA Astrophysics Data System (ADS)

Korb, Judith

2003-05-01

Some of the most sophisticated of all animal-built structures are the mounds of African termites of the subfamily Macrotermitinae, the fungus-growing termites. They have long been studied as fascinating textbook examples of thermoregulation or ventilation of animal buildings. However, little research has been designed to provide critical tests of these paradigms, derived from a very small number of original papers. Here I review results from recent studies on Macrotermes bellicosus that considered the interdependence of ambient temperature, thermoregulation, ventilation and mound architecture, and that question some of the fundamental paradigms of termite mounds. M. bellicosus achieves thermal homeostasis within the mound, but ambient temperature has an influence too. In colonies in comparably cool habitats, mound architecture is adapted to reduce the loss of metabolically produced heat to the environment. While this has no negative consequences in small colonies, it produces a trade-off with gas exchange in large colonies, resulting in suboptimally low nest temperatures and increased CO2 concentrations. Along with the alteration in mound architecture, the gas exchange/ventilation mechanism also changes. While mounds in the thermally appropriate savannah have a very efficient circular ventilation during the day, the ventilation in the cooler forest is a less efficient upward movement of air, with gas exchange restricted by reduced surface exchange area. These results, together with other recent findings, question entrenched ideas such as the thermosiphon-ventilation mechanism or the assumption that mounds function to dissipate internally produced heat. Models trying to explain the proximate mechanisms of mound building, or building elements, are discussed.

Quantification of Age-Related Lung Tissue Mechanics under Mechanical Ventilation.

PubMed

Kim, JongWon; Heise, Rebecca L; Reynolds, Angela M; Pidaparti, Ramana M

2017-09-29

Elderly patients with obstructive lung diseases often receive mechanical ventilation to support their breathing and restore respiratory function. However, mechanical ventilation is known to increase the severity of ventilator-induced lung injury (VILI) in the elderly. Therefore, it is important to investigate the effects of aging to better understand the lung tissue mechanics to estimate the severity of ventilator-induced lung injuries. Two age-related geometric models involving human bronchioles from generation G10 to G23 and alveolar sacs were developed. The first is for a 50-year-old (normal) and second is for an 80-year old (aged) model. Lung tissue mechanics of normal and aged models were investigated under mechanical ventilation through computational simulations. Results obtained indicated that lung tissue strains during inhalation (t = 0.2 s) decreased by about 40% in the alveolar sac (G23) and 27% in the bronchiole (G20), respectively, for the 80-year-old as compared to the 50-year-old. The respiratory mechanics parameters (work of breathing per unit volume and maximum tissue strain) over G20 and G23 for the 80-year-old decreased by about 64% (three-fold) and 80% (four-fold), respectively, during the mechanical ventilation breathing cycle. However, there was a significant increase (by about threefold) in lung compliance for the 80-year-old in comparison to the 50-year-old. These findings from the computational simulations demonstrated that lung mechanical characteristics are significantly compromised in aging tissues, and these effects were quantified in this study.

Calculations of safe collimator settings and β* at the CERN Large Hadron Collider

NASA Astrophysics Data System (ADS)

Bruce, R.; Assmann, R. W.; Redaelli, S.

2015-06-01

The first run of the Large Hadron Collider (LHC) at CERN was very successful and resulted in important physics discoveries. One way of increasing the luminosity in a collider, which gave a very significant contribution to the LHC performance in the first run and can be used even if the beam intensity cannot be increased, is to decrease the transverse beam size at the interaction points by reducing the optical function β*. However, when doing so, the beam becomes larger in the final focusing system, which could expose its aperture to beam losses. For the LHC, which is designed to store beams with a total energy of 362 MJ, this is critical, since the loss of even a small fraction of the beam could cause a magnet quench or even damage. Therefore, the machine aperture has to be protected by the collimation system. The settings of the collimators constrain the maximum beam size that can be tolerated and therefore impose a lower limit on β*. In this paper, we present calculations to determine safe collimator settings and the resulting limit on β*, based on available aperture and operational stability of the machine. Our model was used to determine the LHC configurations in 2011 and 2012 and it was found that β* could be decreased significantly compared to the conservative model used in 2010. The gain in luminosity resulting from the decreased margins between collimators was more than a factor 2, and a further contribution from the use of realistic aperture estimates based on measurements was almost as large. This has played an essential role in the rapid and successful accumulation of experimental data in the LHC.

Readout Electronics for the ATLAS LAr Calorimeter at HL-LHC

NASA Astrophysics Data System (ADS)

Chen, Hucheng; ATLAS Liquid Argon Calorimeter Group

The ATLAS Liquid Argon (LAr) calorimeters are high precision, high sensitivity and high granularity detectors designed to provide precision measurements of electrons, photons, jets and missing transverse energy. ATLAS and its LAr calorimeters have been operating and collecting proton-proton collisions at LHC since 2009. The current front-end electronics of the LAr calorimeters need to be upgraded to sustain the higher radiation levels and data rates expected at the upgraded high luminosity LHC machine (HL-LHC), which will have 5 times more luminosity than the LHC in its ultimate configuration. The complexity of the present electronics and the obsolescence of some of components of which it is made, will not allow a partial replacement of the system. A completely new readout architecture scheme is under study and many components are being developed in various R&D programs of the LAr Calorimeter Group.The new front-end readout electronics will send data continuously at each bunch crossing through high speed radiation resistant optical links. The data will be processed real-time with the possibility of implementing trigger algorithms for clusters and electron/photon identification at a higher granularity than that which is currently implemented. The new architecture will eliminate the intrinsic limitation presently existing on Level-1 trigger acceptance. This article is an overview of the R&D activities which covers architectural design aspects of the new electronics as well as some detailed progress on the development of several ASICs needed, and preliminary studies with FPGAs to cover the backend functions including part of the Level-1 trigger requirements. A recently proposed staged upgrade with hybrid Tower Builder Board (TBB) is also described.

A study of the protective effect and mechanism of ketamine on acute lung injury induced by mechanical ventilation.

PubMed

Wang, W-F; Liu, S; Xu, B

2017-03-01

To investigate the protective effects and mechanism of ketamine on acute lung injury induced by mechanical ventilation. 63 patients with acute lung injury caused by mechanical ventilation in our hospital between June 2014 and May 2015 were chosen and divided into three groups: group A, B, and C. Group A (20 cases) received conventional treatment. Group B (21 cases) was treated with propofol and group C (22 cases) with ketamine. The ventilator application time, the success rate of weaning, the mortality rate, inflammation index (IL-1, Caspase-1, and NF-κB), pulmonary function index and oxygen saturation were compared. The ventilator application time and the mortality rate of group B and group C were significantly (p < 0.05) lower than those of group A. The success rate of weaning of groups B and C was higher (p < 0.05) than that of group A. There was no difference between groups B and C. After intervention, the levels of PaO2 and SpO2 in the three groups increased, while the level of PaCO2decreased with better improvement in group B and group C than in group A (p < 0.05), groups B and C being similar (p > 0.05). After the intervention, the levels of FEV1, FEV1/FVC, FVC and PEER in the three groups increased, but more remarkably in group B and group C (p < 0.05), in which there was no difference. After the intervention, the levels of IL-1β, Caspase-1, and NF-κB in the three groups decreased with the levels of group C obviously lower (p < 0.05) than those of groups B and A, the highest. Both ketamine and propofol can improve the blood gas and pulmonary function index of patients with acute lung injury caused by mechanical ventilation. They shorten the application time of ventilator, improve the success rate of weaning and reduce the mortality rate which is probably related to the reduction of the degree of inflammatory reaction. Ketamine is more effective in reducing inflammatory factors including IL-1β, Caspase-1, and NF-κB than propofol.

Postmortem and ex vivo carbon monoxide ventilation reduces injury in rat lungs transplanted from non-heart-beating donors.

PubMed

Dong, Boming; Stewart, Paul W; Egan, Thomas M

2013-08-01

We sought to determine whether ventilation of lungs after death in non-heart-beating donors with carbon monoxide during warm ischemia and ex vivo lung perfusion and after transplant would reduce ischemia-reperfusion injury and improve lung function. One hour after death, Sprague-Dawley rats were ventilated for another hour with 60% oxygen (control group) or 500 ppm carbon monoxide in 60% oxygen (CO-vent group; n=6/group). Then, lungs were flushed with 20 mL cold Perfadex, stored cold for 1 hour, then warmed to 37 °C in an ex vivo lung perfusion circuit perfused with Steen solution. At 37 °C, lungs were ventilated for 15 minutes with alveolar gas with or without 500 ppm carbon monoxide, then perfusion-cooled to 20 °C, flushed with cold Perfadex and stored cold for 2 hours. The left lung was transplanted using a modified cuff technique. Recipients were ventilated with 60% oxygen with or without carbon monoxide. One hour after transplant, we measured blood gases from the left pulmonary vein and aorta, and wet-to-dry ratio of both lungs. The RNA and protein extracted from graft lungs underwent real-time polymerase chain reaction and Western blotting, and measurement of cyclic guanosine monophosphate by enzyme-linked immunosorbent assay. Carbon monoxide ventilation begun 1 hour after death reduced wet/dry ratio after ex vivo lung perfusion. After transplantation, the carbon monoxide-ventilation group had better oxygenation; higher levels of tissue cyclic guanosine monophosphate, heme oxidase-1 expression, and p38 phosphorylation; reduced c-Jun N-terminal kinase phosphorylation; and reduced expression of interleukin-6 and interleukin-1β messenger RNA. Administration of carbon monoxide to the deceased donor and non-heart-beating donor lungs reduces ischemia-reperfusion injury in rat lungs transplanted from non-heart-beating donors. Therapy to the deceased donor via the airway may improve post-transplant lung function. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Comparison between effects of pressure support and pressure-controlled ventilation on lung and diaphragmatic damage in experimental emphysema.

PubMed

Padilha, Gisele de A; Horta, Lucas F B; Moraes, Lillian; Braga, Cassia L; Oliveira, Milena V; Santos, Cíntia L; Ramos, Isalira P; Morales, Marcelo M; Capelozzi, Vera Luiza; Goldenberg, Regina C S; de Abreu, Marcelo Gama; Pelosi, Paolo; Silva, Pedro L; Rocco, Patricia R M

2016-12-01

In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact of pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) on pulmonary and diaphragmatic damage, as well as cardiac function, in experimental emphysema. Emphysema was induced by intratracheal instillation of porcine pancreatic elastase in Wistar rats, once weekly for 4 weeks. Control animals received saline under the same protocol. Eight weeks after first instillation, control and emphysema rats were randomly assigned to PCV (n = 6/each) or PSV (n = 6/each) under protective tidal volume (6 ml/kg) for 4 h. Non-ventilated control and emphysema animals (n = 6/group) were used to characterize the model and for molecular biology analysis. Cardiorespiratory function, lung histology, diaphragm ultrastructure alterations, extracellular matrix organization, diaphragmatic proteolysis, and biological markers associated with pulmonary inflammation, alveolar stretch, and epithelial and endothelial cell damage were assessed. Emphysema animals exhibited cardiorespiratory changes that resemble human emphysema, such as increased areas of lung hyperinflation, pulmonary amphiregulin expression, and diaphragmatic injury. In emphysema animals, PSV compared to PCV yielded: no changes in gas exchange; decreased mean transpulmonary pressure (Pmean,L), ratio between inspiratory and total time (Ti/Ttot), lung hyperinflation, and amphiregulin expression in lung; increased ratio of pulmonary artery acceleration time to pulmonary artery ejection time, suggesting reduced right ventricular afterload; and increased ultrastructural damage to the diaphragm. Amphiregulin correlated with Pmean,L (r = 0.99, p < 0.0001) and hyperinflation (r = 0.70, p = 0.043), whereas Ti/Ttot correlated with hyperinflation (r = 0.81, p = 0.002) and Pmean,L (r = 0.60, p = 0.04). In the model of elastase-induced emphysema used herein, PSV reduced lung damage and improved cardiac function when compared to PCV, but worsened diaphragmatic injury.

Assessment of regional lung functional impairment with co-registered respiratory-gated ventilation/perfusion SPET-CT images: initial experiences.

PubMed

Suga, Kazuyoshi; Yasuhiko, Kawakami; Zaki, Mohammed; Yamashita, Tomio; Seto, Aska; Matsumoto, Tsuneo; Matsunaga, Naofumi

2004-02-01

In this study, respiratory-gated ventilation and perfusion single-photon emission tomography (SPET) were used to define regional functional impairment and to obtain reliable co-registration with computed tomography (CT) images in various lung diseases. Using a triple-headed SPET unit and a physiological synchroniser, gated perfusion SPET was performed in a total of 78 patients with different pulmonary diseases, including metastatic nodules (n = 15); in 34 of these patients, it was performed in combination with gated technetium-99m Technegas SPET. Projection data were acquired using 60 stops over 120 degrees for each detector. Gated end-inspiration and ungated images were reconstructed from 1/8 data centered at peak inspiration for each regular respiratory cycle and full respiratory cycle data, respectively. Gated images were registered with tidal inspiration CT images using automated three-dimensional (3D) registration software. Registration mismatch was assessed by measuring 3D distance of the centroid of the nine selected round perfusion-defective nodules. Gated SPET images were completed within 29 min, and increased the number of visible ventilation and perfusion defects by 9.7% and 17.2%, respectively, as compared with ungated images; furthermore, lesion-to-normal lung contrast was significantly higher on gated SPET images. In the nine round perfusion-defective nodules, gated images yielded a significantly better SPET-CT match compared with ungated images (4.9 +/- 3.1 mm vs 19.0 +/- 9.1 mm, P<0.001). The co-registered SPET-CT images allowed accurate perception of the location and extent of each ventilation/perfusion defect on the underlying CT anatomy, and characterised the pathophysiology of the various diseases. By reducing respiratory motion effects and enhancing perfusion/ventilation defect clarity, gated SPET can provide reliable co-registered images with CT images to accurately characterise regional functional impairment in various lung diseases.

The structure of the proton in the LHC precision era

NASA Astrophysics Data System (ADS)

Gao, Jun; Harland-Lang, Lucian; Rojo, Juan

2018-05-01

We review recent progress in the determination of the parton distribution functions (PDFs) of the proton, with emphasis on the applications for precision phenomenology at the Large Hadron Collider (LHC). First of all, we introduce the general theoretical framework underlying the global QCD analysis of the quark and gluon internal structure of protons. We then present a detailed overview of the hard-scattering measurements, and the corresponding theory predictions, that are used in state-of-the-art PDF fits. We emphasize here the role that higher-order QCD and electroweak corrections play in the description of recent high-precision collider data. We present the methodology used to extract PDFs in global analyses, including the PDF parametrization strategy and the definition and propagation of PDF uncertainties. Then we review and compare the most recent releases from the various PDF fitting collaborations, highlighting their differences and similarities. We discuss the role that QED corrections and photon-initiated contributions play in modern PDF analysis. We provide representative examples of the implications of PDF fits for high-precision LHC phenomenological applications, such as Higgs coupling measurements and searches for high-mass New Physics resonances. We conclude this report by discussing some selected topics relevant for the future of PDF determinations, including the treatment of theoretical uncertainties, the connection with lattice QCD calculations, and the role of PDFs at future high-energy colliders beyond the LHC.

Probing superfast quarks in nuclei through dijet production at the LHC

DOE PAGES

Freese, Adam J.; Sargsian, Misak M.; Strikman, Mark I.

2015-11-12

We investigate dijet production from proton-nucleus collisions at the Large Hadron Collider (LHC) as a means for observing superfast quarks in nuclei with Bjorken x>1 . Kinematically, superfast quarks can be identified through directly measurable jet kinematics. Dynamically, their description requires understanding several elusive properties of nuclear QCD, such as nuclear forces at very short distances, as well as medium modification of parton distributions in nuclei. In the present work, we develop a model for nuclear parton distributions at large x in which the nuclear dynamics at short distance scales are described by two- and three-nucleon short range correlations (SRCs).more » Nuclear modifications are accounted for using the color screening model, and an improved description of the EMC effect is reached by using a structure function parametrization that includes higher-twist contributions. We apply QCD evolution at the leading order to obtain nuclear parton distributions in the kinematic regime of the LHC, and based on the obtained distributions calculate the cross section for dijet production. We find that the rates of the dijet production in pA collisions at kinematics accessible by ATLAS and CMS are sufficient not only to observe superfast quarks but also to get information about the practically unexplored three-nucleon SRCs in nuclei. Additionally, the LHC can extend our knowledge of the EMC effect to large Q 2 where higher-twist effects are negligible.« less

Probing superfast quarks in nuclei through dijet production at the LHC

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

Freese, Adam J.; Sargsian, Misak M.; Strikman, Mark I.

2015-11-01

We investigate dijet production from proton-nucleus collisions at the Large Hadron Collider (LHC) as a means for observing superfast quarks in nuclei with Bjorken x>1 . Kinematically, superfast quarks can be identified through directly measurable jet kinematics. Dynamically, their description requires understanding several elusive properties of nuclear QCD, such as nuclear forces at very short distances, as well as medium modification of parton distributions in nuclei. In the present work, we develop a model for nuclear parton distributions at large x in which the nuclear dynamics at short distance scales are described by two- and three-nucleon short range correlations (SRCs).more » Nuclear modifications are accounted for using the color screening model, and an improved description of the EMC effect is reached by using a structure function parametrization that includes higher-twist contributions. We apply QCD evolution at the leading order to obtain nuclear parton distributions in the kinematic regime of the LHC, and based on the obtained distributions calculate the cross section for dijet production. We find that the rates of the dijet production in pA collisions at kinematics accessible by ATLAS and CMS are sufficient not only to observe superfast quarks but also to get information about the practically unexplored three-nucleon SRCs in nuclei. Additionally, the LHC can extend our knowledge of the EMC effect to large Q2 where higher-twist effects are negligible.« less

High CO2/H+ dialysis in the caudal ventrolateral medulla (Loeschcke's area) increases ventilation in wakefulness.

PubMed

da Silva, Glauber S F; Li, Aihua; Nattie, Eugene

2010-04-15

Central chemoreception, the detection of CO(2)/H(+) within the brain and the resultant effect on ventilation, was initially localized at two areas on the ventrolateral medulla, one rostral (rVLM-Mitchell's) the other caudal (cVLM-Loeschcke's), by surface application of acidic solutions in anesthetized animals. Focal dialysis of a high CO(2)/H(+) artificial cerebrospinal fluid (aCSF) that produced a milder local pH change in unanesthetized rats (like that with a approximately 6.6mm Hg increase in arterial P(CO2)) delineated putative chemoreceptor regions for the rVLM at the retrotrapezoid nucleus and the rostral medullary raphe that function predominantly in wakefulness and sleep, respectively. Here we ask if chemoreception in the cVLM can be detected by mild focal stimulation and if it functions in a state dependent manner. At responsive sites just beneath Loeschcke's area, ventilation was increased by, on average, 17% (P<0.01) only in wakefulness. These data support our hypothesis that central chemoreception is a distributed property with some sites functioning in a state dependent manner. Copyright 2010 Elsevier B.V. All rights reserved.

Association of center volume with outcomes in critically ill children with acute asthma.

PubMed

Gupta, Punkaj; Tang, Xinyu; Gossett, Jeffrey M; Gall, Christine M; Lauer, Casey; Rice, Tom B; Carroll, Christopher L; Kacmarek, Robert M; Wetzel, Randall C

2014-07-01

Little is known about the relation between center volume and outcomes in children requiring intensive care unit (ICU) admission for acute asthma. To evaluate the association of center volume with the odds of receiving positive pressure ventilation and length of ICU stay. Patients 2 to 18 years of age with the primary diagnosis of asthma were included (2009-2012). Center volume was defined as the average number of mechanical ventilator cases per year for any diagnoses during the study period. In multivariable analysis, the odds of receiving positive pressure ventilation (invasive and noninvasive ventilation) and ICU length of stay were evaluated as a function of center volume. Fifteen thousand eighty-three patients from 103 pediatric ICUs with the primary diagnosis of acute asthma met the inclusion criteria. Seven hundred fifty-two patients (5%) received conventional mechanical ventilation and 964 patients (6%) received noninvasive ventilation. In multivariable analysis, center volume was not associated with the odds of receiving any form of positive pressure ventilation in children with acute asthma, with the exception of high- to medium-volume centers. However, ICU length of stay varied with center volume and was noted to be longer in low-volume centers compared with medium- and high-volume centers. In children with acute asthma, this study establishes a relation between center volume and ICU length of stay. However, this study fails to show any significant relation between center volume and the odds of receiving positive pressure ventilation; further analyses are needed to evaluate this relation in more detail. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Impact of Extraperitoneal Dioxyde Carbon Insufflation on Respiratory Function in Anesthetized Adults: A Preliminary Study Using Electrical Impedance Tomography and Wash-out/Wash-in Technic

PubMed Central

Bordes, Julien; Mazzeo, Cecilia; Gourtobe, Philippe; Cungi, Pierre Julien; Antonini, Francois; Bourgoin, Stephane; Kaiser, Eric

2015-01-01

Background: Extraperitoneal laparoscopy has become a common technique for many surgical procedures, especially for inguinal hernia surgery. Investigations of physiological changes occurring during extraperitoneal carbon dioxide (CO2) insufflation mostly focused on blood gas changes. To date, the impact of extraperitoneal CO2 insufflation on respiratory mechanics remains unknown, whereas changes in respiratory mechanics have been extensively studied in intraperitoneal insufflation. Objectives: The aim of this study was to investigate the effects of extraperitoneal CO2 insufflation on respiratory mechanics. Patients and Methods: A prospective and observational study was performed on nine patients undergoing laparoscopic inguinal hernia repair. Anesthetic management and intraoperative care were standardized. All patients were mechanically ventilated with a tidal volume of 8 mL/kg using an Engström Carestation ventilator (GE Healthcare). Ventilation distribution was assessed by electrical impedance tomography (EIT). End-expiratory lung volume (EELV) was measured by a nitrogen wash-out/wash-in method. Ventilation distribution, EELV, ventilator pressures and hemodynamic parameters were assessed before extraperitoneal insufflation, and during insufflation with a PEEP of 0 cmH2O, 5 cmH20 and of 10 cmH20. Results: EELV and thoracopulmonary compliance were significantly decreased after extraperitoneal insufflation. Ventilation distribution was significantly higher in ventral lung regions during general anesthesia and was not modified after insufflation. A 10 cmH20 PEEP application resulted in a significant increase in EELV, and a shift of ventilation toward the dorsal lung regions. Conclusions: Extraperitoneal insufflation decreased EELV and thoracopulmonary compliance. Application of a 10 cmH20 PEEP increased EELV and homogenized ventilation distribution. This preliminary clinical study showed that extraperitoneal insufflation worsened respiratory mechanics, which may justify further investigations to evaluate the clinical impact. PMID:25789238

Precision searches in dijets at the HL-LHC and HE-LHC

NASA Astrophysics Data System (ADS)

Chekanov, S. V.; Childers, J. T.; Proudfoot, J.; Wang, R.; Frizzell, D.

2018-05-01

This paper explores the physics reach of the High-Luminosity Large Hadron Collider (HL-LHC) for searches of new particles decaying to two jets. We discuss inclusive searches in dijets and b-jets, as well as searches in semi-inclusive events by requiring an additional lepton that increases sensitivity to different aspects of the underlying processes. We discuss the expected exclusion limits for generic models predicting new massive particles that result in resonant structures in the dijet mass. Prospects of the Higher-Energy LHC (HE-LHC) collider are also discussed. The study is based on the Pythia8 Monte Carlo generator using representative event statistics for the HL-LHC and HE-LHC running conditions. The event samples were created using supercomputers at NERSC.

Chiral magnetic currents with QGP medium response in heavy-ion collisions at RHIC and LHC energies

NASA Astrophysics Data System (ADS)

She, Duan; Feng, Sheng-Qin; Zhong, Yang; Yin, Zhong-Bao

2018-03-01

We calculate the electromagnetic current with a more realistic approach in the RHIC and LHC energy regions in the article. We take the partons formation time as the initial time of the magnetic field response of QGP medium. The maximum electromagnetic current and the time-integrated current are two important characteristics of the chiral magnetic effect (CME), which can characterize the intensity and duration of fluctuations of CME. We consider the finite frequency response of CME to a time-varying magnetic field, find a significant impact from QGP medium feedback, and estimate the generated electromagnetic current as a function of time, beam energy and impact parameter.

Parton distributions in the LHC era

NASA Astrophysics Data System (ADS)

Del Debbio, Luigi

2018-03-01

Analyses of LHC (and other!) experiments require robust and statistically accurate determinations of the structure of the proton, encoded in the parton distribution functions (PDFs). The standard description of hadronic processes relies on factorization theorems, which allow a separation of process-dependent short-distance physics from the universal long-distance structure of the proton. Traditionally the PDFs are obtained from fits to experimental data. However, understanding the long-distance properties of hadrons is a nonperturbative problem, and lattice QCD can play a role in providing useful results from first principles. In this talk we compare the different approaches used to determine PDFs, and try to assess the impact of existing, and future, lattice calculations.

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

Gangadharan, Dhevan

Recent measurements have revealed a significant suppression of multipion Bose–Einstein correlations in heavy-ion collisions at the LHC. The suppression may be explained by postulating coherent pion emission. Typically, the suppression of Bose–Einstein correlations due to coherence is taken into account with the coherent state formalism in quantum optics. However, since charged pion correlations are most often measured, the additional constraint of isospin conservation, which is absent in quantum optics, needs to be taken into account. As a consequence, correlations emerge between pions of opposite charge. A calculation of the correlations induced by isospin conservation of coherent emission is made formore » two, three- and four-pion correlation functions and compared to the data from the LHC.« less

Search for new particles in two-jet final states in 7 TeV proton-proton collisions with the ATLAS detector at the LHC.

PubMed

Aad, G; Abbott, B; Abdallah, J; Abdelalim, A A; Abdesselam, A; Abdinov, O; Abi, B; Abolins, M; Abramowicz, H; Abreu, H; Acerbi, E; Acharya, B S; Ackers, M; Adams, D L; Addy, T N; Adelman, J; Aderholz, M; Adomeit, S; Adorisio, C; Adragna, P; Adye, T; Aefsky, S; Aguilar-Saavedra, J A; Aharrouche, M; Ahlen, S P; Ahles, F; Ahmad, A; Ahmed, H; Ahsan, M; Aielli, G; Akdogan, T; Akesson, T P A; Akimoto, G; Akimov, A V; Aktas, A; Alam, M S; Alam, M A; Albrand, S; Aleksa, M; Aleksandrov, I N; Aleppo, M; Alessandria, F; Alexa, C; Alexander, G; Alexandre, G; Alexopoulos, T; Alhroob, M; Aliev, M; Alimonti, G; Alison, J; Aliyev, M; Allport, P P; Allwood-Spiers, S E; Almond, J; Aloisio, A; Alon, R; Alonso, A; Alonso, J; Alviggi, M G; Amako, K; Amaral, P; Ambrosio, G; Amelung, C; Ammosov, V V; Amorim, A; Amorós, G; Amram, N; Anastopoulos, C; Andeen, T; Anders, C F; Anderson, K J; Andreazza, A; Andrei, V; Andrieux, M-L; Anduaga, X S; Angerami, A; Anghinolfi, F; Anjos, N; Annovi, A; Antonaki, A; Antonelli, M; Antonelli, S; Antos, J; Antunovic, B; Anulli, F; Aoun, S; Arabidze, G; Aracena, I; Arai, Y; Arce, A T H; Archambault, J P; Arfaoui, S; Arguin, J-F; Argyropoulos, T; Arik, E; Arik, M; Armbruster, A J; Arms, K E; Armstrong, S R; Arnaez, O; Arnault, C; Artamonov, A; Arutinov, D; Asai, M; Asai, S; Asfandiyarov, R; Ask, S; Asman, B; Asner, D; Asquith, L; Assamagan, K; Astbury, A; Astvatsatourov, A; Atoian, G; Aubert, B; Auerbach, B; Auge, E; Augsten, K; Aurousseau, M; Austin, N; Avolio, G; Avramidou, R; Axen, D; Ay, C; Azuelos, G; Azuma, Y; Baak, M A; Baccaglioni, G; Bacci, C; Bach, A M; Bachacou, H; Bachas, K; Bachy, G; Backes, M; Badescu, E; Bagnaia, P; Bai, Y; Bailey, D C; Bain, T; Baines, J T; Baker, O K; Baker, M D; Baker, S; Baltasar Dos Santos Pedrosa, F; Banas, E; Banerjee, P; Banerjee, S; Banfi, D; Bangert, A; Bansal, V; Baranov, S P; Baranov, S; Barashkou, A; Barbaro Galtieri, A; Barber, T; Barberio, E L; Barberis, D; Barbero, M; Bardin, D Y; Barillari, T; Barisonzi, M; Barklow, T; Barlow, N; Barnett, B M; Barnett, R M; Baroncelli, A; Barone, M; Barr, A J; Barreiro, F; Barreiro Guimarães da Costa, J; Barrillon, P; Bartoldus, R; Bartsch, D; Bates, R L; Batkova, L; Batley, J R; Battaglia, A; Battistin, M; Battistoni, G; Bauer, F; Bawa, H S; Bazalova, M; Beare, B; Beau, T; Beauchemin, P H; Beccherle, R; Bechtle, P; Beck, G A; Beck, H P; Beckingham, M; Becks, K H; Beddall, A J; Beddall, A; Bednyakov, V A; Bee, C; Begel, M; Behar Harpaz, S; Behera, P K; Beimforde, M; Belanger-Champagne, C; Belhorma, B; Bell, P J; Bell, W H; Bella, G; Bellagamba, L; Bellina, F; Bellomo, G; Bellomo, M; Belloni, A; Belotskiy, K; Beltramello, O; Ben Ami, S; Benary, O; Benchekroun, D; Benchouk, C; Bendel, M; Benedict, B H; Benekos, N; Benhammou, Y; Benincasa, G P; Benjamin, D P; Benoit, M; Bensinger, J R; Benslama, K; Bentvelsen, S; Beretta, M; Berge, D; Bergeaas Kuutmann, E; Berger, N; Berghaus, F; Berglund, E; Beringer, J; Bernardet, K; Bernat, P; Bernhard, R; Bernius, C; Berry, T; Bertin, A; 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Brandenburg, G W; Brandt, A; Brandt, G; Brandt, O; Bratzler, U; Brau, B; Brau, J E; Braun, H M; Brelier, B; Bremer, J; Brenner, R; Bressler, S; Breton, D; Brett, N D; Bright-Thomas, P G; Britton, D; Brochu, F M; Brock, I; Brock, R; Brodbeck, T J; Brodet, E; Broggi, F; Bromberg, C; Brooijmans, G; Brooks, W K; Brown, G; Brubaker, E; Bruckman de Renstrom, P A; Bruncko, D; Bruneliere, R; Brunet, S; Bruni, A; Bruni, G; Bruschi, M; Buanes, T; Bucci, F; Buchanan, J; Buchanan, N J; Buchholz, P; Buckingham, R M; Buckley, A G; Budagov, I A; Budick, B; Büscher, V; Bugge, L; Buira-Clark, D; Buis, E J; Bulekov, O; Bunse, M; Buran, T; Burckhart, H; Burdin, S; Burgess, T; Burke, S; Busato, E; Bussey, P; Buszello, C P; Butin, F; Butler, B; Butler, J M; Buttar, C M; Butterworth, J M; Byatt, T; Caballero, J; Cabrera Urbán, S; Caccia, M; Caforio, D; Cakir, O; Calafiura, P; Calderini, G; Calfayan, P; Calkins, R; Caloba, L P; Caloi, R; Calvet, D; Camard, A; Camarri, P; Cambiaghi, M; Cameron, D; Cammin, J; 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Vercesi, V; Verducci, M; Verkerke, W; Vermeulen, J C; Vertogardov, L; Vetterli, M C; Vichou, I; Vickey, T; Viehhauser, G H A; Viel, S; Villa, M; Villani, E G; Villaplana Perez, M; Vilucchi, E; Vincter, M G; Vinek, E; Vinogradov, V B; Virchaux, M; Viret, S; Virzi, J; Vitale, A; Vitells, O; Vivarelli, I; Vives Vaque, F; Vlachos, S; Vlasak, M; Vlasov, N; Vogel, A; Vogt, H; Vokac, P; Volpi, M; Volpini, G; von der Schmitt, H; von Loeben, J; von Radziewski, H; von Toerne, E; Vorobel, V; Vorobiev, A P; Vorwerk, V; Vos, M; Voss, R; Voss, T T; Vossebeld, J H; Vovenko, A S; Vranjes, N; Vranjes Milosavljevic, M; Vrba, V; Vreeswijk, M; Vu Anh, T; Vudragovic, D; Vuillermet, R; Vukotic, I; Wagner, W; Wagner, P; Wahlen, H; Walbersloh, J; Walder, J; Walker, R; Walkowiak, W; Wall, R; Waller, P; Wang, C; Wang, H; Wang, J; Wang, J C; Wang, S M; Warburton, A; Ward, C P; Warsinsky, M; Wastie, R; Watkins, P M; Watson, A T; Watson, M F; Watts, G; Watts, S; Waugh, A T; Waugh, B M; Webel, M; Weber, J; Weber, M; Weber, M S; Weber, P; Weidberg, A R; Weingarten, J; Weiser, C; Wellenstein, H; Wellisch, H P; Wells, P S; Wen, M; Wenaus, T; Wendler, S; Weng, Z; Wengler, T; Wenig, S; Wermes, N; Werner, M; Werner, P; Werth, M; Werthenbach, U; Wessels, M; Whalen, K; Wheeler-Ellis, S J; Whitaker, S P; White, A; White, M J; White, S; Whitehead, S R; Whiteson, D; Whittington, D; Wicek, F; Wicke, D; Wickens, F J; Wiedenmann, W; Wielers, M; Wienemann, P; Wiglesworth, C; Wiik, L A M; Wildauer, A; Wildt, M A; Wilhelm, I; Wilkens, H G; Will, J Z; Williams, E; Williams, H H; Willis, W; Willocq, S; Wilson, J A; Wilson, M G; Wilson, A; Wingerter-Seez, I; Winkelmann, S; Winklmeier, F; Wittgen, M; Woehrling, E; Wolter, M W; Wolters, H; Wosiek, B K; Wotschack, J; Woudstra, M J; Wraight, K; Wright, C; Wright, D; Wrona, B; Wu, S L; Wu, X; Wuestenfeld, J; Wulf, E; Wunstorf, R; Wynne, B M; Xaplanteris, L; Xella, S; Xie, S; Xie, Y; Xu, C; Xu, D; Xu, G; Xu, N; Yabsley, B; Yamada, M; Yamamoto, A; Yamamoto, K; Yamamoto, S; Yamamura, T; Yamaoka, J; Yamazaki, T; Yamazaki, Y; Yan, Z; Yang, H; Yang, S; Yang, U K; Yang, Y; Yang, Y; Yang, Z; Yao, W-M; Yao, Y; Yasu, Y; Ye, J; Ye, S; Yilmaz, M; Yoosoofmiya, R; Yorita, K; Yoshida, R; Young, C; Youssef, S P; Yu, D; Yu, J; Yu, J; Yuan, J; Yuan, L; Yurkewicz, A; Zaets, V G; Zaidan, R; Zaitsev, A M; Zajacova, Z; Zalite, Yo K; Zambrano, V; Zanello, L; Zarzhitsky, P; Zaytsev, A; Zdrazil, M; Zeitnitz, C; Zeller, M; Zema, P F; Zemla, A; Zendler, C; Zenin, A V; Zenin, O; Zenis, T; Zenonos, Z; Zenz, S; Zerwas, D; Zevi Della Porta, G; Zhan, Z; Zhang, H; Zhang, J; Zhang, Q; Zhang, X; Zhao, L; Zhao, T; Zhao, Z; Zhemchugov, A; Zheng, S; Zhong, J; Zhou, B; Zhou, N; Zhou, Y; Zhu, C G; Zhu, H; Zhu, Y; Zhuang, X; Zhuravlov, V; Zilka, B; Zimmermann, R; Zimmermann, S; Zimmermann, S; Ziolkowski, M; Zitoun, R; Zivković, L; Zmouchko, V V; Zobernig, G; Zoccoli, A; Zolnierowski, Y; Zsenei, A; Zur Nedden, M; Zutshi, V

2010-10-15

A search for new heavy particles manifested as resonances in two-jet final states is presented. The data were produced in 7 TeV proton-proton collisions by the LHC and correspond to an integrated luminosity of 315  nb⁻¹ collected by the ATLAS detector. No resonances were observed. Upper limits were set on the product of cross section and signal acceptance for excited-quark (q*) production as a function of q* mass. These exclude at the 95% C.L. the q* mass interval 0.30

Associations of Cognitive Function Scores with Carbon Dioxide, Ventilation, and Volatile Organic Compound Exposures in Office Workers: A Controlled Exposure Study of Green and Conventional Office Environments.

PubMed

Allen, Joseph G; MacNaughton, Piers; Satish, Usha; Santanam, Suresh; Vallarino, Jose; Spengler, John D

2016-06-01

The indoor built environment plays a critical role in our overall well-being because of both the amount of time we spend indoors (~90%) and the ability of buildings to positively or negatively influence our health. The advent of sustainable design or green building strategies reinvigorated questions regarding the specific factors in buildings that lead to optimized conditions for health and productivity. We simulated indoor environmental quality (IEQ) conditions in "Green" and "Conventional" buildings and evaluated the impacts on an objective measure of human performance: higher-order cognitive function. Twenty-four participants spent 6 full work days (0900-1700 hours) in an environmentally controlled office space, blinded to test conditions. On different days, they were exposed to IEQ conditions representative of Conventional [high concentrations of volatile organic compounds (VOCs)] and Green (low concentrations of VOCs) office buildings in the United States. Additional conditions simulated a Green building with a high outdoor air ventilation rate (labeled Green+) and artificially elevated carbon dioxide (CO2) levels independent of ventilation. On average, cognitive scores were 61% higher on the Green building day and 101% higher on the two Green+ building days than on the Conventional building day (p < 0.0001). VOCs and CO2 were independently associated with cognitive scores. Cognitive function scores were significantly better under Green+ building conditions than in the Conventional building conditions for all nine functional domains. These findings have wide-ranging implications because this study was designed to reflect conditions that are commonly encountered every day in many indoor environments. Allen JG, MacNaughton P, Satish U, Santanam S, Vallarino J, Spengler JD. 2016. Associations of cognitive function scores with carbon dioxide, ventilation, and volatile organic compound exposures in office workers: a controlled exposure study of green and conventional office environments. Environ Health Perspect 124:805-812; http://dx.doi.org/10.1289/ehp.1510037.

Hypergravity Alters the Susceptibility of Cells to Anoxia-Reoxygenation Injury

NASA Technical Reports Server (NTRS)

McCloud, Henry; Pink, Yulondo; Harris-Hooker, Sandra A.; Melhado, Caroline D.; Sanford, Gary L.

1997-01-01

Gravity is a physical force, much like shear stress or mechanical stretch, and should affect organ and cellular function. Researchers have shown that gravity plays a role in ventilation and blood flow distribution, gas exchange, alveolar size and mechanical stresses within the lung. Short exposure to microgravity produced marked alterations in lung blood flow and ventilation distribution while hypergravity exaggerated the regional differences in lung structure and function resulting in reduced ventilation at the base and no ventilation of the upper half of the lung. Microgravity also decreased metabolic activity in cardiac cells, WI-38 embryonic lung cells, and human lymphocytes. Rats, in the tail-suspended head-down tilt model, experienced transient loss of lung water, contrary to an expected increase due to pooling of blood in the pulmonary vasculature. Hypergravity has also been found to increase the proliferation of several different cell lines (e.g., chick embryo fibroblasts) while decreasing cell motility and slowing liver regeneration following partial hepatectomy. These studies show that changes in the gravity environment will affect several aspects of organ and cellular function and produce major change in blood flow and tissue/organ perfusion. However, these past studies have not addressed whether ischemia-reperfusion injury will be exacerbated or ameliorated by changes in the gravity environment, e.g., space flight. Currently, nothing is known about how gravity will affect the susceptibility of different lung and vascular cells to this type of injury. We conducted studies that addressed the following question: Does the susceptibility of lung fibroblasts, vascular smooth muscle, and endothelial cells to anoxia/reoxygenation injury change following exposure to hypergravity conditions?

Effects of exercise training on pulmonary mechanics and functional status in patients with prolonged mechanical ventilation.

PubMed

Chen, Yen-Huey; Lin, Hui-Ling; Hsiao, Hsiu-Feng; Chou, Lan-Ti; Kao, Kuo-Chin; Huang, Chung-Chi; Tsai, Ying-Huang

2012-05-01

The functional status and outcomes in patients with prolonged mechanical ventilation (PMV) are often limited by poor endurance and pulmonary mechanics, which result from the primary diseases or prolonged time bedridden. We evaluate the impact of exercise training on pulmonary mechanics, physical functional status, and hospitalization outcomes in PMV patients. Twenty-seven subjects with PMV in our respiratory care center (RCC) were divided randomly into an exercise training group (n = 12) and a control group (n = 15). The exercise program comprised 10 sessions of exercise training. The measurement of pulmonary mechanics and physical functional status (Functional Independence Measurement and Barthel index) were performed pre-study and post-study. The hospitalization outcomes included: days of mechanical ventilation, hospitalization days, and weaning and mortality rates during RCC stay. The training group had significant improvement in tidal volume (143.6 mL vs 192.5 mL, P = .02) and rapid shallow breathing index after training (162.2 vs 110.6, P = .009). No significant change was found in the control group except respiratory rate. Both groups had significant improvement in functional status during the study. However, the training group had greater changes in FIM score than the control group (44.6 vs 34.2, P = .024). The training group also had shorter RCC stay and higher weaning and survival rates than the control group, although no statistical difference was found. Subjects with PMV in our RCC demonstrated significant improvement in pulmonary mechanics and functional status after exercise training. The application of exercise training may be helpful for PMV patients to improve hospitalization outcomes.

A randomized comparison of different ventilator strategies during thoracotomy for pulmonary resection.

PubMed

Maslow, Andrew D; Stafford, Todd S; Davignon, Kristopher R; Ng, Thomas

2013-07-01

Protective lung ventilation is reported to benefit patients with acute respiratory distress syndrome. It is not known whether protective lung ventilation is also beneficial to patients undergoing single-lung ventilation for elective pulmonary resection. In an institutional review board-approved prospective randomized trial, 34 patients undergoing elective pulmonary resection requiring single-lung ventilation were enrolled. Informed consent was obtained. Patients were randomized to 1 of 2 groups: (1) high tidal volume (Hi-TV) of 10 mL/kg, rate of 7 breaths/min, and zero positive end-expiratory pressure or (2) low tidal volume (Lo-TV) of 5 mL/kg, rate of 14 breaths/min, and 5 cmH2O positive end-expiratory pressure. Ventilator settings were continued during both double- and single-lung ventilation. Pulmonary functions, hemodynamics, and postoperative outcomes were recorded. Patient demographics, operative characteristics, intraoperative hemodynamics, and postoperative pain and sedation scores were similar between the 2 groups. During most time periods, airway pressures (peak and plateau) were significantly higher in the Hi-TV group; however, plateau pressures remained less than 30 cmH2O at all times for all patients. The Hi-TV group had significantly lower arterial carbon dioxide tension, less arterial carbon dioxide tension-end-tidal carbon dioxide gradient, lower alveolar dead space ratio, and higher dynamic pulmonary compliance. There were no differences in postoperative morbidity and hospital days between the 2 groups, but atelectasis scores on postoperative days 1 and 2 were lower in the Hi-TV group. The use of Hi-TV during single-lung ventilation for pulmonary resection resulted in no increase in morbidity and was associated with less hypercarbia, less dead space ventilation, better dynamic compliance, and less postoperative atelectasis. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Variable ventilation improves pulmonary function and reduces lung damage without increasing bacterial translocation in a rat model of experimental pneumonia.

PubMed

de Magalhães, Raquel F; Samary, Cynthia S; Santos, Raquel S; de Oliveira, Milena V; Rocha, Nazareth N; Santos, Cintia L; Kitoko, Jamil; Silva, Carlos A M; Hildebrandt, Caroline L; Goncalves-de-Albuquerque, Cassiano F; Silva, Adriana R; Faria-Neto, Hugo C; Martins, Vanessa; Capelozzi, Vera L; Huhle, Robert; Morales, Marcelo M; Olsen, Priscilla; Pelosi, Paolo; de Abreu, Marcelo Gama; Rocco, Patricia R M; Silva, Pedro L

2016-11-25

Variable ventilation has been shown to improve pulmonary function and reduce lung damage in different models of acute respiratory distress syndrome. Nevertheless, variable ventilation has not been tested during pneumonia. Theoretically, periodic increases in tidal volume (V T ) and airway pressures might worsen the impairment of alveolar barrier function usually seen in pneumonia and could increase bacterial translocation into the bloodstream. We investigated the impact of variable ventilation on lung function and histologic damage, as well as markers of lung inflammation, epithelial and endothelial cell damage, and alveolar stress, and bacterial translocation in experimental pneumonia. Thirty-two Wistar rats were randomly assigned to receive intratracheal of Pseudomonas aeruginosa (PA) or saline (SAL) (n = 16/group). After 24-h, animals were anesthetized and ventilated for 2 h with either conventional volume-controlled (VCV) or variable volume-controlled ventilation (VV), with mean V T  = 6 mL/kg, PEEP = 5cmH 2 O, and FiO 2  = 0.4. During VV, tidal volume varied randomly with a coefficient of variation of 30% and a Gaussian distribution. Additional animals assigned to receive either PA or SAL (n = 8/group) were not ventilated (NV) to serve as controls. In both SAL and PA, VV improved oxygenation and lung elastance compared to VCV. In SAL, VV decreased interleukin (IL)-6 expression compared to VCV (median [interquartile range]: 1.3 [0.3-2.3] vs. 5.3 [3.6-7.0]; p = 0.02) and increased surfactant protein-D expression compared to NV (2.5 [1.9-3.5] vs. 1.2 [0.8-1.2]; p = 0.0005). In PA, compared to VCV, VV reduced perivascular edema (2.5 [2.0-3.75] vs. 6.0 [4.5-6.0]; p < 0.0001), septum neutrophils (2.0 [1.0-4.0] vs. 5.0 [3.3-6.0]; p = 0.0008), necrotizing vasculitis (3.0 [2.0-5.5] vs. 6.0 [6.0-6.0]; p = 0.0003), and ultrastructural lung damage scores (16 [14-17] vs. 24 [14-27], p < 0.0001). Blood colony-forming-unit (CFU) counts were comparable (7 [0-28] vs. 6 [0-26], p = 0.77). Compared to NV, VCV, but not VV, increased expression amphiregulin, IL-6, and cytokine-induced neutrophil chemoattractant (CINC)-1 (2.1 [1.6-2.5] vs. 0.9 [0.7-1.2], p = 0.025; 12.3 [7.9-22.0] vs. 0.8 [0.6-1.9], p = 0.006; and 4.4 [2.9-5.6] vs. 0.9 [0.8-1.4], p = 0.003, respectively). Angiopoietin-2 expression was lower in VV compared to NV animals (0.5 [0.3-0.8] vs. 1.3 [1.0-1.5], p = 0.01). In this rat model of pneumonia, VV improved pulmonary function and reduced lung damage as compared to VCV, without increasing bacterial translocation.

Resummation of jet veto logarithms at N 3 LL a + NNLO for W + W ? production at the LHC

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

Dawson, S.; Jaiswal, P.; Li, Ye

We compute the resummed on-shell W+W- production cross section under a jet veto at the LHC to partial N3LL order matched to the fixed-order NNLO result. Differential NNLO cross sections are obtained from an implementation of qT subtraction in Sherpa. The two-loop virtual corrections to the qq¯→W+W- amplitude, used in both fixed-order and resummation predictions, are extracted from the public code qqvvamp. We perform resummation using soft collinear effective theory, with approximate beam functions where only the logarithmic terms are included at two-loop. In addition to scale uncertainties from the hard matching scale and the factorization scale, rapidity scale variationsmore » are obtained within the analytic regulator approach. Our resummation results show a decrease in the jet veto cross section compared to NNLO fixed-order predictions, with reduced scale uncertainties compared to NNLL+NLO resummed predictions. We include the loop-induced gg contribution with jet veto resummation to NLL+LO. The prediction shows good agreement with recent LHC measurements.« less

Resummation of jet veto logarithms at N 3 LL a + NNLO for W + W ? production at the LHC

DOE PAGES

Dawson, S.; Jaiswal, P.; Li, Ye; ...

2016-12-01

We compute the resummed on-shell W+W- production cross section under a jet veto at the LHC to partial N3LL order matched to the fixed-order NNLO result. Differential NNLO cross sections are obtained from an implementation of qT subtraction in Sherpa. The two-loop virtual corrections to the qq¯→W+W- amplitude, used in both fixed-order and resummation predictions, are extracted from the public code qqvvamp. We perform resummation using soft collinear effective theory, with approximate beam functions where only the logarithmic terms are included at two-loop. In addition to scale uncertainties from the hard matching scale and the factorization scale, rapidity scale variationsmore » are obtained within the analytic regulator approach. Our resummation results show a decrease in the jet veto cross section compared to NNLO fixed-order predictions, with reduced scale uncertainties compared to NNLL+NLO resummed predictions. We include the loop-induced gg contribution with jet veto resummation to NLL+LO. The prediction shows good agreement with recent LHC measurements.« less

Improving the Slepton Reach through Cascade Decay at the LHC

NASA Astrophysics Data System (ADS)

Eckel, Jonathan; Su, Shufang; Shepherd, William

2011-10-01

LHC studies on the slepton sector have mostly been focused on direct slepton Drell-Yan pair production. We analyzed the case when the left-handed sleptons are lighter than winos and can appear in the on-shell decay of those particles. The invariant mass of the lepton pairs, Mll, from the neutralino decay has a distinctive triangle shape with a sharp cutoff. We discuss the utilization of the triangle shape in the Mll distribution to identify the slepton signal. We studied the trilepton signal and obtained the σxBR xacceptance that is needed for a 5 σ discovery as a function of the cutoff mass for the LHC with center of mass energy 14 TeV and 100 fb-1 integrated luminosity. Our results are model independent such that they could be applied to other models with similar decay topology. When applied to the MSSM case, it is found that with 30 (100) fb-1, the left-handed slepton mass of about 500 (600) GeV could be reached, which extends far beyond the slepton mass reach in the usual Drell-Yan study.

Automatic delineation of functional lung volumes with 68Ga-ventilation/perfusion PET/CT.

PubMed

Le Roux, Pierre-Yves; Siva, Shankar; Callahan, Jason; Claudic, Yannis; Bourhis, David; Steinfort, Daniel P; Hicks, Rodney J; Hofman, Michael S

2017-10-10

Functional volumes computed from 68 Ga-ventilation/perfusion (V/Q) PET/CT, which we have shown to correlate with pulmonary function test parameters (PFTs), have potential diagnostic utility in a variety of clinical applications, including radiotherapy planning. An automatic segmentation method would facilitate delineation of such volumes. The aim of this study was to develop an automated threshold-based approach to delineate functional volumes that best correlates with manual delineation. Thirty lung cancer patients undergoing both V/Q PET/CT and PFTs were analyzed. Images were acquired following inhalation of Galligas and, subsequently, intravenous administration of 68 Ga-macroaggreted-albumin (MAA). Using visually defined manual contours as the reference standard, various cutoff values, expressed as a percentage of the maximal pixel value, were applied. The average volume difference and Dice similarity coefficient (DSC) were calculated, measuring the similarity of the automatic segmentation and the reference standard. Pearson's correlation was also calculated to compare automated volumes with manual volumes, and automated volumes optimized to PFT indices. For ventilation volumes, mean volume difference was lowest (- 0.4%) using a 15%max threshold with Pearson's coefficient of 0.71. Applying this cutoff, median DSC was 0.93 (0.87-0.95). Nevertheless, limits of agreement in volume differences were large (- 31.0 and 30.2%) with differences ranging from - 40.4 to + 33.0%. For perfusion volumes, mean volume difference was lowest and Pearson's coefficient was highest using a 15%max threshold (3.3% and 0.81, respectively). Applying this cutoff, median DSC was 0.93 (0.88-0.93). Nevertheless, limits of agreement were again large (- 21.1 and 27.8%) with volume differences ranging from - 18.6 to + 35.5%. Using the 15%max threshold, moderate correlation was demonstrated with FEV1/FVC (r = 0.48 and r = 0.46 for ventilation and perfusion images, respectively). No correlation was found between other PFT indices. To automatically delineate functional volumes with 68 Ga-V/Q PET/CT, the most appropriate cutoff was 15%max for both ventilation and perfusion images. However, using this unique threshold systematically provided unacceptable variability compared to the reference volume and relatively poor correlation with PFT parameters. Accordingly, a visually adapted semi-automatic method is favored, enabling rapid and quantitative delineation of lung functional volumes with 68 Ga-V/Q PET/CT.

Rationale and Description of Right Ventricle-Protective Ventilation in ARDS.

PubMed

Paternot, Alexis; Repessé, Xavier; Vieillard-Baron, Antoine

2016-10-01

Pulmonary vascular dysfunction is associated with ARDS and leads to increased right-ventricular afterload and eventually right-ventricular failure, also called acute cor pulmonale. Interest in acute cor pulmonale and its negative impact on outcome in patients with ARDS has grown in recent years. Right-ventricular function in these patients should be closely monitored, and this is helped by the widespread use of echocardiography in intensive care units. Because mechanical ventilation may worsen right-ventricular failure, the interaction between the lungs and the right ventricle appears to be a key factor in the ventilation strategy. In this review, a rationale for a right ventricle-protective ventilation approach is provided, and such a strategy is described, including the reduction of lung stress (ie, the limitation of plateau pressure and driving pressure), the reduction of PaCO2 , and the improvement of oxygenation. Prone positioning seems to be a crucial part of this strategy by protecting both the lungs and the right ventricle, resulting in increased survival of patients with ARDS. Further studies are required to validate the positive impact on prognosis of right ventricle-protective mechanical ventilation. Copyright © 2016 by Daedalus Enterprises.

Ventilation Inception and Washout, Scaling, and Effects on Hydrodynamic Performance of a Surface Piercing Strut

NASA Astrophysics Data System (ADS)

Harwood, Casey; Young, Yin Lu; Ceccio, Steven

2014-11-01

High-lift devices that operate at or near a fluid free surface (such as surface-piercing or shallowly-submerged propellers and hydrofoils) are prone to a multiphase flow phenomenon called ventilation, wherein non-condensable gas is entrained in the low-pressure flow, forming a cavity around the body and dramatically altering the global hydrodynamic forces. Experiments are being conducted at the University of Michigan's towing tank using a canonical surface-piercing strut to investigate atmospheric ventilation. The goals of the work are (i) to gain an understanding of the dominant physics in fully wetted, partially ventilated, and fully ventilated flow regimes, (ii) to quantify the effects of governing dimensionless parameters on the transition between flow regimes, and (iii) to develop scaling relations for the transition between flow regimes. Using theoretical arguments and flow visualization techniques, new criteria are developed for classifying flow regimes and transition mechanisms. Unsteady transition mechanisms are described and mapped as functions of the governing non-dimensional parameters. A theoretical scaling relationship is developed for ventilation washout, which is shown to adequately capture the experimentally-observed washout boundary. This material is based upon work supported by the National Science Foundation Graduate Student Research Fellowship under Grant No. DGE 1256260. Support also comes from the Naval Engineering Education Center (Award No. N65540-10-C-003).

Ventilation/Perfusion Positron Emission Tomography—Based Assessment of Radiation Injury to Lung

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

Siva, Shankar, E-mail: shankar.siva@petermac.org; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville; Hardcastle, Nicholas

2015-10-01

Purpose: To investigate {sup 68}Ga-ventilation/perfusion (V/Q) positron emission tomography (PET)/computed tomography (CT) as a novel imaging modality for assessment of perfusion, ventilation, and lung density changes in the context of radiation therapy (RT). Methods and Materials: In a prospective clinical trial, 20 patients underwent 4-dimensional (4D)-V/Q PET/CT before, midway through, and 3 months after definitive lung RT. Eligible patients were prescribed 60 Gy in 30 fractions with or without concurrent chemotherapy. Functional images were registered to the RT planning 4D-CT, and isodose volumes were averaged into 10-Gy bins. Within each dose bin, relative loss in standardized uptake value (SUV) was recorded for ventilation andmore » perfusion, and loss in air-filled fraction was recorded to assess RT-induced lung fibrosis. A dose-effect relationship was described using both linear and 2-parameter logistic fit models, and goodness of fit was assessed with Akaike Information Criterion (AIC). Results: A total of 179 imaging datasets were available for analysis (1 scan was unrecoverable). An almost perfectly linear negative dose-response relationship was observed for perfusion and air-filled fraction (r{sup 2}=0.99, P<.01), with ventilation strongly negatively linear (r{sup 2}=0.95, P<.01). Logistic models did not provide a better fit as evaluated by AIC. Perfusion, ventilation, and the air-filled fraction decreased 0.75 ± 0.03%, 0.71 ± 0.06%, and 0.49 ± 0.02%/Gy, respectively. Within high-dose regions, higher baseline perfusion SUV was associated with greater rate of loss. At 50 Gy and 60 Gy, the rate of loss was 1.35% (P=.07) and 1.73% (P=.05) per SUV, respectively. Of 8/20 patients with peritumoral reperfusion/reventilation during treatment, 7/8 did not sustain this effect after treatment. Conclusions: Radiation-induced regional lung functional deficits occur in a dose-dependent manner and can be estimated by simple linear models with 4D-V/Q PET/CT imaging. These findings may inform future studies of functional lung avoidance using V/Q PET/CT.« less

NNLO splitting and coefficient functions with time-like kinematics

NASA Astrophysics Data System (ADS)

Mitov, A.; Moch, S.; Vogt, A.

2006-10-01

We discuss recent results on the three-loop (next-to-next-to-leading order, NNLO) time-like splitting functions of QCD and the two-loop (NNLO) coefficient functions in one-particle inclusive e+e--annihilation. These results form the basis for extracting fragmentation functions for light and heavy flavors with NNLO accuracy that will be needed at the LHC and ILC. The two-loop calculations have been performed in Mellin space based on a new method, the main features of which we also describe briefly.

Control technology for integrated circuit fabrication at Micro-Circuit Engineering, Incorporated, West Palm Beach, Florida

NASA Astrophysics Data System (ADS)

Mihlan, G. I.; Mitchell, R. I.; Smith, R. K.

1984-07-01

A survey to assess control technology for integrated circuit fabrication was conducted. Engineering controls included local and general exhaust ventilation, shielding, and personal protective equipment. Devices or work stations that contained toxic materials that were potentially dangerous were controlled by local exhaust ventilation. Less hazardous areas were controlled by general exhaust ventilation. Process isolation was used in the plasma etching, low pressure chemical vapor deposition, and metallization operations. Shielding was used in ion implantation units to control X-ray emissions, in contact mask alignes to limit ultraviolet (UV) emissions, and in plasma etching units to control radiofrequency and UV emissions. Most operations were automated. Use of personal protective equipment varied by job function.

Longitudinal assessment of treatment effects on pulmonary ventilation using 1H/3He MRI multivariate templates

NASA Astrophysics Data System (ADS)

Tustison, Nicholas J.; Contrella, Benjamin; Altes, Talissa A.; Avants, Brian B.; de Lange, Eduard E.; Mugler, John P.

2013-03-01

The utitlity of pulmonary functional imaging techniques, such as hyperpolarized 3He MRI, has encouraged their inclusion in research studies for longitudinal assessment of disease progression and the study of treatment effects. We present methodology for performing voxelwise statistical analysis of ventilation maps derived from hyper­ polarized 3He MRI which incorporates multivariate template construction using simultaneous acquisition of IH and 3He images. Additional processing steps include intensity normalization, bias correction, 4-D longitudinal segmentation, and generation of expected ventilation maps prior to voxelwise regression analysis. Analysis is demonstrated on a cohort of eight individuals with diagnosed cystic fibrosis (CF) undergoing treatment imaged five times every two weeks with a prescribed treatment schedule.

Indoor air quality in a middle school, Part I: Use of CO2 as a tracer for effective ventilation.

PubMed

Scheff, P A; Paulius, V K; Huang, S W; Conroy, L M

2000-11-01

The overall objective of the study was to evaluate the indoor air quality at a middle school with an emphasis on characterizing baseline conditions. The focus of this article is on the relationship between occupancy and measured concentrations of carbon dioxide, and an evaluation of the use of carbon dioxide as a tracer for ventilation in the school. The school was characterized as having no health complaints, good maintenance schedules, no carpeting within the classrooms or hallways, and no significant remodeling, and its officials had agreed to allow the sampling to take place during school hours. Monitoring followed the guidelines recommended in the "Preliminary Draft: Conceptual Standardized EPA Protocol For Characterizing Indoor Air Quality in School Buildings." Four indoor locations including the cafeteria, a science classroom, an art classroom, and the lobby outside the main office, and one outdoor location were sampled for various environmental comfort and pollutant parameters for one week in February 1997. A consistent relationship between hourly occupancy and corresponding carbon dioxide concentrations was seen. Carbon dioxide concentrations in the cafeteria, art room, and lobby were within specified American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) guidelines for comfort (< 1000 ppm). The science room had the highest concentrations (frequently exceeding 1000 ppm) due to high occupancy and non-functioning unit ventilators. Measured ventilation rates were within specified ASHRAE guidelines for the art room, cafeteria, and lobby. The science room, which relied on natural ventilation only, was not able to meet the ASHRAE guideline on one of the three days studied. The use of a completely mixed space, one compartment mass balance model with estimated CO2 generation rates and measured CO2 concentrations is shown to be a useful method for evaluating ventilation. Modeled effective ventilation, air changes per hour, and mixing factors reflected measured carbon dioxide concentrations and measured ventilation in each room. Mechanical ventilation afforded better mixing than natural ventilation. This study demonstrates the usefulness of collecting indoor CO2 and occupancy data when carrying out indoor air quality evaluations in schools.

Electrical impedance tomography during major open upper abdominal surgery: a pilot-study

PubMed Central

2014-01-01

Background Electrical impedance tomography (EIT) of the lungs facilitates visualization of ventilation distribution during mechanical ventilation. Its intraoperative use could provide the basis for individual optimization of ventilator settings, especially in patients at risk for ventilation-perfusion mismatch and impaired gas exchange, such as patients undergoing major open upper abdominal surgery. EIT throughout major open upper abdominal surgery could encounter difficulties in belt positioning and signal quality. Thus, we conducted a pilot-study and tested whether EIT is feasible in patients undergoing major open upper abdominal surgery. Methods Following institutional review board’s approval and written informed consent, we included patients scheduled for major open upper abdominal surgery of at least 3 hours duration. EIT measurements were conducted prior to intubation, at the time of skin incision, then hourly during surgery until shortly prior to extubation and after extubation. Number of successful intraoperative EIT measurements and reasons for failures were documented. From the valid measurements, a functional EIT image of changes in tidal impedance was generated for every time point. Regions of interest were defined as horizontal halves of the picture. Monitoring of ventilation distribution was assessed using the center of ventilation index, and also using the total and dorsal ventilated lung area. All parameter values prior to and post intubation as well as extubation were compared. A p < 0.05 was considered statistically significant. Results A total of 120 intraoperative EIT measurements during major abdominal surgery lasting 4-13 hours were planned in 14 patients. The electrode belt was attached between the 2nd and 4th intercostal space. Consecutive valid measurements could be acquired in 13 patients (93%). 111 intraoperative measurements could be retrieved as planned (93%). Main obstacle was the contact of skin electrodes. Despite the high belt position, distribution of tidal volume showed a significant shift of ventilation towards ventral lung regions after intubation. This was reversed after weaning from mechanical ventilation. Conclusions Despite a high belt position, monitoring of ventilation distribution is feasible in patients undergoing major open upper abdominal surgery lasting from 4 to 13 hours. Therefore, further interventional trials in order to optimize ventilatory management should be initiated. PMID:25018668

Extra corporeal membrane oxygenation to facilitate lung protective ventilation and prevent ventilator-induced lung injury in severe Pneumocystis pneumonia with pneumomediastinum: a case report and short literature review.

PubMed

Ali, Husain Shabbir; Hassan, Ibrahim Fawzy; George, Saibu

2016-04-14

Pulmonary infections caused by Pneumocystis jirovecii in immunocompromised host can be associated with cysts, pneumatoceles and air leaks that can progress to pneumomediastinum and pneumothoraxes. In such cases, it can be challenging to maintain adequate gas exchange by conventional mechanical ventilation and at the same time prevent further ventilator-induced lung injury. We report a young HIV positive male with poorly compliant lungs and pneumomediastinum secondary to severe Pneumocystis infection, rescued with veno-venous extra corporeal membrane oxygenation (V-V ECMO). A 26 year old male with no significant past medical history was admitted with fever, cough and shortness of breath. He initially required non-invasive ventilation for respiratory failure. However, his respiratory function progressively deteriorated due to increasing pulmonary infiltrates and development of pneumomediastinum, eventually requiring endotracheal intubation and invasive ventilation. Despite attempts at optimizing gas exchange by ventilatory maneuvers, patients' pulmonary parameters worsened necessitating rescue ECMO therapy. The introduction of V-V ECMO facilitated the use of ultra-protective lung ventilation and prevented progression of pneumomediastinum, maintaining optimal gas exchange. It allowed time for the antibiotics to show effect and pulmonary parenchyma to heal. Further diagnostic workup revealed Pneumocystis jirovecii as the causative organism for pneumonia and serology confirmed Human Immunodeficiency Virus infection. Patient was successfully treated with appropriate antimicrobials and de-cannulated after six days of ECMO support. ECMO was an effective salvage therapy in HIV positive patient with an otherwise fatal respiratory failure due to Pneumocystis pneumonia and air leak syndrome.

Respiratory mechanics in mechanically ventilated patients.

PubMed

Hess, Dean R

2014-11-01

Respiratory mechanics refers to the expression of lung function through measures of pressure and flow. From these measurements, a variety of derived indices can be determined, such as volume, compliance, resistance, and work of breathing. Plateau pressure is a measure of end-inspiratory distending pressure. It has become increasingly appreciated that end-inspiratory transpulmonary pressure (stress) might be a better indicator of the potential for lung injury than plateau pressure alone. This has resulted in a resurgence of interest in the use of esophageal manometry in mechanically ventilated patients. End-expiratory transpulmonary pressure might also be useful to guide the setting of PEEP to counterbalance the collapsing effects of the chest wall. The shape of the pressure-time curve might also be useful to guide the setting of PEEP (stress index). This has focused interest in the roles of stress and strain to assess the potential for lung injury during mechanical ventilation. This paper covers both basic and advanced respiratory mechanics during mechanical ventilation. Copyright © 2014 by Daedalus Enterprises.

[Diaphragm pacing for the ventilatory support of the quadriplegic patients with respiratory paralysis].

PubMed

Cheng, H; Wang, L S; Pan, H C; Shoung, H M; Lee, L S

1992-02-01

Electrical stimulation of the phrenic nerve to pace the diaphragm in patients with chronic ventilatory insufficiency has been an established therapeutic modality since William W.L. Glenn first described using radiofrequency signals in 1978 to stimulate the phrenic nerves. Before this event, patients who were ventilator-dependent and thus bedridden because of respiratory paralysis associated with quadriplegia usually anticipated little chance for physical or psychosocial rehabilitation. Two cases of C1-C2 subluxtion with cord injury and chronic ventilatory insufficiency were implanted at VGH-Taipei with diaphragm pacemaker in 1988. Postoperative phrenic nerve stimulation was given according to individual training schedule. One case with total phrenic paralysis received bilateral phrenic nerve stimulation and became weaned from the ventilator 6 months later. The other case with partially active ventilatory function received unilateral phrenic nerve stimulation to compensate the ventilation. However, its final outcome still showed the necessity of a bilateral mode to achieve adequate ventilation irrespective of strenuous training for 2 years.

The necessity of HVAC system for the registered architectural cultural heritage building

NASA Astrophysics Data System (ADS)

Popovici, Cătălin George; Hudişteanu, Sebastian Valeriu; Cherecheş, Nelu-Cristian

2018-02-01

This study is intended to highlight the role of the ventilation and air conditioning system for a theatre. It was chosen as a case study the "Vasile Alecsandri" National Theatre of Jassy. The paper also sought to make a comparison in three distinct scenarios for HVAC Main Hall system - ventilation and air conditioning system of the Main Hall doesn't work; only the ventilation system of the Main Hall works and ventilation and air conditioning system of the Main Hall works. For analysing the comfort parameters, the ANSYS-Fluent software was used to build a 2D model of the building and simulation of HVAC system functionality during winter season, in all three scenarios. For the studied scenarios, the external conditions of Jassy and the indoor conditions of the theatre, when the entire spectacle hall is occupied were considered. The main aspects evaluated for each case were the air temperature, air velocity and relative humidity. The results are presented comparatively as plots and spectra of the interest parameters.

The effects of "psychological inoculation" versus ventilation on the mental resilience of Israeli citizens under continuous war stress.

PubMed

Farchi, Moshe; Gidron, Yori

2010-05-01

Anxiety and hopelessness are common reactions of citizens exposed to continuous war threats. Common interventions focus on support, calming, and emotional ventilation, with few attempts to reduce people's cognitive barriers concerning active coping, which could increase their resilience. This study tested the effects of psychological inoculation (PI), which specifically aims to challenge such barriers, on the mental resilience of Israeli citizens living in Sderot. Participants were randomly assigned to either 2 PI sessions or 2 ventilation sessions, provided over the phone. Anxiety, helplessness, pessimism, and functioning were briefly assessed at baseline and 1 week after interventions. No time, group, or group x time interactions were observed. However, a time x group x sex interaction emerged for helplessness: Men benefited from the PI whereas women benefited from ventilation, in reducing helplessness. Under chronic war stress, it seems difficult to improve people's resilience, although PI may be partly beneficial for men. Further research is needed to test the effects of PI on mental resilience.

Effect of hypoxic breathing on cutaneous temperature recovery in man

NASA Astrophysics Data System (ADS)

Fahim, Mohammad

1992-03-01

Effect of hypoxia (12% O2) on skin temperature recovery was studied on healthy young men. Forty male volunteers free of any respiratory disorder were randomly selected to participate in the study. Skin temperature, peripheral blood flow, heart rate and end expiratory PO2 and PCO2 were measured. During hyoxic ventilation the peripheral blood flow was reduced and a corresponding drop in skin temperature occurred. This was partly due to hyperventilation associated with hypoxic ventilation. The recovery of skin temperature after cooling the hand for 2 min in cold water (10 12° C) took 5.5±0.1 min during normal air breathing; during hypoxic ventilation even after 9.1±0.3 min when the skin temperature recovery curve plateaued, the skin temperature remained about 2° C below control. The results of the present investigation indicate that hypoxia interferes with the normal functioning of the thermoregulatory mechanism in man. Hyperventilation associated with hypoxic ventilation is also partly responsible for incomplete recovery of skin temperature.

Volunteer Clouds and Citizen Cyberscience for LHC Physics

NASA Astrophysics Data System (ADS)

Aguado Sanchez, Carlos; Blomer, Jakob; Buncic, Predrag; Chen, Gang; Ellis, John; Garcia Quintas, David; Harutyunyan, Artem; Grey, Francois; Lombrana Gonzalez, Daniel; Marquina, Miguel; Mato, Pere; Rantala, Jarno; Schulz, Holger; Segal, Ben; Sharma, Archana; Skands, Peter; Weir, David; Wu, Jie; Wu, Wenjing; Yadav, Rohit

2011-12-01

Computing for the LHC, and for HEP more generally, is traditionally viewed as requiring specialized infrastructure and software environments, and therefore not compatible with the recent trend in "volunteer computing", where volunteers supply free processing time on ordinary PCs and laptops via standard Internet connections. In this paper, we demonstrate that with the use of virtual machine technology, at least some standard LHC computing tasks can be tackled with volunteer computing resources. Specifically, by presenting volunteer computing resources to HEP scientists as a "volunteer cloud", essentially identical to a Grid or dedicated cluster from a job submission perspective, LHC simulations can be processed effectively. This article outlines both the technical steps required for such a solution and the implications for LHC computing as well as for LHC public outreach and for participation by scientists from developing regions in LHC research.

The use of equine surfactant and positive pressure ventilation to treat a premature alpaca cria with severe hypoventilation and hypercapnia

PubMed Central

Tinkler, Stacy H.; Mathews, Lindsey A.; Firshman, Anna M.; Quandt, Jane E.

2015-01-01

A 5-hour-old, premature alpaca cria was presented with failure to nurse, weakness, hypoglycemia, hypercapnia, and respiratory distress. The cria was treated with 3 doses of fresh, crude equine surfactant, positive pressure ventilation, and supplemental intranasal oxygen. Recovery to discharge was uneventful, and the cria regained apparently normal respiratory function. Three years after hospital discharge, the alpaca was a healthy adult. PMID:25829556

Regional distribution of ventilation assessed by Kr-81m scintigraphy employing temporal Fourier transform

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

Slosman, D.; Susskind, H.; Cinotti, L.

1986-01-01

Temporal Fourier analysis was applied to Kr-81m ventilation scintigraphy to determine the amplitude (AMP1) and phase (PHA1) of the first harmonic of a single composite respiratory cycle and to compare regional patterns in subjects with obstructive pulmonary disease (COPD) and nonobstructed subjects. Six nonobstructed subjects, three subjects with small airway disease, six subjects with COPD, and one subject with restrictive disease were investigated. The mean value of the functional PHA1 image (PHA1m) correlated negatively with 1-second forced expiratory volume (FEV1) (r = -0.801, P less than .001), with %FEV1/FVC (r = -0.636, P less than .01) and maximum midexpiratory flowmore » rate (FEF25-75%) (r = -0.723, P less than .002), and correlated positively with residual volume (r = 0.640, P less than .01). PHA1m values for the six subjects with COPD were significantly higher (t = 2.359, P less than .05) than for the ten nonobstructed subjects. Display of phase and amplitude functional images permits a visual evaluation of the regional distribution of ventilation to be made. Regional abnormalities of air flow were detected in obstructed subjects, and the presence of airway obstruction could be predicted. Dynamic ventilation imaging, therefore, appears to be a potentially useful noninvasive technique to assess lung impairment on a localized level.« less

Respiratory Toxicity of Dimethyl Sulfoxide.

PubMed

Takeda, Kotaro; Pokorski, Mieczyslaw; Sato, Yutaka; Oyamada, Yoshitaka; Okada, Yasumasa

2016-01-01

Dimethyl sulfoxide (DMSO) is one of the most commonly used solvents for hydrophobic substances in biological experiments. In addition, the compound exhibits a plethora of bioactivities, which makes it of potential pharmacological use of its own. The influence on respiration, and thus on arterial blood oxygenation, of DMSO is unclear, contentious, and an area of limited study. Thus, in the present investigation we set out to determine the influence on lung ventilation of cumulated doses of DMSO in the amount of 0.5, 1.5, 3.5, 7.5, and 15.5 g/kg; each dose given intraperitoneally at 1 h interval in conscious mice. Ventilation and its responses to 7 % hypoxia (N(2) balanced) were recorded in a whole body plethsymograph. We demonstrate a dose-dependent inhibitory effect of DMSO on lung ventilation and its hypoxic responsiveness, driven mostly by changes in the tidal component. The maximum safe dose of DMSO devoid of meaningful consequences for respiratory function was 3.5 g/kg. The dose of 7.5 g/kg of DMSO significantly dampened respiration, with yet well preserved hyperventilatory response to hypoxia. The highest dose of 15.5 g/kg severely impaired ventilation and its responses. The study delineates the safety profile of DMSO regarding the respiratory function which is essential for maintaining proper tissue oxygenation. Caution should be exercised concerning dose concentration of DMSO.

[MRI methods for pulmonary ventilation and perfusion imaging].

PubMed

Sommer, G; Bauman, G

2016-02-01

Separate assessment of respiratory mechanics, gas exchange and pulmonary circulation is essential for the diagnosis and therapy of pulmonary diseases. Due to the global character of the information obtained clinical lung function tests are often not sufficiently specific in the differential diagnosis or have a limited sensitivity in the detection of early pathological changes. The standard procedures of pulmonary imaging are computed tomography (CT) for depiction of the morphology as well as perfusion/ventilation scintigraphy and single photon emission computed tomography (SPECT) for functional assessment. Magnetic resonance imaging (MRI) with hyperpolarized gases, O2-enhanced MRI, MRI with fluorinated gases and Fourier decomposition MRI (FD-MRI) are available for assessment of pulmonary ventilation. For assessment of pulmonary perfusion dynamic contrast-enhanced MRI (DCE-MRI), arterial spin labeling (ASL) and FD-MRI can be used. Imaging provides a more precise insight into the pathophysiology of pulmonary function on a regional level. The advantages of MRI are a lack of ionizing radiation, which allows a protective acquisition of dynamic data as well as the high number of available contrasts and therefore accessible lung function parameters. Sufficient clinical data exist only for certain applications of DCE-MRI. For the other techniques, only feasibility studies and case series of different sizes are available. The clinical applicability of hyperpolarized gases is limited for technical reasons. The clinical application of the techniques described, except for DCE-MRI, should be restricted to scientific studies.

Gill remodelling during terrestrial acclimation reduces aquatic respiratory function of the amphibious fish Kryptolebias marmoratus.

PubMed

Turko, Andy J; Cooper, Chris A; Wright, Patricia A

2012-11-15

The skin-breathing amphibious fish Kryptolebias marmoratus experiences rapid environmental changes when moving between water- and air-breathing, but remodelling of respiratory morphology is slower (~1 week). We tested the hypotheses that (1) there is a trade-off in respiratory function of gills displaying aquatic versus terrestrial morphologies and (2) rapidly increased gill ventilation is a mechanism to compensate for reduced aquatic respiratory function. Gill surface area, which varied inversely to the height of the interlamellar cell mass, was increased by acclimating fish for 1 week to air or low ion water, or decreased by acclimating fish for 1 week to hypoxia (~20% dissolved oxygen saturation). Fish were subsequently challenged with acute hypoxia, and gill ventilation or oxygen uptake was measured. Fish with reduced gill surface area increased ventilation at higher dissolved oxygen levels, showed an increased critical partial pressure of oxygen and suffered impaired recovery compared with brackish water control fish. These results indicate that hyperventilation, a rapid compensatory mechanism, was only able to maintain oxygen uptake during moderate hypoxia in fish that had remodelled their gills for land. Thus, fish moving between aquatic and terrestrial habitats may benefit from cutaneously breathing oxygen-rich air, but upon return to water must compensate for a less efficient branchial morphology (mild hypoxia) or suffer impaired respiratory function (severe hypoxia).

[Phrenic nerve stimulation protects against mechanical ventilation-induced diaphragmatic dysfunction through myogenic regulatory factors].

PubMed

An, G H; Chen, M; Zhan, W F; Hu, B; Zhang, H X

2018-02-12

Objective: To explore the protective effect of electrical stimulation of phrenic nerve on diaphragmatic function during mechanical ventilation. Methods: Forty healthy adult SD rats were randomly divided into 5 groups: blank control group (BC), spontaneous breathing group (SB), electrical stimulation group (ES), mechanical ventilation group (MV), and electrical stimulation and mechanical ventilation group (MS). The rats in each group were treated for 18 h except for the BC group. After treatment, the diaphragm muscle tissue was obtained and the diaphragm contractility including peak-to-peak value(Vpp) and maximum rate of contraction(+ dT/dt max) were measured. Expression of MyoD and myogenin were detected. Results: Except for the ES and the MS groups, there was a significant difference for peak-to-peak value (Vpp) between each 2 groups ( P <0.05). Expression levels of MyoD in treatment groups were also significantly different ( P <0.05). Expressions of MS(Q-PCR 2(-ΔΔCt) value: 11.66±2.80) and MV(Q-PCR 2(-ΔΔCt) value: 40.89±24.71) in the treatment group were significantly different ( P <0.05). The expression of myogenin in the MS and the MV groups were significantly different from those of the BC group( P <0.05), however there was no significant difference between the MS(Q-PCR 2(-ΔΔCt) value: 2.58±2.75) and the MV group(Q-PCR 2(-ΔΔCt) value: 1.63±0.71). Conclusions: Electrical stimulation of the phrenic nerve can change the expression level of MyoD and myogenin to offset mechanical ventilation induced diaphragmatic function damage, and therefore plays a protective effect on the diaphragm.

Role of non-invasive ventilation (NIV) in the perioperative period.

PubMed

Jaber, Samir; Michelet, Pierre; Chanques, Gerald

2010-06-01

Anaesthesia, postoperative pain and surgery (more so if the site of the surgery approaches the diaphragm) will induce respiratory modifications: hypoxaemia, pulmonary volume decrease and atelectasis associated to a restrictive syndrome and a diaphragm dysfunction. These modifications of the respiratory function occur early after surgery and may induce acute respiratory failure (ARF). Maintenance of adequate oxygenation in the postoperative period is of major importance, especially when pulmonary complications such as ARF occur. Non-invasive ventilation (NIV) refers to techniques allowing respiratory support without the need of endotracheal intubation. Two types of NIV are commonly used: noninvasive continuous positive airway pressure (CPAP) and noninvasive positive pressure ventilation (NPPV) which delivers two levels of positive pressure (pressure support ventilation + positive end-expiratory pressure). NIV may be an important tool to prevent (prophylactic treatment) or to treat ARF avoiding intubation (curative treatment). The aims of NIV are: (1) to partially compensate for the affected respiratory function by reducing the work of breathing, (2) to improve alveolar recruitment with better gas exchange (oxygenation and ventilation) and (3) to reduce left ventricular after load increasing cardiac output and improving haemodynamics. Evidence suggests that NIV, as a prophylactic or curative treatment, has been proven to be an effective strategy to reduce intubation rates, nosocomial infections, intensive care unit and hospital lengths of stay, morbidity and mortality in postoperative patients. However, before initiating NIV, any surgical complication must be treated. The aims of this article are (1) to describe the rationale behind the application of NIV, (2) to report indications (including induction of anaesthesia) and contraindications and (3) to offer some algorithms for safe usage of NIV in high-risk surgery patients.

Effect of Dexmedetomidine on Mortality and Ventilator-Free Days in Patients Requiring Mechanical Ventilation With Sepsis

PubMed Central

Kawazoe, Yu; Miyamoto, Kyohei; Morimoto, Takeshi; Yamamoto, Tomonori; Fuke, Akihiro; Hashimoto, Atsunori; Koami, Hiroyuki; Beppu, Satoru; Katayama, Yoichi; Itoh, Makoto; Ohta, Yoshinori

2017-01-01

Importance Dexmedetomidine provides sedation for patients undergoing ventilation; however, its effects on mortality and ventilator-free days have not been well studied among patients with sepsis. Objectives To examine whether a sedation strategy with dexmedetomidine can improve clinical outcomes in patients with sepsis undergoing ventilation. Design, Setting, and Participants Open-label, multicenter randomized clinical trial conducted at 8 intensive care units in Japan from February 2013 until January 2016 among 201 consecutive adult patients with sepsis requiring mechanical ventilation for at least 24 hours. Interventions Patients were randomized to receive either sedation with dexmedetomidine (n = 100) or sedation without dexmedetomidine (control group; n = 101). Other agents used in both groups were fentanyl, propofol, and midazolam. Main Outcomes and Measures The co–primary outcomes were mortality and ventilator-free days (over a 28-day duration). Sequential Organ Failure Assessment score (days 1, 2, 4, 6, 8), sedation control, occurrence of delirium and coma, intensive care unit stay duration, renal function, inflammation, and nutrition state were assessed as secondary outcomes. Results Of the 203 screened patients, 201 were randomized. The mean age was 69 years (SD, 14 years); 63% were male. Mortality at 28 days was not significantly different in the dexmedetomidine group vs the control group (19 patients [22.8%] vs 28 patients [30.8%]; hazard ratio, 0.69; 95% CI, 0.38-1.22; P = .20). Ventilator-free days over 28 days were not significantly different between groups (dexmedetomidine group: median, 20 [interquartile range, 5-24] days; control group: median, 18 [interquartile range, 0.5-23] days; P = .20). The dexmedetomidine group had a significantly higher rate of well-controlled sedation during mechanical ventilation (range, 17%-58% vs 20%-39%; P = .01); other outcomes were not significantly different between groups. Adverse events occurred in 8 (8%) and 3 (3%) patients in the dexmedetomidine and control groups, respectively. Conclusions and Relevance Among patients requiring mechanical ventilation, the use of dexmedetomidine compared with no dexmedetomidine did not result in statistically significant improvement in mortality or ventilator-free days. However, the study may have been underpowered for mortality, and additional research may be needed to evaluate this further. Trial Registration clinicaltrials.gov Identifier: NCT01760967 PMID:28322414

Estimation of Lung Ventilation

NASA Astrophysics Data System (ADS)

Ding, Kai; Cao, Kunlin; Du, Kaifang; Amelon, Ryan; Christensen, Gary E.; Raghavan, Madhavan; Reinhardt, Joseph M.

Since the primary function of the lung is gas exchange, ventilation can be interpreted as an index of lung function in addition to perfusion. Injury and disease processes can alter lung function on a global and/or a local level. MDCT can be used to acquire multiple static breath-hold CT images of the lung taken at different lung volumes, or with proper respiratory control, 4DCT images of the lung reconstructed at different respiratory phases. Image registration can be applied to this data to estimate a deformation field that transforms the lung from one volume configuration to the other. This deformation field can be analyzed to estimate local lung tissue expansion, calculate voxel-by-voxel intensity change, and make biomechanical measurements. The physiologic significance of the registration-based measures of respiratory function can be established by comparing to more conventional measurements, such as nuclear medicine or contrast wash-in/wash-out studies with CT or MR. An important emerging application of these methods is the detection of pulmonary function change in subjects undergoing radiation therapy (RT) for lung cancer. During RT, treatment is commonly limited to sub-therapeutic doses due to unintended toxicity to normal lung tissue. Measurement of pulmonary function may be useful as a planning tool during RT planning, may be useful for tracking the progression of toxicity to nearby normal tissue during RT, and can be used to evaluate the effectiveness of a treatment post-therapy. This chapter reviews the basic measures to estimate regional ventilation from image registration of CT images, the comparison of them to the existing golden standard and the application in radiation therapy.

LHC@Home: a BOINC-based volunteer computing infrastructure for physics studies at CERN

NASA Astrophysics Data System (ADS)

Barranco, Javier; Cai, Yunhai; Cameron, David; Crouch, Matthew; Maria, Riccardo De; Field, Laurence; Giovannozzi, Massimo; Hermes, Pascal; Høimyr, Nils; Kaltchev, Dobrin; Karastathis, Nikos; Luzzi, Cinzia; Maclean, Ewen; McIntosh, Eric; Mereghetti, Alessio; Molson, James; Nosochkov, Yuri; Pieloni, Tatiana; Reid, Ivan D.; Rivkin, Lenny; Segal, Ben; Sjobak, Kyrre; Skands, Peter; Tambasco, Claudia; Veken, Frederik Van der; Zacharov, Igor

2017-12-01

The LHC@Home BOINC project has provided computing capacity for numerical simulations to researchers at CERN since 2004, and has since 2011 been expanded with a wider range of applications. The traditional CERN accelerator physics simulation code SixTrack enjoys continuing volunteers support, and thanks to virtualisation a number of applications from the LHC experiment collaborations and particle theory groups have joined the consolidated LHC@Home BOINC project. This paper addresses the challenges related to traditional and virtualized applications in the BOINC environment, and how volunteer computing has been integrated into the overall computing strategy of the laboratory through the consolidated LHC@Home service. Thanks to the computing power provided by volunteers joining LHC@Home, numerous accelerator beam physics studies have been carried out, yielding an improved understanding of charged particle dynamics in the CERN Large Hadron Collider (LHC) and its future upgrades. The main results are highlighted in this paper.

Physics perspectives with AFTER@LHC (A Fixed Target ExpeRiment at LHC)

NASA Astrophysics Data System (ADS)

Massacrier, L.; Anselmino, M.; Arnaldi, R.; Brodsky, S. J.; Chambert, V.; Da Silva, C.; Didelez, J. P.; Echevarria, M. G.; Ferreiro, E. G.; Fleuret, F.; Gao, Y.; Genolini, B.; Hadjidakis, C.; Hřivnáčová, I.; Kikola, D.; Klein, A.; Kurepin, A.; Kusina, A.; Lansberg, J. P.; Lorcé, C.; Lyonnet, F.; Martinez, G.; Nass, A.; Pisano, C.; Robbe, P.; Schienbein, I.; Schlegel, M.; Scomparin, E.; Seixas, J.; Shao, H. S.; Signori, A.; Steffens, E.; Szymanowski, L.; Topilskaya, N.; Trzeciak, B.; Uggerhøj, U. I.; Uras, A.; Ulrich, R.; Wagner, J.; Yamanaka, N.; Yang, Z.

2018-02-01

AFTER@LHC is an ambitious fixed-target project in order to address open questions in the domain of proton and neutron spins, Quark Gluon Plasma and high-x physics, at the highest energy ever reached in the fixed-target mode. Indeed, thanks to the highly energetic 7 TeV proton and 2.76 A.TeV lead LHC beams, center-of-mass energies as large as = 115 GeV in pp/pA and = 72 GeV in AA can be reached, corresponding to an uncharted energy domain between SPS and RHIC. We report two main ways of performing fixed-target collisions at the LHC, both allowing for the usage of one of the existing LHC experiments. In these proceedings, after discussing the projected luminosities considered for one year of data taking at the LHC, we will present a selection of projections for light and heavy-flavour production.

Thermomechanical assessment of the effects of a jaw-beam angle during beam impact on Large Hadron Collider collimators

NASA Astrophysics Data System (ADS)

Cauchi, Marija; Assmann, R. W.; Bertarelli, A.; Carra, F.; Lari, L.; Rossi, A.; Mollicone, P.; Sammut, N.

2015-02-01

The correct functioning of a collimation system is crucial to safely and successfully operate high-energy particle accelerators, such as the Large Hadron Collider (LHC). However, the requirements to handle high-intensity beams can be demanding, and accident scenarios must be well studied in order to assess if the collimator design is robust against possible error scenarios. One of the catastrophic, though not very probable, accident scenarios identified within the LHC is an asynchronous beam dump. In this case, one (or more) of the 15 precharged kicker circuits fires out of time with the abort gap, spraying beam pulses onto LHC machine elements before the machine protection system can fire the remaining kicker circuits and bring the beam to the dump. If a proton bunch directly hits a collimator during such an event, severe beam-induced damage such as magnet quenches and other equipment damage might result, with consequent downtime for the machine. This study investigates a number of newly defined jaw error cases, which include angular misalignment errors of the collimator jaw. A numerical finite element method approach is presented in order to precisely evaluate the thermomechanical response of tertiary collimators to beam impact. We identify the most critical and interesting cases, and show that a tilt of the jaw can actually mitigate the effect of an asynchronous dump on the collimators. Relevant collimator damage limits are taken into account, with the aim to identify optimal operational conditions for the LHC.

Upgrade of Tile Calorimeter of the ATLAS Detector for the High Luminosity LHC.

NASA Astrophysics Data System (ADS)

Valdes Santurio, Eduardo; Tile Calorimeter System, ATLAS

2017-11-01

The Tile Calorimeter (TileCal) is the hadronic calorimeter of ATLAS covering the central region of the ATLAS experiment. TileCal is a sampling calorimeter with steel as absorber and scintillators as active medium. The scintillators are read out by wavelength shifting fibers coupled to photomultiplier tubes (PMT). The analogue signals from the PMTs are amplified, shaped and digitized by sampling the signal every 25 ns. The High Luminosity Large Hadron Collider (HL-LHC) will have a peak luminosity of 5 × 1034 cm -2 s -1, five times higher than the design luminosity of the LHC. TileCal will undergo a major replacement of its on- and off-detector electronics for the high luminosity programme of the LHC in 2026. The calorimeter signals will be digitized and sent directly to the off-detector electronics, where the signals are reconstructed and shipped to the first level of trigger at a rate of 40 MHz. This will provide a better precision of the calorimeter signals used by the trigger system and will allow the development of more complex trigger algorithms. Three different options are presently being investigated for the front-end electronic upgrade. Extensive test beam studies will determine which option will be selected. Field Programmable Gate Arrays (FPGAs) are extensively used for the logic functions of the off- and on-detector electronics. One hybrid demonstrator prototype module with the new calorimeter module electronics, but still compatible with the present system, may be inserted in ATLAS at the end of 2016.

Radiation tolerant power converter controls

NASA Astrophysics Data System (ADS)

Todd, B.; Dinius, A.; King, Q.; Uznanski, S.

2012-11-01

The Large Hadron Collider (LHC) at the European Organisation for Nuclear Research (CERN) is the world's most powerful particle collider. The LHC has several thousand magnets, both warm and super-conducting, which are supplied with current by power converters. Each converter is controlled by a purpose-built electronic module called a Function Generator Controller (FGC). The FGC allows remote control of the power converter and forms the central part of a closed-loop control system where the power converter voltage is set, based on the converter output current and magnet-circuit characteristics. Some power converters and FGCs are located in areas which are exposed to beam-induced radiation. There are numerous radiation induced effects, some of which lead to a loss of control of the power converter, having a direct impact upon the accelerator's availability. Following the first long shut down (LS1), the LHC will be able to run with higher intensity beams and higher beam energy. This is expected to lead to significantly increased radiation induced effects in materials close to the accelerator, including the FGC. Recent radiation tests indicate that the current FGC would not be sufficiently reliable. A so-called FGClite is being designed to work reliably in the radiation environment in the post-LS1 era. This paper outlines the concepts of power converter controls for machines such as the LHC, introduces the risks related to radiation and a radiation tolerant project flow. The FGClite is then described, with its key concepts and challenges: aiming for high reliability in a radiation field.

Study of performance of the ATLAS transition radiation tracker in run 1 of the LHC: Tracking characteristics

NASA Astrophysics Data System (ADS)

Belyaev, N.; Krasnopevtsev, D.; Smirnov, N.

2018-01-01

The ATLAS Transition Radiation Tracker (TRT) contains more than 350000 large straw tubes and it is the outermost of the three subsystems of the ATLAS Inner Detector (ID). The TRT contributes substantially to the ATLAS ID resolution for the tracks of high-energy particles, providing excellent particle identification capabilities and electron-pion separation. Basic performance parameters of the TRT related to its tracking function are described in this paper. The data used in this study were collected during the first period of the Large Hadron Collider (LHC) operation in 2012 with a proton collision energy of 8 TeV. The tracking performance of the TRT has been studied in the case of operating with a Xe-based gas mixture and as a function of the straw occupancy. Special attention was paid to investigation of tracking parameters inside hadronic jets. The experimental data and simulation are in reasonable agreement, even within the dense cores of the most energetic jets.

The family of light-harvesting-related proteins (LHCs, ELIPs, HLIPs): was the harvesting of light their primary function?

PubMed

Montané, M H; Kloppstech, K

2000-11-27

Light-harvesting complex proteins (LHCs) and early light-induced proteins (ELIPs) are essential pigment-binding components of the thylakoid membrane and are encoded by one of the largest and most complex higher plant gene families. The functional diversification of these proteins corresponded to the transition from extrinsic (phycobilisome-based) to intrinsic (LHC-based) light-harvesting antenna systems during the evolution of chloroplasts from cyanobacteria, yet the functional basis of this diversification has been elusive. Here, we propose that the original function of LHCs and ELIPs was not to collect light and to transfer its energy content to the reaction centers but to disperse the absorbed energy of light in the form of heat or fluorescence. These energy-dispersing proteins are believed to have originated in cyanobacteria as one-helix, highly light-inducible proteins (HLIPs) that later acquired four helices through two successive gene duplication steps. We suggest that the ELIPs arose first in this succession, with a primary function in energy dispersion for protection of photosynthetic pigments from photo-oxidation. We consider the LHC I and II families as more recent and very successful evolutionary additions to this family that ultimately attained a new function, thereby replacing the ancestral extrinsic light-harvesting system. Our model accounts for the non-photochemical quenching role recently shown for higher plant psbS proteins.

Issues Using the Life History Calendar in Disability Research

PubMed Central

Scott, Tiffany N.; Harrison, Tracie

2011-01-01

Background Overall, there is a dearth of research reporting mixed-method data collection procedures using the LHC within disability research. Objective This report provides practical knowledge on use of the life history calendar (LHC) from the perspective of a mixed-method life history study of mobility impairment situated within a qualitative paradigm. Methods In this paper the method related literature referring to the LHC was reviewed along with its epistemological underpinnings. Further, the uses of the LHC in disability research were illustrated using preliminary data from reports of disablement in Mexican American and Non-Hispanic White women with permanent mobility impairment. Results From our perspective, the LHC was most useful when approached from an interpretive paradigm when gathering data from women of varied ethnic and socioeconomic strata. While we found the LHC the most useful tool currently available for studying disablement over the life course, there were challenges associated with its use. The LHC required extensive interviewer training. In addition, large segments of time were needed for completion depending on the type of participant responses. Conclusions Researchers planning to conduct a disability study may find our experience using the LHC valuable for anticipating issues that may arise when the LHC is used in mixed-method research. PMID:22014674

Multipion correlations induced by isospin conservation of coherent emission

DOE PAGES

Gangadharan, Dhevan

2016-09-15

Recent measurements have revealed a significant suppression of multipion Bose–Einstein correlations in heavy-ion collisions at the LHC. The suppression may be explained by postulating coherent pion emission. Typically, the suppression of Bose–Einstein correlations due to coherence is taken into account with the coherent state formalism in quantum optics. However, since charged pion correlations are most often measured, the additional constraint of isospin conservation, which is absent in quantum optics, needs to be taken into account. As a consequence, correlations emerge between pions of opposite charge. A calculation of the correlations induced by isospin conservation of coherent emission is made formore » two, three- and four-pion correlation functions and compared to the data from the LHC.« less

Photoproduction of vector mesons in proton-proton ultraperipheral collisions at the CERN Large Hadron Collider

NASA Astrophysics Data System (ADS)

Xie, Ya-Ping; Chen, Xurong

2018-05-01

Photoproduction of vector mesons is computed with dipole model in proton-proton ultraperipheral collisions (UPCs) at the CERN Large Hadron Collider (LHC). The dipole model framework is employed in the calculations of vector mesons production in diffractive processes. Parameters of the bCGC model are refitted with the latest inclusive deep inelastic scattering experimental data. Employing the bCGC model and boosted Gaussian light-cone wave function for vector mesons, we obtain the prediction of rapidity distributions of J/ψ and ψ(2s) mesons in proton-proton ultraperipheral collisions at the LHC. The predictions give a good description of the experimental data of LHCb. Predictions of ϕ and ω mesons are also evaluated in this paper.

OZONE-INDUCED RESPIRATORY SYMPTOMS AND LUNG FUNCTION DECREMENTS IN HUMANS: EXPOSURE-RESPONSE MODELS

EPA Science Inventory

Short duration exposure to ozone (<8 hr) is known to result in lung function decrements and respiratory symptoms in humans. The magnitudes of these responses are functions of ozone concentration (C), activity level measured by minute ventilation (Ve), duration of exposure (T), a...

The role of hyperpolarized 129xenon in MR imaging of pulmonary function

PubMed Central

Ebner, Lukas; Kammerman, Jeff; Driehuys, Bastiaan; Schiebler, Mark L.; Cadman, Robert V.; Fain, Sean B.

2016-01-01

In the last two decades, functional imaging of the lungs using hyperpolarized noble gases has entered the clinical stage. Both helium (3 He) and xenon (129Xe) gas have been thoroughly investigated for their ability to assess both the global and regional patterns of lung ventilation. With advances in polarizer technology and the current transition towards the widely available 129Xe gas, this method is ready for translation to the clinic. Currently, hyperpolarized (HP) noble gas lung MRI is limited to selected academic institutions; yet, the promising results from initial clinical trials have drawn the attention of the pulmonary medicine community. HP 129Xe MRI provides not only 3-dimensional ventilation imaging, but also unique capabilities for probing regional lung physiology. In this review article, we aim to (1) provide a brief overview of current ventilation MR imaging techniques, (2) emphasize the role of HP 129Xe MRI within the array of different imaging strategies, (3) discuss the unique imaging possibilities with HP 129Xe MRI, and (4) propose clinical applications. PMID:27707585

Bacteriological evaluation of a down-draught necropsy table ventilation system.

PubMed

al-Wali, W; Kibbler, C C; McLaughlin, J E

1993-08-01

To evaluate the microbiological efficacy of a down-draught necropsy table ventilation system (which surrounds the cadaver with a "curtain" of air under continuous extraction) during post mortem procedures. Air sampling was carried out both in the presence and absence of staff and cadaver and during a full post mortem procedure, with functioning and non-functioning table air extraction. The penetration of the air "curtain" was also examined during the use of an oscillating bone saw by means of a tracer organism, Bacillus subtilis var niger, painted on to the skull. There was little difference between bacterial counts obtained in the presence of staff only, staff plus cadaver, or during a post mortem examination. With all counts obtained, however, there was a two to three-fold reduction when the ventilation was in operation compared with when the extract duct was occluded. Using the tracer organism, a two to three log reduction in counts was shown when the "curtain" was in operation during the use of the oscillating bone saw. These results suggest that the system provides potential protection for post mortem room staff against airborne infections.

Halo-gravity traction combined with assisted ventilation: an effective pre-operative management for severe adult scoliosis complicated with respiratory dysfunction.

PubMed

Bao, Hongda; Yan, Peng; Bao, Mike; Qiu, Yong; Zhu, Zezhang; Liu, Zhen; Cheng, Jack C Y; Ng, Bobby K W; Zhu, Feng

2016-08-01

To investigate the change of pulmonary function in adult scoliosis patients with respiratory dysfunction undergoing HGT combined with assisted ventilation. 21 adult patients were retrospectively reviewed with a mean age of 26.2 years. Inclusion criteria were as follows: age over 18 years old; coronal Cobb angle greater than 100°; with respiratory failure; and duration of HGT more than 1 month. All patients underwent respiratory training. The Cobb angle averaged 131.21° and was reduced to 107.68° after HGT. Significantly increased mean forced vital capacity (FVC) was found after HGT (P = 0.003) with significantly improved percent-predicted values for FVC (P < 0.001). Meanwhile, significantly increased forced expiratory volume in 1 s (FEV1) was also observed (P < 0.001) with significantly improved percent-predicted values for FEV1 (P = 0.003) after HGT. The results of our study revealed that combined HGT and assisted ventilation would be beneficial to pulmonary function improvement in severe adult scoliosis cases, most of which were young adults.

Performance of the CMS precision electromagnetic calorimeter at LHC Run II and prospects for High-Luminosity LHC

NASA Astrophysics Data System (ADS)

Zhang, Zhicai

2018-04-01

Many physics analyses using the Compact Muon Solenoid (CMS) detector at the LHC require accurate, high-resolution electron and photon energy measurements. Following the excellent performance achieved during LHC Run I at center-of-mass energies of 7 and 8 TeV, the CMS electromagnetic calorimeter (ECAL) is operating at the LHC with proton-proton collisions at 13 TeV center-of-mass energy. The instantaneous luminosity delivered by the LHC during Run II has achieved unprecedented levels. The average number of concurrent proton-proton collisions per bunch-crossing (pileup) has reached up to 40 interactions in 2016 and may increase further in 2017. These high pileup levels necessitate a retuning of the ECAL readout and trigger thresholds and reconstruction algorithms. In addition, the energy response of the detector must be precisely calibrated and monitored. We present new reconstruction algorithms and calibration strategies that were implemented to maintain the excellent performance of the CMS ECAL throughout Run II. We will show performance results from the 2015-2016 data taking periods and provide an outlook on the expected Run II performance in the years to come. Beyond the LHC, challenging running conditions for CMS are expected after the High-Luminosity upgrade of the LHC (HL-LHC) . We review the design and R&D studies for the CMS ECAL and present first test beam studies. Particular challenges at HL-LHC are the harsh radiation environment, the increasing data rates, and the extreme level of pile-up events, with up to 200 simultaneous proton-proton collisions. We present test beam results of hadron irradiated PbWO crystals up to fluences expected at the HL-LHC . We also report on the R&D for the new readout and trigger electronics, which must be upgraded due to the increased trigger and latency requirements at the HL-LHC.

Taxonomic distribution and origins of the extended LHC (light-harvesting complex) antenna protein superfamily

PubMed Central

2010-01-01

Background The extended light-harvesting complex (LHC) protein superfamily is a centerpiece of eukaryotic photosynthesis, comprising the LHC family and several families involved in photoprotection, like the LHC-like and the photosystem II subunit S (PSBS). The evolution of this complex superfamily has long remained elusive, partially due to previously missing families. Results In this study we present a meticulous search for LHC-like sequences in public genome and expressed sequence tag databases covering twelve representative photosynthetic eukaryotes from the three primary lineages of plants (Plantae): glaucophytes, red algae and green plants (Viridiplantae). By introducing a coherent classification of the different protein families based on both, hidden Markov model analyses and structural predictions, numerous new LHC-like sequences were identified and several new families were described, including the red lineage chlorophyll a/b-binding-like protein (RedCAP) family from red algae and diatoms. The test of alternative topologies of sequences of the highly conserved chlorophyll-binding core structure of LHC and PSBS proteins significantly supports the independent origins of LHC and PSBS families via two unrelated internal gene duplication events. This result was confirmed by the application of cluster likelihood mapping. Conclusions The independent evolution of LHC and PSBS families is supported by strong phylogenetic evidence. In addition, a possible origin of LHC and PSBS families from different homologous members of the stress-enhanced protein subfamily, a diverse and anciently paralogous group of two-helix proteins, seems likely. The new hypothesis for the evolution of the extended LHC protein superfamily proposed here is in agreement with the character evolution analysis that incorporates the distribution of families and subfamilies across taxonomic lineages. Intriguingly, stress-enhanced proteins, which are universally found in the genomes of green plants, red algae, glaucophytes and in diatoms with complex plastids, could represent an important and previously missing link in the evolution of the extended LHC protein superfamily. PMID:20673336

Paclitaxel-induced lung injury and its amelioration by parecoxib sodium.

PubMed

Liu, Wen-jie; Zhong, Zhong-jian; Cao, Long-hui; Li, Hui-ting; Zhang, Tian-hua; Lin, Wen-qian

2015-08-10

To investigate the mechanism of paclitaxel-induced lung injury and its amelioration by parecoxib sodium. In this study, rats were randomly divided into: the control group (Con); the paclitaxel chemotherapy group (Pac); the paclitaxel+ parecoxib sodium intervention group (Pac + Pare); and the parecoxib sodium group (Pare). We observed changes in alveolar ventilation function, alveolar-capillary membrane permeability, lung tissue pathology and measured the levels of inflammatory cytokines and cyclooxygenase-2 (Cox-2) in lung tissue, the expression of tight junction proteins (Zo-1 and Claudin-4). Compared with the Con group, the lung tissue of the Pac group showed significantly increased expression of Cox-2 protein (p < 0.01), significant lung tissue inflammatory changes, significantly increased expression of inflammatory cytokines, decreased expression of Zo-1 and Claudin-4 proteins (p < 0.01), increased alveolar-capillary membrane permeability (p < 0.01), and reduced ventilation function (p < 0.01). Notably, in Pac + Pare group, intraperitoneal injection of parecoxib sodium led to decreased Cox-2 and ICAM-1 levels and reduced inflammatory responses, the recovered expression of Zo-1 and Claudin-4, reduced level of indicators reflecting the high permeability state, and close-to-normal levels of ventilation function. Intervention by the Cox-2-specific inhibitor parecoxib sodium can block this damage.

Paclitaxel-induced lung injury and its amelioration by parecoxib sodium

PubMed Central

Liu, Wen-jie; Zhong, Zhong-jian; Cao, Long-hui; Li, Hui-ting; Zhang, Tian-hua; Lin, Wen-qian

2015-01-01

To investigate the mechanism of paclitaxel-induced lung injury and its amelioration by parecoxib sodium. In this study, rats were randomly divided into: the control group (Con); the paclitaxel chemotherapy group (Pac); the paclitaxel+ parecoxib sodium intervention group (Pac + Pare); and the parecoxib sodium group (Pare). We observed changes in alveolar ventilation function, alveolar-capillary membrane permeability, lung tissue pathology and measured the levels of inflammatory cytokines and cyclooxygenase-2 (Cox-2) in lung tissue, the expression of tight junction proteins (Zo-1 and Claudin-4). Compared with the Con group, the lung tissue of the Pac group showed significantly increased expression of Cox-2 protein (p < 0.01), significant lung tissue inflammatory changes, significantly increased expression of inflammatory cytokines, decreased expression of Zo-1 and Claudin-4 proteins (p < 0.01), increased alveolar-capillary membrane permeability (p < 0.01), and reduced ventilation function (p < 0.01). Notably, in Pac + Pare group, intraperitoneal injection of parecoxib sodium led to decreased Cox-2 and ICAM-1 levels and reduced inflammatory responses, the recovered expression of Zo-1 and Claudin-4, reduced level of indicators reflecting the high permeability state, and close-to-normal levels of ventilation function. Intervention by the Cox-2-specific inhibitor parecoxib sodium can block this damage. PMID:26256764

Effects of Intermittent Positive Pressure Ventilation on Cardiopulmonary Function in Horses Anesthetized with Total Intravenous Anesthesia Using Combination of Medetomidine, Lidocaine, Butorphanol and Propofol (MLBP-TIVA)

PubMed Central

ISHIZUKA, Tomohito; TAMURA, Jun; NAGARO, Tsukasa; SUDO, Kanako; ITAMI, Takaharu; UMAR, Mohammed Ahamed; MIYOSHI, Kenjirou; SANO, Tadashi; YAMASHITA, Kazuto

2014-01-01

Effects of intermittent positive pressure ventilation (IPPV) on cardiopulmonary function were evaluated in horses anesthetized with total intravenous anesthesia using constant rate infusions of medetomidine (3.5 µg/kg/hr), lidocaine (3 mg/kg/hr), butorphanol (24 µg/kg/hr) and propofol (0.1 mg/kg/min) (MLBP-TIVA). Five horses were anesthetized twice using MLBP-TIVA with or without IPPV at 4-week interval (crossover study). In each occasion, the horses breathed 100% oxygen with spontaneous ventilation (SB-group, n=5) or with IPPV (CV-group, n=5), and changes in cardiopulmonary parameters were observed for 120 min. In the SB-group, cardiovascular parameters were maintained within acceptable ranges (heart rate: 33–35 beats/min, cardiac output: 27–30 l/min, mean arterial blood pressure [MABP]: 114–123 mmHg, mean pulmonary arterial pressure [MPAP]: 28–29 mmHg and mean right atrial pressure [MRAP]: 19–21 mmHg), but severe hypercapnea and insufficient oxygenation were observed (arterial CO2 pressure [PaCO2]: 84–103 mmHg and arterial O2 pressure [PaO2]: 155–172 mmHg). In the CV-group, normocapnea (PaCO2: 42–50 mmHg) and good oxygenation (PaO2: 395–419 mmHg) were achieved by the IPPV without apparent cardiovascular depression (heart rate: 29–31 beats/min, cardiac output: 17–21 l /min, MABP: 111–123 mmHg, MPAP: 27–30 mmHg and MRAP: 15–16 mmHg). MLBP-TIVA preserved cardiovascular function even in horses artificially ventilated. PMID:25649938

Combination of Extracorporeal Life Support and Mesenchymal Stem Cell Therapy for Treatment of ARDS in Combat Casualties and Evacuation of Service Members with ARDS

DTIC Science & Technology

2017-10-01

invasiveness of mechanical ventilation and inflammatory mediators as well as improvement in oxygenation and functional outcome. 4 Keywords Acute...The Clark system is allowing us to measure the mitochondrial activity by the oxygen consumption during activation. Because the LPS-induced injury we... Ventilation • Tidal Volume • Respiratory Rate • Peak inspiratory Pressure • Positive End Expiratory Pressure (PEEP) • Fraction of inspired oxygen

Studies of the Effects of Perfluorocarbon Emulsions on Platelet Number and Function in Models of Critical Battlefield Injury

DTIC Science & Technology

2016-01-01

TBI), hemorrhagic shock and burns by enhanced delivery of oxygen . A class-based side effect of PFC (day 2-5 after infusion in 30-50%) may be...anesthesia level assessment. Animals were transported to the laboratory. Then, the animals were intubated and ventilated with 70% nitrogen/30% oxygen ...intubated with an endotracheal tube (ID= 9~10 mm with cuff), an orogastric tube placed to expel vomit, and ventilated with mixed nitrogen/ oxygen (80:20

Reproducibility of Lobar Perfusion and Ventilation Quantification Using SPECT/CT Segmentation Software in Lung Cancer Patients.

PubMed

Provost, Karine; Leblond, Antoine; Gauthier-Lemire, Annie; Filion, Édith; Bahig, Houda; Lord, Martin

2017-09-01

Planar perfusion scintigraphy with 99m Tc-labeled macroaggregated albumin is often used for pretherapy quantification of regional lung perfusion in lung cancer patients, particularly those with poor respiratory function. However, subdividing lung parenchyma into rectangular regions of interest, as done on planar images, is a poor reflection of true lobar anatomy. New tridimensional methods using SPECT and SPECT/CT have been introduced, including semiautomatic lung segmentation software. The present study evaluated inter- and intraobserver agreement on quantification using SPECT/CT software and compared the results for regional lung contribution obtained with SPECT/CT and planar scintigraphy. Methods: Thirty lung cancer patients underwent ventilation-perfusion scintigraphy with 99m Tc-macroaggregated albumin and 99m Tc-Technegas. The regional lung contribution to perfusion and ventilation was measured on both planar scintigraphy and SPECT/CT using semiautomatic lung segmentation software by 2 observers. Interobserver and intraobserver agreement for the SPECT/CT software was assessed using the intraclass correlation coefficient, Bland-Altman plots, and absolute differences in measurements. Measurements from planar and tridimensional methods were compared using the paired-sample t test and mean absolute differences. Results: Intraclass correlation coefficients were in the excellent range (above 0.9) for both interobserver and intraobserver agreement using the SPECT/CT software. Bland-Altman analyses showed very narrow limits of agreement. Absolute differences were below 2.0% in 96% of both interobserver and intraobserver measurements. There was a statistically significant difference between planar and SPECT/CT methods ( P < 0.001) for quantification of perfusion and ventilation for all right lung lobes, with a maximal mean absolute difference of 20.7% for the right middle lobe. There was no statistically significant difference in quantification of perfusion and ventilation for the left lung lobes using either method; however, absolute differences reached 12.0%. The total right and left lung contributions were similar for the two methods, with a mean difference of 1.2% for perfusion and 2.0% for ventilation. Conclusion: Quantification of regional lung perfusion and ventilation using SPECT/CT-based lung segmentation software is highly reproducible. This tridimensional method yields statistically significant differences in measurements for right lung lobes when compared with planar scintigraphy. We recommend that SPECT/CT-based quantification be used for all lung cancer patients undergoing pretherapy evaluation of regional lung function. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

Assessment of pulmonary structure-function relationships in young children and adolescents with cystic fibrosis by multivolume proton-MRI and CT.

PubMed

Pennati, Francesca; Roach, David J; Clancy, John P; Brody, Alan S; Fleck, Robert J; Aliverti, Andrea; Woods, Jason C

2018-02-19

Lung disease is the most frequent cause of morbidity and mortality in patients with cystic fibrosis (CF), and there is a shortage of sensitive biomarkers able to regionally monitor disease progression and to assess early responses to therapy. To determine the feasibility of noncontrast-enhanced multivolume MRI, which assesses intensity changes between expiratory and inspiratory breath-hold images, to detect and quantify regional ventilation abnormalities in CF lung disease, with a focus on the structure-function relationship. Retrospective. Twenty-nine subjects, including healthy young children (n = 9, 7-37 months), healthy adolescents (n = 4, 14-22 years), young children with CF lung disease (n = 10, 7-47 months), and adolescents with CF lung disease (n = 6, 8-18 years) were studied. 3D spoiled gradient-recalled sequence at 1.5T. Subjects were scanned during breath-hold at functional residual capacity (FRC) and total lung capacity (TLC) through noncontrast-enhanced MRI and CT. Expiratory-inspiratory differences in MR signal-intensity (Δ 1 H-MRI) and CT-density (ΔHU) were computed to estimate regional ventilation. MR and CT images were also evaluated using a CF-specific scoring system. Quadratic regression, Spearman's correlation, one-way analysis of variance (ANOVA). Δ 1 H-MRI maps were sensitive to ventilation heterogeneity related to gravity dependence in healthy lung and to ventilation impairment in CF lung disease. A high correlation was found between MRI and CT ventilation maps (R 2  = 0.79, P < 0.001). Globally, Δ 1 H-MRI and ΔHU decrease with increasing morphological score (respectively, R 2  = 0.56, P < 0.001 and R 2  = 0.31, P < 0.001). Locally, Δ 1 H-MRI was higher in healthy regions (median 15%) compared to regions with bronchiectasis, air trapping, consolidation, and to segments fed by airways with bronchial wall thickening (P < 0.001). Multivolume noncontrast-enhanced MRI, as a nonionizing imaging modality that can be used on nearly any MRI scanner without specialized equipment or gaseous tracers, may be particularly valuable in CF care, providing a new imaging biomarker to detect early alterations in regional lung structure-function. 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018. © 2018 International Society for Magnetic Resonance in Medicine.

Turning the LHC ring into a new physics search machine

NASA Astrophysics Data System (ADS)

Orava, Risto

2017-03-01

The LHC Collider Ring is proposed to be turned into an ultimate automatic search engine for new physics in four consecutive phases: (1) Searches for heavy particles produced in Central Exclusive Process (CEP): pp → p + X + p based on the existing Beam Loss Monitoring (BLM) system of the LHC; (2) Feasibility study of using the LHC Ring as a gravitation wave antenna; (3) Extensions to the current BLM system to facilitate precise registration of the selected CEP proton exit points from the LHC beam vacuum chamber; (4) Integration of the BLM based event tagging system together with the trigger/data acquisition systems of the LHC experiments to facilitate an on-line automatic search machine for the physics of tomorrow.

Delirium After Mechanical Ventilation in Intensive Care Units: The Cognitive and Psychosocial Assessment (CAPA) Study Protocol.

PubMed

Bulic, Daniella; Bennett, Michael; Rodgers, Helen; Nourse, Mary; Rubie, Patrick; Looi, Jeffrey Cl; Van Haren, Frank

2017-02-28

In the intensive care unit (ICU), critical illness delirium occurs in the context of multiple comorbidities, multi-organ failure, and invasive management techniques, such as mechanical ventilation, sedation, and lack of sleep. Delirium is characterized by an acute confusional state defined by fluctuating mental status, inattention, and either disorganized thinking or an altered level of consciousness. The long-term cognitive and psychosocial function of patients that experience delirium in the ICU is of crucial interest because preliminary data suggest a strong association between ICU-related delirium and long-term cognitive impairment. The aim of this study is to explore the relationship between delirium in the ICU and adverse outcomes by following mechanically ventilated patients for one year following their discharge from the ICU and collecting data on their long-term cognition and psychosocial function. This study will be conducted by enrolling patients in two tertiary ICUs in Australia. We aim to recruit 200 patients who have been mechanically ventilated for more than 24 hours. Data will be collected at the following three time points: (1) at discharge where they will be administered the Mini-Mental State Examination (MMSE); (2) at 6 months after discharge from the ICU discharge where the Impact of Events Scale Revised (IES-R) and the Telephone Inventory for Cognitive Status (TICS) tests will be administered; and (3) at 12 months after discharge from the ICU where the patients will be administered the TICS and IES-R tests, as well as the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE). The IQCODE will be administered to their "person responsible" or the significant other of the patient. Long-term cognition and psychosocial function will be the primary outcome of this study. Mortality will also be investigated as a secondary outcome. Active enrollment will take place until the end of September 2016 and data collection will conclude at the end of September 2017. The analysis and results are expected to be available by March 2018. Delirium during mechanical ventilation has been linked to longer ICU and hospital stays, higher financial burdens, increased risks of long-term cognitive impairment (ie, dementia), poor functional outcomes and quality of life, and decreased survival. However, delirium during mechanical ventilation in the ICU is not well understood. This study will advance our knowledge of the comprehensive, long-term effects of delirium on cognitive and psychosocial function. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616001116415; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371216 (Archived by WebCite at http://www.webcitation.org/ 6nfDkGTcW). ©Daniella Bulic, Michael Bennett, Helen Rodgers, Mary Nourse, Patrick Rubie, Jeffrey CL Looi, Frank Van Haren. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 28.02.2017.

Effect of prone positioning on cannula function and impaired oxygenation during extracorporeal circulation.

PubMed

Masuda, Yoshiki; Tatsumi, Hiroomi; Imaizumi, Hitoshi; Gotoh, Kyoko; Yoshida, Shinichiro; Chihara, Shinya; Takahashi, Kanako; Yamakage, Michiaki

2014-03-01

Prone ventilation is an effective method for improving oxygenation in patients with acute respiratory failure. However, in extracorporeal circulation, there is a risk of cannula-related complications when changing the position. In this study, we investigated cannula-related complications when changing position for prone ventilation and the effect of prone ventilation on impaired oxygenation in patients who underwent extracorporeal membrane oxygenation (ECMO). The study subjects were patients who underwent prone ventilation during ECMO in the period from 2004 to 2011. Indication for prone ventilation was the presence of dorsal infiltration shown by lung computed tomography. Factors investigated were cannula insertion site, dislodgement or obstruction of the cannula, malfunction of vascular access and unplanned dislodgement of the catheters when changing position. Mean arterial pressure, PaO2/FiO2, PEEP level, blood flow and rotation speed of the pump were also determined before and after position change. Five patients were selected as study subjects. The mean duration of prone positioning was 15.3 ± 0.5 h. Strict management during position changes prevented cannula-related complications in the patients who underwent extracorporeal circulation. There were no significant changes in mean arterial pressure, PEEP level, blood flow and rotation speed of the pump when changing position. Low PaO2/FiO2 prior to prone ventilation was significantly increased after supine to prone and then prone to supine position. Prone positioning to improve impaired oxygenation is a safe procedure and not a contraindication in patients receiving extracorporeal circulation.

Lung Volume Reduction Surgery for Respiratory Failure in Infants With Bronchopulmonary Dysplasia.

PubMed

Sohn, Bongyeon; Park, Samina; Park, In Kyu; Kim, Young Tae; Park, June Dong; Park, Sung-Hye; Kang, Chang Hyun

2018-04-01

Lung volume reduction surgery (LVRS) can be performed in patients with severe emphysematous disease. However, LVRS in pediatric patients has not yet been reported. Here, we report our experience with 2 cases of pediatric LVRS. The first patient was a preterm infant girl with severe bronchopulmonary dysplasia, pulmonary hypertension, and hypothyroidism. The emphysematous portion of the right lung was removed via sternotomy and right hemiclamshell incision. The patient was discharged on full-time home ventilator support for 3 months after the surgery. Since then, her respiratory function has improved continuously. She no longer needs oxygen supplementation or ventilator care. Her T-cannula was removed recently. The second patient was also a preterm infant girl with bronchopulmonary dysplasia. She was born with pulmonary hypertension and multiple congenital anomalies, including an atrial septal defect. Despite receiving the best supportive care, she could not be taken off the mechanical ventilator because of severe hypercapnia. We performed LVRS on the right lung via thoracotomy. She was successfully weaned off the mechanical ventilator 1 month after the surgery. She was discharged without severe complications at 3 months after the operation. At present, she is growing well with the help of intermittent home ventilator support. She can now tolerate an oral diet. Our experience shows that LVRS can be considered as a treatment option for pediatric patients with severe emphysematous lung. It is especially helpful for discontinuing prolonged mechanical ventilator care for patients with respiratory failure. Copyright © 2018 by the American Academy of Pediatrics.

Open lung approach vs acute respiratory distress syndrome network ventilation in experimental acute lung injury.

PubMed

Spieth, P M; Güldner, A; Carvalho, A R; Kasper, M; Pelosi, P; Uhlig, S; Koch, T; Gama de Abreu, M

2011-09-01

Setting and strategies of mechanical ventilation with positive end-expiratory pressure (PEEP) in acute lung injury (ALI) remains controversial. This study compares the effects between lung-protective mechanical ventilation according to the Acute Respiratory Distress Syndrome Network recommendations (ARDSnet) and the open lung approach (OLA) on pulmonary function and inflammatory response. Eighteen juvenile pigs were anaesthetized, mechanically ventilated, and instrumented. ALI was induced by surfactant washout. Animals were randomly assigned to mechanical ventilation according to the ARDSnet protocol or the OLA (n=9 per group). Gas exchange, haemodynamics, pulmonary blood flow (PBF) distribution, and respiratory mechanics were measured at intervals and the lungs were removed after 6 h of mechanical ventilation for further analysis. PEEP and mean airway pressure were higher in the OLA than in the ARDSnet group [15 cmH(2)O, range 14-18 cmH(2)O, compared with 12 cmH(2)O; 20.5 (sd 2.3) compared with 18 (1.4) cmH(2)O by the end of the experiment, respectively], and OLA was associated with improved oxygenation compared with the ARDSnet group after 6 h. OLA showed more alveolar overdistension, especially in gravitationally non-dependent regions, while the ARDSnet group was associated with more intra-alveolar haemorrhage. Inflammatory mediators and markers of lung parenchymal stress did not differ significantly between groups. The PBF shifted from ventral to dorsal during OLA compared with ARDSnet protocol [-0.02 (-0.09 to -0.01) compared with -0.08 (-0.12 to -0.06), dorsal-ventral gradients after 6 h, respectively]. According to the OLA, mechanical ventilation improved oxygenation and redistributed pulmonary perfusion when compared with the ARDSnet protocol, without differences in lung inflammatory response.

Neurally Adjusted Ventilatory Assist After Pediatric Cardiac Surgery: Clinical Experience and Impact on Ventilation Pressures.

PubMed

Crulli, Benjamin; Khebir, Mariam; Toledano, Baruch; Vobecky, Suzanne; Poirier, Nancy; Emeriaud, Guillaume

2018-02-01

After pediatric cardiac surgery, ventilation with high airway pressures can be detrimental to right ventricular function and pulmonary blood flow. Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interactions, helping maintain spontaneous ventilation. This study reports our experience with the use of NAVA in children after a cardiac surgery. We hypothesize that using NAVA in this population is feasible and allows for lower ventilation pressures. We retrospectively studied all children ventilated with NAVA (invasively or noninvasively) after undergoing cardiac surgery between January 2013 and May 2015 in our pediatric intensive care unit. The number and duration of NAVA episodes were described. For the first period of invasive NAVA in each subject, detailed clinical and ventilator data in the 4 h before and after the start of NAVA were extracted. 33 postoperative courses were included in 28 subjects with a median age of 3 [interquartile range (IQR) 1-12] months. NAVA was used invasively in 27 courses for a total duration of 87 (IQR 15-334) h per course. Peak inspiratory pressures and mean airway pressures decreased significantly after the start of NAVA (mean differences of 5.8 cm H 2 O (95% CI 4.1-7.5) and 2.0 cm H 2 O (95% CI 1.2-2.8), respectively, P < .001 for both). There was no significant difference in vital signs or blood gas values. NAVA was used noninvasively in 14 subjects, over 79 (IQR 25-137) h. NAVA could be used in pediatric subjects after cardiac surgery. The significant decrease in airway pressures observed after transition to NAVA could have a beneficial impact in this specific population, which should be investigated in future interventional studies. Copyright © 2018 by Daedalus Enterprises.

A multiscale MDCT image-based breathing lung model with time-varying regional ventilation

PubMed Central

Yin, Youbing; Choi, Jiwoong; Hoffman, Eric A.; Tawhai, Merryn H.; Lin, Ching-Long

2012-01-01

A novel algorithm is presented that links local structural variables (regional ventilation and deforming central airways) to global function (total lung volume) in the lung over three imaged lung volumes, to derive a breathing lung model for computational fluid dynamics simulation. The algorithm constitutes the core of an integrative, image-based computational framework for subject-specific simulation of the breathing lung. For the first time, the algorithm is applied to three multi-detector row computed tomography (MDCT) volumetric lung images of the same individual. A key technique in linking global and local variables over multiple images is an in-house mass-preserving image registration method. Throughout breathing cycles, cubic interpolation is employed to ensure C1 continuity in constructing time-varying regional ventilation at the whole lung level, flow rate fractions exiting the terminal airways, and airway deformation. The imaged exit airway flow rate fractions are derived from regional ventilation with the aid of a three-dimensional (3D) and one-dimensional (1D) coupled airway tree that connects the airways to the alveolar tissue. An in-house parallel large-eddy simulation (LES) technique is adopted to capture turbulent-transitional-laminar flows in both normal and deep breathing conditions. The results obtained by the proposed algorithm when using three lung volume images are compared with those using only one or two volume images. The three-volume-based lung model produces physiologically-consistent time-varying pressure and ventilation distribution. The one-volume-based lung model under-predicts pressure drop and yields un-physiological lobar ventilation. The two-volume-based model can account for airway deformation and non-uniform regional ventilation to some extent, but does not capture the non-linear features of the lung. PMID:23794749

[Cardiac efficiency in patients with Cheyne-Stokes respiration as a result of heart insufficiency during long-term nasal respiratory treatment with adaptive servo ventilation (AutoSet CS)].

PubMed

Schädlich, S; Königs, I; Kalbitz, F; Blankenburg, T; Busse, H-J; Schütte, W

2004-06-01

Cheyne-Stokes respiration (CSR) is known to be an important negative predictor of outcome in patients with congestive heart failure. The goal of this study was to investigate whether the use of adaptive servo ventilation (AutoSet CS) would permit sufficient suppression of this pathological breathing pattern and improve cardiac function in longterm use over 1 year. Inclusion criteria for the study were congestive heart failure (left ventricular ejection fraction 20-50%), proven CSR with a central apnea-hypopnea index (AHI) > 15/h and stable clinical status with standard medical therapy. Patients with obstructive sleep apnea and COPD were excluded. Twenty consecutive patients (16 male) age 65.5 years (range 48-77) were followed with full blood counts, blood gas analysis, lung function tests and questionnaires for cardiopulmonary capacities (Minnesota, MRC Scale) and sleepiness (Epworth Sleepiness Scale). In addition, we performed 6-min walk distance (6MWD), echocardiography and polysomnography just before and after adjusting to adaptive servo ventilation and 3 and 12 months later. Mean usage of adaptive servo ventilation was sufficient (4.3 +/- 2.1 h/day at 12 months). No significant changes in blood gas analysis, blood counts and pulmonary function were detectable. CSR disappeared almost completely in all patients (AHI pre-study 44.3 +/- 13.4/h vs 3.4 +/- 8.0/h at 12 months; p < 0.0001). Saturation normalized steadily over the course of the study. The desaturation index decreased from 45.3 +/- 17.8/h to 5.2 +/- 11.5/h at 12 months (p < 0.0001). Mean saturation increased with the first night of sleep with adaptive servo ventilation from 92.0 +/- 2.5% to 93.0 +/- 1.6% (p < 0.05) and then to 94.1 +/- 1.9% at 3, and 94.2 +/- 1.9% at 12 months (p < 0.001). Quality of sleep was significantly improved with an increase of slow-wave sleep from 4.5 +/- 4.6% to 13.7 +/- 6.9% at 12 months (p < 0.0001). The arousal index concomitantly decreased from 29.8 +/- 17.9/h pre-study to 12.0 +/- 10.3/h at 12 months (p < 0.01). REM-sleep and sleep efficiency remained unchanged. The Epworth Sleepiness Scale showed only a trend to improvement. Cardiac function improved significantly during the course of the study. The ejection fraction increased from mean 37.1 +/- 12.5% pre-study to 41.7 +/- 8.8% at 12 months (p < 0.05). The 6-min walk distance increased from 192 +/- 110 m to 277 +/- 130 m at 12 months (p < 0.01). The MRC and Minnesota score were not significantly different pre- and post-study. We conclude that long-term respirator therapy with adaptive servo ventilation has sufficiently suppressed CSR and improved cardiac function in patients with congestive heart failure. Thus, safety and feasibility of this respirator therapy could be demonstrated. However, due to methodological reasons (no control group, no randomization) a direct effect on cardiac function could not be confirmed.

Spatial correspondence of 4D CT ventilation and SPECT pulmonary perfusion defects in patients with malignant airway stenosis

NASA Astrophysics Data System (ADS)

Castillo, Richard; Castillo, Edward; McCurdy, Matthew; Gomez, Daniel R.; Block, Alec M.; Bergsma, Derek; Joy, Sarah; Guerrero, Thomas

2012-04-01

To determine the spatial overlap agreement between four-dimensional computed tomography (4D CT) ventilation and single photon emission computed tomography (SPECT) perfusion hypo-functioning pulmonary defect regions in a patient population with malignant airway stenosis. Treatment planning 4D CT images were obtained retrospectively for ten lung cancer patients with radiographically demonstrated airway obstruction due to gross tumor volume. Each patient also received a SPECT perfusion study within one week of the planning 4D CT, and prior to the initiation of treatment. Deformable image registration was used to map corresponding lung tissue elements between the extreme component phase images, from which quantitative three-dimensional (3D) images representing the local pulmonary specific ventilation were constructed. Semi-automated segmentation of the percentile perfusion distribution was performed to identify regional defects distal to the known obstructing lesion. Semi-automated segmentation was similarly performed by multiple observers to delineate corresponding defect regions depicted on 4D CT ventilation. Normalized Dice similarity coefficient (NDSC) indices were determined for each observer between SPECT perfusion and 4D CT ventilation defect regions to assess spatial overlap agreement. Tidal volumes determined from 4D CT ventilation were evaluated versus measurements obtained from lung parenchyma segmentation. Linear regression resulted in a linear fit with slope = 1.01 (R2 = 0.99). Respective values for the average DSC, NDSC1 mm and NDSC2 mm for all cases and multiple observers were 0.78, 0.88 and 0.99, indicating that, on average, spatial overlap agreement between ventilation and perfusion defect regions was comparable to the threshold for agreement within 1-2 mm uncertainty. Corresponding coefficients of variation for all metrics were similarly in the range: 0.10%-19%. This study is the first to quantitatively assess 3D spatial overlap agreement between clinically acquired SPECT perfusion and specific ventilation from 4D CT. Results suggest high correlation between methods within the sub-population of lung cancer patients with malignant airway stenosis.

Indoor Air Quality Assessment of the San Francisco Federal Building

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

Apte, Michael; Bennett, Deborah H.; Faulkner, David

2008-07-01

An assessment of the indoor air quality (IAQ) of the San Francisco Federal Building (SFFB) was conducted on May 12 and 14, 2009 at the request of the General Services Administration (GSA). The purpose of the assessment was for a general screening of IAQ parameters typically indicative of well functioning building systems. One naturally ventilated space and one mechanically ventilated space were studied. In both zones, the levels of indoor air contaminants, including CO2, CO, particulate matter, volatile organic compounds, and aldehydes, were low, relative to reference exposure levels and air quality standards for comparable office buildings. We found slightlymore » elevated levels of volatile organic compounds (VOCs) including two compounds often found in"green" cleaning products. In addition, we found two industrial solvents at levels higher than typically seen in office buildings, but the levels were not sufficient to be of a health concern. The ventilation rates in the two study spaces were high by any standard. Ventilation rates in the building should be further investigated and adjusted to be in line with the building design. Based on our measurements, we conclude that the IAQ is satisfactory in the zone we tested, but IAQ may need to be re-checked after the ventilation rates have been lowered.« less

Mechanical ventilation and management of an adult horse with presumptive botulism.

PubMed

Taylor, Sandra D; Toth, Balazs; Townsend, Wendy M; Bentley, Robin Timothy

2014-01-01

To describe the clinical course, management, and outcome of a horse with a presumptive diagnosis of botulism treated with long-term mechanical ventilation. A 6-year-old Quarter Horse gelding with a history of esophageal obstruction was evaluated for progressive tetraparesis. Generalized and progressive skeletal muscle weakness characterized by recumbency, decreased tongue, tail, eyelid, and anal tone, and respiratory failure was observed. Anticholinergic signs including decreased salivation, xerophthalmia, and ileus were also noted. A presumptive diagnosis of botulism was made, although mouse inoculation and spore identification testing were negative. Pentavalent botulism antitoxin was administered on Day 3. The horse was maintained on a water mattress and was managed with mechanical ventilation for 2 weeks. Complications encountered included necrotic rhinitis, intertrigo, decubital ulceration, jugular and cephalic vein thrombophlebitis, corneal ulceration, and transient ventricular tachycardia. The horse showed marked improvement in skeletal muscle strength and parasympathetic nervous system function, allowing it to be successfully weaned from the ventilator but suffered large colon volvulus on Day 21 and was euthanized. To the authors' knowledge, this is the first report of successful weaning from long-term mechanical ventilation and management of recumbency using a water mattress in an adult horse with presumptive botulism. © Veterinary Emergency and Critical Care Society 2014.

Non-invasive ventilation after surgery in amyotrophic lateral sclerosis.

PubMed

Olivieri, C; Castioni, C A; Livigni, S; Bersano, E; Cantello, R; Della Corte, F; Mazzini, L

2014-04-01

Surgery in patients affected by amyotrophic lateral sclerosis (ALS) presents a particular anesthetic challenge because of the risk of post-operative pulmonary complications. We report on the use of non-invasive ventilation (NIV) to prevent post-operative pulmonary complications (PPCs) in nine patients affected by ALS enrolled in a phase-1 clinical trial with stem cell transplantation. All patients were treated with autologous mesenchymal stem cells implanted into the spinal cord with a surgical procedure. Anesthesia was induced with propofol and maintained with remifentanil and sevoflurane. No muscle relaxant was used. After awakening and regain of spontaneous breathing, patients were tracheally extubated. Non-invasive ventilation through nasal mask was delivered and non-invasive positive pressure ventilation and continuous positive pressure ventilation were started. The average time on NIV after surgery was 3 h and 12 min. All patients regained stable spontaneous breathing after NIV discontinuation and had no episodes of respiratory failure until the following day. Our case series suggest that the use of NIV after surgery can be a safe strategy to prevent PPCs in patients affected by ALS. The perioperative procedure we chose for these patients appeared safe even in patients with advanced functional stage of the disease. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Driving pressure and survival in the acute respiratory distress syndrome.

PubMed

Amato, Marcelo B P; Meade, Maureen O; Slutsky, Arthur S; Brochard, Laurent; Costa, Eduardo L V; Schoenfeld, David A; Stewart, Thomas E; Briel, Matthias; Talmor, Daniel; Mercat, Alain; Richard, Jean-Christophe M; Carvalho, Carlos R R; Brower, Roy G

2015-02-19

Mechanical-ventilation strategies that use lower end-inspiratory (plateau) airway pressures, lower tidal volumes (VT), and higher positive end-expiratory pressures (PEEPs) can improve survival in patients with the acute respiratory distress syndrome (ARDS), but the relative importance of each of these components is uncertain. Because respiratory-system compliance (CRS) is strongly related to the volume of aerated remaining functional lung during disease (termed functional lung size), we hypothesized that driving pressure (ΔP=VT/CRS), in which VT is intrinsically normalized to functional lung size (instead of predicted lung size in healthy persons), would be an index more strongly associated with survival than VT or PEEP in patients who are not actively breathing. Using a statistical tool known as multilevel mediation analysis to analyze individual data from 3562 patients with ARDS enrolled in nine previously reported randomized trials, we examined ΔP as an independent variable associated with survival. In the mediation analysis, we estimated the isolated effects of changes in ΔP resulting from randomized ventilator settings while minimizing confounding due to the baseline severity of lung disease. Among ventilation variables, ΔP was most strongly associated with survival. A 1-SD increment in ΔP (approximately 7 cm of water) was associated with increased mortality (relative risk, 1.41; 95% confidence interval [CI], 1.31 to 1.51; P<0.001), even in patients receiving "protective" plateau pressures and VT (relative risk, 1.36; 95% CI, 1.17 to 1.58; P<0.001). Individual changes in VT or PEEP after randomization were not independently associated with survival; they were associated only if they were among the changes that led to reductions in ΔP (mediation effects of ΔP, P=0.004 and P=0.001, respectively). We found that ΔP was the ventilation variable that best stratified risk. Decreases in ΔP owing to changes in ventilator settings were strongly associated with increased survival. (Funded by Fundação de Amparo e Pesquisa do Estado de São Paulo and others.).

LHC: The Emptiest Space in the Solar System

ERIC Educational Resources Information Center

Cid-Vidal, Xabier; Cid, Ramon

2011-01-01

Proton beams have been colliding at 7 TeV in the Large Hadron Collider (LHC) since 30 March 2010, meaning that the LHC research programme is underway. Particle physicists around the world are looking forward to using the data from these collisions, as the LHC is running at an energy three and a half times higher than previously achieved at any…

Induced activation studies for the LHC upgrade to High Luminosity LHC

NASA Astrophysics Data System (ADS)

Adorisio, C.; Roesler, S.

2018-06-01

The Large Hadron Collider (LHC) will be upgraded in 2019/2020 to increase its luminosity (rate of collisions) by a factor of five beyond its design value and the integrated luminosity by a factor ten, in order to maintain scientific progress and exploit its full capacity. The novel machine configuration, called High Luminosity LHC (HL-LHC), will increase consequently the level of activation of its components. The evaluation of the radiological impact of the HL-LHC operation in the Long Straight Sections of the Insertion Region 1 (ATLAS) and Insertion Region 5 (CMS) is presented. Using the Monte Carlo code FLUKA, ambient dose equivalent rate estimations have been performed on the basis of two announced operating scenarios and using the latest available machine layout. The HL-LHC project requires new technical infrastructure with caverns and 300 m long tunnels along the Insertion Regions 1 and 5. The new underground service galleries will be accessible during the operation of the accelerator machine. The radiological risk assessment for the Civil Engineering work foreseen to start excavating the new galleries in the next LHC Long Shutdown and the radiological impact of the machine operation will be discussed.

Anatomy of the inert two-Higgs-doublet model in the light of the LHC and non-LHC dark matter searches

NASA Astrophysics Data System (ADS)

Belyaev, Alexander; Cacciapaglia, Giacomo; Ivanov, Igor P.; Rojas-Abatte, Felipe; Thomas, Marc

2018-02-01

The inert two-Higgs-doublet model (i2HDM) is a theoretically well-motivated example of a minimal consistent dark matter (DM) model which provides monojet, mono-Z , mono-Higgs, and vector-boson-fusion +ETmiss signatures at the LHC, complemented by signals in direct and indirect DM search experiments. In this paper we have performed a detailed analysis of the constraints in the full five-dimensional parameter space of the i2HDM, coming from perturbativity, unitarity, electroweak precision data, Higgs data from the LHC, DM relic density, direct/indirect DM detection, and LHC monojet analysis, as well as implications of experimental LHC studies on disappearing charged tracks relevant to a high DM mass region. We demonstrate the complementarity of the above constraints and present projections for future LHC data and direct DM detection experiments to probe further i2HDM parameter space. The model is implemented into the CalcHEP and micrOMEGAs packages, which are publicly available at the HEPMDB database, and it is ready for a further exploration in the context of the LHC, relic density, and DM direct detection.

Physiologic Evaluation of Ventilation Perfusion Mismatch and Respiratory Mechanics at Different Positive End-expiratory Pressure in Patients Undergoing Protective One-lung Ventilation.

PubMed

Spadaro, Savino; Grasso, Salvatore; Karbing, Dan Stieper; Fogagnolo, Alberto; Contoli, Marco; Bollini, Giacomo; Ragazzi, Riccardo; Cinnella, Gilda; Verri, Marco; Cavallesco, Narciso Giorgio; Rees, Stephen Edward; Volta, Carlo Alberto

2018-03-01

Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed. Shunt fraction, high V/Q and respiratory mechanics were measured at positive end-expiratory pressure 0 cm H2O during bilateral lung ventilation and one-lung ventilation and, subsequently, during one-lung ventilation at 5 or 10 cm H2O of positive end-expiratory pressure. Shunt fraction and high V/Q were measured using variation of inspired oxygen fraction and measurement of respiratory gas concentration and arterial blood gas. The level of positive end-expiratory pressure was applied in random order and maintained for 15 min before measurements. During one-lung ventilation, increasing positive end-expiratory pressure from 0 cm H2O to 5 cm H2O and 10 cm H2O resulted in a shunt fraction decrease of 5% (0 to 11) and 11% (5 to 16), respectively (P < 0.001). The PaO2/FIO2 ratio increased significantly only at a positive end-expiratory pressure of 10 cm H2O (P < 0.001). Driving pressure decreased from 16 ± 3 cm H2O at a positive end-expiratory pressure of 0 cm H2O to 12 ± 3 cm H2O at a positive end-expiratory pressure of 10 cm H2O (P < 0.001). The high V/Q ratio did not change. During low VT one-lung ventilation, high positive end-expiratory pressure levels improve pulmonary function without increasing high V/Q and reduce driving pressure.

Run II of the LHC: The Accelerator Science

NASA Astrophysics Data System (ADS)

Redaelli, Stefano

2015-04-01

In 2015 the Large Hadron Collider (LHC) at the European Organization for Nuclear Research (CERN) starts its Run II operation. After the successful Run I at 3.5 TeV and 4 TeV in the 2010-2013 period, a first long shutdown (LS1) was mainly dedicated to the consolidation of the LHC magnet interconnections, to allow the LHC to operate at its design beam energy of 7 TeV. Other key accelerator systems have also been improved to optimize the performance reach at higher beam energies. After a review of the LS1 activities, the status of the LHC start-up progress is reported, addressing in particular the status of the LHC hardware commissioning and of the training campaign of superconducting magnets that will determine the operation beam energy in 2015. Then, the plans for the Run II operation are reviewed in detail, covering choice of initial machine parameters and strategy to improve the Run II performance. Future prospects of the LHC and its upgrade plans are also presented.

Will there be energy frontier colliders after LHC?

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

Shiltsev, Vladimir

2016-09-15

High energy particle colliders have been in the forefront of particle physics for more than three decades. At present the near term US, European and international strategies of the particle physics community are centered on full exploitation of the physics potential of the Large Hadron Collider (LHC) through its high-luminosity upgrade (HL-LHC). The future of the world-wide HEP community critically depends on the feasibility of possible post-LHC colliders. The concept of the feasibility is complex and includes at least three factors: feasibility of energy, feasibility of luminosity and feasibility of cost. Here we overview all current options for post-LHC collidersmore » from such perspective (ILC, CLIC, Muon Collider, plasma colliders, CEPC, FCC, HE-LHC) and discuss major challenges and accelerator R&D required to demonstrate feasibility of an energy frontier accelerator facility following the LHC. We conclude by taking a look into ultimate energy reach accelerators based on plasmas and crystals, and discussion on the perspectives for the far future of the accelerator-based particle physics.« less

The High Luminosity LHC Project

NASA Astrophysics Data System (ADS)

Rossi, Lucio

The High Luminosity LHC is one of the major scientific project of the next decade. It aims at increasing the luminosity reach of LHC by a factor five for peak luminosity and a factor ten in integrated luminosity. The project, now fully approved and funded, will be finished in ten years and will prolong the life of LHC until 2035-2040. It implies deep modifications of the LHC for about 1.2 km around the high luminosity insertions of ATLAS and CMS and relies on new cutting edge technologies. We are developing new advanced superconducting magnets capable of reaching 12 T field; superconducting RF crab cavities capable to rotate the beams with great accuracy; 100 kA and hundred meter long superconducting links for removing the power converter out of the tunnel; new collimator concepts, etc... Beside the important physics goals, the High Luminosity LHC project is an ideal test bed for new technologies for the next hadron collider for the post-LHC era.

High Resolution Time Series Cave Ventilation Processes and the Effects on Cave Air Chemistry and Drip Waters: Speleoclimatology and Proxy Calibration

NASA Astrophysics Data System (ADS)

Kowalczk, A. J.; Froelich, P. N.; Gaffka, C.; Tremaine, D.

2008-12-01

Continuous high resolution (sub-hourly), long-term (Nov 2007-present) monitoring of cave air chemistry (Temperature, Relative Humidity, Barometric Pressure, Radon-222, CO2, Air flow, Wind speed and direction) in a shallow subtropical cave (Hollow Ridge) in N Florida reveals two major ventilation mechanisms: 1) ventilation driven by winds across the cave entrances, and 2) ventilation driven by density differences between atmospheric and cave air. The degree and type of ventilation strongly influence the 222Rn and CO2 of cave air, which in turn affects the timing and extent of calcite deposition in speleothems. The degree of ventilation is estimated using a cave air CO2-δ13CO2 Keeling Plot, or a simple radon deficiency model. Results show cave air has an atmospheric component ranging from 10-90%. During fall and winter, average CO2 (700 ppmv) and 222Rn (50-100 dpm/L) are lower than in spring and summer (CO2 = 1200 ppmv; 222Rn = 1000 dpm/L) due to increased winter ventilation. Decreased ventilation during the summer allows CO2 and 222Rn levels to rise. Winter daily ventilation is primarily a function of density gradients between cave air and atmospheric air, while summer daily ventilation is primarily a function of late morning NW-NE winds above the cave. Stable isotope analyses of drip water (fracture drip and pore flow drip) and aquifer water from Hollow Ridge agree with previous isotope studies of drip water at Florida Caverns State Park, 2 km to the NE. During summer, isotopic composition of pore flow drip water (δ18O -3.8 to -4.0 per mil; δD -17.3 to -20.2 per mil VSMOW) and aquifer water (δ18O -4.0 per mil; δD -18.0 to -21.1 per mil) are similar to average annual weighted isotopic composition of precipitation (δ18O -3.6 per mil) while fracture drip waters (δ18O -3 to -3.4 per mil; δD -11.9 to -14.3 per mil) likely reflect the isotopic composition of individual precipitation events. Pore flow drip waters δ18O are weakly correlated with drip rates (enriched δ18O during periods of higher drip rates) but show no correlation to precipitation amount. Knowledge of the type of drip flow is important when considering stalagmites for paleoclimate studies. A significant decrease in drip rate was observed from June (1034 drips/hour) through August 2008 (34 drips/hour). Higher water demands during summer months with increased evapotranspiration may be responsible for this decrease. A semi-diurnal drip rate cycle, negatively correlated with barometric pressure, is also observed throughout the period. This strong negative correlation is hypothesized to be controlled by atmospheric tidal oscillations. Observations into the fall and winter seasons should reveal seasonality, if any, and if there is an evapotranspiration effect present in the water cycle. High resolution studies of cave air chemistry and ventilation processes will enhance knowledge of the timing, extent, and isotopic and chemical composition of calcite deposition. When combined with drip water and precipitation isotope analyses, these studies will improve the understanding and interpretation of high- resolution (sub-annual) speleothem paleoclimate records.

Using tevatron magnets for HE-LHC or new ring in LHC tunnel

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

Piekarz, Henryk; /Fermilab

Two injector accelerator options for HE-LHC of p{sup +} - p{sup +} collisions at 33 TeV cms energy are briefly outlined. One option is based on the Super-SPS (S-SPS) accelerator in the SPS tunnel, and the other one is based on the LER (Low-Energy-Ring) accelerator in the LHC tunnel. Expectations of performance of the main arc accelerator magnets considered for the construction of the S-SPS and of the LER accelerators are used to tentatively devise some selected properties of these accelerators as potential injectors to HE-LHC.

The development of diamond tracking detectors for the LHC

NASA Astrophysics Data System (ADS)

Adam, W.; Berdermann, E.; Bergonzo, P.; de Boer, W.; Bogani, F.; Borchi, E.; Brambilla, A.; Bruzzi, M.; Colledani, C.; Conway, J.; D'Angelo, P.; Dabrowski, W.; Delpierre, P.; Doroshenko, J.; Dulinski, W.; van Eijk, B.; Fallou, A.; Fischer, P.; Fizzotti, F.; Furetta, C.; Gan, K. K.; Ghodbane, N.; Grigoriev, E.; Hallewell, G.; Han, S.; Hartjes, F.; Hrubec, J.; Husson, D.; Kagan, H.; Kaplon, J.; Karl, C.; Kass, R.; Keil, M.; Knöpfle, K. T.; Koeth, T.; Krammer, M.; Logiudice, A.; Lu, R.; mac Lynne, L.; Manfredotti, C.; Marshall, R. D.; Meier, D.; Menichelli, D.; Meuser, S.; Mishina, M.; Moroni, L.; Noomen, J.; Oh, A.; Perera, L.; Pernegger, H.; Pernicka, M.; Polesello, P.; Potenza, R.; Riester, J. L.; Roe, S.; Rudge, A.; Sala, S.; Sampietro, M.; Schnetzer, S.; Sciortino, S.; Stelzer, H.; Stone, R.; Sutera, C.; Trischuk, W.; Tromson, D.; Tuve, C.; Vincenzo, B.; Weilhammer, P.; Wermes, N.; Wetstein, M.; Zeuner, W.; Zoeller, M.; RD42 Collaboration

2003-11-01

Chemical vapor deposition diamond has been discussed extensively as an alternate sensor material for use very close to the interaction region of the LHC where extreme radiation conditions exist. During the last few years diamond devices have been manufactured and tested with LHC electronics with the goal of creating a detector usable by all LHC experiment. Extensive progress on diamond quality, on the development of diamond trackers and on radiation hardness studies has been made. Transforming the technology to the LHC specific requirements is now underway. In this paper we present the recent progress achieved.

WASTE HANDLING BUILDING VENTILATION SYSTEM DESCRIPTION DOCUMENT

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

P.A. Kumar

2000-06-21

The Waste Handling Building Ventilation System provides heating, ventilation, and air conditioning (HVAC) for the contaminated, potentially contaminated, and uncontaminated areas of the Monitored Geologic Repository's (MGR) Waste Handling Building (WHB). In the uncontaminated areas, the non-confinement area ventilation system maintains the proper environmental conditions for equipment operation and personnel comfort. In the contaminated and potentially contaminated areas, in addition to maintaining the proper environmental conditions for equipment operation and personnel comfort, the contamination confinement area ventilation system directs potentially contaminated air away from personnel in the WHB and confines the contamination within high-efficiency particulate air (HEPA) filtration units. Themore » contamination confinement areas ventilation system creates airflow paths and pressure zones to minimize the potential for spreading contamination within the building. The contamination confinement ventilation system also protects the environment and the public by limiting airborne releases of radioactive or other hazardous contaminants from the WHB. The Waste Handling Building Ventilation System is designed to perform its safety functions under accident conditions and other Design Basis Events (DBEs) (such as earthquakes, tornadoes, fires, and loss of the primary electric power). Additional system design features (such as compartmentalization with independent subsystems) limit the potential for cross-contamination within the WHB. The system provides status of important system parameters and equipment operation, and provides audible and/or visual indication of off-normal conditions and equipment failures. The Waste Handling Building Ventilation System confines the radioactive and hazardous material within the building such that the release rates comply with regulatory limits. The system design, operations, and maintenance activities incorporate ALARA (as low as is reasonably achievable) principles to maintain personnel radiation doses to all occupational workers below regulatory limits and as low as is reasonably achievable. The Waste Handling Building Ventilation System interfaces with the Waste Handling Building System by being located within the WHB and by maintaining specific pressures, temperatures, and humidity within the building. The system also depends on the WHB for water supply. The system interfaces with the Site Radiological Monitoring System for continuous monitoring of the exhaust air; the Waste Handling Building Fire Protection System for detection of fire and smoke; the Waste Handling Building Electrical System for normal, emergency, and standby power; and the Monitored Geologic Repository Operations Monitoring and Control System for monitoring and control of the system.« less

TU-G-BRA-03: Predicting Radiation Therapy Induced Ventilation Changes Using 4DCT Jacobian Calculations

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

Patton, T; Du, K; Bayouth, J

2015-06-15

Purpose: Longitudinal changes in lung ventilation following radiation therapy can be mapped using four-dimensional computed tomography(4DCT) and image registration. This study aimed to predict ventilation changes caused by radiation therapy(RT) as a function of pre-RT ventilation and delivered dose. Methods: 4DCT images were acquired before and 3 months after radiation therapy for 13 subjects. Jacobian ventilation maps were calculated from the 4DCT images, warped to a common coordinate system, and a Jacobian ratio map was computed voxel-by-voxel as the ratio of post-RT to pre-RT Jacobian calculations. A leave-one-out method was used to build a response model for each subject: post-RTmore » to pre-RT Jacobian ratio data and dose distributions of 12 subjects were applied to the subject’s pre-RT Jacobian map to predict the post-RT Jacobian. The predicted Jacobian map was compared to the actual post-RT Jacobian map to evaluate efficacy. Within this cohort, 8 subjects had repeat pre-RT scans that were compared as a reference for no ventilation change. Maps were compared using gamma pass rate criteria of 2mm distance-to-agreement and 6% ventilation difference. Gamma pass rates were compared using paired t-tests to determine significant differences. Further analysis masked non-radiation induced changes by excluding voxels below specified dose thresholds. Results: Visual inspection demonstrates the predicted post-RT ventilation map is similar to the actual map in magnitude and distribution. Quantitatively, the percentage of voxels in agreement when excluding voxels receiving below specified doses are: 74%/20Gy, 73%/10Gy, 73%/5Gy, and 71%/0Gy. By comparison, repeat scans produced 73% of voxels within the 6%/2mm criteria. The agreement of the actual post-RT maps with the predicted maps was significantly better than agreement with pre-RT maps (p<0.02). Conclusion: This work validates that significant changes to ventilation post-RT can be predicted. The differences between the predicted and actual outcome are similar to differences between repeat scans with equivalent ventilation. This work was supported by NIH grant CA166703 and a Pilot Grant from University of Iowa Carver College of Medicine.« less

Corticosteroids and fetal intervention interact to alter lung maturation in preterm lambs.

PubMed

Tabor, B L; Lewis, J F; Ikegami, M; Polk, D; Jobe, A H

1994-04-01

The relationship between cortisol infusion and time of fetal catheterization on postnatal lung function of prematurely delivered lambs was investigated with the hypothesis that the intervention of catheterization would alter fetal responsiveness to the maturational effects of corticosteroids. Fetal catheterization was performed on d 117 or on d 122 of gestation. Cortisol or saline control infusions were begun on d 126, with delivery 60 h later on d 128. The animals were ventilated for 1.25 h after delivery, and compliance, the ventilation efficiency index, labeled albumin leak into and out of the lungs, alveolar and lung saturated phosphatidylcholine and surfactant protein A were measured to evaluate lung performance and biochemical indicators of maturation. Cortisol improved compliance and ventilation efficiency and decreased labeled albumin recovery without changing alveolar saturated phosphatidylcholine or surfactant protein A in the animals catheterized at 122 d relative to 122-d saline-infused animals. However, the animals catheterized at 117 d and infused with saline were as mature as assessed by compliance and ventilation efficiency as the 122-d cortisol-treated animals. The 117-d cortisol-infused animals had significantly augmented lung function relative to either 117-d saline-infused or 122-d cortisol-treated lambs and were the only group that had increased alveolar surfactant protein A and lung saturated phosphatidylcholine pool sizes. This study demonstrates that the response of the fetal lung to a maturational agent such as cortisol is dependent on the history of previous fetal interventions.

Prevention of abnormal pulmonary mechanics in the postmortem guinea pig lung.

PubMed

Reynolds, A M; McEvoy, R D

1988-04-01

Severe postmortem bronchoconstriction has been shown previously in guinea pig lungs and linked to pulmonary blood loss during exsanguination (Lai et al., J. Appl. Physiol. 56: 308-314, 1984). To reexamine this phenomenon we measured postmortem airway function in anesthetized open-chest guinea pigs after sudden circulatory arrest. Animals were divided into 4 groups of 10 and ventilated for 15 min postmortem with different gases: 1) room air, 2) conditioned air, 3) dry 5% CO2-21% O2-74% N2, and 4) conditioned 5% CO2-21% O2-74% N2. In room air-ventilated lungs there was a 50% decrease in dynamic compliance (Cdyn) by 15 min and marked gas trapping compared with control lungs. Conditioning the room air did not attenuate these changes, but when 5% CO2 was added to the conditioned postmortem inspirate, gas trapping was eliminated and the fall in Cdyn was almost abolished. Ventilation with a dry 5% CO2 gas mixture at room temperature resulted in a 31% fall in Cdyn at 15 min but no gas trapping. We conclude that marked abnormalities of airway function occur postmortem in room air-ventilated guinea pig lungs in the absence of pulmonary blood loss. The changes are mainly due to airway hypocarbia, a known cause of bronchoconstriction, but a reduction in Cdyn can also occur if there is marked airway cooling and drying. Acute postmortem airway dysfunction can be prevented in the guinea pig by maintaining normal airway gas composition.

Dihadron production at the LHC: full next-to-leading BFKL calculation

NASA Astrophysics Data System (ADS)

Celiberto, Francesco G.; Ivanov, Dmitry Yu.; Murdaca, Beatrice; Papa, Alessandro

2017-06-01

The study of the inclusive production of a pair of charged light hadrons (a "dihadron" system) featuring high transverse momenta and well separated in rapidity represents a clear channel for the test of the BFKL dynamics at the Large Hadron Collider (LHC). This process has much in common with the well-known Mueller-Navelet jet production; however, hadrons can be detected at much smaller values of the transverse momentum than jets, thus allowing to explore an additional kinematic range, supplementary to the one studied with Mueller-Navelet jets. Furthermore, it makes it possible to constrain not only the parton densities (PDFs) for the initial proton, but also the parton fragmentation functions (FFs) describing the detected hadron in the final state. Here, we present the first full NLA BFKL analysis for cross sections and azimuthal angle correlations for dihadrons produced in the LHC kinematic ranges. We make use of the Brodsky-Lapage-Mackenzie optimization method to set the values of the renormalization scale and study the effect of choosing different values for the factorization scale. We also gauge the uncertainty coming from the use of different PDF and FF parametrizations.

Enhanced Higgs mass in Compact Supersymmetry

DOE PAGES

Tobioka, Kohsaku; Kitano, Ryuichiro; Murayama, Hitoshi

2016-04-05

The current LHC results make weak scale supersymmetry difficult due to relatively heavy mass of the discovered Higgs boson and the null results of new particle searches. Geometrical supersymmetry breaking from extra dimensions, Scherk-Schwarz mechanism, is possible to accommodate such situations. A concrete example, the Compact Supersymmetry model, has a compressed spectrum ameliorating the LHC bounds and large mixing in the top and scalar top quark sector with (Formula presented.) which radiatively raises the Higgs mass. And while the zero mode contribution of the model has been considered, in this paper we calculate the Kaluza-Klein tower effect to the Higgsmore » mass. Although such contributions are naively expected to be as small as a percent level for 10 TeV Kaluza-Klein modes, we find the effect significantly enhances the radiative correction to the Higgs quartic coupling by from 10 to 50%. This is mainly because the top quark wave function is pushed out from the brane, which makes the top mass depend on higher powers in the Higgs field. And, as a result the Higgs mass is enhanced up to 15 GeV from the previous calculation. We also show the whole parameter space is testable at the LHC run II.« less

Role of analgesics, sedatives, neuromuscular blockers, and delirium.

PubMed

Hall, Jesse B; Schweickert, William; Kress, John P

2009-10-01

A major focus on critical care medicine concerns the institution of life-support therapies, such as mechanical ventilation, during periods of organ failure to permit a window of opportunity to diagnose and treat underlying disorders so that patients may be returned to their prior functional status upon recovery. With the growing success of these intensive care unit-based therapies and longer-term follow-up of patients, severe weakness involving the peripheral nervous system and muscles has been identified in many recovering patients, often confounding the time course or magnitude of recovery. Mechanical ventilation is often accompanied by pharmacologic treatments including analgesics, sedatives, and neuromuscular blockers. These drugs and the encephalopathies accompanying some forms of critical illness result in a high prevalence of delirium in mechanically ventilated patients. These drug effects likely contribute to an impaired ability to assess the magnitude of intensive care unit-acquired weakness, to additional time spent immobilized and mechanically ventilated, and to additional weakness from the patient's relative immobility and bedridden state. This review surveys recent literature documenting these relationships and identifying approaches to minimize pharmacologic contributions to intensive care unit-acquired weakness.

Clinical characteristics of long-term survival with non-invasive ventilation and factors affecting the transition to invasive ventilation in ALS.

PubMed

Hirose, Takahiko; Kimura, Fumiharu; Tani, Hiroki; Ota, Shin; Tsukahara, Akihiro; Sano, Eri; Shigekiyo, Taro; Nakamura, Yoshitsugu; Kakiuchi, Kensuke; Motoki, Mikiko; Unoda, Kiichi; Ishida, Simon; Nakajima, Hideto; Arawaka, Shigeki

2018-04-20

Introduction We evaluated post non-invasive ventilation survival and factors for the transition to tracheostomy in amyotrophic lateral sclerosis. Methods We analyzed 197 patients using a prospectively-collected database, with 114 patients since 2000. Results Of 114 patients, 59 patients underwent non-invasive ventilation (NIV), which prolonged the total median survival time to 43 months compared with 32 months without treatment. The best post-NIV survival was associated with a lack of bulbar symptoms, higher measured pulmonary function, and a slower rate of progression at diagnosis. The transition rate from NIV to tracheostomy gradually decreased over the years. Patients using NIV for more than 6 months were more likely to refuse tracheostomy and to be female. Discussion This study confirmed a positive survival effect with NIV, which was less effective in patients with bulbar dysfunction. Further studies are necessary to determine the best timing for using NIV with ALS in patients with bulbar dysfunction. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

New experimental constrains on chiral magnetic effect using charge-dependent azimuthal correlation in pPb and PbPb collisions at the LHC

NASA Astrophysics Data System (ADS)

Tu, Zhoudunming

2018-01-01

Studies of charge-dependent azimuthal correlations for the same- and oppositesign particle pairs are presented in PbPb collisions at 5 TeV and pPb collisions at 5 and 8.16 TeV, with the CMS experiment at the LHC. The azimuthal correlations are evaluated with respect to the second- and also higher-order event planes, as a function of particle pseudorapidity and transverse momentum, and event multiplicity. By employing an event-shape engineering technique, the dependence of correlations on azimuthal anisotropy flow is investigated. Results presented provide new insights to the origin of observed charge-dependent azimuthal correlations, and have important implications to the search for the chiral magnetic effect in heavy ion collisions.

Energy dependence of strangeness production and event-byevent fluctuations

NASA Astrophysics Data System (ADS)

Rustamov, Anar

2018-02-01

We review the energy dependence of strangeness production in nucleus-nucleus collisions and contrast it with the experimental observations in pp and p-A collisions at LHC energies as a function of the charged particle multiplicities. For the high multiplicity final states the results from pp and p-Pb reactions systematically approach the values obtained from Pb-Pb collisions. In statistical models this implies an approach to the thermodynamic limit, where differences of mean multiplicities between various formalisms, such as Canonical and Grand Canonical Ensembles, vanish. Furthermore, we report on event-by-event net-proton fluctuations as measured by STAR at RHIC/BNL and by ALICE at LHC/CERN and discuss various non-dynamical contributions to these measurements, which should be properly subtracted before comparison to theoretical calculations on dynamical net-baryon fluctuations.

The front-end data conversion and readout electronics for the CMS ECAL upgrade

NASA Astrophysics Data System (ADS)

Mazza, G.; Cometti, S.

2018-03-01

The High Luminosity LHC (HL-LHC) will require a significant upgrade of the readout electronics for the CMS Electromagnetic Calorimeter (ECAL). The Very Front-End (VFE) output signal will be sampled at 160 MS/s (i.e. four times the current sampling rate) with a 13 bits resolution. Therefore, a high-speed, high-resolution ADC is required. Moreover, each readout channel will produce 2.08 Gb/s, thus requiring a fast data transmission circuitry. A new readout architecture, based on two 12 bit, 160 MS/s ADCs, lossless data compression algorithms and fast serial links have been developed for the ECAL upgrade. These functions will be integrated in a single ASIC which is currently under design in a commercial CMOS 65 nm technology using radiation damage mitigation techniques.

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

Aaboud, M.; Aad, G.; Abbott, B.

A search for W' bosons in events with one lepton (electron or muon) and missing transverse momentum is presented. The search uses 3.2 fb -1 of pp collision data collected at √s=13 TeV by the ATLAS experiment at the LHC in 2015. The transverse mass distribution is examined and no significant excess of events above the level expected from Standard Model processes is observed. Upper limits on the W' boson cross-section times branching ratio to leptons are set as a function of the W' mass. Within the Sequential Standard Model W ' masses below 4.07 TeV are excluded at the 95%more » confidence level. This extends the limit set using LHC data at √s=8 TeV by around 800 GeV.« less

Observation of a diffractive contribution to dijet production in proton-proton collisions at s=7TeV

NASA Astrophysics Data System (ADS)

Chatrchyan, S.; Khachatryan, V.; Sirunyan, A. M.; Tumasyan, A.; Adam, W.; Aguilo, E.; Bergauer, T.; Dragicevic, M.; Erö, J.; Fabjan, C.; Friedl, M.; Frühwirth, R.; Ghete, V. M.; Hammer, J.; Hörmann, N.; Hrubec, J.; Jeitler, M.; Kiesenhofer, W.; Knünz, V.; Krammer, M.; Krätschmer, I.; Liko, D.; Mikulec, I.; Pernicka, M.; Rahbaran, B.; Rohringer, C.; Rohringer, H.; Schöfbeck, R.; Strauss, J.; Taurok, A.; Waltenberger, W.; Walzel, G.; Widl, E.; Wulz, C.-E.; Mossolov, V.; Shumeiko, N.; Suarez Gonzalez, J.; Bansal, S.; Cornelis, T.; De Wolf, E. A.; Janssen, X.; Luyckx, S.; Mucibello, L.; Ochesanu, S.; Roland, B.; Rougny, R.; Selvaggi, M.; Staykova, Z.; Van Haevermaet, H.; Van Mechelen, P.; Van Remortel, N.; Van Spilbeeck, A.; Blekman, F.; Blyweert, S.; D'Hondt, J.; Gonzalez Suarez, R.; Kalogeropoulos, A.; Maes, M.; Olbrechts, A.; Van Doninck, W.; Van Mulders, P.; Van Onsem, G. P.; Villella, I.; Clerbaux, B.; De Lentdecker, G.; Dero, V.; Gay, A. P. R.; Hreus, T.; Léonard, A.; Marage, P. E.; Mohammadi, A.; Reis, T.; Thomas, L.; Vander Marcken, G.; Vander Velde, C.; Vanlaer, P.; Wang, J.; Adler, V.; Beernaert, K.; Cimmino, A.; Costantini, S.; Garcia, G.; Grunewald, M.; Klein, B.; Lellouch, J.; Marinov, A.; Mccartin, J.; Ocampo Rios, A. A.; Ryckbosch, D.; Strobbe, N.; Thyssen, F.; Tytgat, M.; Verwilligen, P.; Walsh, S.; Yazgan, E.; Zaganidis, N.; Basegmez, S.; Bruno, G.; Castello, R.; Ceard, L.; Delaere, C.; du Pree, T.; Favart, D.; Forthomme, L.; Giammanco, A.; Hollar, J.; Lemaitre, V.; Liao, J.; Militaru, O.; Nuttens, C.; Pagano, D.; Pin, A.; Piotrzkowski, K.; Schul, N.; Vizan Garcia, J. M.; Beliy, N.; Caebergs, T.; Daubie, E.; Hammad, G. H.; Alves, G. A.; Correa Martins Junior, M.; De Jesus Damiao, D.; Martins, T.; Pol, M. E.; Souza, M. H. G.; Aldá Júnior, W. L.; Carvalho, W.; Custódio, A.; Da Costa, E. M.; De Oliveira Martins, C.; Fonseca De Souza, S.; Matos Figueiredo, D.; Mundim, L.; Nogima, H.; Oguri, V.; Prado Da Silva, W. L.; Santoro, A.; Soares Jorge, L.; Sznajder, A.; Anjos, T. S.; Bernardes, C. A.; Dias, F. A.; Fernandez Perez Tomei, T. R.; Gregores, E. M.; Lagana, C.; Marinho, F.; Mercadante, P. G.; Novaes, S. F.; Padula, Sandra S.; Genchev, V.; Iaydjiev, P.; Piperov, S.; Rodozov, M.; Stoykova, S.; Sultanov, G.; Tcholakov, V.; Trayanov, R.; Vutova, M.; Dimitrov, A.; Hadjiiska, R.; Kozhuharov, V.; Litov, L.; Pavlov, B.; Petkov, P.; Bian, J. G.; Chen, G. M.; Chen, H. S.; Jiang, C. H.; Liang, D.; Liang, S.; Meng, X.; Tao, J.; Wang, J.; Wang, X.; Wang, Z.; Xiao, H.; Xu, M.; Zang, J.; Zhang, Z.; Asawatangtrakuldee, C.; Ban, Y.; Guo, S.; Guo, Y.; Li, W.; Liu, S.; Mao, Y.; Qian, S. J.; Teng, H.; Wang, D.; Zhang, L.; Zhu, B.; Zou, W.; Avila, C.; Gomez, J. P.; Gomez Moreno, B.; Osorio Oliveros, A. F.; Sanabria, J. C.; Godinovic, N.; Lelas, D.; Plestina, R.; Polic, D.; Puljak, I.; Antunovic, Z.; Kovac, M.; Brigljevic, V.; Duric, S.; Kadija, K.; Luetic, J.; Morovic, S.; Attikis, A.; Galanti, M.; Mavromanolakis, G.; Mousa, J.; Nicolaou, C.; Ptochos, F.; Razis, P. A.; Finger, M.; Finger, M., Jr.; Assran, Y.; Elgammal, S.; Ellithi Kamel, A.; Khalil, S.; Mahmoud, M. A.; Radi, A.; Kadastik, M.; Müntel, M.; Raidal, M.; Rebane, L.; Tiko, A.; Eerola, P.; Fedi, G.; Voutilainen, M.; Härkönen, J.; Heikkinen, A.; Karimäki, V.; Kinnunen, R.; Kortelainen, M. J.; Lampén, T.; Lassila-Perini, K.; Lehti, S.; Lindén, T.; Luukka, P.; Mäenpää, T.; Peltola, T.; Tuominen, E.; Tuominiemi, J.; Tuovinen, E.; Ungaro, D.; Wendland, L.; Banzuzi, K.; Karjalainen, A.; Korpela, A.; Tuuva, T.; Besancon, M.; Choudhury, S.; Dejardin, M.; Denegri, D.; Fabbro, B.; Faure, J. L.; Ferri, F.; Ganjour, S.; Givernaud, A.; Gras, P.; Hamel de Monchenault, G.; Jarry, P.; Locci, E.; Malcles, J.; Millischer, L.; Nayak, A.; Rander, J.; Rosowsky, A.; Shreyber, I.; Titov, M.; Baffioni, S.; Beaudette, F.; Benhabib, L.; Bianchini, L.; Bluj, M.; Broutin, C.; Busson, P.; Charlot, C.; Daci, N.; Dahms, T.; Dobrzynski, L.; Granier de Cassagnac, R.; Haguenauer, M.; Miné, P.; Mironov, C.; Naranjo, I. N.; Nguyen, M.; Ochando, C.; Paganini, P.; Sabes, D.; Salerno, R.; Sirois, Y.; Veelken, C.; Zabi, A.; Agram, J.-L.; Andrea, J.; Bloch, D.; Bodin, D.; Brom, J.-M.; Cardaci, M.; Chabert, E. C.; Collard, C.; Conte, E.; Drouhin, F.; Ferro, C.; Fontaine, J.-C.; Gelé, D.; Goerlach, U.; Juillot, P.; Le Bihan, A.-C.; Van Hove, P.; Fassi, F.; Mercier, D.; Beauceron, S.; Beaupere, N.; Bondu, O.; Boudoul, G.; Chasserat, J.; Chierici, R.; Contardo, D.; Depasse, P.; El Mamouni, H.; Fay, J.; Gascon, S.; Gouzevitch, M.; Ille, B.; Kurca, T.; Lethuillier, M.; Mirabito, L.; Perries, S.; Sordini, V.; Tschudi, Y.; Verdier, P.; Viret, S.; Tsamalaidze, Z.; Anagnostou, G.; Beranek, S.; Edelhoff, M.; Feld, L.; Heracleous, N.; Hindrichs, O.; Jussen, R.; Klein, K.; Merz, J.; Ostapchuk, A.; Perieanu, A.; Raupach, F.; Sammet, J.; Schael, S.; Sprenger, D.; Weber, H.; Wittmer, B.; Zhukov, V.; Ata, M.; Caudron, J.; Dietz-Laursonn, E.; Duchardt, D.; Erdmann, M.; Fischer, R.; Güth, A.; Hebbeker, T.; Heidemann, C.; Hoepfner, K.; Klingebiel, D.; Kreuzer, P.; Magass, C.; Merschmeyer, M.; Meyer, A.; Olschewski, M.; Papacz, P.; Pieta, H.; Reithler, H.; Schmitz, S. A.; Sonnenschein, L.; Steggemann, J.; Teyssier, D.; Weber, M.; Bontenackels, M.; Cherepanov, V.; Flügge, G.; Geenen, H.; Geisler, M.; Haj Ahmad, W.; Hoehle, F.; Kargoll, B.; Kress, T.; Kuessel, Y.; Nowack, A.; Perchalla, L.; Pooth, O.; Sauerland, P.; Stahl, A.; Aldaya Martin, M.; Behr, J.; Behrenhoff, W.; Behrens, U.; Bergholz, M.; Bethani, A.; Borras, K.; Burgmeier, A.; Cakir, A.; Calligaris, L.; Campbell, A.; Castro, E.; Costanza, F.; Dammann, D.; Diez Pardos, C.; Eckerlin, G.; Eckstein, D.; Flucke, G.; Geiser, A.; Glushkov, I.; Gunnellini, P.; Habib, S.; Hauk, J.; Hellwig, G.; Jung, H.; Kasemann, M.; Katsas, P.; Kleinwort, C.; Kluge, H.; Knutsson, A.; Krämer, M.; Krücker, D.; Kuznetsova, E.; Lange, W.; Lohmann, W.; Lutz, B.; Mankel, R.; Marfin, I.; Marienfeld, M.; Melzer-Pellmann, I.-A.; Meyer, A. B.; Mnich, J.; Mussgiller, A.; Naumann-Emme, S.; Olzem, J.; Perrey, H.; Petrukhin, A.; Pitzl, D.; Raspereza, A.; Ribeiro Cipriano, P. M.; Riedl, C.; Ron, E.; Rosin, M.; Salfeld-Nebgen, J.; Schmidt, R.; Schoerner-Sadenius, T.; Sen, N.; Spiridonov, A.; Stein, M.; Walsh, R.; Wissing, C.; Autermann, C.; Blobel, V.; Draeger, J.; Enderle, H.; Erfle, J.; Gebbert, U.; Görner, M.; Hermanns, T.; Höing, R. S.; Kaschube, K.; Kaussen, G.; Kirschenmann, H.; Klanner, R.; Lange, J.; Mura, B.; Nowak, F.; Peiffer, T.; Pietsch, N.; Rathjens, D.; Sander, C.; Schettler, H.; Schleper, P.; Schlieckau, E.; Schmidt, A.; Schröder, M.; Schum, T.; Seidel, M.; Sola, V.; Stadie, H.; Steinbrück, G.; Thomsen, J.; Vanelderen, L.; Barth, C.; Berger, J.; Böser, C.; Chwalek, T.; De Boer, W.; Descroix, A.; Dierlamm, A.; Feindt, M.; Guthoff, M.; Hackstein, C.; Hartmann, F.; Hauth, T.; Heinrich, M.; Held, H.; Hoffmann, K. H.; Honc, S.; Katkov, I.; Komaragiri, J. R.; Lobelle Pardo, P.; Martschei, D.; Mueller, S.; Müller, Th.; Niegel, M.; Nürnberg, A.; Oberst, O.; Oehler, A.; Ott, J.; Quast, G.; Rabbertz, K.; Ratnikov, F.; Ratnikova, N.; Röcker, S.; Scheurer, A.; Schilling, F.-P.; Schott, G.; Simonis, H. J.; Stober, F. M.; Troendle, D.; Ulrich, R.; Wagner-Kuhr, J.; Wayand, S.; Weiler, T.; Zeise, M.; Daskalakis, G.; Geralis, T.; Kesisoglou, S.; Kyriakis, A.; Loukas, D.; Manolakos, I.; Markou, A.; Markou, C.; Mavrommatis, C.; Ntomari, E.; Gouskos, L.; Mertzimekis, T. J.; Panagiotou, A.; Saoulidou, N.; Evangelou, I.; Foudas, C.; Kokkas, P.; Manthos, N.; Papadopoulos, I.; Patras, V.; Bencze, G.; Hajdu, C.; Hidas, P.; Horvath, D.; Sikler, F.; Veszpremi, V.; Vesztergombi, G.; Beni, N.; Czellar, S.; Molnar, J.; Palinkas, J.; Szillasi, Z.; Karancsi, J.; Raics, P.; Trocsanyi, Z. L.; Ujvari, B.; Bansal, M.; Beri, S. B.; Bhatnagar, V.; Dhingra, N.; Gupta, R.; Kaur, M.; Mehta, M. Z.; Nishu, N.; Saini, L. K.; Sharma, A.; Singh, J. B.; Kumar, Ashok; Kumar, Arun; Ahuja, S.; Bhardwaj, A.; Choudhary, B. C.; Malhotra, S.; Naimuddin, M.; Ranjan, K.; Sharma, V.; Shivpuri, R. K.; Banerjee, S.; Bhattacharya, S.; Dutta, S.; Gomber, B.; Jain, Sa.; Jain, Sh.; Khurana, R.; Sarkar, S.; Sharan, M.; Abdulsalam, A.; Choudhury, R. K.; Dutta, D.; Kailas, S.; Kumar, V.; Mehta, P.; Mohanty, A. K.; Pant, L. M.; Shukla, P.; Aziz, T.; Ganguly, S.; Guchait, M.; Maity, M.; Majumder, G.; Mazumdar, K.; Mohanty, G. B.; Parida, B.; Sudhakar, K.; Wickramage, N.; Banerjee, S.; Dugad, S.; Arfaei, H.; Bakhshiansohi, H.; Etesami, S. M.; Fahim, A.; Hashemi, M.; Hesari, H.; Jafari, A.; Khakzad, M.; Mohammadi Najafabadi, M.; Paktinat Mehdiabadi, S.; Safarzadeh, B.; Zeinali, M.; Abbrescia, M.; Barbone, L.; Calabria, C.; Chhibra, S. S.; Colaleo, A.; Creanza, D.; De Filippis, N.; De Palma, M.; Fiore, L.; Iaselli, G.; Lusito, L.; Maggi, G.; Maggi, M.; Marangelli, B.; My, S.; Nuzzo, S.; Pacifico, N.; Pompili, A.; Pugliese, G.; Selvaggi, G.; Silvestris, L.; Singh, G.; Venditti, R.; Zito, G.; Abbiendi, G.; Benvenuti, A. C.; Bonacorsi, D.; Braibant-Giacomelli, S.; Brigliadori, L.; Capiluppi, P.; Castro, A.; Cavallo, F. R.; Cuffiani, M.; Dallavalle, G. M.; Fabbri, F.; Fanfani, A.; Fasanella, D.; Giacomelli, P.; Grandi, C.; Guiducci, L.; Marcellini, S.; Masetti, G.; Meneghelli, M.; Montanari, A.; Navarria, F. L.; Odorici, F.; Perrotta, A.; Primavera, F.; Rossi, A. M.; Rovelli, T.; Siroli, G. P.; Travaglini, R.; Albergo, S.; Cappello, G.; Chiorboli, M.; Costa, S.; Potenza, R.; Tricomi, A.; Tuve, C.; Barbagli, G.; Ciulli, V.; Civinini, C.; D'Alessandro, R.; Focardi, E.; Frosali, S.; Gallo, E.; Gonzi, S.; Meschini, M.; Paoletti, S.; Sguazzoni, G.; Tropiano, A.; Benussi, L.; Bianco, S.; Colafranceschi, S.; Fabbri, F.; Piccolo, D.; Fabbricatore, P.; Musenich, R.; Tosi, S.; Benaglia, A.; De Guio, F.; Di Matteo, L.; Fiorendi, S.; Gennai, S.; Ghezzi, A.; Malvezzi, S.; Manzoni, R. A.; Martelli, A.; Massironi, A.; Menasce, D.; Moroni, L.; Paganoni, M.; Pedrini, D.; Ragazzi, S.; Redaelli, N.; Sala, S.; Tabarelli de Fatis, T.; Buontempo, S.; Carrillo Montoya, C. A.; Cavallo, N.; De Cosa, A.; Dogangun, O.; Fabozzi, F.; Iorio, A. O. M.; Lista, L.; Meola, S.; Merola, M.; Paolucci, P.; Azzi, P.; Bacchetta, N.; Bellan, P.; Bisello, D.; Branca, A.; Carlin, R.; Checchia, P.; Dorigo, T.; Gasparini, F.; Gozzelino, A.; Kanishchev, K.; Lacaprara, S.; Lazzizzera, I.; Margoni, M.; Meneguzzo, A. T.; Pazzini, J.; Pozzobon, N.; Ronchese, P.; Simonetto, F.; Torassa, E.; Tosi, M.; Triossi, A.; Vanini, S.; Zotto, P.; Zumerle, G.; Gabusi, M.; Ratti, S. P.; Riccardi, C.; Torre, P.; Vitulo, P.; Biasini, M.; Bilei, G. M.; Fanò, L.; Lariccia, P.; Lucaroni, A.; Mantovani, G.; Menichelli, M.; Nappi, A.; Romeo, F.; Saha, A.; Santocchia, A.; Spiezia, A.; Taroni, S.; Azzurri, P.; Bagliesi, G.; Boccali, T.; Broccolo, G.; Castaldi, R.; D'Agnolo, R. T.; Dell'Orso, R.; Fiori, F.; Foà, L.; Giassi, A.; Kraan, A.; Ligabue, F.; Lomtadze, T.; Martini, L.; Messineo, A.; Palla, F.; Rizzi, A.; Serban, A. T.; Spagnolo, P.; Squillacioti, P.; Tenchini, R.; Tonelli, G.; Venturi, A.; Verdini, P. G.; Barone, L.; Cavallari, F.; Del Re, D.; Diemoz, M.; Fanelli, C.; Grassi, M.; Longo, E.; Meridiani, P.; Micheli, F.; Nourbakhsh, S.; Organtini, G.; Paramatti, R.; Rahatlou, S.; Sigamani, M.; Soffi, L.; Amapane, N.; Arcidiacono, R.; Argiro, S.; Arneodo, M.; Biino, C.; Cartiglia, N.; Costa, M.; Demaria, N.; Mariotti, C.; Maselli, S.; Migliore, E.; Monaco, V.; Musich, M.; Obertino, M. M.; Pastrone, N.; Pelliccioni, M.; Potenza, A.; Romero, A.; Ruspa, M.; Sacchi, R.; Solano, A.; Staiano, A.; Vilela Pereira, A.; Belforte, S.; Candelise, V.; Cossutti, F.; Della Ricca, G.; Gobbo, B.; Marone, M.; Montanino, D.; Penzo, A.; Schizzi, A.; Heo, S. G.; Kim, T. Y.; Nam, S. K.; Chang, S.; Kim, D. H.; Kim, G. N.; Kong, D. J.; Park, H.; Ro, S. R.; Son, D. C.; Son, T.; Kim, J. Y.; Kim, Zero J.; Song, S.; Choi, S.; Gyun, D.; Hong, B.; Jo, M.; Kim, H.; Kim, T. J.; Lee, K. S.; Moon, D. H.; Park, S. K.; Choi, M.; Kim, J. H.; Park, C.; Park, I. C.; Park, S.; Ryu, G.; Cho, Y.; Choi, Y.; Choi, Y. K.; Goh, J.; Kim, M. S.; Kwon, E.; Lee, B.; Lee, J.; Lee, S.; Seo, H.; Yu, I.; Bilinskas, M. J.; Grigelionis, I.; Janulis, M.; Juodagalvis, A.; Castilla-Valdez, H.; De La Cruz-Burelo, E.; Heredia-de La Cruz, I.; Lopez-Fernandez, R.; Magaña Villalba, R.; Martínez-Ortega, J.; Sánchez-Hernández, A.; Villasenor-Cendejas, L. M.; Carrillo Moreno, S.; Vazquez Valencia, F.; Salazar Ibarguen, H. A.; Casimiro Linares, E.; Morelos Pineda, A.; Reyes-Santos, M. A.; Krofcheck, D.; Bell, A. J.; Butler, P. H.; Doesburg, R.; Reucroft, S.; Silverwood, H.; Ahmad, M.; Ansari, M. H.; Asghar, M. I.; Hoorani, H. R.; Khalid, S.; Khan, W. A.; Khurshid, T.; Qazi, S.; Shah, M. A.; Shoaib, M.; Bialkowska, H.; Boimska, B.; Frueboes, T.; Gokieli, R.; Górski, M.; Kazana, M.; Nawrocki, K.; Romanowska-Rybinska, K.; Szleper, M.; Wrochna, G.; Zalewski, P.; Brona, G.; Bunkowski, K.; Cwiok, M.; Dominik, W.; Doroba, K.; Kalinowski, A.; Konecki, M.; Krolikowski, J.; Almeida, N.; Bargassa, P.; David, A.; Faccioli, P.; Ferreira Parracho, P. 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V.; Vinogradov, A.; Azhgirey, I.; Bayshev, I.; Bitioukov, S.; Grishin, V.; Kachanov, V.; Konstantinov, D.; Korablev, A.; Krychkine, V.; Petrov, V.; Ryutin, R.; Sobol, A.; Tourtchanovitch, L.; Troshin, S.; Tyurin, N.; Uzunian, A.; Volkov, A.; Adzic, P.; Djordjevic, M.; Ekmedzic, M.; Krpic, D.; Milosevic, J.; Aguilar-Benitez, M.; Alcaraz Maestre, J.; Arce, P.; Battilana, C.; Calvo, E.; Cerrada, M.; Chamizo Llatas, M.; Colino, N.; De La Cruz, B.; Delgado Peris, A.; Domínguez Vázquez, D.; Fernandez Bedoya, C.; Fernández Ramos, J. P.; Ferrando, A.; Flix, J.; Fouz, M. C.; Garcia-Abia, P.; Gonzalez Lopez, O.; Goy Lopez, S.; Hernandez, J. M.; Josa, M. I.; Merino, G.; Puerta Pelayo, J.; Quintario Olmeda, A.; Redondo, I.; Romero, L.; Santaolalla, J.; Soares, M. S.; Willmott, C.; Albajar, C.; Codispoti, G.; de Trocóniz, J. F.; Brun, H.; Cuevas, J.; Fernandez Menendez, J.; Folgueras, S.; Gonzalez Caballero, I.; Lloret Iglesias, L.; Piedra Gomez, J.; Brochero Cifuentes, J. A.; Cabrillo, I. 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U.; Mulders, M.; Musella, P.; Nesvold, E.; Orimoto, T.; Orsini, L.; Palencia Cortezon, E.; Perez, E.; Perrozzi, L.; Petrilli, A.; Pfeiffer, A.; Pierini, M.; Pimiä, M.; Piparo, D.; Polese, G.; Quertenmont, L.; Racz, A.; Reece, W.; Rodrigues Antunes, J.; Rolandi, G.; Rovelli, C.; Rovere, M.; Sakulin, H.; Santanastasio, F.; Schäfer, C.; Schwick, C.; Segoni, I.; Sekmen, S.; Sharma, A.; Siegrist, P.; Silva, P.; Simon, M.; Sphicas, P.; Spiga, D.; Tsirou, A.; Veres, G. I.; Vlimant, J. R.; Wöhri, H. K.; Worm, S. D.; Zeuner, W. D.; Bertl, W.; Deiters, K.; Erdmann, W.; Gabathuler, K.; Horisberger, R.; Ingram, Q.; Kaestli, H. C.; König, S.; Kotlinski, D.; Langenegger, U.; Meier, F.; Renker, D.; Rohe, T.; Sibille, J.; Bäni, L.; Bortignon, P.; Buchmann, M. A.; Casal, B.; Chanon, N.; Deisher, A.; Dissertori, G.; Dittmar, M.; Donegà, M.; Dünser, M.; Eugster, J.; Freudenreich, K.; Grab, C.; Hits, D.; Lecomte, P.; Lustermann, W.; Marini, A. 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D.; Symonds, P.; Teodorescu, L.; Turner, M.; Hatakeyama, K.; Liu, H.; Scarborough, T.; Charaf, O.; Henderson, C.; Rumerio, P.; Avetisyan, A.; Bose, T.; Fantasia, C.; Heister, A.; St. John, J.; Lawson, P.; Lazic, D.; Rohlf, J.; Sperka, D.; Sulak, L.; Alimena, J.; Bhattacharya, S.; Cutts, D.; Ferapontov, A.; Heintz, U.; Jabeen, S.; Kukartsev, G.; Laird, E.; Landsberg, G.; Luk, M.; Narain, M.; Nguyen, D.; Segala, M.; Sinthuprasith, T.; Speer, T.; Tsang, K. V.; Breedon, R.; Breto, G.; Calderon De La Barca Sanchez, M.; Chauhan, S.; Chertok, M.; Conway, J.; Conway, R.; Cox, P. T.; Dolen, J.; Erbacher, R.; Gardner, M.; Houtz, R.; Ko, W.; Kopecky, A.; Lander, R.; Miceli, T.; Pellett, D.; Ricci-tam, F.; Rutherford, B.; Searle, M.; Smith, J.; Squires, M.; Tripathi, M.; Vasquez Sierra, R.; Andreev, V.; Cline, D.; Cousins, R.; Duris, J.; Erhan, S.; Everaerts, P.; Farrell, C.; Hauser, J.; Ignatenko, M.; Jarvis, C.; Plager, C.; Rakness, G.; Schlein, P.; Traczyk, P.; Valuev, V.; Weber, M.; Babb, J.; Clare, R.; Dinardo, M. E.; Ellison, J.; Gary, J. W.; Giordano, F.; Hanson, G.; Jeng, G. Y.; Liu, H.; Long, O. R.; Luthra, A.; Nguyen, H.; Paramesvaran, S.; Sturdy, J.; Sumowidagdo, S.; Wilken, R.; Wimpenny, S.; Andrews, W.; Branson, J. G.; Cerati, G. 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T.; Gaz, A.; Heyburn, B.; Luiggi Lopez, E.; Smith, J. G.; Stenson, K.; Ulmer, K. A.; Wagner, S. R.; Alexander, J.; Chatterjee, A.; Eggert, N.; Gibbons, L. K.; Heltsley, B.; Khukhunaishvili, A.; Kreis, B.; Mirman, N.; Nicolas Kaufman, G.; Patterson, J. R.; Ryd, A.; Salvati, E.; Sun, W.; Teo, W. D.; Thom, J.; Thompson, J.; Tucker, J.; Vaughan, J.; Weng, Y.; Winstrom, L.; Wittich, P.; Winn, D.; Abdullin, S.; Albrow, M.; Anderson, J.; Bauerdick, L. A. T.; Beretvas, A.; Berryhill, J.; Bhat, P. C.; Bloch, I.; Burkett, K.; Butler, J. N.; Chetluru, V.; Cheung, H. W. K.; Chlebana, F.; Elvira, V. D.; Fisk, I.; Freeman, J.; Gao, Y.; Green, D.; Gutsche, O.; Hanlon, J.; Harris, R. M.; Hirschauer, J.; Hooberman, B.; Jindariani, S.; Johnson, M.; Joshi, U.; Kilminster, B.; Klima, B.; Kunori, S.; Kwan, S.; Leonidopoulos, C.; Linacre, J.; Lincoln, D.; Lipton, R.; Lykken, J.; Maeshima, K.; Marraffino, J. 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V.; Haas, J.; Hagopian, S.; Hagopian, V.; Jenkins, M.; Johnson, K. F.; Prosper, H.; Veeraraghavan, V.; Weinberg, M.; Baarmand, M. M.; Dorney, B.; Hohlmann, M.; Kalakhety, H.; Vodopiyanov, I.; Adams, M. R.; Anghel, I. M.; Apanasevich, L.; Bai, Y.; Bazterra, V. E.; Betts, R. R.; Bucinskaite, I.; Callner, J.; Cavanaugh, R.; Dragoiu, C.; Evdokimov, O.; Gauthier, L.; Gerber, C. E.; Hofman, D. J.; Khalatyan, S.; Lacroix, F.; Malek, M.; O'Brien, C.; Silkworth, C.; Strom, D.; Varelas, N.; Akgun, U.; Albayrak, E. A.; Bilki, B.; Clarida, W.; Duru, F.; Griffiths, S.; Merlo, J.-P.; Mermerkaya, H.; Mestvirishvili, A.; Moeller, A.; Nachtman, J.; Newsom, C. R.; Norbeck, E.; Onel, Y.; Ozok, F.; Sen, S.; Tiras, E.; Wetzel, J.; Yetkin, T.; Yi, K.; Barnett, B. A.; Blumenfeld, B.; Bolognesi, S.; Fehling, D.; Giurgiu, G.; Gritsan, A. V.; Guo, Z. J.; Hu, G.; Maksimovic, P.; Rappoccio, S.; Swartz, M.; Whitbeck, A.; Baringer, P.; Bean, A.; Benelli, G.; Grachov, O.; Kenny, R. P., Iii; Murray, M.; Noonan, D.; Sanders, S.; Stringer, R.; Tinti, G.; Wood, J. S.; Zhukova, V.; Barfuss, A. F.; Bolton, T.; Chakaberia, I.; Ivanov, A.; Khalil, S.; Makouski, M.; Maravin, Y.; Shrestha, S.; Svintradze, I.; Gronberg, J.; Lange, D.; Wright, D.; Baden, A.; Boutemeur, M.; Calvert, B.; Eno, S. C.; Gomez, J. A.; Hadley, N. J.; Kellogg, R. G.; Kirn, M.; Kolberg, T.; Lu, Y.; Marionneau, M.; Mignerey, A. C.; Pedro, K.; Peterman, A.; Skuja, A.; Temple, J.; Tonjes, M. B.; Tonwar, S. C.; Twedt, E.; Apyan, A.; Bauer, G.; Bendavid, J.; Busza, W.; Butz, E.; Cali, I. A.; Chan, M.; Dutta, V.; Gomez Ceballos, G.; Goncharov, M.; Hahn, K. A.; Kim, Y.; Klute, M.; Krajczar, K.; Li, W.; Luckey, P. D.; Ma, T.; Nahn, S.; Paus, C.; Ralph, D.; Roland, C.; Roland, G.; Rudolph, M.; Stephans, G. S. F.; Stöckli, F.; Sumorok, K.; Sung, K.; Velicanu, D.; Wenger, E. A.; Wolf, R.; Wyslouch, B.; Xie, S.; Yang, M.; Yilmaz, Y.; Yoon, A. S.; Zanetti, M.; Cooper, S. I.; Dahmes, B.; De Benedetti, A.; Franzoni, G.; Gude, A.; Kao, S. C.; Klapoetke, K.; Kubota, Y.; Mans, J.; Pastika, N.; Rusack, R.; Sasseville, M.; Singovsky, A.; Tambe, N.; Turkewitz, J.; Cremaldi, L. M.; Kroeger, R.; Perera, L.; Rahmat, R.; Sanders, D. A.; Avdeeva, E.; Bloom, K.; Bose, S.; Butt, J.; Claes, D. R.; Dominguez, A.; Eads, M.; Keller, J.; Kravchenko, I.; Lazo-Flores, J.; Malbouisson, H.; Malik, S.; Snow, G. R.; Baur, U.; Godshalk, A.; Iashvili, I.; Jain, S.; Kharchilava, A.; Kumar, A.; Shipkowski, S. P.; Smith, K.; Alverson, G.; Barberis, E.; Baumgartel, D.; Chasco, M.; Haley, J.; Nash, D.; Trocino, D.; Wood, D.; Zhang, J.; Anastassov, A.; Kubik, A.; Mucia, N.; Odell, N.; Ofierzynski, R. A.; Pollack, B.; Pozdnyakov, A.; Schmitt, M.; Stoynev, S.; Velasco, M.; Won, S.; Antonelli, L.; Berry, D.; Brinkerhoff, A.; Hildreth, M.; Jessop, C.; Karmgard, D. J.; Kolb, J.; Lannon, K.; Luo, W.; Lynch, S.; Marinelli, N.; Morse, D. M.; Pearson, T.; Ruchti, R.; Slaunwhite, J.; Valls, N.; Wayne, M.; Wolf, M.; Bylsma, B.; Durkin, L. S.; Hill, C.; Hughes, R.; Hughes, R.; Kotov, K.; Ling, T. Y.; Puigh, D.; Rodenburg, M.; Vuosalo, C.; Williams, G.; Winer, B. L.; Adam, N.; Berry, E.; Elmer, P.; Gerbaudo, D.; Halyo, V.; Hebda, P.; Hegeman, J.; Hunt, A.; Jindal, P.; Lopes Pegna, D.; Lujan, P.; Marlow, D.; Medvedeva, T.; Mooney, M.; Olsen, J.; Piroué, P.; Quan, X.; Raval, A.; Safdi, B.; Saka, H.; Stickland, D.; Tully, C.; Werner, J. S.; Zuranski, A.; Acosta, J. G.; Brownson, E.; Huang, X. T.; Lopez, A.; Mendez, H.; Oliveros, S.; Ramirez Vargas, J. E.; Zatserklyaniy, A.; Alagoz, E.; Barnes, V. E.; Benedetti, D.; Bolla, G.; Bortoletto, D.; De Mattia, M.; Everett, A.; Hu, Z.; Jones, M.; Koybasi, O.; Kress, M.; Laasanen, A. T.; Leonardo, N.; Maroussov, V.; Merkel, P.; Miller, D. H.; Neumeister, N.; Shipsey, I.; Silvers, D.; Svyatkovskiy, A.; Vidal Marono, M.; Yoo, H. D.; Zablocki, J.; Zheng, Y.; Guragain, S.; Parashar, N.; Adair, A.; Boulahouache, C.; Ecklund, K. M.; Geurts, F. J. M.; Padley, B. P.; Redjimi, R.; Roberts, J.; Zabel, J.; Betchart, B.; Bodek, A.; Chung, Y. S.; Covarelli, R.; de Barbaro, P.; Demina, R.; Eshaq, Y.; Garcia-Bellido, A.; Goldenzweig, P.; Han, J.; Harel, A.; Miner, D. C.; Vishnevskiy, D.; Zielinski, M.; Bhatti, A.; Ciesielski, R.; Demortier, L.; Goulianos, K.; Lungu, G.; Malik, S.; Mesropian, C.; Arora, S.; Barker, A.; Chou, J. P.; Contreras-Campana, C.; Contreras-Campana, E.; Duggan, D.; Ferencek, D.; Gershtein, Y.; Gray, R.; Halkiadakis, E.; Hidas, D.; Lath, A.; Panwalkar, S.; Park, M.; Patel, R.; Rekovic, V.; Robles, J.; Rose, K.; Salur, S.; Schnetzer, S.; Seitz, C.; Somalwar, S.; Stone, R.; Thomas, S.; Cerizza, G.; Hollingsworth, M.; Spanier, S.; Yang, Z. C.; York, A.; Eusebi, R.; Flanagan, W.; Gilmore, J.; Kamon, T.; Khotilovich, V.; Montalvo, R.; Osipenkov, I.; Pakhotin, Y.; Perloff, A.; Roe, J.; Safonov, A.; Sakuma, T.; Sengupta, S.; Suarez, I.; Tatarinov, A.; Toback, D.; Akchurin, N.; Damgov, J.; Dudero, P. R.; Jeong, C.; Kovitanggoon, K.; Lee, S. W.; Libeiro, T.; Roh, Y.; Volobouev, I.; Appelt, E.; Delannoy, A. G.; Florez, C.; Greene, S.; Gurrola, A.; Johns, W.; Johnston, C.; Kurt, P.; Maguire, C.; Melo, A.; Sharma, M.; Sheldon, P.; Snook, B.; Tuo, S.; Velkovska, J.; Arenton, M. W.; Balazs, M.; Boutle, S.; Cox, B.; Francis, B.; Goodell, J.; Hirosky, R.; Ledovskoy, A.; Lin, C.; Neu, C.; Wood, J.; Yohay, R.; Gollapinni, S.; Harr, R.; Karchin, P. E.; Kottachchi Kankanamge Don, C.; Lamichhane, P.; Sakharov, A.; Anderson, M.; Bachtis, M.; Belknap, D.; Borrello, L.; Carlsmith, D.; Cepeda, M.; Dasu, S.; Friis, E.; Gray, L.; Grogg, K. S.; Grothe, M.; Hall-Wilton, R.; Herndon, M.; Hervé, A.; Klabbers, P.; Klukas, J.; Lanaro, A.; Lazaridis, C.; Leonard, J.; Loveless, R.; Mohapatra, A.; Ojalvo, I.; Palmonari, F.; Pierro, G. A.; Ross, I.; Savin, A.; Smith, W. H.; Swanson, J.

2013-01-01

The cross section for dijet production in proton-proton collisions at s=7TeV is presented as a function of ξ˜, a variable that approximates the fractional momentum loss of the scattered proton in single-diffractive events. The analysis is based on an integrated luminosity of 2.7nb-1 collected with the CMS detector at the LHC at low instantaneous luminosities, and uses events with jet transverse momentum of at least 20 GeV. The dijet cross section results are compared to the predictions of diffractive and nondiffractive models. The low-ξ˜ data show a significant contribution from diffractive dijet production, observed for the first time at the LHC. The associated rapidity gap survival probability is estimated.

Comparison of hadron production models for π±, k±, protons and antiprotons production in proton-carbon interactions at 60 GeV/c

NASA Astrophysics Data System (ADS)

Ajaz, M.; Ullah, S.; Ali, Y.; Younis, H.

2018-02-01

In this research paper, the comprehensive results on the double differential yield of π± and k± mesons, protons and antiprotons as a function of laboratory momentum are reported. These hadrons are produced in proton-carbon interaction at 60 GeV/c. EPOS 1.99, EPOS-LHC and QGSJETII-04 models are used to perform simulations. Comparing the predictions of these models show that QGSJETII-04 model predicts higher yields of all the hadrons in most of the cases at the peak of the distribution. In this interval, the EPOS 1.99 and EPOS-LHC produce similar results. In most of the cases at higher momentum of the hadrons, all the three models are in good agreement. For protons, all models are in good agreement. EPOS-LHC gives high yield of antiprotons at high momentum values as compared to the other two models. EPOS-LHC gives higher prediction at the peak value for π+ mesons and protons at higher polar angle intervals of 100 < 𝜃 < 420 and 100 < 𝜃 < 360, respectively, and EPOS 1.99 gives higher prediction at the peak value for π- mesons for 140 < 𝜃 < 420. The model predictions, except for antiprotons, are compared with the data obtained by the NA61/SHINE experiment at 31 GeV/c proton-carbon collision, which clearly shows that the behavior of the distributions in models are similar to the ones from the data but the yield in data is low because of lower beam energy.

Introducing the LHC in the classroom: an overview of education resources available

NASA Astrophysics Data System (ADS)

Wiener, Gerfried J.; Woithe, Julia; Brown, Alexander; Jende, Konrad

2016-05-01

In the context of the recent re-start of CERN’s Large Hadron Collider (LHC) and the challenge presented by unidentified falling objects (UFOs), we seek to facilitate the introduction of high energy physics in the classroom. Therefore, this paper provides an overview of the LHC and its operation, highlighting existing education resources, and linking principal components of the LHC to topics in physics curricula.

A microprocessor-controlled tracheal insufflation-assisted total liquid ventilation system.

PubMed

Parker, James Courtney; Sakla, Adel; Donovan, Francis M; Beam, David; Chekuri, Annu; Al-Khatib, Mohammad; Hamm, Charles R; Eyal, Fabien G

2009-09-01

A prototype time cycled, constant volume, closed circuit perfluorocarbon (PFC) total liquid ventilator system is described. The system utilizes microcontroller-driven display and master control boards, gear motor pumps, and three-way solenoid valves to direct flow. A constant tidal volume and functional residual capacity (FRC) are maintained with feedback control using end-expiratory and end-inspiratory stop-flow pressures. The system can also provide a unique continuous perfusion (bias flow, tracheal insufflation) through one lumen of a double-lumen endotracheal catheter to increase washout of dead space liquid. FRC and arterial blood gases were maintained during ventilation with Rimar 101 PFC over 2-3 h in normal piglets and piglets with simulated pulmonary edema induced by instillation of albumin solution. Addition of tracheal insufflation flow significantly improved the blood gases and enhanced clearance of instilled albumin solution during simulated edema.

Humidification on Ventilated Patients: Heated Humidifications or Heat and Moisture Exchangers?

PubMed Central

Cerpa, F; Cáceres, D; Romero-Dapueto, C; Giugliano-Jaramillo, C; Pérez, R; Budini, H; Hidalgo, V; Gutiérrez, T; Molina, J; Keymer, J

2015-01-01

The normal physiology of conditioning of inspired gases is altered when the patient requires an artificial airway access and an invasive mechanical ventilation (IMV). The endotracheal tube (ETT) removes the natural mechanisms of filtration, humidification and warming of inspired air. Despite the noninvasive ventilation (NIMV) in the upper airways, humidification of inspired gas may not be optimal mainly due to the high flow that is being created by the leakage compensation, among other aspects. Any moisture and heating deficit is compensated by the large airways of the tracheobronchial tree, these are poorly suited for this task, which alters mucociliary function, quality of secretions, and homeostasis gas exchange system. To avoid the occurrence of these events, external devices that provide humidification, heating and filtration have been developed, with different degrees of evidence that support their use. PMID:26312102

Humidification on Ventilated Patients: Heated Humidifications or Heat and Moisture Exchangers?

PubMed

Cerpa, F; Cáceres, D; Romero-Dapueto, C; Giugliano-Jaramillo, C; Pérez, R; Budini, H; Hidalgo, V; Gutiérrez, T; Molina, J; Keymer, J

2015-01-01

The normal physiology of conditioning of inspired gases is altered when the patient requires an artificial airway access and an invasive mechanical ventilation (IMV). The endotracheal tube (ETT) removes the natural mechanisms of filtration, humidification and warming of inspired air. Despite the noninvasive ventilation (NIMV) in the upper airways, humidification of inspired gas may not be optimal mainly due to the high flow that is being created by the leakage compensation, among other aspects. Any moisture and heating deficit is compensated by the large airways of the tracheobronchial tree, these are poorly suited for this task, which alters mucociliary function, quality of secretions, and homeostasis gas exchange system. To avoid the occurrence of these events, external devices that provide humidification, heating and filtration have been developed, with different degrees of evidence that support their use.

Physics Goals and Experimental Challenges of the Proton-Proton High-Luminosity Operation of the LHC

NASA Astrophysics Data System (ADS)

Campana, P.; Klute, M.; Wells, P. S.

2016-10-01

The completion of Run 1 of the Large Hadron Collider (LHC) at CERN has seen the discovery of the Higgs boson and an unprecedented number of precise measurements of the Standard Model, and Run 2 has begun to provide the first data at higher energy. The high-luminosity upgrade of the LHC (HL-LHC) and the four experiments (ATLAS, CMS, ALICE, and LHCb) will exploit the full potential of the collider to discover and explore new physics beyond the Standard Model. We review the experimental challenges and the physics opportunities in proton-proton collisions at the HL-LHC.

Abort Gap Cleaning for LHC Run 2

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

Uythoven, Jan; Boccardi, Andrea; Bravin, Enrico

2014-07-01

To minimize the beam losses at the moment of an LHC beam dump the 3 μs long abort gap should contain as few particles as possible. Its population can be minimised by abort gap cleaning using the LHC transverse damper system. The LHC Run 1 experience is briefly recalled; changes foreseen for the LHC Run 2 are presented. They include improvements in the observation of the abort gap population and the mechanism to decide if cleaning is required, changes to the hardware of the transverse dampers to reduce the detrimental effect on the luminosity lifetime and proposed changes to themore » applied cleaning algorithms.« less

P-Type Silicon Strip Sensors for the new CMS Tracker at HL-LHC

NASA Astrophysics Data System (ADS)

Adam, W.; Bergauer, T.; Brondolin, E.; Dragicevic, M.; Friedl, M.; Frühwirth, R.; Hoch, M.; Hrubec, J.; König, A.; Steininger, H.; Waltenberger, W.; Alderweireldt, S.; Beaumont, W.; Janssen, X.; Lauwers, J.; Van Mechelen, P.; Van Remortel, N.; Van Spilbeeck, A.; Beghin, D.; Brun, H.; Clerbaux, B.; Delannoy, H.; De Lentdecker, G.; Fasanella, G.; Favart, L.; Goldouzian, R.; Grebenyuk, A.; Karapostoli, G.; Lenzi, Th.; Léonard, A.; Luetic, J.; Postiau, N.; Seva, T.; Vanlaer, P.; Vannerom, D.; Wang, Q.; Zhang, F.; Abu Zeid, S.; Blekman, F.; De Bruyn, I.; De Clercq, J.; D'Hondt, J.; Deroover, K.; Lowette, S.; Moortgat, S.; Moreels, L.; Python, Q.; Skovpen, K.; Van Mulders, P.; Van Parijs, I.; Bakhshiansohi, H.; Bondu, O.; Brochet, S.; Bruno, G.; Caudron, A.; Delaere, C.; Delcourt, M.; De Visscher, S.; Francois, B.; Giammanco, A.; Jafari, A.; Komm, M.; Krintiras, G.; Lemaitre, V.; Magitteri, A.; Mertens, A.; Michotte, D.; Musich, M.; Piotrzkowski, K.; Quertenmont, L.; Szilasi, N.; Vidal Marono, M.; Wertz, S.; Beliy, N.; Caebergs, T.; Daubie, E.; Hammad, G. H.; Härkönen, J.; Lampén, T.; Luukka, P.; Peltola, T.; Tuominen, E.; Tuovinen, E.; Eerola, P.; Tuuva, T.; Baulieu, G.; Boudoul, G.; Caponetto, L.; Combaret, C.; Contardo, D.; Dupasquier, T.; Gallbit, G.; Lumb, N.; Mirabito, L.; Perries, S.; Vander Donckt, M.; Viret, S.; Agram, J.-L.; Andrea, J.; Bloch, D.; Bonnin, C.; Brom, J.-M.; Chabert, E.; Chanon, N.; Charles, L.; Conte, E.; Fontaine, J.-Ch.; Gross, L.; Hosselet, J.; Jansova, M.; Tromson, D.; Autermann, C.; Feld, L.; Karpinski, W.; Kiesel, K. M.; Klein, K.; Lipinski, M.; Ostapchuk, A.; Pierschel, G.; Preuten, M.; Rauch, M.; Schael, S.; Schomakers, C.; Schulz, J.; Schwering, G.; Wlochal, M.; Zhukov, V.; Pistone, C.; Fluegge, G.; Kuensken, A.; Pooth, O.; Stahl, A.; Aldaya, M.; Asawatangtrakuldee, C.; Beernaert, K.; Bertsche, D.; Contreras-Campana, C.; Eckerlin, G.; Eckstein, D.; Eichhorn, T.; Gallo, E.; Garay Garcia, J.; Hansen, K.; Haranko, M.; Harb, A.; Hauk, J.; Keaveney, J.; Kalogeropoulos, A.; Kleinwort, C.; Lohmann, W.; Mankel, R.; Maser, H.; Mittag, G.; Muhl, C.; Mussgiller, A.; Pitzl, D.; Reichelt, O.; Savitskyi, M.; Schuetze, P.; Walsh, R.; Zuber, A.; Biskop, H.; Buhmann, P.; Centis-Vignali, M.; Garutti, E.; Haller, J.; Hoffmann, M.; Lapsien, T.; Matysek, M.; Perieanu, A.; Scharf, Ch.; Schleper, P.; Schmidt, A.; Schwandt, J.; Sonneveld, J.; Steinbrück, G.; Vormwald, B.; Wellhausen, J.; Abbas, M.; Amstutz, C.; Barvich, T.; Barth, Ch.; Boegelspacher, F.; De Boer, W.; Butz, E.; Caselle, M.; Colombo, F.; Dierlamm, A.; Freund, B.; Hartmann, F.; Heindl, S.; Husemann, U.; Kornmayer, A.; Kudella, S.; Muller, Th.; Simonis, H. J.; Steck, P.; Weber, M.; Weiler, Th.; Anagnostou, G.; Asenov, P.; Assiouras, P.; Daskalakis, G.; Kyriakis, A.; Loukas, D.; Paspalaki, L.; Siklér, F.; Veszprémi, V.; Bhardwaj, A.; Dalal, R.; Jain, G.; Ranjan, K.; Bakhshiansohl, H.; Behnamian, H.; Khakzad, M.; Naseri, M.; Cariola, P.; Creanza, D.; De Palma, M.; De Robertis, G.; Fiore, L.; Franco, M.; Loddo, F.; Silvestris, L.; Maggi, G.; Martiradonna, S.; My, S.; Selvaggi, G.; Albergo, S.; Cappello, G.; Chiorboli, M.; Costa, S.; Di Mattia, A.; Giordano, F.; Potenza, R.; Saizu, M. A.; Tricomi, A.; Tuve, C.; Barbagli, G.; Brianzi, M.; Ciaranfi, R.; Ciulli, V.; Civinini, C.; D'Alessandro, R.; Focardi, E.; Latino, G.; Lenzi, P.; Meschini, M.; Paoletti, S.; Russo, L.; Scarlini, E.; Sguazzoni, G.; Strom, D.; Viliani, L.; Ferro, F.; Lo Vetere, M.; Robutti, E.; Dinardo, M. E.; Fiorendi, S.; Gennai, S.; Malvezzi, S.; Manzoni, R. A.; Menasce, D.; Moroni, L.; Pedrini, D.; Azzi, P.; Bacchetta, N.; Bisello, D.; Dall'Osso, M.; Pozzobon, N.; Tosi, M.; De Canio, F.; Gaioni, L.; Manghisoni, M.; Nodari, B.; Riceputi, E.; Re, V.; Traversi, G.; Comotti, D.; Ratti, L.; Alunni Solestizi, L.; Biasini, M.; Bilei, G. M.; Cecchi, C.; Checcucci, B.; Ciangottini, D.; Fanò, L.; Gentsos, C.; Ionica, M.; Leonardi, R.; Manoni, E.; Mantovani, G.; Marconi, S.; Mariani, V.; Menichelli, M.; Modak, A.; Morozzi, A.; Moscatelli, F.; Passeri, D.; Placidi, P.; Postolache, V.; Rossi, A.; Saha, A.; Santocchia, A.; Storchi, L.; Spiga, D.; Androsov, K.; Azzurri, P.; Arezzini, S.; Bagliesi, G.; Basti, A.; Boccali, T.; Borrello, L.; Bosi, F.; Castaldi, R.; Ciampa, A.; Ciocci, M. A.; Dell'Orso, R.; Donato, S.; Fedi, G.; Giassi, A.; Grippo, M. T.; Ligabue, F.; Lomtadze, T.; Magazzu, G.; Martini, L.; Mazzoni, E.; Messineo, A.; Moggi, A.; Morsani, F.; Palla, F.; Palmonari, F.; Raffaelli, F.; Rizzi, A.; Savoy-Navarro, A.; Spagnolo, P.; Tenchini, R.; Tonelli, G.; Venturi, A.; Verdini, P. G.; Bellan, R.; Costa, M.; Covarelli, R.; Da Rocha Rolo, M.; Demaria, N.; Rivetti, A.; Dellacasa, G.; Mazza, G.; Migliore, E.; Monteil, E.; Pacher, L.; Ravera, F.; Solano, A.; Fernandez, M.; Gomez, G.; Jaramillo Echeverria, R.; Moya, D.; Gonzalez Sanchez, F. J.; Vila, I.; Virto, A. L.; Abbaneo, D.; Ahmed, I.; Albert, E.; Auzinger, G.; Berruti, G.; Bianchi, G.; Blanchot, G.; Bonnaud, J.; Caratelli, A.; Ceresa, D.; Christiansen, J.; Cichy, K.; Daguin, J.; D'Auria, A.; Detraz, S.; Deyrail, D.; Dondelewski, O.; Faccio, F.; Frank, N.; Gadek, T.; Gill, K.; Honma, A.; Hugo, G.; Jara Casas, L. M.; Kaplon, J.; Kornmayer, A.; Kottelat, L.; Kovacs, M.; Krammer, M.; Lenoir, P.; Mannelli, M.; Marchioro, A.; Marconi, S.; Mersi, S.; Martina, S.; Michelis, S.; Moll, M.; Onnela, A.; Orfanelli, S.; Pavis, S.; Peisert, A.; Pernot, J.-F.; Petagna, P.; Petrucciani, G.; Postema, H.; Rose, P.; Tropea, P.; Troska, J.; Tsirou, A.; Vasey, F.; Vichoudis, P.; Verlaat, B.; Zwalinski, L.; Bachmair, F.; Becker, R.; di Calafiori, D.; Casal, B.; Berger, P.; Djambazov, L.; Donega, M.; Grab, C.; Hits, D.; Hoss, J.; Kasieczka, G.; Lustermann, W.; Mangano, B.; Marionneau, M.; Martinez Ruiz del Arbol, P.; Masciovecchio, M.; Meinhard, M.; Perozzi, L.; Roeser, U.; Starodumov, A.; Tavolaro, V.; Wallny, R.; Zhu, D.; Amsler, C.; Bösiger, K.; Caminada, L.; Canelli, F.; Chiochia, V.; de Cosa, A.; Galloni, C.; Hreus, T.; Kilminster, B.; Lange, C.; Maier, R.; Ngadiuba, J.; Pinna, D.; Robmann, P.; Taroni, S.; Yang, Y.; Bertl, W.; Deiters, K.; Erdmann, W.; Horisberger, R.; Kaestli, H.-C.; Kotlinski, D.; Langenegger, U.; Meier, B.; Rohe, T.; Streuli, S.; Cussans, D.; Flacher, H.; Goldstein, J.; Grimes, M.; Jacob, J.; Seif El Nasr-Storey, S.; Cole, J.; Hoad, C.; Hobson, P.; Morton, A.; Reid, I. D.; Auzinger, G.; Bainbridge, R.; Dauncey, P.; Hall, G.; James, T.; Magnan, A.-M.; Pesaresi, M.; Raymond, D. M.; Uchida, K.; Garabedian, A.; Heintz, U.; Narain, M.; Nelson, J.; Sagir, S.; Speer, T.; Swanson, J.; Tersegno, D.; Watson-Daniels, J.; Chertok, M.; Conway, J.; Conway, R.; Flores, C.; Lander, R.; Pellett, D.; Ricci-Tam, F.; Squires, M.; Thomson, J.; Yohay, R.; Burt, K.; Ellison, J.; Hanson, G.; Olmedo, M.; Si, W.; Yates, B. R.; Gerosa, R.; Sharma, V.; Vartak, A.; Yagil, A.; Zevi Della Porta, G.; Dutta, V.; Gouskos, L.; Incandela, J.; Kyre, S.; Mullin, S.; Patterson, A.; Qu, H.; White, D.; Dominguez, A.; Bartek, R.; Cumalat, J. P.; Ford, W. T.; Jensen, F.; Johnson, A.; Krohn, M.; Leontsinis, S.; Mulholland, T.; Stenson, K.; Wagner, S. R.; Apresyan, A.; Bolla, G.; Burkett, K.; Butler, J. N.; Canepa, A.; Cheung, H. W. K.; Chramowicz, J.; Christian, D.; Cooper, W. E.; Deptuch, G.; Derylo, G.; Gingu, C.; Grünendahl, S.; Hasegawa, S.; Hoff, J.; Howell, J.; Hrycyk, M.; Jindariani, S.; Johnson, M.; Kahlid, F.; Lei, C. M.; Lipton, R.; Lopes De Sá, R.; Liu, T.; Los, S.; Matulik, M.; Merkel, P.; Nahn, S.; Prosser, A.; Rivera, R.; Schneider, B.; Sellberg, G.; Shenai, A.; Spiegel, L.; Tran, N.; Uplegger, L.; Voirin, E.; Berry, D. R.; Chen, X.; Ennesser, L.; Evdokimov, A.; Evdokimov, O.; Gerber, C. E.; Hofman, D. J.; Makauda, S.; Mills, C.; Sandoval Gonzalez, I. D.; Alimena, J.; Antonelli, L. J.; Francis, B.; Hart, A.; Hill, C. S.; Parashar, N.; Stupak, J.; Bortoletto, D.; Bubna, M.; Hinton, N.; Jones, M.; Miller, D. H.; Shi, X.; Tan, P.; Baringer, P.; Bean, A.; Khalil, S.; Kropivnitskaya, A.; Majumder, D.; Wilson, G.; Ivanov, A.; Mendis, R.; Mitchell, T.; Skhirtladze, N.; Taylor, R.; Anderson, I.; Fehling, D.; Gritsan, A.; Maksimovic, P.; Martin, C.; Nash, K.; Osherson, M.; Swartz, M.; Xiao, M.; Bloom, K.; Claes, D. R.; Fangmeier, C.; Gonzalez Suarez, R.; Monroy, J.; Siado, J.; Hahn, K.; Sevova, S.; Sung, K.; Trovato, M.; Bartz, E.; Gershtein, Y.; Halkiadakis, E.; Kyriacou, S.; Lath, A.; Nash, K.; Osherson, M.; Schnetzer, S.; Stone, R.; Walker, M.; Malik, S.; Norberg, S.; Ramirez Vargas, J. E.; Alyari, M.; Dolen, J.; Godshalk, A.; Harrington, C.; Iashvili, I.; Kharchilava, A.; Nguyen, D.; Parker, A.; Rappoccio, S.; Roozbahani, B.; Alexander, J.; Chaves, J.; Chu, J.; Dittmer, S.; McDermott, K.; Mirman, N.; Rinkevicius, A.; Ryd, A.; Salvati, E.; Skinnari, L.; Soffi, L.; Tao, Z.; Thom, J.; Tucker, J.; Zientek, M.; Akgün, B.; Ecklund, K. M.; Kilpatrick, M.; Nussbaum, T.; Zabel, J.; Betchart, B.; Covarelli, R.; Demina, R.; Hindrichs, O.; Petrillo, G.; Eusebi, R.; Osipenkov, I.; Perloff, A.; Ulmer, K. A.

2017-06-01

The upgrade of the LHC to the High-Luminosity LHC (HL-LHC) is expected to increase the LHC design luminosity by an order of magnitude. This will require silicon tracking detectors with a significantly higher radiation hardness. The CMS Tracker Collaboration has conducted an irradiation and measurement campaign to identify suitable silicon sensor materials and strip designs for the future outer tracker at the CMS experiment. Based on these results, the collaboration has chosen to use n-in-p type silicon sensors and focus further investigations on the optimization of that sensor type. This paper describes the main measurement results and conclusions that motivated this decision.

Introduction to the HL-LHC Project

NASA Astrophysics Data System (ADS)

Rossi, L.; Brüning, O.

The Large Hadron Collider (LHC) is one of largest scientific instruments ever built. It has been exploring the new energy frontier since 2010, gathering a global user community of 7,000 scientists. To extend its discovery potential, the LHC will need a major upgrade in the 2020s to increase its luminosity (rate of collisions) by a factor of five beyond its design value and the integrated luminosity by a factor of ten. As a highly complex and optimized machine, such an upgrade of the LHC must be carefully studied and requires about ten years to implement. The novel machine configuration, called High Luminosity LHC (HL-LHC), will rely on a number of key innovative technologies, representing exceptional technological challenges, such as cutting-edge 11-12 tesla superconducting magnets, very compact superconducting cavities for beam rotation with ultra-precise phase control, new technology for beam collimation and 300-meter-long high-power superconducting links with negligible energy dissipation. HL-LHC federates efforts and R&D of a large community in Europe, in the US and in Japan, which will facilitate the implementation of the construction phase as a global project.

Analysis of the SPS Long Term Orbit Drifts

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

Velotti, Francesco; Bracco, Chiara; Cornelis, Karel

2016-06-01

The Super Proton Synchrotron (SPS) is the last accelerator in the Large Hadron Collider (LHC) injector chain, and has to deliver the two high-intensity 450 GeV proton beams to the LHC. The transport from SPS to LHC is done through the two Transfer Lines (TL), TI2 and TI8, for Beam 1 (B1) and Beam 2 (B2) respectively. During the first LHC operation period Run 1, a long term drift of the SPS orbit was observed, causing changes in the LHC injection due to the resulting changes in the TL trajectories. This translated into longer LHC turnaround because of the necessitymore » to periodically correct the TL trajectories in order to preserve the beam quality at injection into the LHC. Different sources for the SPS orbit drifts have been investigated: each of them can account only partially for the total orbit drift observed. In this paper, the possible sources of such drift are described, together with the simulated and measured effect they cause. Possible solutions and countermeasures are also discussed.« less

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

Rossi, Adriana; et al.

Long-range beam-beam (LRBB) interactions can be a source of emittance growth and beam losses in the LHC during physics and will become even more relevant with the smaller '* and higher bunch intensities foreseen for the High Luminosity LHC upgrade (HL-LHC), in particular if operated without crab cavities. Both beam losses and emittance growth could be mitigated by compensat-ing the non-linear LRBB kick with a correctly placed current carrying wire. Such a compensation scheme is currently being studied in the LHC through a demonstration test using current-bearing wires embedded into col-limator jaws, installed either side of the high luminosity interactionmore » regions. For HL-LHC two options are considered, a current-bearing wire as for the demonstrator, or electron lenses, as the ideal distance between the particle beam and compensating current may be too small to allow the use of solid materials. This paper reports on the ongoing activities for both options, covering the progress of the wire-in-jaw collimators, the foreseen LRBB experiments at the LHC, and first considerations for the design of the electron lenses to ultimately replace material wires for HL-LHC.« less

Depressive disorders during weaning from prolonged mechanical ventilation.

PubMed

Jubran, Amal; Lawm, Gerald; Kelly, Joanne; Duffner, Lisa A; Gungor, Gokay; Collins, Eileen G; Lanuza, Dorothy M; Hoffman, Leslie A; Tobin, Martin J

2010-05-01

Patients who require mechanical ventilation are at risk of emotional stress because of total dependence on a machine for breathing. The stress may negatively impact ventilator weaning and survival. The purpose of this study was to determine whether depressive disorders in patients being weaned from prolonged mechanical ventilation are linked to weaning failure and decreased survival. A prospective study of 478 consecutive patients transferred to a long-term acute care hospital for weaning from prolonged ventilation was undertaken. A clinical psychologist conducted a psychiatric interview to assess for the presence of depressive disorders. Of the 478 patients, 142 had persistent coma or delirium and were unable to be evaluated for depressive disorders. Of the remaining 336 patients, 142 (42%) were diagnosed with depressive disorders. In multivariate analysis, co-morbidity score [odds ratio (OR), 1.23; P = 0.007], functional dependence before the acute illness (OR, 1.70, P = 0.03) and history of psychiatric disorders (OR, 3.04, P = 0.0001) were independent predictors of depressive disorders. The rate of weaning failure was higher in patients with depressive disorders than in those without such disorders (61 vs. 33%, P = 0.0001), as was mortality (24 vs. 10%, P = 0.0008). The presence of depressive disorders was independently associated with mortality (OR, 4.3; P = 0.0002); age (OR, 1.06; P = 0.001) and co-morbidity score (OR, 1.24; P = 0.02) also predicted mortality. Depressive disorders were diagnosed in 42% of patients who were being weaned from prolonged ventilation. Patients with depressive disorders were more likely to experience weaning failure and death.

Whole lung lavage with intermittent double lung ventilation. A modified technique for managing pulmonary alveolar proteinosis.

PubMed

Ahmed, Raees; Iqbal, Mobeen; Kashef, Sayed H; Almomatten, Mohammed I

2005-01-01

Whole lung lavage is still the most effective treatment for pulmonary alveolar proteinosis. We report a 21-year-old male diagnosed with pulmonary alveolar proteinosis by open lung biopsy and who underwent whole lung lavage with a modified technique. He showed significant improvement in clinical and functional parameters. The technique of intermittent double lung ventilation during lavage procedure keeps the oxygen saturation in acceptable limits in patients at risk for severe hypoxemia and allows the procedure to be completed in a single setting.

Update on the Role of Extracorporeal CO2 Removal as an Adjunct to Mechanical Ventilation in ARDS

DTIC Science & Technology

2015-03-16

alveoli, atelectotrauma, and increased in- flammatory mediator levels [7]. The ARDSNet study re- ported a reduction in mortality with a ventilation... mortality rates [6]. Impaired RV function in early stage ARDS may be under- diagnosed and yet it might be the harbinger of a down- ward spiral in the ...them according to the ARDSNet protocol for 72 h, at which point the tidal volume was reduced from 6 to 4 ml/kg in all patients (n = 10) who had a plateau

Nocturnal mechanical ventilation for chronic hypoventilation in patients with neuromuscular and chest wall disorders.

PubMed

Annane, Djillali; Orlikowski, David; Chevret, Sylvie

2014-12-13

Chronic alveolar hypoventilation is a common complication of many neuromuscular and chest wall disorders. Long-term nocturnal mechanical ventilation is commonly used to treat it. This is a 2014 update of a review first published in 2000 and previously updated in 2007. To examine the effects on mortality of nocturnal mechanical ventilation in people with neuromuscular or chest wall disorders. Subsidiary endpoints were to examine the effects of respiratory assistance on improvement of chronic hypoventilation, sleep quality, hospital admissions and quality of life. We searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE and EMBASE on 10 June 2014. We contacted authors of identified trials and other experts in the field. We searched for quasi-randomised or randomised controlled trials of participants of all ages with neuromuscular or chest wall disorder-related stable chronic hypoventilation of all degrees of severity, receiving any type and any mode of long-term nocturnal mechanical ventilation. The primary outcome measure was one-year mortality and secondary outcomes were unplanned hospital admission, short-term and long-term reversal of hypoventilation-related clinical symptoms and daytime hypercapnia, improvement of lung function and sleep breathing disorders. We used standard Cochrane methodology to select studies, extract data and assess the risk of bias in included studies. The 10 eligible trials included a total of 173 participants. Roughly half of the trials were at low risk of selection, attrition or reporting bias, and almost all were at high risk of performance and detection bias. Four trials reported mortality data in the long term. The pooled risk ratio (RR) of dying was 0.62 (95% confidence interval (CI) 0.42 to 0.91, P value = 0.01) in favour of nocturnal mechanical ventilation compared to spontaneous breathing. There was considerable and significant heterogeneity between the trials, possibly related to differences between the study populations. Information on unplanned hospitalisation was available from two studies. The corresponding pooled RR was 0.25 (95% CI 0.08 to 0.82, P value = 0.02) in favour of nocturnal mechanical ventilation. For most of the outcome measures there was no significant long-term difference between nocturnal mechanical ventilation and no ventilation. Most of the secondary outcomes were not assessed in the eligible trials. Three out of the 10 trials, accounting for 39 participants, two with a cross-over design and one with two parallel groups, compared volume- and pressure-cycled non-invasive mechanical ventilation in the short term. From the only trial (16 participants) on parallel groups, there was no difference in mortality (one death in each arm) between volume- and pressure-cycled mechanical ventilation. Data from the two cross-over trials suggested that compared with pressure-cycled ventilation, volume-cycled ventilation was associated with less sleep time spent with an arterial oxygen saturation below 90% (mean difference (MD) 6.83 minutes, 95% CI 4.68 to 8.98, P value = 0.00001) and a lower apnoea-hypopnoea (per sleep hour) index (MD -0.65, 95% CI -0.84 to -0.46, P value = 0.00001). We found no study that compared invasive and non-invasive mechanical ventilation or intermittent positive pressure versus negative pressure ventilation. Current evidence about the therapeutic benefit of mechanical ventilation is of very low quality, but is consistent, suggesting alleviation of the symptoms of chronic hypoventilation in the short term. In four small studies, survival was prolonged and unplanned hospitalisation was reduced, mainly in participants with motor neuron diseases. With the exception of motor neuron disease and Duchenne muscular dystrophy, for which the natural history supports the survival benefit of mechanical ventilation against no ventilation, further larger randomised trials should assess the long-term benefit of different types and modes of nocturnal mechanical ventilation on quality of life, morbidity and mortality, and its cost-benefit ratio in neuromuscular and chest wall diseases.

The HL-LHC Accelerator Physics Challenges

NASA Astrophysics Data System (ADS)

Fartoukh, S.; Zimmermann, F.

The conceptual baseline of the HL-LHC project is reviewed, putting into perspective the main beam physics challenges of this new collider in comparison with the existing LHC, and the series of solutions and possible mitigation measures presently envisaged.

Impact of a CP-violating Higgs sector: from LHC to baryogenesis.

PubMed

Shu, Jing; Zhang, Yue

2013-08-30

We observe a generic connection between LHC Higgs data and electroweak baryogenesis: the particle that contributes to the CP-odd hgg or hγγ vertex would provide the CP-violating source during a first-order phase transition. It is illustrated in the two Higgs doublet model that a common complex phase controls the lightest Higgs properties at the LHC, electric dipole moments, and the CP-violating source for electroweak baryogenesis. We perform a general parametrization of Higgs effective couplings and a global fit to the LHC Higgs data. Current LHC measurements prefer a nonzero phase for tanβ≲1 and electric dipole moment constraints still allow an order-one phase for tanβ∼1, which gives sufficient room to generate the correct cosmic baryon asymmetry. We also give some prospects in the direct measurements of CP violation in the Higgs sector at the LHC.

Radiation Hard Silicon Particle Detectors for Phase-II LHC Trackers

NASA Astrophysics Data System (ADS)

Oblakowska-Mucha, A.

2017-02-01

The major LHC upgrade is planned after ten years of accelerator operation. It is foreseen to significantly increase the luminosity of the current machine up to 1035 cm-2s-1 and operate as the upcoming High Luminosity LHC (HL-LHC) . The major detectors upgrade, called the Phase-II Upgrade, is also planned, a main reason being the aging processes caused by severe particle radiation. Within the RD50 Collaboration, a large Research and Development program has been underway to develop silicon sensors with sufficient radiation tolerance for HL-LHC trackers. In this summary, several results obtained during the testing of the devices after irradiation to HL-LHC levels are presented. Among the studied structures, one can find advanced sensors types like 3D silicon detectors, High-Voltage CMOS technologies, or sensors with intrinsic gain (LGAD). Based on these results, the RD50 Collaboration gives recommendation for the silicon detectors to be used in the detector upgrade.

Small Airway Dysfunction and Abnormal Exercise Responses

PubMed Central

Petsonk, Edward L.; Stansbury, Robert C.; Beeckman-Wagner, Lu-Ann; Long, Joshua L.; Wang, Mei Lin

2016-01-01

Rationale Coal mine dust exposure can cause symptoms and loss of lung function from multiple mechanisms, but the roles of each disease process are not fully understood. Objectives We investigated the implications of small airway dysfunction for exercise physiology among a group of workers exposed to coal mine dust. Methods Twenty coal miners performed spirometry, first breathing air and then helium-oxygen, single-breath diffusing capacity, and computerized chest tomography, and then completed cardiopulmonary exercise testing. Measurements and Main Results Six participants meeting criteria for small airway dysfunction were compared with 14 coal miners who did not. At submaximal workload, miners with small airway dysfunction used a higher proportion of their maximum voluntary ventilation and had higher ventilatory equivalents for both O2 and CO2. Regression modeling indicated that inefficient ventilation was significantly related to small airway dysfunction but not to FEV1 or diffusing capacity. At the end of exercise, miners with small airway dysfunction had 27% lower O2 consumption. Conclusions Small airway abnormalities may be associated with important inefficiency of exercise ventilation. In dust-exposed individuals with only mild abnormalities on resting lung function tests or chest radiographs, cardiopulmonary exercise testing may be important in defining causes of exercise intolerance. PMID:27073987

Bacteriological evaluation of a down-draught necropsy table ventilation system.

PubMed Central

al-Wali, W; Kibbler, C C; McLaughlin, J E

1993-01-01

AIMS--To evaluate the microbiological efficacy of a down-draught necropsy table ventilation system (which surrounds the cadaver with a "curtain" of air under continuous extraction) during post mortem procedures. METHODS--Air sampling was carried out both in the presence and absence of staff and cadaver and during a full post mortem procedure, with functioning and non-functioning table air extraction. The penetration of the air "curtain" was also examined during the use of an oscillating bone saw by means of a tracer organism, Bacillus subtilis var niger, painted on to the skull. RESULTS--There was little difference between bacterial counts obtained in the presence of staff only, staff plus cadaver, or during a post mortem examination. With all counts obtained, however, there was a two to three-fold reduction when the ventilation was in operation compared with when the extract duct was occluded. Using the tracer organism, a two to three log reduction in counts was shown when the "curtain" was in operation during the use of the oscillating bone saw. CONCLUSIONS--These results suggest that the system provides potential protection for post mortem room staff against airborne infections. PMID:8408701

Positive pressure ventilation in the management of acute and chronic cardiac failure: a systematic review and meta-analysis.

PubMed

Nadar, Sunil; Prasad, Neeraj; Taylor, Rod S; Lip, Gregory Y H

2005-03-18

Chronic heart failure (CHF) is a common condition and is associated with excess morbidity and mortality, in spite of the many advances in its treatment. Chronic stable heart failure is also associated with an increased incidence of sleep-related breathing disorders, such as central sleep apnoea (CSA) and Cheyne Stokes respiration (CSR). Continuous positive airways pressure (CPAP) has been shown to alleviate the symptoms of CHF, improve left ventricular function and oxygenation. To a certain extent, CPAP also abolishes sleep-related breathing disorders in patients with chronic heart failure. In patients with acute pulmonary oedema, the use of positive pressure ventilation improves cardiac haemodynamic indices, as well as symptoms and oxygenation, and is associated with a lower need for intubation. However, some studies have cast doubts about its safety and suggest a higher rate of myocardial infarction associated with its use. In our opinion, non-invasive positive pressure ventilation and CPAP offers an adjunctive mode of therapy in patients with acute pulmonary oedema and chronic heart failure, who may not be suitable for intubation and in those not responsive to conventional therapies. Non-invasive ventilation also helps to improve oxygenation in those patients with exhaustion and respiratory acidosis. Many trials are still ongoing and the results of these studies would throw more light on the present role of non-invasive ventilation in the management of CHF.

Diaphragm Dysfunction in Mechanically Ventilated Patients.

PubMed

Dot, Irene; Pérez-Teran, Purificación; Samper, Manuel-Andrés; Masclans, Joan-Ramon

2017-03-01

Muscle involvement is found in most critical patients admitted to the intensive care unit (ICU). Diaphragmatic muscle alteration, initially included in this category, has been differentiated in recent years, and a specific type of muscular dysfunction has been shown to occur in patients undergoing mechanical ventilation. We found this muscle dysfunction to appear in this subgroup of patients shortly after the start of mechanical ventilation, observing it to be mainly associated with certain control modes, and also with sepsis and/or multi-organ failure. Although the specific etiology of process is unknown, the muscle presents oxidative stress and mitochondrial changes. These cause changes in protein turnover, resulting in atrophy and impaired contractility, and leading to impaired functionality. The term 'ventilator-induced diaphragm dysfunction' was first coined by Vassilakopoulos et al. in 2004, and this phenomenon, along with injury cause by over-distention of the lung and barotrauma, represents a challenge in the daily life of ventilated patients. Diaphragmatic dysfunction affects prognosis by delaying extubation, prolonging hospital stay, and impairing the quality of life of these patients in the years following hospital discharge. Ultrasound, a non-invasive technique that is readily available in most ICUs, could be used to diagnose this condition promptly, thus preventing delays in starting rehabilitation and positively influencing prognosis in these patients. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Load compensation as a function of state during sleep onset.

PubMed

Gora, J; Kay, A; Colrain, I M; Kleiman, J; Trinder, J

1998-06-01

Ventilation decreases and airway resistance increases with the loss of electroencephalogram alpha activity at sleep onset. The aim of this study was to determine whether reflexive load compensation is lost immediately on the loss of alpha activity. Six healthy male subjects were studied under two conditions (load and control-no load), in three states (continuous alpha, continuous theta, and immediately after a transition from alpha to theta), and in two phases (early and late sleep onset). Ventilation and respiratory timing were measured. A comparison of loaded with control conditions indicated that loading had no effect on inspiratory minute ventilation during continuous alpha (differential effect of 0.00 l/min) and only a small, nonsignificant effect in theta immediately after phase 2 transitions (0.31 l/min), indicating a preservation of load compensation at these times. However, there were significant decreases in inspiratory minute ventilation on loaded trials during continuous theta in phase 2 (0.77 l/min) and phase 3 (1.15 l/min) and during theta immediately after a transition in phase 3 (0.87 l/min), indicating a lack of reflexive load compensation. The results indicate that, because reflex load compensation is state dependent, state-related changes in airway resistance contribute to state-related changes in ventilation during sleep onset. However, this effect was slightly delayed with transitions into theta early in sleep.

Impact of acoustic airflow on intrasinus drug deposition: New insights into the vibrating mode and the optimal acoustic frequency to enhance the delivery of nebulized antibiotic.

PubMed

Leclerc, Lara; Merhie, Amira El; Navarro, Laurent; Prévôt, Nathalie; Durand, Marc; Pourchez, Jérémie

2015-10-15

We investigated the impact of vibrating acoustic airflow, the high frequency (f≥100 Hz) and the low frequency (f≤45 Hz) sound waves, on the enhancement of intrasinus drug deposition. (81m)Kr-gas ventilation study was performed in a plastinated human cast with and without the addition of vibrating acoustic airflow. Similarly, intrasinus drug deposition in a nasal replica using gentamicin as a marker was studied with and without the superposition of different modes of acoustic airflow. Ventilation experiments demonstrate that no sinus ventilation was observed without acoustic airflow although sinus ventilation occurred whatever the modes of acoustic airflow applied. Intrasinus drug deposition experiments showed that the high frequency acoustic airflow led to 4-fold increase in gentamicin deposition into the left maxillary sinus and to 2-fold deposition increase into the right maxillary sinus. Besides, the low frequency acoustic airflow demonstrated a significant increase of 4-fold and 2-fold in the right and left maxillary sinuses, respectively. We demonstrated the benefit of different modes of vibrating acoustic airflow for maxillary sinus ventilation and intrasinus drug deposition. The degree of gentamicin deposition varies as a function of frequency of the vibrating acoustic airflow and the geometry of the ostia. Copyright © 2015 Elsevier B.V. All rights reserved.

Simultaneous magnetic resonance imaging of ventilation distribution and gas uptake in the human lung using hyperpolarized xenon-129

PubMed Central

Mugler, John P.; Altes, Talissa A.; Ruset, Iulian C.; Dregely, Isabel M.; Mata, Jaime F.; Miller, G. Wilson; Ketel, Stephen; Ketel, Jeffrey; Hersman, F. William; Ruppert, Kai

2010-01-01

Despite a myriad of technical advances in medical imaging, as well as the growing need to address the global impact of pulmonary diseases, such as asthma and chronic obstructive pulmonary disease, on health and quality of life, it remains challenging to obtain in vivo regional depiction and quantification of the most basic physiological functions of the lung—gas delivery to the airspaces and gas uptake by the lung parenchyma and blood—in a manner suitable for routine application in humans. We report a method based on MRI of hyperpolarized xenon-129 that permits simultaneous observation of the 3D distributions of ventilation (gas delivery) and gas uptake, as well as quantification of regional gas uptake based on the associated ventilation. Subjects with lung disease showed variations in gas uptake that differed from those in ventilation in many regions, suggesting that gas uptake as measured by this technique reflects such features as underlying pathological alterations of lung tissue or of local blood flow. Furthermore, the ratio of the signal associated with gas uptake to that associated with ventilation was substantially altered in subjects with lung disease compared with healthy subjects. This MRI-based method provides a way to quantify relationships among gas delivery, exchange, and transport, and appears to have significant potential to provide more insight into lung disease. PMID:21098267

Simulation of ventilation efficiency, and pre-closure temperatures in emplacement drifts at Yucca Mountain, Nevada, using Monte Carlo and composite thermal-pulse methods

USGS Publications Warehouse

Case, J.B.; Buesch, D.C.

2004-01-01

Predictions of waste canister and repository driftwall temperatures as functions of space and time are important to evaluate pre-closure performance of the proposed repository for spent nuclear fuel and high-level radioactive waste at Yucca Mountain, Nevada. Variations in the lithostratigraphic features in densely welded and crystallized rocks of the 12.8-million-year-old Topopah Spring Tuff, especially the porosity resulting from lithophysal cavities, affect thermal properties. A simulated emplacement drift is based on projecting lithophysal cavity porosity values 50 to 800 m from the Enhanced Characterization of the Repository Block cross drift. Lithophysal cavity porosity varies from 0.00 to 0.05 cm3/cm3 in the middle nonlithophysal zone and from 0.03 to 0.28 cm3/cm3 in the lower lithophysal zone. A ventilation model and computer program titled "Monte Carlo Simulation of Ventilation" (MCSIMVENT), which is based on a composite thermal-pulse calculation, simulates statistical variability and uncertainty of rock-mass thermal properties and ventilation performance along a simulated emplacement drift for a pre-closure period of 50 years. Although ventilation efficiency is relatively insensitive to thermal properties, variations in lithophysal porosity along the drift can result in a range of peak driftwall temperatures can range from 40 to 85??C for the preclosure period. Copyright ?? 2004 by ASME.

Positive End-Expiratory Pressure and Variable Ventilation in Lung-Healthy Rats under General Anesthesia

PubMed Central

Camilo, Luciana M.; Ávila, Mariana B.; Cruz, Luis Felipe S.; Ribeiro, Gabriel C. M.; Spieth, Peter M.; Reske, Andreas A.; Amato, Marcelo; Giannella-Neto, Antonio; Zin, Walter A.; Carvalho, Alysson R.

2014-01-01

Objectives Variable ventilation (VV) seems to improve respiratory function in acute lung injury and may be combined with positive end-expiratory pressure (PEEP) in order to protect the lungs even in healthy subjects. We hypothesized that VV in combination with moderate levels of PEEP reduce the deterioration of pulmonary function related to general anesthesia. Hence, we aimed at evaluating the alveolar stability and lung protection of the combination of VV at different PEEP levels. Design Randomized experimental study. Setting Animal research facility. Subjects Forty-nine male Wistar rats (200–270 g). Interventions Animals were ventilated during 2 hours with protective low tidal volume (VT) in volume control ventilation (VCV) or VV and PEEP adjusted at the level of minimum respiratory system elastance (Ers), obtained during a decremental PEEP trial subsequent to a recruitment maneuver, and 2 cmH2O above or below of this level. Measurements and Main Results Ers, gas exchange and hemodynamic variables were measured. Cytokines were determined in lung homogenate and plasma samples and left lung was used for histologic analysis and diffuse alveolar damage scoring. A progressive time-dependent increase in Ers was observed independent on ventilatory mode or PEEP level. Despite of that, the rate of increase of Ers and lung tissue IL-1 beta concentration were significantly lower in VV than in VCV at the level of the PEEP of minimum Ers. A significant increase in lung tissue cytokines (IL-6, IL-1 beta, CINC-1 and TNF-alpha) as well as a ventral to dorsal and cranial to caudal reduction in aeration was observed in all ventilated rats with no significant differences among groups. Conclusions VV combined with PEEP adjusted at the level of the PEEP of minimal Ers seemed to better prevent anesthesia-induced atelectasis and might improve lung protection throughout general anesthesia. PMID:25383882

[Recent insights into the possibilities of resuscitation of dogs and cats].

PubMed

How, K L; Reens, N; Stokhof, A A; Hellebrekers, L J

1998-08-15

This article reviews the present state of the art of resuscitation of dogs and cats. The purpose of resuscitation is to revive animals so that the vital functions resume together with a normal brain function. Resuscitation must be started as soon as the cardiopulmonary arrest has been confirmed. Adequate ventilation and effective circulation to the most vital body organs, the heart and the brain, have the highest priority. They can be achieved by endotracheal intubation, artificial ventilation with 100% oxygen and rhythmic compression of the closed chest or direct cardiac massage following thoracotomy. Medical therapy is an important part of resuscitation. In the absence of a central venous route, deep endotracheal administration is the preferred method of administration. Most medications can be administered through the endotracheal tube in this fashion.

MEchatronic REspiratory System SImulator for Neonatal Applications (MERESSINA) project: a novel bioengineering goal

PubMed Central

Scaramuzzo, Rosa T; Ciantelli, Massimiliano; Baldoli, Ilaria; Bellanti, Lisa; Gentile, Marzia; Cecchi, Francesca; Sigali, Emilio; Tognarelli, Selene; Ghirri, Paolo; Mazzoleni, Stefano; Menciassi, Arianna; Cuttano, Armando; Boldrini, Antonio; Laschi, Cecilia; Dario, Paolo

2013-01-01

Respiratory function is mandatory for extrauterine life, but is sometimes impaired in newborns due to prematurity, congenital malformations, or acquired pathologies. Mechanical ventilation is standard care, but long-term complications, such as bronchopulmonary dysplasia, are still largely reported. Therefore, continuous medical education is mandatory to correctly manage devices for assistance. Commercially available breathing function simulators are rarely suitable for the anatomical and physiological realities. The aim of this study is to develop a high-fidelity mechatronic simulator of neonatal airways and lungs for staff training and mechanical ventilator testing. The project is divided into three different phases: (1) a review study on respiratory physiology and pathophysiology and on already available single and multi-compartment models; (2) the prototyping phase; and (3) the on-field system validation. PMID:23966804

P-Type Silicon Strip Sensors for the new CMS Tracker at HL-LHC

DOE PAGES

Adam, W.; Bergauer, T.; Brondolin, E.; ...

2017-06-27

The upgrade of the LHC to the High-Luminosity LHC (HL-LHC) is expected to increase the LHC design luminosity by an order of magnitude. This will require silicon tracking detectors with a significantly higher radiation hardness. The CMS Tracker Collaboration has conducted an irradiation and measurement campaign to identify suitable silicon sensor materials and strip designs for the future outer tracker at the CMS experiment. Based on these results, the collaboration has chosen to use n-in-p type silicon sensors and focus further investigations on the optimization of that sensor type. Furthermore, this paper describes the main measurement results and conclusions thatmore » motivated this decision.« less

P-Type Silicon Strip Sensors for the new CMS Tracker at HL-LHC

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

Adam, W.; Bergauer, T.; Brondolin, E.

The upgrade of the LHC to the High-Luminosity LHC (HL-LHC) is expected to increase the LHC design luminosity by an order of magnitude. This will require silicon tracking detectors with a significantly higher radiation hardness. The CMS Tracker Collaboration has conducted an irradiation and measurement campaign to identify suitable silicon sensor materials and strip designs for the future outer tracker at the CMS experiment. Based on these results, the collaboration has chosen to use n-in-p type silicon sensors and focus further investigations on the optimization of that sensor type. Furthermore, this paper describes the main measurement results and conclusions thatmore » motivated this decision.« less

Quarkonium polarization and the long distance matrix elements hierarchies using jet substructure

NASA Astrophysics Data System (ADS)

Dai, Lin; Shrivastava, Prashant

2017-08-01

We investigate the quarkonium production mechanisms in jets at the LHC, using the fragmenting jet functions (FJF) approach. Specifically, we discuss the jet energy dependence of the J /ψ production cross section at the LHC. By comparing the cross sections for the different NRQCD production channels (1S0[8], 3S1[8], 3PJ[8], and 3cripts>S1[1]), we find that at fixed values of energy fraction z carried by the J /ψ , if the normalized cross section is a decreasing function of the jet energy, in particular for z >0.5 , then the depolarizing 1S0[8] must be the dominant channel. This makes the prediction made in [Baumgart et al., J. High Energy Phys. 11 (2014) 003, 10.1007/JHEP11(2014)003] for the FJF's also true for the cross section. We also make comparisons between the long distance matrix elements extracted by various groups. This analysis could potentially shed light on the polarization properties of the J /ψ production in high pT region.

New parton distribution functions from a global analysis of quantum chromodynamics

DOE PAGES

Dulat, Sayipjamal; Hou, Tie -Jiun; Gao, Jun; ...

2016-02-16

Here, we present new parton distribution functions (PDFs) up to next-to-next-to-leading order (NNLO) from the CTEQ-TEA global analysis of quantum chromodynamics. These differ from previous CT PDFs in several respects, including the use of data from LHC experiments and the new D0 charged lepton rapidity asymmetry data, as well as the use of more flexible parametrization of PDFs that, in particular, allows a better fit to different combinations of quark flavors. Predictions for important LHC processes, especially Higgs boson production at 13 TeV, are presented. These CT14 PDFs include a central set and error sets in the Hessian representation. Formore » completeness, we also present the CT14 PDFs determined at the leading order (LO) and the next-to-leading order (NLO) in QCD. Besides these general-purpose PDF sets, we provide a series of (N)NLO sets with various α s values and additional sets in general-mass variable flavor number (GM-VFN) schemes, to deal with heavy partons, with up to 3, 4, and 6 active flavors.« less

Pesticide exposure and lymphohaematopoietic cancers: a case-control study in an agricultural region (Larissa, Thessaly, Greece).

PubMed

Kokouva, Maria; Bitsolas, Nikolaos; Hadjigeorgiou, Georgios M; Rachiotis, George; Papadoulis, Nikolaos; Hadjichristodoulou, Christos

2011-01-04

The causality of lymphohaematopoietic cancers (LHC) is multifactorial and studies investigating the association between chemical exposure and LHC have produced variable results. The aim of this study was to investigate the relationships between exposure to pesticides and LHC in an agricultural region of Greece. A structured questionnaire was employed in a hospital-based case control study to gather information on demographics, occupation, exposure to pesticides, agricultural practices, family and medical history and smoking. To control for confounders, backward conditional and multinomial logistic regression analyses were used. To assess the dose-response relationship between exposure and disease, the chi-square test for trend was used. Three hundred and fifty-four (354) histologically confirmed LHC cases diagnosed from 2004 to 2006 and 455 sex- and age-matched controls were included in the study. Pesticide exposure was associated with total LHC cases (OR 1.46, 95% CI 1.05-2.04), myelodysplastic syndrome (MDS) (OR 1.87, 95% CI 1.00-3.51) and leukaemia (OR 2.14, 95% CI 1.09-4.20). A dose-response pattern was observed for total LHC cases (P = 0.004), MDS (P = 0.024) and leukaemia (P = 0.002). Pesticide exposure was independently associated with total LHC cases (OR 1.41, 95% CI 1.00 - 2.00) and leukaemia (OR 2.05, 95% CI 1.02-4.12) after controlling for age, smoking and family history (cancers, LHC and immunological disorders). Smoking during application of pesticides was strongly associated with total LHC cases (OR 3.29, 95% CI 1.81-5.98), MDS (OR 3.67, 95% CI 1.18-12.11), leukaemia (OR 10.15, 95% CI 2.15-65.69) and lymphoma (OR 2.72, 95% CI 1.02-8.00). This association was even stronger for total LHC cases (OR 18.18, 95% CI 2.38-381.17) when eating simultaneously with pesticide application. Lymphohaematopoietic cancers were associated with pesticide exposure after controlling for confounders. Smoking and eating during pesticide application were identified as modifying factors increasing the risk for LHC. The poor pesticide work practices identified during this study underline the need for educational campaigns for farmers.

Respiratory System Function in Patients After Minimally Invasive Aortic Valve Replacement Surgery: A Case Control Study.

PubMed

Stoliński, Jarosław; Musiał, Robert; Plicner, Dariusz; Andres, Janusz

The aim of the study was to comparatively analyze respiratory system function after minimally invasive, through right minithoracotomy aortic valve replacement (RT-AVR) to conventional AVR. Analysis of 201 patients scheduled for RT-AVR and 316 for AVR between January 2010 and November 2013. Complications of the respiratory system and pulmonary functional status are presented. Complications of the respiratory system occurred in 16.8% of AVR and 11.0% of RT-AVR patients (P = 0.067). The rate of pleural effusions, thoracenteses, pneumonias, or phrenic nerve dysfunctions was not significantly different between groups. Perioperative mortality was 1.9% in AVR and 1.0% in RT-AVR (P = 0.417). Mechanical ventilation time after surgery was 9.7 ± 5.9 hours for AVR and 7.2 ± 3.2 hours for RT-AVR patients (P < 0.001). Stroke (odds ratio [OR] = 13.4, P = 0.008), increased postoperative blood loss (OR = 9.6, P < 0.001), and chronic obstructive pulmonary disease (OR = 7.7, P < 0.001) were risk factors of prolonged mechanical lung ventilation. A week after surgery, the results of most pulmonary function tests were lower in the AVR than in the RT-AVR group (P < 0.001 was seen for forced expiratory volume in the first second, vital capacity, total lung capacity, maximum inspiratory pressure and maximum expiratory pressure, P = 0.377 was seen for residual volume). Right anterior aortic valve replacement minithoracotomy surgery with single-lung ventilation did not result in increased rate of respiratory system complications. Spirometry examinations revealed that pulmonary functional status was more impaired after AVR in comparison with RT-AVR surgery.

Cardiopulmonary function after pulmonary contusion and partial liquid ventilation.

PubMed

Moomey, C B; Fabian, T C; Croce, M A; Melton, S M; Proctor, K G

1998-08-01

To compare the effects of mechanical ventilation with either positive end-expiratory pressure (PEEP) or partial liquid ventilation (PLV) on cardiopulmonary function after severe pulmonary contusion. Mongrel pigs (32 +/- 1 kg) were anesthetized, paralyzed, and mechanically ventilated (8-10 mL/kg tidal volume; 12 breaths/min; FiO2 = 0.5). Systemic hemodynamics and pulmonary function were measured for 7 hours after a captive bolt gun delivered a blunt injury to the right chest. After 5 hours, FiO2 was increased to 1.0 and either PEEP (n = 7) in titrated increments to 25 cm H2O or PLV with perflubron (LiquiVent, 30 mL/kg, endotracheal) and no PEEP (n = 7) was administered for 2 hours. Two control groups received injury without treatment (n = 6) or no injury with PLV (n = 3). Fluids were liberalized with PEEP versus PLV (27 +/- 3 vs. 18 +/- 2 mL.kg-1.h-1) to maintain cardiac filling pressures. Before treatment at 5 hours after injury, physiologic dead space fraction (30 +/- 4%), pulmonary vascular resistance (224 +/- 20% of baseline), and airway resistance (437 +/- 110% of baseline) were all increased (p < 0.05). In addition, PaO2/FiO2 had decreased to 112 +/- 18 mm Hg, compliance was depressed to 11 +/- 1 mL/cm H2O (36 +/- 3% of baseline), and shunt fraction was increased to 22 +/- 4% (all p < 0.05). Blood pressure and cardiac index remained stable relative to baseline, but stroke index and systemic oxygen delivery were depressed by 15 to 30% (both p < 0.05). After 2 hours of treatment with PEEP versus PLV, PO2/FiO2 was higher (427 +/- 20 vs. 263 +/- 37) and dead space ventilation was lower (4 +/- 3 vs. 28 +/- 7%) (both p < 0.05), whereas compliance tended to be higher (26 +/- 2 vs. 20 +/- 2) and shunt fraction tended to be lower (0 +/- 0 vs. 7 +/- 4). With PEEP versus PLV, however, cardiac index, stroke index, and systemic oxygen delivery were 30 to 60% lower (all p < 0.05). Furthermore, although contused lungs showed similar damage with either treatment, the secondary injury in the contralateral lung (as manifested by intra-alveolar hemorrhage) was more severe with PEEP than with PLV. Both PEEP and PLV improved pulmonary function after severe unilateral pulmonary contusion, but negative hemodynamic and histologic changes were associated with PEEP and not with PLV. These data suggest that PLV is a promising novel ventilatory strategy for unilateral pulmonary contusion that might ameliorate secondary injury in the contralateral uninjured lung.

OZONE-INDUCED RESPIRATORY SYMPTOMS: EXPOSURE-RESPONSE MODELS AND ASSOCIATION WITH LUNG FUNCTION

EPA Science Inventory

Ozone-induced respiratory symptoms are known to be functions of concentration, minute ventilation, and duration of exposure. The purposes of this study were to identify an exposure-response model for symptoms, to determine whether response was related to age, and to assess the re...

Prevalence and test characteristics of national health safety network ventilator-associated events.

PubMed

Lilly, Craig M; Landry, Karen E; Sood, Rahul N; Dunnington, Cheryl H; Ellison, Richard T; Bagley, Peter H; Baker, Stephen P; Cody, Shawn; Irwin, Richard S

2014-09-01

The primary aim of the study was to measure the test characteristics of the National Health Safety Network ventilator-associated event/ventilator-associated condition constructs for detecting ventilator-associated pneumonia. Its secondary aims were to report the clinical features of patients with National Health Safety Network ventilator-associated event/ventilator-associated condition, measure costs of surveillance, and its susceptibility to manipulation. Prospective cohort study. Two inpatient campuses of an academic medical center. Eight thousand four hundred eight mechanically ventilated adults discharged from an ICU. None. The National Health Safety Network ventilator-associated event/ventilator-associated condition constructs detected less than a third of ventilator-associated pneumonia cases with a sensitivity of 0.325 and a positive predictive value of 0.07. Most National Health Safety Network ventilator-associated event/ventilator-associated condition cases (93%) did not have ventilator-associated pneumonia or other hospital-acquired complications; 71% met the definition for acute respiratory distress syndrome. Similarly, most patients with National Health Safety Network probable ventilator-associated pneumonia did not have ventilator-associated pneumonia because radiographic criteria were not met. National Health Safety Network ventilator-associated event/ventilator-associated condition rates were reduced 93% by an unsophisticated manipulation of ventilator management protocols. The National Health Safety Network ventilator-associated event/ventilator-associated condition constructs failed to detect many patients who had ventilator-associated pneumonia, detected many cases that did not have a hospital complication, and were susceptible to manipulation. National Health Safety Network ventilator-associated event/ventilator-associated condition surveillance did not perform as well as ventilator-associated pneumonia surveillance and had several undesirable characteristics.

Considerations on Energy Frontier Colliders after LHC

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

Shiltsev, Vladimir

2016-11-15

Since 1960’s, particle colliders have been in the forefront of particle physics, 29 total have been built and operated, 7 are in operation now. At present the near term US, European and international strategies of the particle physics community are centered on full exploitation of the physics potential of the Large Hadron Collider (LHC) through its high-luminosity upgrade (HL-LHC). The future of the world-wide HEP community critically depends on the feasibility of possible post-LHC colliders. The concept of the feasibility is complex and includes at least three factors: feasibility of energy, feasibility of luminosity and feasibility of cost. Here wemore » overview all current options for post-LHC colliders from such perspective (ILC, CLIC, Muon Collider, plasma colliders, CEPC, FCC, HE-LHC) and discuss major challenges and accelerator R&D required to demonstrate feasibility of an energy frontier accelerator facility following the LHC. We conclude by taking a look into ultimate energy reach accelerators based on plasmas and crystals, and discussion on the perspectives for the far future of the accelerator-based particle physics. This paper largely follows previous study [1] and the presenta ion given at the ICHEP’2016 conference in Chicago [2].« less

Commissioning the cryogenic system of the first LHC sector

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

Millet, F.; Claudet, S.; Ferlin, G.

2007-12-01

The LHC machine, composed of eight sectors with superconducting magnets and accelerating cavities, requires a complex cryogenic system providing high cooling capacities (18 kW equivalent at 4.5 K and 2.4 W at 1.8 K per sector produced in large cold boxes and distributed via 3.3-km cryogenic transfer lines). After individual reception tests of the cryogenic subsystems (cryogen storages, refrigerators, cryogenic transfer lines and distribution boxes) performed since 2000, the commissioning of the cryogenic system of the first LHC sector has been under way since November 2006. After a brief introduction to the LHC cryogenic system and its specificities, the commissioningmore » is reported detailing the preparation phase (pressure and leak tests, circuit conditioning and flushing), the cool-down sequences including the handling of cryogenic fluids, the magnet powering phase and finally the warm-up. Preliminary conclusions on the commissioning of the first LHC sector will be drawn with the review of the critical points already solved or still pending. The last part of the paper reports on the first operational experience of the LHC cryogenic system in the perspective of the commissioning of the remaining LHC sectors and the beam injection test.« less

Performance of heated humidifiers with a heated wire according to ventilatory settings.

PubMed

Nishida, T; Nishimura, M; Fujino, Y; Mashimo, T

2001-01-01

Delivering warm, humidified gas to patients is important during mechanical ventilation. Heated humidifiers are effective and popular. The humidifying efficiency is influenced not only by performance and settings of the devices but the settings of ventilator. We compared the efficiency of humidifying devices with a heated wire and servo-controlled function under a variety of ventilator settings. A bench study was done with a TTL model lung. The study took place in the laboratory of the University Hospital, Osaka, Japan. Four devices (MR290 with MR730, MR310 with MR730; both Fisher & Paykel, ConchaTherm IV; Hudson RCI, and HummaxII; METRAN) were tested. Hummax II has been developed recently, and it consists of a heated wire and polyethylene microporous hollow fiber. Both wire and fiber were put inside of an inspiratory circuit, and water vapor is delivered throughout the circuit. The Servo 300 was connected to the TTL with a standard ventilator circuit. The ventilator settings were as follows; minute ventilation (V(E)) 5, 10, and 15 L/min, a respiratory rate of 10 breaths/min, I:E ratio 1:1, 1:2, and 1:4, and no applied PEEP. Humidifying devices were set to maintain the temperature of airway opening at 32 degrees C and 37 degrees C. The greater V(E) the lower the humidity with all devices except Hummax II. Hummax II delivered 100% relative humidity at all ventilator and humidifier settings. When airway temperature control of the devices was set at 32 degrees C, the ConchaTherm IV did not deliver 30 mg/L of vapor, which is the value recommended by American National Standards at all V(E) settings. At 10 and 15 L/min of V(E) settings MR310 with MR730 did not deliver recommended vapor, either. In conclusion, airway temperature setting of the humidifying devices influenced the humidity of inspiratory gas greatly. Ventilatory settings also influenced the humidity of inspiratory gas. The Hummax II delivered sufficient water vapor under a variety of minute ventilation.

Electrical impedance tomography

PubMed Central

Lobo, Beatriz; Hermosa, Cecilia; Abella, Ana

2018-01-01

Continuous assessment of respiratory status is one of the cornerstones of modern intensive care unit (ICU) monitoring systems. Electrical impedance tomography (EIT), although with some constraints, may play the lead as a new diagnostic and guiding tool for an adequate optimization of mechanical ventilation in critically ill patients. EIT may assist in defining mechanical ventilation settings, assess distribution of tidal volume and of end-expiratory lung volume (EELV) and contribute to titrate positive end-expiratory pressure (PEEP)/tidal volume combinations. It may also quantify gains (recruitment) and losses (overdistention or derecruitment), granting a more realistic evaluation of different ventilator modes or recruitment maneuvers, and helping in the identification of responders and non-responders to such maneuvers. Moreover, EIT also contributes to the management of life-threatening lung diseases such as pneumothorax, and aids in guiding fluid management in the critical care setting. Lastly, assessment of cardiac function and lung perfusion through electrical impedance is on the way. PMID:29430443

Benefits of awake uniportal pulmonary resection in a patient with a previous contralateral lobectomy

PubMed Central

Navarro-Martinez, Jose; Bolufer, Sergio; Lirio, Francisco; Mafe, Juan Jose; Rivera, Maria Jesus; Roca, Joaquin; Baschwitz, Benno

2014-01-01

Surgical resection of a contralateral recurrence of non-small cell lung cancer (NSCLC) is indicated in patients without evidence of disseminated disease and considered functionally operable. General anesthesia and double-lumen intubation involves one lobe ventilation in a patient treated with a previous lobectomy, thus increasing the risks of ventilator-induced injuries and the morbidity. Awake procedures facilitate the surgery decreasing the anesthetic and surgical times, keeping the diaphragm motion and diminishing the ventilator-induced injuries into the remaining contralateral lobe. We present a 43-year-old woman with a previous left-lower lobectomy for a 3.1-cm mucinous adenocarcinoma 15 months before without nodal involvement, who presents a right-lower lobe 8-mm cavitated nodule, with evident radiological growth and fine-needle aspiration concordant with mucinous adenocarcinoma. We suggest an awake procedure with locoregional epidural anesthesia. PMID:25405168

Benefits of awake uniportal pulmonary resection in a patient with a previous contralateral lobectomy.

PubMed

Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Lirio, Francisco; Mafe, Juan Jose; Rivera, Maria Jesus; Roca, Joaquin; Baschwitz, Benno

2014-09-01

Surgical resection of a contralateral recurrence of non-small cell lung cancer (NSCLC) is indicated in patients without evidence of disseminated disease and considered functionally operable. General anesthesia and double-lumen intubation involves one lobe ventilation in a patient treated with a previous lobectomy, thus increasing the risks of ventilator-induced injuries and the morbidity. Awake procedures facilitate the surgery decreasing the anesthetic and surgical times, keeping the diaphragm motion and diminishing the ventilator-induced injuries into the remaining contralateral lobe. We present a 43-year-old woman with a previous left-lower lobectomy for a 3.1-cm mucinous adenocarcinoma 15 months before without nodal involvement, who presents a right-lower lobe 8-mm cavitated nodule, with evident radiological growth and fine-needle aspiration concordant with mucinous adenocarcinoma. We suggest an awake procedure with locoregional epidural anesthesia.

Unsteady two dimensional airloads acting on oscillating thin airfoils in subsonic ventilated wind tunnels

NASA Technical Reports Server (NTRS)

Fromme, J.; Golberg, M.

1978-01-01

The numerical calculation of unsteady two dimensional airloads which act upon thin airfoils in subsonic ventilated wind tunnels was studied. Neglecting certain quadrature errors, Bland's collocation method is rigorously proved to converge to the mathematically exact solution of Bland's integral equation, and a three way equivalence was established between collocation, Galerkin's method and least squares whenever the collocation points are chosen to be the nodes of the quadrature rule used for Galerkin's method. A computer program displayed convergence with respect to the number of pressure basis functions employed, and agreement with known special cases was demonstrated. Results are obtained for the combined effects of wind tunnel wall ventilation and wind tunnel depth to airfoil chord ratio, and for acoustic resonance between the airfoil and wind tunnel walls. A boundary condition is proposed for permeable walls through which mass flow rate is proportional to pressure jump.

Overview of LHC physics results at ICHEP

ScienceCinema

Mangano, Michelangelo

2018-06-20

This month LHC physics day will review the physics results presented by the LHC experiments at the 2010 ICHEP in Paris. The experimental presentations will be preceeded by the bi-weekly LHC accelerator status report.The meeting will be broadcast via EVO (detailed info will appear at the time of the meeting in the "Video Services" item on the left menu bar). For those attending, information on accommodation, access to CERN and laptop registration is available from http://cern.ch/lpcc/visits

Design and prototyping of HL-LHC double quarter wave crab cavities for SPS test

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

Verdu-Andres, S.; Skaritka, J.; Wu, Q.

2015-05-03

The LHC high luminosity project envisages the use of the crabbing technique for increasing and levelling the LHC luminosity. Double Quarter Wave (DQW) resonators are compact cavities especially designed to meet the technical and performance requirements for LHC beam crabbing. Two DQW crab cavities are under fabrication and will be tested with beam in the Super Proton Synchrotron (SPS) at CERN by 2017. This paper describes the design and prototyping of the DQW crab cavities for the SPS test.

Overview of LHC physics results at ICHEP

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

None

2011-02-25

 This month LHC physics day will review the physics results presented by the LHC experiments at the 2010 ICHEP in Paris. The experimental presentations will be preceeded by the bi-weekly LHC accelerator status report.The meeting will be broadcast via EVO (detailed info will appear at the time of the meeting in the "Video Services" item on the left menu bar)For those attending, information on accommodation, access to CERN and laptop registration is available from http://cern.ch/lpcc/visits

The Large Hadron Collider (LHC): The Energy Frontier

NASA Astrophysics Data System (ADS)

Brianti, Giorgio; Jenni, Peter

The following sections are included: * Introduction * Superconducting Magnets: Powerful, Precise, Plentiful * LHC Cryogenics: Quantum Fluids at Work * Current Leads: High Temperature Superconductors to the Fore * A Pumping Vacuum Chamber: Ultimate Simplicity * Vertex Detectors at LHC: In Search of Beauty * Large Silicon Trackers: Fast, Precise, Efficient * Two Approaches to High Resolution Electromagnetic Calorimetry * Multigap Resistive Plate Chamber: Chronometry of Particles * The LHCb RICH: The Lord of the Cherenkov Rings * Signal Processing: Taming the LHC Data Avalanche * Giant Magnets for Giant Detectors

Calibration techniques and strategies for the present and future LHC electromagnetic calorimeters

NASA Astrophysics Data System (ADS)

Aleksa, M.

2018-02-01

This document describes the different calibration strategies and techniques applied by the two general purpose experiments at the LHC, ATLAS and CMS, and discusses them underlining their respective strengths and weaknesses from the view of the author. The resulting performances of both calorimeters are described and compared on the basis of selected physics results. Future upgrade plans for High Luminosity LHC (HL-LHC) are briefly introduced and planned calibration strategies for the upgraded detectors are shown.

Air Trapping on Chest CT Is Associated with Worse Ventilation Distribution in Infants with Cystic Fibrosis Diagnosed following Newborn Screening

PubMed Central

Hall, Graham L.; Logie, Karla M.; Parsons, Faith; Schulzke, Sven M.; Nolan, Gary; Murray, Conor; Ranganathan, Sarath; Robinson, Phil; Sly, Peter D.; Stick, Stephen M.

2011-01-01

Background In school-aged children with cystic fibrosis (CF) structural lung damage assessed using chest CT is associated with abnormal ventilation distribution. The primary objective of this analysis was to determine the relationships between ventilation distribution outcomes and the presence and extent of structural damage as assessed by chest CT in infants and young children with CF. Methods Data of infants and young children with CF diagnosed following newborn screening consecutively reviewed between August 2005 and December 2009 were analysed. Ventilation distribution (lung clearance index and the first and second moment ratios [LCI, M1/M0 and M2/M0, respectively]), chest CT and airway pathology from bronchoalveolar lavage were determined at diagnosis and then annually. The chest CT scans were evaluated for the presence or absence of bronchiectasis and air trapping. Results Matched lung function, chest CT and pathology outcomes were available in 49 infants (31 male) with bronchiectasis and air trapping present in 13 (27%) and 24 (49%) infants, respectively. The presence of bronchiectasis or air trapping was associated with increased M2/M0 but not LCI or M1/M0. There was a weak, but statistically significant association between the extent of air trapping and all ventilation distribution outcomes. Conclusion These findings suggest that in early CF lung disease there are weak associations between ventilation distribution and lung damage from chest CT. These finding are in contrast to those reported in older children. These findings suggest that assessments of LCI could not be used to replace a chest CT scan for the assessment of structural lung disease in the first two years of life. Further research in which both MBW and chest CT outcomes are obtained is required to assess the role of ventilation distribution in tracking the progression of lung damage in infants with CF. PMID:21886842

Chronic obstructive pulmonary disease: quantitative and visual ventilation pattern analysis at xenon ventilation CT performed by using a dual-energy technique.

PubMed

Park, Eun-Ah; Goo, Jin Mo; Park, Sang Joon; Lee, Hyun Ju; Lee, Chang Hyun; Park, Chang Min; Yoo, Chul-Gyu; Kim, Jong Hyo

2010-09-01

To evaluate the potential of xenon ventilation computed tomography (CT) in the quantitative and visual analysis of chronic obstructive pulmonary disease (COPD). This study was approved by the institutional review board. After informed consent was obtained, 32 patients with COPD underwent CT performed before the administration of xenon, two-phase xenon ventilation CT with wash-in (WI) and wash-out (WO) periods, and pulmonary function testing (PFT). For quantitative analysis, results of PFT were compared with attenuation parameters from prexenon images and xenon parameters from xenon-enhanced images in the following three areas at each phase: whole lung, lung with normal attenuation, and low-attenuating lung (LAL). For visual analysis, ventilation patterns were categorized according to the pattern of xenon attenuation in the area of structural abnormalities compared with that in the normal-looking background on a per-lobe basis: pattern A consisted of isoattenuation or high attenuation in the WI period and isoattenuation in the WO period; pattern B, isoattenuation or high attenuation in the WI period and high attenuation in the WO period; pattern C, low attenuation in both the WI and WO periods; and pattern D, low attenuation in the WI period and isoattenuation or high attenuation in the WO period. Among various attenuation and xenon parameters, xenon parameters of the LAL in the WO period showed the best inverse correlation with results of PFT (P < .0001). At visual analysis, while emphysema (which affected 99 lobes) commonly showed pattern A or B, airway diseases such as obstructive bronchiolitis (n = 5) and bronchiectasis (n = 2) and areas with a mucus plug (n = 1) or centrilobular nodules (n = 5) showed pattern D or C. WI and WO xenon ventilation CT is feasible for the simultaneous regional evaluation of structural and ventilation abnormalities both quantitatively and qualitatively in patients with COPD. (c) RSNA, 2010.

Enhanced Photoacoustic Gas Analyser Response Time and Impact on Accuracy at Fast Ventilation Rates during Multiple Breath Washout

PubMed Central

Horsley, Alex; Macleod, Kenneth; Gupta, Ruchi; Goddard, Nick; Bell, Nicholas

2014-01-01

Background The Innocor device contains a highly sensitive photoacoustic gas analyser that has been used to perform multiple breath washout (MBW) measurements using very low concentrations of the tracer gas SF6. Use in smaller subjects has been restricted by the requirement for a gas analyser response time of <100 ms, in order to ensure accurate estimation of lung volumes at rapid ventilation rates. Methods A series of previously reported and novel enhancements were made to the gas analyser to produce a clinically practical system with a reduced response time. An enhanced lung model system, capable of delivering highly accurate ventilation rates and volumes, was used to assess in vitro accuracy of functional residual capacity (FRC) volume calculation and the effects of flow and gas signal alignment on this. Results 10–90% rise time was reduced from 154 to 88 ms. In an adult/child lung model, accuracy of volume calculation was −0.9 to 2.9% for all measurements, including those with ventilation rate of 30/min and FRC of 0.5 L; for the un-enhanced system, accuracy deteriorated at higher ventilation rates and smaller FRC. In a separate smaller lung model (ventilation rate 60/min, FRC 250 ml, tidal volume 100 ml), mean accuracy of FRC measurement for the enhanced system was minus 0.95% (range −3.8 to 2.0%). Error sensitivity to flow and gas signal alignment was increased by ventilation rate, smaller FRC and slower analyser response time. Conclusion The Innocor analyser can be enhanced to reliably generate highly accurate FRC measurements down at volumes as low as those simulating infant lung settings. Signal alignment is a critical factor. With these enhancements, the Innocor analyser exceeds key technical component recommendations for MBW apparatus. PMID:24892522

Jet angularity measurements for single inclusive jet production

NASA Astrophysics Data System (ADS)

Kang, Zhong-Bo; Lee, Kyle; Ringer, Felix

2018-04-01

We study jet angularity measurements for single-inclusive jet production at the LHC. Jet angularities depend on a continuous parameter a allowing for a smooth interpolation between different traditional jet shape observables. We establish a factorization theorem within Soft Collinear Effective Theory (SCET) where we consistently take into account in- and out-of-jet radiation by making use of semi-inclusive jet functions. For comparison, we elaborate on the differences to jet angularities measured on an exclusive jet sample. All the necessary ingredients for the resummation at next-to-leading logarithmic (NLL) accuracy are presented within the effective field theory framework. We expect semiinclusive jet angularity measurements to be feasible at the LHC and we present theoretical predictions for the relevant kinematic range. In addition, we investigate the potential impact of jet angularities for quark-gluon discrimination.

Commissioning of a CERN Production and Analysis Facility Based on xrootd

NASA Astrophysics Data System (ADS)

Campana, Simone; van der Ster, Daniel C.; Di Girolamo, Alessandro; Peters, Andreas J.; Duellmann, Dirk; Coelho Dos Santos, Miguel; Iven, Jan; Bell, Tim

2011-12-01

The CERN facility hosts the Tier-0 of the four LHC experiments, but as part of WLCG it also offers a platform for production activities and user analysis. The CERN CASTOR storage technology has been extensively tested and utilized for LHC data recording and exporting to external sites according to experiments computing model. On the other hand, to accommodate Grid data processing activities and, more importantly, chaotic user analysis, it was realized that additional functionality was needed including a different throttling mechanism for file access. This paper will describe the xroot-based CERN production and analysis facility for the ATLAS experiment and in particular the experiment use case and data access scenario, the xrootd redirector setup on top of the CASTOR storage system, the commissioning of the system and real life experience for data processing and data analysis.

The ATLAS Data Acquisition System: from Run 1 to Run 2

NASA Astrophysics Data System (ADS)

Panduro Vazquez, William; ATLAS Collaboration

2016-04-01

The experience gained during the first period of very successful data taking of the ATLAS experiment (Run 1) has inspired a number of ideas for improvement of the Data Acquisition (DAQ) system that are being put in place during the so-called Long Shutdown 1 of the Large Hadron Collider (LHC), in 2013/14. We have updated the data-flow architecture, rewritten an important fraction of the software and replaced hardware, profiting from state of the art technologies. This paper summarizes the main changes that have been applied to the ATLAS DAQ system and highlights the expected performance and functional improvements that will be available for the LHC Run 2. Particular emphasis will be put on explaining the reasons for our architectural and technical choices, as well as on the simulation and testing approach used to validate this system.

Validation and performance of the LHC cryogenic system through commissioning of the first sector

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

Serio, L.; Bouillot, A.; Casas-Cubillos, J.

2007-12-01

The cryogenic system [1] for the Large Hadron Collider accelerator is presently in its final phase of commissioning at nominal operating conditions. The refrigeration capacity for the LHC is produced using eight large cryogenic plants and eight 1.8 K refrigeration units installed on five cryogenic islands. Machine cryogenic equipment is installed in a 26.7-km circumference ring deep underground tunnel and are maintained at their nominal operating conditions via a distribution system consisting of transfer lines, cold interconnection boxes at each cryogenic island and a cryogenic distribution line. The functional analysis of the whole system during all operating conditions was establishedmore » and validated during the first sector commissioning in order to maximize the system availability. Analysis, operating modes, main failure scenarios, results and performance of the cryogenic system are presented.« less

Supersymmetry Breaking, Gauge Mediation, and the LHC

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

Shih, David

2015-04-14

Gauge mediated SUSY breaking (GMSB) is a promising class of supersymmetric models that automatically satisfies the precision constraints. Prior work of Meade, Seiberg and Shih in 2008 established the full, model-independent parameter space of GMSB, which they called "General Gauge Mediation" (GGM). During the first half of 2010-2015, Shih and his collaborators thoroughly explored the parameter space of GGM and established many well-motivated benchmark models for use by the experimentalists at the LHC. Through their work, the current constraints on GGM from LEP, the Tevatron and the LHC were fully elucidated, together with the possible collider signatures of GMSB atmore » the LHC. This ensured that the full discovery potential for GGM could be completely realized at the LHC.« less

Simple replacement of violaxanthin by zeaxanthin in LHC-II does not cause chlorophyll fluorescence quenching.

PubMed

Dreuw, Andreas; Wormit, Michael

2008-03-01

Recently, a mechanism for the energy-dependent component (qE) of non-photochemical quenching (NPQ), the fundamental photo-protection mechanism in green plants, has been suggested. Replacement of violaxanthin by zeaxanthin in the binding pocket of the major light harvesting complex LHC-II may be sufficient to invoke efficient chlorophyll fluorescence quenching. Our quantum chemical calculations, however, show that the excited state energies of violaxanthin and zeaxanthin are practically identical when their geometry is constrained to the naturally observed structure of violaxanthin in LHC-II. Therefore, since violaxanthin does not quench LHC-II, zeaxanthin should not either. This theoretical finding is nicely in agreement with experimental results obtained by femtosecond spectroscopy on LHC-II complexes containing violaxanthin or zeaxanthin.

Respiratory effort correction strategies to improve the reproducibility of lung expansion measurements

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

Du, Kaifang; Reinhardt, Joseph M.; Christensen, Gary E.

2013-12-15

Purpose: Four-dimensional computed tomography (4DCT) can be used to make measurements of pulmonary function longitudinally. The sensitivity of such measurements to identify change depends on measurement uncertainty. Previously, intrasubject reproducibility of Jacobian-based measures of lung tissue expansion was studied in two repeat prior-RT 4DCT human acquisitions. Difference in respiratory effort such as breathing amplitude and frequency may affect longitudinal function assessment. In this study, the authors present normalization schemes that correct ventilation images for variations in respiratory effort and assess the reproducibility improvement after effort correction.Methods: Repeat 4DCT image data acquired within a short time interval from 24 patients priormore » to radiation therapy (RT) were used for this analysis. Using a tissue volume preserving deformable image registration algorithm, Jacobian ventilation maps in two scanning sessions were computed and compared on the same coordinate for reproducibility analysis. In addition to computing the ventilation maps from end expiration to end inspiration, the authors investigated the effort normalization strategies using other intermediated inspiration phases upon the principles of equivalent tidal volume (ETV) and equivalent lung volume (ELV). Scatter plots and mean square error of the repeat ventilation maps and the Jacobian ratio map were generated for four conditions: no effort correction, global normalization, ETV, and ELV. In addition, gamma pass rate was calculated from a modified gamma index evaluation between two ventilation maps, using acceptance criterions of 2 mm distance-to-agreement and 5% ventilation difference.Results: The pattern of regional pulmonary ventilation changes as lung volume changes. All effort correction strategies improved reproducibility when changes in respiratory effort were greater than 150 cc (p < 0.005 with regard to the gamma pass rate). Improvement of reproducibility was correlated with respiratory effort difference (R = 0.744 for ELV in the cohort with tidal volume difference greater than 100 cc). In general for all subjects, global normalization, ETV and ELV significantly improved reproducibility compared to no effort correction (p = 0.009, 0.002, 0.005 respectively). When tidal volume difference was small (less than 100 cc), none of the three effort correction strategies improved reproducibility significantly (p = 0.52, 0.46, 0.46 respectively). For the cohort (N = 13) with tidal volume difference greater than 100 cc, the average gamma pass rate improves from 57.3% before correction to 66.3% after global normalization, and 76.3% after ELV. ELV was found to be significantly better than global normalization (p = 0.04 for all subjects, and p = 0.003 for the cohort with tidal volume difference greater than 100 cc).Conclusions: All effort correction strategies improve the reproducibility of the authors' pulmonary ventilation measures, and the improvement of reproducibility is highly correlated with the changes in respiratory effort. ELV gives better results as effort difference increase, followed by ETV, then global. However, based on the spatial and temporal heterogeneity in the lung expansion rate, a single scaling factor (e.g., global normalization) appears to be less accurate to correct the ventilation map when changes in respiratory effort are large.« less

Effects of budesonide on the lung functions, inflammation and apoptosis in a saline-lavage model of acute lung injury.

PubMed

Mokra, D; Kosutova, P; Balentova, S; Adamkov, M; Mikolka, P; Mokry, J; Antosova, M; Calkovska, A

2016-12-01

Diffuse alveolar injury, edema, and inflammation are fundamental signs of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Whereas the systemic administration of corticosteroids previously led to controversial results, this study evaluated if corticosteroids given intratracheally may improve lung functions and reduce edema formation, migration of cells into the lung and their activation in experimentally-induced ALI. In oxygen-ventilated rabbits, ALI was induced by repetitive saline lung lavage, until PaO2 decreased to < 26.7 kPa in FiO 2 1.0. Then, one group of animals was treated with corticosteroid budesonide (Pulmicort susp inh, AstraZeneca; 0.25 mg/kg) given intratracheally by means of inpulsion regime of high-frequency jet ventilation, while another group was non-treated, and both groups were oxygen-ventilated for following 5 hours. Another group of animals served as healthy controls. After sacrifice of animals, left lung was saline-lavaged and protein content was measured and cells in the lavage fluid were determined microscopically. Right lung tissue was used for estimation of edema formation (expressed as wet/dry weight ratio), for histomorphological investigation, immunohistochemical determination of apoptosis of lung cells, and for determination of markers of inflammation and lung injury (IL-1β, IL-6, IL-8, TNF-α, IFNγ, esRAGE, caspase-3) by ELISA methods. Levels of several cytokines were estimated also in plasma. Repetitive lung lavage worsened gas exchange, induced lung injury, inflammation and lung edema and increased apoptosis of lung epithelial cells. Budesonide reduced lung edema, cell infiltration into the lung and apoptosis of epithelial cells and decreased concentrations of proinflammatory markers in the lung and blood. These changes resulted in improved ventilation. Concluding, curative intratracheal treatment with budesonide alleviated lung injury, inflammation, apoptosis of lung epithelial cells and lung edema and improved lung functions in a lavage model of ALI. These findings suggest a potential of therapy with inhaled budesonide also for patients with ARDS.

Recommendations on presenting LHC searches for missing transverse energy signals using simplified s-channel models of dark matter

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

Boveia, Antonio; Buchmueller, Oliver; Busoni, Giorgio

2016-03-14

This document summarises the proposal of the LHC Dark Matter Working Group on how to present LHC results on s-channel simplified dark matter models and to compare them to direct (indirect) detection experiments.

High Luminosity LHC: challenges and plans

NASA Astrophysics Data System (ADS)

Arduini, G.; Barranco, J.; Bertarelli, A.; Biancacci, N.; Bruce, R.; Brüning, O.; Buffat, X.; Cai, Y.; Carver, L. R.; Fartoukh, S.; Giovannozzi, M.; Iadarola, G.; Li, K.; Lechner, A.; Medina Medrano, L.; Métral, E.; Nosochkov, Y.; Papaphilippou, Y.; Pellegrini, D.; Pieloni, T.; Qiang, J.; Redaelli, S.; Romano, A.; Rossi, L.; Rumolo, G.; Salvant, B.; Schenk, M.; Tambasco, C.; Tomás, R.; Valishev, S.; Van der Veken, F. F.

2016-12-01

The Large Hadron Collider (LHC) is one of the largest scientific instruments ever built. Since opening up a new energy frontier for exploration in 2010, it has gathered a global user community working in fundamental particle physics and the physics of hadronic matter at extreme temperature and density. To sustain and extend its discovery potential, the LHC will undergo a major upgrade in the 2020s. This will increase its rate of collisions by a factor of five beyond the original design value and the integrated luminosity by a factor ten. The new configuration, known as High Luminosity LHC (HL-LHC), will rely on a number of key innovations that push accelerator technology beyond its present limits. Among these are cutting-edge 11-12 T superconducting magnets, including Nb3Sn-based magnets never used in accelerators before, compact superconducting cavities for longitudinal beam rotation, new technology and physical processes for beam collimation. The dynamics of the HL-LHC beams will be also particularly challenging and this aspect is the main focus of this paper.

Stepping outside the neighborhood of T at LHC

NASA Astrophysics Data System (ADS)

Wiedemann, Urs Achim

2009-11-01

“ As you are well aware, many in the RHIC community are interested in the LHC heavy-ion program, but have several questions: What can we learn at the LHC that is qualitatively new? Are collisions at LHC similar to RHIC ones, just with a somewhat hotter/denser initial state? If not, why not? These questions are asked in good faith, and this talk is an opportunity to answer them directly to much of the RHIC community.” With these words, the organizers of Quark Matter 2009 in Knoxville invited me to discuss the physics opportunities for heavy ion collisions at the LHC without recalling the standard arguments, which are mainly based on the extended kinematic reach of the machine. In response, I emphasize here that lattice QCD indicates characteristic qualitative differences between thermal physics in the neighborhood of the critical temperature (T400-500MeV), for which the relevant energy densities will be solely attainable at the LHC.

Feasibility of applying the life history calendar in a population of chronic opioid users to identify patterns of drug use and addiction treatment.

PubMed

Fikowski, Jill; Marchand, Kirsten; Palis, Heather; Oviedo-Joekes, Eugenia

2014-01-01

Uncovering patterns of drug use and treatment access is essential to improving treatment for opioid dependence. The life history calendar (LHC) could be a valuable instrument for capturing time-sensitive data on lifetime patterns of drug use and addiction treatment. This study describes the methodology applied when collecting data using the LHC in a sample of individuals with long-term opioid dependence and aims to identify specific factors that impact the feasibility of administering the LHC interview. In this study, the LHC allowed important events such as births, intimate relationships, housing, or incarcerations to become reference points for recalling details surrounding drug use and treatment access. The paper concludes that the administration of the LHC was a resource-intensive process and required special attention to interviewer training and experience with the study population. These factors should be considered and integrated into study plans by researchers using the LHC in addiction research.

FLUKA Monte Carlo simulations and benchmark measurements for the LHC beam loss monitors

NASA Astrophysics Data System (ADS)

Sarchiapone, L.; Brugger, M.; Dehning, B.; Kramer, D.; Stockner, M.; Vlachoudis, V.

2007-10-01

One of the crucial elements in terms of machine protection for CERN's Large Hadron Collider (LHC) is its beam loss monitoring (BLM) system. On-line loss measurements must prevent the superconducting magnets from quenching and protect the machine components from damages due to unforeseen critical beam losses. In order to ensure the BLM's design quality, in the final design phase of the LHC detailed FLUKA Monte Carlo simulations were performed for the betatron collimation insertion. In addition, benchmark measurements were carried out with LHC type BLMs installed at the CERN-EU high-energy Reference Field facility (CERF). This paper presents results of FLUKA calculations performed for BLMs installed in the collimation region, compares the results of the CERF measurement with FLUKA simulations and evaluates related uncertainties. This, together with the fact that the CERF source spectra at the respective BLM locations are comparable with those at the LHC, allows assessing the sensitivity of the performed LHC design studies.

Simulations of fast crab cavity failures in the high luminosity Large Hadron Collider

NASA Astrophysics Data System (ADS)

Yee-Rendon, Bruce; Lopez-Fernandez, Ricardo; Barranco, Javier; Calaga, Rama; Marsili, Aurelien; Tomás, Rogelio; Zimmermann, Frank; Bouly, Frédéric

2014-05-01

Crab cavities (CCs) are a key ingredient of the high luminosity Large Hadron Collider (HL-LHC) project for increasing the luminosity of the LHC. At KEKB, CCs have exhibited abrupt changes of phase and voltage during a time period of the order of a few LHC turns and considering the significant stored energy in the HL-LHC beam, CC failures represent a serious threat in regard to LHC machine protection. In this paper, we discuss the effect of CC voltage or phase changes on a time interval similar to, or longer than, the one needed to dump the beam. The simulations assume a quasistationary-state distribution to assess the particles losses for the HL-LHC. These distributions produce beam losses below the safe operation threshold for Gaussian tails, while, for non-Gaussian tails are on the same order of the limit. Additionally, some mitigation strategies are studied for reducing the damage caused by the CC failures.

Measurements of major VOCs released into the closed cabin environment of different automobiles under various engine and ventilation scenarios.

PubMed

Kim, Ki-Hyun; Szulejko, Jan E; Jo, Hyo-Jae; Lee, Min-Hee; Kim, Yong-Hyun; Kwon, Eilhann; Ma, Chang-Jin; Kumar, Pawan

2016-08-01

Volatile organic compounds (VOCs) in automobile cabins were measured quantitatively to describe their emission characteristics in relation to various idling scenarios using three used automobiles (compact, intermediate sedan, and large sedan) under three different idling conditions ([1] cold engine off and ventilation off, [2] exterior air ventilation with idling warm engine, and [3] internal air recirculation with idling warm engine). The ambient air outside the vehicle was also analyzed as a reference. A total of 24 VOCs (with six functional groups) were selected as target compounds. Accordingly, the concentration of 24 VOC quantified as key target compounds averaged 4.58 ± 3.62 ppb (range: 0.05 (isobutyl alcohol) ∼ 38.2 ppb (formaldehyde)). Moreover, if their concentrations are compared between different automobile operational modes: the 'idling engine' levels (5.24 ± 4.07) was 1.3-5 times higher than the 'engine off' levels (4.09 ± 3.23) across all 3 automobile classes. In summary, automobile in-cabin VOC emissions are highly contingent on changes in engine and ventilation modes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Non-contrast-enhanced perfusion and ventilation assessment of the human lung by means of fourier decomposition in proton MRI.

PubMed

Bauman, Grzegorz; Puderbach, Michael; Deimling, Michael; Jellus, Vladimir; Chefd'hotel, Christophe; Dinkel, Julien; Hintze, Christian; Kauczor, Hans-Ulrich; Schad, Lothar R

2009-09-01

Assessment of regional lung perfusion and ventilation has significant clinical value for the diagnosis and follow-up of pulmonary diseases. In this work a new method of non-contrast-enhanced functional lung MRI (not dependent on intravenous or inhalative contrast agents) is proposed. A two-dimensional (2D) true fast imaging with steady precession (TrueFISP) pulse sequence (TR/TE = 1.9 ms/0.8 ms, acquisition time [TA] = 112 ms/image) was implemented on a 1.5T whole-body MR scanner. The imaging protocol comprised sets of 198 lung images acquired with an imaging rate of 3.33 images/s in coronal and sagittal view. No electrocardiogram (ECG) or respiratory triggering was used. A nonrigid image registration algorithm was applied to compensate for respiratory motion. Rapid data acquisition allowed observing intensity changes in corresponding lung areas with respect to the cardiac and respiratory frequencies. After a Fourier analysis along the time domain, two spectral lines corresponding to both frequencies were used to calculate the perfusion- and ventilation-weighted images. The described method was applied in preliminary studies on volunteers and patients showing clinical relevance to obtain non-contrast-enhanced perfusion and ventilation data.

Anaesthesia ventilators.

PubMed

Jain, Rajnish K; Swaminathan, Srinivasan

2013-09-01

Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bellows ventilators, ascending bellows design is safer than descending bellows. Piston ventilators have the advantage of delivering accurate tidal volume. They work with electricity as their driving force and do not require a driving gas. To enable improved patient safety, several modifications were done in circle system with the different types of anaesthesia ventilators. Fresh gas decoupling is a modification done in piston ventilators and in descending bellows ventilator to reduce th incidence of ventilator induced volutrauma. In addition to the conventional volume control mode, modern anaesthesia ventilators also provide newer modes of ventilation such as synchronised intermittent mandatory ventilation, pressure-control ventilation and pressure-support ventilation (PSV). PSV mode is particularly useful for patients maintained on spontaneous respiration with laryngeal mask airway. Along with the innumerable benefits provided by these machines, there are various inherent hazards associated with the use of the ventilators in the operating room. To use these workstations safely, it is important for every Anaesthesiologist to have a basic understanding of the mechanics of these ventilators and breathing circuits.

Asthma prevalence in German Olympic athletes: A comparison of winter and summer sport disciplines.

PubMed

Selge, Charlotte; Thomas, Silke; Nowak, Dennis; Radon, Katja; Wolfarth, Bernd

2016-09-01

Prevalence of asthma in elite athletes shows very wide ranges. It remains unclear to what extent this is influenced by the competition season (winter vs. summer) or the ventilation rate achieved during competition. The aim of this study was to evaluate prevalence of asthma in German elite winter and summer athletes from a wide range of sport disciplines and to identify high risk groups. In total, 265 German elite winter athletes (response 77%) and 283 German elite summer athletes (response 64%) answered validated respiratory questionnaires. Using logistic regression, the asthma risks associated with competition season and ventilation rate during competition, respectively, were investigated. A subset of winter athletes was also examined for their FENO-levels and lung function. With respect to all asthma outcomes, no association was found with the competition season. Regarding the ventilation rate, athletes in high ventilation sports were at increased risk of asthma, as compared to athletes in low ventilation sports (doctors' diagnosed asthma: OR 2.32, 95% CI 1.19-4.53; use of asthma medication: OR 4.46, 95% CI 1.52-13.10; current wheeze or use of asthma medication: OR 2.78, 95% CI 1.34-5.76). Athletes with doctors' diagnosed asthma were at an approximate four-fold risk of elevated FENO-values. The clinically relevant finding of this study is that athletes' asthma seems to be more common in sports with high ventilation during competition, whereas the summer or winter season had no impact on the frequency of the disease. Among winter athletes, elevated FENO suggested suboptimal control of asthma. Copyright © 2016 Elsevier Ltd. All rights reserved.

Technical Note: A proposal of air ventilation system design criteria for a clinical room in a heavy-ion medical facility.

PubMed

Kum, Oyeon

2018-06-01

An optimized air ventilation system design for a treatment room in Heavy-ion Medical Facility is an important issue in the aspects of nuclear safety because the activated air produced in a treatment room can directly affect the medical staff and the general public in the radiation-free area. Optimized design criteria of air ventilation system for a clinical room in 430 MeV/u carbon ion beam medical accelerator facility was performed by using a combination of MCNPX2.7.0 and CINDER'90 codes. Effective dose rate and its accumulated effective dose by inhalation and residual gamma were calculated for a normal treatment scenario (2 min irradiation for one fraction) as a function of decay time. Natural doses around the site were measured before construction and used as reference data. With no air ventilation system, the maximum effective dose rate was about 3 μSv/h (total dose of 90 mSv/y) and minimum 0.2 μSv/h (total dose of 6 mSv/y), which are over the legal limits for medical staff and for the general public. Although inhalation dose contribution was relatively small, it was considered seriously because of its long-lasting effects in the body. The integrated dose per year was 1.8 mSv/y in the radiation-free area with the 20-min rate of air ventilation system. An optimal air ventilation rate of 20 min is proposed for a clinical room, which also agrees with the best mechanical design value. © 2018 American Association of Physicists in Medicine.

Ventilator-dependent children and the health services system. Unmet needs and coordination of care.

PubMed

Hefner, Jennifer L; Tsai, Wan Chong

2013-10-01

Children dependent on mechanical ventilation are a vulnerable population by virtue of their chronic disability and are therefore at increased risk for health disparities and access barriers. The present study is the first, to our knowledge, to conduct a large-scale survey of caregivers of ventilator-dependent children to develop a comprehensive socio-demographic profile. To describe the demographic and health status profile of ventilator-dependent children, to identify the types of unmet needs families caring for a child on a ventilator face, and to determine the correlates of access to care coordination. A survey was administered to 122 parents whose children attended a pediatric home ventilator clinic at a large tertiary Midwestern medical center (84% of the clinic population). Half of the patient population had severe functional limitations, and 70% had one or more comorbidities. One quarter of caregivers reported current financial struggles, and 16% screened positive for a probable depressive disorder. More than half of families reported unmet needs for care, most frequently therapeutic services and skilled nursing care. Of those reporting an unmet need for skilled nursing care, lack of adequate staffing was the main barrier (71.1%). Financial struggles and a probable caregiver depressive disorder were significantly associated with an unmet need for care coordination. This is the first large-scale quantitative study to investigate the themes of unmet need and care coordination within this vulnerable population. The results suggest these families face barriers accessing therapeutic and skilled nursing services, and caregiver mental health and financial struggles may be important points of intervention for service providers through the inclusion of multidisciplinary care teams and the strengthening of social services referral networks.

The effects of exogenous surfactant administration on ventilation-induced inflammation in mouse models of lung injury.

PubMed

Puntorieri, Valeria; Hiansen, Josh Qua; McCaig, Lynda A; Yao, Li-Juan; Veldhuizen, Ruud A W; Lewis, James F

2013-11-20

Mechanical ventilation (MV) is an essential supportive therapy for acute lung injury (ALI); however it can also contribute to systemic inflammation. Since pulmonary surfactant has anti-inflammatory properties, the aim of the study was to investigate the effect of exogenous surfactant administration on ventilation-induced systemic inflammation. Mice were randomized to receive an intra-tracheal instillation of a natural exogenous surfactant preparation (bLES, 50 mg/kg) or no treatment as a control. MV was then performed using the isolated and perfused mouse lung (IPML) set up. This model allowed for lung perfusion during MV. In experiment 1, mice were exposed to mechanical ventilation only (tidal volume =20 mL/kg, 2 hours). In experiment 2, hydrochloric acid or air was instilled intra-tracheally four hours before applying exogenous surfactant and ventilation (tidal volume =5 mL/kg, 2 hours). For both experiments, exogenous surfactant administration led to increased total and functional surfactant in the treated groups compared to the controls. Exogenous surfactant administration in mice exposed to MV only did not affect peak inspiratory pressure (PIP), lung IL-6 levels and the development of perfusate inflammation compared to non-treated controls. Acid injured mice exposed to conventional MV showed elevated PIP, lung IL-6 and protein levels and greater perfusate inflammation compared to air instilled controls. Instillation of exogenous surfactant did not influence the development of lung injury. Moreover, exogenous surfactant was not effective in reducing the concentration of inflammatory cytokines in the perfusate. The data indicates that exogenous surfactant did not mitigate ventilation-induced systemic inflammation in our models. Future studies will focus on altering surfactant composition to improve its immuno-modulating activity.

Neurally adjusted ventilatory assist in patients with acute respiratory failure: study protocol for a randomized controlled trial.

PubMed

Villar, Jesús; Belda, Javier; Blanco, Jesús; Suarez-Sipmann, Fernando; Añón, José Manuel; Pérez-Méndez, Lina; Ferrando, Carlos; Parrilla, Dácil; Montiel, Raquel; Corpas, Ruth; González-Higueras, Elena; Pestaña, David; Martínez, Domingo; Fernández, Lorena; Soro, Marina; García-Bello, Miguel Angel; Fernández, Rosa Lidia; Kacmarek, Robert M

2016-10-13

Patient-ventilator asynchrony is a common problem in mechanically ventilated patients with acute respiratory failure. It is assumed that asynchronies worsen lung function and prolong the duration of mechanical ventilation (MV). Neurally Adjusted Ventilatory Assist (NAVA) is a novel approach to MV based on neural respiratory center output that is able to trigger, cycle, and regulate the ventilatory cycle. We hypothesized that the use of NAVA compared to conventional lung-protective MV will result in a reduction of the duration of MV. It is further hypothesized that NAVA compared to conventional lung-protective MV will result in a decrease in the length of ICU and hospital stay, and mortality. This is a prospective, multicenter, randomized controlled trial in 306 mechanically ventilated patients with acute respiratory failure from several etiologies. Only patients ventilated for less than 5 days, and who are expected to require prolonged MV for an additional 72 h or more and are able to breathe spontaneously, will be considered for enrollment. Eligible patients will be randomly allocated to two ventilatory arms: (1) conventional lung-protective MV (n = 153) and conventional lung-protective MV with NAVA (n = 153). Primary outcome is the number of ventilator-free days, defined as days alive and free from MV at day 28 after endotracheal intubation. Secondary outcomes are total length of MV, and ICU and hospital mortality. This is the first randomized clinical trial examining, on a multicenter scale, the beneficial effects of NAVA in reducing the dependency on MV of patients with acute respiratory failure. ClinicalTrials.gov website ( NCT01730794 ). Registered on 15 November 2012.

Constant-flow ventilation in canine experimental pulmonary emphysema.

PubMed

Hachenberg, T; Wendt, M; Meyer, J; Struckmeier, O; Lawin, P

1989-07-01

The efficacy of constant-flow ventilation (CFV) was investigated in eight mongrel dogs before (control-phase) and after development of papain-induced panlobular emphysema (PLE-phase). For CFV, heated, humidified and oxygen-enriched air was continuously delivered via two catheters positioned within each mainstem bronchus at flow rates (V) of 0.33, 0.5 and 0.66 l/s. Data obtained during intermittent positive pressure ventilation (IPPV) served as reference. In the control-phase, Pao2 was lower (P less than or equal to 0.05) and alveolo-arterial O2 difference (P(A-a)O2) was higher (P less than or equal to 0.01) during CFV at all flow rates when compared with IPPV. This may be due to inhomogeneities of intrapulmonary gas distribution and increased ventilation-perfusion (VA/Q) mismatching. Paco2 and V showed a hyperbolic relationship; constant normocapnia (5.3 kPa) was achieved at 0.48 +/- 0.21 l/s (V53). Development of PLE resulted in an increase of functional residual capacity (FRC), residual volume (RV) and static compliance (Cstat) (P less than or equal to 0.05). PaO2 had decreased and P(A-a)O2 had increased (P less than or equal to 0.05), indicating moderate pulmonary dysfunction. Oxygenation during CFV was not significantly different in the PLE-phase when compared with the control-phase. Paco2 and V showed a hyperbolic relationship and V5.3 was even lower than in the control-group (0.42 +/- 0.13 l/s). In dogs with emphysematous lungs CFV maintains sufficient gas exchange. This may be due to preferential ventilation of basal lung units, thereby counterbalancing the effects of impaired lung morphometry and increased airtrapping. Conventional mechanical ventilation is more effective in terms of oxygenation and CO2-elimination.

Evaluation of ventilators for mouthpiece ventilation in neuromuscular disease.

PubMed

Khirani, Sonia; Ramirez, Adriana; Delord, Vincent; Leroux, Karl; Lofaso, Frédéric; Hautot, Solène; Toussaint, Michel; Orlikowski, David; Louis, Bruno; Fauroux, Brigitte

2014-09-01

Daytime mouthpiece ventilation is a useful adjunct to nocturnal noninvasive ventilation (NIV) in patients with neuromuscular disease. The aims of the study were to analyze the practice of mouthpiece ventilation and to evaluate the performance of ventilators for mouthpiece ventilation. Practice of mouthpiece ventilation was assessed by a questionnaire, and the performance of 6 home ventilators with mouthpiece ventilation was assessed in a bench test using 24 different conditions per ventilator: 3 mouthpieces, a child and an adult patient profile, and 4 ventilatory modes. Questionnaires were obtained from 30 subjects (mean age 33 ± 11 y) using NIV for 12 ± 7 y. Fifteen subjects used NIV for > 20 h/day, and 11 were totally ventilator-dependent. The subject-reported benefits of mouthpiece ventilation were a reduction in dyspnea (73%) and fatigue (93%) and an improvement in speech (43%) and eating (27%). The bench study showed that none of the ventilators, even those with mouthpiece ventilation software, were able to deliver mouthpiece ventilation without alarms and/or autotriggering in each condition. Alarms and/or ineffective triggering or autotriggering were observed in 135 of the 198 conditions. The occurrence of alarms was more common with a large mouthpiece without a filter compared to a small mouthpiece with a filter (P < .001), but it was not related to the patient profile, the ventilatory mode, or the type of ventilator. Subjects are satisfied with mouthpiece ventilation. Alarms are common with home ventilators, although less common in those with mouthpiece ventilation software. Improvements in home ventilators are needed to facilitate the expansion of mouthpiece ventilation. Copyright © 2014 by Daedalus Enterprises.

Quench simulations for superconducting elements in the LHC accelerator

NASA Astrophysics Data System (ADS)

Sonnemann, F.; Schmidt, R.

2000-08-01

The design of the protection system for the superconducting elements in an accelerator such as the large Hadron collider (LHC), now under construction at CERN, requires a detailed understanding of the thermo-hydraulic and electrodynamic processes during a quench. A numerical program (SPQR - simulation program for quench research) has been developed to evaluate temperature and voltage distributions during a quench as a function of space and time. The quench process is simulated by approximating the heat balance equation with the finite difference method in presence of variable cooling and powering conditions. The simulation predicts quench propagation along a superconducting cable, forced quenching with heaters, impact of eddy currents induced by a magnetic field change, and heat transfer through an insulation layer into helium, an adjacent conductor or other material. The simulation studies allowed a better understanding of experimental quench data and were used for determining the adequate dimensioning and protection of the highly stabilised superconducting cables for connecting magnets (busbars), optimising the quench heater strip layout for the main magnets, and studying quench back by induced eddy currents in the superconductor. After the introduction of the theoretical approach, some applications of the simulation model for the LHC dipole and corrector magnets are presented and the outcome of the studies is compared with experimental data.

A new strips tracker for the upgraded ATLAS ITk detector

NASA Astrophysics Data System (ADS)

David, C.

2018-01-01

The ATLAS detector has been designed and developed to function in the environment of the present Large Hadron Collider (LHC). At the next-generation tracking detector proposed for the High Luminosity LHC (HL-LHC), the so-called ATLAS Phase-II Upgrade, the fluences and radiation levels will be higher by as much as a factor of ten. The new sub-detectors must thus be faster, of larger area, more segmented and more radiation hard while the amount of inactive material should be minimized and the power supply to the front-end systems should be increased. For those reasons, the current inner tracker of the ATLAS detector will be fully replaced by an all-silicon tracking system that consists of a pixel detector at small radius close to the beam line and a large area strip tracker surrounding it. This document gives an overview of the design of the strip inner tracker (Strip ITk) and summarises the intensive R&D activities performed over the last years by the numerous institutes within the Strips ITk collaboration. These studies are accompanied with a strong prototyping effort to contribute to the optimisation of the Strip ITk's structure and components. This effort culminated recently in the release of the ATLAS Strips ITk Technical Design Report (TDR).

Magnetic Frequency Response of HL-LHC Beam Screens

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

Morrone, M.; Martino, M.; De Maria, R.

Magnetic fields used to control particle beams in accelerators are usually controlled by regulating the electrical current of the power converters. In order to minimize lifetime degradation and ultimately luminosity loss in circular colliders, current-noise is a highly critical figure of merit of power converters, in particular for magnets located in areas with high beta-function, like the High Luminosity Large Hadron Collider (HL-LHC) insertions. However, what is directly acting upon the beam is the magnetic field and not the current of the power converter, which undergoes several frequency-dependent transformations until the desired magnetic field, seen by the beam, is obtained.more » Beam screens are very rarely considered when assessing or specifying the noise figure of merit, but their magnetic frequency response is such that they realize relatively effective low pass filtering of the magnetic field produced by the system magnet-power converter. This work aims at filling this gap by quantifying the expected impact of different beam screen layouts for the most relevant HL-LHC insertion magnets. A welldefined post-processing technique is used to derive the frequency response of the different multipoles from multi-physics Finite Element Method (FEM) simulation results. In addition, a well approximated analytical formula for the low-frequency range of multi-layered beam screens is presented.« less

Conceptual design of hollow electron lenses for beam halo control in the Large Hadron Collider

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

Stancari, Giulio; Previtali, Valentina; Valishev, Alexander

Collimation with hollow electron beams is a technique for halo control in high-power hadron beams. It is based on an electron beam (possibly pulsed or modulated in intensity) guided by strong axial magnetic fields which overlaps with the circulating beam in a short section of the ring. The concept was tested experimentally at the Fermilab Tevatron collider using a hollow electron gun installed in one of the Tevatron electron lenses. We are proposing a conceptual design for applying this technique to the Large Hadron Collider at CERN. A prototype hollow electron gun for the LHC was built and tested. Themore » expected performance of the hollow electron beam collimator was based on Tevatron experiments and on numerical tracking simulations. Halo removal rates and enhancements of halo diffusivity were estimated as a function of beam and lattice parameters. Proton beam core lifetimes and emittance growth rates were checked to ensure that undesired effects were suppressed. Hardware specifications were based on the Tevatron devices and on preliminary engineering integration studies in the LHC machine. Required resources and a possible timeline were also outlined, together with a brief discussion of alternative halo-removal schemes and of other possible uses of electron lenses to improve the performance of the LHC.« less

CERN data services for LHC computing

NASA Astrophysics Data System (ADS)

Espinal, X.; Bocchi, E.; Chan, B.; Fiorot, A.; Iven, J.; Lo Presti, G.; Lopez, J.; Gonzalez, H.; Lamanna, M.; Mascetti, L.; Moscicki, J.; Pace, A.; Peters, A.; Ponce, S.; Rousseau, H.; van der Ster, D.

2017-10-01

Dependability, resilience, adaptability and efficiency. Growing requirements require tailoring storage services and novel solutions. Unprecedented volumes of data coming from the broad number of experiments at CERN need to be quickly available in a highly scalable way for large-scale processing and data distribution while in parallel they are routed to tape for long-term archival. These activities are critical for the success of HEP experiments. Nowadays we operate at high incoming throughput (14GB/s during 2015 LHC Pb-Pb run and 11PB in July 2016) and with concurrent complex production work-loads. In parallel our systems provide the platform for the continuous user and experiment driven work-loads for large-scale data analysis, including end-user access and sharing. The storage services at CERN cover the needs of our community: EOS and CASTOR as a large-scale storage; CERNBox for end-user access and sharing; Ceph as data back-end for the CERN OpenStack infrastructure, NFS services and S3 functionality; AFS for legacy distributed-file-system services. In this paper we will summarise the experience in supporting LHC experiments and the transition of our infrastructure from static monolithic systems to flexible components providing a more coherent environment with pluggable protocols, tuneable QoS, sharing capabilities and fine grained ACLs management while continuing to guarantee dependable and robust services.

Big data analytics for the Future Circular Collider reliability and availability studies

NASA Astrophysics Data System (ADS)

Begy, Volodimir; Apollonio, Andrea; Gutleber, Johannes; Martin-Marquez, Manuel; Niemi, Arto; Penttinen, Jussi-Pekka; Rogova, Elena; Romero-Marin, Antonio; Sollander, Peter

2017-10-01

Responding to the European Strategy for Particle Physics update 2013, the Future Circular Collider study explores scenarios of circular frontier colliders for the post-LHC era. One branch of the study assesses industrial approaches to model and simulate the reliability and availability of the entire particle collider complex based on the continuous monitoring of CERN’s accelerator complex operation. The modelling is based on an in-depth study of the CERN injector chain and LHC, and is carried out as a cooperative effort with the HL-LHC project. The work so far has revealed that a major challenge is obtaining accelerator monitoring and operational data with sufficient quality, to automate the data quality annotation and calculation of reliability distribution functions for systems, subsystems and components where needed. A flexible data management and analytics environment that permits integrating the heterogeneous data sources, the domain-specific data quality management algorithms and the reliability modelling and simulation suite is a key enabler to complete this accelerator operation study. This paper describes the Big Data infrastructure and analytics ecosystem that has been put in operation at CERN, serving as the foundation on which reliability and availability analysis and simulations can be built. This contribution focuses on data infrastructure and data management aspects and presents case studies chosen for its validation.

Surface damage characterization of FBK devices for High Luminosity LHC (HL-LHC) operations

NASA Astrophysics Data System (ADS)

Moscatelli, F.; Passeri, D.; Morozzi, A.; Dalla Betta, G.-F.; Mattiazzo, S.; Bomben, M.; Bilei, G. M.

2017-12-01

The very high fluences (e.g. up to 2×1016 1 MeV neq/cm2) and total ionising doses (TID) of the order of 1 Grad, expected at the High Luminosity LHC (HL-LHC), impose new challenges for the design of effective, radiation resistant detectors. Ionising energy loss is the dominant effect for what concerns SiO2 and SiO2/Si interface radiation damage. In particular, surface damage can create a positive charge layer near the SiO2/Si interface and interface traps along the SiO2/Si interface, which strongly influence the breakdown voltage, the inter-electrode isolation and capacitance, and might also impact the charge collection properties of silicon sensors. To better understand in a comprehensive framework the complex and articulated phenomena related to surface damage at these very high doses, measurements on test structures have been carried out in this work (e.g. C-V and I-V). In particular, we have studied the properties of the SiO2 layer and of the SiO2/Si interface, using MOS capacitors, gated diodes (GD) and MOSFETs manufactured by FBK on high-resistivity n-type and p-type silicon, before and after irradiation with X-rays in the range from 50 krad(SiO2) to 20 Mrad(SiO2). Relevant parameters have been determined for all the tested devices, converging in the oxide charge density NOX, the surface generation velocity s0 and the integrated interface-trap density NIT dose-dependent values. These parameters have been extracted to both characterize the technology as a function of the dose and to be used in TCAD simulations for the surface damage effect modeling and the analysis and optimization of different classes of detectors for the next HEP experiments.

Erratum to: Constraining couplings of top quarks to the Z boson in $$ t\\overline{t} $$ + Z production at the LHC

DOE PAGES

Röntsch, Raoul; Schulze, Markus

2015-09-21

We study top quark pair production in association with a Z boson at the Large Hadron Collider (LHC) and investigate the prospects of measuring the couplings of top quarks to the Z boson. To date these couplings have not been constrained in direct measurements. Such a determination will be possible for the first time at the LHC. Our calculation improves previous coupling studies through the inclusion of next-to-leading order (NLO) QCD corrections in production and decays of all unstable particles. We treat top quarks in the narrow-width approximation and retain all NLO spin correlations. To determine the sensitivity of amore » coupling measurement we perform a binned log-likelihood ratio test based on normalization and shape information of the angle between the leptons from the Z boson decay. The obtained limits account for statistical uncertainties as well as leading theoretical systematics from residual scale dependence and parton distribution functions. We use current CMS data to place the first direct constraints on the ttbZ couplings. We also consider the upcoming high-energy LHC run and find that with 300 inverse fb of data at an energy of 13 TeV the vector and axial ttbZ couplings can be constrained at the 95% confidence level to C_V=0.24^{+0.39}_{-0.85} and C_A=-0.60^{+0.14}_{-0.18}, where the central values are the Standard Model predictions. This is a reduction of uncertainties by 25% and 42%, respectively, compared to an analysis based on leading-order predictions. We also translate these results into limits on dimension-six operators contributing to the ttbZ interactions beyond the Standard Model.« less

Potential risk for bacterial contamination in conventional reused ventilator systems and disposable closed ventilator-suction systems.

PubMed

Li, Ya-Chi; Lin, Hui-Ling; Liao, Fang-Chun; Wang, Sing-Siang; Chang, Hsiu-Chu; Hsu, Hung-Fu; Chen, Sue-Hsien; Wan, Gwo-Hwa

2018-01-01

Few studies have investigated the difference in bacterial contamination between conventional reused ventilator systems and disposable closed ventilator-suction systems. The aim of this study was to investigate the bacterial contamination rates of the reused and disposable ventilator systems, and the association between system disconnection and bacterial contamination of ventilator systems. The enrolled intubated and mechanically ventilated patients used a conventional reused ventilator system and a disposable closed ventilator-suction system, respectively, for a week; specimens were then collected from the ventilator circuit systems to evaluate human and environmental bacterial contamination. The sputum specimens from patients were also analyzed in this study. The detection rate of bacteria in the conventional reused ventilator system was substantially higher than that in the disposable ventilator system. The inspiratory and expiratory limbs of the disposable closed ventilator-suction system had higher bacterial concentrations than the conventional reused ventilator system. The bacterial concentration in the heated humidifier of the reused ventilator system was significantly higher than that in the disposable ventilator system. Positive associations existed among the bacterial concentrations at different locations in the reused and disposable ventilator systems, respectively. The predominant bacteria identified in the reused and disposable ventilator systems included Acinetobacter spp., Bacillus cereus, Elizabethkingia spp., Pseudomonas spp., and Stenotrophomonas (Xan) maltophilia. Both the reused and disposable ventilator systems had high bacterial contamination rates after one week of use. Disconnection of the ventilator systems should be avoided during system operation to decrease the risks of environmental pollution and human exposure, especially for the disposable ventilator system. ClinicalTrials.gov PRS / NCT03359148.

LIL3, a Light-Harvesting Complex Protein, Links Terpenoid and Tetrapyrrole Biosynthesis in Arabidopsis thaliana1[OPEN

PubMed Central

Rothbart, Maxi; Herbst, Josephine; Wittmann, Daniel; Gruhl, Kirsten

2017-01-01

The LIL3 protein of Arabidopsis (Arabidopsis thaliana) belongs to the light-harvesting complex (LHC) protein family, which also includes the light-harvesting chlorophyll-binding proteins of photosystems I and II, the early-light-inducible proteins, PsbS involved in nonphotochemical quenching, and the one-helix proteins and their cyanobacterial homologs designated high-light-inducible proteins. Each member of this family is characterized by one or two LHC transmembrane domains (referred to as the LHC motif) to which potential functions such as chlorophyll binding, protein interaction, and integration of interacting partners into the plastid membranes have been attributed. Initially, LIL3 was shown to interact with geranylgeranyl reductase (CHLP), an enzyme of terpene biosynthesis that supplies the hydrocarbon chain for chlorophyll and tocopherol. Here, we show another function of LIL3 for the stability of protochlorophyllide oxidoreductase (POR). Multiple protein-protein interaction analyses suggest the direct physical interaction of LIL3 with POR but not with chlorophyll synthase. Consistently, LIL3-deficient plants exhibit substantial loss of POR as well as CHLP, which is not due to defective transcription of the POR and CHLP genes but to the posttranslational modification of their protein products. Interestingly, in vitro biochemical analyses provide novel evidence that LIL3 shows high binding affinity to protochlorophyllide, the substrate of POR. Taken together, this study suggests a critical role for LIL3 in the organization of later steps in chlorophyll biosynthesis. We suggest that LIL3 associates with POR and CHLP and thus contributes to the supply of the two metabolites, chlorophyllide and phytyl pyrophosphate, required for the final step in chlorophyll a synthesis. PMID:28432258

LIL3, a Light-Harvesting Complex Protein, Links Terpenoid and Tetrapyrrole Biosynthesis in Arabidopsis thaliana.

PubMed

Hey, Daniel; Rothbart, Maxi; Herbst, Josephine; Wang, Peng; Müller, Jakob; Wittmann, Daniel; Gruhl, Kirsten; Grimm, Bernhard

2017-06-01

The LIL3 protein of Arabidopsis ( Arabidopsis thaliana ) belongs to the light-harvesting complex (LHC) protein family, which also includes the light-harvesting chlorophyll-binding proteins of photosystems I and II, the early-light-inducible proteins, PsbS involved in nonphotochemical quenching, and the one-helix proteins and their cyanobacterial homologs designated high-light-inducible proteins. Each member of this family is characterized by one or two LHC transmembrane domains (referred to as the LHC motif) to which potential functions such as chlorophyll binding, protein interaction, and integration of interacting partners into the plastid membranes have been attributed. Initially, LIL3 was shown to interact with geranylgeranyl reductase (CHLP), an enzyme of terpene biosynthesis that supplies the hydrocarbon chain for chlorophyll and tocopherol. Here, we show another function of LIL3 for the stability of protochlorophyllide oxidoreductase (POR). Multiple protein-protein interaction analyses suggest the direct physical interaction of LIL3 with POR but not with chlorophyll synthase. Consistently, LIL3-deficient plants exhibit substantial loss of POR as well as CHLP, which is not due to defective transcription of the POR and CHLP genes but to the posttranslational modification of their protein products. Interestingly, in vitro biochemical analyses provide novel evidence that LIL3 shows high binding affinity to protochlorophyllide, the substrate of POR. Taken together, this study suggests a critical role for LIL3 in the organization of later steps in chlorophyll biosynthesis. We suggest that LIL3 associates with POR and CHLP and thus contributes to the supply of the two metabolites, chlorophyllide and phytyl pyrophosphate, required for the final step in chlorophyll a synthesis. © 2017 American Society of Plant Biologists. All Rights Reserved.

Supersymmetry production from a TeV scale black hole at CERN LHC

NASA Astrophysics Data System (ADS)

Chamblin, Andrew; Cooper, Fred; Nayak, Gouranga C.

2004-10-01

If the fundamental Planck scale is near a TeV, then we should expect to see TeV scale black holes at the CERN LHC. Similarly, if the scale of supersymmetry (SUSY) breaking is sufficiently low, then we might expect to see light supersymmetric particles in the next generation of colliders. If the mass of the supersymmetric particle is of order a TeV and is comparable to the temperature of a typical TeV scale black hole, then such sparticles will be copiously produced via Hawking radiation: The black hole will act as a resonance for sparticles, among other things. In this paper we compare various signatures for SUSY production at LHC, and we contrast the situation where the sparticles are produced directly via parton fusion processes with the situation where they are produced indirectly through black hole resonances. We found that black hole resonances provide a larger source for heavy mass SUSY (squark and gluino) production than the direct perturbative QCD-SUSY production via parton fusion processes depending on the values of the Planck mass and black hole mass. Hence black hole production at LHC may indirectly act as a dominant channel for SUSY production. We also found that the differential cross section dσ/dpt for SUSY production increases as a function of the pt (up to pt equal to about 1TeV or more) of the SUSY particles (squarks and gluinos), which is in sharp contrast with the pQCD predictions where the differential cross section dσ/dpt decreases as pt increases for high pt about 1TeV or higher. This is a feature for any particle emission from a TeV scale black hole as long as the temperature of the black hole is very high (˜TeV). Hence the measurement of increase of dσ/dpt with pt for pt up to about 1TeV or higher for final state particles might be a useful signature for black hole production at LHC.

DECT Ventilation Imaging

ClinicalTrials.gov

2018-03-21

For Oncologic Patients; Potentially Operable Lung Tumor; With a Recent (Less Than 1 Month) VQ Scan; For Lung Transplant Recipients; Single of Bilateral Lung Transplant; From 5 Months Onwards; With Recent (Less Than 1 Month) Respiratory Functional Explorations

Design New Buildings To Save Energy -- and Money

ERIC Educational Resources Information Center

Rittelmann, Richard

1974-01-01

Buildings should be designed so that energy systems function with maximum efficiency. Re-evaluation of standards for ventilation and lighting is recommended. Heat recovery techniques and topography can reduce heating loads. (MF)

Effect of fenspiride on pulmonary function in the rat and guinea pig.

PubMed

Bee, D; Laude, E A; Emery, C J; Howard, P

1995-03-01

1. Fenspiride is an anti-inflammatory agent that may have a role in reversible obstructive airways disease. Small, but significant, improvements have been seen in airways function and arterial oxygen tension in patients with mild chronic obstructive pulmonary disease. These changes have been attributed to the anti-inflammatory properties of the drug. However, airways function can be improved by other means, e.g. improved ventilation/perfusion ratio or reduced airways resistance. The possibility that fenspiride may have actions other than anti-inflammatory was investigated in two animal species. 2. In the rat, actions on the pulmonary circulation were investigated in the isolated perfused lung, but fenspiride proved to be a poor pulmonary vasodilator, showing only a small reversal of the raised pulmonary artery pressure induced by hypoxia. 3. Ventilation was measured in the anaesthetized rat using whole-body plethysmography. Fenspiride caused no increase in ventilation or changes in arterial blood gases. However, a profound hypotensive action was observed with high doses. 4. The possibility that a decrease in airways resistance (R(aw)) might occur with fenspiride was investigated in anaesthetized guinea pigs. Capsaicin (30 mumol/l) was used to increase baseline R(aw) through bronchoconstriction. Fenspiride gave a dose-dependent partial reversal of the raised R(aw), and its administration by aerosol proved as efficacious as the intravenous route. In addition, the hypotensive side-effect found with intravenous injection was alleviated by aerosolized fenspiride.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of substance P on cardiovascular and respiratory function in subjects.

PubMed

Fuller, R W; Maxwell, D L; Dixon, C M; McGregor, G P; Barnes, V F; Bloom, S R; Barnes, P J

1987-04-01

The effect of substance P (SP), administered both intravenously and by inhalation, has been studied in normal and asthmatic humans. Intravenous infusion of SP (0.2-3.3 pmol X kg-1 X min-1) achieving a plasma concentration of SP between 5 and 25 pM produced vasodilatation (mean +/- SD), maximal increase in skin temperature (0.9 +/- 0.3 degree C) (P less than 0.05), and fall in diastolic blood pressure (8.5 +/- 2.9 mmHg) (P less than 0.05) associated with an increase in heart rate (15 +/- 10 beats/min) (P less than 0.05). All subjects had a fall in Vp30 (airflow at 70% of forced vital capacity measured from total lung capacity after a forced partial expiratory flow maneuver) at low infusion rate (P less than 0.05) and a significant rise at the highest infusion rate (P less than 0.05). Ventilation at rest and when stimulated by transient hypoxia increased (mean increase in resting ventilation 0.73 +/- 0.4 l/min and mean percent increase in transient ventilatory hypoxic response 41 +/- 27%). There was a small nonsignificant increase in plasma norepinephrine but no change in epinephrine or histamine. Inhaled SP, up to 0.7 mumol, caused a small nonsignificant fall in airway function in asthmatic subjects. SP has demonstrable effects on vascular smooth muscle and control of ventilation but at the doses studied had little effect on airway function.

Commissioning of the cryogenics of the LHC long straight sections

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

Perin, A.; Casas-Cubillos, J.; Claudet, S.

2010-01-01

The LHC is made of eight circular arcs interspaced with eight Long Straight Sections (LSS). Most powering interfaces to the LHC are located in these sections where the particle beams are focused and shaped for collision, cleaning and acceleration. The LSSs are constituted of several unique cryogenic devices and systems like electrical feed-boxes, standalone superconducting magnets, superconducting links, RF cavities and final focusing superconducting magnets. This paper presents the cryogenic commissioning and the main results obtained during the first operation of the LHC Long Straight Sections.

Detector Developments for the High Luminosity LHC Era (1/4)

ScienceCinema

Straessner, Arno

2018-04-27

Calorimetry and Muon Spectrometers - Part I : In the first part of the lecture series, the motivation for a high luminosity upgrade of the LHC will be quickly reviewed together with the challenges for the LHC detectors. In particular, the plans and ongoing research for new calorimeter detectors will be explained. The main issues in the high-luminosity era are an improved radiation tolerance, natural ageing of detector components and challenging trigger and physics requirements. The new technological solutions for calorimetry at a high-luminosity LHC will be reviewed.

Torsion limits from t t macr production at the LHC

NASA Astrophysics Data System (ADS)

de Almeida, F. M. L.; de Andrade, F. R.; do Vale, M. A. B.; Nepomuceno, A. A.

2018-04-01

Torsion models constitute a well-known class of extended quantum gravity models. In this work, one investigates the phenomenological consequences of a torsion field interacting with top quarks at the LHC. A torsion field could appear as a new heavy state characterized by its mass and couplings to fermions. This new state would form a resonance decaying into a top antitop pair. The latest ATLAS t t ¯ production results from LHC 13 TeV data are used to set limits on torsion parameters. The integrated luminosity needed to observe torsion resonance at the next LHC upgrades are also evaluated, considering different values for the torsion mass and its couplings to Standard Model fermions. Finally, prospects for torsion exclusion at the future LHC phases II and III are obtained using fast detector simulations.

C P -violation in the two Higgs doublet model: From the LHC to EDMs

NASA Astrophysics Data System (ADS)

Chen, Chien-Yi; Li, Hao-Lin; Ramsey-Musolf, Michael

2018-01-01

We study the prospective sensitivity to C P -violating two Higgs doublet models from the 14 TeV LHC and future electric dipole moment (EDM) experiments. We concentrate on the search for a resonant heavy Higgs that decays to a Z boson and a SM-like Higgs h , leading to the Z (ℓℓ)h (b b ¯ ) final state. The prospective LHC reach is analyzed using the Boosted Decision Tree method. We illustrate the complementarity between the LHC and low energy EDM measurements and study the dependence of the physics reach on the degree of deviation from the alignment limit. In all cases, we find that there exists a large part of parameter space that is sensitive to both EDMs and LHC searches.

Support Structure Design of the $$\\hbox{Nb}_{3}\\hbox{Sn}$$ Quadrupole for the High Luminosity LHC

DOE PAGES

Juchno, M.; Ambrosio, G.; Anerella, M.; ...

2014-10-31

New low-β quadrupole magnets are being developed within the scope of the High Luminosity LHC (HL-LHC) project in collaboration with the US LARP program. The aim of the HLLHC project is to study and implement machine upgrades necessary for increasing the luminosity of the LHC. The new quadrupoles, which are based on the Nb₃Sn superconducting technology, will be installed in the LHC Interaction Regions and will have to generate a gradient of 140 T/m in a coil aperture of 150 mm. In this paper, we describe the design of the short model magnet support structure and discuss results of themore » detailed 3D numerical analysis performed in preparation for the first short model test.« less

Experiential learning in high energy physics: a survey of students at the LHC

NASA Astrophysics Data System (ADS)

Camporesi, Tiziano; Catalano, Gelsomina; Florio, Massimo; Giffoni, Francesco

2017-03-01

More than 36 000 students and post-docs will be involved until 2025 in research at the Large Hadron Collider (LHC) mainly through international collaborations. To what extent they value the skills acquired? Do students expect that their learning experience will have an impact on their professional future? By drawing from earlier literature on experiential learning, we have designed a survey of current and former students at LHC. To quantitatively measure the students’ perceptions, we compare the salary expectations of current students with the assessment of those now employed in different jobs. Survey data are analysed by ordered logistic regression models, which allow multivariate statistical analyses with limited dependent variables. Results suggest that experiential learning at LHC positively correlates with both current and former students’ salary expectations. Those already employed clearly confirm the expectations of current students. At least two not mutually exclusive explanations underlie the results. First, the training at LHC is perceived to provide students valuable skills, which in turn affect the salary expectations; secondly, the LHC research experience per se may act as signal in the labour market. Respondents put a price tag on their learning experience, a ‘LHC salary premium’ ranging from 5% to 12% compared with what they would have expected for their career without such an experience at CERN.