Best Practices for Unstructured Grid Shock-Fitting

NASA Technical Reports Server (NTRS)

McCoud, Peter L.

2017-01-01

Unstructured grid solvers have well-known issues predicting surface heat fluxes when strong shocks are present. Various efforts have been made to address the underlying numerical issues that cause the erroneous predictions. The present work addresses some of the shortcomings of unstructured grid solvers, not by addressing the numerics, but by applying structured grid best practices to unstructured grids. A methodology for robust shock detection and shock-fitting is outlined and applied to production-relevant cases. Results

Transient Two-Dimensional Analysis of Side Load in Liquid Rocket Engine Nozzles

NASA Technical Reports Server (NTRS)

Wang, Ten-See

2004-01-01

Two-dimensional planar and axisymmetric numerical investigations on the nozzle start-up side load physics were performed. The objective of this study is to develop a computational methodology to identify nozzle side load physics using simplified two-dimensional geometries, in order to come up with a computational strategy to eventually predict the three-dimensional side loads. The computational methodology is based on a multidimensional, finite-volume, viscous, chemically reacting, unstructured-grid, and pressure-based computational fluid dynamics formulation, and a transient inlet condition based on an engine system modeling. The side load physics captured in the low aspect-ratio, two-dimensional planar nozzle include the Coanda effect, afterburning wave, and the associated lip free-shock oscillation. Results of parametric studies indicate that equivalence ratio, combustion and ramp rate affect the side load physics. The side load physics inferred in the high aspect-ratio, axisymmetric nozzle study include the afterburning wave; transition from free-shock to restricted-shock separation, reverting back to free-shock separation, and transforming to restricted-shock separation again; and lip restricted-shock oscillation. The Mach disk loci and wall pressure history studies reconfirm that combustion and the associated thermodynamic properties affect the formation and duration of the asymmetric flow.

Rocket Engine Nozzle Side Load Transient Analysis Methodology: A Practical Approach

NASA Technical Reports Server (NTRS)

Shi, John J.

2005-01-01

During the development stage, in order to design/to size the rocket engine components and to reduce the risks, the local dynamic environments as well as dynamic interface loads must be defined. There are two kinds of dynamic environment, i.e. shock transients and steady-state random and sinusoidal vibration environments. Usually, the steady-state random and sinusoidal vibration environments are scalable, but the shock environments are not scalable. In other words, based on similarities only random vibration environments can be defined for a new engine. The methodology covered in this paper provides a way to predict the shock environments and the dynamic loads for new engine systems and new engine components in the early stage of new engine development or engine nozzle modifications.

Estimation of the Reactive Flow Model Parameters for an Ammonium Nitrate-Based Emulsion Explosive Using Genetic Algorithms

NASA Astrophysics Data System (ADS)

Ribeiro, J. B.; Silva, C.; Mendes, R.

2010-10-01

A real coded genetic algorithm methodology that has been developed for the estimation of the parameters of the reaction rate equation of the Lee-Tarver reactive flow model is described in detail. This methodology allows, in a single optimization procedure, using only one experimental result and, without the need of any starting solution, to seek the 15 parameters of the reaction rate equation that fit the numerical to the experimental results. Mass averaging and the plate-gap model have been used for the determination of the shock data used in the unreacted explosive JWL equation of state (EOS) assessment and the thermochemical code THOR retrieved the data used in the detonation products' JWL EOS assessments. The developed methodology was applied for the estimation of the referred parameters for an ammonium nitrate-based emulsion explosive using poly(methyl methacrylate) (PMMA)-embedded manganin gauge pressure-time data. The obtained parameters allow a reasonably good description of the experimental data and show some peculiarities arising from the intrinsic nature of this kind of composite explosive.

Best Practices for Unstructured Grid Shock Fitting

NASA Technical Reports Server (NTRS)

McCloud, Peter L.

2017-01-01

Unstructured grid solvers have well-known issues predicting surface heat fluxes when strong shocks are present. Various efforts have been made to address the underlying numerical issues that cause the erroneous predictions. The present work addresses some of the shortcomings of unstructured grid solvers, not by addressing the numerics, but by applying structured grid best practices to unstructured grids. A methodology for robust shock detection and shock fitting is outlined and applied to production relevant cases. Results achieved by using the Loci-CHEM Computational Fluid Dynamics solver are provided.

AEROFROSH: a shock condition calculator for multi-component fuel aerosol-laden flows

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

Campbell, Matthew Frederick; Haylett, D. R.; Davidson, D. F.

Here, this paper introduces an algorithm that determines the thermodynamic conditions behind incident and reflectedshocksinaerosol-ladenflows.Importantly,the algorithm accounts for the effects of droplet evaporation on post-shock properties. Additionally, this article describes an algorithm for resolving the effects of multiple-component- fuel droplets. This article presents the solution methodology and compares the results to those of another similar shock calculator. It also provides examples to show the impact of droplets on post-shock properties and the impact that multi-component fuel droplets have on shock experimental parameters. Finally, this paper presents a detailed uncertainty analysis of this algorithm’s calculations given typical exper- imental uncertainties

AEROFROSH: a shock condition calculator for multi-component fuel aerosol-laden flows

DOE PAGES

Campbell, Matthew Frederick; Haylett, D. R.; Davidson, D. F.; ...

2015-08-18

Here, this paper introduces an algorithm that determines the thermodynamic conditions behind incident and reflectedshocksinaerosol-ladenflows.Importantly,the algorithm accounts for the effects of droplet evaporation on post-shock properties. Additionally, this article describes an algorithm for resolving the effects of multiple-component- fuel droplets. This article presents the solution methodology and compares the results to those of another similar shock calculator. It also provides examples to show the impact of droplets on post-shock properties and the impact that multi-component fuel droplets have on shock experimental parameters. Finally, this paper presents a detailed uncertainty analysis of this algorithm’s calculations given typical exper- imental uncertainties

Reversible increase in maximal cortisol secretion rate in septic shock.

PubMed

Dorin, Richard I; Qualls, Clifford R; Torpy, David J; Schrader, Ronald M; Urban, Frank K

2015-03-01

Cortisol clearance is reduced in sepsis and may contribute to the development of impaired adrenocortical function that is thought to contribute to the pathophysiology of critical illness-related corticosteroid insufficiency. We sought to assess adrenocortical function using computer-assisted numerical modeling methodology to characterize and compare maximal cortisol secretion rate and free cortisol half-life in septic shock, sepsis, and healthy control subjects. Post hoc analysis of previously published total cortisol, free cortisol, corticosteroid-binding globulin, and albumin concentration data. Single academic medical center. Subjects included septic shock (n = 45), sepsis (n = 25), and healthy controls (n = 10). I.v. cosyntropin (250 μg). Solutions for maximal cortisol secretion rate and free cortisol half-life were obtained by least squares solution of simultaneous, nonlinear differential equations that account for free cortisol appearance and elimination as well as reversible binding to corticosteroid-binding globulin and albumin. Maximal cortisol secretion rate was significantly greater in septic shock (0.83 nM/s [0.44, 1.58 nM/s] reported as median [lower quartile, upper quartile]) compared with sepsis (0.51 nM/s [0.36, 0.62 nM/s]; p = 0.007) and controls (0.49 nM/s [0.42, 0.62 nM/s]; p = 0.04). The variance of maximal cortisol secretion rate in septic shock was also greater than that of sepsis or control groups (F test, p < 0.001). Free cortisol half-life was significantly increased in septic shock (4.6 min [2.2, 6.3 min]) and sepsis (3.0 min [2.3, 4.8 min] when compared with controls (2.0 min [1.2, 2.6 min]) (both p < 0.004). Results obtained by numerical modeling are consistent with comparable measures obtained by the gold standard stable isotope dilution method. Septic shock is associated with generally not only higher levels but also greater variance of maximal cortisol secretion rate when compared with control and sepsis groups. Additional studies would be needed to determine whether assessment of cortisol kinetic parameters such as maximal cortisol secretion rate and free cortisol half-life is useful in the diagnosis or management of critical illness-related corticosteroid insufficiency.

Biomechanical and Biochemical Cellular Response Due to Shock Waves

DTIC Science & Technology

2008-12-01

112, 1183-1195. Yen, C.-F., 2008, US Army Reserach Laboratory. Zhong, P., I. Cioanta, F. H. Cocks, and G. M. Preminger, 1997: Inertial cavitation...2940-2950. Zhong, P., H. F. Lin, X. F. Xi, S. L. Zhu, and E. S. Bhogte, 1999: Shock wave-inertial microbubble interaction: Methodology

Fracture Analysis of Vessels. Oak Ridge FAVOR, v06.1, Computer Code: Theory and Implementation of Algorithms, Methods, and Correlations

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

Williams, P. T.; Dickson, T. L.; Yin, S.

The current regulations to insure that nuclear reactor pressure vessels (RPVs) maintain their structural integrity when subjected to transients such as pressurized thermal shock (PTS) events were derived from computational models developed in the early-to-mid 1980s. Since that time, advancements and refinements in relevant technologies that impact RPV integrity assessment have led to an effort by the NRC to re-evaluate its PTS regulations. Updated computational methodologies have been developed through interactions between experts in the relevant disciplines of thermal hydraulics, probabilistic risk assessment, materials embrittlement, fracture mechanics, and inspection (flaw characterization). Contributors to the development of these methodologies include themore » NRC staff, their contractors, and representatives from the nuclear industry. These updated methodologies have been integrated into the Fracture Analysis of Vessels -- Oak Ridge (FAVOR, v06.1) computer code developed for the NRC by the Heavy Section Steel Technology (HSST) program at Oak Ridge National Laboratory (ORNL). The FAVOR, v04.1, code represents the baseline NRC-selected applications tool for re-assessing the current PTS regulations. This report is intended to document the technical bases for the assumptions, algorithms, methods, and correlations employed in the development of the FAVOR, v06.1, code.« less

Comparison of main-shock and aftershock fragility curves developed for New Zealand and US buildings

USGS Publications Warehouse

Uma, S.R.; Ryu, H.; Luco, N.; Liel, A.B.; Raghunandan, M.

2011-01-01

Seismic risk assessment involves the development of fragility functions to express the relationship between ground motion intensity and damage potential. In evaluating the risk associated with the building inventory in a region, it is essential to capture 'actual' characteristics of the buildings and group them so that 'generic building types' can be generated for further analysis of their damage potential. Variations in building characteristics across regions/countries largely influence the resulting fragility functions, such that building models are unsuitable to be adopted for risk assessment in any other region where a different set of building is present. In this paper, for a given building type (represented in terms of height and structural system), typical New Zealand and US building models are considered to illustrate the differences in structural model parameters and their effects on resulting fragility functions for a set of main-shocks and aftershocks. From this study, the general conclusion is that the methodology and assumptions used to derive basic capacity curve parameters have a considerable influence on fragility curves.

Transient three-dimensional startup side load analysis of a regeneratively cooled nozzle

NASA Astrophysics Data System (ADS)

Wang, Ten-See

2009-07-01

The objective of this effort is to develop a computational methodology to capture the side load physics and to anchor the computed aerodynamic side loads with the available data by simulating the startup transient of a regeneratively cooled, high-aspect-ratio nozzle, hot-fired at sea level. The computational methodology is based on an unstructured-grid, pressure-based, reacting flow computational fluid dynamics and heat transfer formulation, and a transient inlet history based on an engine system simulation. Emphases were put on the effects of regenerative cooling on shock formation inside the nozzle, and ramp rate on side load reduction. The results show that three types of asymmetric shock physics incur strong side loads: the generation of combustion wave, shock transitions, and shock pulsations across the nozzle lip, albeit the combustion wave can be avoided with sparklers during hot-firing. Results from both regenerative cooled and adiabatic wall boundary conditions capture the early shock transitions with corresponding side loads matching the measured secondary side load. It is theorized that the first transition from free-shock separation to restricted-shock separation is caused by the Coanda effect. After which the regeneratively cooled wall enhances the Coanda effect such that the supersonic jet stays attached, while the hot adiabatic wall fights off the Coanda effect, and the supersonic jet becomes detached most of the time. As a result, the computed peak side load and dominant frequency due to shock pulsation across the nozzle lip associated with the regeneratively cooled wall boundary condition match those of the test, while those associated with the adiabatic wall boundary condition are much too low. Moreover, shorter ramp time results show that higher ramp rate has the potential in reducing the nozzle side loads.

Transient Three-Dimensional Startup Side Load Analysis of a Regeneratively Cooled Nozzle

NASA Technical Reports Server (NTRS)

Wang, Ten-See

2008-01-01

The objective of this effort is to develop a computational methodology to capture the startup side load physics and to anchor the computed aerodynamic side loads with the available data from a regeneratively cooled, high-aspect-ratio nozzle, hot-fired at sea level. The computational methodology is based on an unstructured-grid, pressure-based, reacting flow computational fluid dynamics and heat transfer formulation, a transient 5 s inlet history based on an engine system simulation, and a wall temperature distribution to reflect the effect of regenerative cooling. To understand the effect of regenerative wall cooling, two transient computations were performed using the boundary conditions of adiabatic and cooled walls, respectively. The results show that three types of shock evolution are responsible for side loads: generation of combustion wave; transitions among free-shock separation, restricted-shock separation, and simultaneous free-shock and restricted shock separations; along with the pulsation of shocks across the lip, although the combustion wave is commonly eliminated with the sparklers during actual test. The test measured two side load events: a secondary and lower side load, followed by a primary and peak side load. Results from both wall boundary conditions captured the free-shock separation to restricted-shock separation transition with computed side loads matching the measured secondary side load. For the primary side load, the cooled wall transient produced restricted-shock pulsation across the nozzle lip with peak side load matching that of the test, while the adiabatic wall transient captured shock transitions and free-shock pulsation across the lip with computed peak side load 50% lower than that of the measurement. The computed dominant pulsation frequency of the cooled wall nozzle agrees with that of a separate test, while that of the adiabatic wall nozzle is more than 50% lower than that of the measurement. The computed teepee-like formation and the tangential motion of the shocks during lip pulsation also qualitatively agree with those of test observations. Moreover, a third transient computation was performed with a proportionately shortened 1 s sequence, and lower side loads were obtained with the higher ramp rate.

Evaluating the Mechanism of Oil Price Shocks and Fiscal Policy Responses in the Malaysian Economy

NASA Astrophysics Data System (ADS)

Bekhet, Hussain A.; Yusoff, Nora Yusma Mohamed

2013-06-01

The paper aims to explore the symmetric impact of oil price shock on economy, to understand its mechanism channel and how fiscal policy response towards it. The Generalized Impulse Response Function and Variance Decomposition under the VAR methodology were employed. The empirical findings suggest that symmetric oil price shock has a positive and direct impact on oil revenue and government expenditure. However, the real GDP is vulnerable in a short-term but not in the long term period. These results would confirm that fiscal policy is the main mechanism channel that mitigates the adverse effects oil price shocks to the economy.

Peyronie's disease intervention trials: methodological challenges and issues.

PubMed

Müller, Alexander; Mulhall, John P

2009-03-01

Peyronie's Disease (PD) has been studied for more than 260 years since Francois de la Peyronie's description in 1743. Based on the current literature, the prevalence of PD seems 3-9% with an average age of onset in the fifth life decade. Much effort has been spent on developing nonsurgical treatment options to cure or at least prevent disease progression. The recent examination of drug trials for erectile dysfunction has led us to assess PD trial methodology more closely. An Iinternet search on PubMed was performed using MeSH words PD, clinical trials, oral, transdermal, intralesional and shock wave therapy focusing on 26 representing studies published over the last 15 years. Mean Outcome Measures. A comprehensive review of the current literature on nonsurgical treatment options for PD was conducted to address methodological issues and challenges in PD trials highlighting trial design, patient population, and symptom and sign assessment. The majority of the reviewed studies are underpowered and the heterogeneity in the methodological approach and patient assessment between the studies is one of the remarkable findings from our review. Studies should use a uniform means of defining the degree and type of penile deformity and a large enough cohort of patients should be studied for adequate study power. An ideally designed PD intervention trial should comprise: (i) a randomized, placebo-controlled design; (ii) with a PD patient set representative of the general PD population; and (iii) a comprehensive symptom and sign assessment before and at the end of treatment which includes an assessment of at least deformity, pain, and sexual function. A number of challenges exist for the design of PD intervention trials and deciphering the data generated from them. The field would benefit greatly from a consensus statement or guidelines development on the design and conduct of such trials.

Rocket Engine Nozzle Side Load Transient Analysis Methodology: A Practical Approach

NASA Technical Reports Server (NTRS)

Shi, John J.

2005-01-01

At the sea level, a phenomenon common with all rocket engines, especially for a highly over-expanded nozzle, during ignition and shutdown is that of flow separation as the plume fills and empties the nozzle, Since the flow will be separated randomly. it will generate side loads, i.e. non-axial forces. Since rocket engines are designed to produce axial thrust to power the vehicles, it is not desirable to be excited by non-axial input forcing functions, In the past, several engine failures were attributed to side loads. During the development stage, in order to design/size the rocket engine components and to reduce the risks, the local dynamic environments as well as dynamic interface loads have to be defined. The methodology developed here is the way to determine the peak loads and shock environments for new engine components. In the past it is not feasible to predict the shock environments, e.g. shock response spectra, from one engine to the other, because it is not scaleable. Therefore, the problem has been resolved and the shock environments can be defined in the early stage of new engine development. Additional information is included in the original extended abstract.

Micro-Ramps for External Compression Low-Boom Inlets

NASA Technical Reports Server (NTRS)

Rybalko, Michael; Loth, Eric; Chima, Rodrick V.; Hirt, Stefanie M.; DeBonis, James R.

2010-01-01

The application of vortex generators for flow control in an external compression, axisymmetric, low-boom concept inlet was investigated using RANS simulations with three-dimensional (3-D), structured, chimera (overset) grids and the WIND-US code. The low-boom inlet design is based on previous scale model 1- by 1-ft wind tunnel tests and features a zero-angle cowl and relaxed isentropic compression centerbody spike, resulting in defocused oblique shocks and a weak terminating normal shock. Validation of the methodology was first performed for micro-ramps in supersonic flow on a flat plate with and without oblique shocks. For the inlet configuration, simulations with several types of vortex generators were conducted for positions both upstream and downstream of the terminating normal shock. The performance parameters included incompressible axisymmetric shape factor, separation area, inlet pressure recovery, and massflow ratio. The design of experiments (DOE) methodology was used to select device size and location, analyze the resulting data, and determine the optimal choice of device geometry. The optimum upstream configuration was found to substantially reduce the post-shock separation area but did not significantly impact recovery at the aerodynamic interface plane (AIP). Downstream device placement allowed for fuller boundary layer velocity profiles and reduced distortion. This resulted in an improved pressure recovery and massflow ratio at the AIP compared to the baseline solid-wall configuration.

Review and assessment of turbulence models for hypersonic flows

NASA Astrophysics Data System (ADS)

Roy, Christopher J.; Blottner, Frederick G.

2006-10-01

Accurate aerodynamic prediction is critical for the design and optimization of hypersonic vehicles. Turbulence modeling remains a major source of uncertainty in the computational prediction of aerodynamic forces and heating for these systems. The first goal of this article is to update the previous comprehensive review of hypersonic shock/turbulent boundary-layer interaction experiments published in 1991 by Settles and Dodson (Hypersonic shock/boundary-layer interaction database. NASA CR 177577, 1991). In their review, Settles and Dodson developed a methodology for assessing experiments appropriate for turbulence model validation and critically surveyed the existing hypersonic experiments. We limit the scope of our current effort by considering only two-dimensional (2D)/axisymmetric flows in the hypersonic flow regime where calorically perfect gas models are appropriate. We extend the prior database of recommended hypersonic experiments (on four 2D and two 3D shock-interaction geometries) by adding three new geometries. The first two geometries, the flat plate/cylinder and the sharp cone, are canonical, zero-pressure gradient flows which are amenable to theory-based correlations, and these correlations are discussed in detail. The third geometry added is the 2D shock impinging on a turbulent flat plate boundary layer. The current 2D hypersonic database for shock-interaction flows thus consists of nine experiments on five different geometries. The second goal of this study is to review and assess the validation usage of various turbulence models on the existing experimental database. Here we limit the scope to one- and two-equation turbulence models where integration to the wall is used (i.e., we omit studies involving wall functions). A methodology for validating turbulence models is given, followed by an extensive evaluation of the turbulence models on the current hypersonic experimental database. A total of 18 one- and two-equation turbulence models are reviewed, and results of turbulence model assessments for the six models that have been extensively applied to the hypersonic validation database are compiled and presented in graphical form. While some of the turbulence models do provide reasonable predictions for the surface pressure, the predictions for surface heat flux are generally poor, and often in error by a factor of four or more. In the vast majority of the turbulence model validation studies we review, the authors fail to adequately address the numerical accuracy of the simulations (i.e., discretization and iterative error) and the sensitivities of the model predictions to freestream turbulence quantities or near-wall y+ mesh spacing. We recommend new hypersonic experiments be conducted which (1) measure not only surface quantities but also mean and fluctuating quantities in the interaction region and (2) provide careful estimates of both random experimental uncertainties and correlated bias errors for the measured quantities and freestream conditions. For the turbulence models, we recommend that a wide-range of turbulence models (including newer models) be re-examined on the current hypersonic experimental database, including the more recent experiments. Any future turbulence model validation efforts should carefully assess the numerical accuracy and model sensitivities. In addition, model corrections (e.g., compressibility corrections) should be carefully examined for their effects on a standard, low-speed validation database. Finally, as new experiments or direct numerical simulation data become available with information on mean and fluctuating quantities, they should be used to improve the turbulence models and thus increase their predictive capability.

Simulation of Ejecta Production and Mixing Process of Sn Sample under shock loading

NASA Astrophysics Data System (ADS)

Wang, Pei; Chen, Dawei; Sun, Haiquan; Ma, Dongjun

2017-06-01

Ejection may occur when a strong shock wave release at the free surface of metal material and the ejecta of high-speed particulate matter will be formed and further mixed with the surrounding gas. Ejecta production and its mixing process has been one of the most difficult problems in shock physics remain unresolved, and have many important engineering applications in the imploding compression science. The present paper will introduce a methodology for the theoretical modeling and numerical simulation of the complex ejection and mixing process. The ejecta production is decoupled with the particle mixing process, and the ejecta state can be achieved by the direct numerical simulation for the evolution of initial defect on the metal surface. Then the particle mixing process can be simulated and resolved by a two phase gas-particle model which uses the aforementioned ejecta state as the initial condition. A preliminary ejecta experiment of planar Sn metal Sample has validated the feasibility of the proposed methodology.

Venous-to-arterial carbon dioxide difference in the resuscitation of patients with severe sepsis and septic shock: A systematic review.

PubMed

Diaztagle Fernández, J J; Rodríguez Murcia, J C; Sprockel Díaz, J J

2017-10-01

The way to assess tissue perfusion during the resuscitation of patients with severe sepsis and septic shock is a current subject of research and debate. Venous oxygen saturation and lactate concentration have been the most frequently used criteria, though they involve known limitations. The venous-to-arterial difference of carbon dioxide (pCO 2 delta) is a parameter than can be used to indicate tissue perfusion, and its determination therefore may be useful in these patients. A qualitative systematic review of the literature was made, comprising studies that assessed pCO 2 delta in adult patients with severe sepsis or septic shock, and published between January 1966 and November 2016 in the Medline-PubMed, Embase-Elsevier, Cochrane Library, and LILACS databases. There was no language restriction. The PRISMA statement was followed, and methodological quality was evaluated. Twelve articles were included, all of an observational nature, and including 10 prospective studies (9 published since 2010). Five documented greater mortality among patients with high pCO 2 delta values, in 3 cases even when achieving venous oxygen saturation targets. In 4 studies, a high pCO 2 delta was related to lower venous oxygen saturation and higher lactate levels, and another 3 documented lesser percentage lactate reductions. The parameter pCO 2 delta has been more frequently assessed in the management of patients with severe sepsis during the last few years. The studies demonstrate its correlation to mortality and other clinical outcomes, defining pCO 2 delta as a useful tool in the management of these patients. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Implementation of an Inpatient Pediatric Sepsis Identification Pathway.

PubMed

Bradshaw, Chanda; Goodman, Ilyssa; Rosenberg, Rebecca; Bandera, Christopher; Fierman, Arthur; Rudy, Bret

2016-03-01

Early identification and treatment of severe sepsis and septic shock improves outcomes. We sought to identify and evaluate children with possible sepsis on a pediatric medical/surgical unit through successful implementation of a sepsis identification pathway. The sepsis identification pathway, a vital sign screen and subsequent physician evaluation, was implemented in October 2013. Quality improvement interventions were used to improve physician and nursing adherence with the pathway. We reviewed charts of patients with positive screens on a monthly basis to assess for nursing recognition/physician notification, physician evaluation for sepsis, and subsequent physician diagnosis of sepsis and severe sepsis/septic shock. Adherence data were analyzed on a run chart and statistical process control p-chart. Nursing and physician pathway adherence of >80% was achieved over a 6-month period and sustained for the following 6 months. The direction of improvements met standard criteria for special causes. Over a 1-year period, there were 963 admissions to the unit. Positive screens occurred in 161 (16.7%) of these admissions and 38 (23.5%) of these had a physician diagnosis of sepsis, severe sepsis, or septic shock. One patient with neutropenia and septic shock had a negative sepsis screen due to lack of initial fever. Using quality improvement methodology, we successfully implemented a sepsis identification pathway on our pediatric unit. The pathway provided a standardized process to identify and evaluate children with possible sepsis requiring timely evaluation and treatment. Copyright © 2016 by the American Academy of Pediatrics.

Noninvasive NIR measurement of tissue pH to assess hemorrhagic shock in swine

NASA Astrophysics Data System (ADS)

Soller, Babs R.; Zhang, Songbiao; Micheels, Ronald H.; Puyana, Juan C.

1999-07-01

Body-worn noninvasive physilogical sensors are needed to continuously monitor soldiers for hemorrhage and to provide real-time information for minimally skilled medics to treat the injured. In the hospital intramucosal pHi of the gut is used to monitor shock and its treatment. We hypothesize that abdominal wall muscle (AWM) pH can be measured noninvasively using near infrared (NIR) spectroscopy and partial least squares analysis (PLS) and will correlate with pHi. METHODS: AWM pH was measured with microelectrodes and gastric pHi was measured with a tonometric catheter simultaneously while NIR spectra were collected using prototype LED spectrometers placed on the pig's flanks. Animals were subject to hemorrhagic shock at 45 mm Hg for 45 minutes, then resuscitated with blood and lactated ringers. Relationships between electrode pH, pHi and NIR spectra were developed using PLS with cross validation. RESULTS: NIR spectral changes noninvasively acquired through the skin were shown to be from the muscle, not from changes in skin blood flow. Trending ability (R2) model accuracy (RMSD), and relative error were calculated for individual pigs. Using electrode pH as the reference, average R2 was 0.88 with a predicted accuracy of 0.17 pH units, a 9.3% relative error. Slightly degraded results were observed when pHi was used as a reference. CONCLUSIONS: NIR measurement of tissue pH can be used to noninvasively monitor for shock and guide its treatment in a swine model. These measurements correlate with gastric pHi, a clinically accepted measure of shock, providing an approach to develop similar methodology for humans.

The Shock and Vibration Digest, Volume 14, Number 4

DTIC Science & Technology

1982-04-01

temperature, humidity, shock, and vibration -- can influence this capability; as a result an almost continuous program of research and development has...pro- ducing reliability tests. For some time there has been interest in the Army Test Methodology program for developing a vibration system capable...geology of the Livermore Valley is obtained. 82-768 Transient Stress Wave Propagation in HTGR Fuel Element Impacts I.T. Almajan and P.D. Smith

Biophysical analysis of bacterial and viral systems. A shock tube study of bio-aerosols and a correlated AFM/nanosims investigation of vaccinia virus

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

Gates, Sean Damien

2013-05-01

The work presented herein is concerned with the development of biophysical methodology designed to address pertinent questions regarding the behavior and structure of select pathogenic agents. Two distinct studies are documented: a shock tube analysis of endospore-laden bio-aerosols and a correlated AFM/NanoSIMS study of the structure of vaccinia virus.

DREAM: An Efficient Methodology for DSMC Simulation of Unsteady Processes

NASA Astrophysics Data System (ADS)

Cave, H. M.; Jermy, M. C.; Tseng, K. C.; Wu, J. S.

2008-12-01

A technique called the DSMC Rapid Ensemble Averaging Method (DREAM) for reducing the statistical scatter in the output from unsteady DSMC simulations is introduced. During post-processing by DREAM, the DSMC algorithm is re-run multiple times over a short period before the temporal point of interest thus building up a combination of time- and ensemble-averaged sampling data. The particle data is regenerated several mean collision times before the output time using the particle data generated during the original DSMC run. This methodology conserves the original phase space data from the DSMC run and so is suitable for reducing the statistical scatter in highly non-equilibrium flows. In this paper, the DREAM-II method is investigated and verified in detail. Propagating shock waves at high Mach numbers (Mach 8 and 12) are simulated using a parallel DSMC code (PDSC) and then post-processed using DREAM. The ability of DREAM to obtain the correct particle velocity distribution in the shock structure is demonstrated and the reduction of statistical scatter in the output macroscopic properties is measured. DREAM is also used to reduce the statistical scatter in the results from the interaction of a Mach 4 shock with a square cavity and for the interaction of a Mach 12 shock on a wedge in a channel.

Simulation of the detonation process of an ammonium nitrate based emulsion explosive using the lee-tarver reactive flow model

NASA Astrophysics Data System (ADS)

Ribeiro, José B.; Silva, Cristóvão; Mendes, Ricardo; Plaksin, I.; Campos, Jose

2012-03-01

The use of emulsion explosives [EEx] for processing materials (compaction, welding and forming) requires the ability to perform detailed simulations of its detonation process [DP]. Detailed numerical simulations of the DP of this kind of explosives, characterized by having a finite reaction zone thickness, are thought to be suitably performed using the Lee-Tarver reactive flow model. In this work a real coded genetic algorithm methodology was used to estimate the 15 parameters of the reaction rate equation [RRE] of that model for a particular EEx. This methodology allows, in a single optimization procedure, using only one experimental result and without the need of any starting solution, to seek for the 15 parameters of the RRE that fit the numerical to the experimental results. Mass averaging and the Plate-Gap Model have been used for the determination of the shock data used in the unreacted explosive JWL EoS assessment, and the thermochemical code THOR retrieved the data used in the detonation products JWL EoS assessment. The obtained parameters allow a reasonable description of the experimental data.

Multi-fidelity numerical simulations of shock/turbulent-boundary layer interaction with uncertainty quantification

NASA Astrophysics Data System (ADS)

Bermejo-Moreno, Ivan; Campo, Laura; Larsson, Johan; Emory, Mike; Bodart, Julien; Palacios, Francisco; Iaccarino, Gianluca; Eaton, John

2013-11-01

We study the interaction between an oblique shock wave and the turbulent boundary layers inside a nearly-square duct by combining wall-modeled LES, 2D and 3D RANS simulations, targeting the experiment of Campo, Helmer & Eaton, 2012 (nominal conditions: M = 2 . 05 , Reθ = 6 , 500). A primary objective is to quantify the effect of aleatory and epistemic uncertainties on the STBLI. Aleatory uncertainties considered include the inflow conditions (Mach number of the incoming air stream and thickness of the boundary layers) and perturbations of the duct geometry upstream of the interaction. The epistemic uncertainty under consideration focuses on the RANS turbulence model form by injecting perturbations in the Reynolds stress anisotropy in regions of the flow where the model assumptions (in particular, the Boussinesq eddy-viscosity hypothesis) may be invalid. These perturbations are then propagated through the flow solver into the solution. The uncertainty quantification (UQ) analysis is done through 2D and 3D RANS simulations, assessing the importance of the three-dimensional effects imposed by the nearly-square duct geometry. Wall-modeled LES are used to verify elements of the UQ methodology and to explore the flow features and physics of the STBLI for multiple shock strengths. Financial support from the United States Department of Energy under the PSAAP program is gratefully acknowledged.

Shell shock, trauma, and the First World War: the making of a diagnosis and its histories.

PubMed

Loughran, Tracey

2012-01-01

During the First World War, thousands of soldiers were treated for "shell shock," a condition which encompassed a range of physical and psychological symptoms. Shell shock has most often been located within a "genealogy of trauma," and identified as an important marker in the gradual recognition of the psychological afflictions caused by combat. In recent years, shell shock has increasingly been viewed as a powerful emblem of the suffering of war. This article, which focuses on Britain, extends scholarly analyses which question characterizations of shell shock as an early form of post-traumatic stress disorder. It also considers some of the methodological problems raised by recasting shell shock as a wartime medical construction rather than an essentially timeless manifestation of trauma. It argues that shell shock must be analyzed as a diagnosis shaped by a specific set of contemporary concerns, knowledges, and practices. Such an analysis challenges accepted understandings of what shell shock "meant" in the First World War, and also offers new perspectives on the role of shell shock in shaping the emergence of psychology and psychiatry in the early part of the twentieth century. The article also considers what relation, if any, might exist between intellectual and other histories, literary approaches, and perceptions of trauma as timeless and unchanging.

On the 'flip-flop' instability of Bondi-Hoyle accretion flows

NASA Technical Reports Server (NTRS)

Livio, Mario; Soker, Noam; Matsuda, Takuya; Anzer, Ulrich

1991-01-01

A simple physical interpretation is advanced by means of an analysis of the shock cone in the accretion flows past a compact object and with an examination of the accretion-line stability analyses. The stability of the conical shock is examined against small angular deflections with attention given to several simplifying assumptions. A line instability is identified in the Bondi-Hoyle accretion flows that leads to the formation of a large opening-angle shock. When the opening angle becomes large the instability becomes irregular oscillation. The analytical methodology is compared to previous numerical configurations that demonstrate different shock morphologies. The Bondi-Hoyle accretion onto a compact object is concluded to generate a range of nonlinear instabilities in both homogeneous and inhomogeneous cases with a quasiperiodic oscillation in the linear regime.

Oxy-acetylene driven laboratory scale shock tubes for studying blast wave effects

NASA Astrophysics Data System (ADS)

Courtney, Amy C.; Andrusiv, Lubov P.; Courtney, Michael W.

2012-04-01

This paper describes the development and characterization of modular, oxy-acetylene driven laboratory scale shock tubes. Such tools are needed to produce realistic blast waves in a laboratory setting. The pressure-time profiles measured at 1 MHz using high-speed piezoelectric pressure sensors have relevant durations and show a true shock front and exponential decay characteristic of free-field blast waves. Descriptions are included for shock tube diameters of 27-79 mm. A range of peak pressures from 204 kPa to 1187 kPa (with 0.5-5.6% standard error of the mean) were produced by selection of the driver section diameter and distance from the shock tube opening. The peak pressures varied predictably with distance from the shock tube opening while maintaining both a true blast wave profile and relevant pulse duration for distances up to about one diameter from the shock tube opening. This shock tube design provides a more realistic blast profile than current compression-driven shock tubes, and it does not have a large jet effect. In addition, operation does not require specialized personnel or facilities like most blast-driven shock tubes, which reduces operating costs and effort and permits greater throughput and accessibility. It is expected to be useful in assessing the response of various sensors to shock wave loading; assessing the reflection, transmission, and absorption properties of candidate armor materials; assessing material properties at high rates of loading; assessing the response of biological materials to shock wave exposure; and providing a means to validate numerical models of the interaction of shock waves with structures. All of these activities have been difficult to pursue in a laboratory setting due in part to lack of appropriate means to produce a realistic blast loading profile.

Ensuring safe operation and assessing the condition underground structures by the method of acoustic resonance flaw detection

NASA Astrophysics Data System (ADS)

Meskhi, Besarion; Pleshko, Mikhail; Buligin, Yuriy; Alexeenko, Lyudmila; Molev, Mikhail

2017-10-01

In the article the main results of theoretical and experimental research in the field of nondestructive testing and forecasting of the geomechanical state of the dome part of transport tunnels. It is shown that for this purpose it is possible to apply the acoustic resonance defectoscopy method. The method of mine measurements consisted in fixing the forced oscillations of a multilayer carbon-rock massif with the shock initiation of a seismoacoustic signal. The excitation and reception of acoustic standing waves were carried out in the lower rock layer. The actual characteristics of the efficiency of the acoustic assessment of the state of the geoenvironment provide the authors the opportunity to recommend the described methodology for mass practical application in the transport tunnels.

Extracorporeal shock wave therapy for calcific and noncalcific tendonitis of the rotator cuff: a systematic review.

PubMed

Harniman, Elaine; Carette, Simon; Kennedy, Carol; Beaton, Dorcas

2004-01-01

The authors conducted a systematic review to assess the effectiveness of extracorporeal shock wave therapy (ESWT) for the treatment of calcific and noncalcific tendonitis of the rotator cuff. Conservative treatment for rotator cuff tendonitis includes physiotherapy, nonsteroidal antiinflammatory drugs, and corticosteroid injections. If symptoms persist with conservative treatment, surgery is often considered. Extracorporeal shock wave therapy has been suggested as a treatment alternative for chronic rotator cuff tendonitis, which may decrease the need for surgery. Articles for this review were identified by electronically searching Medline, EMBASE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), and Evidence Based Medicine (EBM) and hand-screening references. Two reviewers selected the trials that met the inclusion criteria, extracted the data, and assessed the methodological quality of the selected trials. Finally, the strength of scientific evidence was appraised. Evidence was classified as strong, moderate, limited, or conflicting. Sixteen trials met the inclusion criteria. There were only five randomized, controlled trials and all involved chronic (>/=3 months) conditions, three for calcific tendonitis and two for noncalcific tendonitis. For randomized, controlled trials, two (40%) were of high quality, one (33%) for calcific tendonitis and one (50%) for noncalcific tendonitis. The 11 nonrandomized trials included nine that involved calcific tendonitis and two that involved both calcific and noncalcific tendonitis. Common problem areas were sample size, randomization, blinding, treatment provider bias, and outcome measures. There is moderate evidence that high-energy ESWT is effective in treating chronic calcific rotator cuff tendonitis when the shock waves are focused at the calcified deposit. There is moderate evidence that low-energy ESWT is not effective for treating chronic noncalcific rotator cuff tendonitis, although this conclusion is based on only one high-quality study, which was underpowered. High-quality randomized, controlled trials are needed with larger sample sizes, better randomization and blinding, and better outcome measures.

[Basics of emergency ultrasound].

PubMed

Schellhaas, S; Breitkreutz, R

2012-09-05

Focused ultrasound is a key methodology of critical care medicine. By referencing few ultrasound differential diagnosis, it is possible to identifying in real-time the reason of the critical state of a patient. Therefore typical focused ultrasound protocols were developed. The well known Focused Assessment with Sonography for trauma (FAST) was incorporated into the Advanced Trauma Life Support (ATLS) for shock room. Focused echocardiographic evaluation in life support (FEEL) has been designed to be conformed with the universal Advanced Life Support (ALS) algorithm and to identify treatable conditions such as acute right ventricular pressure overload in pulmonary embolism, hypovolemia, or pericardial effusion/tamponade. Using lung ultrasound one can differentiate pulmonary edema, pleural effusion or pneumothorax.

Probabilistic models and uncertainty quantification for the ionization reaction rate of atomic Nitrogen

NASA Astrophysics Data System (ADS)

Miki, K.; Panesi, M.; Prudencio, E. E.; Prudhomme, S.

2012-05-01

The objective in this paper is to analyze some stochastic models for estimating the ionization reaction rate constant of atomic Nitrogen (N + e- → N+ + 2e-). Parameters of the models are identified by means of Bayesian inference using spatially resolved absolute radiance data obtained from the Electric Arc Shock Tube (EAST) wind-tunnel. The proposed methodology accounts for uncertainties in the model parameters as well as physical model inadequacies, providing estimates of the rate constant that reflect both types of uncertainties. We present four different probabilistic models by varying the error structure (either additive or multiplicative) and by choosing different descriptions of the statistical correlation among data points. In order to assess the validity of our methodology, we first present some calibration results obtained with manufactured data and then proceed by using experimental data collected at EAST experimental facility. In order to simulate the radiative signature emitted in the shock-heated air plasma, we use a one-dimensional flow solver with Park's two-temperature model that simulates non-equilibrium effects. We also discuss the implications of the choice of the stochastic model on the estimation of the reaction rate and its uncertainties. Our analysis shows that the stochastic models based on correlated multiplicative errors are the most plausible models among the four models proposed in this study. The rate of the atomic Nitrogen ionization is found to be (6.2 ± 3.3) × 1011 cm3 mol-1 s-1 at 10,000 K.

Verification assessment of piston boundary conditions for Lagrangian simulation of compressible flow similarity solutions

DOE PAGES

Ramsey, Scott D.; Ivancic, Philip R.; Lilieholm, Jennifer F.

2015-12-10

This work is concerned with the use of similarity solutions of the compressible flow equations as benchmarks or verification test problems for finite-volume compressible flow simulation software. In practice, this effort can be complicated by the infinite spatial/temporal extent of many candidate solutions or “test problems.” Methods can be devised with the intention of ameliorating this inconsistency with the finite nature of computational simulation; the exact strategy will depend on the code and problem archetypes under investigation. For example, self-similar shock wave propagation can be represented in Lagrangian compressible flow simulations as rigid boundary-driven flow, even if no such “piston”more » is present in the counterpart mathematical similarity solution. The purpose of this work is to investigate in detail the methodology of representing self-similar shock wave propagation as a piston-driven flow in the context of various test problems featuring simple closed-form solutions of infinite spatial/temporal extent. The closed-form solutions allow for the derivation of similarly closed-form piston boundary conditions (BCs) for use in Lagrangian compressible flow solvers. Finally, the consequences of utilizing these BCs (as opposed to directly initializing the self-similar solution in a computational spatial grid) are investigated in terms of common code verification analysis metrics (e.g., shock strength/position errors and global convergence rates).« less

Verification assessment of piston boundary conditions for Lagrangian simulation of compressible flow similarity solutions

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

Ramsey, Scott D.; Ivancic, Philip R.; Lilieholm, Jennifer F.

This work is concerned with the use of similarity solutions of the compressible flow equations as benchmarks or verification test problems for finite-volume compressible flow simulation software. In practice, this effort can be complicated by the infinite spatial/temporal extent of many candidate solutions or “test problems.” Methods can be devised with the intention of ameliorating this inconsistency with the finite nature of computational simulation; the exact strategy will depend on the code and problem archetypes under investigation. For example, self-similar shock wave propagation can be represented in Lagrangian compressible flow simulations as rigid boundary-driven flow, even if no such “piston”more » is present in the counterpart mathematical similarity solution. The purpose of this work is to investigate in detail the methodology of representing self-similar shock wave propagation as a piston-driven flow in the context of various test problems featuring simple closed-form solutions of infinite spatial/temporal extent. The closed-form solutions allow for the derivation of similarly closed-form piston boundary conditions (BCs) for use in Lagrangian compressible flow solvers. Finally, the consequences of utilizing these BCs (as opposed to directly initializing the self-similar solution in a computational spatial grid) are investigated in terms of common code verification analysis metrics (e.g., shock strength/position errors and global convergence rates).« less

Numerical 3+1 General Relativistic Magnetohydrodynamics: A Local Characteristic Approach

NASA Astrophysics Data System (ADS)

Antón, Luis; Zanotti, Olindo; Miralles, Juan A.; Martí, José M.; Ibáñez, José M.; Font, José A.; Pons, José A.

2006-01-01

We present a general procedure to solve numerically the general relativistic magnetohydrodynamics (GRMHD) equations within the framework of the 3+1 formalism. The work reported here extends our previous investigation in general relativistic hydrodynamics (Banyuls et al. 1997) where magnetic fields were not considered. The GRMHD equations are written in conservative form to exploit their hyperbolic character in the solution procedure. All theoretical ingredients necessary to build up high-resolution shock-capturing schemes based on the solution of local Riemann problems (i.e., Godunov-type schemes) are described. In particular, we use a renormalized set of regular eigenvectors of the flux Jacobians of the relativistic MHD equations. In addition, the paper describes a procedure based on the equivalence principle of general relativity that allows the use of Riemann solvers designed for special relativistic MHD in GRMHD. Our formulation and numerical methodology are assessed by performing various test simulations recently considered by different authors. These include magnetized shock tubes, spherical accretion onto a Schwarzschild black hole, equatorial accretion onto a Kerr black hole, and magnetized thick disks accreting onto a black hole and subject to the magnetorotational instability.

Life Prediction Methodologies for Aerospace Materials

DTIC Science & Technology

2000-08-01

stress in Ti-6Al-4V generated by laser shock peening have been investigated. 15. SUBJECT TERMS Titanium aluminides, gamma, orthorhombic, titanium...effects of stress ratio on FCG in an Al-alloy in the absence of closure and prediction of residual stress in Ti-6Al-4V generated by laser shock... keyhole ) C(T) specimens. Two temperatures, 540 °C and 760 °C, and two notch radii, 5.1 and 1.5 mm (0.2 and 0.06 in) are being considered for a gamma

Simulation of the detonation process of an ammonium nitrate based emulsion explosive using the Lee-Tarver reactive flow model

NASA Astrophysics Data System (ADS)

Ribeiro, Jose; Silva, Cristovao; Mendes, Ricardo; Plaksin, Igor; Campos, Jose

2011-06-01

The use of emulsion explosives [EEx] for processing materials (compaction, welding and forming) requires the ability to perform detailed simulations of its detonation process [DP]. Detailed numerical simulations of the DP of this kind of explosives, characterized by having a finite reaction zone thickness, are thought to be suitable performed using the Lee-Tarver reactive flow model. In this work a real coded genetic algorithm methodology was used to estimate the 15 parameters of the reaction rate equation [RRE] of that model for a particular EEx. This methodology allows, in a single optimization procedure, using only one experimental result and without the need of any starting solution, to seek for the 15 parameters of the RRE that fit the numerical to the experimental results. Mass averaging and the Plate-Gap Model have been used for the determination of the shock data used in the unreacted explosive JWL EoS assessment and the thermochemical code THOR retrieved the data used in the detonation products JWL EoS assessment. The obtained parameters allow a good description of the experimental data and show some peculiarities arising from the intrinsic nature of this kind of composite explosive.

Chemical methodology as a source of small-molecule checkpoint inhibitors and heat shock protein 70 (Hsp70) modulators.

PubMed

Huryn, Donna M; Brodsky, Jeffrey L; Brummond, Kay M; Chambers, Peter G; Eyer, Benjamin; Ireland, Alex W; Kawasumi, Masaoki; Laporte, Matthew G; Lloyd, Kayla; Manteau, Baptiste; Nghiem, Paul; Quade, Bettina; Seguin, Sandlin P; Wipf, Peter

2011-04-26

Unique chemical methodology enables the synthesis of innovative and diverse scaffolds and chemotypes and allows access to previously unexplored "chemical space." Compound collections based on such new synthetic methods can provide small-molecule probes of proteins and/or pathways whose functions are not fully understood. We describe the identification, characterization, and evolution of two such probes. In one example, a pathway-based screen for DNA damage checkpoint inhibitors identified a compound, MARPIN (ATM and ATR pathway inhibitor) that sensitizes p53-deficient cells to DNA-damaging agents. Modification of the small molecule and generation of an immobilized probe were used to selectively bind putative protein target(s) responsible for the observed activity. The second example describes a focused library approach that relied on tandem multicomponent reaction methodologies to afford a series of modulators of the heat shock protein 70 (Hsp70) molecular chaperone. The synthesis of libraries based on the structure of MAL3-101 generated a collection of chemotypes, each modulating Hsp70 function, but exhibiting divergent pharmacological activities. For example, probes that compromise the replication of a disease-associated polyomavirus were identified. These projects highlight the importance of chemical methodology development as a source of small-molecule probes and as a drug discovery starting point.

Chemical methodology as a source of small-molecule checkpoint inhibitors and heat shock protein 70 (Hsp70) modulators

PubMed Central

Huryn, Donna M.; Brodsky, Jeffrey L.; Brummond, Kay M.; Chambers, Peter G.; Eyer, Benjamin; Ireland, Alex W.; Kawasumi, Masaoki; LaPorte, Matthew G.; Lloyd, Kayla; Manteau, Baptiste; Nghiem, Paul; Quade, Bettina; Seguin, Sandlin P.; Wipf, Peter

2011-01-01

Unique chemical methodology enables the synthesis of innovative and diverse scaffolds and chemotypes and allows access to previously unexplored “chemical space.” Compound collections based on such new synthetic methods can provide small-molecule probes of proteins and/or pathways whose functions are not fully understood. We describe the identification, characterization, and evolution of two such probes. In one example, a pathway-based screen for DNA damage checkpoint inhibitors identified a compound, MARPIN (ATM and ATR pathway inhibitor) that sensitizes p53-deficient cells to DNA-damaging agents. Modification of the small molecule and generation of an immobilized probe were used to selectively bind putative protein target(s) responsible for the observed activity. The second example describes a focused library approach that relied on tandem multicomponent reaction methodologies to afford a series of modulators of the heat shock protein 70 (Hsp70) molecular chaperone. The synthesis of libraries based on the structure of MAL3-101 generated a collection of chemotypes, each modulating Hsp70 function, but exhibiting divergent pharmacological activities. For example, probes that compromise the replication of a disease-associated polyomavirus were identified. These projects highlight the importance of chemical methodology development as a source of small-molecule probes and as a drug discovery starting point. PMID:21502524

Methodology for the investigation of ignition near hot surfaces in a high-pressure shock tube

NASA Astrophysics Data System (ADS)

Niegemann, P.; Fikri, M.; Wlokas, I.; Röder, M.; Schulz, C.

2018-05-01

Autoignition of fuel/air mixtures is a determining process in internal combustion engines. Ignition can start either homogeneously in the gas phase after compression or in the vicinity of hot surfaces. While ignition properties of commercial fuels are conventionally described by a single quantity (octane number), it is known that some fuels have a varying propensity to the two processes. We present a new experimental concept that generates well-controlled temperature inhomogeneities in the shock-heated gases of a high-pressure shock tube. A shock-heated reactive mixture is brought into contact with a heated silicon nitride ceramic glow plug. The glow-plug temperature can be set up to 1200 K, higher than the post-reflected-shock gas temperatures (650-1050 K). High-repetition-rate chemiluminescence imaging is used to localize the onset of ignition in the vicinity of the hot surface. In experiments with ethanol, the results show that in most cases under shock-heated conditions, the ignition begins inhomogeneously in the vicinity of the glow plug and is favored because of the high wall temperature. Additionally, the interaction of geometry, external heating, and gas-dynamic effects was investigated by numerical simulations of the shock wave in a non-reactive flow.

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

Rodriguez, George; Gilbertson, Steve Michael

Chirped fiber Bragg grating (CFBG) sensors coupled to high speed interrogation systems are described as robust diagnostic approaches to monitoring shock wave and detonation front propagation tracking events for use in high energy density shock physics applications. Taking advantage of the linear distributed spatial encoding of the spectral band in single-mode CFBGs, embedded fiber systems and associated photonic interrogation methodologies are shown as an effective approach to sensing shock and detonation-driven loading processes along the CFBG length. Two approaches, one that detects spectral changes in the integrated spectrum of the CFBG and another coherent pulse interrogation approach that fully resolvesmore » its spectral response, shows that 100-MHz–1-GHz interrogation rates are possible with spatial resolution along the CFBG in the 50 µm to sub-millimeter range depending on the combination of CFBG parameters (i.e., length, chirp rate, spectrum) and interrogator design specifics. In conclusion, results from several dynamic tests are used to demonstrate the performance of these high speed systems for shock and detonation propagation tracking under strong and weak shock pressure loading: (1) linear detonation front tracking in the plastic bonded explosive (PBX) PBX-9501; (2) tracking of radial decaying shock with crossover to non-destructive CFBG response; (3) shock wave tracking along an aluminum cylinder wall under weak loading accompanied by dynamic strain effects in the CFBG sensor.« less

Methodology for the investigation of ignition near hot surfaces in a high-pressure shock tube.

PubMed

Niegemann, P; Fikri, M; Wlokas, I; Röder, M; Schulz, C

2018-05-01

Autoignition of fuel/air mixtures is a determining process in internal combustion engines. Ignition can start either homogeneously in the gas phase after compression or in the vicinity of hot surfaces. While ignition properties of commercial fuels are conventionally described by a single quantity (octane number), it is known that some fuels have a varying propensity to the two processes. We present a new experimental concept that generates well-controlled temperature inhomogeneities in the shock-heated gases of a high-pressure shock tube. A shock-heated reactive mixture is brought into contact with a heated silicon nitride ceramic glow plug. The glow-plug temperature can be set up to 1200 K, higher than the post-reflected-shock gas temperatures (650-1050 K). High-repetition-rate chemiluminescence imaging is used to localize the onset of ignition in the vicinity of the hot surface. In experiments with ethanol, the results show that in most cases under shock-heated conditions, the ignition begins inhomogeneously in the vicinity of the glow plug and is favored because of the high wall temperature. Additionally, the interaction of geometry, external heating, and gas-dynamic effects was investigated by numerical simulations of the shock wave in a non-reactive flow.

Ultrafast Fiber Bragg Grating Interrogation for Sensing in Detonation and Shock Wave Experiments.

PubMed

Rodriguez, George; Gilbertson, Steve M

2017-01-27

Chirped fiber Bragg grating (CFBG) sensors coupled to high speed interrogation systems are described as robust diagnostic approaches to monitoring shock wave and detonation front propagation tracking events for use in high energy density shock physics applications. Taking advantage of the linear distributed spatial encoding of the spectral band in single-mode CFBGs, embedded fiber systems and associated photonic interrogation methodologies are shown as an effective approach to sensing shock and detonation-driven loading processes along the CFBG length. Two approaches, one that detects spectral changes in the integrated spectrum of the CFBG and another coherent pulse interrogation approach that fully resolves its spectral response, shows that 100-MHz-1-GHz interrogation rates are possible with spatial resolution along the CFBG in the 50 µm to sub-millimeter range depending on the combination of CFBG parameters (i.e., length, chirp rate, spectrum) and interrogator design specifics. Results from several dynamic tests are used to demonstrate the performance of these high speed systems for shock and detonation propagation tracking under strong and weak shock pressure loading: (1) linear detonation front tracking in the plastic bonded explosive (PBX) PBX-9501; (2) tracking of radial decaying shock with crossover to non-destructive CFBG response; (3) shock wave tracking along an aluminum cylinder wall under weak loading accompanied by dynamic strain effects in the CFBG sensor.

Ultrafast Fiber Bragg Grating Interrogation for Sensing in Detonation and Shock Wave Experiments

PubMed Central

Rodriguez, George; Gilbertson, Steve M.

2017-01-01

Chirped fiber Bragg grating (CFBG) sensors coupled to high speed interrogation systems are described as robust diagnostic approaches to monitoring shock wave and detonation front propagation tracking events for use in high energy density shock physics applications. Taking advantage of the linear distributed spatial encoding of the spectral band in single-mode CFBGs, embedded fiber systems and associated photonic interrogation methodologies are shown as an effective approach to sensing shock and detonation-driven loading processes along the CFBG length. Two approaches, one that detects spectral changes in the integrated spectrum of the CFBG and another coherent pulse interrogation approach that fully resolves its spectral response, shows that 100-MHz–1-GHz interrogation rates are possible with spatial resolution along the CFBG in the 50 μm to sub-millimeter range depending on the combination of CFBG parameters (i.e., length, chirp rate, spectrum) and interrogator design specifics. Results from several dynamic tests are used to demonstrate the performance of these high speed systems for shock and detonation propagation tracking under strong and weak shock pressure loading: (1) linear detonation front tracking in the plastic bonded explosive (PBX) PBX-9501; (2) tracking of radial decaying shock with crossover to non-destructive CFBG response; (3) shock wave tracking along an aluminum cylinder wall under weak loading accompanied by dynamic strain effects in the CFBG sensor. PMID:28134819

Ultrafast Fiber Bragg Grating Interrogation for Sensing in Detonation and Shock Wave Experiments

DOE PAGES

Rodriguez, George; Gilbertson, Steve Michael

2017-01-27

Chirped fiber Bragg grating (CFBG) sensors coupled to high speed interrogation systems are described as robust diagnostic approaches to monitoring shock wave and detonation front propagation tracking events for use in high energy density shock physics applications. Taking advantage of the linear distributed spatial encoding of the spectral band in single-mode CFBGs, embedded fiber systems and associated photonic interrogation methodologies are shown as an effective approach to sensing shock and detonation-driven loading processes along the CFBG length. Two approaches, one that detects spectral changes in the integrated spectrum of the CFBG and another coherent pulse interrogation approach that fully resolvesmore » its spectral response, shows that 100-MHz–1-GHz interrogation rates are possible with spatial resolution along the CFBG in the 50 µm to sub-millimeter range depending on the combination of CFBG parameters (i.e., length, chirp rate, spectrum) and interrogator design specifics. In conclusion, results from several dynamic tests are used to demonstrate the performance of these high speed systems for shock and detonation propagation tracking under strong and weak shock pressure loading: (1) linear detonation front tracking in the plastic bonded explosive (PBX) PBX-9501; (2) tracking of radial decaying shock with crossover to non-destructive CFBG response; (3) shock wave tracking along an aluminum cylinder wall under weak loading accompanied by dynamic strain effects in the CFBG sensor.« less

Optimal Control of Shock Wave Turbulent Boundary Layer Interactions Using Micro-Array Actuation

NASA Technical Reports Server (NTRS)

Anderson, Bernhard H.; Tinapple, Jon; Surber, Lewis

2006-01-01

The intent of this study on micro-array flow control is to demonstrate the viability and economy of Response Surface Methodology (RSM) to determine optimal designs of micro-array actuation for controlling the shock wave turbulent boundary layer interactions within supersonic inlets and compare these concepts to conventional bleed performance. The term micro-array refers to micro-actuator arrays which have heights of 25 to 40 percent of the undisturbed supersonic boundary layer thickness. This study covers optimal control of shock wave turbulent boundary layer interactions using standard micro-vane, tapered micro-vane, and standard micro-ramp arrays at a free stream Mach number of 2.0. The effectiveness of the three micro-array devices was tested using a shock pressure rise induced by the 10 shock generator, which was sufficiently strong as to separate the turbulent supersonic boundary layer. The overall design purpose of the micro-arrays was to alter the properties of the supersonic boundary layer by introducing a cascade of counter-rotating micro-vortices in the near wall region. In this manner, the impact of the shock wave boundary layer (SWBL) interaction on the main flow field was minimized without boundary bleed.

Assessment of Neutrophil Function in Patients with Septic Shock: Comparison of Methods

PubMed Central

Wenisch, C.; Fladerer, P.; Patruta, S.; Krause, R.; Hörl, W.

2001-01-01

Patients with septic shock are shown to have decreased neutrophil phagocytic function by multiple assays, and their assessment by whole-blood assays (fluorescence-activated cell sorter analysis) correlates with assays requiring isolated neutrophils (microscopic and spectrophotometric assays). For patients with similar underlying conditions but without septic shock, this correlation does not occur. PMID:11139215

Study of compressible turbulent flows in supersonic environment by large-eddy simulation

NASA Astrophysics Data System (ADS)

Genin, Franklin

The numerical resolution of turbulent flows in high-speed environment is of fundamental importance but remains a very challenging problem. First, the capture of strong discontinuities, typical of high-speed flows, requires the use of shock-capturing schemes, which are not adapted to the resolution of turbulent structures due to their intrinsic dissipation. On the other hand, low-dissipation schemes are unable to resolve shock fronts and other sharp gradients without creating high amplitude numerical oscillations. Second, the nature of turbulence in high-speed flows differs from its incompressible behavior, and, in the context of Large-Eddy Simulation, the subgrid closure must be adapted to the modeling of compressibility effects and shock waves on turbulent flows. The developments described in this thesis are two-fold. First, a state of the art closure approach for LES is extended to model subgrid turbulence in compressible flows. The energy transfers due to compressible turbulence and the diffusion of turbulent kinetic energy by pressure fluctuations are assessed and integrated in the Localized Dynamic ksgs model. Second, a hybrid numerical scheme is developed for the resolution of the LES equations and of the model transport equation, which combines a central scheme for turbulent resolutions to a shock-capturing method. A smoothness parameter is defined and used to switch from the base smooth solver to the upwind scheme in regions of discontinuities. It is shown that the developed hybrid methodology permits a capture of shock/turbulence interactions in direct simulations that agrees well with other reference simulations, and that the LES methodology effectively reproduces the turbulence evolution and physical phenomena involved in the interaction. This numerical approach is then employed to study a problem of practical importance in high-speed mixing. The interaction of two shock waves with a high-speed turbulent shear layer as a mixing augmentation technique is considered. It is shown that the levels of turbulence are increased through the interaction, and that the mixing is significantly improved in this flow configuration. However, the region of increased mixing is found to be localized to a region close to the impact of the shocks, and that the statistical levels of turbulence relax to their undisturbed levels some short distance downstream of the interaction. The present developments are finally applied to a practical configuration relevant to scramjet injection. The normal injection of a sonic jet into a supersonic crossflow is considered numerically, and compared to the results of an experimental study. A fair agreement in the statistics of mean and fluctuating velocity fields is obtained. Furthermore, some of the instantaneous flow structures observed in experimental visualizations are identified in the present simulation. The dynamics of the interaction for the reference case, based on the experimental study, as well as for a case of higher freestream Mach number and a case of higher momentum ratio, are examined. The classical instantaneous vortical structures are identified, and their generation mechanisms, specific to supersonic flow, are highlighted. Furthermore, two vortical structures, recently revealed in low-speed jets in crossflow but never documented for high-speed flows, are identified during the flow evolution.

A method for resilience assessment in dry Mediterranean socio-ecological systems

NASA Astrophysics Data System (ADS)

jucker riva, matteo; schwilch, gudrun; liniger, hanspeter

2016-04-01

Resilience is acknowledged as an important concept to understand and forecast the evolution of ecosystems. Even more so when these ecosystems are at risk of undergoing a regime shift that could radically modify its functioning and the provision of important ecosystem services. However, there is a lack of methodologies for practical assessment of resilience on the ground that could be useful to improve land management strategies. We present here a methodology based on the WOCAT approach to land management evaluation, that allows assessing in a semi quantitative way the resilience of a land use system, and in particular the role of land management in preventing, mitigating or fostering recovery following a disturbance. The first step of the evaluation centers on assessing the values of land users with regards to the provision of ESS and the perception of degradation; this allows defining the healthy state of the system in a participative way. Furthermore, scientific and experience knowledge are combined to assess the possible evolution of the system and of the internal and external pressure sources that can degrade it, and the impact of shocks and disturbances on the system. The contribution of land management practices to the resilience of the system is analyzed in detail, together with the resilience of land management itself across time, space and different disturbances. Results from the first application of the Resilience Assessment Tool in the study sites of the CASCADE project will be shown, along with some general conclusions about the most relevant factors playing a role in the resilience of dry Mediterranean socio-ecological systems.

Injection of thermal and suprathermal seed particles into coronal shocks of varying obliquity

NASA Astrophysics Data System (ADS)

Battarbee, M.; Vainio, R.; Laitinen, T.; Hietala, H.

2013-10-01

Context. Diffusive shock acceleration in the solar corona can accelerate solar energetic particles to very high energies. Acceleration efficiency is increased by entrapment through self-generated waves, which is highly dependent on the amount of accelerated particles. This, in turn, is determined by the efficiency of particle injection into the acceleration process. Aims: We present an analysis of the injection efficiency at coronal shocks of varying obliquity. We assessed injection through reflection and downstream scattering, including the effect of a cross-shock potential. Both quasi-thermal and suprathermal seed populations were analysed. We present results on the effect of cross-field diffusion downstream of the shock on the injection efficiency. Methods: Using analytical methods, we present applicable injection speed thresholds that were compared with both semi-analytical flux integration and Monte Carlo simulations, which do not resort to binary thresholds. Shock-normal angle θBn and shock-normal velocity Vs were varied to assess the injection efficiency with respect to these parameters. Results: We present evidence of a significant bias of thermal seed particle injection at small shock-normal angles. We show that downstream isotropisation methods affect the θBn-dependence of this result. We show a non-negligible effect caused by the cross-shock potential, and that the effect of downstream cross-field diffusion is highly dependent on boundary definitions. Conclusions: Our results show that for Monte Carlo simulations of coronal shock acceleration a full distribution function assessment with downstream isotropisation through scatterings is necessary to realistically model particle injection. Based on our results, seed particle injection at quasi-parallel coronal shocks can result in significant acceleration efficiency, especially when combined with varying field-line geometry. Appendices are available in electronic form at http://www.aanda.org

Assessment of renal injury with a clinical dual head lithotriptor delivering 240 shock waves per minute.

PubMed

Handa, Rajash K; McAteer, James A; Evan, Andrew P; Connors, Bret A; Pishchalnikov, Yuri A; Gao, Sujuan

2009-02-01

Lithotriptors with 2 treatment heads deliver shock waves along separate paths. Firing 1 head and then the other in alternating mode has been suggested as a strategy to treat stones twice as rapidly as with conventional shock wave lithotripsy. Because the shock wave rate is known to have a role in shock wave lithotripsy induced injury, and given that treatment using 2 separate shock wave sources exposes more renal tissue to shock wave energy than treatment with a conventional lithotriptor, we assessed renal trauma in pigs following treatment at rapid rate (240 shock waves per minute and 120 shock waves per minute per head) using a Duet lithotriptor (Direx Medical Systems, Petach Tikva, Israel) fired in alternating mode. Eight adult female pigs (Hardin Farms, Danville, Indiana) each were treated with sham shock wave lithotripsy or 2,400 shock waves delivered in alternating mode (1,200 shock waves per head, 120 shock waves per minute per head and 240 shock waves per minute overall at a power level of 10) to the lower renal pole. Renal functional parameters, including glomerular filtration rate and effective renal plasma flow, were determined before and 1 hour after shock wave lithotripsy. The kidneys were perfusion fixed in situ and the hemorrhagic lesion was quantified as a percent of functional renal volume. Shock wave treatment resulted in no significant change in renal function and the response was similar to the functional response seen in sham shock wave treated animals. In 6 pigs treated with alternating mode the renal lesion was small at a mean +/- SEM of 0.22% +/- 0.09% of functional renal volume. Kidney tissue and function were minimally affected by a clinical dose of shock waves delivered in alternating mode (120 shock waves per minute per head and 240 shock waves per minute overall) with a Duet lithotriptor. These observations decrease concern that dual head lithotripsy at a rapid rate is inherently dangerous.

H-P adaptive methods for finite element analysis of aerothermal loads in high-speed flows

NASA Technical Reports Server (NTRS)

Chang, H. J.; Bass, J. M.; Tworzydlo, W.; Oden, J. T.

1993-01-01

The commitment to develop the National Aerospace Plane and Maneuvering Reentry Vehicles has generated resurgent interest in the technology required to design structures for hypersonic flight. The principal objective of this research and development effort has been to formulate and implement a new class of computational methodologies for accurately predicting fine scale phenomena associated with this class of problems. The initial focus of this effort was to develop optimal h-refinement and p-enrichment adaptive finite element methods which utilize a-posteriori estimates of the local errors to drive the adaptive methodology. Over the past year this work has specifically focused on two issues which are related to overall performance of a flow solver. These issues include the formulation and implementation (in two dimensions) of an implicit/explicit flow solver compatible with the hp-adaptive methodology, and the design and implementation of computational algorithm for automatically selecting optimal directions in which to enrich the mesh. These concepts and algorithms have been implemented in a two-dimensional finite element code and used to solve three hypersonic flow benchmark problems (Holden Mach 14.1, Edney shock on shock interaction Mach 8.03, and the viscous backstep Mach 4.08).

A NON-OSCILLATORY SCHEME FOR OPEN CHANNEL FLOWS. (R825200)

EPA Science Inventory

In modeling shocks in open channel flows, the traditional finite difference schemes become inefficient and warrant special numerical treatment for smooth computations. This paper provides a general introduction to the non-oscillatory high-resolution methodology, coupled with the ...

Amorphization and nanocrystallization of silcon under shock compression

DOE PAGES

Remington, B. A.; Wehrenberg, C. E.; Zhao, S.; ...

2015-11-06

High-power, short-duration, laser-driven, shock compression and recovery experiments on [001] silicon unveiled remarkable structural changes above a pressure threshold. Two distinct amorphous regions were identified: (a) a bulk amorphous layer close to the surface and (b) amorphous bands initially aligned with {111} slip planes. Further increase of the laser energy leads to the re-crystallization of amorphous silicon into nanocrystals with high concentration of nano-twins. This amorphization is produced by the combined effect of high magnitude hydrostatic and shear stresses under dynamic shock compression. Shock-induced defects play a very important role in the onset of amorphization. Calculations of the free energymore » changes with pressure and shear, using the Patel-Cohen methodology, are in agreement with the experimental results. Molecular dynamics simulation corroborates the amorphization, showing that it is initiated by the nucleation and propagation of partial dislocations. As a result, the nucleation of amorphization is analyzed qualitatively by classical nucleation theory.« less

Estimation of Supersonic Stage Separation Aerodynamics of Winged-Body Launch Vehicles Using Response Surface Methods

NASA Technical Reports Server (NTRS)

Erickson, Gary E.

2010-01-01

Response surface methodology was used to estimate the longitudinal stage separation aerodynamic characteristics of a generic, bimese, winged multi-stage launch vehicle configuration at supersonic speeds in the NASA LaRC Unitary Plan Wind Tunnel. The Mach 3 staging was dominated by shock wave interactions between the orbiter and booster vehicles throughout the relative spatial locations of interest. The inference space was partitioned into several contiguous regions within which the separation aerodynamics were presumed to be well-behaved and estimable using central composite designs capable of fitting full second-order response functions. The underlying aerodynamic response surfaces of the booster vehicle in belly-to-belly proximity to the orbiter vehicle were estimated using piecewise-continuous lower-order polynomial functions. The quality of fit and prediction capabilities of the empirical models were assessed in detail, and the issue of subspace boundary discontinuities was addressed. Augmenting the central composite designs to full third-order using computer-generated D-optimality criteria was evaluated. The usefulness of central composite designs, the subspace sizing, and the practicality of fitting lower-order response functions over a partitioned inference space dominated by highly nonlinear and possibly discontinuous shock-induced aerodynamics are discussed.

Combined Measurement of Soluble ST2 and Amino-Terminal Pro-B-Type Natriuretic Peptide Provides Early Assessment of Severity in Cardiogenic Shock Complicating Acute Coronary Syndrome.

PubMed

Tolppanen, Heli; Rivas-Lasarte, Mercedes; Lassus, Johan; Sadoune, Malha; Gayat, Etienne; Pulkki, Kari; Arrigo, Mattia; Krastinova, Evguenia; Sionis, Alessandro; Parissis, John; Spinar, Jindrich; Januzzi, James; Harjola, Veli-Pekka; Mebazaa, Alexandre

2017-07-01

Mortality in cardiogenic shock complicating acute coronary syndrome is high, and objective risk stratification is needed for rational use of advanced therapies such as mechanical circulatory support. Traditionally, clinical variables have been used to judge risk in cardiogenic shock. The aim of this study was to assess the added value of serial measurement of soluble ST2 and amino-terminal pro-B-type natriuretic peptide to clinical parameters for risk stratification in cardiogenic shock. CardShock (www.clinicaltrials.gov NCT01374867) is a prospective European multinational study of cardiogenic shock. The main study introduced CardShock risk score, which is calculated from seven clinical variables at baseline, and was associated with short-term mortality. Nine tertiary care university hospitals. Patients with cardiogenic shock caused by acute coronary syndrome (n=145). In this substudy, plasma samples from the study patients were analyzed at eight time points during the ICU or cardiac care unit stay. Additional prognostic value of the biomarkers was assessed with incremental discrimination improvement. The combination of soluble ST2 and amino-terminal pro-B-type natriuretic peptide showed excellent discrimination for 30-day mortality (area under the curve, 0.77 at 12 hr up to 0.93 at 5-10 d after cardiogenic shock onset). At 12 hours, patients with both biomarkers elevated (soluble ST2, ≥ 500 ng/mL and amino-terminal pro-B-type natriuretic peptide, ≥ 4,500 ng/L) had higher 30-day mortality (79%) compared to those with one or neither biomarkers elevated (31% or 10%, respectively; p < 0.001). Combined measurement of soluble ST2 and amino-terminal pro-B-type natriuretic peptide at 12 hours added value to CardShock risk score, correctly reclassifying 11% of patients. The combination of results for soluble ST2 and amino-terminal pro-B-type natriuretic peptide provides early risk assessment beyond clinical variables in patients with acute coronary syndrome-related cardiogenic shock and may help therapeutic decision making in these patients.

Assessment of Near-Field Sonic Boom Simulation Tools

NASA Technical Reports Server (NTRS)

Casper, J. H.; Cliff, S. E.; Thomas, S. D.; Park, M. A.; McMullen, M. S.; Melton, J. E.; Durston, D. A.

2008-01-01

A recent study for the Supersonics Project, within the National Aeronautics and Space Administration, has been conducted to assess current in-house capabilities for the prediction of near-field sonic boom. Such capabilities are required to simulate the highly nonlinear flow near an aircraft, wherein a sonic-boom signature is generated. There are many available computational fluid dynamics codes that could be used to provide the near-field flow for a sonic boom calculation. However, such codes have typically been developed for applications involving aerodynamic configuration, for which an efficiently generated computational mesh is usually not optimum for a sonic boom prediction. Preliminary guidelines are suggested to characterize a state-of-the-art sonic boom prediction methodology. The available simulation tools that are best suited to incorporate into that methodology are identified; preliminary test cases are presented in support of the selection. During this phase of process definition and tool selection, parallel research was conducted in an attempt to establish criteria that link the properties of a computational mesh to the accuracy of a sonic boom prediction. Such properties include sufficient grid density near shocks and within the zone of influence, which are achieved by adaptation and mesh refinement strategies. Prediction accuracy is validated by comparison with wind tunnel data.

Coronary artery dilatation in toxic shock-like syndrome: the Kawasaki disease shock syndrome.

PubMed

Yim, Deane; Ramsay, James; Kothari, Darshan; Burgner, David

2010-11-01

Kawasaki disease is a common systemic vasculitis of childhood that may result in life-threatening coronary artery abnormalities. Despite an overlap of clinical features with toxic shock syndrome, children with Kawasaki disease generally do not develop shock. We report two cases of older children who presented with a toxic shock-like illness, and were diagnosed with Kawasaki disease when coronary artery abnormalities were found on echocardiography, in keeping with the recently described 'Kawasaki disease shock syndrome'. Clinicians should consider Kawasaki disease in all children presenting with toxic shock and assess for coronary artery damage.

Predictors of septic shock in obstructive acute pyelonephritis.

PubMed

Tambo, Mitsuhiro; Okegawa, Takatsugu; Shishido, Toshihide; Higashihara, Eiji; Nutahara, Kikuo

2014-06-01

Acute pyelonephritis (APN) with obstructive uropathy is not uncommon and often causes serious conditions including sepsis and septic shock. We assessed the risk factors for septic shock in patients with obstructive APN associated with upper urinary tract calculi. We retrospectively studied 69 patients with obstructive APN associated with upper urinary tract calculi who were admitted to our hospital. Emergency drainage for decompression of the renal collecting system was performed for empirical treatment in cases of failure of initial treatment and for severe cases. We assessed the risk factors for septic shock by multivariate logistic regression analysis. Overall, 45 patients (65.2 %) underwent emergency drainage and 23 (33.3 %) patients showed septic shock. Poor performance status and the presence of diabetes mellitus (DM) in the septic shock group were more common than in the non-septic shock group (p = 0.012 and p = 0.011, respectively). The platelet count and serum albumin level in the septic shock group were significantly lower than in the non-septic shock group (p = 0.002 and p = 0.003, respectively). Positive rates of midstream urine culture and blood culture in the septic shock group were significantly higher than in the non-septic shock group (p = 0.022 and p = 0.001, respectively). Multivariate analysis showed that decreases in the platelet count (OR 5.43, p = 0.014) and serum albumin level (OR 5.88, p = 0.023) were independent risk factors for septic shock. Patients with obstructive APN associated with upper urinary tract calculi who have decreases in platelet count and serum albumin level should be treated with caution against the development of septic shock.

Mesoscale Computational Investigation of Shocked Heterogeneous Materials with Application to Large Impact Craters

NASA Technical Reports Server (NTRS)

Crawford, D. A.; Barnouin-Jha, O. S.; Cintala, M. J.

2003-01-01

The propagation of shock waves through target materials is strongly influenced by the presence of small-scale structure, fractures, physical and chemical heterogeneities. Pre-existing fractures often create craters that appear square in outline (e.g. Meteor Crater). Reverberations behind the shock from the presence of physical heterogeneity have been proposed as a mechanism for transient weakening of target materials. Pre-existing fractures can also affect melt generation. In this study, we are attempting to bridge the gap in numerical modeling between the micro-scale and the continuum, the so-called meso-scale. To accomplish this, we are developing a methodology to be used in the shock physics hydrocode (CTH) using Monte-Carlo-type methods to investigate the shock properties of heterogeneous materials. By comparing the results of numerical experiments at the micro-scale with experimental results and by using statistical techniques to evaluate the performance of simple constitutive models, we hope to embed the effect of physical heterogeneity into the field variables (pressure, stress, density, velocity) allowing us to directly imprint the effects of micro-scale heterogeneity at the continuum level without incurring high computational cost.

Three-temperature plasma shock solutions with gray radiation diffusion

DOE PAGES

Johnson, Bryan M.; Klein, Richard I.

2016-04-19

Here we discuss the effects of radiation on the structure of shocks in a fully ionized plasma are investigated by solving the steady-state fluid equations for ions, electrons, and radiation. The electrons and ions are assumed to have the same bulk velocity but separate temperatures, and the radiation is modeled with the gray diffusion approximation. Both electron and ion conduction are included, as well as ion viscosity. When the material is optically thin, three-temperature behavior occurs. When the diffusive flux of radiation is important but radiation pressure is not, two-temperature behavior occurs, with the electrons strongly coupled to the radiation.more » Since the radiation heats the electrons on length scales that are much longer than the electron–ion Coulomb coupling length scale, these solutions resemble radiative shock solutions rather than plasma shock solutions that neglect radiation. When radiation pressure is important, all three components are strongly coupled. Results with constant values for the transport and coupling coefficients are compared to a full numerical simulation with a good match between the two, demonstrating that steady shock solutions constitute a straightforward and comprehensive verification test methodology for multi-physics numerical algorithms.« less

Quantified Energy Dissipation Rates in the Terrestrial Bow Shock. 1.; Analysis Techniques and Methodology

NASA Technical Reports Server (NTRS)

Wilson, L. B., III; Sibeck, D. G.; Breneman, A.W.; Le Contel, O.; Cully, C.; Turner, D. L.; Angelopoulos, V.; Malaspina, D. M.

2014-01-01

We present a detailed outline and discussion of the analysis techniques used to compare the relevance of different energy dissipation mechanisms at collisionless shock waves. We show that the low-frequency, quasi-static fields contribute less to ohmic energy dissipation, (-j · E ) (minus current density times measured electric field), than their high-frequency counterparts. In fact, we found that high-frequency, large-amplitude (greater than 100 millivolts per meter and/or greater than 1 nanotesla) waves are ubiquitous in the transition region of collisionless shocks. We quantitatively show that their fields, through wave-particle interactions, cause enough energy dissipation to regulate the global structure of collisionless shocks. The purpose of this paper, part one of two, is to outline and describe in detail the background, analysis techniques, and theoretical motivation for our new results presented in the companion paper. The companion paper presents the results of our quantitative energy dissipation rate estimates and discusses the implications. Together, the two manuscripts present the first study quantifying the contribution that high-frequency waves provide, through wave-particle interactions, to the total energy dissipation budget of collisionless shock waves.

Three-temperature plasma shock solutions with gray radiation diffusion

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

Johnson, Bryan M.; Klein, Richard I.

Here we discuss the effects of radiation on the structure of shocks in a fully ionized plasma are investigated by solving the steady-state fluid equations for ions, electrons, and radiation. The electrons and ions are assumed to have the same bulk velocity but separate temperatures, and the radiation is modeled with the gray diffusion approximation. Both electron and ion conduction are included, as well as ion viscosity. When the material is optically thin, three-temperature behavior occurs. When the diffusive flux of radiation is important but radiation pressure is not, two-temperature behavior occurs, with the electrons strongly coupled to the radiation.more » Since the radiation heats the electrons on length scales that are much longer than the electron–ion Coulomb coupling length scale, these solutions resemble radiative shock solutions rather than plasma shock solutions that neglect radiation. When radiation pressure is important, all three components are strongly coupled. Results with constant values for the transport and coupling coefficients are compared to a full numerical simulation with a good match between the two, demonstrating that steady shock solutions constitute a straightforward and comprehensive verification test methodology for multi-physics numerical algorithms.« less

Local Analysis of Shock Capturing Using Discontinuous Galerkin Methodology

NASA Technical Reports Server (NTRS)

Atkins, H. L.

1997-01-01

The compact form of the discontinuous Galerkin method allows for a detailed local analysis of the method in the neighborhood of the shock for a non-linear model problem. Insight gained from the analysis leads to new flux formulas that are stable and that preserve the compactness of the method. Although developed for a model equation, the flux formulas are applicable to systems such as the Euler equations. This article presents the analysis for methods with a degree up to 5. The analysis is accompanied by supporting numerical experiments using Burgers' equation and the Euler equations.

Development and Realization of a Shock Wave Test on Expert Flap Qualification Model

NASA Astrophysics Data System (ADS)

De Fruytier, C.; Dell'Orco, F.; Ullio, R.; Gomiero, F.

2012-07-01

This paper presents the methodology and the results of the shock test campaign conducted by TAS-I and TAS ETCA to qualify the EXPERT Flap in regards of shock wave and acoustic load generated by pyrocord detonation at stages 2/3 separation phase of the EXPERT vehicle. The design concept of the open flap (manufactured by MT AEROSPACE) is a fully integral manufactured, four sided control surface, with an additional stiffening rib and flanges to meet the first eigenfrequency and the allowable deformation requirement with a minimum necessary mass. The objectives were to reproduce equivalent loading at test article level in terms of pulse duration, front pressure, front velocity and acoustic emission. The Thales Alenia Space ETCA pyrotechnic shock test device is usually used to produce high level shocks by performing a shock on a test fixture supporting the unit under test. In this case, the facility has been used to produce a shock wave, with different requested physical characteristics, directed to the unit under test. Different configurations have been tried on a dummy of the unit to test, following an empirical process. This unusual work has lead to the definition of a nominal set- up meeting the requested physical parameters. Two blast sensors have been placed to acquire the pressure around the flap. The distance between the two sensors has allowed estimating the front pressure velocity. Then, several locations have been selected to acquire the acceleration responses on the unit when it was submitted to this environment. Additionally, a “standard” shock test has been performed on this model. The qualification of the flap, in regards of shock environment, has been successfully conducted.

Numerical computation of Pop plot

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

Menikoff, Ralph

The Pop plot — distance-of-run to detonation versus initial shock pressure — is a key characterization of shock initiation in a heterogeneous explosive. Reactive burn models for high explosives (HE) must reproduce the experimental Pop plot to have any chance of accurately predicting shock initiation phenomena. This report describes a methodology for automating the computation of a Pop plot for a specific explosive with a given HE model. Illustrative examples of the computation are shown for PBX 9502 with three burn models (SURF, WSD and Forest Fire) utilizing the xRage code, which is the Eulerian ASC hydrocode at LANL. Comparisonmore » of the numerical and experimental Pop plot can be the basis for a validation test or as an aid in calibrating the burn rate of an HE model. Issues with calibration are discussed.« less

Mortality Measures to Profile Hospital Performance for Patients With Septic Shock.

PubMed

Walkey, Allan J; Shieh, Meng-Shiou; Liu, Vincent X; Lindenauer, Peter K

2018-04-30

Sepsis care is becoming a more common target for hospital performance measurement, but few studies have evaluated the acceptability of sepsis or septic shock mortality as a potential performance measure. In the absence of a gold standard to identify septic shock in claims data, we assessed agreement and stability of hospital mortality performance under different case definitions. Retrospective cohort study. U.S. acute care hospitals. Hospitalized with septic shock at admission, identified by either implicit diagnosis criteria (charges for antibiotics, cultures, and vasopressors) or by explicit International Classification of Diseases, 9th revision, codes. None. We used hierarchical logistic regression models to determine hospital risk-standardized mortality rates and hospital performance outliers. We assessed agreement in hospital mortality rankings when septic shock cases were identified by either explicit International Classification of Diseases, 9th revision, codes or implicit diagnosis criteria. Kappa statistics and intraclass correlation coefficients were used to assess agreement in hospital risk-standardized mortality and hospital outlier status, respectively. Fifty-six thousand six-hundred seventy-three patients in 308 hospitals fulfilled at least one case definition for septic shock, whereas 19,136 (33.8%) met both the explicit International Classification of Diseases, 9th revision, and implicit septic shock definition. Hospitals varied widely in risk-standardized septic shock mortality (interquartile range of implicit diagnosis mortality: 25.4-33.5%; International Classification of Diseases, 9th revision, diagnosis: 30.2-38.0%). The median absolute difference in hospital ranking between septic shock cohorts defined by International Classification of Diseases, 9th revision, versus implicit criteria was 37 places (interquartile range, 16-70), with an intraclass correlation coefficient of 0.72, p value of less than 0.001; agreement between case definitions for identification of outlier hospitals was moderate (kappa, 0.44 [95% CI, 0.30-0.58]). Risk-standardized septic shock mortality rates varied considerably between hospitals, suggesting that septic shock is an important performance target. However, efforts to profile hospital performance were sensitive to septic shock case definitions, suggesting that septic shock mortality is not currently ready for widespread use as a hospital quality measure.

Isolation of a conjugative F-like plasmid from a multidrug-resistant Escherichia coli strain CM6 using tandem shock wave-mediated transformation.

PubMed

Soto-Alonso, G; Cruz-Medina, J A; Caballero-Pérez, J; Arvizu-Hernández, I; Ávalos-Esparza, L M; Cruz-Hernández, A; Romero-Gómez, S; Rodríguez, A L; Pastrana-Martínez, X; Fernández, F; Loske, A M; Campos-Guillén, J

2015-07-01

Genetic characterization of plasmids from bacterial strains provides insight about multidrug resistance. Ten wild type Escherichia coli (E. coli) strains isolated from cow fecal samples were characterized by their antibiotic resistance profile, plasmid patterns and three different identification methods. From one of the strains, a fertility factor-like plasmid was replicated using tandem shock wave-mediated transformation. Underwater shock waves with a positive pressure peak of up to approximately 40 MPa, followed by a pressure trough of approximately -19 MPa were generated using an experimental piezoelectric shock wave source. Three different shock wave energies and a fixed delay of 750 μs were used to study the relationship between energy and transformation efficiency (TE), as well as the influence of shock wave energy on the integrity of the plasmid. Our results showed that the mean shock wave-mediated TE and the integrity of the large plasmid (~70 kb) were reduced significantly at the energy levels tested. The sequencing analysis of the plasmid revealed a high identity to the pHK17a plasmid, including the replication system, which was similar to the plasmid incompatibility group FII. It also showed that it carried an extended spectrum beta-lactamase gene, ctx-m-14. Furthermore, diverse genes for the conjugative mechanism were identified. Our results may be helpful in improving methodologies for conjugative plasmid transfer and directly selecting the most interesting plasmids from environmental samples. Copyright © 2015 Elsevier B.V. All rights reserved.

Climate smart agriculture, farm household typologies and food security: An ex-ante assessment from Eastern India.

PubMed

Lopez-Ridaura, Santiago; Frelat, Romain; van Wijk, Mark T; Valbuena, Diego; Krupnik, Timothy J; Jat, M L

2018-01-01

One of the great challenges in agricultural development and sustainable intensification is the assurance of social equity in food security oriented interventions. Development practitioners, researchers, and policy makers alike could benefit from prior insight into what interventions or environmental shocks might differentially affect farmers' food security status, in order to move towards more informed and equitable development. We examined the food security status and livelihood activities of 269 smallholder farm households (HHs) in Bihar, India. Proceeding with a four-step analysis, we first applied a multivariate statistical methodology to differentiate five primary farming system types. We next applied an indicator of food security in the form of HH potential food availability (PFA), and examined the contribution of crop, livestock, and on- and off-farm income generation to PFA within each farm HH type. Lastly, we applied scenario analysis to examine the potential impact of the adoption of 'climate smart' agricultural (CSA) practices in the form of conservation agriculture (CA) and improved livestock husbandry, and environmental shocks on HH PFA. Our results indicate that compared to livestock interventions, CA may hold considerable potential to boost HH PFA, though primarily for wealthier and medium-scale cereal farmers. These farm HH types were however considerably more vulnerable to food insecurity risks resulting from simulated drought, while part-time farmers and resource-poor agricultural laborers generating income from off-farm pursuits were comparatively less vulnerable, due in part to their more diversified income sources and potential to migrate in search of work. Our results underscore the importance of prior planning for development initiatives aimed at increasing smallholder food security while maintaining social equity, while providing a robust methodology to vet the implications of agricultural interventions on an ex ante basis.

Transient Three-Dimensional Side Load Analysis of a Film Cooled Nozzle

NASA Technical Reports Server (NTRS)

Wang, Ten-See; Guidos, Mike

2008-01-01

Transient three-dimensional numerical investigations on the side load physics for an engine encompassing a film cooled nozzle extension and a regeneratively cooled thrust chamber, were performed. The objectives of this study are to identify the three-dimensional side load physics and to compute the associated aerodynamic side load using an anchored computational methodology. The computational methodology is based on an unstructured-grid, pressure-based computational fluid dynamics formulation, and a transient inlet history based on an engine system simulation. Ultimately, the computational results will be provided to the nozzle designers for estimating of effect of the peak side load on the nozzle structure. Computations simulating engine startup at ambient pressures corresponding to sea level and three high altitudes were performed. In addition, computations for both engine startup and shutdown transients were also performed for a stub nozzle, operating at sea level. For engine with the full nozzle extension, computational result shows starting up at sea level, the peak side load occurs when the lambda shock steps into the turbine exhaust flow, while the side load caused by the transition from free-shock separation to restricted-shock separation comes at second; and the side loads decreasing rapidly and progressively as the ambient pressure decreases. For the stub nozzle operating at sea level, the computed side loads during both startup and shutdown becomes very small due to the much reduced flow area.

Advanced Shock Position Control for Mode Transition in a Turbine Based Combined Cycle Engine Inlet Model

NASA Technical Reports Server (NTRS)

Csank, Jeffrey T.; Stueber, Thomas J.

2013-01-01

A dual flow-path inlet system is being tested to evaluate methodologies for a Turbine Based Combined Cycle (TBCC) propulsion system to perform a controlled inlet mode transition. Prior to experimental testing, simulation models are used to test, debug, and validate potential control algorithms. One simulation package being used for testing is the High Mach Transient Engine Cycle Code simulation, known as HiTECC. This paper discusses the closed loop control system, which utilizes a shock location sensor to improve inlet performance and operability. Even though the shock location feedback has a coarse resolution, the feedback allows for a reduction in steady state error and, in some cases, better performance than with previous proposed pressure ratio based methods. This paper demonstrates the design and benefit with the implementation of a proportional-integral controller, an H-Infinity based controller, and a disturbance observer based controller.

In Vivo Monitoring of Hemodynamic Changes during Clogging and Unclogging of Blood Supply for the Application of Clinical Shock Detection

NASA Astrophysics Data System (ADS)

Kanawade, Rajesh; Stelzle, Florian; Schmidt, Michael

This paper presents a novel methodology in early detection of clinical shock by monitoring hemodynamic changes using diffuse reflectance measurement technique. Detailed prototype of the reflectance measurement system and data analysis technique of hemodynamic monitoring was carried out in our laboratory. The real time in-vivo measurements were done from the index finger. This study demonstrates preliminary results of real time monitoring of reduced/- oxyhemoglobin changes during clogging and unclogging of blood flow in the finger tip. The obtained results were verified with pulse-oximeter values, connected to the tip of the same index finger.

Vasopressin synthesis by the magnocellular neurons is different in the supraoptic nucleus and in the paraventricular nucleus in human and experimental septic shock.

PubMed

Sonneville, Romain; Guidoux, Céline; Barrett, Lucinda; Viltart, Odile; Mattot, Virginie; Polito, Andrea; Siami, Shidasp; de la Grandmaison, Geoffroy Lorin; Blanchard, Anne; Singer, Mervyn; Annane, Djillali; Gray, Françoise; Brouland, Jean-Philippe; Sharshar, Tarek

2010-05-01

Impaired arginine vasopressin (AVP) synthesis and release by the neurohypophyseal system, which includes the neurohypophysis and magnocellular neurons of the paraventricular and supraoptic nuclei, have been postulated in septic shock, but changes in this system have never been assessed in human septic shock, and only partially experimentally. We investigated AVP synthesis and release by the neurohypophyseal system in 9 patients who died from septic shock and 10 controls, and in 20 rats with fecal peritonitis-induced sepsis and 8 sham-operation controls. Ten rats died spontaneously from septic shock, and the others were sacrificed. In patients with septic shock, as in rats that died spontaneously following sepsis induction, AVP immunohistochemical expression was decreased in the neurohypophysis and supraoptic magnocellular neurons, whereas it was increased in the paraventricular magnocellular neurons. No significant change was observed in AVP messenger RiboNucleic Acid (mRNA) expression assessed by in situ hybridization in either paraventricular or supraoptic magnocellular cells. This study shows that both in human and experimental septic shock, AVP posttranscriptional synthesis and transport are differently modified in the magnocellular neurons of the supraoptic and paraventricular nuclei. This may account for the inappropriate AVP release in septic shock and suggests that distinct pathogenic mechanisms operate in these nuclei.

Fractional Order Modeling of Atmospheric Turbulence - A More Accurate Modeling Methodology for Aero Vehicles

NASA Technical Reports Server (NTRS)

Kopasakis, George

2014-01-01

The presentation covers a recently developed methodology to model atmospheric turbulence as disturbances for aero vehicle gust loads and for controls development like flutter and inlet shock position. The approach models atmospheric turbulence in their natural fractional order form, which provides for more accuracy compared to traditional methods like the Dryden model, especially for high speed vehicle. The presentation provides a historical background on atmospheric turbulence modeling and the approaches utilized for air vehicles. This is followed by the motivation and the methodology utilized to develop the atmospheric turbulence fractional order modeling approach. Some examples covering the application of this method are also provided, followed by concluding remarks.

Effects of implantable cardioverter/defibrillator shock and antitachycardia pacing on anxiety and quality of life: A MADIT-RIT substudy.

PubMed

Perini, Alessandro Paoletti; Kutyifa, Valentina; Veazie, Peter; Daubert, James P; Schuger, Claudio; Zareba, Wojciech; McNitt, Scott; Rosero, Spencer; Tompkins, Christine; Padeletti, Luigi; Moss, Arthur J

2017-07-01

Effects of implantable cardioverter/defibrillator (ICD) shocks and antitachycardia pacing (ATP) on anxiety and quality of life (QoL) in ICD patients are poorly understood. We evaluated changes in QoL from baseline to 9-month follow-up using the EQ-5D questionnaire in patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) (n=1,268). We assessed anxiety levels using the Florida Shock Anxiety Scale (1-10 score) in patients with appropriate or inappropriate shocks or ATP compared to those with no ICD therapy during the first 9 months postimplant. The analysis was stratified by number of ATP or shocks (0-1 vs ≥2) and adjusted for covariates. In MADIT-RIT, 15 patients (1%) had ≥2 appropriate shocks, 38 (3%) had ≥2 appropriate ATPs. Two or more inappropriate shocks were delivered in 16 patients (1%); ≥2 inappropriate ATPs, in 70. In multivariable analysis, patients with ≥2 appropriate shocks had higher levels of shock-related anxiety than those with ≤1 appropriate shock (P<.01). Furthermore, ≥2 inappropriate shocks produced more anxiety than ≤1 inappropriate shock (P=.005). Consistently, ≥2 appropriate ATPs resulted in more anxiety than ≤1 (P=.028), whereas the number of inappropriate ATPs showed no association with anxiety levels (P=.997). However, there was no association between QoL and appropriate or inappropriate ATP/shock (all P values > .05). In MADIT-RIT, ≥2 appropriate or inappropriate ICD shocks and ≥2 appropriate ATPs are associated with more anxiety at 9-month follow-up despite no significant changes in the assessment of global QoL by the EQ-5D questionnaire. Innovative ICD programming reducing inappropriate therapies may help deal with patient concerns about the device. Copyright © 2017 Elsevier Inc. All rights reserved.

Context conditioning and behavioral avoidance in a virtual reality environment: effect of predictability.

PubMed

Grillon, Christian; Baas, Johanna M P; Cornwell, Brian; Johnson, Linda

2006-10-01

Sustained anxiety can be modeled using context conditioning, which can be studied in a virtual reality environment. Unpredictable stressors increase context conditioning in animals. This study examined context conditioning to predictable and unpredictable shocks in humans using behavioral avoidance, potentiated startle, and subjective reports of anxiety. Subjects were guided through three virtual rooms (no-shock, predictable, unpredictable contexts). Eight-sec duration colored lights served as conditioned stimuli (CS). During acquisition, no shock was administered in the no-shock context. Shocks were paired with the CS in the predictable context and were administered randomly in the unpredictable context. No shock was administered during extinction. Startle stimuli were delivered during CS and between CS to assess cued and context conditioning, respectively. To assess avoidance, subjects freely navigated into two of the three contexts to retrieve money. Startle between CS was potentiated in the unpredictable context compared to the two other contexts. Following acquisition, subjects showed a strong preference for the no-shock context and avoidance of the unpredictable context. Consistent with animal data, context conditioning is increased by unpredictability. These data support virtual reality as a tool to extend research on physiological and behavioral signs of fear and anxiety in humans.

Overview of the LaNCETS Flight Experiment and CFD Analysis. Supplemental Movies

NASA Technical Reports Server (NTRS)

Cliatt, Larry J., II; Haering, Edward A., Jr.; Bui, Trong

2008-01-01

This presentation focuses on nearfield airborne pressure signatures from the Lift and Nozzle Change Effect on Tail Shocks (LaNCETS) flight test experiment. The primary motivation for nearfield probing in the supersonic regime is to measure the shock structure of aircraft in an ongoing effort to overcome the overland sonic boom barrier for commercial supersonic transportation. LaNCETS provides the opportunity to investigate lift distribution and engine plume effects. During Phase 1 flight testing an F-15B was used to probe the F-15 LaNCETS aircraft in order to validate CFD and pre-flight prediction tools. A total of 29 probings were taken at 40,000 ft. altitude at Machs 1.2, 1.4 and 1.6. LaNCETS Phase 1 flight data are presented as a detailed pressure signature superimposed over a picture of the LaNCETS aircraft. The attenuation of the Inlet-Canard shocks with distance as well as its forward propagation and the coalescence of the noseboom shock are illustrated. A detailed CFD study on a simplified LaNCETS aircraft jet nozzle was performed providing the ability to more accurately capture the shocks from the propulsion system and emphasizing how under- and over-expanding the nozzle affects the existence of shock trains inside the jet plume. With Phase 1 being a success preparations are being made to move forward to Phase 2. Phase 2 will fly similar flight conditions, but this time changing the aircraft's lift distribution by biasing the canard positions, and changing the plume shape by under- and over-expanding the nozzle. Nearfield probing will again be completed in the same manner as in Phase 1. An additional presentation focuses on LaNCETS CFD solution methodology. Discussions highlight grid preprocessing, grid shearing and stretching, flow solving and contour plots. Efforts are underway to better capture the flow features via grid modification and flow solution methodology, which will help to achieve better agreement with flight data. An included CD-ROM provides animations of the nearfield probing procedure and of real data from one of the probings integrated with GPS positional and velocity data. An additional in-flight video from the rear seat of the probing aircraft is also provided.

Septic shock sera containing circulating histones induce dendritic cell-regulated necrosis in fatal septic shock patients.

PubMed

Raffray, Loic; Douchet, Isabelle; Augusto, Jean-Francois; Youssef, Jihad; Contin-Bordes, Cecile; Richez, Christophe; Duffau, Pierre; Truchetet, Marie-Elise; Moreau, Jean-Francois; Cazanave, Charles; Leroux, Lionel; Mourrissoux, Gaelle; Camou, Fabrice; Clouzeau, Benjamin; Jeannin, Pascale; Delneste, Yves; Gabinski, Claude; Guisset, Olivier; Lazaro, Estibaliz; Blanco, Patrick

2015-04-01

Innate immune system alterations, including dendritic cell loss, have been reproducibly observed in patients with septic shock and correlated to adverse outcomes or nosocomial infections. The goal of this study is to better understand the mechanisms behind this observation in order to better assess septic shock pathogenesis. Prospective, controlled experimental study. Research laboratory at an academic medical center. The study enrolled 71 patients, 49 with septic shock and 22 with cardiogenic shock. Seventeen healthy controls served as reference. In vitro monocyte-derived dendritic cells were generated from healthy volunteers. Sera were assessed for their ability to promote in vitro dendritic cell death through flow cytometry detection in each group of patients. The percentage of apoptotic or necrotic dendritic cells was evaluated by annexin-V and propidium iodide staining. We observed that only patients with septic shock and not patients with pure cardiogenic shock were characterized by a rapid and profound loss of circulating dendritic cells. In vitro analysis revealed that sera from patients with septic shock induced higher dendritic cell death compared to normal sera or cardiogenic shock (p<0.005). Sera from surviving patients induced dendritic cell death through a caspase-dependent apoptotic pathway, whereas sera from nonsurviving patients induced dendritic cell-regulated necrosis. Dendritic cell necrosis was not due to necroptosis but was dependent of the presence of circulating histone. The toxicity of histones toward dendritic cell could be prevented by recombinant human activated protein C. Finally, we observed a direct correlation between the levels of circulating histones in patients and the ability of the sera to promote dendritic cell-regulated necrosis. The study demonstrates a differential mechanism of dendritic cell death in patients with septic shock that is dependent on the severity of the disease.

Medium-term survival after primary angioplasty for myocardial infarction complicated by cardiogenic shock after the age of 75 years.

PubMed

Samadi, A; Le Feuvre, C; Allali, Y; Collet, J-P; Barthélémy, O; Beygui, F; Helft, G; Montalescot, G; Metzger, J-P

2008-03-01

To assess mortality in people > or =75 years of age 6 months after myocardial infarction complicated by cardiogenic shock and treated by angioplasty with complete revascularisation and optimal anti-thrombotic treatment; to compare results to those of younger patients with or without shock and to analyse predictive factors for death. The study is based on 1011 consecutive patients with myocardial infarction admitted for primary angioplasty, subdivided into four groups by age and the presence or absence of cardiogenic shock: group 1 (<75 years of age without shock, n=733), group 2 (<75 years of age with shock, n=49), group 3 (> or =75 years of age without shock, n=208) and group 4 (> or =75 years of age with shock, n=20). These four patient groups were compared for mortality rates and predictive factors for in-hospital and 6 month mortality. In-hospital mortality in groups 1 to 4 was 1.7%, 30.6%, 9.1%, and 70% (p<0.0001) respectively and 6-month mortality was 3.1%, 40%, 16% and 78% (P<0.0001). By univariate analysis renal failure was a predictive factor for death at 6 months in patients without cardiogenic shock (groups 1 and 3), and left ventricular function in patients in group 2. No predictive factors were found in group 4 patients. The independent predictive factors for death at 6 months were: age >75 years of age (P<0.0003), cardiogenic shock (P<0.0001), triple vessel lesions (P<0.01) and creatinine clearance (P=0.004). Mortality after angioplasty remains high in people > or =75 years with cardiogenic shock despite all the advances in the management of myocardial infarction. These disappointing results should encourage us to assess the role of surgical revascularisation and circulatory assistance.

Sticker Shock: Management Professors' Perspectives on the Rising Costs of College Textbooks

ERIC Educational Resources Information Center

Williamson, Stan; Stevens, Robert E.; Silver, Lawrence S.; Clow, Kenneth E.

2011-01-01

This study uses Internet survey methodology to target management instructors' views on the cost of textbooks and the strategies that might be exercised by universities, publishers, and legislatures to control cost increases. From a random sample of 2,893 management professors selected, using university websites, from universities throughout the…

Meta-analyses on intra-aortic balloon pump in cardiogenic shock complicating acute myocardial infarction may provide biased results.

PubMed

Acconcia, M C; Caretta, Q; Romeo, F; Borzi, M; Perrone, M A; Sergi, D; Chiarotti, F; Calabrese, C M; Sili Scavalli, A; Gaudio, C

2018-04-01

Intra-aortic balloon pump (IABP) is the device most commonly investigated in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI). Recently meta-analyses on this topic showed opposite results: some complied with the actual guideline recommendations, while others did not, due to the presence of bias. We investigated the reasons for the discrepancy among meta-analyses and strategies employed to avoid the potential source of bias. Scientific databases were searched for meta-analyses of IABP support in AMI complicated by CS. The presence of clinical diversity, methodological diversity and statistical heterogeneity were analyzed. When we found clinical or methodological diversity, we reanalyzed the data by comparing the patients selected for homogeneous groups. When the fixed effect model was employed despite the presence of statistical heterogeneity, the meta-analysis was repeated adopting the random effect model, with the same estimator used in the original meta-analysis. Twelve meta-analysis were selected. Six meta-analyses of randomized controlled trials (RCTs) were inconclusive because underpowered to detect the IABP effect. Five included RCTs and observational studies (Obs) and one only Obs. Some meta-analyses on RCTs and Obs had biased results due to presence of clinical and/or methodological diversity. The reanalysis of data reallocated for homogeneous groups was no more in contrast with guidelines recommendations. Meta-analyses performed without controlling for clinical and/or methodological diversity, represent a confounding message against a good clinical practice. The reanalysis of data demonstrates the validity of the current guidelines recommendations in addressing clinical decision making in providing IABP support in AMI complicated by CS.

Methodology for the Design of Streamline-Traced External-Compression Supersonic Inlets

NASA Technical Reports Server (NTRS)

Slater, John W.

2014-01-01

A design methodology based on streamline-tracing is discussed for the design of external-compression, supersonic inlets for flight below Mach 2.0. The methodology establishes a supersonic compression surface and capture cross-section by tracing streamlines through an axisymmetric Busemann flowfield. The compression system of shock and Mach waves is altered through modifications to the leading edge and shoulder of the compression surface. An external terminal shock is established to create subsonic flow which is diffused in the subsonic diffuser. The design methodology was implemented into the SUPIN inlet design tool. SUPIN uses specified design factors to design the inlets and computes the inlet performance, which includes the flow rates, total pressure recovery, and wave drag. A design study was conducted using SUPIN and the Wind-US computational fluid dynamics code to design and analyze the properties of two streamline-traced, external-compression (STEX) supersonic inlets for Mach 1.6 freestream conditions. The STEX inlets were compared to axisymmetric pitot, two-dimensional, and axisymmetric spike inlets. The STEX inlets had slightly lower total pressure recovery and higher levels of total pressure distortion than the axisymmetric spike inlet. The cowl wave drag coefficients of the STEX inlets were 20% of those for the axisymmetric spike inlet. The STEX inlets had external sound pressures that were 37% of those of the axisymmetric spike inlet, which may result in lower adverse sonic boom characteristics. The flexibility of the shape of the capture cross-section may result in benefits for the integration of STEX inlets with aircraft.

Health shocks and risk aversion.

PubMed

Decker, Simon; Schmitz, Hendrik

2016-12-01

We empirically assess whether a health shock influences individual risk aversion. We use grip strength data to obtain an objective health shock indicator. In order to account for the non-random nature of our data regression-adjusted matching is employed. Risk preferences are traditionally assumed to be constant. However, we find that a health shock increases individual risk aversion. The finding is robust to a series of sensitivity analyses and persists for at least four years after the shock. Income changes do not seem to be the driving mechanism. Copyright © 2016 Elsevier B.V. All rights reserved.

Assessment of shock effects on amphibole water contents and hydrogen isotope compositions: 1. Amphibolite experiments

NASA Astrophysics Data System (ADS)

Minitti, Michelle E.; Rutherford, Malcolm J.; Taylor, Bruce E.; Dyar, M. Darby; Schultz, Peter H.

2008-02-01

Kaersutitic amphiboles found within a subset of the Martian meteorites have low water contents and variably heavy hydrogen isotope compositions. In order to assess if impact shock-induced devolatilization and hydrogen isotope fractionation were determining factors in these water and isotopic characteristics of the Martian kaersutites, we conducted impact shock experiments on samples of Gore Mountain amphibolite in the Ames Vertical Gun Range (AVGR). A parallel shock experiment conducted on an anorthosite sample indicated that contamination of shocked samples by the AVGR hydrogen propellant was unlikely. Petrographic study of the experimental amphibolite shock products indicates that only ˜ 10% of the shock products experienced levels of damage equivalent to those found in the most highly shocked kaersutite-bearing Martian meteorites (30-35 GPa). Ion microprobe studies of highly shocked hornblende from the amphibolite exhibited elevated water contents (ΔH 2O ˜ 0.1 wt.%) and enriched hydrogen isotope compositions (Δ D ˜ + 10‰) relative to unshocked hornblende. Water and hydrogen isotope analyses of tens of milligrams of unshocked, moderately shocked, and highly shocked hornblende samples by vacuum extraction/uranium reduction and isotope ratio mass spectrometry (IRMS), respectively, are largely consistent with analyses of single grains from the ion microprobe. The mechanisms thought to have produced the excess water in most of the shocked hornblendes are shock-induced reduction of hornblende Fe and/or irreversible adsorption of hydrogen. Addition of the isotopically enriched Martian atmosphere to the Martian meteorite kaersutites via these mechanisms could explain their enriched and variable isotopic compositions. Alternatively, regrouping the water extraction and IRMS analyses on the basis of isotopic composition reveals a small, but consistent, degree of impact-induced devolatilization (˜ 0.1 wt.% H 2O) and H isotope enrichment (Δ D ˜ + 10‰). Extrapolating the shock signature of the regrouped data to grains that experienced Martian meteorite-like shock pressures suggests that shock-induced water losses and hydrogen isotope enrichments could approach 1 wt.% H 2O and Δ D = + 100‰, respectively. If these values are valid, then impact shock effects could explain a substantial fraction of the low water contents and variable hydrogen isotope compositions of the Martian meteorite kaersutites.

Cost--utility analysis of a shock-absorbing floor intervention to prevent injuries from falls in hospital wards for older people.

PubMed

Latimer, Nicholas; Dixon, Simon; Drahota, Amy Kim; Severs, Martin

2013-09-01

hospital falls place a substantial burden on healthcare systems. There has been limited research into the use of hospital flooring as an intervention against fall-related injuries. to assess the cost-effectiveness of shock-absorbing flooring compared with standard hospital flooring in hospital wards for older people. a cost-utility analysis was undertaken drawing upon data collected in a pilot cluster randomised controlled trial and the wider literature. the trial included eight hospital sites across England. Four sites installed shock-absorbing flooring in one bay, and four maintained their standard flooring. falls and resulting injuries and treatment were reported by hospital staff. Data on destination of discharge were collected. Patients were followed up at 3 months and further resource use data were collected. Health-related quality of life was assessed, allowing quality-adjusted life years (QALYs) to be estimated. The incremental cost-effectiveness ratio of the shock-absorbing flooring was assessed compared with the standard hospital flooring. in the base case, the shock-absorbing flooring was cost saving, but generated QALY losses due to an increase in the faller rate reported in the intervention arm. Scenario analysis showed that if the shock-absorbing flooring does not increase the faller rate it is likely to represent a dominant economic strategy-generating cost savings and QALY gains. the shock-absorbing flooring intervention has the potential to be cost-effective but further research is required on whether the intervention flooring results in a higher faller rate than standard flooring.

A comparative study of advanced shock-capturing schemes applied to Burgers' equation

NASA Technical Reports Server (NTRS)

Yang, H. Q.; Przekwas, A. J.

1990-01-01

Several variations of the TVD scheme, ENO scheme, FCT scheme, and geometrical schemes, such as MUSCL and PPM, are considered. A comparative study of these schemes as applied to the Burgers' equation is presented. The objective is to assess their performance for problems involving formation and propagation of shocks, shock collisions, and expansion of discontinuities.

Statistical power of intervention analyses: simulation and empirical application to treated lumber prices

Treesearch

Jeffrey P. Prestemon

2009-01-01

Timber product markets are subject to large shocks deriving from natural disturbances and policy shifts. Statistical modeling of shocks is often done to assess their economic importance. In this article, I simulate the statistical power of univariate and bivariate methods of shock detection using time series intervention models. Simulations show that bivariate methods...

Shock-wave flow regimes at entry into the diffuser of a hypersonic ramjet engine: Influence of physical properties of the gas medium

NASA Astrophysics Data System (ADS)

Tarnavskii, G. A.

2006-07-01

The physical aspects of the effective-adiabatic-exponent model making it possible to decompose the total problem on modeling of high-velocity gas flows into individual subproblems (“physicochemical processes” and “ aeromechanics”), which ensures the creation of a universal and efficient computer complex divided into a number of independent units, have been analyzed. Shock-wave structures appearing at entry into the duct of a hypersonic aircraft have been investigated based on this methodology, and the influence of the physical properties of the gas medium in a wide range of variations of the effective adiabatic exponent has been studied.

Assessment of numerical methods for the solution of fluid dynamics equations for nonlinear resonance systems

NASA Technical Reports Server (NTRS)

Przekwas, A. J.; Yang, H. Q.

1989-01-01

The capability of accurate nonlinear flow analysis of resonance systems is essential in many problems, including combustion instability. Classical numerical schemes are either too diffusive or too dispersive especially for transient problems. In the last few years, significant progress has been made in the numerical methods for flows with shocks. The objective was to assess advanced shock capturing schemes on transient flows. Several numerical schemes were tested including TVD, MUSCL, ENO, FCT, and Riemann Solver Godunov type schemes. A systematic assessment was performed on scalar transport, Burgers' and gas dynamic problems. Several shock capturing schemes are compared on fast transient resonant pipe flow problems. A system of 1-D nonlinear hyperbolic gas dynamics equations is solved to predict propagation of finite amplitude waves, the wave steepening, formation, propagation, and reflection of shocks for several hundred wave cycles. It is shown that high accuracy schemes can be used for direct, exact nonlinear analysis of combustion instability problems, preserving high harmonic energy content for long periods of time.

Discovery of Ahrensite γ-Fe2SiO4 and Tissintite (Ca,Na,[])AlSi2O6, Two New Shock-induced Minerals from the Tissint Martian Meteorite: a Nanomineralogy Investigation

NASA Astrophysics Data System (ADS)

Ma, C.; Tschauner, O. D.; Liu, Y.; Sinogeikin, S. V.; Zhuravlev, K. K.; Prakapenka, V.; Dera, P. K.; Taylor, L. A.

2013-12-01

The recent Martian meteorite fall, Tissint, is a fresh olivine-phyric shergottite, with strong shock features. During our nano-mineralogy investigation of the Tissint meteorite with a combined analytical scanning electron microscope and synchrotron diffraction approach, two new shock-induced minerals have been discovered; these provide new insights into understanding shock conditions and impact processes on Mars. Ahrensite (IMA 2013-028), the Fe-analogue (γ-Fe2SiO4) of ringwoodite, is a new high-pressure mineral identified in Tissint. Both ahrensite and ringwoodite occur in Tissint as fine-grained polycrystalline aggregates in the rims of olivines around some shock-melt pockets. The morphology and texture of these silicate-spinels suggest formation by a solid-state transformation from Fe-rich olivine. Associated with the ahrensite and ringwoodite, inside melt pockets, often resides a thin layer of vitrified silicate-perovskite and magnesio-wüstite or wüstite. Such transitions represent a unique pressure and temperature gradient. Tissintite (IMA 2013-027), (Ca,Na,[])AlSi2O6 with the C2/c clinopyroxene structure, is a new jadeite-like mineral in Tissint. It appears as fine-grained aggregates within plagioclase glass, inside many shock-melt pockets. Both ahrensite and tissintite are high-pressure minerals formed by shock during the impact event(s) on Mars that excavated and ejected the rock off Mars. We will discuss the path of structure analysis for both new-mineral cases. Such novel methodology be utilized for many cases of mineralogical phase identification or structure analysis; this demonstrates how nano-mineralogy can be addressed and how it may play a unique role in meteorite and Mars rock research, in general.

A Study of Supersonic Compression-Corner Interactions using Hybrid LES/RANS Models

DTIC Science & Technology

2014-01-20

Mach 2.5 shock / boundary layer interaction in a wind tunnel (experiments conducted at Cambridge University [15]) as a means of assessing methods... wind tunnel . The shock impinges upon the bottom surface of the wind tunnel , creating a region of shock -separated flow. The structure of the SBLI... waves into a shock wave (Figure 19, X = 0.1016 and X = 0.1278 stations) are also not well-predicted. The hot-wire measurements may not be as

Quality of mango nectar processed by high-pressure homogenization with optimized heat treatment.

PubMed

Tribst, Alline Artigiani Lima; Franchi, Mark Alexandrow; de Massaguer, Pilar Rodriguez; Cristianini, Marcelo

2011-03-01

This work aimed to evaluate the effect of high-pressure homogenization (HPH) with heat shock on Aspergillus niger, vitamin C, and color of mango nectar. The nectar was processed at 200 MPa followed by heat shock, which was optimized by response surface methodology by using mango nectar ratio (45 to 70), heat time (10 to 20), and temperature (60 to 85 °C) as variables. The color of mango nectar and vitamin C retention were evaluated at the optimized treatments, that is, 200 MPa + 61.5 °C/20 min or 73.5 °C/10 min. The mathematical model indicates that heat shock time and temperature showed a positive effect in the mould inactivation, whereas increasing ratio resulted in a protective effect on A. niger. The optimized treatments did not increase the retention of vitamin C, but had positive effect for the nectar color, in particular for samples treated at 200 MPa + 61.5 °C/20 min. The results obtained in this study show that the conidia can be inactivated by applying HPH with heat shock, particularly to apply HPH as an option to pasteurize fruit nectar for industries.

Shock anxiety among implantable cardioverter defibrillator recipients with recent tachyarrhythmia.

PubMed

Morken, Ingvild M; Isaksen, Kjetil; Karlsen, Bjørg; Norekvål, Tone M; Bru, Edvin; Larsen, Alf Inge

2012-11-01

Shock anxiety has been documented irrespective of shock exposure in implantable cardioverter defibrillator (ICD) recipients. The presence of tachyarrhythmia may lead to an anticipation of receiving a shock and thereby give rise to shock anxiety. The aims were to assess: (1) the level of shock anxiety in a sample of ICD recipients, (2) the relationship between such anxiety and shock exposure, and (3) the relationship between recent tachyarrhythmia and shock anxiety. ICD recipients (n = 167) completed the Florida Shock Anxiety Scale measure of shock anxiety. The recipients were divided into three groups: (1) Recipients with no documented tachyarrhythmia over the previous 12 months (n = 56), (2) recipients with documented tachyarrhythmia over the previous twelve months (n = 54), and (3) recipients with any history of shocks (n = 57). Of the recipients, 44% experienced some form of shock anxiety, whereas 15% reported general shock anxiety. Analyses of covariance revealed that recipients with recent tachyarrhythmia (F = 7.675 df = 9/100, P = 0.007) as well as recipients with a shock history (F = 9.976, df = 9/103, P = 0.002) reported higher levels of shock anxiety than recipients with no recent tachyarrhythmia. This study indicates that although a substantial proportion of the ICD recipients experienced some form of shock anxiety, only a relatively small proportion reported general shock anxiety. ICD recipients with recent tachyarrhythmia, in addition to recipients with shock history, appear to be at greater risk for development of shock anxiety. This implies that these recipients may profit from clinical-based strategies and interventions targeting shock anxiety. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

Controlled hypotension versus normotensive resuscitation strategy for people with ruptured abdominal aortic aneurysm.

PubMed

Moreno, Daniel H; Cacione, Daniel G; Baptista-Silva, Jose C C

2016-05-13

An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries and healthcare systems, with mortality ranging from 53% to 90%. Definitive treatment for ruptured AAA includes open surgery or endovascular repair. The management of haemorrhagic shock is crucial for the person's outcome and aims to restore organ perfusion and systolic blood pressure above 100 mm Hg through immediate and aggressive fluid replacement. This rapid fluid replacement is known as the normotensive resuscitation strategy. However, evidence suggests that infusing large volumes of cold fluid causes dilutional and hypothermic coagulopathy. The association of these factors may exacerbate bleeding, resulting in a 'lethal triad' of hypothermia, acidaemia, and coagulopathy. An alternative to the normotensive resuscitation strategy is the controlled (permissive) hypotension resuscitation strategy, with a target systolic blood pressure of 50 to 100 mm Hg. The principle of controlled or hypotensive resuscitation has been used in some management protocols for endovascular repair of ruptured AAA. It may be beneficial in preventing blood loss by avoiding the clot disruption caused by the rapid increase in systolic blood pressure; avoiding dilution of clotting factors, platelets and fibrinogen; and by avoiding the temperature decrease that inhibits enzyme activity involved in platelet and clotting factor function. To compare the effects of controlled (permissive) hypotension resuscitation and normotensive resuscitation strategies for people with ruptured AAA. The Cochrane Vascular Information Specialist searched the Specialised Register (April 2016) and the Cochrane Register of Studies (CENTRAL (2016, Issue 3)). Clinical trials databases were searched (April 2016) for details of ongoing or unpublished studies. We sought all published and unpublished randomised controlled trial (RCTs) that compared controlled hypotension and normotensive resuscitation strategies for the management of shock in patients with ruptured abdominal aortic aneurysms. Two review authors independently assessed identified studies for potential inclusion in the review. We used standard methodological procedures in accordance with the Cochrane Handbook for Systematic Review of Interventions. We identified no RCTs that met the inclusion criteria. We found no RCTs that compared controlled hypotension and normotensive resuscitation strategies in the management of haemorrhagic shock in patients with ruptured abdominal aortic aneurysm that assessed mortality, presence of coagulopathy, intensive care unit length of stay, and the presence of myocardial infarct and renal failure. High quality studies that evaluate the best strategy for managing haemorrhagic shock in ruptured abdominal aortic aneurysms are required.

Controlled hypotension versus normotensive resuscitation strategy for people with ruptured abdominal aortic aneurysm.

PubMed

Moreno, Daniel H; Cacione, Daniel G; Baptista-Silva, Jose Cc

2018-06-13

An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries and healthcare systems, with mortality ranging from 53% to 90%. Definitive treatment for ruptured AAA includes open surgery or endovascular repair. The management of haemorrhagic shock is crucial for the person's outcome and aims to restore organ perfusion and systolic blood pressure above 100 mmHg through immediate and aggressive fluid replacement. This rapid fluid replacement is known as the normotensive resuscitation strategy. However, evidence suggests that infusing large volumes of cold fluid causes dilutional and hypothermic coagulopathy. The association of these factors may exacerbate bleeding, resulting in a 'lethal triad' of hypothermia, acidaemia, and coagulopathy. An alternative to the normotensive resuscitation strategy is the controlled (permissive) hypotension resuscitation strategy, with a target systolic blood pressure of 50 mmHg to 100 mmHg. The principle of controlled or hypotensive resuscitation has been used in some management protocols for endovascular repair of ruptured AAA. It may be beneficial in preventing blood loss by avoiding the clot disruption caused by the rapid increase in systolic blood pressure; avoiding dilution of clotting factors, platelets and fibrinogen; and by avoiding the temperature decrease that inhibits enzyme activity involved in platelet and clotting factor function. This is an update of a review first published in 2016. To compare the effects of controlled (permissive) hypotension resuscitation and normotensive resuscitation strategies for people with ruptured AAA. The Cochrane Vascular Information Specialist searched the Specialised Register (August 2017), the Cochrane Register of Studies (CENTRAL (2017, Issue 7)) and EMBASE (August 2017). The Cochrane Vascular Information Specialist also searched clinical trials databases (August 2017) for details of ongoing or unpublished studies. We sought all published and unpublished randomised controlled trial (RCTs) that compared controlled hypotension and normotensive resuscitation strategies for the management of shock in patients with ruptured abdominal aortic aneurysms. Two review authors independently assessed identified studies for potential inclusion in the review. We used standard methodological procedures in accordance with the Cochrane Handbook for Systematic Review of Interventions. We identified no RCTs that met the inclusion criteria. We found no RCTs that compared controlled hypotension and normotensive resuscitation strategies in the management of haemorrhagic shock in patients with ruptured abdominal aortic aneurysm that assessed mortality, presence of coagulopathy, intensive care unit length of stay, and the presence of myocardial infarct and renal failure. High quality studies that evaluate the best strategy for managing haemorrhagic shock in ruptured abdominal aortic aneurysms are required.

Psychometric evaluation of the Environmental Reality Shock-Related Issues and Concerns instrument for newly graduated nurses.

PubMed

Kim, Eun-Young; Yeo, Jung Hee; Park, Hyunjeong; Sin, Kyung Mi; Jones, Cheryl B

2018-02-01

Reality shock is a critical representation of the gap between nursing education and clinical practice and it is important to explore the level of reality shock among nurses. However, there is no relevant instrument to assess the level of reality shock in South Korea. The purpose of this is to determine the validity and reliability of the Korean version of the Environmental Reality Shock-Related Issues and Concerns instrument. A cross-sectional study design was used in this study. The data collection was conducted in selected 15 hospitals in South Korea. A convenience sample of 216 newly graduated nurses participated in the study. The Korean version of the Environmental Reality Shock-Related Issues and Concerns instrument was developed through the forward-backward translation technique, and revision based on feedback from expert groups. The internal consistency reliability was assessed using Cronbach's alpha, and the construct validity was determined via exploratory and confirmatory factor analysis. The Korean version of the Environmental Reality Shock-Related Issues and Concerns has reliable internal consistency (Cronbach's alpha=0.91). Exploratory factor analysis revealed five factors including job, relationships, expectations, private life, and performance, which explained 61.92% of variance. The factor loadings ranged from 0.451 to 0.832. The five-factor structure was validated by confirmatory factor analysis (RMR<0.05, CFI>0.9). It was concluded that the Korean version of the Environmental Reality Shock-Related Issues and Concerns instrument has satisfactory construct validity and reliability to measure the reality shock of newly graduated nurses in South Korea. Copyright © 2017 Elsevier Ltd. All rights reserved.

An overview of the dynamic calibration of piezoelectric pressure transducers

NASA Astrophysics Data System (ADS)

Theodoro, F. R. F.; Reis, M. L. C. C.; d’ Souto, C.

2018-03-01

Dynamic calibration is a research area that is still under development and is of great interest to aerospace and automotive industries. This study discusses some concepts regarding dynamic measurements of pressure quantities and presents an overview of dynamic calibration of pressure transducers. Studies conducted by the Institute of Aeronautics and Space focusing on research regarding piezoelectric pressure transducer calibration in shock tube are presented. We employed the Guide to the Expression of Uncertainty and a Monte Carlo Method in the methodology. The results show that both device and methodology employed are adequate to calibrate the piezoelectric sensor.

Mice subjected to uncontrollable electric shocks show depression-like behaviors irrespective of their state of helplessness.

PubMed

Kim, Jin Yong; Yang, Soo Hyun; Kwon, Jihyun; Lee, Hyun Woo; Kim, Hyun

2017-03-30

The unpredictable and inescapable electric shock-induced "learned helplessness" paradigm has long been used to produce an animal model of depression to identify the molecules associated with depressive symptoms or to assess the efficacy of pharmacological treatments for depression. After exposure to unpredictable and inescapable shocks (uncontrollable stress), most of mice showed defect in escape behavior in active avoidance test (learned helplessness, LH), while others did not (non-learned helplessness, NLH). Here, we investigated whether mice with LH or NLH exhibited depressive symptoms, including anhedonia, anxiety, and despair. We found that compared with control naïve mice, both uncontrollable shocks-induced LH and NLH mice showed increased anhedonia- and anxiety- but not despair-like behaviors. Notably, mice subjected to uncontrollable shocks showed similar behaviors, irrespective of whether they also showed LH or NLH. Furthermore, since both LH and NLH mice showed only anhedonia- and anxiety- but not despair-like behaviors, this model may be generally inadequate for classic depression-like behavior assessment. In conclusion, uncontrollable electric shock induces depression-like behavior, irrespective of the state of helplessness. Copyright © 2017 Elsevier B.V. All rights reserved.

Blast and Shock Mitigation Through the Use of Advanced Materials

NASA Astrophysics Data System (ADS)

Bartyczak, Susan; Edgerton, Lauren; Mock, Willis

2017-06-01

The dynamic response to low amplitude blast waves of four viscoelastic materials has been investigated: Dragonshield BCTM and three polyurea formulations (P1000, P650, and a P250/1000 blend). A 40-mm-bore gas gun was used as a shock tube to generate planar blast waves, ranging from 1 to 2 bars, that impacted instrumented target assemblies mounted on the gas gun muzzle. Each target assembly consisted of a viscoelastic material sample sandwiched between two gauge assemblies for measuring wave velocity and input/output stresses. Each gauge assembly consisted of one polyvinylidene fluoride (PVDF) stress gauge sandwiched between two 3.25 inch diameter 6061-T6 aluminum discs. Impedance matching techniques were used on the stress measurements to calculate the stresses on the front and back of the samples. The shock velocity-particle velocity relationship, stress-particle velocity relationship, and blast attenuation for each material were determined. The experimental technique, analysis methodology, and results will be presented.

Efficiency assessment of shock wave therapy in patients with pelvic pain employing harmonic analysis of penile bioimpedance.

PubMed

Khodyreva, L A; Dudareva, A A; Mudraya, I S; Markosyan, T G; Revenko, S V; Kumachev, K V; Logvinov, L A

2013-06-01

In searching for novel objective methods to diagnosticate pelvic pain and assess efficiency of analgesic therapy, 37 male patients were examined prior to and after the course of extracorporeal shock wave therapy (5-10 sessions) with the waves directed to projections of prostate and/or crura and shaft of the penis. The repetition rate of mechanical pulses was 3-5 Hz. The range of energy pulse density was 0.09-0.45 mJ/mm(2). The overall number of pulses in a session was 1500-3000 in any treated zone with total energy smaller than 60 J. The applicator was relocated every other series of 300-500 pulses. Effect of the shock wave therapy was assessed according to subjective symptomatic scales: International Prostate Symptom Score, International Index of Erectile Function, Quality of Life, and nociceptive Visual Analog Scale. The objective assessment of shock wave therapy was performed with harmonic analysis of penile bioimpedance variability, which quantitatively evaluated the low-frequency rhythmic and asynchronous activities at rest as well as the total pulsatile activity of the penis. The magnitude of spectrum components of bioimpedance variations was assessed with a novel parameter, the effective impedance. The spectral parameters were measured in 16 patients prior to and after the treatment course. The corresponding control values were measured in the group of healthy patients. Prior to the shock wave therapy course, all spectrum parameters of penile bioimpedance significantly differed from the control (p<0.05). After this course, low-frequency rhythmic and the total pulsatile activity decreased to normal, while asynchronous activity remained significantly different from the normal. The novel objective physiological criteria of pelvic pain diagnostics and efficiency of its treatment reflecting the regional features of circulation and neural activity corresponded to the clinical symptom scaling prior to and after the shock wave course, and on the whole, these criteria corroborated improvement of the patient state after this therapy.

An assessment of the 3D geometric surrogacy of shock timing diagnostic techniques for tuning experiments on the NIF

NASA Astrophysics Data System (ADS)

Robey, H. F.; Munro, D. H.; Spears, B. K.; Marinak, M. M.; Jones, O. S.; Patel, M. V.; Haan, S. W.; Salmonson, J. D.; Landen, O. L.; Boehly, T. R.; Nikroo, A.

2008-05-01

Ignition capsule implosions planned for the National Ignition Facility (NIF) require a pulse shape with a carefully designed series of four steps, which launch a corresponding series of shocks through the ablator and DT ice shell. The relative timing of these shocks is critical for maintaining the DT fuel on a low adiabat. The current NIF specification requires that the timing of all four shocks be tuned to an accuracy of <= +/- 100ps. To meet these stringent requirements, dedicated tuning experiments are being planned to measure and adjust the shock timing on NIF. These tuning experiments will be performed in a modified hohlraum geometry, where a re-entrant Au cone is added to the standard NIF hohlraum to provide optical diagnostic (VISAR and SOP) access to the shocks as they break out of the ablator. This modified geometry is referred to as the 'keyhole' hohlraum and introduces a geometric difference between these tuning-experiments and the full ignition geometry. In order to assess the surrogacy of this modified geometry, 3D simulations using HYDRA [1] have been performed. The results from simulations of a quarter of the target geometry are presented. Comparisons of the hohlraum drive conditions and the resulting effect on the shock timing in the keyhole hohlraum are compared with the corresponding results for the standard ignition hohlraum.

Assessing the Role of Anhydrite in the KT Mass Extinction: Hints from Shock-loading Experiments

NASA Technical Reports Server (NTRS)

Skala, R.; Lnagenhorst, F.; Hoerz, F.

2004-01-01

Various killing mechanisms have been suggested to contribute to the mass extinctions at the KT boundary, including severe, global deterioration of the atmosphere and hydrosphere due to SO(x) released from heavily shocked, sulfate-bearing target rocks. The devolatilization of anhydrite is predominantly inferred from thermodynamic considerations and lacks experimental confirmation. To date, the experimentally determined shock behavior of anhydrite is limited to solid-state effects employing X-ray diffraction methods. The present report employs additional methods to characterize experimentally shocked anhydrite.

Assessment of CFD capability for prediction of hypersonic shock interactions

NASA Astrophysics Data System (ADS)

Knight, Doyle; Longo, José; Drikakis, Dimitris; Gaitonde, Datta; Lani, Andrea; Nompelis, Ioannis; Reimann, Bodo; Walpot, Louis

2012-01-01

The aerothermodynamic loadings associated with shock wave boundary layer interactions (shock interactions) must be carefully considered in the design of hypersonic air vehicles. The capability of Computational Fluid Dynamics (CFD) software to accurately predict hypersonic shock wave laminar boundary layer interactions is examined. A series of independent computations performed by researchers in the US and Europe are presented for two generic configurations (double cone and cylinder) and compared with experimental data. The results illustrate the current capabilities and limitations of modern CFD methods for these flows.

Utility of Functional Hemodynamics and Echocardiography to Aid Diagnosis and Management of Shock.

PubMed

McGee, William T; Raghunathan, Karthik; Adler, Adam C

2015-12-01

The utility of functional hemodynamics and bedside ultrasonography is increasingly recognized as advantageous for both improved diagnosis and management of shock states. In contrast to conventional "static" measures, "dynamic" hemodynamic measures and bedside imaging modalities enhance pathophysiology-based comprehensive understanding of shock states and the response to therapy. The current editions of major textbooks in the primary specialties--in which clinicians routinely encounter patients in shock--including surgery, anesthesia, emergency medicine, and internal medicine continue to incorporate traditional (conventional) descriptions of shock that use well-described (but potentially misleading) intravascular pressures to classify shock states. Reliance on such intravascular pressure measurements is not as helpful as newer "dynamic" functional measures including ultrasonography to both better assess volume responsiveness and biventricular cardiac function. This review thus emphasizes the application of current functional hemodynamics and ultrasonography to the diagnosis and management of shock as a contrast to conventional "static" pressure-based measures.

Various continuum approaches for studying shock wave structure in carbon dioxide

NASA Astrophysics Data System (ADS)

Alekseev, I. V.; Kosareva, A. A.; Kustova, E. V.; Nagnibeda, E. A.

2018-05-01

Shock wave structure in carbon dioxide is studied using different continuum models within the framework of one-temperature thermal equilibrium flow description. Navier-Stokes and Euler equations as well as commonly used Rankine-Hugoniot equations with different specific heat ratios are used to find the gas-dynamic parameters behind the shock wave. The accuracy of the Rankine-Hugoniot relations in polyatomic gases is assessed, and it is shown that they give a considerable error in the predicted values of fluid-dynamic variables. The effect of bulk viscosity on the shock wave structure in CO2 is evaluated. Taking into account bulk viscosity yields a significant increase in the shock wave width; for the complete model, the shock wave thickness varies non-monotonically with the Mach number.

Survival, quality of life and impact of right heart failure in patients with acute cardiogenic shock treated with ECMO.

PubMed

Schoenrath, Felix; Hoch, Dennis; Maisano, Francesco; Starck, Christoph T; Seifert, Burkhardt; Wenger, Urs; Ruschitzka, Frank; Wilhelm, Markus J

2016-01-01

Mechanical circulatory support is increasingly used in acute cardiogenic shock. To assess treatment strategies for cardiogenic shock. Data of 57 patients in acute intrinsic cardiogenic shock treated with ECMO were analyzed. Different subsequent strategies (weaning, VAD, transplantation) were followed.​ Overall 1, 2, and 4-year survival was 36.8 ± 6.4%, 32.2 ± 6.4%, 29.8 ± 6.3%. Elevated lactate and hemorrhagic complications (all p in patients with right heart failure prior to ECMO implantation, BVAD therapy showed a trend (p=0.058) towards superior survival compared with LVAD therapy. Seven of the BVAD patients received successful transplantation, with a 1-year survival of 71%. Among survivors Short Form 36 reported significantly lower combined physical scores (p=0.004). Right heart assessment prior to ECMO implantation may be beneficial to provide tailored therapy if ECMO weaning fails. Survival after cardiogenic shock requiring ECMO seems to be associated with impaired long-term quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

Enhanced kidney stone fragmentation by short delay tandem conventional and modified lithotriptor shock waves: a numerical analysis.

PubMed

Tham, Leung-Mun; Lee, Heow Pueh; Lu, Chun

2007-07-01

We evaluated the effectiveness of modified lithotriptor shock waves using computer models. Finite element models were used to simulate the propagation of lithotriptor shock waves in human renal calculi in vivo. Kidney stones were assumed to be spherical, homogeneous, isotropic and linearly elastic, and immersed in a continuum fluid. Single and tandem shock wave pulses modified to intensify the collapse of cavitation bubbles near the stone surface to increase fragmentation efficiency and suppress the expansion of intraluminal bubbles for decreased vascular injury were analyzed. The effectiveness of the modified shock waves was assessed by comparing the states of loading in the renal calculi induced by these shock waves to those produced by conventional shock waves. Our numerical simulations revealed that modified shock waves produced marginally lower stresses in spherical renal calculi than those produced by conventional shock waves. Tandem pulses of conventional or modified shock waves produced peak stresses in the front and back halves of the renal calculi. However, the single shock wave pulses generated significant peak stresses in only the back halves of the renal calculi. Our numerical simulations suggest that for direct stress wave induced fragmentation modified shock waves should be as effective as conventional shock waves for fragmenting kidney stones. Also, with a small interval of 20 microseconds between the pulses tandem pulse lithotripsy using modified or conventional shock waves could be considerably more effective than single pulse lithotripsy for fragmenting kidney stones.

Pancreatic injury in patients with septic shock: A literature review

PubMed Central

Chaari, Anis; Abdel Hakim, Karim; Bousselmi, Kamel; Etman, Mahmoud; El Bahr, Mohamed; El Saka, Ahmed; Hamza, Eman; Ismail, Mohamed; Khalil, Elsayed Mahmoud; Kauts, Vipin; Casey, William Francis

2016-01-01

Sepsis and septic shock are life threatening condition associated with high mortality rate in critically-ill patients. This high mortality is mainly related to the inadequacy between oxygen delivery and cellular demand leading to the onset of multiorgan dysfunction. Whether this multiorgan failure affect the pancreas is not fully investigated. In fact, pancreatic injury may occur because of ischemia, overwhelming inflammatory response, oxidative stress, cellular apoptosis and/or metabolic derangement. Increased serum amylase and/or lipase levels are common in patients with septic shock. However, imaging test rarely reveal significant pancreatic damage. Whether pancreatic dysfunction does affect the prognosis of patients with septic shock or not is still a matter of debate. In fact, only few studies with limited sample size assessed the clinical relevance of the pancreatic injury in this group of patients. In this review, we aimed to describe the epidemiology and the physiopathology of pancreatic injury in septic shock patients, to clarify whether it requires specific management and to assess its prognostic value. Our main finding is that pancreatic injury does not significantly affect the outcome in septic shock patients. Hence, increased serum pancreatic enzymes without clinical features of acute pancreatitis do not require further imaging investigations and specific therapeutic intervention. PMID:27559431

Assessing the shock state of the lunar highlands: Implications for the petrogenesis and chronology of crustal anorthosites.

PubMed

Pernet-Fisher, J F; Joy, K H; Martin, D J P; Donaldson Hanna, K L

2017-07-19

Our understanding of the formation and evolution of the primary lunar crust is based on geochemical systematics from the lunar ferroan anorthosite (FAN) suite. Recently, much effort has been made to understand this suite's petrologic history to constrain the timing of crystallisation and to interpret FAN chemical diversity. We investigate the shock histories of lunar anorthosites by combining Optical Microscope (OM) 'cold' cathodoluminescence (CL)-imaging and Fourier Transform Infrared (FTIR) spectroscopy analyses. In the first combined study of its kind, this study demonstrates that over ~4.5 Ga of impact processing, plagioclase is on average weakly shocked (<15 GPa) and examples of high shock states (>30 GPa; maskelynite) are uncommon. To investigate how plagioclase trace-element systematics are affected by moderate to weak shock (~5 to 30 GPa) we couple REE+Y abundances with FTIR analyses for FAN clasts from lunar meteorite Northwest Africa (NWA) 2995. We observe weak correlations between plagioclase shock state and some REE+Y systematics (e.g., La/Y and Sm/Nd ratios). This observation could prove significant to our understanding of how crystallisation ages are evaluated (e.g., plagioclase-whole rock Sm-Nd isochrons) and for what trace-elements can be used to differentiate between lunar lithologies and assess magma source compositional differences.

Shock wave treatment improves nerve regeneration in the rat.

PubMed

Mense, Siegfried; Hoheisel, Ulrich

2013-05-01

The aims of the experiments were to: (1) determine whether low-energy shock wave treatment accelerates the recovery of muscle sensitivity and functionality after a nerve lesion; and (2) assess the effect of shock waves on the regeneration of injured nerve fibers. After compression of a muscle nerve in rats the effects of shock wave treatment on the sequelae of the lesion were tested. In non-anesthetized animals, pressure pain thresholds and exploratory activity were determined. The influence of the treatment on the distance of nerve regeneration was studied in immunohistochemical experiments. Both behavioral and immunohistochemical data show that shock wave treatment accelerates the recovery of muscle sensitivity and functionality and promotes regeneration of injured nerve fibers. Treatment with focused shock waves induces an improvement of nerve regeneration in a rodent model of nerve compression. Copyright © 2012 Wiley Periodicals, Inc.

Towards Perfectly Absorbing Boundary Conditions for Euler Equations

NASA Technical Reports Server (NTRS)

Hayder, M. Ehtesham; Hu, Fang Q.; Hussaini, M. Yousuff

1997-01-01

In this paper, we examine the effectiveness of absorbing layers as non-reflecting computational boundaries for the Euler equations. The absorbing-layer equations are simply obtained by splitting the governing equations in the coordinate directions and introducing absorption coefficients in each split equation. This methodology is similar to that used by Berenger for the numerical solutions of Maxwell's equations. Specifically, we apply this methodology to three physical problems shock-vortex interactions, a plane free shear flow and an axisymmetric jet- with emphasis on acoustic wave propagation. Our numerical results indicate that the use of absorbing layers effectively minimizes numerical reflection in all three problems considered.

Modelling socio-metabolic transitions: The historical take-off, the acceleration of fossil fuel use, and the 1970s oil price shock - the first trigger of a future decline?

NASA Astrophysics Data System (ADS)

Wiedenhofer, Dominik; Rovenskaya, Elena; Krausmann, Fridolin; Haas, Willi; Fischer-Kowalski, Marina

2013-04-01

By talking about socio-metabolic transitions, we talk about changes in the energy base of socio-economic systems, leading to fundamental changes in social and environmental relations. This refers to the historical shift from a biomass-based (agrarian) economy to a fossil fuel based (industrial) economy just as much as to a future shift from fossil fuels to renewable energy carriers. In our presentation, • We will first show that this pattern of transition can be identified for most high income industrial countries: the later the transition started, the faster it proceeded, and the turning point to stabilization of metabolic rates in all of them happened in the early 1970ies. Due to the inherent non-linearity of this process, two approaches will be aplied to estimate parameters for the starting point, transition speed and saturation level: firstly a combination of an expontential and a generalized logistic function and secondly a Gompertz function. For both an iterative test procedure is applied to find the global minimum of the residual error for the whole function and all its parameters. This theory-based approach allows us to apply a robust methodology across all cases, thereby yielding results which can be generalized. • Next, we will show that this was not just a "historical" socio-ecological transition, however. Currently, a substantial number of countries comprising more than half of the world's population are following a similar transitional pathway at an ever accelerating pace. Based on empirical data on physical resource use and the above sketched methodology, we can show that these so-called emerging economies are currently in the take-off or acceleration phase of the very same transition. • Apart from these "endogenous" processes of socio-metabolic transition, we will investigate the effect of external shocks and their impact on the dynamics of energy and materials use. The first such shock we will explore is the oil crisis of 1972 that possibly triggered the end of rapid physical growth in high income countries. This could contribute to understanding the potential effect of other such shocks such as the rise in energy prices preceding the recent crisis, or future shocks related to the risks of nuclear energy or unconventional fossil fuels.

Dynamic comparisons of piezoelectric ejecta diagnostics

NASA Astrophysics Data System (ADS)

Buttler, W. T.; Zellner, M. B.; Olson, R. T.; Rigg, P. A.; Hixson, R. S.; Hammerberg, J. E.; Obst, A. W.; Payton, J. R.; Iverson, A.; Young, J.

2007-03-01

We investigate the quantitative reliability and precision of three different piezoelectric technologies for measuring ejected areal mass from shocked surfaces. Specifically we performed ejecta measurements on Sn shocked at two pressures, P ≈215 and 235 kbar. The shock in the Sn was created by launching a impactor with a powder gun. We self-compare and cross-compare these measurements to assess the ability of these probes to precisely determine the areal mass ejected from a shocked surface. We demonstrate the precision of each technology to be good, with variabilities on the order of ±10%. We also discuss their relative accuracy.

Diaphragm opening effects on shock wave formation and acceleration in a rectangular cross section channel

NASA Astrophysics Data System (ADS)

Pakdaman, S. A.; Garcia, M.; Teh, E.; Lincoln, D.; Trivedi, M.; Alves, M.; Johansen, C.

2016-11-01

Shock wave formation and acceleration in a high-aspect ratio cross section shock tube were studied experimentally and numerically. The relative importance of geometric effects and diaphragm opening time on shock formation are assessed. The diaphragm opening time was controlled through the use of slit-type (fast opening time) and petal-type (slow opening time) diaphragms. A novel method of fabricating the petal-type diaphragms, which results in a consistent burst pressure and symmetric opening without fragmentation, is presented. High-speed schlieren photography was used to visualize the unsteady propagation of the lead shock wave and trailing gas dynamic structures. Surface-mounted pressure sensors were used to capture the spatial and temporal development of the pressure field. Unsteady Reynolds-Averaged Navier-Stokes simulation predictions using the shear-stress-transport turbulence model are compared to the experimental data. Simulation results are used to explain the presence of high-frequency pressure oscillations observed experimentally in the driver section as well as the cause of the initial acceleration and subsequent rapid decay of shock velocity measured along the top and bottom channel surfaces. A one-dimensional theoretical model predicting the effect of the finite opening time of the diaphragm on the rate of driver depressurization and shock acceleration is proposed. The model removes the large amount of empiricism that accompanies existing models published in the literature. Model accuracy is assessed through comparisons with experiments and simulations. Limitations of and potential improvements in the model are discussed.

Surface Preparation Methods to Enhance Dynamic Surface Property Measurements of Shocked Metal Surfaces

NASA Astrophysics Data System (ADS)

Zellner, Michael; McNeil, Wendy; Gray, George, III; Huerta, David; King, Nicholas; Neal, George; Payton, Jeremy; Rubin, Jim; Stevens, Gerald; Turley, William; Buttler, William

2008-03-01

This effort investigates surface-preparation methods to enhance dynamic surface-property measurements of shocked metal surfaces. To assess the ability of making reliable and consistent dynamic surface-property measurements, the amount of material ejected from the free-surface upon shock release to vacuum (ejecta) was monitored for shocked Al-1100 and Sn targets. Four surface preparation methods were considered: fly-cut machined finish, diamond-turned machine finish, polished finish, and ball-rolled. The samples were shock loaded by in-contact detonation of HE PBX-9501 on the front-side of the metal coupons. Ejecta production at the back-side or free-side of the metal coupons was monitored using piezoelectric pins, optical shadowgraphy, and x-ray attenuation radiography.

Surface preparation methods to enhance dynamic surface property measurements of shocked metal surfaces

NASA Astrophysics Data System (ADS)

Zellner, M. B.; Vogan McNeil, W.; Gray, G. T.; Huerta, D. C.; King, N. S. P.; Neal, G. E.; Valentine, S. J.; Payton, J. R.; Rubin, J.; Stevens, G. D.; Turley, W. D.; Buttler, W. T.

2008-04-01

This effort investigates surface-preparation methods to enhance dynamic surface-property measurements of shocked metal surfaces. To assess the ability of making reliable and consistent dynamic surface-property measurements, the amount of material ejected from the free surface upon shock release to vacuum (ejecta) was monitored for shocked Al-1100 and Sn targets. Four surface-preparation methods were considered: Fly-cut machine finish, diamond-turned machine finish, polished finish, and ball rolled. The samples were shock loaded by in-contact detonation of HE PBX-9501 on the front side of the metal coupons. Ejecta production at the back side or free side of the metal coupons was monitored using piezoelectric pins, optical shadowgraphy, and x-ray attenuation radiography.

Guidance on the Assessment and Development of Insensitive Munitions (MURAT)

DTIC Science & Technology

2006-05-01

theoretical modelling . For this reason it is the best understood of all the areas on the flowchart. If the charge is already shocked by a previous impact...the initiation of heterogeneous high explosives due to shock waves are finite rate chemical reactions involved in the conversion of solid explosive ... explosive , increasing the chance of shock initiation (N26) Such an impact would have to take account of case material ahead of the fragment

A time-accurate high-resolution TVD scheme for solving the Navier-Stokes equations

NASA Technical Reports Server (NTRS)

Kim, Hyun Dae; Liu, Nan-Suey

1992-01-01

A total variation diminishing (TVD) scheme has been developed and incorporated into an existing time-accurate high-resolution Navier-Stokes code. The accuracy and the robustness of the resulting solution procedure have been assessed by performing many calculations in four different areas: shock tube flows, regular shock reflection, supersonic boundary layer, and shock boundary layer interactions. These numerical results compare well with corresponding exact solutions or experimental data.

Flow and Turbulence Modeling and Computation of Shock Buffet Onset for Conventional and Supercritical Airfoils

NASA Technical Reports Server (NTRS)

Bartels, Robert E.

1998-01-01

Flow and turbulence models applied to the problem of shock buffet onset are studied. The accuracy of the interactive boundary layer and the thin-layer Navier-Stokes equations solved with recent upwind techniques using similar transport field equation turbulence models is assessed for standard steady test cases, including conditions having significant shock separation. The two methods are found to compare well in the shock buffet onset region of a supercritical airfoil that involves strong trailing-edge separation. A computational analysis using the interactive-boundary layer has revealed a Reynolds scaling effect in the shock buffet onset of the supercritical airfoil, which compares well with experiment. The methods are next applied to a conventional airfoil. Steady shock-separated computations of the conventional airfoil with the two methods compare well with experiment. Although the interactive boundary layer computations in the shock buffet region compare well with experiment for the conventional airfoil, the thin-layer Navier-Stokes computations do not. These findings are discussed in connection with possible mechanisms important in the onset of shock buffet and the constraints imposed by current numerical modeling techniques.

Density Effects on Post-shock Turbulence Structure

NASA Astrophysics Data System (ADS)

Tian, Yifeng; Jaberi, Farhad; Livescu, Daniel; Li, Zhaorui; Michigan State University Collaboration; Los Alamos National Laboratory Collaboration; Texas A&M University-Corpus Christi Collaboration

2017-11-01

The effects of density variations due to mixture composition on post-shock turbulence structure are studied using turbulence-resolving shock-capturing simulations. This work extends the canonical Shock-Turbulence Interaction (STI) problem to involve significant variable density effects. The numerical method has been verified using a series of grid and LIA convergence tests, and is used to generate accurate post-shock turbulence data for a detailed flow study. Density effects on post-shock turbulent statistics are shown to be significant, leading to an increased amplification of turbulent kinetic energy (TKE). Eulerian and Lagrangian analyses show that the increase in the post-shock correlation between rotation and strain is weakened in the case with significant density variations (referred to as the ``multi-fluid'' case). Similar to previous single-fluid results and LIA predictions, the shock wave significantly changes the topology of the turbulent structures, exhibiting a symmetrization of the joint PDF of second and third invariant of the deviatoric part of velocity gradient tensor. In the multi-fluid case, this trend is more significant and mainly manifested in the heavy fluid regions. Lagrangian data are also used to study the evolution of turbulence structure away from the shock wave and assess the accuracy of Lagrangian dynamical models.

Relation between total shock energy and mortality in patients with implantable cardioverter-defibrillator.

PubMed

Tenma, Taro; Yokoshiki, Hisashi; Mitsuyama, Hirofumi; Watanabe, Masaya; Mizukami, Kazuya; Kamada, Rui; Takahashi, Masayuki; Sasaki, Ryo; Maeno, Motoki; Okamoto, Kaori; Chiba, Yuki; Anzai, Toshihisa

2018-05-15

Implantable Cardioverter-Defibrillator (ICD) shocks have been associated with mortality. However, no study has examined the relation between total shock energy and mortality. The aim of this study is to assess the association of total shock energy with mortality, and to determine the patients who are at risk of this association. Data from 316 consecutive patients who underwent initial ICD implantation in our hospital between 2000 and 2011 were retrospectively studied. We collected shock energy for 3 years from the ICD implantation, and determined the relation of shock energy on mortality after adjusting confounding factors. Eighty-seven ICD recipients experienced shock(s) within 3 years from ICD implantation and 43 patients had died during the follow-up. The amount of shock energy was significantly associated with all-cause death [adjusted hazard ratio (HR) 1.26 (per 100 joule increase), p < 0.01] and tended to be associated with cardiac death (adjusted HR 1.30, p = 0.08). The survival rate of patients with high shock energy accumulation (≥182 joule) was lower (p < 0.05), as compared to low shock energy accumulation (<182 joule), likewise to no shock. Besides, the relation between high shock energy accumulation and all-cause death was remarkable in the patients with low left ventricular ejection fraction (LVEF ≤40%) or atrial fibrillation (AF). Increase of shock energy was related to mortality in ICD recipients. This relation was evident in patients with low LVEF or AF. Copyright © 2018 Elsevier B.V. All rights reserved.

Monetary policy and the effects of oil price shocks on the Japanese economy

NASA Astrophysics Data System (ADS)

Lee, Byung Rhae

1998-12-01

The evidence of output decreases and price level increases following oil price shocks in the Japanese economy is presented in this paper. These negative effects of oil shocks are better explained by Hamilton's (1996) net oil price increase measure (NOPI) than by other oil measures. The fact that an oil shock has a statistically significant effect on the call money rate and real output and that the call money rate also has a statistically significant effect on real output appears to explain that the effects of oil price shocks on economic activity are partially attributed to contractionary monetary policy responses. The asymmetric effects of positive and negative oil shocks are also found in the Japanese economy and this asymmetry can also be partially explained by monetary policy responses. To assess the relative contribution of oil shocks and endogenous monetary policy responses to the economic downturns, I shut off the responses of the call money rate to oil shocks utilizing the impulse response results from the VAR model. Then, I re-run the VAR with the adjusted call money rate series. The empirical results show that around 30--40% of the negative effects of oil price shocks on the Japanese economy can be accounted for by oil shock induced monetary tightening.

Impaired left atrial function predicts inappropriate shocks in primary prevention implantable cardioverter-defibrillator candidates.

PubMed

Tao, Susumu; Ashikaga, Hiroshi; Ciuffo, Luisa A; Yoneyama, Kihei; Lima, Joao A C; Frank, Terry F; Weiss, Robert G; Tomaselli, Gordon F; Wu, Katherine C

2017-07-01

Inappropriate implantable cardioverter-defibrillator (ICD) shocks, commonly caused by atrial fibrillation (AF), are associated with an increased mortality. Because impaired left atrial (LA) function predicts development of AF, we hypothesized that impaired LA function predicts inappropriate shocks beyond a history of AF. We prospectively analyzed the association between LA function and incident inappropriate shocks in primary prevention ICD candidates. In the Prospective Observational Study of ICD (PROSE-ICD), we assessed LA function using tissue-tracking cardiac magnetic resonance (CMR) prior to ICD implantation. A total of 162 patients (113 males, age 56 ± 15 years) were included. During the mean follow-up of 4.0 ± 2.9 years, 26 patients (16%) experienced inappropriate shocks due to AF (n = 19; 73%), supraventricular tachycardia (n = 5; 19%), and abnormal sensing (n = 2; 8%). In univariable analyses, inappropriate shocks were associated with AF history prior to ICD implantation, age below 70 years, QRS duration less than 120 milliseconds, larger LA minimum volume, lower LA stroke volume, lower LA emptying fraction, impaired LA maximum and preatrial contraction strains (S max and S preA ), and impaired LA strain rate during left ventricular systole and atrial contraction (SR s and SR a ). In multivariable analysis, impaired S max (hazard ratio [HR]: 0.96, P = 0.044), S preA (HR: 0.94, P = 0.030), and SR a (HR: 0.25, P < 0.001) were independently associated with inappropriate shocks. The receiver-operating characteristics curve showed that SR a improved the predictive value beyond the patient demographics including AF history (P = 0.033). Impaired LA function assessed by tissue-tracking CMR is an independent predictor of inappropriate shocks in primary prevention ICD candidates beyond AF history. © 2017 Wiley Periodicals, Inc.

Impact of aging and comorbidity on the efficacy of low-intensity shock wave therapy for erectile dysfunction.

PubMed

Hisasue, Shin-ichi; China, Toshiyuki; Horiuchi, Akira; Kimura, Masaki; Saito, Keisuke; Isotani, Shuji; Ide, Hisamitsu; Muto, Satoru; Yamaguchi, Raizo; Horie, Shigeo

2016-01-01

To evaluate the efficacy of low-intensity shock wave therapy and to identify the predictive factors of its efficacy in Japanese patients with erectile dysfunction. The present study included 57 patients with erectile dysfunction who satisfied all the following conditions: more than 6-months history of erectile dysfunction, sexual health inventory for men score of ≤ 12 without phosphodiesterase type-5 inhibitor, erection hardness score grade 1 or 2, mean penile circumferential change by erectometer assessing sleep related erection of < 25 mm and non-neurological pathology. Patients were treated by a low-energy shock waves generator (ED1000; Medispec, Gaithersburg, MD, USA). A total of 12 shock wave treatments were applied. Sexual health inventory for men score, erection hardness score with or without phosphodiesterase type-5 inhibitor, and mean penile circumferential change were assessed at baseline, 1, 3 and 6 months after the termination of low-intensity shock wave therapy. Of 57 patients who were assigned for the low-intensity shock wave therapy trial, 56 patients were analyzed. Patients had a median age of 64 years. The sexual health inventory for men and erection hardness score (with and without phosphodiesterase type-5 inhibitor) were significantly increased (P < 0.001) at each time-point. The mean penile circumferential change was also increased from 13.1 to 20.2 mm after low-intensity shock wave therapy (P < 0.001). In the multivariate analysis, age and the number of concomitant comorbidities were statistically significant predictors for the efficacy. Low-intensity shock wave therapy seems to be an effective physical therapy for erectile dysfunction. Age and comorbidities are negative predictive factors of therapeutic response. © 2015 The Japanese Urological Association.

The Synchrotron Shock Model Confronts a "Line of Death" in the BATSE Gamma-Ray Burst Data

NASA Technical Reports Server (NTRS)

Preece, Robert D.; Briggs, Michael S.; Mallozzi, Robert S.; Pendleton, Geoffrey N.; Paciesas, W. S.; Band, David L.

1998-01-01

The synchrotron shock model (SSM) for gamma-ray burst emission makes a testable prediction: that the observed low-energy power-law photon number spectral index cannot exceed -2/3 (where the photon model is defined with a positive index: $dN/dE \\propto E{alpha}$). We have collected time-resolved spectral fit parameters for over 100 bright bursts observed by the Burst And Transient Source Experiment on board the {\\it Compton Gamma Ray Observatory}. Using this database, we find 23 bursts in which the spectral index limit of the SSM is violated, We discuss elements of the analysis methodology that affect the robustness of this result, as well as some of the escape hatches left for the SSM by theory.

Numerical study of blast characteristics from detonation of homogeneous explosives

NASA Astrophysics Data System (ADS)

Balakrishnan, Kaushik; Genin, Franklin; Nance, Doug V.; Menon, Suresh

2010-04-01

A new robust numerical methodology is used to investigate the propagation of blast waves from homogeneous explosives. The gas-phase governing equations are solved using a hybrid solver that combines a higher-order shock capturing scheme with a low-dissipation central scheme. Explosives of interest include Nitromethane, Trinitrotoluene, and High-Melting Explosive. The shock overpressure and total impulse are estimated at different radial locations and compared for the different explosives. An empirical scaling correlation is presented for the shock overpressure, incident positive phase pressure impulse, and total impulse. The role of hydrodynamic instabilities to the blast effects of explosives is also investigated in three dimensions, and significant mixing between the detonation products and air is observed. This mixing results in afterburn, which is found to augment the impulse characteristics of explosives. Furthermore, the impulse characteristics are also observed to be three-dimensional in the region of the mixing layer. This paper highlights that while some blast features can be successfully predicted from simple one-dimensional studies, the growth of hydrodynamic instabilities and the impulsive loading of homogeneous explosives require robust three-dimensional investigation.

Quantitative Phosphoproteomics Reveals the Role of Protein Arginine Phosphorylation in the Bacterial Stress Response*

PubMed Central

Schmidt, Andreas; Trentini, Débora Broch; Spiess, Silvia; Fuhrmann, Jakob; Ammerer, Gustav; Mechtler, Karl; Clausen, Tim

2014-01-01

Arginine phosphorylation is an emerging protein modification implicated in the general stress response of Gram-positive bacteria. The modification is mediated by the arginine kinase McsB, which phosphorylates and inactivates the heat shock repressor CtsR. In this study, we developed a mass spectrometric approach accounting for the peculiar chemical properties of phosphoarginine. The improved methodology was used to analyze the dynamic changes in the Bacillus subtilis arginine phosphoproteome in response to different stress situations. Quantitative analysis showed that a B. subtilis mutant lacking the YwlE arginine phosphatase accumulated a strikingly large number of arginine phosphorylations (217 sites in 134 proteins), however only a minor fraction of these sites was increasingly modified during heat shock or oxidative stress. The main targets of McsB-mediated arginine phosphorylation comprise central factors of the stress response system including the CtsR and HrcA heat shock repressors, as well as major components of the protein quality control system such as the ClpCP protease and the GroEL chaperonine. These findings highlight the impact of arginine phosphorylation in orchestrating the bacterial stress response. PMID:24263382

Retroreflective Background Oriented Schlieren Imaging Results from the NASA Plume/Shock Interaction Test

NASA Technical Reports Server (NTRS)

Smith, Nathanial T.; Durston, Donald A.; Heineck, James T.

2017-01-01

In support of NASA's Commercial Supersonics Technology (CST) project, a test was conducted in the 9-by-7 ft. supersonic section of the NASA Ames Unitary Plan Wind Tunnel (UPWT). The tests were designed to study the interaction of shocks with a supersonic jet characteristic of those that may occur on a commercial supersonic aircraft. Multiple shock generating geometries were tested to examine the interaction dynamics as they pertain to sonic boom mitigation. An integral part of the analyses of these interactions are the interpretation of the data generated from the retroreflective Background Oriented Schlieren (RBOS) imaging technique employed for this test. The regularization- based optical flow methodology used to generate these data is described. Sample results are compared to those using normalized cross-correlation. The reduced noise, additional feature detail, and fewer false artifacts provided by the optical flow technique produced clearer time-averaged images, allowing for better interpretation of the underlying flow phenomena. These images, coupled with pressure signatures in the near field, are used to provide an overview of the detailed interaction flowfields.

Quantitative phosphoproteomics reveals the role of protein arginine phosphorylation in the bacterial stress response.

PubMed

Schmidt, Andreas; Trentini, Débora Broch; Spiess, Silvia; Fuhrmann, Jakob; Ammerer, Gustav; Mechtler, Karl; Clausen, Tim

2014-02-01

Arginine phosphorylation is an emerging protein modification implicated in the general stress response of Gram-positive bacteria. The modification is mediated by the arginine kinase McsB, which phosphorylates and inactivates the heat shock repressor CtsR. In this study, we developed a mass spectrometric approach accounting for the peculiar chemical properties of phosphoarginine. The improved methodology was used to analyze the dynamic changes in the Bacillus subtilis arginine phosphoproteome in response to different stress situations. Quantitative analysis showed that a B. subtilis mutant lacking the YwlE arginine phosphatase accumulated a strikingly large number of arginine phosphorylations (217 sites in 134 proteins), however only a minor fraction of these sites was increasingly modified during heat shock or oxidative stress. The main targets of McsB-mediated arginine phosphorylation comprise central factors of the stress response system including the CtsR and HrcA heat shock repressors, as well as major components of the protein quality control system such as the ClpCP protease and the GroEL chaperonine. These findings highlight the impact of arginine phosphorylation in orchestrating the bacterial stress response.

Assessment of In Situ Time Resolved Shock Experiments at Synchrotron Light Sources*

NASA Astrophysics Data System (ADS)

Belak, J.; Ilavsky, J.; Hessler, J. P.

2005-07-01

Prior to fielding in situ time resolved experiments of shock wave loading at the Advanced Photon Source, we have performed feasibility experiments assessing a single photon bunch. Using single and poly-crystal Al, Ti, V and Cu shock to incipient spallation on the gas gun, samples were prepared from slices normal to the spall plane of thickness 100-500 microns. In addition, single crystal Al of thickness 500 microns was shocked to incipient spallation and soft recovered using the LLNL e-gun mini-flyer system. The e-gun mini-flyer impacts the sample target producing a 10's ns flat-top shock transient. Here, we present results for imaging, small-angle scattering (SAS), and diffraction. In particular, there is little SAS away from the spall plane and significant SAS at the spall plane, demonstrating the presence of sub-micron voids. * Use of the Advanced Photon Source was supported by the U. S. Department of Energy, Office of Science, Office of Basic Energy Sciences, under Contract No. W-31-109-Eng-38 and work performed under the auspices of the U.S. Department of Energy by University of California, Lawrence Livermore National Laboratory under Contract W-7405-Eng-48.

Experimental Study of Hypersonic Wing/Fin Root Heating at Mach 8

DTIC Science & Technology

2012-12-27

at 700%, 200% and 60% for 45?, 55? and 65? of sweep respectively. 15. SUBJECT TERMS Hypersonics, Hypersonic Test Facilities , Shock Tunnels , wing...consisting of a flat plate and a cylinder with an adjustable sweep angle. The tests were conducted in the T4 shock tunnel at conditions simulating Mach 8...root experiment began with an assessment of design considerations for the experiment and the parameters of the T4 shock tunnel facilities. A CAD

Pretest predictions of surface strain and fluid pressures in mercury targets undergoing thermal shock

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

Taleyarkhan, R.P.; Kim, S.H.; Haines, J.

The authors provide a perspective overview of pretest modeling and analysis work related to thermal shock effects in spallation neutron source targets that were designed for conducting thermal shock experiments at the Los Alamos Neutron Science Center (LANSCE). Data to be derived are to be used for benchmarking computational tools as well as to assess the efficacy of optical gauges for monitoring dynamic fluid pressures and phenomena such as the onset of cavitation.

Shock-treated Lunar Soil Simulant: Preliminary Assessment as a Construction Material

NASA Technical Reports Server (NTRS)

Boslough, Mark B.; Bernold, Leonhard E.; Horie, Yasuyuki

1992-01-01

In an effort to examine the feasibility of applying dynamic compaction techniques to fabricate construction materials from lunar regolith, preliminary explosive shock-loading experiments on lunar soil simulants were carried out. Analysis of our shock-treated samples suggests that binding additives, such as metallic aluminum powder, may provide the necessary characteristics to fabricate a strong and durable building material (lunar adobe) that takes advantage of a cheap base material available in abundance: lunar regolith.

Proposal for a method to estimate nutrient shock effects in bacteria

PubMed Central

2012-01-01

Background Plating methods are still the golden standard in microbiology; however, some studies have shown that these techniques can underestimate the microbial concentrations and diversity. A nutrient shock is one of the mechanisms proposed to explain this phenomenon. In this study, a tentative method to assess nutrient shock effects was tested. Findings To estimate the extent of nutrient shock effects, two strains isolated from tap water (Sphingomonas capsulata and Methylobacterium sp.) and two culture collection strains (E. coli CECT 434 and Pseudomonas fluorescens ATCC 13525) were exposed both to low and high nutrient conditions for different times and then placed in low nutrient medium (R2A) and rich nutrient medium (TSA). The average improvement (A.I.) of recovery between R2A and TSA for the different times was calculated to more simply assess the difference obtained in culturability between each medium. As expected, A.I. was higher when cells were plated after the exposition to water than when they were recovered from high-nutrient medium showing the existence of a nutrient shock for the diverse bacteria used. S. capsulata was the species most affected by this phenomenon. Conclusions This work provides a method to consistently determine the extent of nutrient shock effects on different microorganisms and hence quantify the ability of each species to deal with sudden increases in substrate concentration. PMID:22873690

Suppression of large intraluminal bubble expansion in shock wave lithotripsy without compromising stone comminution: Methodology and in vitro experiments

NASA Astrophysics Data System (ADS)

Zhong, Pei; Zhou, Yufeng

2001-12-01

To reduce the potential of vascular injury without compromising the stone comminution capability of a Dornier HM-3 lithotripter, we have devised a method to suppress intraluminal bubble expansion via in situ pulse superposition. A thin shell ellipsoidal reflector insert was designed and fabricated to fit snugly into the original reflector of an HM-3 lithotripter. The inner surface of the reflector insert shares the same first focus with the original HM-3 reflector, but has its second focus located 5 mm proximal to the generator than that of the HM-3 reflector. With this modification, the original lithotripter shock wave is partitioned into a leading lithotripter pulse (peak positive pressure of 46 MPa and positive pulse duration of 1 μs at 24 kV) and an ensuing second compressive wave of 10 MPa peak pressure and 2 μs pulse duration, separated from each other by about 4 μs. Superposition of the two waves leads to a selective truncation of the trailing tensile component of the lithotripter shock wave, and consequently, a reduction in the maximum bubble expansion up to 41% compared to that produced by the original reflector. The pulse amplitude and -6 dB beam width of the leading lithotripter shock wave from the upgraded reflector at 24 kV are comparable to that produced by the original HM-3 reflector at 20 kV. At the lithotripter focus, while only about 30 shocks are needed to cause a rupture of a blood vessel phantom made of cellulose hollow fiber (i.d.=0.2 mm) using the original HM-3 reflector at 20 kV, no rupture could be produced after 200 shocks using the upgraded reflector at 24 kV. On the other hand, after 100 shocks the upgraded reflector at 24 kV can achieve a stone comminution efficiency of 22%, which is better than the 18% efficiency produced by the original reflector at 20 kV (p=0.043). All together, it has been shown in vitro that the upgraded reflector can produce satisfactory stone comminution while significantly reducing the potential for vessel rupture in shock wave lithotripsy.

Effect of extracorporeal cytokine removal on vascular barrier function in a septic shock patient.

PubMed

David, Sascha; Thamm, Kristina; Schmidt, Bernhard M W; Falk, Christine S; Kielstein, Jan T

2017-01-01

Sepsis and septic shock are major healthcare problems, affecting millions of individuals around the world each year. Pathophysiologically, septic multiple organ dysfunction (MOD) is a life-threatening condition caused by an overwhelming systemic inflammatory response of the host's organism to an infection. We experimentally tested if high circulating cytokine levels might increase vascular permeability-a critical hallmark of the disease-and if this phenomenon can be reversed by therapeutic cytokine removal (CytoSorb®) in an exemplary patient. A 32-year-old Caucasian female presented with septic shock and accompanying acute kidney injury (Sequential Organ Failure Assessment (SOFA) = 18) to our ICU. In spite of a broad anti-infective regimen, adequate fluid resuscitation, and high doses of inotropics and catecholamines, she remained refractory hypotensive. The extraordinary severity of septic shock suggested an immense overwhelming host response assumingly accompanied by a notable cytokine storm such as known from patients with toxic shock syndrome. Thus, a CytoSorb® filter was added to the dialysis circuit to remove excess shock-perpetuating cytokines. To analyze the endothelial phenotype in vitro before and after extracorporeal cytokine removal, we tested the septic shock patient's serum on human umbilical vein endothelial cells (HUVECs). The effect on endothelial integrity was assessed both on the morphological (fluorescent immunocytochemistry for VE-cadherin and F-actin) and functional (transendothelial electrical resistance (TER)) level that was recorded in real time with an "electric cell-substrate impedance sensing" (ECIS) system (ibidi). We found (1) severe alterations of cell-cell contacts and the cytoskeletal architecture and (2) profound functional permeability changes, the putative cellular correlate of the clinical vascular leakage syndrome. However, the endothelial barrier was protected from these profound adverse effects when HUVECs were challenged with septic shock serum that was collected after extracorporeal cytokine removal. Beneficial observations of extracorporeal cytokine removal in septic shock patients might-at least in part-be promoted via protection of vascular barrier function.

Performance assessment of conventional and base-isolated nuclear power plants for earthquake and blast loadings

NASA Astrophysics Data System (ADS)

Huang, Yin-Nan

Nuclear power plants (NPPs) and spent nuclear fuel (SNF) are required by code and regulations to be designed for a family of extreme events, including very rare earthquake shaking, loss of coolant accidents, and tornado-borne missile impacts. Blast loading due to malevolent attack became a design consideration for NPPs and SNF after the terrorist attacks of September 11, 2001. The studies presented in this dissertation assess the performance of sample conventional and base isolated NPP reactor buildings subjected to seismic effects and blast loadings. The response of the sample reactor building to tornado-borne missile impacts and internal events (e.g., loss of coolant accidents) will not change if the building is base isolated and so these hazards were not considered. The sample NPP reactor building studied in this dissertation is composed of containment and internal structures with a total weight of approximately 75,000 tons. Four configurations of the reactor building are studied, including one conventional fixed-base reactor building and three base-isolated reactor buildings using Friction Pendulum(TM), lead rubber and low damping rubber bearings. The seismic assessment of the sample reactor building is performed using a new procedure proposed in this dissertation that builds on the methodology presented in the draft ATC-58 Guidelines and the widely used Zion method, which uses fragility curves defined in terms of ground-motion parameters for NPP seismic probabilistic risk assessment. The new procedure improves the Zion method by using fragility curves that are defined in terms of structural response parameters since damage and failure of NPP components are more closely tied to structural response parameters than to ground motion parameters. Alternate ground motion scaling methods are studied to help establish an optimal procedure for scaling ground motions for the purpose of seismic performance assessment. The proposed performance assessment procedure is used to evaluate the vulnerability of the conventional and base-isolated NPP reactor buildings. The seismic performance assessment confirms the utility of seismic isolation at reducing spectral demands on secondary systems. Procedures to reduce the construction cost of secondary systems in isolated reactor buildings are presented. A blast assessment of the sample reactor building is performed for an assumed threat of 2000 kg of TNT explosive detonated on the surface with a closest distance to the reactor building of 10 m. The air and ground shock waves produced by the design threat are generated and used for performance assessment. The air blast loading to the sample reactor building is computed using a Computational Fluid Dynamics code Air3D and the ground shock time series is generated using an attenuation model for soil/rock response. Response-history analysis of the sample conventional and base isolated reactor buildings to external blast loadings is performed using the hydrocode LS-DYNA. The spectral demands on the secondary systems in the isolated reactor building due to air blast loading are greater than those for the conventional reactor building but much smaller than those spectral demands associated with Safe Shutdown Earthquake shaking. The isolators are extremely effective at filtering out high acceleration, high frequency ground shock loading.

Experts' recommendations for the management of cardiogenic shock in children.

PubMed

Brissaud, Olivier; Botte, Astrid; Cambonie, Gilles; Dauger, Stéphane; de Saint Blanquat, Laure; Durand, Philippe; Gournay, Véronique; Guillet, Elodie; Laux, Daniela; Leclerc, Francis; Mauriat, Philippe; Boulain, Thierry; Kuteifan, Khaldoun

2016-12-01

Cardiogenic shock which corresponds to an acute state of circulatory failure due to impairment of myocardial contractility is a very rare disease in children, even more than in adults. To date, no international recommendations regarding its management in critically ill children are available. An experts' recommendations in adult population have recently been made (Levy et al. Ann Intensive Care 5(1):52, 2015; Levy et al. Ann Intensive Care 5(1):26, 2015). We present herein recommendations for the management of cardiogenic shock in children, developed with the grading of recommendations' assessment, development, and evaluation system by an expert group of the Groupe Francophone de Réanimation et Urgences Pédiatriques (French Group for Pediatric Intensive Care and Emergencies). The recommendations cover four major fields of application such as: recognition of early signs of shock and the patient pathway, management principles and therapeutic goals, monitoring hemodynamic and biological variables, and circulatory support (indications, techniques, organization, and transfer criteria). Major principle care for children with cardiogenic shock is primarily based on clinical and echocardiographic assessment. There are few drugs reported as effective in childhood in the medical literature. The use of circulatory support should be facilitated in terms of organization and reflected in the centers that support these children. Children with cardiogenic shock are vulnerable and should be followed regularly by intensivist cardiologists and pediatricians. The experts emphasize the multidisciplinary nature of management of children with cardiogenic shock and the importance of effective communication between emergency medical assistance teams (SAMU), mobile pediatric emergency units (SMUR), pediatric emergency departments, pediatric cardiology and cardiac surgery departments, and pediatric intensive care units.

Effects of nonuniform Mach-number entrance on scramjet nozzle flowfield and performance

NASA Astrophysics Data System (ADS)

Zhang, Pu; Xu, Jinglei; Quan, Zhibin; Mo, Jianwei

2016-12-01

Considering the non-uniformities of nozzle entrance influenced by the upstream, the effects of nonuniform Mach-number coupled with shock and expansion-wave on the flowfield and performances of single expansion ramp nozzle (SERN) are numerically studied using Reynolds-Averaged Navier-Stokes equations. The adopted Reynolds-averaged Navier-Stokes methodology is validated by comparing the numerical results with the cold experimental data, and the average method used in this paper is discussed. Uniform and nonuniform facility nozzles are designed to generate different Mach-number profile for the inlet of SERN, which is direct-connected with different facility nozzle, and the whole flowfield is simulated. Because of the coupling of shock and expansion-wave, flow direction of nonuniform SERN entrance is distorted. Compared with Mach contour of uniform case, the line is more curved for coupling shock-wave entrance (SWE) case, and flatter for the coupling expansion-wave entrance (EWE) case. Wall pressure distribution of SWE case appears rising region, whereas decreases like stairs of EWE case. The numerical results reveal that the coupled shock and expansion-wave play significant roles on nozzle performances. Compared with the SERN performances of uniform entrance case at the same work conditions, the thrust of nonuniform entrance cases reduces by 3-6%, pitch moment decreases by 2.5-7%. The negative lift presents an incremental trend with EWE while the situation is the opposite with SWE. These results confirm that considering the entrance flow parameter nonuniformities of a scramjet nozzle coupled with shock or expansion-wave from the upstream is necessary.

Estimates of immediate effects on world markets of a hypothetical disruption to Russia’s supply of six mineral commodities

USGS Publications Warehouse

Safirova, Elena; Barry, James J.; Hastorun, Sinan; Matos, Grecia R.; Perez, Alberto Alexander; Bedinger, George M.; Bray, E. Lee; Jasinski, Stephen M.; Kuck, Peter H.; Loferski, Patricia J.

2017-05-18

The potential immediate effects of a hypothetical shock to Russia’s supply of selected mineral commodities on the world market and on individual countries were determined and monetized (in 2014 U.S. dollars). The mineral commodities considered were aluminum (refined primary), nickel (refined primary), palladium (refined) and platinum (refined), potash, and titanium (mill products), and the regions and countries of primary interest were the United States, the European Union (EU–28), and China. The shock is assumed to have infinite duration, but only the immediate effects, those limited by a 1-year period, are considered.A methodology for computing and monetizing the potential impacts was developed. Then the data pertaining to all six mineral commodities were collected and the most likely effects were computed. Because of the uncertainties associated with some of the data, sensitivity analyses were conducted to confirm the validity of the results.Results indicate that the impact on the United States arising from a shock to Russia’s supply, in terms of the value of net exports, would range from a gain of \\$336 million for titanium mill products to a loss of \\$237 million for potash; thus, the overall effect of a supply shock is likely to be quite modest. The study also demonstrates that, taken alone, Russia’s share in the world production of a particular commodity is not necessarily indicative of the size of potential impacts resulting from a supply shock; other factors, such as prices, domestic production, and the structure of international commodity flows were found to be important as well.

An overview of research on waverider design methodology

NASA Astrophysics Data System (ADS)

Ding, Feng; Liu, Jun; Shen, Chi-bing; Liu, Zhen; Chen, Shao-hua; Fu, Xiang

2017-11-01

A waverider is any supersonic or hypersonic lifting body that is characterized by an attached, or nearly attached, bow shock wave along its leading edge. As a waverider can possess a high lift-to-drag ratio as well as an ideal precompression surface of the inlet system, it has become one of the most promising designs for air-breathing hypersonic vehicles. This paper reviews and classifies waverider design methodologies developed by local and foreign scholars up until 2016. The design concept of a waverider can be summarized as follows: modeling of the basic flow field is used to design the waverider in the streamwise direction and the osculating theory is used to design the waverider in the spanwise direction.

Juncture flow improvement for wing/pylon configurations by using CFD methodology

NASA Technical Reports Server (NTRS)

Gea, Lie-Mine; Chyu, Wei J.; Stortz, Michael W.; Chow, Chuen-Yen

1993-01-01

Transonic flow field around a fighter wing/pylon configuration was simulated by using an implicit upwinding Navier-Stokes flow solver (F3D) and overset grid technology (Chimera). Flow separation and local shocks near the wing/pylon junction were observed in flight and predicted by numerical calculations. A new pylon/fairing shape was proposed to improve the flow quality. Based on numerical results, the size of separation area is significantly reduced and the onset of separation is delayed farther downstream. A smoother pressure gradient is also obtained near the junction area. This paper demonstrates that computational fluid dynamics (CFD) methodology can be used as a practical tool for aircraft design.

The Shock Index revisited – a fast guide to transfusion requirement? A retrospective analysis on 21,853 patients derived from the TraumaRegister DGU®

PubMed Central

2013-01-01

Introduction Isolated vital signs (for example, heart rate or systolic blood pressure) have been shown unreliable in the assessment of hypovolemic shock. In contrast, the Shock Index (SI), defined by the ratio of heart rate to systolic blood pressure, has been advocated to better risk-stratify patients for increased transfusion requirements and early mortality. Recently, our group has developed a novel and clinical reliable classification of hypovolemic shock based upon four classes of worsening base deficit (BD). The objective of this study was to correlate this classification to corresponding strata of SI for the rapid assessment of trauma patients in the absence of laboratory parameters. Methods Between 2002 and 2011, data for 21,853 adult trauma patients were retrieved from the TraumaRegister DGU® database and divided into four strata of worsening SI at emergency department arrival (group I, SI <0.6; group II, SI ≥0.6 to <1.0; group III, SI ≥1.0 to <1.4; and group IV, SI ≥1.4) and were assessed for demographics, injury characteristics, transfusion requirements, fluid resuscitation and outcomes. The four strata of worsening SI were compared with our recently suggested BD-based classification of hypovolemic shock. Results Worsening of SI was associated with increasing injury severity scores from 19.3 (± 12) in group I to 37.3 (± 16.8) in group IV, while mortality increased from 10.9% to 39.8%. Increments in SI paralleled increasing fluid resuscitation, vasopressor use and decreasing hemoglobin, platelet counts and Quick’s values. The number of blood units transfused increased from 1.0 (± 4.8) in group I to 21.4 (± 26.2) in group IV patients. Of patients, 31% in group III and 57% in group IV required ≥10 blood units until ICU admission. The four strata of SI discriminated transfusion requirements and massive transfusion rates equally with our recently introduced BD-based classification of hypovolemic shock. Conclusion SI upon emergency department arrival may be considered a clinical indicator of hypovolemic shock in respect to transfusion requirements, hemostatic resuscitation and mortality. The four SI groups have been shown to equal our recently suggested BD-based classification. In daily clinical practice, SI may be used to assess the presence of hypovolemic shock if point-of-care testing technology is not available. PMID:23938104

The Accuracy of Shock Capturing in Two Spatial Dimensions

NASA Technical Reports Server (NTRS)

Carpenter, Mark H.; Casper, Jay H.

1997-01-01

An assessment of the accuracy of shock capturing schemes is made for two-dimensional steady flow around a cylindrical projectile. Both a linear fourth-order method and a nonlinear third-order method are used in this study. It is shown, contrary to conventional wisdom, that captured two-dimensional shocks are asymptotically first-order, regardless of the design accuracy of the numerical method. The practical implications of this finding are discussed in the context of the efficacy of high-order numerical methods for discontinuous flows.

Vulnerability to shocks in the global seafood trade network

NASA Astrophysics Data System (ADS)

Gephart, Jessica A.; Rovenskaya, Elena; Dieckmann, Ulf; Pace, Michael L.; Brännström, Åke

2016-03-01

Trade can allow countries to overcome local or regional losses (shocks) to their food supply, but reliance on international food trade also exposes countries to risks from external perturbations. Countries that are nutritionally or economically dependent on international trade of a commodity may be adversely affected by such shocks. While exposure to shocks has been studied in financial markets, communication networks, and some infrastructure systems, it has received less attention in food-trade networks. Here, we develop a forward shock-propagation model to quantify how trade flows are redistributed under a range of shock scenarios and assess the food-security outcomes by comparing changes in national fish supplies to indices of each country’s nutritional fish dependency. Shock propagation and distribution among regions are modeled on a network of historical bilateral seafood trade data from UN Comtrade using 205 reporting territories grouped into 18 regions. In our model exposure to shocks increases with total imports and the number of import partners. We find that Central and West Africa are the most vulnerable to shocks, with their vulnerability increasing when a willingness-to-pay proxy is included. These findings suggest that countries can reduce their overall vulnerability to shocks by reducing reliance on imports and diversifying food sources. As international seafood trade grows, identifying these types of potential risks and vulnerabilities is important to build a more resilient food system.

Aversive conditioning in honey bees (Apis mellifera anatolica): a comparison of drones and workers.

PubMed

Dinges, Christopher W; Avalos, Arian; Abramson, Charles I; Craig, David Philip Arthur; Austin, Zoe M; Varnon, Christopher A; Dal, Fatima Nur; Giray, Tugrul; Wells, Harrington

2013-11-01

Honey bees provide a model system to elucidate the relationship between sociality and complex behaviors within the same species, as females (workers) are highly social and males (drones) are more solitary. We report on aversive learning studies in drone and worker honey bees (Apis mellifera anatolica) in escape, punishment and discriminative punishment situations. In all three experiments, a newly developed electric shock avoidance assay was used. The comparisons of expected and observed responses were performed with conventional statistical methods and a systematic randomization modeling approach called object oriented modeling. The escape experiment consisted of two measurements recorded in a master-yoked paradigm: frequency of response and latency to respond following administration of shock. Master individuals could terminate an unavoidable shock triggered by a decrementing 30 s timer by crossing the shuttlebox centerline following shock activation. Across all groups, there was large individual response variation. When assessing group response frequency and latency, master subjects performed better than yoked subjects for both workers and drones. In the punishment experiment, individuals were shocked upon entering the shock portion of a bilaterally wired shuttlebox. The shock portion was spatially static and unsignalled. Only workers effectively avoided the shock. The discriminative punishment experiment repeated the punishment experiment but included a counterbalanced blue and yellow background signal and the side of shock was manipulated. Drones correctly responded less than workers when shock was paired with blue. However, when shock was paired with yellow there was no observable difference between drones and workers.

On the propagation and multiple reflections of a blast wave travelling through a dusty gas in a closed box

NASA Astrophysics Data System (ADS)

Lappa, Marcello; Drikakis, Dimitris; Kokkinakis, Ioannis

2017-03-01

This paper concerns the propagation of shock waves in an enclosure filled with dusty gas. The main motivation for this problem is to probe the effect on such dynamics of solid particles dispersed in the fluid medium. This subject, which has attracted so much attention over recent years given its important implications in the study of the structural stability of systems exposed to high-energy internal detonations, is approached here in the framework of a hybrid numerical two-way coupled Eulerian-Lagrangian methodology. In particular, insights are sought by considering a relatively simple archetypal setting corresponding to a shock wave originating from a small spherical region initialized on the basis of available analytic solutions. The response of the system is explored numerically with respect to several parameters, including the blast intensity (via the related value of the initial shock Mach number), the solid mass fraction (mass load), and the particle size (Stokes number). Results are presented in terms of pressure-load diagrams. Beyond practical applications, it is shown that a kaleidoscope of fascinating patterns is produced by the "triadic" relationships among multiple shock reflection events and particle-fluid and particle-wall interaction dynamics. These would be of great interest to researchers and scientists interested in fundamental problems relating to the general theory of pattern formation in complex nonlinear multiphase systems.

25 Years of ESWL — From the Past to the Future

NASA Astrophysics Data System (ADS)

Forssmann, Bernd

2006-05-01

It was a revolution in the treatment of urolithiasis 25 years ago, when the first extracorporeal shock wave lithotripsy (ESWL) was carried out on the prototype HM1 equipped with an electrohydraulic shock wave source. Further developments led to the HM3, the legendary bath tub that is used with high success to this day. The history of investigations to disintegrate urinary stone with one shock wave pulse by means of high power is described. Break trough for clinical application was achieved when the shock waves were applied in a sequence of pulses with low energy. In the late eighties the effectiveness of second generation lithotripters wase only judged by means of peak pressure and focal extension so that effectiveness was often misinterpreted. Despite standardization of shock wave parameters the assessment of lithotripters remains unsatisfactory. The concept of effective energy considers the whole temporal and spatial field of the shock wave and allows to determine the energy dose of stone disintegration. Thus, clinical energy dose is expected to reveal additional information to evaluate the success of shock wave lithotripsy in terms of fragmentation and side effects.

Lunar and Planetary Science XXXV: Effects of Impacts: Shock and Awe

NASA Technical Reports Server (NTRS)

Kyte, F. T.; Koeberl, C.

2004-01-01

This document discusses the following topics: Zircon as a Shock Indicator in Impactites of Drill Core Yaxcopoil-1, Chicxulub Impact Structure, Mexico; Experimental Investigation of Shock Effects in a Metapelitic Granulite; Experimental Reproduction of Shock Veins in Single-Crystal Minerals; Post-Shock Crystal-Plastic Processes in Quartz from Crystalline Target Rocks of the Charlevoix Impact Structure; Shock Reequilibration of Fluid Inclusions; How Does Tektite Glass Lose Its Water?; Assessing the Role of Anhydrite in the KT Mass Extinction: Hints from Shock-loading Experiments; A Mineralogical and Geochemical Study of the Nonmarine Permian/Triassic Boundary in the Southern Karoo Basin, South Africa; Extraterrestrial Chromium in the Permian-Triassic Boundary at Graphite Peak, Antarctica; Magnetic Fe,Si,Al-rich Impact Spherules from the P-T Boundary Layer at Graphite Peak, Antarctica; A Newly Recognized Late Archean Impact Spherule Layer in the Reivilo Formation, Griqualand West Basin, South Africa; Initial Cr-Isotopic and Iridium Measurements of Concentrates from Late Eocene Cpx-Spherule Deposits; An Ordinary Chondrite Impactor Composition for the Bosumtwi Impact Structure, Ghana, West Africa: Discussion of Siderophile Element Contents and Os and Cr Isotope Data.

Stabilized Finite Elements in FUN3D

NASA Technical Reports Server (NTRS)

Anderson, W. Kyle; Newman, James C.; Karman, Steve L.

2017-01-01

A Streamlined Upwind Petrov-Galerkin (SUPG) stabilized finite-element discretization has been implemented as a library into the FUN3D unstructured-grid flow solver. Motivation for the selection of this methodology is given, details of the implementation are provided, and the discretization for the interior scheme is verified for linear and quadratic elements by using the method of manufactured solutions. A methodology is also described for capturing shocks, and simulation results are compared to the finite-volume formulation that is currently the primary method employed for routine engineering applications. The finite-element methodology is demonstrated to be more accurate than the finite-volume technology, particularly on tetrahedral meshes where the solutions obtained using the finite-volume scheme can suffer from adverse effects caused by bias in the grid. Although no effort has been made to date to optimize computational efficiency, the finite-element scheme is competitive with the finite-volume scheme in terms of computer time to reach convergence.

Numerical Solutions for a Cylindrical Laser Diffuser Flowfield

DTIC Science & Technology

1990-06-01

exhaust conditions with minimum losses to optimize performance of the system. Thus, the handling of the system of shock waves to decelerate the flow...requirement for exhaustive experimental work will result in significant savings of both time and resources. As more advanced computers are developed, the...Mach number (ɚ.5) flows. Recent interest in hypersonic engine inlet performance has resulted in an extension of the methodology to high Mach number

FAVOR: A new fracture mechanics code for reactor pressure vessels subjected to pressurized thermal shock

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

Dickson, T.L.

1993-01-01

This report discusses probabilistic fracture mechanics (PFM) analysis which is a major element of the comprehensive probabilistic methodology endorsed by the NRC for evaluation of the integrity of Pressurized Water Reactor (PWR) pressure vessels subjected to pressurized-thermal-shock (PTS) transients. It is anticipated that there will be an increasing need for an improved and validated PTS PFM code which is accepted by the NRC and utilities, as more plants approach the PTS screening criteria and are required to perform plant-specific analyses. The NRC funded Heavy Section Steel Technology (HSST) Program at Oak Ridge National Laboratories is currently developing the FAVOR (Fracturemore » Analysis of Vessels: Oak Ridge) PTS PFM code, which is intended to meet this need. The FAVOR code incorporates the most important features of both OCA-P and VISA-II and contains some new capabilities such as PFM global modeling methodology, the capability to approximate the effects of thermal streaming on circumferential flaws located inside a plume region created by fluid and thermal stratification, a library of stress intensity factor influence coefficients, generated by the NQA-1 certified ABAQUS computer code, for an adequate range of two and three dimensional inside surface flaws, the flexibility to generate a variety of output reports, and user friendliness.« less

FAVOR: A new fracture mechanics code for reactor pressure vessels subjected to pressurized thermal shock

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

Dickson, T.L.

1993-04-01

This report discusses probabilistic fracture mechanics (PFM) analysis which is a major element of the comprehensive probabilistic methodology endorsed by the NRC for evaluation of the integrity of Pressurized Water Reactor (PWR) pressure vessels subjected to pressurized-thermal-shock (PTS) transients. It is anticipated that there will be an increasing need for an improved and validated PTS PFM code which is accepted by the NRC and utilities, as more plants approach the PTS screening criteria and are required to perform plant-specific analyses. The NRC funded Heavy Section Steel Technology (HSST) Program at Oak Ridge National Laboratories is currently developing the FAVOR (Fracturemore » Analysis of Vessels: Oak Ridge) PTS PFM code, which is intended to meet this need. The FAVOR code incorporates the most important features of both OCA-P and VISA-II and contains some new capabilities such as PFM global modeling methodology, the capability to approximate the effects of thermal streaming on circumferential flaws located inside a plume region created by fluid and thermal stratification, a library of stress intensity factor influence coefficients, generated by the NQA-1 certified ABAQUS computer code, for an adequate range of two and three dimensional inside surface flaws, the flexibility to generate a variety of output reports, and user friendliness.« less

The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review.

PubMed

Mani-Babu, Sethu; Morrissey, Dylan; Waugh, Charlotte; Screen, Hazel; Barton, Christian

2015-03-01

There is accumulating evidence for the effectiveness of extracorporeal shock wave therapy (ESWT) when treating lower limb tendinopathies including greater trochanteric pain syndrome (GTPS), patellar tendinopathy (PT), and Achilles tendinopathy (AT). To evaluate the effectiveness of ESWT for lower limb tendinopathies. Systematic review and meta-analysis. PubMed (Medline), Embase, Web of Knowledge, Cochrane, and CINAHL were searched from inception to February 2013 for studies of any design investigating the effectiveness of ESWT in GTPS, PT, and AT. Citation tracking was performed using PubMed and Google Scholar. Animal and non-English language studies were excluded. A quality assessment was performed by 2 independent reviewers, and effect size calculations were computed when sufficient data were provided. A total of 20 studies were identified, with 13 providing sufficient data to compute effect size calculations. The energy level, number of impulses, number of sessions, and use of a local anesthetic varied between studies. Additionally, current evidence is limited by low participant numbers and a number of methodological weaknesses including inadequate randomization. Moderate evidence indicates that ESWT is more effective than home training and corticosteroid injection in the short (<12 months) and long (>12 months) term for GTPS. Limited evidence indicates that ESWT is more effective than alternative nonoperative treatments including nonsteroidal anti-inflammatory drugs, physical therapy, and an exercise program and equal to patellar tenotomy surgery in the long term for PT. Moderate evidence indicates that ESWT is more effective than eccentric loading for insertional AT and equal to eccentric loading for midportion AT in the short term. Additionally, there is moderate evidence that combining ESWT and eccentric loading in midportion AT may produce superior outcomes to eccentric loading alone. Extracorporeal shock wave therapy is an effective intervention and should be considered for GTPS, PT, and AT particularly when other nonoperative treatments have failed. © 2014 The Author(s).

Modified Linear Theory Aircraft Design Tools and Sonic Boom Minimization Strategy Applied to Signature Freezing via F-function Lobe Balancing

NASA Astrophysics Data System (ADS)

Jung, Timothy Paul

Commercial supersonic travel has strong business potential; however, in order for the Federal Aviation Administration to lift its ban on supersonic flight overland, designers must reduce aircraft sonic boom strength to an acceptable level. An efficient methodology and associated tools for designing aircraft for minimized sonic booms are presented. The computer-based preliminary design tool, RapidF, based on modified linear theory, enables quick assessment of an aircraft's sonic boom with run times less than 30 seconds on a desktop computer. A unique feature of RapidF is that it tracks where on the aircraft each segment of the of the sonic boom came from, enabling precise modifications, speeding the design process. Sonic booms from RapidF are compared to flight test data, showing that it is capability of predicting a sonic boom duration, overpressure, and interior shock locations. After the preliminary design is complete, scaled flight tests should be conducted to validate the low boom design. When conducting such tests, it is insufficient to just scale the length; thus, equations to scale the weight and propagation distance are derived. Using RapidF, a conceptual supersonic business jet design is presented that uses F-function lobe balancing to create a frozen sonic boom using lifting surfaces. The leading shock is reduced from 1.4 to 0.83 psf, and the trailing shock from 1.2 to 0.87 psf, 41% and 28% reductions respectfully. By changing the incidence angle of the surfaces, different sonic boom shapes can be created, and allowing the lobes to be re-balanced for new flight conditions. Computational fluid dynamics is conducted to validate the sonic boom predictions. Off-design analysis is presented that varies weight, altitude, Mach number, and propagation angle, demonstrating that lobe-balance is robust. Finally, the Perceived Level of Loudness metric is analyzed, resulting in a modified design that incorporates other boom minimization techniques to further reduce the sonic boom.

77 FR 21594 - Duke Energy Carolinas, LLC; Environmental Assessment and Finding of No Significant Impact, Oconee...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... of light-water nuclear power reactors provide adequate margins of safety during any condition of... toughness requirements for protection against pressurized thermal shock (PTS) events. The proposed action... for Protection Against Pressurized Thermal Shock Events,'' and 10 CFR part 50 Appendix G, ``Fracture...

Estimation of Supersonic Stage Separation Aerodynamics of Winged-Body Launch Vehicles Using Response Surface Methods

NASA Technical Reports Server (NTRS)

Erickson, Gary E.; Deloach, Richard

2008-01-01

A collection of statistical and mathematical techniques referred to as response surface methodology was used to estimate the longitudinal stage separation aerodynamic characteristics of a generic, bimese, winged multi-stage launch vehicle configuration using data obtained on small-scale models at supersonic speeds in the NASA Langley Research Center Unitary Plan Wind Tunnel. The simulated Mach 3 staging was dominated by multiple shock wave interactions between the orbiter and booster vehicles throughout the relative spatial locations of interest. This motivated a partitioning of the overall inference space into several contiguous regions within which the separation aerodynamics were presumed to be well-behaved and estimable using cuboidal and spherical central composite designs capable of fitting full second-order response functions. The primary goal was to approximate the underlying overall aerodynamic response surfaces of the booster vehicle in belly-to-belly proximity to the orbiter vehicle using relatively simple, lower-order polynomial functions that were piecewise-continuous across the full independent variable ranges of interest. The quality of fit and prediction capabilities of the empirical models were assessed in detail, and the issue of subspace boundary discontinuities was addressed. The potential benefits of augmenting the central composite designs to full third order using computer-generated D-optimality criteria were also evaluated. The usefulness of central composite designs, the subspace sizing, and the practicality of fitting low-order response functions over a partitioned inference space dominated by highly nonlinear and possibly discontinuous shock-induced aerodynamics are discussed.

Shock effects in particle beam fusion targets

NASA Astrophysics Data System (ADS)

Sweeney, M. A.; Perry, F. C.; Asay, J. R.; Widner, M. M.

1982-04-01

At Sandia National Laboratorics we are assessing the response of fusion target materials to shock loading with the particle beam accelerators HYDRA and PROTO I and the gas gun facility. Nonlinear shock-accelerated unstable growth of fabriction irregularities has been demonstrated, and jetting is found to occur in imploding targets because of asymmetric beam deposition. Cylindrical ion targets display an instability due either to beam or target nonuniformity. However, the data suggest targets with aspect ratios of 30 may implode stably. The first time- and space-resolved measurements of shock-induced vaporization have been made. A homogeneous mixed phase EOS model cannot adequately explain the results because of the kinetic effects of vapor formation and expansion.

The NOL Gap Test: Past, present, and future

NASA Technical Reports Server (NTRS)

Jacobs, S. J.; Price, D.

1980-01-01

A brief history of the development of the gap test is presented with emphasis on accumulated knowledge of how best to use it as a tool to assess relative shock sensitivity of explosives and propellants. Present information about the detonation process in build-up, steady state, and failure is used to show that failure diameter cannot give the desired shock sensitivity assessment. Suggestions are made for improving the test to an experiment. The use of spherical donors, water as attenuator, and camera instrumentation are briefly discussed.

Mechanical analysis of a heat-shock induced developmental defect

NASA Astrophysics Data System (ADS)

Crews, Sarah M.; McCleery, W. Tyler; Hutson, M. Shane

2014-03-01

Embryonic development in Drosophila is a complex process involving coordinated movements of mechanically interacting tissues. Perturbing this system with a transient heat shock can result in a number of developmental defects. In particular, a heat shock applied during the earliest morphogenetic movements of gastrulation can lead to apparent recovery, but then subsequent morphogenetic failure 5-6 hours later during germ band retraction. The process of germ band retraction requires an intact amnioserosa - a single layered extra-embryonic epithelial tissue - and heat shock at gastrulation can induce the later opening of holes in the amnioserosa. These holes are highly correlated with failures of germ band retraction. These holes could be caused by a combination of mechanical weakness in the amnioserosa or local increases in mechanical stress. Here, we assess the role of mechanical stress using confocal imaging to compare cell and tissue morphology in the amnioserosa of normal and heat-shocked embryos and laser hole drilling to map the stress field around the times and locations at which heat-shock induced holes open.

Don’t forget the posters! Quality and content variables associated with accepted abstracts at a national trauma meeting

PubMed Central

Dossett, Lesly A.; Fox, Erin E.; del Junco, Deborah J.; Zaydfudim, Victor; Kauffmann, Rondi; Shelton, Julia; Wang, Weiwei; Cioffi, William G.; Holcomb, John B.; Cotton, Bryan A.

2014-01-01

BACKGROUND As a primary venue for presenting research results, abstracts selected for presentation at national meetings should be of the highest scientific merit and research quality. It is uncertain to what degree this is achieved as the methodological quality of abstracts submitted to national surgical meetings has not been previously described. The objective of this study was to evaluate abstracts presented at a leading trauma meeting for methodological quality. METHODS All abstracts accepted for the 2009 American Association for the Surgery of Trauma meeting were reviewed and scored for methodological quality based on 10 criteria (scores, 0–10; 10 being the highest). Criteria were based on nationally published methodology guidelines. Two independent reviewers who were blinded to institution, region, and author reviewed each abstract. RESULTS A total of 187 abstracts were accepted for presentation (67 oral and 120 posters). The most frequent clinical topics were shock/transfusion (23%), abdomen (12%), and nervous system (11%). Shock/transfusion abstracts were more common in the oral presentations (31% vs. 19%; p =0.06). Abstracts from the northeast and south regions were the most common in both oral (26% and 29%) and posters (25% and 24%). Basic science accounted for 12% of accepted studies, while 51% were clinical and 28% were health services/outcomes. Only 8% of abstracts presented randomized data and only 11% reported null findings. Overall abstract scores ranged from 3 to 10 (median, 7; mean, 7.4). Abstracts selected for poster presentation had an overall higher score than those selected for oral presentation (7.4 ±1.7 vs. 6.8 ±1.7; p =0.02). CONCLUSION Although oral presentations traditionally receive the most attention and interest, the methodological quality of abstracts accepted for poster presentation equals (and sometimes exceeds) that of oral abstracts. Attendees of these national meetings should reconsider their time spent in viewing and visiting these poster sessions as with the oral presentations. In light of our findings, we highly encourage that all members and guests attend the American Association for the Surgery of Trauma Poster Rounds at each year’s scientific assembly. PMID:22673278

Don't forget the posters! Quality and content variables associated with accepted abstracts at a national trauma meeting.

PubMed

Dossett, Lesly A; Fox, Erin E; del Junco, Deborah J; Zaydfudim, Victor; Kauffmann, Rondi; Shelton, Julia; Wang, Weiwei; Cioffi, William G; Holcomb, John B; Cotton, Bryan A

2012-05-01

As a primary venue for presenting research results, abstracts selected for presentation at national meetings should be of the highest scientific merit and research quality. It is uncertain to what degree this is achieved as the methodological quality of abstracts submitted to national surgical meetings has not been previously described. The objective of this study was to evaluate abstracts presented at a leading trauma meeting for methodological quality. All abstracts accepted for the 2009 American Association for the Surgery of Trauma meeting were reviewed and scored for methodological quality based on 10 criteria (scores, 0-10; 10 being the highest). Criteria were based on nationally published methodology guidelines. Two independent reviewers who were blinded to institution, region, and author reviewed each abstract. A total of 187 abstracts were accepted for presentation (67 oral and 120 posters). The most frequent clinical topics were shock/transfusion (23%), abdomen (12%), and nervous system (11%). Shock/transfusion abstracts were more common in the oral presentations (31% vs. 19%; p = 0.06). Abstracts from the northeast and south regions were the most common in both oral (26% and 29%) and posters (25% and 24%). Basic science accounted for 12% of accepted studies, while 51% were clinical and 28% were health services/outcomes. Only 8% of abstracts presented randomized data and only 11% reported null findings. Overall abstract scores ranged from 3 to 10 (median, 7; mean, 7.4). Abstracts selected for poster presentation had an overall higher score than those selected for oral presentation (7.4 ± 1.7 vs. 6.8 ± 1.7; p = 0.02). Although oral presentations traditionally receive the most attention and interest, the methodological quality of abstracts accepted for poster presentation equals (and sometimes exceeds) that of oral abstracts. Attendees of these national meetings should reconsider their time spent in viewing and visiting these poster sessions as with the oral presentations. In light of our findings, we highly encourage that all members and guests attend the American Association for the Surgery of Trauma Poster Rounds at each year's scientific assembly.

Detection of induced seismicity effects on ground surface using data from Sentinel 1A/1B satellites

NASA Astrophysics Data System (ADS)

Milczarek, W.

2017-12-01

Induced seismicity is the result of human activity and manifests itself in the form of shock and vibration of the ground surface. One of the most common factors causing the occurrence of induced shocks is underground mining activity. Sufficiently strong high-energy shocks may cause displacements of the ground surface. This type of shocks can have a significant impact on buildings and infrastructure. Assessment of the size and influence of induced seismicity on the ground surface is one of the major problems associated with mining activity. In Poland (Central Eastern Europe) induced seismicity occurs in the area of hard coal mining in the Upper Silesian Coal Basin and in the area of the Legnica - Głogów Copper Basin.The study presents an assessment of the use of satellite radar data (SAR) for the detection influence of induced seismicity in mining regions. Selected induced shocks from the period 2015- 2017 which occurred in the Upper Silesian Coal Basin and the Legnica - Głogów Copper Basin areas have been analyzed. In the calculations SAR data from the Sentinel 1A and Sentinel 1B satellites have been used. The results indicate the possibility of quickly and accurate detection of ground surface displacements after an induced shock. The results of SAR data processing were compared with the results from geodetic measurements. It has been shown that SAR data can be used to detect ground surface displacements on the relative small regions.

Sepsis and Shock Response Team: Impact of a Multidisciplinary Approach to Implementing Surviving Sepsis Campaign Guidelines and Surviving the Process.

PubMed

Grek, Ami; Booth, Sandra; Festic, Emir; Maniaci, Michael; Shirazi, Ehsan; Thompson, Kristine; Starbuck, Angela; Mcree, Chad; Naessens, James M; Moreno Franco, Pablo

The Surviving Sepsis Campaign guidelines are designed to decrease mortality through consistent application of a 7-element bundle. This study evaluated the impact of improvement in bundle adherence using a time-series analysis of compliance with the bundle elements before and after interventions intended to improve the process, while also looking at hospital mortality. This article describes interventions used to improve bundle compliance and hospital mortality in patients admitted through the emergency department with sepsis, severe sepsis, or septic shock. Quality improvement methodology was used to develop high-impact interventions that led to dramatically improved adherence to the Surviving Sepsis Campaign guidelines bundle. Improved performance was associated with a significant decrease in the in-hospital mortality of severe sepsis patients presenting to the emergency department.

Bifurcation parameters of a reflected shock wave in cylindrical channels of different roughnesses

NASA Astrophysics Data System (ADS)

Penyazkov, O.; Skilandz, A.

2018-03-01

To investigate the effect of bifurcation on the induction time in cylindrical shock tubes used for chemical kinetic experiments, one should know the parameters of the bifurcation structure of a reflected shock wave. The dynamics and parameters of the shock wave bifurcation, which are caused by reflected shock wave-boundary layer interactions, are studied experimentally in argon, in air, and in a hydrogen-nitrogen mixture for Mach numbers M = 1.3-3.5 in a 76-mm-diameter shock tube without any ramp. Measurements were taken at a constant gas density behind the reflected shock wave. Over a wide range of experimental conditions, we studied the axial projection of the oblique shock wave and the pressure distribution in the vicinity of the triple Mach configuration at 50, 150, and 250 mm from the endwall, using side-wall schlieren and pressure measurements. Experiments on a polished shock tube and a shock tube with a surface roughness of 20 {μ }m Ra were carried out. The surface roughness was used for initiating small-scale turbulence in the boundary layer behind the incident shock wave. The effect of small-scale turbulence on the homogenization of the transition zone from the laminar to turbulent boundary layer along the shock tube perimeter was assessed, assuming its influence on a subsequent stabilization of the bifurcation structure size versus incident shock wave Mach number, as well as local flow parameters behind the reflected shock wave. The influence of surface roughness on the bifurcation development and pressure fluctuations near the wall, as well as on the Mach number, at which the bifurcation first develops, was analyzed. It was found that even small additional surface roughness can lead to an overshoot in pressure growth by a factor of two, but it can stabilize the bifurcation structure along the shock tube perimeter.

Uncertainty Assessment of Hypersonic Aerothermodynamics Prediction Capability

NASA Technical Reports Server (NTRS)

Bose, Deepak; Brown, James L.; Prabhu, Dinesh K.; Gnoffo, Peter; Johnston, Christopher O.; Hollis, Brian

2011-01-01

The present paper provides the background of a focused effort to assess uncertainties in predictions of heat flux and pressure in hypersonic flight (airbreathing or atmospheric entry) using state-of-the-art aerothermodynamics codes. The assessment is performed for four mission relevant problems: (1) shock turbulent boundary layer interaction on a compression corner, (2) shock turbulent boundary layer interaction due a impinging shock, (3) high-mass Mars entry and aerocapture, and (4) high speed return to Earth. A validation based uncertainty assessment approach with reliance on subject matter expertise is used. A code verification exercise with code-to-code comparisons and comparisons against well established correlations is also included in this effort. A thorough review of the literature in search of validation experiments is performed, which identified a scarcity of ground based validation experiments at hypersonic conditions. In particular, a shortage of useable experimental data at flight like enthalpies and Reynolds numbers is found. The uncertainty was quantified using metrics that measured discrepancy between model predictions and experimental data. The discrepancy data is statistically analyzed and investigated for physics based trends in order to define a meaningful quantified uncertainty. The detailed uncertainty assessment of each mission relevant problem is found in the four companion papers.

Potential of shock waves to remove calculus and biofilm.

PubMed

Müller, Philipp; Guggenheim, Bernhard; Attin, Thomas; Marlinghaus, Ernst; Schmidlin, Patrick R

2011-12-01

Effective calculus and biofilm removal is essential to treat periodontitis. Sonic and ultrasonic technologies are used in several scaler applications. This was the first feasibility study to assess the potential of a shock wave device to remove calculus and biofilms and to kill bacteria. Ten extracted teeth with visible subgingival calculus were treated with either shock waves for 1 min at an energy output of 0.4 mJ/mm(2) at 3 Hz or a magnetostrictive ultrasonic scaler at medium power setting for 1 min, which served as a control. Calculus was determined before and after treatment planimetrically using a custom-made software using a grey scale threshold. In a second experiment, multispecies biofilms were formed on saliva-preconditioned bovine enamel discs during 64.5 h. They were subsequently treated with shock waves or the ultrasonic scaler (N = 6/group) using identical settings. Biofilm detachment and bactericidal effects were then assessed. Limited efficiency of the shock wave therapy in terms of calculus removal was observed: only 5% of the calculus was removed as compared to 100% when ultrasound was used (P ≤ 0.0001). However, shock waves were able to significantly reduce adherent bacteria by three orders of magnitude (P ≤ 0.0001). The extent of biofilm removal by the ultrasonic device was statistically similar. Only limited bactericidal effects were observed using both methods. Within the limitations of this preliminary study, the shock wave device was not able to reliably remove calculus but had the potential to remove biofilms by three log steps. To increase the efficacy, technical improvements are still required. This novel noninvasive intervention, however, merits further investigation.

Assessment of damage in ceramics and ceramic matrix composites using ultrasonic techniques

NASA Technical Reports Server (NTRS)

Chu, Y. C.; Baaklini, G. Y.; Rokhlin, S.I.

1993-01-01

This paper addresses the application of ultrasonic sensing to damage assessment in ceramics and ceramic matrix composites. It focuses on damage caused by thermal shock or oxidation at elevated temperatures, which often results in elastic anisotropy. This damaged-induced anisotropy is determined by measuring the velocities of ultrasonic waves in different propagation directions. Thermal shock damage is assessed in ceramic samples of reaction bonded silicon nitride (RBSN). Thermal shock treatment from different temperatures up to 1000 C is applied to produce the microcracks. Results indicate that most microcracks produced by thermal shock are located near sample surfaces. Ultrasonic measurements using the surface wave method are found to correlate well with measurements of degradation of mechanical properties obtained independently by other authors using destructive methods. Oxidation damage is assessed in silicon carbide fiber/reaction bonded silicon nitride matrix (SCS-6/RBSN) composites. The oxidation is done by exposing the samples in a flowing oxygen environment at elevated temperatures, up to 1400 C, for 100 hr. The Youngs' modulus in the fiber direction as obtained from ultrasonic measurements decreases significantly at 600 C but retains its original value at temperatures above 1200 C. This agrees well with the results of destructive tests by other authors. On the other hand, the transverse moduli obtained from ultrasonic measurements decrease continually until 1200 C. Measurements on the shear stiffnesses show behavior similar to the transverse moduli. The results of this work show that the damage-induced anisotropy in both ceramics and ceramic matrix composites can be determined successfully by ultrasonic methods. This suggests the possibility of assessing damage severity using ultrasonic techniques.

Assessment of a Modified Acoustic Lens for Electromagnetic Shock Wave Lithotripters in a Swine Model

PubMed Central

Mancini, John G.; Neisius, Andreas; Smith, Nathan; Sankin, Georgy; Astroza, Gaston M.; Lipkin, Michael E.; Simmons, Walther N.; Preminger, Glenn M.; Zhong, Pei

2013-01-01

Purpose The acoustic lens of the Siemens Modularis electromagnetic (EM) shock wave lithotripter has been modified to produce a pressure waveform and focal zone more closely resembling that of the original Dornier HM3 device. Herein, we assess the newly designed acoustic lens in vivo in an animal model. Materials and Methods Stone fragmentation and tissue injury produced by the original and modified lenses of a Siemens lithotripter were evaluated in a swine model under equivalent acoustic pulse energy (~45 mJ) at 1 Hz pulse repetition frequency. Stone fragmentation was determined by the weight percent of stone fragments less than 2 mm. For tissue injury assessment, shock wave-treated kidneys were perfused, dehydrated, cast in paraffin wax and sectioned. Digital images were captured every 120 µm and processed to determine the functional renal volume damage. Results After 500 shocks, stone fragmentation efficiency produced by the original and modified lenses was 48 ± 12% and 52 ± 17% (p=0.60), respectively. However, after 2000 shocks, the modified lens showed significantly improved stone fragmentation of 86 ± 10%, compared to 72 ± 12% for the original lens (p=0.02). Tissue injury caused by the original and modified lenses was minimal at 0.57 ± 0.44% and 0.25 ± 0.25% (p=0.27), respectively. Conclusions With lens modification, the Siemens Modularis lithotripter demonstrates significantly improved stone fragmentation with minimal tissue injury at clinically relevant acoustic pulse energy. This new lens design could potentially be retrofitted to existing lithotripters, thereby improving the effectiveness of EM lithotripters. PMID:23485509

Mechanisms of Thrombocytopenia During Septic Shock: A Multiplex Cluster Analysis of Endogenous Sepsis Mediators.

PubMed

Bedet, Alexandre; Razazi, Keyvan; Boissier, Florence; Surenaud, Mathieu; Hue, Sophie; Giraudier, Stéphane; Brun-Buisson, Christian; Mekontso Dessap, Armand

2018-06-01

Thrombocytopenia is a common feature of sepsis and may involve various mechanisms often related to the inflammatory response. This study aimed at evaluating factors associated with thrombocytopenia during human septic shock. In particular, we used a multiplex analysis to assess the role of endogenous sepsis mediators. Prospective, observational study. Thrombocytopenia was defined as an absolute platelet count <100 G/L or a 50% relative decrease in platelet count during the first week of septic shock. Plasma concentrations of 27 endogenous mediators involved in sepsis and platelet pathophysiology were assessed at day-1 using a multi-analyte Milliplex human cytokine kit. Patients with underlying diseases at risk of thrombocytopenia (hematological malignancies, chemotherapy, cirrhosis, and chronic heart failure) were excluded. Thrombocytopenia occurred in 33 (55%) of 60 patients assessed. Patients with thrombocytopenia were more prone to present with extrapulmonary infections and bacteremia. Disseminated intravascular coagulation was frequent (81%) in these patients. Unbiased hierarchical clustering identified five different clusters of sepsis mediators, including one with markers of platelet activation (e.g., thrombospondin-1) positively associated with platelet count, one with markers of inflammation (e.g., tumor necrosis factor alpha and heat shock protein 70), and endothelial dysfunction (e.g., intercellular adhesion molecule-1 and vascular cell adhesion molecule-1) negatively associated with platelet count, and another involving growth factors of thrombopoiesis (e.g., thrombopoietin), also negatively associated with platelet count. Surrogates of hemodilution (e.g., hypoprotidemia and higher fluid balance) were also associated with thrombocytopenia. Multiple mechanisms seemed involved in thrombocytopenia during septic shock, including endothelial dysfunction/coagulopathy, hemodilution, and altered thrombopoiesis.

Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter-defibrillator in swine

PubMed Central

KILLINGSWORTH, CHERYL R.; MELNICK, SHARON B.; LITOVSKY, SILVIO H.; IDEKER, RAYMOND E.; WALCOTT, GREGORY P.

2013-01-01

Background A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. Methods During sinus rhythm, anesthetized pigs (38±6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24-hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semi-quantitative scoring. Results Troponin I was significantly elevated at 4- and 24-hours (22.6±16.3 and 3.1±1.3 ng/ml; baseline 0.07±0.09 ng/ml) in control pigs but not in S-ICD pigs (0.12±0.11 and 0.13±0.13 ng/ml; baseline 0.06±0.03 ng/ml). CK-MM was significantly elevated in S-ICD pigs after shocks (6544±1496 and 9705±6240 U/L; baseline 704±398 U/L) but not in controls. ECG changes occurred post-shock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Conclusion Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks. PMID:23713608

Relative Bradycardia in Patients With Septic Shock Requiring Vasopressor Therapy.

PubMed

Beesley, Sarah J; Wilson, Emily L; Lanspa, Michael J; Grissom, Colin K; Shahul, Sajid; Talmor, Daniel; Brown, Samuel M

2017-02-01

Tachycardia is common in septic shock, but many patients with septic shock are relatively bradycardic. The prevalence, determinants, and implications of relative bradycardia (heart rate, < 80 beats/min) in septic shock are unknown. To determine mortality associated with patients who are relatively bradycardic while in septic shock. Retrospective study of patients admitted for septic shock to study ICUs during 2005-2013. One large academic referral hospital and two community hospitals. Adult patients with septic shock requiring vasopressors. None. Primary outcome was 28-day mortality. We used multivariate logistic regression to evaluate the association between relative bradycardia and mortality, controlling for confounding with inverse probability treatment weighting using a propensity score. We identified 1,554 patients with septic shock, of whom 686 (44%) met criteria for relative bradycardia at some time. Twenty-eight-day mortality in this group was 21% compared to 34% in the never-bradycardic group (p < 0.001). Relatively bradycardic patients were older (65 vs 60 yr; p < 0.001) and had slightly lower illness severity (Sequential Organ Failure Assessment, 10 vs 11; p = 0.004; and Acute Physiology and Chronic Health Evaluation II, 27 vs 28; p = 0.008). After inverse probability treatment weighting, covariates were balanced, and the association between relative bradycardia and survival persisted (p < 0.001). Relative bradycardia in patients with septic shock is associated with lower mortality, even after adjustment for confounding. Our data support expanded investigation into whether inducing relative bradycardia will benefit patients with septic shock.

Emission lifetimes of a fluorescent dye under shock compression

DOE PAGES

Liu, Wei-long; Bassett, Will P.; Christensen, James M.; ...

2015-10-15

The emission lifetimes of rhodamine 6G (R6G), were measured under shock compression to 9.1 GPa, with the dual intent of better understanding molecular photophysics in extreme environments and assessing the usefulness of fluorescence lifetime microscopy to measure spatially-dependent pressure distributions in shocked microstructured media. R6G was studied as free dye dissolved in poly-methyl methacrylate (PMMA), or dye encapsulated in silica microparticles suspended in PMMA. Thin layers of these materials in impedance-matched geometries were subjected to planar single-stage shocks created by laser-driven flyer plates. A synchronized femtosecond laser excited the dye at selected times relative to flyer plate arrival and themore » emission lifetimes were measured with a streak camera. Lifetimes decreased when shocks arrived. The lifetime decrease was attributed to a shock-induced enhancement of R6G nonradiative relaxation. At least part of the relaxation involved shock-enhanced intersystem crossing. For free dye in PMMA, the lifetime decrease during the shock was shown to be a linear function of shock pressure from 0-9 GPa, with a slope of -0.22 ns·GPa -1. Furthermore, the linear relationship makes it simple to convert lifetimes into pressures. Lifetime measurements in shocked microenvironments may be better than emission intensity measurements, since lifetimes are sensitive to the surrounding environment, but insensitive to intensity variations associated with the motion and optical properties of a dynamically changing structure.« less

Ability of the Confined Explosive Component Water Gap Test STANAG 4363 to Assess the Shock Sensitivity of MM-Scale Detonators

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

Lefrancois, A S; Roeske, F; Benterou, J

2006-02-10

The Explosive Component Water Gap Test (ECWGT) has been validated to assess the shock sensitivity of lead and booster components having a diameter larger than 5 mm. Several countries have investigated by experiments and numerical simulations the effect of confinement on the go/no go threshold for Pentaerythritol Tetranitrate (PETN) pellets having a height and diameter of 3 mm, confined by a steel annulus of wall thickness 1-3.5 mm. Confinement of the PETN by a steel annulus of the same height of the pellet with 1-mm wall thickness makes the component more sensitive (larger gap). As the wall thickness is increasedmore » to 2-mm, the gap increases a lesser amount, but when the wall thickness is increased to 3.5-mm a decrease in sensitivity is observed (smaller gap). This decrease of the water gap has been reproduced experimentally. Recent numerical simulations using Ignition and Growth model [1] for the PETN Pellet have reproduced the experimental results for the steel confinement up to 2 mm thick [2]. The presence of a stronger re-shock following the first input shock from the water and focusing on the axis have been identified in the pellet due to the steel confinement. The double shock configuration is well-known to lead in some cases to shock desensitization. This work presents the numerical simulations using Ignition and Growth model for LX16 (PETN based HE) and LX19 (CL20 based HE) Pellets [3] in order to assess the shock sensitivity of mm-scale detonators. The pellets are 0.6 mm in diameter and 3 mm length with different type of steel confinement 2.2 mm thick and 4.7 mm thick. The influence of an aluminum confinement is calculated for the standard LX 16 pellet 3 mm in diameter and 3 mm in height. The question of reducing the size of the donor charge is also investigated to small scale the test itself.« less

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

Liu, Wei-long; Bassett, Will P.; Christensen, James M.

The emission lifetimes of rhodamine 6G (R6G), were measured under shock compression to 9.1 GPa, with the dual intent of better understanding molecular photophysics in extreme environments and assessing the usefulness of fluorescence lifetime microscopy to measure spatially-dependent pressure distributions in shocked microstructured media. R6G was studied as free dye dissolved in poly-methyl methacrylate (PMMA), or dye encapsulated in silica microparticles suspended in PMMA. Thin layers of these materials in impedance-matched geometries were subjected to planar single-stage shocks created by laser-driven flyer plates. A synchronized femtosecond laser excited the dye at selected times relative to flyer plate arrival and themore » emission lifetimes were measured with a streak camera. Lifetimes decreased when shocks arrived. The lifetime decrease was attributed to a shock-induced enhancement of R6G nonradiative relaxation. At least part of the relaxation involved shock-enhanced intersystem crossing. For free dye in PMMA, the lifetime decrease during the shock was shown to be a linear function of shock pressure from 0-9 GPa, with a slope of -0.22 ns·GPa -1. Furthermore, the linear relationship makes it simple to convert lifetimes into pressures. Lifetime measurements in shocked microenvironments may be better than emission intensity measurements, since lifetimes are sensitive to the surrounding environment, but insensitive to intensity variations associated with the motion and optical properties of a dynamically changing structure.« less

Atrial fibrillation in cardiac resynchronization therapy with a defibrillator: a risk factor for mortality, appropriate and inappropriate shocks.

PubMed

van Boven, Nick; Theuns, Dominic; Bogaard, Kjell; Ruiter, Jaap; Kimman, Geert; Berman, Lily; VAN DER Ploeg, Tjeerd; Kardys, Isabella; Umans, Victor

2013-10-01

Knowledge about predictive factors for mortality and (in)appropriate shocks in cardiac resynchronization therapy with a defibrillator (CRT-D) should be available and updated to predict clinical outcome. We retrospectively analyzed 543 consecutive patients assigned to CRT-D in 2 tertiary medical centers. The aim of this study was to assess risk factors for all-cause mortality, appropriate and inappropriate shocks. Mean follow-up time was 3.2 (±1.8) years. A total of 110 (20%) patients died, 71 (13%) received ≥1 appropriate shocks, and 33 (6.1%) received ≥1 inappropriate shocks. No patients received a His bundle ablation and biventricular pacing percentage was not analyzed. Multivariable Cox regression analysis showed that a history of atrial fibrillation (AF) (HR 1.74 CI 1.06-2.86), higher creatinine (HR 1.12; CI 1.08-1.16), and a poorer left ventricular ejection fraction (LVEF) (HR 0.97; CI 0.94-1.01) independently predict all-cause mortality. In the entire cohort, history of AF and secondary prevention were independent predictors of appropriate shocks and variables associated with inappropriate shocks were history of AF and QRS ≥150 milliseconds. In primary prevention patients, history of AF also predicted appropriate shocks as did ischemic cardiomyopathy and poorer LVEF. History of AF, QRS ≥150 milliseconds, and lower creatinine were associated with inappropriate shocks in this subgroup. Appropriate shocks increased mortality risk, but inappropriate shocks did not. In symptomatic CHF patients treated with CRT-D, history of AF is an independent risk factor not only for mortality, but also for appropriate and inappropriate shocks. Further efforts in AF management may optimize the care in CRT-D patients. © 2013 Wiley Periodicals, Inc.

Is Survival Time After Hemorrhage a Heritable, Quantitative Trait?: An Initial Assessment

DTIC Science & Technology

2008-06-01

The epidemiology of traumatic death. A population-based analysis. Arch Surg 128:571Y575, 1993. 5. Sauaia A, Moore FA, Moore EE, Moser KS, Brennan R...therapeutic goals and early warning of death. Arch Surg 106:630Y636, 1973. 752 SHOCK VOL. 29, NO. 6 KLEMCKE ET AL. Copyright @ 200 by the Shock...Hemorrhagic shock in rats. Measured blood volumes as the basis for the extent of hemorrhage. Arch Surg 99:484Y488, 1969. 19. Nose H, Morita M, Yawata T

Role of echocardiography/Doppler in cardiogenic shock: silent mitral regurgitation.

PubMed

Goldman, A P; Glover, M U; Mick, W; Pupello, D F; Hiro, S P; Lopez-Cuenca, E; Maniscalco, B S

1991-08-01

Two cases of cardiogenic shock and pulmonary edema due to acute, severe, silent mitral regurgitation are discussed. The mechanism for the mitral regurgitation was papillary muscle rupture in the setting of acute myocardial infarction. Echocardiography established the presence, severity, and cause of the mitral regurgitation and the associated hyperdynamic left ventricular function in the setting of cardiogenic shock. Transesophageal echocardiography is excellent for assessing the mitral valve in critically ill patients in whom transthoracic echocardiography may be inadequate or misleading. This allowed for emergency mitral valve replacement without prolonged attempts at medical stabilization.

Effects of porosity on shock-induced melting of honeycomb-shaped Cu nanofoams

NASA Astrophysics Data System (ADS)

Zhao, Fengpeng

Metallic foams are of fundamental and applied interests in various areas, including structure engineering (e.g., lightweight structural members and energy absorbers), and shock physics (e.g., as laser ablators involving shock-induced melting and vaporization).Honeycomb-shaped metallic foams consist of regular array of hexagonal cells in two dimensions and have extensive applications and represent a unique, simple yet useful model structure for exploring mechanisms and making quantitative assessment. We investigate shock-induced melting in honeycomb-shaped Cu nanofoams with extensive molecular dynamics simulations. A total of ten porosities (phi) are explored, ranging from 0 to 0.9 at an increment of 0.1. Upon shock compression, void collapse induces local melting followed by supercooling for sufficiently high porosity at low shock strengths. While superheating of solid remnants occurs for sufficiently strong shocks at phi<0.1. Both supercooling of melts and superheating of solid remnants are transient, and the equilibrated shock states eventually fall on the equilibrium melting curve for partial melting. However, phase equilibrium has not been achieved on the time scale of simulations in supercooled Cu liquid (from completely melted nanofoams). The temperatures for incipient and complete melting are related to porosity via a power law and approach the melting temperature at zero pressure as phi tends to 1.

Dynamic characterization of frequency response of shock mitigation of a polymethylene diisocyanate (PMDI) based rigid polyurethane foam

DOE PAGES

Song, Bo; Nelson, Kevin

2015-09-01

Kolsky compression bar experiments were conducted to characterize the shock mitigation response of a polymethylene diisocyanate (PMDI) based rigid polyurethane foam, abbreviated as PMDI foam in this study. The Kolsky bar experimental data was analyzed in the frequency domain with respect to impact energy dissipation and acceleration attenuation to perform a shock mitigation assessment on the foam material. The PMDI foam material exhibits excellent performance in both energy dissipation and acceleration attenuation, particularly for the impact frequency content over 1.5 kHz. This frequency (1.5 kHz) was observed to be independent of specimen thickness and impact speed, which may represent themore » characteristic shock mitigation frequency of the PMDI foam material under investigation. The shock mitigation characteristics of the PMDI foam material were insignificantly influenced by the specimen thickness. As a result, impact speed did have some effect.« less

Serotonin Augmentation Reduces Response to Attack in Aggressive Individuals

PubMed Central

Berman, Mitchell E.; McCloskey, Michael S.; Fanning, Jennifer R.; Schumacher, Julie A.; Coccaro, Emil F.

2009-01-01

We tested the theory that central serotonin (5- hydroxytryptamine, or 5-HT) activity regulates aggression by modulating response to provocation. Eighty men and women (40 with and 40 without a history of aggression) were randomly assigned to receive either 40 mg of paroxetine (to acutely augment serotonergic activity) or a placebo, administered using double-blind procedures. Aggression was assessed during a competitive reaction time game with a fictitious opponent. Shocks were selected by the participant and opponent before each trial, with the loser on each trial receiving the shock set by the other player. Provocation was manipulated by having the opponent select increasingly intense shocks for the participant and eventually an ostensibly severe shock toward the end of the trials. Aggression was measured by the number of severe shocks set by the participant for the opponent. As predicted, aggressive responding after provocation was attenuated by augmentation of serotonin in individuals with a pronounced history of aggression. PMID:19422623

Predictions of Supersonic Jet Mixing and Shock-Associated Noise Compared With Measured Far-Field Data

NASA Technical Reports Server (NTRS)

Dahl, Milo D.

2010-01-01

Codes for predicting supersonic jet mixing and broadband shock-associated noise were assessed using a database containing noise measurements of a jet issuing from a convergent nozzle. Two types of codes were used to make predictions. Fast running codes containing empirical models were used to compute both the mixing noise component and the shock-associated noise component of the jet noise spectrum. One Reynolds-averaged, Navier-Stokes-based code was used to compute only the shock-associated noise. To enable the comparisons of the predicted component spectra with data, the measured total jet noise spectra were separated into mixing noise and shock-associated noise components. Comparisons were made for 1/3-octave spectra and some power spectral densities using data from jets operating at 24 conditions covering essentially 6 fully expanded Mach numbers with 4 total temperature ratios.

Dynamic characterization of frequency response of shock mitigation of a polymethylene diisocyanate (PMDI) based rigid polyurethane foam

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

Song, Bo; Nelson, Kevin

Kolsky compression bar experiments were conducted to characterize the shock mitigation response of a polymethylene diisocyanate (PMDI) based rigid polyurethane foam, abbreviated as PMDI foam in this study. The Kolsky bar experimental data was analyzed in the frequency domain with respect to impact energy dissipation and acceleration attenuation to perform a shock mitigation assessment on the foam material. The PMDI foam material exhibits excellent performance in both energy dissipation and acceleration attenuation, particularly for the impact frequency content over 1.5 kHz. This frequency (1.5 kHz) was observed to be independent of specimen thickness and impact speed, which may represent themore » characteristic shock mitigation frequency of the PMDI foam material under investigation. The shock mitigation characteristics of the PMDI foam material were insignificantly influenced by the specimen thickness. As a result, impact speed did have some effect.« less

Adaptive magnetorheological seat suspension for shock mitigation

NASA Astrophysics Data System (ADS)

Singh, Harinder J.; Wereley, Norman M.

2013-04-01

An adaptive magnetorheological seat suspension (AMSS) was analyzed for optimal protection of occupants from shock loads caused by the impact of a helicopter with the ground. The AMSS system consists of an adaptive linear stroke magnetorheological shock absorber (MRSA) integrated into the seat structure of a helicopter. The MRSA provides a large controllability yield force to accommodate a wide spectrum for shock mitigation. A multiple degrees-of-freedom nonlinear biodynamic model for a 50th percentile male occupant was integrated with the dynamics of MRSA and the governing equations of motion were investigated theoretically. The load-stroke profile of MRSA was optimized with the goal of minimizing the potential for injuries. The MRSA yield force and the shock absorber stroke limitations were the most crucial parameters for improved biodynamic response mitigation. An assessment of injuries based on established injury criteria for different body parts was carried out.

Tactical Damage Control Resuscitation.

PubMed

Fisher, Andrew D; Miles, Ethan A; Cap, Andrew P; Strandenes, Geir; Kane, Shawn F

2015-08-01

Recently the Committee on Tactical Combat Casualty Care changed the guidelines on fluid use in hemorrhagic shock. The current strategy for treating hemorrhagic shock is based on early use of components: Packed Red Blood Cells (PRBCs), Fresh Frozen Plasma (FFP) and platelets in a 1:1:1 ratio. We suggest that lack of components to mimic whole blood functionality favors the use of Fresh Whole Blood in managing hemorrhagic shock on the battlefield. We present a safe and practical approach for its use at the point of injury in the combat environment called Tactical Damage Control Resuscitation. We describe pre-deployment preparation, assessment of hemorrhagic shock, and collection and transfusion of fresh whole blood at the point of injury. By approaching shock with goal-directed therapy, it is possible to extend the period of survivability in combat casualties. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Micro-X-ray diffraction assessment of shock stage in enstatite chondrites

NASA Astrophysics Data System (ADS)

Izawa, Matthew R. M.; Flemming, Roberta L.; Banerjee, Neil R.; McCausland, Philip J. A.

2011-05-01

A new method for assessing the shock stage of enstatite chondrites has been developed, using in situ micro-X-ray diffraction (μXRD) to measure the full width at half maximum (FWHMχ) of peak intensity distributed along the direction of the Debye rings, or chi angle (χ), corresponding to individual lattice reflections in two-dimensional XRD patterns. This μXRD technique differs from previous XRD shock characterization methods: it does not require single crystals or powders. In situ μXRD has been applied to polished thin sections and whole-rock meteorite samples. Three frequently observed orthoenstatite reflections were measured: (020), (610), and (131); these were selected as they did not overlap with diffraction lines from other phases. Enstatite chondrites are commonly fine grained, stained or darkened by weathering, shock-induced oxidation, and metal/sulfide inclusions; furthermore, most E chondrites have little olivine or plagioclase. These characteristics inhibit transmitted-light petrography, nevertheless, shock stages have been assigned MacAlpine Hills (MAC) 02837 (EL3) S3, Pecora Escarpment (PCA) 91020 (EL3) S5, MAC 02747 (EL4) S4, Thiel Mountains (TIL) 91714 (EL5) S2, Allan Hills (ALHA) 81021 (EL6) S2, Elephant Moraine (EET) 87746 (EH3) S3, Meteorite Hills (MET) 00783 (EH4) S4, EET 96135 (EH4-5) S2, Lewis Cliff (LEW) 88180 (EH5) S2, Queen Alexandra Range (QUE) 94204 (EH7) S2, LaPaz Icefield (LAP) 02225 (EH impact melt) S1; for the six with published shock stages, there is agreement with the published classification. FWHMχ plotted against petrographic shock stage demonstrates positive linear correlation. FWHMχ ranges corresponding to shock stages were assigned as follows: S1 < 0.7°, S2 = 0.7-1.2°, S3 = 1.2-2.3°, S4 = 2.3-3.5°, S5 > 3.5°, S6—not measured. Slabs of Abee (EH impact-melt breccia), and Northwest Africa (NWA) 2212 (EL6) were examined using μXRD alone; FWHMχ values place both in the S2 range, consistent with literature values. Micro-XRD analysis may be applicable to other shocked orthopyroxene-bearing rocks.

Modeling of structural uncertainties in Reynolds-averaged Navier-Stokes closures

NASA Astrophysics Data System (ADS)

Emory, Michael; Larsson, Johan; Iaccarino, Gianluca

2013-11-01

Estimation of the uncertainty in numerical predictions by Reynolds-averaged Navier-Stokes closures is a vital step in building confidence in such predictions. An approach to model-form uncertainty quantification that does not assume the eddy-viscosity hypothesis to be exact is proposed. The methodology for estimation of uncertainty is demonstrated for plane channel flow, for a duct with secondary flows, and for the shock/boundary-layer interaction over a transonic bump.

Shock-isolation material selection for electronic packages in hard-target environment

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

Stotts, Jarrett Eugene

High velocity munitions and kinetic penetrators experience monumental external forces, impulses, and accelerations. The hard target environment is immensely taxing on sophisticated electronic components and recorders designed to retrieve valuable data related to the systems performance and characteristics in the periods of flight, impact, and post-impact. Such electronic systems have upper limits of overall shock intensity which, if exceeded, will either shorten the operating life of the parts or risk destruction resulting in loss of both the data and the principal value of the recorder. The focus of this project was to refine the categorization of leading material types formore » encapsulation and passive shock isolation and implement them in a method useable for a wide variety of environments. Namely, a design methodology capable of being tailored to the specific impact conditions to maximize the lively hood of sensitive electronics and the information recorded. The results of the study concluded that the materials observed under consistent dynamic high strain rate tests, which include Conathane® EN-4/9, Slygard®-184, and Stycast™-2651, behaved well in certain aspects of energy transmission and shock when considering the frequency environment or package coupled with the isolation material’s application. Key points about the implementation of the materials in extreme shock environments is discussed with the connection to energy analysis, loss attributes, and pulse transmissibility modeling. However, attempts to model the materials solely based on energy transmissibility in the frequency domain using only external experimental data and simplified boundary conditions was not found to be consistent with that acquired from the pressure bar experiments. Further work will include the addition of further material experimentation of the encapsulants in other frequency and temperature states, confined and pre-load boundary states, and composite constructions.« less

Numerical Simulations of High-Speed Chemically Reacting Flow

NASA Technical Reports Server (NTRS)

Ton, V. T.; Karagozian, A. R.; Marble, F. E.; Osher, S. J.; Engquist, B. E.

1994-01-01

The essentially nonoscillatory (ENO) shock-capturing scheme for the solution of hyperbolic equations is extended to solve a system of coupled conservation equations governing two-dimensional, time-dependent, compressible chemically reacting flow with full chemistry. The thermodynamic properties of the mixture are modeled accurately, and stiff kinetic terms are separated from the fluid motion by a fractional step algorithm. The methodology is used to study the concept of shock-induced mixing and combustion, a process by which the interaction of a shock wave with a jet of low-density hydrogen fuel enhances mixing through streamwise vorticity generation. Test cases with and without chemical reaction are explored here. Our results indicate that, in the temperature range examined, vorticity generation as well as the distribution of atomic species do not change significantly with the introduction of a chemical reaction and subsequent heat release. The actual diffusion of hydrogen is also relatively unaffected by the reaction process. This suggests that the fluid mechanics of this problem may be successfully decoupled from the combustion processes, and that computation of the mixing problem (without combustion chemistry) can elucidate much of the important physical features of the flow.

Numerical Simulations of High-Speed Chemically Reacting Flow

NASA Technical Reports Server (NTRS)

Ton, V. T.; Karagozin, A. R.; Marble, F. E.; Osher, S. J.; Engquist, B. E.

1994-01-01

The Essentially NonOscillatory (ENO) shock-capturing scheme for the solution of hyperbolic equations is extended to solve a system of coupled conservation equations governing two-dimensional, time-dependent, compressible chemically reacting flow with full chemistry. The thermodynamic properties of the mixture are modeled accurately, and stiff kinetic terms are separated from the fluid motion by a fractional step algorithm. The methodology is used to study the concept of shock-induced mixing and combustion, a process by which the interaction of a shock wave with a jet of low-density hydrogen fuel enhances mixing through streamwise vorticity generation. Test cases with and without chemical reaction are explored here. Our results indicate that, in the temperature range examined, vorticity generation as well as the distribution of atomic species do not change significantly with the introduction of a chemical reaction and subsequent heat release. The actual diffusion of hydrogen is also relatively unaffected by the reaction process. This suggests that the fluid mechanics of this problem may be successfully decoupled from the combustion processes, and that computation of the mixing problem (without combustion chemistry) can elucidate much of the important physical features of the flow.

Validation of Air-Backed Underwater Explosion Experiments with ALE3D

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

Leininger, L D

2005-02-04

This paper summarizes an exercise carried out to validate the process of implementing LLNL's ALE3D to predict the permanent deformation and rupture of an air-backed steel plate subjected to underwater shock. Experiments were performed in a shock tank at the Naval Science and Technology Laboratory in Visakhapatnam India, and the results are documented in reference. A consistent set of air-backed plates is subjected to shocks from increasing weights of explosives ranging from 10g-80g. At 40g and above, rupture is recorded in the experiment and, without fracture mechanics implemented in ALE3D, only the cases of 10g, 20g, and 30g are presentedmore » here. This methodology applies the Jones-Wilkins-Lee (JWL) Equation of State (EOS) to predict the pressure of the expanding detonation products, the Gruneisein EOS for water under highly dynamic compressible flow - both on 1-point integrated 3-d continuum elements. The steel plates apply a bilinear elastic-plastic response with failure and are simulated with 3-point integrated shell elements. The failure for this exercise is based on effective (or equivalent) plastic strain.« less

Macro policy responses to oil booms and busts in the United Arab Emirates

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

Al-Mutawa, A.K.

1991-01-01

The effects of oil shocks and macro policy changes in the United Arab Emirates are analyzed. A theoretical model is developed within the framework of the Dutch Disease literature. It contains four unique features that are applicable to the United Arab Emirates' economy. There are: (1) the presence of a large foreign labor force; (2) OPEC's oil export quotas; (3) the division of oil profits; and (4) the important role of government expenditures. The model is then used to examine the welfare effects of the above-mentioned shocks. An econometric model is then specified that conforms to the analytical model. Inmore » the econometric model the method of principal components' is applied owing to the undersized sample data. The principal components methodology is used in both the identification testing and the estimation of the structural equations. The oil and macro policy shocks are then simulated. The simulation results show that an oil-quantity boom leads to a higher welfare gain than an oil-price boom. Under certain circumstances, this finding is also confirmed by the comparative statistics that follow from the analytical model.« less

Novel methodology to obtain salient biomechanical characteristics of insole materials.

PubMed

Lavery, L A; Vela, S A; Ashry, H R; Lanctot, D R; Athanasiou, K A

1997-06-01

Viscoelastic inserts are commonly used as artificial shock absorbers to prevent neuropathic foot ulcerations by decreasing pressure on the sole of the foot. Unfortunately, there is little scientific information available to guide physicians in the selection of appropriate insole materials. Therefore, a novel methodology was developed to form a rational platform for biomechanical characterizations of insole material durability, which consisted of in vivo gait analysis and in vitro bioengineering measurements. Results show significant differences in the compressive stiffness of the tested insoles and the rate of change over time in both compressive stiffness and peak pressures measured. Good correlations were found between pressure-time integral and Young's modulus (r2 = 0.93), and total energy applied and Young's modulus (r2 = 0.87).

Analysis of a Shock-Associated Noise Prediction Model Using Measured Jet Far-Field Noise Data

NASA Technical Reports Server (NTRS)

Dahl, Milo D.; Sharpe, Jacob A.

2014-01-01

A code for predicting supersonic jet broadband shock-associated noise was assessed using a database containing noise measurements of a jet issuing from a convergent nozzle. The jet was operated at 24 conditions covering six fully expanded Mach numbers with four total temperature ratios. To enable comparisons of the predicted shock-associated noise component spectra with data, the measured total jet noise spectra were separated into mixing noise and shock-associated noise component spectra. Comparisons between predicted and measured shock-associated noise component spectra were used to identify deficiencies in the prediction model. Proposed revisions to the model, based on a study of the overall sound pressure levels for the shock-associated noise component of the measured data, a sensitivity analysis of the model parameters with emphasis on the definition of the convection velocity parameter, and a least-squares fit of the predicted to the measured shock-associated noise component spectra, resulted in a new definition for the source strength spectrum in the model. An error analysis showed that the average error in the predicted spectra was reduced by as much as 3.5 dB for the revised model relative to the average error for the original model.

Less or more hemodynamic monitoring in critically ill patients.

PubMed

Jozwiak, Mathieu; Monnet, Xavier; Teboul, Jean-Louis

2018-06-07

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

Analysis of transthoracic impedance during real cardiac arrest defibrillation attempts in older children and adolescents: are stacked-shocks appropriate?

PubMed

Niles, Dana E; Nishisaki, Akira; Sutton, Robert M; Brunner, Sara; Stavland, Mette; Mahadevaiah, Shruthi; Meaney, Peter A; Maltese, Matthew R; Berg, Robert A; Nadkarni, Vinay M

2010-11-01

In 2005, the AHA changed the treatment recommendation for shockable rhythms from 3 transthoracic stacked-shocks to a single shock followed by immediate chest compressions. The stacked-shock recommendation was based on low first-shock efficacy of monophasic waveforms and the theoretical decrease in transthoracic impedance (TTI) following each shock. The objective of this study was to characterize TTI following biphasic defibrillation attempts in children ≥ 8 yrs during cardiac arrest to assess whether a stacked-shock approach may be appropriate to improve defibrillation success. TTI (Ohms (Ω)) was collected via standard anterior-apical defibrillator electrode pads during consecutive in-hospital cardiac arrest biphasic defibrillation attempts in children ≥ 8 yrs. Analytic data points for TTI were: 0.1s pre-shock (baseline); post-shock at 0.1, 0.5, 1.0, 1.5, and 2.0 s. TTI variables analyzed with descriptive summaries/paired t-test. p values < 0.05 considered statistically significant after correction for multiple comparisons. Analysis yielded 13 evaluable shock events during 5 cardiac arrests (mean age 14.3 ± 5 yrs, weight 47.4 ± 7.3 kg) between September 2006 and May 2009. Compared to 0.1s pre-shock baseline values (56.8 ± 23.4 Ω), TTI was significantly lower immediately 0.1s post-shock (55.2 ± 22.2 Ω, p = 0.003). Post-shock mean difference from baseline was 1.6 Ω at 0.1s (p = 0.015), 1.4 Ω at 0.5s (p = 0.019) 1.4 Ω at 1.0 s (p = 0.023), 1.1 Ω at 1.5 s (p = 0.028), and 0.95 Ω at 2.0 s (p = 0.096). Time to recharge our clinical defibrillators to standard biphasic shock dose was 2.80 ± 0.05 s. During cardiac arrests in children ≥ 8 yrs, TTI decreased after biphasic shocks, but the limited magnitude and duration of TTI changes suggest that stacked-shocks would not improve defibrillation success. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Computational Modeling of Meteor-Generated Ground Pressure Signatures

NASA Technical Reports Server (NTRS)

Nemec, Marian; Aftosmis, Michael J.; Brown, Peter G.

2017-01-01

We present a thorough validation of a computational approach to predict infrasonic signatures of centimeter-sized meteoroids. We assume that the energy deposition along the meteor trail is dominated by atmospheric drag and simulate the steady, inviscid flow of air in thermochemical equilibrium to compute the meteoroid's near-body pressure signature. This signature is then propagated through a stratified and windy atmosphere to the ground using a methodology adapted from aircraft sonic-boom analysis. An assessment of the numerical accuracy of the near field and the far field solver is presented. The results show that when the source of the signature is the cylindrical Mach-cone, the simulations closely match the observations. The prediction of the shock rise-time, the zero-peak amplitude of the waveform, and the duration of the positive pressure phase are consistently within 10% of the measurements. Uncertainty in the shape of the meteoroid results in a poorer prediction of the trailing part of the waveform. Overall, our results independently verify energy deposition estimates deduced from optical observations.

Resveratrol Rescues Kidney Mitochondrial Function Following Hemorrhagic Shock

PubMed Central

Wang, Hao; Guan, Yuxia; Karamercan, Mehmet Akif; Ye, Lan; Bhatti, Tricia; Becker, Lance B.; Baur, Joseph A.; Sims, Carrie A.

2015-01-01

Objective Hemorrhagic shock may contribute to acute kidney injury by profoundly altering renal mitochondrial function. Resveratrol (RSV), a naturally occurring sirtuin-1 (SIRT1) activator, has been shown to promote mitochondrial function and reduce oxidative damage in a variety of aging-related disease states. We hypothesized that RSV treatment during resuscitation would ameliorate kidney mitochondrial dysfunction and decrease oxidative damage following hemorrhagic shock. Method Using a decompensated hemorrhagic shock model, male Long-Evans rats (n=6 per group) were sacrificed prior to hemorrhage (Sham), at severe shock, and following either lactated Ringer’s (LR) Resuscitation or LR+RSV Resuscitation (RSV: 30mg/kg). At each time point, blood samples were assayed for arterial blood gases, lactate, blood urea nitrogen (BUN) and serum creatinine. Mitochondria were also isolated from kidney samples in order to assess individual electron transport complexes (CI, CII, and CIV) using high-resolution respirometry. Total mitochondria reactive oxygen species (ROS) were measured using fluorometry and lipid peroxidation was assessed by measuring 4-hydroxynonenal by Western blot. qPCR was used quantify mRNA from PGC1-α, SIRT1, and proteins known to mitigate oxidative damage and promote mitochondrial biogenesis. Results RSV supplementation during resuscitation restored mitochondrial respiratory capacity, decreased mitochondrial ROS and lipid peroxidation. Compared to standard LR resuscitation, RSV treatment significantly increased SIRT1 and PGC1-α expression and significantly increased both SOD2 and catalase expression. Although RSV was associated with decreased lactate production, pH, BUN and serum creatinine values did not differ between resuscitation strategies. Conclusions Resuscitation with RSV significantly restored renal mitochondrial function and decreased oxidative damage following hemorrhagic shock. PMID:25895148

Electric shocks at work in Europe: development of a job exposure matrix.

PubMed

Huss, Anke; Vermeulen, Roel; Bowman, Joseph D; Kheifets, Leeka; Kromhout, Hans

2013-04-01

Electric shocks have been suggested as a potential risk factor for neurological disease, in particular for amyotrophic lateral sclerosis. While actual exposure to shocks is difficult to measure, occurrence and variation of electric injuries could serve as an exposure proxy. We assessed risk of electric injury, using occupational accident registries across Europe to develop an electric shock job-exposure-matrix (JEM). Injury data were obtained from five European countries, and the number of workers per occupation and country from EUROSTAT was compiled at a 3-digit International Standard Classification of Occupations 1988 level. We pooled accident rates across countries with a random effects model and categorised jobs into low, medium and high risk based on the 75th and 90th percentile. We next compared our JEM to a JEM that classified extremely low frequency magnetic field exposure of jobs into low, medium and high. Of 116 job codes, occupations with high potential for electric injury exposure were electrical and electronic equipment mechanics and fitters, building frame workers and finishers, machinery mechanics and fitters, metal moulders and welders, assemblers, mining and construction labourers, metal-products machine operators, ships' decks crews and power production and related plant operators. Agreement between the electrical injury and magnetic field JEM was 67.2%. Our JEM classifies occupational titles according to risk of electric injury as a proxy for occurrence of electric shocks. In addition to assessing risk potentially arising from electric shocks, this JEM might contribute to disentangling risks from electric injury from those of extremely low frequency magnetic field exposure.

Preoperative prognostic factors for mortality in peptic ulcer perforation: a systematic review.

PubMed

Møller, Morten Hylander; Adamsen, Sven; Thomsen, Reimar Wernich; Møller, Ann Merete

2010-08-01

Mortality and morbidity following perforated peptic ulcer (PPU) is substantial and probably related to the development of sepsis. During the last three decades a large number of preoperative prognostic factors in patients with PPU have been examined. The aim of this systematic review was to summarize available evidence on these prognostic factors. MEDLINE (January 1966 to June 2009), EMBASE (January 1980 to June 2009), and the Cochrane Library (Issue 3, 2009) were screened for studies reporting preoperative prognostic factors for mortality in patients with PPU. The methodological quality of the included studies was assessed. Summary relative risks with 95% confidence intervals for the identified prognostic factors were calculated and presented as Forest plots. Fifty prognostic studies with 37 prognostic factors comprising a total of 29,782 patients were included in the review. The overall methodological quality was acceptable, yet only two-thirds of the studies provided confounder adjusted estimates. The studies provided strong evidence for an association of older age, comorbidity, and use of NSAIDs or steroids with mortality. Shock upon admission, preoperative metabolic acidosis, tachycardia, acute renal failure, low serum albumin level, high American Society of Anaesthesiologists score, and preoperative delay >24 h were associated with poor prognosis. In patients with PPU, a number of negative prognostic factors can be identified prior to surgery, and many of these seem to be related to presence of the sepsis syndrome.

Ameliorating Impact of Prophylactic Intranasal Oxytocin on Signs of Fear in a Rat Model of Traumatic Stress

PubMed Central

Renicker, Micah D.; Cysewski, Nicholas; Palmer, Samuel; Nakonechnyy, Dmytro; Keef, Andrew; Thomas, Morgan; Magori, Krisztian; Daberkow, David P.

2018-01-01

Oxytocin treatment reduces signs of long-term emotional stress after exposure to trauma; however, little is known about the potential protective effects of oxytocin treatment on behavioral and physiological changes associated with extreme stress exposure. The objective of this study was to investigate oxytocin treatment as a prophylactic measure against rat signs of fear. Two separate experiments were conducted in which the time of intranasal oxytocin administration differed. Intranasal oxytocin (1.0 μg/kg) was administered 5 min after daily exposure to foot shock in Experiment #1 and 1 h before foot shock in Experiment #2. In Experiment #1, possible massage-evoked oxytocin release (5 min after foot shock) was also investigated. In both experiments, a contextual fear conditioning procedure was employed in which stress was induced via inescapable foot shock (3 days, 40 shocks/day, 8 mA/shock) in a fear conditioning chamber. Male Sprague-Dawley rats (n = 24) were divided into four groups (n = 6, per group) for each experiment. Experiment #1 groups: Control Exp#1 (intranasal saline and no foot shock); Stress Exp#1 (intranasal saline 5 min after foot shock); Massage+Stress Exp#1 (massage-like stroking and intranasal saline 5 min after foot shock); Oxytocin+Stress Exp#1 (intranasal oxytocin 5 min after foot shock). Experiment #2 groups: Control Exp#2 (intranasal saline and no foot shock); Stress Exp#2 (intranasal saline 1 h before foot shock); Oxytocin Exp#2 (intranasal oxytocin and no foot shock); Oxytocin+Stress Exp#2 (intranasal oxytocin 1 h before foot shock). One week after fear conditioning (and other treatments), rats were independently evaluated for behavioral signs of fear. Two weeks after conditioning, physiological signs of fear were also assessed (Experiment #1). Relative to controls, rats treated with intranasal oxytocin 5 min after daily foot shock sessions exhibited significantly less immobility upon re-exposure to the shock chamber and attenuated physiological responses related to fear (e.g., elevated heart rate and blood pressure). Furthermore, intranasal oxytocin treatment given 1 h before daily foot shock sessions significantly decreased immobility and defecation upon re-exposure to the shock chamber, relative to controls. The results of this study suggest that prophylactic intranasal oxytocin, administered contemporaneously with aversive stimuli, mitigates behavioral and physiological responses associated with traumatic stress. PMID:29892216

Social Skills Difficulty: Model of Culture Shock for International Graduate Students

ERIC Educational Resources Information Center

Chapdelaine, Raquel Faria; Alexitch, Louise R.

2004-01-01

This study expanded and tested Furnham and Bochner's (1982) model of culture shock, employing a sample of 156 male international students in a Canadian university. Path analysis was used to assess the effects of cultural differences, size of co-national group, family status, cross-cultural experience, and social interaction with hosts on culture…

Safety of transvenous low energy cardioversion of atrial fibrillation in patients with a history of ventricular tachycardia: effects of rate and repolarization time on proarrhythmic risk.

PubMed

Simons, G R; Newby, K H; Kearney, M M; Brandon, M J; Natale, A

1998-02-01

The objective of this study was to assess the safety and efficacy of transvenous low energy cardioversion of atrial fibrillation in patients with ventricular tachycardia and atrial fibrillation and to study the mechanisms of proarrhythmia. Previous studies have demonstrated that cardioversion of atrial fibrillation using low energy, R wave synchronized, direct current shocks applied between catheters in the coronary sinus and right atrium is feasible. However, few data are available regarding the risk of ventricular proarrhythmia posed by internal atrial defibrillation shocks among patients with ventricular arrhythmias or structural heart disease. Atrial defibrillation was performed on 32 patients with monomorphic ventricular tachycardia and left ventricular dysfunction. Shocks were administered during atrial fibrillation (baseline shocks), isoproterenol infusion, ventricular pacing, ventricular tachycardia, and atrial pacing. Baseline shocks were also administered to 29 patients with a history of atrial fibrillation but no ventricular arrhythmias. A total of 932 baseline shocks were administered. No ventricular proarrhythmia was observed after well-synchronized baseline shocks, although rare inductions of ventricular fibrillation occurred after inappropriate T wave sensing. Shocks administered during wide-complex rhythms (ventricular pacing or ventricular tachycardia) frequently induced ventricular arrhythmias, but shocks administered during atrial pacing at identical ventricular rates did not cause proarrhythmia. The risk of ventricular proarrhythmia after well-synchronized atrial defibrillation shocks administered during narrow-complex rhythms is low, even in patients with a history of ventricular tachycardia. The mechanism of proarrhythmia during wide-complex rhythms appears not to be related to ventricular rate per se, but rather to the temporal relationship between shock delivery and the repolarization time of the previous QRS complex.

The Effects of Calcitonin on the Development of and Ca2+ Levels in Heat-shocked Bovine Preimplantation Embryos In Vitro

PubMed Central

KAMANO, Shumpei; IKEDA, Shuntaro; SUGIMOTO, Miki; KUME, Shinichi

2014-01-01

Intracellular calcium homeostasis is essential for proper cell function. We investigated the effects of heat shock on the development of and the intracellular Ca2+ levels in bovine preimplantation embryos in vitro and the effects of calcitonin (CT), a receptor-mediated Ca2+ regulator, on heat shock-induced events. Heat shock (40.5 C for 10 h between 20 and 30 h postinsemination) of in vitro-produced bovine embryos did not affect the cleavage rate; however, it significantly decreased the rates of development to the 5- to 8-cell and blastocyst stages as compared with those of the control cultured for the entire period at 38.5 C (P < 0.05). The relative intracellular Ca2+ levels at the 1-cell stage (5 h after the start of heat shock), as assessed by Fluo-8 AM, a fluorescent probe for Ca2+, indicated that heat shock significantly lowered the Ca2+ level as compared with the control level. Semiquantitative reverse transcription PCR and western blot analyses revealed the expression of CT receptor in bovine preimplantation embryos. The addition of CT (10 nM) to the culture medium ameliorated the heat shock-induced impairment of embryonic development beyond the 5- to 8-cell stage. The Ca2+ level in the heat-shocked embryos cultured with CT was similar to that of the control embryos, suggesting that heat shock lowers the Ca2+ level in fertilized embryos in vitro and that a lower Ca2+ level is implicated in heat shock-induced impairment of embryonic development. Intracellular Ca2+-mobilizing agents, e.g., CT, may effectively circumvent the detrimental effects of heat shock on early embryonic development. PMID:24899099

A review of recent developments in the understanding of transonic shock buffet

NASA Astrophysics Data System (ADS)

Giannelis, Nicholas F.; Vio, Gareth A.; Levinski, Oleg

2017-07-01

Within a narrow band of flight conditions in the transonic regime, interactions between shock-waves and intermittently separated shear layers result in large amplitude, self-sustained shock oscillations. This phenomenon, known as transonic shock buffet, limits the flight envelope and is detrimental to both platform handling quality and structural integrity. The severity of this instability has incited a plethora of research to ascertain an underlying physical mechanism, and yet, with over six decades of investigation, aspects of this complex phenomenon remain inexplicable. To promote continual progress in the understanding of transonic shock buffet, this review presents a consolidation of recent investigations in the field. The paper begins with a conspectus of the seminal literature on shock-induced separation and modes of shock oscillation. The currently prevailing theories for the governing physics of transonic shock buffet are then detailed. This is followed by an overview of computational studies exploring the phenomenon, where the results of simulation are shown to be highly sensitive to the specific numerical methods employed. Wind tunnel investigations on two-dimensional aerofoils at shock buffet conditions are then outlined and the importance of these experiments for the development of physical models stressed. Research considering dynamic structural interactions in the presence of shock buffet is also highlighted, with a particular emphasis on the emergence of a frequency synchronisation phenomenon. An overview of three-dimensional buffet is provided next, where investigations suggest the governing mechanism may differ significantly from that of two-dimensional sections. Subsequently, a number of buffet suppression technologies are described and their efficacy in mitigating shock oscillations is assessed. To conclude, recommendations for the direction of future research efforts are given.

The efficacy, safety, effectiveness, and cost-effectiveness of ultrasound and shock wave therapies for low back pain: a systematic review.

PubMed

Seco, Jesús; Kovacs, Francisco M; Urrutia, Gerard

2011-10-01

Shock wave and especially ultrasound are commonly used to treat low back pain (LBP) in routine practice. To assess the evidence on the efficacy, effectiveness, cost-effectiveness, and safety of ultrasound and shock wave to treat LBP. Systematic review. An electronic search was performed in MEDLINE, EMBASE, and the Cochrane Library databases up to July 2009 to identify randomized controlled trials (RCTs) comparing vibrotherapy with placebo or with other treatments for LBP. No language restrictions were applied. Additional data were requested from the authors of the original studies. The risk of bias of each study was assessed following the criteria recommended by the Cochrane Back Review Group. Thirteen studies were identified. The four RCTs complying with the inclusion criteria included 252 patients. Two of the three RCTs on ultrasound had a high risk of bias. For acute patients with LBP and leg pain attributed to disc herniation, ultrasound, traction, and low-power laser obtained similar results. For chronic LBP patients without leg pain, ultrasound was less effective than spinal manipulation, whereas a shock wave device and transcutaneous electrical nerve stimulation led to similar results. Results from the only study comparing ultrasound versus a sham procedure are unreliable because of the inappropriateness of the sham procedure, low sample size, and lack of adjustment for potential confounders. No study assessed cost-effectiveness. No adverse events were reported. The available evidence does not support the effectiveness of ultrasound or shock wave for treating LBP. High-quality RCTs are needed to assess their efficacy versus appropriate sham procedures, and their effectiveness and cost-effectiveness versus other procedures shown to be effective for LBP. In the absence of such evidence, the clinical use of these forms of treatment is not justified and should be discouraged. Copyright © 2011 Elsevier Inc. All rights reserved.

Thin metal thermistors for shock temperature measurements of polymers

NASA Astrophysics Data System (ADS)

Taylor, N. E.; Williamson, D. M.; Picard, A.; Cunningham, L. K.; Jardine, A. P.

2015-06-01

Equations of state can be used to predict the relationship between pressure, volume and temperature. However, in shock physics, they are usually only constrained by experimental observations of pressure and volume. Direct observation of temperature in a shock is therefore valuable in constraining equations of state. Bloomquist and Sheffield (1980, 1981) and Rosenberg and Partom (1984) have attempted such observations in poly(methyl methacrylate) (PMMA). However, their results disagree strongly above 2 GPa shock pressure. The present authors previously presented an improved fabrication technique, to examine this outstanding issue. This technique made use of the fact that the electrical resistivity of most metals is a known function of both pressure and temperature. By fabricating a thin metal thermistor gauge and measuring its change in resistance during a shock experiment of known pressure, its temperature can be recovered. Heat transfer into the gauge depends strongly on the gauge dimensions and the thermal conductivity of the shocked PMMA. Here we present several improvements to the technique. By varying the gauge thickness over the range 100 nm to 10 μ m we assess the heat transfer into the gauge.

Experimental study of moving throat plug in a shock tunnel

NASA Astrophysics Data System (ADS)

Lee, J. K.; Park, C.; Kwon, O. J.

2015-07-01

An experimental study has been carried out to investigate the flow in the KAIST shock tunnel with two moving throat plugs at a primary shock velocity of 1.19 km/s. The nozzle reservoir pressure and the Pitot pressure at the exit of the nozzle were measured to examine the influence of the moving throat plugs on the shock tunnel flow. To assess the present experimental results, comparisons with previous work using a stationary throat plug were made. The mechanism for closing the moving throat plug was developed and verified. The source of the force to move the plug was the pressure generated when the primary shock was reflected at the bottom of the plug. It was observed that the two plugs terminated the shock tunnel flow after the steady flow. .The time for the plugs to terminate the flow showed good agreement with the calculation of the proposed simple analytic solution. There was a negligible difference in flow values such as the reflected pressure and the Pitot pressure between the moving and the stationary plugs.

Improvement of lipid yield from microalgae Spirulina platensis using ultrasound assisted osmotic shock extraction method

NASA Astrophysics Data System (ADS)

Adetya, NP; Hadiyanto, H.

2018-01-01

Microalgae Spirulina sp. has been identified as potential source of natural food supplement and food colorant. The high water content of microalgae (70-90%) causes an obstacle in biomass dehydration which requires large amounts of energy, eventually damaging the lipid in the microalgae. Therefore, the lipid must be extracted by using a suitable method which complies to wet biomass conditions. One of the methods is applying osmotic shock. This study was aimed to investigate the influence of osmotic agent (NaCl) concentration (10-30%) and extraction time (20-50 min) on yield of lipid and also to determine the optimal conditions in the extraction process through response surface methodology. The extraction was conducted at a temperature of 40°C under ultrasound frequency of 40 kHz. The result showed that the optimum yield lipid obtained was 6.39% in 16.98% NaCl concentration for 36 minutes 10 seconds.

Sharp Refractory Composite Leading Edges on Hypersonic Vehicles

NASA Technical Reports Server (NTRS)

Walker, Sandra P.; Sullivan, Brian J.

2003-01-01

On-going research of advanced sharp refractory composite leading edges for use on hypersonic air-breathing vehicles is presented in this paper. Intense magnitudes of heating and of heating gradients on the leading edge lead to thermal stresses that challenge the survivability of current material systems. A fundamental understanding of the problem is needed to further design development. Methodology for furthering the technology along with the use of advanced fiber architectures to improve the thermal-structural response is explored in the current work. Thermal and structural finite element analyses are conducted for several advanced fiber architectures of interest. A tailored thermal shock parameter for sharp orthotropic leading edges is identified for evaluating composite material systems. The use of the tailored thermal shock parameter has the potential to eliminate the need for detailed thermal-structural finite element analyses for initial screening of material systems being considered for a leading edge component.

Artificial fluid properties for large-eddy simulation of compressible turbulent mixing

NASA Astrophysics Data System (ADS)

Cook, Andrew W.

2007-05-01

An alternative methodology is described for large-eddy simulation (LES) of flows involving shocks, turbulence, and mixing. In lieu of filtering the governing equations, it is postulated that the large-scale behavior of a LES fluid, i.e., a fluid with artificial properties, will be similar to that of a real fluid, provided the artificial properties obey certain constraints. The artificial properties consist of modifications to the shear viscosity, bulk viscosity, thermal conductivity, and species diffusivity of a fluid. The modified transport coefficients are designed to damp out high wavenumber modes, close to the resolution limit, without corrupting lower modes. Requisite behavior of the artificial properties is discussed and results are shown for a variety of test problems, each designed to exercise different aspects of the models. When combined with a tenth-order compact scheme, the overall method exhibits excellent resolution characteristics for turbulent mixing, while capturing shocks and material interfaces in a crisp fashion.

The development of flux-split algorithms for flows with non-equilibrium thermodynamics and chemical reactions

NASA Technical Reports Server (NTRS)

Grossman, B.; Cinella, P.

1988-01-01

A finite-volume method for the numerical computation of flows with nonequilibrium thermodynamics and chemistry is presented. A thermodynamic model is described which simplifies the coupling between the chemistry and thermodynamics and also results in the retention of the homogeneity property of the Euler equations (including all the species continuity and vibrational energy conservation equations). Flux-splitting procedures are developed for the fully coupled equations involving fluid dynamics, chemical production and thermodynamic relaxation processes. New forms of flux-vector split and flux-difference split algorithms are embodied in a fully coupled, implicit, large-block structure, including all the species conservation and energy production equations. Several numerical examples are presented, including high-temperature shock tube and nozzle flows. The methodology is compared to other existing techniques, including spectral and central-differenced procedures, and favorable comparisons are shown regarding accuracy, shock-capturing and convergence rates.

Prediction of unsuppressed jet engine exhaust noise in flight from static data

NASA Technical Reports Server (NTRS)

Stone, J. R.

1980-01-01

A methodology developed for predicting in-flight exhaust noise from static data is presented and compared with experimental data for several unsuppressed turbojet engines. For each engine, static data over a range of jet velocities are compared with the predicted jet mixing noise and shock-cell noise. The static engine noise over and above the jet and shock noises is identified as excess noise. The excess noise data are then empirically correlated to smooth the spectral and directivity relations and account for variations in test conditions. This excess noise is then projected to flight based on the assumption that the only effects of flight are a Doppler frequency shift and a level change given by 40 log (1 - m sub 0 cos theta), where M sub 0 is the flight Mach number and theta is the observer angle relative to the jet axis.

Neurobiology of secure infant attachment and attachment despite adversity: a mouse model.

PubMed

Roth, T L; Raineki, C; Salstein, L; Perry, R; Sullivan-Wilson, T A; Sloan, A; Lalji, B; Hammock, E; Wilson, D A; Levitt, P; Okutani, F; Kaba, H; Sullivan, R M

2013-10-01

Attachment to an abusive caregiver has wide phylogenetic representation, suggesting that animal models are useful in understanding the neural basis underlying this phenomenon and subsequent behavioral outcomes. We previously developed a rat model, in which we use classical conditioning to parallel learning processes evoked during secure attachment (odor-stroke, with stroke mimicking tactile stimulation from the caregiver) or attachment despite adversity (odor-shock, with shock mimicking maltreatment). Here we extend this model to mice. We conditioned infant mice (postnatal day (PN) 7-9 or 13-14) with presentations of peppermint odor and either stroking or shock. We used (14) C 2-deoxyglucose (2-DG) to assess olfactory bulb and amygdala metabolic changes following learning. PN7-9 mice learned to prefer an odor following either odor-stroke or shock conditioning, whereas odor-shock conditioning at PN13-14 resulted in aversion/fear learning. 2-DG data indicated enhanced bulbar activity in PN7-9 preference learning, whereas significant amygdala activity was present following aversion learning at PN13-14. Overall, the mouse results parallel behavioral and neural results in the rat model of attachment, and provide the foundation for the use of transgenic and knockout models to assess the impact of both genetic (biological vulnerabilities) and environmental factors (abusive) on attachment-related behaviors and behavioral development. © 2013 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

Investigating the role of nisoldipine in foot-shock-induced post-traumatic stress disorder in mice.

PubMed

Verma, Meenu; Bali, Anjana; Singh, Nirmal; Jaggi, Amteshwar S

2016-04-01

This study was designed to investigate the effectiveness of nisoldipine, an L-type voltage-sensitive calcium channel blocker, to ameliorate anxiety and fear response in a mouse model of post-traumatic stress disorder (PTSD). Acute trauma was induced in Swiss albino mice in a 2-day electric foot-shock paradigm consisting of 15 intermittent foot-shocks of 0.8 mA intensity, 10-s duration and 10-s intershock interval, during 5 min, followed by 3 weekly situational reminders, that is, once per week in the same context on three successive weeks. PTSD-induced behavioral changes were assessed using actophotometer, open-field, social interaction test, and freezing behavior. Biochemically, the serum corticosterone levels were estimated. Electric foot-shock and situational reminders produced behavioral alterations and decreased corticosterone levels, assessed on the 21st day following the traumatic event. Administration of sertraline (Ser 15 mg/kg), a selective serotonin reuptake inhibitor (SSRI) and nisoldipine (20 and 40 mg/kg), significantly attenuated the foot-shock-trauma-induced behavioral changes along with normalization of the corticosterone levels. It may be concluded that nisoldipine produces beneficial effects in re-establishing behavioral alterations, which may be due to normalization of reduced corticosterone levels in PTSD in mice. © 2015 Société Française de Pharmacologie et de Thérapeutique.

Statistical analysis of earthquakes after the 1999 MW 7.7 Chi-Chi, Taiwan, earthquake based on a modified Reasenberg-Jones model

NASA Astrophysics Data System (ADS)

Chen, Yuh-Ing; Huang, Chi-Shen; Liu, Jann-Yenq

2015-12-01

We investigated the temporal-spatial hazard of the earthquakes after the 1999 September 21 MW = 7.7 Chi-Chi shock in a continental region of Taiwan. The Reasenberg-Jones (RJ) model (Reasenberg and Jones, 1989, 1994) that combines the frequency-magnitude distribution (Gutenberg and Richter, 1944) and time-decaying occurrence rate (Utsu et al., 1995) is conventionally employed for assessing the earthquake hazard after a large shock. However, it is found that the b values in the frequency-magnitude distribution of the earthquakes in the study region dramatically decreased from background values after the Chi-Chi shock, and then gradually increased up. The observation of a time-dependent frequency-magnitude distribution motivated us to propose a modified RJ model (MRJ) to assess the earthquake hazard. To see how the models perform on assessing short-term earthquake hazard, the RJ and MRJ models were separately used to sequentially forecast earthquakes in the study region. To depict the potential rupture area for future earthquakes, we further constructed relative hazard (RH) maps based on the two models. The Receiver Operating Characteristics (ROC) curves (Swets, 1988) finally demonstrated that the RH map based on the MRJ model was, in general, superior to the one based on the original RJ model for exploring the spatial hazard of earthquakes in a short time after the Chi-Chi shock.

Shock reliability analysis and improvement of MEMS electret-based vibration energy harvesters

NASA Astrophysics Data System (ADS)

Renaud, M.; Fujita, T.; Goedbloed, M.; de Nooijer, C.; van Schaijk, R.

2015-10-01

Vibration energy harvesters can serve as a replacement solution to batteries for powering tire pressure monitoring systems (TPMS). Autonomous wireless TPMS powered by microelectromechanical system (MEMS) electret-based vibration energy harvester have been demonstrated. The mechanical reliability of the MEMS harvester still has to be assessed in order to bring the harvester to the requirements of the consumer market. It should survive the mechanical shocks occurring in the tire environment. A testing procedure to quantify the shock resilience of harvesters is described in this article. Our first generation of harvesters has a shock resilience of 400 g, which is far from being sufficient for the targeted application. In order to improve this aspect, the first important aspect is to understand the failure mechanism. Failure is found to occur in the form of fracture of the device’s springs. It results from impacts between the anchors of the springs when the harvester undergoes a shock. The shock resilience of the harvesters can be improved by redirecting these impacts to nonvital parts of the device. With this philosophy in mind, we design three types of shock absorbing structures and test their effect on the shock resilience of our MEMS harvesters. The solution leading to the best results consists of rigid silicon stoppers covered by a layer of Parylene. The shock resilience of the harvesters is brought above 2500 g. Results in the same range are also obtained with flexible silicon bumpers, which are simpler to manufacture.

A cross-country analysis of climate shocks and smallholder food insecurity.

PubMed

Niles, Meredith T; Salerno, Jonathan D

2018-01-01

Future climate changes will affect smallholder farmers in the developing world, posing threats to household food security. Nevertheless, there remains limited comparable evidence across multiple countries and regions regarding the global extent of climate shocks affecting smallholder food security. We examine data from 5,299 household surveys across 15 countries in Latin America, Africa and South Asia to assess the extent of climate shocks and their association with food insecurity, as well as what strategies may help buffer against climate shocks. We find that 71% of households reported experiencing a climate shock in the previous five years. Fifty-four percent reported experiencing food insecurity during one or more months annually. A multilevel statistical model estimated factors correlated with food insecurity as well as factors correlated with food insecurity among households that had experienced a climate shock. Households that reported experiencing a climate shock were 1.73 times more likely to be food insecure. As well, larger and poorer households were associated with higher odds of food insecurity while using pesticides, keeping large livestock, and being more educated are associated with lower odds of food insecurity. Among households that had experienced a climate shock, additional factors are correlated with lower odds of food insecurity when compared to otherwise similar households: use of fertilizers, pesticides, veterinary medicines, large livestock, and household assets. Together, these results demonstrate the extent of existing climate shocks affecting smallholder farmers and how interventions may potentially support adaptation and reduce food insecurity.

A cross-country analysis of climate shocks and smallholder food insecurity

PubMed Central

Salerno, Jonathan D.

2018-01-01

Future climate changes will affect smallholder farmers in the developing world, posing threats to household food security. Nevertheless, there remains limited comparable evidence across multiple countries and regions regarding the global extent of climate shocks affecting smallholder food security. We examine data from 5,299 household surveys across 15 countries in Latin America, Africa and South Asia to assess the extent of climate shocks and their association with food insecurity, as well as what strategies may help buffer against climate shocks. We find that 71% of households reported experiencing a climate shock in the previous five years. Fifty-four percent reported experiencing food insecurity during one or more months annually. A multilevel statistical model estimated factors correlated with food insecurity as well as factors correlated with food insecurity among households that had experienced a climate shock. Households that reported experiencing a climate shock were 1.73 times more likely to be food insecure. As well, larger and poorer households were associated with higher odds of food insecurity while using pesticides, keeping large livestock, and being more educated are associated with lower odds of food insecurity. Among households that had experienced a climate shock, additional factors are correlated with lower odds of food insecurity when compared to otherwise similar households: use of fertilizers, pesticides, veterinary medicines, large livestock, and household assets. Together, these results demonstrate the extent of existing climate shocks affecting smallholder farmers and how interventions may potentially support adaptation and reduce food insecurity. PMID:29474383

Inhibition of glycogen synthase kinase (GSK)-3-β improves liver microcirculation and hepatocellular function after hemorrhagic shock.

PubMed

Jellestad, Lena; Fink, Tobias; Pradarutti, Sascha; Kubulus, Darius; Wolf, Beate; Bauer, Inge; Thiemermann, Chris; Rensing, Hauke

2014-02-05

Ischemia and reperfusion may cause liver injury and are characterized by hepatic microperfusion failure and a decreased hepatocellular function. Inhibition of glycogen synthase kinase (GSK)-3β, a serine-threonine kinase that has recently emerged as a key regulator in the modulation of the inflammatory response after stress events, may be protective in conditions like sepsis, inflammation and shock. Therefore, aim of the study was to assess the role of GSK-3β in liver microcirculation and hepatocellular function after hemorrhagic shock and resuscitation (H/R). Anesthetized male Sprague-Dawley rats underwent pretreatment with Ringer´s solution, vehicle (DMSO) or TDZD-8 (1 mg/kg), a selective GSK-3β inhibitor, 30 min before induction of hemorrhagic shock (mean arterial pressure 35±5 mmHg for 90 min) and were resuscitated with shed blood and Ringer´s solution (2h). 5h after resuscitation hepatic microcirculation was assessed by intravital microscopy. Propidium iodide (PI) positive cells, liver enzymes and alpha-GST were measured as indicators of hepatic injury. Liver function was estimated by assessment of indocyanine green plasma disappearance rate. H/R led to a significant decrease in sinusoidal diameters and impairment of liver function compared to sham operation. Furthermore, the number of PI positive cells in the liver as well as serum activities of liver enzymes and alpha-GST increased significantly after H/R. Pretreatment with TDZD-8 prevented the changes in liver microcirculation, hepatocellular injury and liver function after H/R. A significant rise in the plasma level of IL-10 was observed. Thus, inhibition of GSK-3β before hemorrhagic shock modulates the inflammatory response and improves hepatic microcirculation and hepatocellular function. Copyright © 2013 Elsevier B.V. All rights reserved.

Pivotal role of glutathione depletion in plasma-induced endothelial oxidative stress during sepsis.

PubMed

Huet, Olivier; Cherreau, Christaine; Nicco, Carole; Dupic, Laurent; Conti, Marc; Borderie, Didier; Pene, Frédéric; Vicaut, Eric; Benhamou, Dan; Mira, Jean-Paul; Duranteau, Jacques; Batteux, Frédéric

2008-08-01

Plasma from septic shock patients can induce production of reactive oxygen species (ROS) by human umbilical vein endothelial cells (HUVEC) in vitro. How endothelial cells defend themselves against ROS under increased oxidative stress has not yet been examined. This study investigates the antioxidant defenses of HUVEC exposed to plasma obtained from either septic shock patients or healthy volunteers. Prospective, observational study. Medical intensive care unit in a university hospital. Twenty-five patients with septic shock and 10 healthy volunteers. Blood samples were collected within the first 24 hrs of septic shock. In vitro HUVEC production of ROS was studied by spectrofluorimetry using 2',7'-dichlorodihydrofluorescein diacetate fluorescent dye. Reactive nitrogen species were also assessed. Intracellular reduced glutathione (GSH) levels were measured using monochlorobimane fluorescent dye. Activity of catalase and superoxide dismutase in HUVEC were also measured. Cell death was assessed using YOPRO fluorescent dye and the MTT assay. On admission, the septic shock population's mean age was 55 yrs old, the mean Sequential Organ Failure Assessment score was 12, mean simplified acute physiology score was 50, and intensive care unit mortality rate was 45%. Evaluation of HUVEC antioxidant defenses showed a significantly decreased GSH level, increased catalase activity, and unchanged superoxide dismutase activity. ROS levels and cell death were significantly reduced when cells were pretreated with N-acetylcysteine or GSH, but no changes in reactive nitrogen species were observed. This study demonstrates that plasma-induced ROS production by HUVEC is associated with an intracellular decrease in reduced GSH. Both ROS levels and cell death decreased when N-acetylcysteine or GSH were added before exposing the cells to plasma. These data suggest a pivotal role of alterations in GSH in damage caused by sepsis-generated ROS in endothelial cell.

C3I system modification and EMC (electromagnetic compatibility) methodology, volume 1

NASA Astrophysics Data System (ADS)

Wilson, J. L.; Jolly, M. B.

1984-01-01

A methodology (i.e., consistent set of procedures) for assessing the electromagnetic compatibility (EMC) of RF subsystem modifications on C3I aircraft was generated during this study (Volume 1). An IEMCAP (Intrasystem Electromagnetic Compatibility Analysis Program) database for the E-3A (AWACS) C3I aircraft RF subsystem was extracted to support the design of the EMC assessment methodology (Volume 2). Mock modifications were performed on the E-3A database to assess, using a preliminary form of the methodology, the resulting EMC impact. Application of the preliminary assessment methodology to modifications in the E-3A database served to fine tune the form of a final assessment methodology. The resulting final assessment methodology is documented in this report in conjunction with the overall study goals, procedures, and database. It is recommended that a similar EMC assessment methodology be developed for the power subsystem within C3I aircraft. It is further recommended that future EMC assessment methodologies be developed around expert systems (i.e., computer intelligent agents) to control both the excruciating detail and user requirement for transparency.

Heterogeneous mineral assemblages in martian meteorite Tissint as a result of a recent small impact event on Mars

NASA Astrophysics Data System (ADS)

Walton, E. L.; Sharp, T. G.; Hu, J.; Filiberto, J.

2014-09-01

The microtexture and mineralogy of shock melts in the Tissint martian meteorite were investigated using scanning electron microscopy, Raman spectroscopy, transmission electron microscopy and synchrotron micro X-ray diffraction to understand shock conditions and duration. Distinct mineral assemblages occur within and adjacent to the shock melts as a function of the thickness and hence cooling history. The matrix of thin veins and pockets of shock melt consists of clinopyroxene + ringwoodite ± stishovite embedded in glass with minor Fe-sulfide. The margins of host rock olivine in contact with the melt, as well as entrained olivine fragments, are now amorphosed silicate perovskite + magnesiowüstite or clinopyroxene + magnesiowüstite. The pressure stabilities of these mineral assemblages are ∼15 GPa and >19 GPa, respectively. The ∼200-μm-wide margin of a thicker, mm-size (up to 1.4 mm) shock melt vein contains clinopyroxene + olivine, with central regions comprising glass + vesicles + Fe-sulfide spheres. Fragments of host rock within the melt are polycrystalline olivine (after olivine) and tissintite + glass (after plagioclase). From these mineral assemblages the crystallization pressure at the vein edge was as high as 14 GPa. The interior crystallized at ambient pressure. The shock melts in Tissint quench-crystallized during and after release from the peak shock pressure; crystallization pressures and those determined from olivine dissociation therefore represent the minimum shock loading. Shock deformation in host rock minerals and complete transformation of plagioclase to maskelynite suggest the peak shock pressure experienced by Tissint ⩾ 29-30 GPa. These pressure estimates support our assessment that the peak shock pressure in Tissint was significantly higher than the minimum 19 GPa required to transform olivine to silicate perovskite plus magnesiowüstite. Small volumes of shock melt (<100 μm) quench rapidly (0.01 s), whereas thermal equilibration will occur within 1.2 s in larger volumes of melt (1 mm2). The apparent variation in shock pressure recorded by variable mineral assemblages within and around shock melts in Tissint is consistent with a shock pulse on the order of 10-20 ms combined with a longer duration of post-shock cooling and complex thermal history. This implies that the impact on Mars that shocked and ejected Tissint at ∼1 Ma was not exceptionally large.

Oil and the world economy: some possible futures.

PubMed

Kumhof, Michael; Muir, Dirk

2014-01-13

This paper, using a six-region dynamic stochastic general equilibrium model of the world economy, assesses the output and current account implications of permanent oil supply shocks hitting the world economy. For modest-sized shocks and conventional production technologies, the effects are modest. But for larger shocks, for elasticities of substitution that decline as oil usage is reduced to a minimum, and for production functions in which oil acts as a critical enabler of technologies, output growth could drop significantly. Also, oil prices could become so high that smooth adjustment, as assumed in the model, may become very difficult.

Sepsis and Septic Shock Strategies.

PubMed

Armstrong, Bracken A; Betzold, Richard D; May, Addison K

2017-12-01

Three therapeutic principles most substantially improve organ dysfunction and survival in sepsis: early, appropriate antimicrobial therapy; restoration of adequate cellular perfusion; timely source control. The new definitions of sepsis and septic shock reflect the inadequate sensitivity, specify, and lack of prognostication of systemic inflammatory response syndrome criteria. Sequential (sepsis-related) organ failure assessment more effectively prognosticates in sepsis and critical illness. Inadequate cellular perfusion accelerates injury and reestablishing perfusion limits injury. Multiple organ systems are affected by sepsis and septic shock and an evidence-based multipronged approach to systems-based therapy in critical illness results in improve outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Ionization of Interstellar Hydrogen Beyond the Termination Shock

NASA Astrophysics Data System (ADS)

Gruntman, Mike

2016-11-01

Models of solar wind interaction with the surrounding interstellar medium usually disregard ionization of interstellar hydrogen atoms beyond the solar wind termination shock. If and when included, the effects of ionization in the heliospheric interface region are often obscured by complexities of the interaction. This work assesses the importance of interstellar hydrogen ionization in the heliosheath. Photoionization could be accounted for in a straightforward way. In contrast, electron impact ionization is largely unknown because of poorly understood energy transfer to electrons at the termination shock and beyond. We first estimate the effect of photoionization and then use it as a yardstick to assess the role of electron impact ionization. The physical estimates show that ionization of interstellar hydrogen may lead to significant mass loading in the inner heliosheath which would slow down plasma flowing toward the heliotail and deplete populations of nonthermal protons, with the corresponding effect on heliospheric fluxes of energetic neutral atoms.

Assessing Mongolian gerbil emotional behavior: effects of two shock intensities and response-independent shocks during an extended inhibitory-avoidance task.

PubMed

Hurtado-Parrado, Camilo; González-León, Camilo; Arias-Higuera, Mónica A; Cardona, Angelo; Medina, Lucia G; García-Muñoz, Laura; Sánchez, Christian; Cifuentes, Julián; Forigua, Juan Carlos; Ortiz, Andrea; Acevedo-Triana, Cesar A; Rico, Javier L

2017-01-01

Despite step-down inhibitory avoidance procedures that have been widely implemented in rats and mice to study learning and emotion phenomena, performance of other species in these tasks has received less attention. The case of the Mongolian gerbil is of relevance considering the discrepancies in the parameters of the step-down protocols implemented, especially the wide range of foot-shock intensities (i.e., 0.4-4.0 mA), and the lack of information on long-term performance, extinction effects, and behavioral patterning during these tasks. Experiment 1 aimed to (a) characterize gerbils' acquisition, extinction, and steady-state performance during a multisession (i.e., extended) step-down protocol adapted for implementation in a commercially-available behavioral package (Video Fear Conditioning System-MED Associates Fairfax, VT, USA), and (b) compare gerbils' performance in this task with two shock intensities - 0.5 vs. 1.0 mA-considered in the low-to-mid range. Results indicated that the 1.0 mA protocol produced more reliable and clear evidence of avoidance learning, extinction, and reacquisition in terms of increments in freezing and on-platform time as well as suppression of platform descent. Experiment 2 aimed to (a) assess whether an alternate protocol consisting of a random delivery of foot shocks could replicate the effects of Experiment 1 and (b) characterize gerbils' exploratory behavior during the step-down task (jumping, digging, rearing, and probing). Random shocks did not reproduce the effects observed with the first protocol. The data also indicated that a change from random to response-dependent shocks affects (a) the length of each visit to the platform, but not the frequency of platform descends or freezing time, and (b) the patterns of exploratory behavior, namely, suppression of digging and rearing, as well as increments in probing and jumping. Overall, the study demonstrated the feasibility of the extended step-down protocol for studying steady performance, extinction, and reacquisition of avoidance behavior in gerbils, which could be easily implemented in a commercially available system. The observation that 1.0 mA shocks produced a clear and consistent avoidance behavior suggests that implementation of higher intensities is unnecessary for reproducing aversive-conditioning effects in this species. The observed patterning of freezing, platform descents, and exploratory responses produced by the change from random to periodic shocks may relate to the active defensive system of the gerbil. Of special interest is the probing behavior, which could be interpreted as risk assessment and has not been reported in other rodent species exposed to step-down and similar tasks.

Assessing Mongolian gerbil emotional behavior: effects of two shock intensities and response-independent shocks during an extended inhibitory-avoidance task

PubMed Central

González-León, Camilo; Arias-Higuera, Mónica A.; Cardona, Angelo; Medina, Lucia G.; García-Muñoz, Laura; Sánchez, Christian; Cifuentes, Julián; Forigua, Juan Carlos; Ortiz, Andrea; Acevedo-Triana, Cesar A.; Rico, Javier L.

2017-01-01

Despite step-down inhibitory avoidance procedures that have been widely implemented in rats and mice to study learning and emotion phenomena, performance of other species in these tasks has received less attention. The case of the Mongolian gerbil is of relevance considering the discrepancies in the parameters of the step-down protocols implemented, especially the wide range of foot-shock intensities (i.e., 0.4–4.0 mA), and the lack of information on long-term performance, extinction effects, and behavioral patterning during these tasks. Experiment 1 aimed to (a) characterize gerbils’ acquisition, extinction, and steady-state performance during a multisession (i.e., extended) step-down protocol adapted for implementation in a commercially-available behavioral package (Video Fear Conditioning System—MED Associates Fairfax, VT, USA), and (b) compare gerbils’ performance in this task with two shock intensities – 0.5 vs. 1.0 mA—considered in the low-to-mid range. Results indicated that the 1.0 mA protocol produced more reliable and clear evidence of avoidance learning, extinction, and reacquisition in terms of increments in freezing and on-platform time as well as suppression of platform descent. Experiment 2 aimed to (a) assess whether an alternate protocol consisting of a random delivery of foot shocks could replicate the effects of Experiment 1 and (b) characterize gerbils’ exploratory behavior during the step-down task (jumping, digging, rearing, and probing). Random shocks did not reproduce the effects observed with the first protocol. The data also indicated that a change from random to response-dependent shocks affects (a) the length of each visit to the platform, but not the frequency of platform descends or freezing time, and (b) the patterns of exploratory behavior, namely, suppression of digging and rearing, as well as increments in probing and jumping. Overall, the study demonstrated the feasibility of the extended step-down protocol for studying steady performance, extinction, and reacquisition of avoidance behavior in gerbils, which could be easily implemented in a commercially available system. The observation that 1.0 mA shocks produced a clear and consistent avoidance behavior suggests that implementation of higher intensities is unnecessary for reproducing aversive-conditioning effects in this species. The observed patterning of freezing, platform descents, and exploratory responses produced by the change from random to periodic shocks may relate to the active defensive system of the gerbil. Of special interest is the probing behavior, which could be interpreted as risk assessment and has not been reported in other rodent species exposed to step-down and similar tasks. PMID:29152417

Focal gene misexpression in zebrafish embryos induced by local heat shock using a modified soldering iron.

PubMed

Hardy, Melissa E; Ross, Louis V; Chien, Chi-Bin

2007-11-01

Misexpression of genes in a temporally and spatially controlled fashion is an important tool for assessing gene function during development. Because few tissue-specific promoters have been identified in zebrafish, inducible systems such as the Cre/LoxP and Tet repressor systems are of limited utility. Here we describe a new method of misexpression: local heat shock using a modified soldering iron. Zebrafish carrying transgenes under the control of a heat shock promoter (hsp70) are focally heated with the soldering iron to induce gene expression in a small area of the embryo. We have validated this method in three stable transgenic lines and at three developmental timepoints. Local heat shock is a fast, easy, and inexpensive method for gene misexpression. Copyright 2007 Wiley-Liss, Inc.

Decision Making Methodology to Mitigate Damage From Glacial Lake Outburst Floods From Imja Lake in Nepal

NASA Astrophysics Data System (ADS)

McKinney, D. C.; Cuellar, A. D.

2015-12-01

Climate change has accelerated glacial retreat in high altitude glaciated regions of Nepal leading to the growth and formation of glacier lakes. Glacial lake outburst floods (GLOF) are sudden events triggered by an earthquake, moraine failure or other shock that causes a sudden outflow of water. These floods are catastrophic because of their sudden onset, the difficulty predicting them, and enormous quantity of water and debris rapidly flooding downstream areas. Imja Lake in the Himalaya of Nepal has experienced accelerated growth since it first appeared in the 1960s. Communities threatened by a flood from Imja Lake have advocated for projects to adapt to the increasing threat of a GLOF. Nonetheless, discussions surrounding projects for Imja have not included a rigorous analysis of the potential consequences of a flood, probability of an event, or costs of mitigation projects in part because this information is unknown or uncertain. This work presents a demonstration of a decision making methodology developed to rationally analyze the risks posed by Imja Lake and the various adaptation projects proposed using available information. In this work the authors use decision analysis, data envelopement analysis (DEA), and sensitivity analysis to assess proposed adaptation measures that would mitigate damage in downstream communities from a GLOF. We use an existing hydrodynamic model of the at-risk area to determine how adaptation projects will affect downstream flooding and estimate fatalities using an empirical method developed for dam failures. The DEA methodology allows us to estimate the value of a statistical life implied by each project given the cost of the project and number of lives saved to determine which project is the most efficient. In contrast the decision analysis methodology requires fatalities to be assigned a cost but allows the inclusion of uncertainty in the decision making process. We compare the output of these two methodologies and determine the sensitivity of the conclusions to changes in uncertain input parameters including project cost, value of a statistical life, and time to a GLOF event.

Understanding the Reach of Agricultural Impacts from Climate Extremes in the Agricultural Model Intercomparison and Improvement Project (AgMIP)

NASA Astrophysics Data System (ADS)

Ruane, A. C.

2016-12-01

The Agricultural Model Intercomparison and Improvement Project (AgMIP) has been working since 2010 to build a modeling framework capable of representing the complexities of agriculture, its dependence on climate, and the many elements of society that depend on food systems. AgMIP's 30+ activities explore the interconnected nature of climate, crop, livestock, economics, food security, and nutrition, using common protocols to systematically evaluate the components of agricultural assessment and allow multi-model, multi-scale, and multi-method analysis of intertwining changes in socioeconomic development, environmental change, and technological adaptation. AgMIP is now launching Coordinated Global and Regional Assessments (CGRA) with a particular focus on unforeseen consequences of development strategies, interactions between global and local systems, and the resilience of agricultural systems to extreme climate events. Climate extremes shock the agricultural system through local, direct impacts (e.g., droughts, heat waves, floods, severe storms) and also through teleconnections propagated through international trade. As the climate changes, the nature of climate extremes affecting agriculture is also likely to change, leading to shifting intensity, duration, frequency, and geographic extents of extremes. AgMIP researchers are developing new scenario methodologies to represent near-term extreme droughts in a probabilistic manner, field experiments that impose heat wave conditions on crops, increased resolution to differentiate sub-national drought impacts, new behavioral functions that mimic the response of market actors faced with production shortfalls, analysis of impacts from simultaneous failures of multiple breadbasket regions, and more detailed mapping of food and socioeconomic indicators into food security and nutrition metrics that describe the human impact in diverse populations. Agricultural models illustrate the challenges facing agriculture, allowing resilience planning even as precise prediction of extremes remains difficult. Increased research is necessary to understand hazards, vulnerability, and exposure of populations to characterize the risk of shocks and mechanisms by which unexpected losses drive land-use transitions.

Systematic review and meta-analysis of the clinical effectiveness of shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy for lower-pole renal stones.

PubMed

Donaldson, James F; Lardas, Michael; Scrimgeour, Duncan; Stewart, Fiona; MacLennan, Steven; Lam, Thomas B L; McClinton, Samuel

2015-04-01

The prevalence of urolithiasis is increasing. Lower-pole stones (LPS) are the most common renal calculi and the most likely to require treatment. A systematic review comparing shock wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), and percutaneous nephrolithotomy (PNL) in the treatment of ≤20 mm LPS in adults was performed. Comprehensive searches revealed 2741 records; 7 randomised controlled trials (RCTs) recruiting 691 patients were included. Meta-analyses for stone-free rate (SFR) at ≤3 mo favoured PNL over SWL (risk ratio [RR]: 2.04; 95% confidence interval [CI], 1.50-2.77) and RIRS over SWL (RR: 1.31; 95% CI, 1.08-1.59). Stone size subgroup analyses revealed PNL and RIRS were considerably more effective than SWL for >10 mm stones, but the magnitude of benefit was markedly less for ≤10 mm stones. The quality of evidence (Grading of Recommendations Assessment, Development, and Evaluation [GRADE]) for SFR was moderate for these comparisons. The median SFR from reported RCTs suggests PNL is more effective than RIRS. The findings regarding other outcomes were inconclusive because of limited and inconsistent data. Well-designed, prospective, comparative studies that measure these outcomes using standardised definitions are required, particularly for the direct comparison of PNL and RIRS. This systematic review, which used Cochrane methodology and GRADE quality-of-evidence assessment, provides the first level 1a evidence for the management of LPS. We thoroughly examined the literature to compare the benefits and harms of the different ways of treating kidney stones located at the lower pole. PNL and RIRS were superior to SWL in clearing the stones within 3 mo, but we were unable to make any conclusions regarding other outcomes. More data is required from reliable studies before firm recommendations can be made. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

A Comparison of Two Methods of Assessing Representation-Mediated Food Aversions Based on Shock or Illness

ERIC Educational Resources Information Center

Holland, Peter C.

2008-01-01

In experiments that measured food consumption, Holland (1981; "Learning and Motivation," 12, 1-18) found that food aversions were formed when an exteroceptive associate of food was paired with illness, but not when such an associate was paired with shock. By contrast, measuring the ability of food to reinforce instrumental responding,…

Assessing the Role of Effort Reduction in the Reinforcing Efficacy of Timeout from Avoidance

ERIC Educational Resources Information Center

Galuska, Chad M.; Mikorski, Jeff; Perone, Michael

2012-01-01

Rats responded on concurrent schedules of shock-postponement or deletion (avoidance) and timeout from avoidance. In Experiment 1, 3 rats' responses on one lever postponed shocks for 20 s and responses on a second lever produced a 1-min timeout according to a variable-interval 45-s schedule. Across conditions, a warning signal (white noise) was…

Assessment of two-temperature kinetic model for dissociating and weakly-ionizing nitrogen

NASA Technical Reports Server (NTRS)

Park, C.

1986-01-01

The validity of the author's two-temperature, chemical/kinetic model which the author has recently improved is assessed by comparing the calculated results with the existing experimental data for nitrogen in the dissociating and weakly ionizing regime produced behind a normal shock wave. The computer program Shock Tube Radiation Program (STRAP) based on the two-temperature model is used in calculating the flow properties behind the shock wave and the Nonequilibrium Air Radiation (NEQAIR) program, in determining the radiative characteristics of the flow. Both programs were developed earlier. Comparison is made between the calculated and the existing shock tube data on (1) spectra in the equilibrium region, (2) rotational temperature of the N2(+) B state, (3) vibrational temperature of the N2(+) B state, (4) electronic excitation temperature of the N2 B state, (5) the shape of time-variation of radiation intensities, (6) the times to reach the peak in radiation intensity and equilibrium, and (7) the ratio of nonequilibrium to equilibrium radiative heat fluxes. Good agreement is seen between the experimental data and the present calculation except for the vibrational temperature. A possible reason for the discrepancy is given.

How, why, and when may atrial defibrillation find a specific role in implantable devices? A clinical viewpoint.

PubMed

Boriani, Giuseppe; Diemberger, Igor; Biffi, Mauro; Martignani, Cristian; Ziacchi, Matteo; Bertini, Matteo; Valzania, Cinzia; Bronzetti, Gabriele; Rapezzi, Claudio; Branzi, Angelo

2007-03-01

This viewpoint article discusses the potential for incorporation of atrial defibrillation capabilities in modern multi-chamber devices. In the late 1990s, the possibility of using shock-only therapy to treat selected patients with recurrent atrial fibrillation (AF) was explored in the context of the stand-alone atrial defibrillator. The failure of this strategy can be attributed to the technical limitations of the stand-alone device, low tolerance of atrial shocks, difficulties in patient selection, a lack of predictive knowledge about the evolution of AF, and, last but not least, commercial considerations. An open question is how atrial defibrillation capability may now assume a specific new role in devices implanted for sudden death prevention or cardiac resynchronization. For patients who already have indications for implantable devices, device-based atrial defibrillation appears attractive as a "backup" option for managing AF when preventive pharmacological/electrical measures fail. This and several other personalized hybrid therapeutic approaches await exploration, though assessment of their efficacy is methodologically challenging. Achievement of acceptance by patients is an essential premise for any updated atrial defibrillation strategy. Strategies that are being investigated to improve patient tolerance include waveform shaping, pharmacologic modulation of pain, and patient-activated defibrillation (patients might also perceive the problem of discomfort somewhat differently in the context of a backup therapy). The economic impact of implementing atrial defibrillation features in available devices is progressively decreasing, and financial feasibility need not be a major issue. Future studies should examine clinically relevant outcomes and not be limited (as occurred with stand-alone defibrillators) to technical or other soft endpoints.

Polydatin Alleviates Small Intestine Injury during Hemorrhagic Shock as a SIRT1 Activator

PubMed Central

Zeng, Zhenhua; Chen, Zhongqing; Xu, Siqi; Song, Rui; Yang, Hong; Zhao, Ke-seng

2015-01-01

Objective. To evaluate the role of SIRT1 in small intestine damage following severe hemorrhagic shock and to investigate whether polydatin (PD) can activate SIRT1 in shock treatment. Research Design and Methods. The severe hemorrhagic shock model was reproduced in Sprague Dawley rats. Main Outcome Measures. Two hours after drug administration, half of the rats were assessed for survival time evaluation and the remainder were used for small intestinal tissue sample collection. Results. Bleeding and swelling appeared in the small intestine with epithelial apoptosis and gut barrier disturbance during hemorrhagic shock. SIRT1 activity and PGC-1α protein expression of the small intestine were decreased, which led to an increase in acetylated SOD2 and decreases in the expression and activity of SOD2, resulting in severe oxidative stress. The decreased SIRT1 activity and expression were partially restored in the PD administration group, which showed reduced intestine injury and longer survival time. Notably, the effect of PD was abolished after the addition of Ex527, a selective inhibitor of SIRT1. Conclusions. The results collectively suggest a role for the SIRT1-PGC-1α-SOD2 axis in small intestine injury following severe hemorrhagic shock and that PD is an effective SIRT1 activator for the shock treatment. PMID:26301045

Diagnostic value of Pentraxin-3 in patients with sepsis and septic shock in accordance with latest sepsis-3 definitions.

PubMed

Hamed, Sonja; Behnes, Michael; Pauly, Dominic; Lepiorz, Dominic; Barre, Max; Becher, Tobias; Lang, Siegfried; Akin, Ibrahim; Borggrefe, Martin; Bertsch, Thomas; Hoffmann, Ursula

2017-08-09

Pentraxin-3 (PTX-3) is an acute-phase protein involved in inflammatory and infectious processes. This study assesses its diagnostic and prognostic value in patients with sepsis or septic shock in a medical intensive care unit (ICU). The study includes 213 ICU patients with clinical criteria of sepsis and septic shock. 77 donors served as controls. Plasma levels of PTX-3, procalcitonin (PCT) and interleukin-6 were measured on day 1, 3 and 8. PTX-3 correlated with higher lactate levels as well as with APACHE II and SOFA scores (p = 0.0001). PTX-3 levels of patients with sepsis or septic shock were consistently significantly higher than in the control group (p ≤ 0.001). Plasma levels were able to discriminate sepsis and septic shock significantly on day 1, 3 and 8 (range of AUC 0.73-0.92, p = 0.0001). Uniform cut-off levels were defined at ≥5 ng/ml for at least sepsis, ≥9 ng/ml for septic shock (p = 0.0001). PTX-3 reveals diagnostic value for sepsis and septic shock during the first week of intensive care treatment, comparable to interleukin-6 according to latest Sepsis-3 definitions. NCT01535534 . Registered 14.02.2012.

Analysis of a Shock-Associated Noise Prediction Model Using Measured Jet Far-Field Noise Data

NASA Technical Reports Server (NTRS)

Dahl, Milo D.; Sharpe, Jacob A.

2014-01-01

A code for predicting supersonic jet broadband shock-associated noise was assessed us- ing a database containing noise measurements of a jet issuing from a convergent nozzle. The jet was operated at 24 conditions covering six fully expanded Mach numbers with four total temperature ratios. To enable comparisons of the predicted shock-associated noise component spectra with data, the measured total jet noise spectra were separated into mixing noise and shock-associated noise component spectra. Comparisons between predicted and measured shock-associated noise component spectra were used to identify de ciencies in the prediction model. Proposed revisions to the model, based on a study of the overall sound pressure levels for the shock-associated noise component of the mea- sured data, a sensitivity analysis of the model parameters with emphasis on the de nition of the convection velocity parameter, and a least-squares t of the predicted to the mea- sured shock-associated noise component spectra, resulted in a new de nition for the source strength spectrum in the model. An error analysis showed that the average error in the predicted spectra was reduced by as much as 3.5 dB for the revised model relative to the average error for the original model.

ShockOmics: multiscale approach to the identification of molecular biomarkers in acute heart failure induced by shock.

PubMed

Aletti, Federico; Conti, Costanza; Ferrario, Manuela; Ribas, Vicent; Bollen Pinto, Bernardo; Herpain, Antoine; Post, Emiel; Romay Medina, Eduardo; Barlassina, Cristina; de Oliveira, Eliandre; Pastorelli, Roberta; Tedeschi, Gabriella; Ristagno, Giuseppe; Taccone, Fabio S; Schmid-Schönbein, Geert W; Ferrer, Ricard; De Backer, Daniel; Bendjelid, Karim; Baselli, Giuseppe

2016-01-28

The ShockOmics study (ClinicalTrials.gov identifier NCT02141607) is a multicenter prospective observational trial aimed at identifying new biomarkers of acute heart failure in circulatory shock, by means of a multiscale analysis of blood samples and hemodynamic data from subjects with circulatory shock. Ninety septic shock and cardiogenic shock patients will be recruited in three intensive care units (ICU) (Hôpital Erasme, Université Libre de Bruxelles, Belgium; Hospital Universitari Mutua Terrassa, Spain; Hôpitaux Universitaires de Genève, Switzerland). Hemodynamic signals will be recorded every day for up to seven days from shock diagnosis (time T0). Clinical data and blood samples will be collected for analysis at: i) T1 < 16 h from T0; ii) T2 = 48 h after T0; iii) T3 = day 7 or before discharge or before discontinuation of therapy in case of fatal outcome; iv) T4 = day 100. The inclusion criteria are: shock, Sequential Organ Failure Assessment (SOFA) score > 5 and lactate levels ≥ 2 mmol/L. The exclusion criteria are: expected death within 24 h since ICU admission; > 4 units of red blood cells or >1 fresh frozen plasma transfused; active hematological malignancy; metastatic cancer; chronic immunodepression; pre-existing end stage renal disease requiring renal replacement therapy; recent cardiac surgery; Child-Pugh C cirrhosis; terminal illness. Enrollment will be preceded by the signature of the Informed Consent by the patient or his/her relatives and by the physician in charge. Three non-shock control groups will be included in the study: a) healthy blood donors (n = 5); b) septic patients (n = 10); c) acute myocardial infarction or patients with prolonged acute arrhythmia (n = 10). The hemodynamic data will be downloaded from the ICU monitors by means of dedicated software. The blood samples will be utilized for transcriptomics, proteomics and metabolomics ("-omics") analyses. ShockOmics will provide new insights into the pathophysiological mechanisms underlying shock as well as new biomarkers for the timely diagnosis of cardiac dysfunction in shock and quantitative indices for assisting the therapeutic management of shock patients.

Focal mechanism of the seismic series prior to the 2011 El Hierro eruption

NASA Astrophysics Data System (ADS)

del Fresno, C.; Buforn, E.; Cesca, S.; Domínguez Cerdeña, I.

2015-12-01

The onset of the submarine eruption of El Hierro (10-Oct-2011) was preceded by three months of low-magnitude seismicity (Mw<4.0) characterized by a well documented hypocenter migration from the center to the south of the island. Seismic sources of this series have been studied in order to understand the physical process of magma migration. Different methodologies were used to obtain focal mechanisms of largest shocks. Firstly, we have estimated the joint fault plane solutions for 727 shocks using first motion P polarities to infer the stress pattern of the sequence and to determine the time evolution of principle axes orientation. Results show almost vertical T-axes during the first two months of the series and horizontal P-axes on N-S direction coinciding with the migration. Secondly, a point source MT inversion was performed with data of the largest 21 earthquakes of the series (M>3.5). Amplitude spectra was fitted at local distances (<20km). Reliability and stability of the results were evaluated with synthetic data. Results show a change in the focal mechanism pattern within the first days of October, varying from complex sources of higher non-double-couple components before that date to a simpler strike-slip mechanism with horizontal tension axes on E-W direction the week prior to the eruption onset. A detailed study was carried out for the 8 October 2011 earthquake (Mw=4.0). Focal mechanism was retrieved using a MT inversion at regional and local distances. Results indicate an important component of strike-slip fault and null isotropic component. The stress pattern obtained corresponds to horizontal compression in a NNW-SSE direction, parallel to the southern ridge of the island, and a quasi-horizontal extension in an EW direction. Finally, a simple source time function of 0.3s has been estimated for this shock using the Empirical Green function methodology.

3D Simulations of the ``Keyhole'' Hohlraum for Shock Timing on NIF

NASA Astrophysics Data System (ADS)

Robey, H. F.; Marinak, M. M.; Munro, D. H.; Jones, O. S.

2007-11-01

Ignition implosions planned for the National Ignition Facility (NIF) require a pulse shape with a carefully designed series of steps, which launch a series of shocks through the ablator and DT fuel. The relative timing of these shocks must be tuned to better than +/- 100ps to maintain the DT fuel on a sufficiently low adiabat. To meet these requirements, pre-ignition tuning experiments using a modified hohlraum geometry are being planned. This modified geometry, known as the ``keyhole'' hohlraum, adds a re-entrant gold cone, which passes through the hohlraum and capsule walls, to provide an optical line-of-sight to directly measure the shocks as they break out of the ablator. In order to assess the surrogacy of this modified geometry, 3D simulations using HYDRA [1] have been performed. The drive conditions and the resulting effect on shock timing in the keyhole hohlraum will be compared with the corresponding results for the standard ignition hohlraum. [1] M.M. Marinak, et al., Phys. Plasmas 8, 2275 (2001).

A NOVEL SCORING SYSTEM: PREDICTING SEPTIC SHOCK AT DIAGNOSIS EASILY IN ACUTE COMPLICATED PYELONEPHRITIS PATIENTS.

PubMed

Kubota, Masashi; Kanno, Toru; Nishiyama, Ryuichi; Okada, Takashi; Higashi, Yoshihito; Yamada, Hitoshi

2016-01-01

(Objectives) Because acute complicated pyelonephritis can easily cause sepsis and concomitant shock status, it is a potentially lethal disease. However, the predictors for the severity of pyelonephritis is not well analyzed. In this study, we aimed at clarifying the clinical characteristic risk factors associated with septic shock in patients with acute complicated pyelonephritis. (Materials and methods) From May 2009 to March 2014, 267 patients with acute complicated pyelonephritis were treated at our institution. We investigated the characteristics of the patients associated with septic shock, and assessed risk factors in these patients. By using these risk factors, we established a novel scoring system to predict septic shock. (Results) 267 patients included 145 patients with ureteral calculi and 75 patients with stent-related pyelonephritis. Septic shock occurred in 35 patients (13%), and the mortality rate was 0.75%. Multivariate analysis revealed that (P): Performance Status ≥3 (p=0.0014), (U): Presence of Ureteral calculi (p=0.043), (S): Sex of female (p=0.023), and (H): the presence of Hydronephrosis (p=0.039) were independent risk factors for septic shock. P.U.S.H. scoring system (range 0-4), which consists of these 4 factors, were positively correlated with the rate of septic shock (score 0: 0%, 1: 5.3%, 2: 3.4%, 3: 25.0%, 4: 42.3%). Importantly, patients with 3-4 P.U.S.H. scores were statistically more likely to become septic shock than those with 0-2 score (p=0.00014). (Conclusions) These results suggest that P.U.S.H. scoring system using 4 clinical factors is useful to predict the status of septic shock in patients with acute complicated pyelonephritis.

Skill acquisition and retention in automated external defibrillator (AED) use and CPR by lay responders: a prospective study.

PubMed

Woollard, Malcolm; Whitfeild, Richard; Smith, Anna; Colquhoun, Michael; Newcombe, Robert G; Vetteer, Norman; Chamberlain, Douglas

2004-01-01

This prospective study evaluated the acquisition and retention of skills in cardio-pulmonary resuscitation (CPR) and the use of the automated external defibrillator (AED) by lay volunteers involved in the Department of Health, England National Defibrillator Programme. One hundred and twelve trainees were tested immediately before and after and initial 4-h class; 76 were similarly reassessed at refresher training 6 months later. A standardised test scenario that required assessment of the casualty, CPR and the use of on AED was evaluated using recording manikin data and video recordings. Before training only 44% of subjects delivered a shock. Afterwards, all did so and the average delay to first shock was reduced by 57 s. All trainees placed the defibrillator electrodes in an "acceptable" position after training, but very few did so in the recommended "ideal" position. After refresher training 80% of subjects used the correct sequence for CPR and shock delivery, yet a third failed to perform adequate safety checks before all shocks. The trainees self-assessed AED competence score was 86 (scale 0-100) after the initial class and their confidence that they would act in a real emergency was rated at a similar level. Initial training improved performance of all CPR skills, although all except compression rate had deteriorated after 6 months. The proportion of subjects able to correctly perform most CPR skill was higher following refresher training that after the initial class. Although this course was judged to be effective in teaching delivery of counter-shocks, the need was identified for more emphasis on positioning of electrodes, pre-shock safety checks, airway opening, ventilation volume, checking for signs of a circulation, hand positioning, and depth and rate of chest compressions.

Hypotonic Shock Modulates Na+ Current via a Cl- and Ca2+/Calmodulin Dependent Mechanism in Alveolar Epithelial Cells

PubMed Central

Tatur, Sabina; Brochiero, Emmanuelle; Grygorczyk, Ryszard; Berthiaume, Yves

2013-01-01

Alveolar epithelial cells are involved in Na+ absorption via the epithelial Na+ channel (ENaC), an important process for maintaining an appropriate volume of liquid lining the respiratory epithelium and for lung oedema clearance. Here, we investigated how a 20% hypotonic shock modulates the ionic current in these cells. Polarized alveolar epithelial cells isolated from rat lungs were cultured on permeant filters and their electrophysiological properties recorded. A 20% bilateral hypotonic shock induced an immediate, but transient 52% rise in total transepithelial current and a 67% increase in the amiloride-sensitive current mediated by ENaC. Amiloride pre-treatment decreased the current rise after hypotonic shock, showing that ENaC current is involved in this response. Since Cl- transport is modulated by hypotonic shock, its contribution to the basal and hypotonic-induced transepithelial current was also assessed. Apical NPPB, a broad Cl- channel inhibitor and basolateral DIOA a potassium chloride co-transporter (KCC) inhibitor reduced the total and ENaC currents, showing that transcellular Cl- transport plays a major role in that process. During hypotonic shock, a basolateral Cl- influx, partly inhibited by NPPB is essential for the hypotonic-induced current rise. Hypotonic shock promoted apical ATP secretion and increased intracellular Ca2+. While apyrase, an ATP scavenger, did not inhibit the hypotonic shock current response, W7 a calmodulin antagonist completely prevented the hypotonic current rise. These results indicate that a basolateral Cl- influx as well as Ca2+/calmodulin, but not ATP, are involved in the acute transepithelial current rise elicited by hypotonic shock. PMID:24019969

Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones.

PubMed

Srisubat, Attasit; Potisat, Somkiat; Lojanapiwat, Bannakij; Setthawong, Vasun; Laopaiboon, Malinee

2014-11-24

Stones in the urinary tract are a common medical problem in the general population. At present, the great expansion in minimally invasive techniques has led to the decrease in open surgery. Extracorporeal shock wave lithotripsy (ESWL) has been introduced as an alternative approach which disintegrates stones in the kidney and upper urinary tract through the use of shock waves. Nevertheless, as there are limitations with the success rate in ESWL, other minimally invasive modalities for kidney stones such as percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) are also widely applied. This is an update of a review first published in 2009. This review aimed to assess the effectiveness and complications of ESWL for kidney stones compared with PCNL or RIRS. We searched the Cochrane Renal Group's Specialised Register to 3 March 2014 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Randomised controlled trials (RCTs) assessing the use of ESWL compared to PCNL or RIRS for kidney stone management. Two authors independently assessed all the studies for inclusion. Statistical analyses were performed using the random effects model and the results expressed as risk ratio (RR) for dichotomous outcomes or mean difference (MD) for continuous data with 95% confidence intervals (CI). Five studies (338 patients) were included, four studies compared ESWL to PCNL and one compared ESWL with RIRS. Random sequence generation was reported in three studies and unclear in two. Allocation concealment was not reported in any of the included studies. Blinding of participants and investigators could not be undertaken due to the nature of the interventions; blinding of outcome assessors was not reported. Reporting bias was judged to be low risk in all studies. One study was funded by industry and in one study the number of participants in each group was unbalanced.The success of treatment at three months was significantly greater in the PCNL compared to the ESWL group (3 studies, 201 participants: RR 0.46, 95% CI 0.35 to 0.62). Re-treatment (1 study, 122 participants: RR 1.81, 95% CI 0.66 to 4.99) and using auxiliary procedures (2 studies, 184 participants: RR 9.06, 95% CI 1.20 to 68.64) was significantly increased with ESWL group compared to PCNL. The efficiency quotient (EQ; used to assess the effectiveness of procedures) higher for PCNL than ESWL; however EQ decreased when stone size increased. Duration of treatment (MD -36.00 min, 95% CI -54.10 to -17.90) and hospital stay (1 study, 49 participants: MD -3.30 days, 95% CI -5.45 to -1.15) were significantly shorter in the ESWL group. Overall more complications were reported with PCNL, however we were unable to meta-analyse the included studies due to the differing outcomes reported and the timing of the outcome measurements.One study compared ESWL versus RIRS for lower pole kidney stones. The success of treatment was not significantly different at the end of the third month (58 participants: RR 0.91, 95% CI 0.64 to 1.30). Mean procedural time and mean hospital stay was reported to be longer in the RIRS group. Results from five small studies, with low methodological quality, indicated ESWL is less effective for kidney stones than PCNL but not significantly different from RIRS. Hospital stay and duration of treatment was less with ESWL. Larger RCTs with high methodological quality are required to investigate the effectiveness and complications of ESWL for kidney stones compared to PCNL if there is any technological progress in the non-invasive elimination of the residual fragments. Moreover, further research is required for the outcomes of ESWL and RIRS in lower and non-lower pole studies including PCNL versus RIRS.

Ares I-X Launch Abort System, Crew Module, and Upper Stage Simulator Vibroacoustic Flight Data Evaluation, Comparison to Predictions, and Recommendations for Adjustments to Prediction Methodology and Assumptions

NASA Technical Reports Server (NTRS)

Smith, Andrew; Harrison, Phil

2010-01-01

The National Aeronautics and Space Administration (NASA) Constellation Program (CxP) has identified a series of tests to provide insight into the design and development of the Crew Launch Vehicle (CLV) and Crew Exploration Vehicle (CEV). Ares I-X was selected as the first suborbital development flight test to help meet CxP objectives. The Ares I-X flight test vehicle (FTV) is an early operational model of CLV, with specific emphasis on CLV and ground operation characteristics necessary to meet Ares I-X flight test objectives. The in-flight part of the test includes a trajectory to simulate maximum dynamic pressure during flight and perform a stage separation of the Upper Stage Simulator (USS) from the First Stage (FS). The in-flight test also includes recovery of the FS. The random vibration response from the ARES 1-X flight will be reconstructed for a few specific locations that were instrumented with accelerometers. This recorded data will be helpful in validating and refining vibration prediction tools and methodology. Measured vibroacoustic environments associated with lift off and ascent phases of the Ares I-X mission will be compared with pre-flight vibration predictions. The measured flight data was given as time histories which will be converted into power spectral density plots for comparison with the maximum predicted environments. The maximum predicted environments are documented in the Vibroacoustics and Shock Environment Data Book, AI1-SYS-ACOv4.10 Vibration predictions made using statistical energy analysis (SEA) VAOne computer program will also be incorporated in the comparisons. Ascent and lift off measured acoustics will also be compared to predictions to assess whether any discrepancies between the predicted vibration levels and measured vibration levels are attributable to inaccurate acoustic predictions. These comparisons will also be helpful in assessing whether adjustments to prediction methodologies are needed to improve agreement between the predicted and measured flight data. Future assessment will incorporate hybrid methods in VAOne analysis (i.e., boundary element methods, BEM and finite element methods, FEM). These hybrid methods will enable the ability to import NASTRAN models providing much more detailed modeling of the underlying beams and support structure of the ARES 1-X test vehicle. Measured acoustic data will be incorporated into these analyses to improve correlation for additional post flight analysis.

Comparison of theory with atomic oxygen 130.4 nm radiation data from the Bow Shock ultraviolet 2 rocket flight

NASA Technical Reports Server (NTRS)

Levin, Deborah A.; Candler, Graham V.; Collins, Robert J.; Howlett, Carl L.; Espy, Patrick; Whiting, Ellis; Park, Chul

1993-01-01

Comparison is made between the results obtained from a state-of-the-art flow and radiative model and bow shock vacuum ultraviolet (VUV) data obtained the recent Bow Shock 2 Flight Experiment. An extensive data set was obtained from onboard rocket measurements at a reentry speed of 5 km/sec between the altitudes of approximately 65-85 km. A description of the NO photoionization cell used, the data, and the interpretation of the data will be presented. The primary purpose of the analyses is to assess the utility of the data and to propose a radiation model appropriate to the flight conditions of Bow Shock 2. Theoretical predictions based on flow modeling discussed in earlier work and a new radiation model are compared with data.

Mechanical device for determining the stiffness and the viscous friction coefficient of shock absorber elements modelled by bond graph

NASA Astrophysics Data System (ADS)

Ibănescu, R.; Ibănescu, M.

2016-11-01

The present paper presents a mechanical device for the assessment of the fundamental parameters of a shock absorber: the spring stiffness and the viscous friction coefficient, without disassembling the absorber. The device produces an oscillatory motion of the shock absorber and can measure its amplitude and angular velocities. The dynamic model of the system, consisting of the mechanical device and the shock absorber, is performed by using the bond- graph method. Based on this model, the motion equations are obtained, which by integration lead to the motion law. The two previously mentioned parameters are determined by using this law and the measured values of two amplitudes and of their corresponding angular velocities. They result as solutions of a system of two non-linear algebraic equations.

Detection and Identification of Small Seismic Events Following the 3 September 2017 UNT Around North Korean Nuclear Test Site

NASA Astrophysics Data System (ADS)

Kim, W. Y.; Richards, P. G.

2017-12-01

At least four small seismic events were detected around the North Korean nuclear test site following the 3 September 2017 underground nuclear test. The magnitude of these shocks range from 2.6 to 3.5. Based on their proximity to the September 3 UNT, these shocks may be considered as aftershocks of the UNT. We assess the best method to classify these small events based on spectral amplitude ratios of regional P and S wave from the shocks. None of these shocks are classified as explosion-like based on P/S spectral amplitude ratios. We examine additional possible small seismic events around the North Korean test site by using seismic data from stations in southern Korea and northeastern China including IMS seismic arrays, GSN stations, and regional network stations in the region.

Clinical impact of defibrillation testing at the time of implantable cardioverter-defibrillator insertion.

PubMed

Hadid, Claudio; Atienza, Felipe; Strasberg, Boris; Arenal, Ángel; Codner, Pablo; González-Torrecilla, Esteban; Datino, Tomás; Percal, Tamara; Almendral, Jesús; Ortiz, Mercedes; Martins, Raphael; Martinez-Alzamora, Nieves; Fernandez Aviles, Francisco

2015-01-01

Ventricular fibrillation is routinely induced during implantable cardioverter-defibrillator insertion to assess defibrillator performance, but this strategy is experiencing a progressive decline. We aimed to assess the efficacy of defibrillator therapies and long-term outcome in a cohort of patients that underwent defibrillator implantation with and without defibrillation testing. Retrospective observational series of consecutive patients undergoing initial defibrillator insertion or generator replacement. We registered spontaneous ventricular arrhythmias incidence and therapy efficacy, and mortality. A total of 545 patients underwent defibrillator implantation (111 with and 434 without defibrillation testing). After 19 (range 9-31) months of follow-up, the death rate per observation year (4% vs. 4%; p = 0.91) and the rate of patients with defibrillator-treated ventricular arrhythmic events per observation year (with test: 10% vs. without test: 12%; p = 0.46) were similar. The generalized estimating equations-adjusted first shock probability of success in patients with test (95%; CI 88-100%) vs. without test (98%; CI 96-100%; p = 0.42) and the proportion of successful antitachycardia therapies (with test: 87% vs. without test: 80%; p = 0.35) were similar between groups. There was no difference in the annualized rate of failed first shock per patient and per shocked patient between groups (5% vs. 4%; p = 0.94). In this observational study, that included an unselected population of patients with a defibrillator, no difference was found in overall mortality, first shock efficacy and rate of failed shocks regardless of whether defibrillation testing was performed or not.

The Dose-Related Effects of Extracorporeal Shock Wave Therapy for Knee Osteoarthritis

PubMed Central

Kim, Jin-Hong; Kim, Ja-Young; Choi, Cheol-Min; Lee, June-Kyung; Kee, Hoi-Sung; Jung, Kwang-Ik

2015-01-01

Objective To investigate the dose-related effects of extracorporeal shock wave therapy (ESWT) for knee osteoarthritis. Methods Seventy-five subjects were recruited, 60 of which met the inclusion criteria. The patients were randomly classified into two groups: group L, which was a low-energy group (n=30; 1,000 shocks/session; energy flux density [EFD], 0.040 mJ/mm2) and group M, which was a medium-energy group (n=30; 1,000 shocks/session; EFD, 0.093 mJ/mm2). For each group, 1,000 shock waves were delivered to the medial tibial plateau area, once a week, for 3 weeks. The main outcome measures were the visual analogue scale (VAS), the Roles and Maudsley (RM) score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and the Lequesne index. Each assessment was performed at the baseline and at 1, 4, and 12 weeks after ESWT. Results In both groups, the VAS, the RM and WOMAC scores, and the Lequesne index were significantly improved over time (p<0.001), and group M showed greater improvement over group L at the 1, 4 and 12 weeks assessments. Conclusion In this study, medium-energy group (group M) showed greater improvement in regard to relieving pain and restoring functional outcome than the low-energy group (group L). Therefore, EFD can be considered to have significant influence when treating with ESWT for knee osteoarthritis. PMID:26361599

Effectiveness of Lower Energy Density Extracorporeal Shock Wave Therapy in the Early Stage of Avascular Necrosis of the Femoral Head.

PubMed

Han, Yong; Lee, June-Kyung; Lee, Bong-Yeon; Kee, Hoi-Sung; Jung, Kwang-Ik; Yoon, Seo-Ra

2016-10-01

To evaluate the effectiveness of lower energy flux density (EFD) extracorporeal shock wave therapy (ESWT) in the early stage of avascular necrosis (AVN) of the femoral head. Nineteen patients and 30 hips were enrolled. All subjects received 4 weekly sessions of ESWT, at different energy levels; group A (n=15; 1,000 shocks/session, EFD per shock 0.12 mJ/mm 2 ) and group B (n=15; 1,000 shocks/session, EFD per shock 0.32 mJ/mm 2 ). We measured pain by using the visual analog scale (VAS), and disability by using the Harris hip score, Hip dysfunction and Osteoarthritis Outcome Score (HOOS), and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). To determine the effect of the lower EFD ESWT, we assessed the VAS, Harris hip score, HOOS, WOMAC of the subjects before and at 1, 3, and 6 months. In both groups, the VAS, Harris hip score, HOOS, and WOMAC scores improved over time (p<0.05). Lower EFD ESWT may be an effective method to improve the function and to relieve pain in the early stage of AVN.

Shock Desensitization Effect in the STANAG 4363 Confined Explosive Component Water Gap Test

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

Lefrancois, A S; Lee, R S; Tarver, C M

2006-06-07

The Explosive Component Water Gap Test (ECWGT) in the Stanag 4363 has been recently investigated to assess the shock sensitivity of lead and booster components having a diameter less than 5 mm. For that purpose, Pentaerythritol Tetranitrate (PETN) based pellets having a height and diameter of 3 mm have been confined by a steel annulus of wall thickness 1-3.5 mm and with the same height as the pellet. 1-mm wall thickness makes the component more sensitive (larger gap). As the wall thickness is increased to 2-mm, the gap increases a lesser amount, but when the wall thickness is increased tomore » 3.5-mm a decrease in sensitivity is observed (smaller gap). This decrease of the water gap has been reproduced experimentally by many nations. Numerical simulations using Ignition and Growth model have been performed in this paper and have reproduced the experimental results for the steel confinement up to 2 mm thick and aluminum confinement. A stronger re-shock following the first input shock from the water is focusing on the axis due to the confinement. The double shock configuration is well-known to lead in some cases to shock desensitization.« less

Recent Advances in Modeling Hugoniots with Cheetah

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

Glaesemann, K R; Fried, L E

2005-07-26

We describe improvements to the Cheetah thermochemical-kinetics code's equilibrium solver to enable it to find a wider range of thermodynamic states. Cheetah supports a wide range of elements, condensed detonation products, and gas phase reactions. Therefore, Cheetah can be applied to a wide range of shock problems involving both energetic and non-energetic materials. An improve equation of state is also introduced. New experimental validations of Cheetah's equation of state methodology have been performed, including both reacted and unreacted Hugoniots.

Recent Advances in Modeling Hugoniots with Cheetah

NASA Astrophysics Data System (ADS)

Glaesemann, K. R.; Fried, L. E.

2006-07-01

We describe improvements to the Cheetah thermochemical-kinetics code's equilibrium solver to enable it to find a wider range of thermodynamic states. Cheetah supports a wide range of elements, condensed detonation products, and gas phase reactions. Therefore, Cheetah can be applied to a wide range of shock problems involving both energetic and non-energetic materials. An improve equation of state is also introduced. New experimental validations of Cheetah's equation of state methodology have been performed, including both reacted and unreacted Hugoniots.

[Assistenza cardiocircolatoria. (Cardio-circulatory care)].

PubMed

Cogo, P E

2010-06-01

Mortality in pediatric cardiovascular failure is markedly improved with the advent of neonatal and pediatric intensive care and with the implementation of treatment guidelines. In 2002 the American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Shock reported mortality rates of 0%-5% in previously healthy and 10% in chronically ill children with septic shock associated with implementation of "best clinical practices". Early recognition of shock is the key to successful resuscitation in critically ill children. Often, shock results in or co-exists with myo-cardial dysfunction or acute lung injury. Recognition and appropriate management of these insults is crucial for successful outcomes. Resuscitation should be directed to restoration of tissue perfusion and normalization of cardiac and respiratory function. The underlying cause of shock should also be addressed urgently. The physiological response of individual children to shock resuscitation varies and is often unpredictable. Therefore, repeated assessments of vital parameters are needed for taking appropriate decisions. Global indices of tissue oxygen delivery help in targeting therapies more accurately. Isotonic fluids form the cornerstone of treatment and the amount required for resuscitation is based on etiologies and therapeutic response. After resuscitation has been initiated, targeted history and clinical evaluation must be performed to ascertain the cause of shock and management of co-morbidities should be implemented simultaneously. While the management of shock can be protocol based, the treatment needs to be individualized depending on the suspected etiology and therapeutic response particularly for children who suffer from congenital heart disease.

Early initiation of low-dose hydrocortisone treatment for septic shock in adults: A randomized clinical trial.

PubMed

Lv, Qing-Quan; Gu, Xiao-Hua; Chen, Qi-Hong; Yu, Jiang-Quan; Zheng, Rui-Qiang

2017-12-01

Physiologic dose hydrocortisone is part of the suggested adjuvant therapies for patients with septic shock. However, the association between the corticosteroid therapy and mortality in patients with septic shock is still not clear. Some authors considered that the mortality is related to the time frame between development of septic shock and start of low dose hydrocortisone. Thus we designed a placebo-controlled, randomized clinical trial to assess the importance of early initiation of low dose hydrocortisone for the final outcome. A total of 118 patients with septic shock were recruited in the study. All eligible patients were randomized to receive hydrocortisone (n=58) or normal saline (n=60). The study medication (hydrocortisone and normal saline) was initiated simultaneously with vasopressors. The primary end-point was 28-day mortality. The secondary end-points were the reversal of shock, in-hospital mortality and the duration of ICU and hospital stay. The proportion of patients with reversal of shock was similar in the two groups (P=0.602); There were no significant differences in 28-day or hospital all-cause mortality; length of stay in the ICU or hospital between patients treated with hydrocortisone or normal saline. The early initiation of low-dose of hydrocortisone did not decrease the risk of mortality, and the length of stay in the ICU or hospital in adults with septic shock. www.clinicaltrials.govNCT02580240. Copyright © 2017 Elsevier Inc. All rights reserved.

Self-regulation of 70-kilodalton heat shock proteins in Saccharomyces cerevisiae.

PubMed Central

Stone, D E; Craig, E A

1990-01-01

To determine whether the 70-kilodalton heat shock proteins of Saccharomyces cerevisiae play a role in regulating their own synthesis, we studied the effect of overexpressing the SSA1 protein on the activity of the SSA1 5'-regulatory region. The constitutive level of Ssa1p was increased by fusing the SSA1 structural gene to the GAL1 promoter. A reporter vector consisting of an SSA1-lacZ translational fusion was used to assess SSA1 promoter activity. In a strain producing approximately 10-fold the normal heat shock level of Ssa1p, induction of beta-galactosidase activity by heat shock was almost entirely blocked. Expression of a transcriptional fusion vector in which the CYC1 upstream activating sequence of a CYC1-lacZ chimera was replaced by a sequence containing a heat shock upstream activating sequence (heat shock element 2) from the 5'-regulatory region of SSA1 was inhibited by excess Ssa1p. The repression of an SSA1 upstream activating sequence by the SSA1 protein indicates that SSA1 self-regulation is at least partially mediated at the transcriptional level. The expression of another transcriptional fusion vector, containing heat shock element 2 and a lesser amount of flanking sequence, is not inhibited when Ssa1p is overexpressed. This suggests the existence of an element, proximal to or overlapping heat shock element 2, that confers sensitivity to the SSA1 protein. Images PMID:2181281

Detection of significant variation in acoustic output of an electromagnetic lithotriptor.

PubMed

Pishchalnikov, Yuri A; McAteer, James A; Vonderhaar, R Jason; Pishchalnikova, Irina V; Williams, James C; Evan, Andrew P

2006-11-01

We describe the observation of significant instability in the output of an electromagnetic lithotriptor. This instability had a form that was not detected by routine assessment, but rather was observed only by collecting many consecutive shock waves in nonstop regimen. A Dornier DoLi-50 lithotriptor used exclusively for basic research was tested and approved by the regional technician. This assessment included hydrophone measures at select power levels with the collection of about 25 shock waves per setting. Subsequent laboratory characterization used a fiberoptic hydrophone and storage oscilloscope for data acquisition. Waveforms were collected nonstop for hundreds of pulses. Output was typically stable for greater than 1,000 shock waves but substantial fluctuations in acoustic pressures were also observed. For example, output at power level 3 (mean peak positive acoustic pressure +/- SD normally 44 +/- 2 MPa) increased dramatically to greater than 50 MPa or decreased significantly to approximately 30 MPa for hundreds of shock waves. The cause of instability was eventually traced to a faulty lithotriptor power supply. Instability in lithotriptor acoustic output can occur and it may not be detected by routine assessment. Collecting waveforms in a nonstop regimen dramatically increases sampling size, improving the detection of instability. Had the instability that we observed occurred during patient treatment, the energy delivered may well have exceeded the planned dose. Since the potential for adverse effects in lithotripsy increases as the dose is increased, it would be valuable to develop ways to better monitor the acoustic output of lithotriptors.

Alternate methodologies to experimentally investigate shock initiation properties of explosives

NASA Astrophysics Data System (ADS)

Svingala, Forrest R.; Lee, Richard J.; Sutherland, Gerrit T.; Benjamin, Richard; Boyle, Vincent; Sickels, William; Thompson, Ronnie; Samuels, Phillip J.; Wrobel, Erik; Cornell, Rodger

2017-01-01

Reactive flow models are desired for new explosive formulations early in the development stage. Traditionally, these models are parameterized by carefully-controlled 1-D shock experiments, including gas-gun testing with embedded gauges and wedge testing with explosive plane wave lenses (PWL). These experiments are easy to interpret due to their 1-D nature, but are expensive to perform and cannot be performed at all explosive test facilities. This work investigates alternative methods to probe shock-initiation behavior of new explosives using widely-available pentolite gap test donors and simple time-of-arrival type diagnostics. These experiments can be performed at a low cost at most explosives testing facilities. This allows experimental data to parameterize reactive flow models to be collected much earlier in the development of an explosive formulation. However, the fundamentally 2-D nature of these tests may increase the modeling burden in parameterizing these models and reduce general applicability. Several variations of the so-called modified gap test were investigated and evaluated for suitability as an alternative to established 1-D gas gun and PWL techniques. At least partial agreement with 1-D test methods was observed for the explosives tested, and future work is planned to scope the applicability and limitations of these experimental techniques.

Hypersonic Shock Wave Computations Using the Generalized Boltzmann Equation

NASA Astrophysics Data System (ADS)

Agarwal, Ramesh; Chen, Rui; Cheremisin, Felix G.

2006-11-01

Hypersonic shock structure in diatomic gases is computed by solving the Generalized Boltzmann Equation (GBE), where the internal and translational degrees of freedom are considered in the framework of quantum and classical mechanics respectively [1]. The computational framework available for the standard Boltzmann equation [2] is extended by including both the rotational and vibrational degrees of freedom in the GBE. There are two main difficulties encountered in computation of high Mach number flows of diatomic gases with internal degrees of freedom: (1) a large velocity domain is needed for accurate numerical description of the distribution function resulting in enormous computational effort in calculation of the collision integral, and (2) about 50 energy levels are needed for accurate representation of the rotational spectrum of the gas. Our methodology addresses these problems, and as a result the efficiency of calculations has increased by several orders of magnitude. The code has been validated by computing the shock structure in Nitrogen for Mach numbers up to 25 including the translational and rotational degrees of freedom. [1] Beylich, A., ``An Interlaced System for Nitrogen Gas,'' Proc. of CECAM Workshop, ENS de Lyon, France, 2000. [2] Cheremisin, F., ``Solution of the Boltzmann Kinetic Equation for High Speed Flows of a Rarefied Gas,'' Proc. of the 24th Int. Symp. on Rarefied Gas Dynamics, Bari, Italy, 2004.

Simulations of viscous and compressible gas-gas flows using high-order finite difference schemes

NASA Astrophysics Data System (ADS)

Capuano, M.; Bogey, C.; Spelt, P. D. M.

2018-05-01

A computational method for the simulation of viscous and compressible gas-gas flows is presented. It consists in solving the Navier-Stokes equations associated with a convection equation governing the motion of the interface between two gases using high-order finite-difference schemes. A discontinuity-capturing methodology based on sensors and a spatial filter enables capturing shock waves and deformable interfaces. One-dimensional test cases are performed as validation and to justify choices in the numerical method. The results compare well with analytical solutions. Shock waves and interfaces are accurately propagated, and remain sharp. Subsequently, two-dimensional flows are considered including viscosity and thermal conductivity. In Richtmyer-Meshkov instability, generated on an air-SF6 interface, the influence of the mesh refinement on the instability shape is studied, and the temporal variations of the instability amplitude is compared with experimental data. Finally, for a plane shock wave propagating in air and impacting a cylindrical bubble filled with helium or R22, numerical Schlieren pictures obtained using different grid refinements are found to compare well with experimental shadow-photographs. The mass conservation is verified from the temporal variations of the mass of the bubble. The mean velocities of pressure waves and bubble interface are similar to those obtained experimentally.

Navy Enhanced Sierra Mechanics (NESM): Toolbox for predicting Navy shock and damage

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

Moyer, Thomas; Stergiou, Jonathan; Reese, Garth

Here, the US Navy is developing a new suite of computational mechanics tools (Navy Enhanced Sierra Mechanics) for the prediction of ship response, damage, and shock environments transmitted to vital systems during threat weapon encounters. NESM includes fully coupled Euler-Lagrange solvers tailored to ship shock/damage predictions. NESM is optimized to support high-performance computing architectures, providing the physics-based ship response/threat weapon damage predictions needed to support the design and assessment of highly survivable ships. NESM is being employed to support current Navy ship design and acquisition programs while being further developed for future Navy fleet needs.

Instrument to detect syncope and the onset of shock

NASA Astrophysics Data System (ADS)

McAdams, Daniel R.; Kolodziejski, Noah J.; Stapels, Christopher J.; Fernandez, Daniel E.; Podolsky, Matthew J.; Farkas, Dana; Christian, James F.; Joyner, Michael J.; Johnson, Christopher P.; Paradis, Norman A.

2016-03-01

Currently the diagnosis of hemorrhagic shock is essentially clinical, relying on the expertise of nurses and doctors. One of the first measurable physiological changes that marks the onset of hemorrhagic shock is a decrease in capillary blood flow. Diffuse correlation spectroscopy (DCS) quantifies this decrease. DCS collects and analyzes multiply scattered, coherent, near infrared light to assess relative blood flow. This work presents a preliminary study using a DCS instrument with human subjects undergoing a lower body negative pressure (LBNP) protocol. This work builds on previous successful DCS instrumentation development and we believe it represents progress toward understanding how DCS can be used in a clinical setting.

Navy Enhanced Sierra Mechanics (NESM): Toolbox for predicting Navy shock and damage

DOE PAGES

Moyer, Thomas; Stergiou, Jonathan; Reese, Garth; ...

2016-05-25

Here, the US Navy is developing a new suite of computational mechanics tools (Navy Enhanced Sierra Mechanics) for the prediction of ship response, damage, and shock environments transmitted to vital systems during threat weapon encounters. NESM includes fully coupled Euler-Lagrange solvers tailored to ship shock/damage predictions. NESM is optimized to support high-performance computing architectures, providing the physics-based ship response/threat weapon damage predictions needed to support the design and assessment of highly survivable ships. NESM is being employed to support current Navy ship design and acquisition programs while being further developed for future Navy fleet needs.

Multiple Shocks, Coping and Welfare Consequences: Natural Disasters and Health Shocks in the Indian Sundarbans

PubMed Central

Mazumdar, Sumit; Mazumdar, Papiya Guha; Kanjilal, Barun; Singh, Prashant Kumar

2014-01-01

Background Based on a household survey in Indian Sundarbans hit by tropical cyclone Aila in May 2009, this study tests for evidence and argues that health and climatic shocks are essentially linked forming a continuum and with exposure to a marginal one, coping mechanisms and welfare outcomes triggered in the response is significantly affected. Data & Methods The data for this study is based on a cross-sectional household survey carried out during June 2010. The survey was aimed to assess the impact of cyclone Aila on households and consequent coping mechanisms in three of the worst-affected blocks (a sub-district administrative unit), viz. Hingalganj, Gosaba and Patharpratima. The survey covered 809 individuals from 179 households, cross cutting age and gender. A separate module on health-seeking behaviour serves as the information source of health shocks defined as illness episodes (ambulatory or hospitalized) experienced by household members. Key findings Finding reveals that over half of the households (54%) consider that Aila has dealt a high, damaging impact on their household assets. Result further shows deterioration of health status in the period following the incidence of Aila. Finding suggests having suffered multiple shocks increases the number of adverse welfare outcomes by 55%. Whereas, suffering either from the climatic shock (33%) or the health shock (25%) alone increases such risks by a much lesser extent. The multiple-shock households face a significantly higher degree of difficulty to finance expenses arising out of health shocks, as opposed to their counterparts facing only the health shock. Further, these households are more likely to finance the expenses through informal loans and credit from acquaintances or moneylenders. Conclusion This paper presented empirical evidence on how natural and health shocks mutually reinforce their resultant impact, making coping increasingly difficult and present significant risks of welfare loss, having short as well as long-run development manifestations. PMID:25170846

Cardiac output and systemic vascular resistance: Clinical assessment compared with a noninvasive objective measurement in children with shock.

PubMed

Razavi, Asma; Newth, Christopher J L; Khemani, Robinder G; Beltramo, Fernando; Ross, Patrick A

2017-06-01

To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support. Two to 3 physicians clinically assessed cardiac output and systemic vascular resistance, categorizing them as high, normal, or low. An investigator simultaneously measured cardiac index (CI) and systemic vascular resistance index (SVRI) with USCOM categorized as high, normal, or low. Overall agreement between physician and USCOM for CI (48.5% [κ = 0.18]) and SVRI (45.9% [κ = 0.16]) was poor. Interobserver agreement was also poor for CI (58.7% [κ = 0.33]) and SVRI (52.3% [κ = 0.28]). Comparing theoretical physician interventions to "acceptable" or "unacceptable" clinical interventions, based on USCOM measurement, 56 (21%) physician interventions were found to be "unacceptable." There is poor agreement between physician-assessed CI and SVRI and USCOM, with significant interobserver variability among physicians. Objective measurement of CI and SVRI may reduce variability and improve diagnostic accuracy. Copyright © 2016 Elsevier Inc. All rights reserved.

Use of the Exponential and Exponentiated Demand Equations to Assess the Behavioral Economics of Negative Reinforcement

PubMed Central

Fragale, Jennifer E. C.; Beck, Kevin D.; Pang, Kevin C. H.

2017-01-01

Abnormal motivation and hedonic assessment of aversive stimuli are symptoms of anxiety and depression. Symptoms influenced by motivation and anhedonia predict treatment success or resistance. Therefore, a translational approach to the study of negatively motivated behaviors is needed. We describe a novel use of behavioral economics demand curve analysis to investigate negative reinforcement in animals that separates hedonic assessment of footshock termination (i.e., relief) from motivation to escape footshock. In outbred Sprague Dawley (SD) rats, relief increased as shock intensity increased. Likewise, motivation to escape footshock increased as shock intensity increased. To demonstrate the applicability to anxiety disorders, hedonic and motivational components of negative reinforcement were investigated in anxiety vulnerable Wistar Kyoto (WKY) rats. WKY rats demonstrated increased motivation for shock cessation with no difference in relief as compared to control SD rats, consistent with a negative bias for motivation in anxiety vulnerability. Moreover, motivation was positively correlated with relief in SD, but not in WKY. This study is the first to assess the hedonic and motivational components of negative reinforcement using behavioral economic analysis. This procedure can be used to investigate positive and negative reinforcement in humans and animals to gain a better understanding of the importance of motivated behavior in stress-related disorders. PMID:28270744

Augmented renal clearance is not a risk factor for mortality in Enterobacteriaceae bloodstream infections treated with appropriate empiric antimicrobials.

PubMed

Burnham, Jason P; Micek, Scott T; Kollef, Marin H

2017-01-01

The main objective of the study was to assess whether augmented renal clearance was a risk factor for mortality in a cohort of patients with Enterobacteriaceae sepsis, severe sepsis, or septic shock that all received appropriate antimicrobial therapy within 12 hours. Using a retrospective cohort from Barnes-Jewish Hospital, a 1,250-bed teaching hospital, we collected data on individuals with Enterobacteriaceae sepsis, severe sepsis, and septic shock who received appropriate initial antimicrobial therapy between June 2009 and December 2013. Clinical outcomes were compared according to renal clearance, as assessed by Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas, sepsis classification, demographics, severity of illness, and comorbidities. We identified 510 patients with Enterobacteriaceae bacteremia and sepsis, severe sepsis, or septic shock. Sixty-seven patients (13.1%) were nonsurvivors. Augmented renal clearance was uncommon (5.1% of patients by MDRD and 3.0% by CKD-EPI) and was not associated with increased mortality. Our results are limited by the absence of prospective determination of augmented renal clearance. However, in this small cohort, augmented renal clearance as assessed by MDRD and CKD-EPI does not seem to be a risk factor for mortality in patients with Enterobacteriaceae sepsis. Future studies should assess this finding prospectively.

Dynamic load synthesis for shock numerical simulation in space structure design

NASA Astrophysics Data System (ADS)

Monti, Riccardo; Gasbarri, Paolo

2017-08-01

Pyroshock loads are the most stressing environments that a space equipment experiences during its operating life from a mechanical point of view. In general, the mechanical designer considers the pyroshock analysis as a very demanding constraint. Unfortunately, due to the non-linear behaviour of the structure under such loads, only the experimental tests can demonstrate if it is able to withstand these dynamic loads. By taking all the previous considerations into account, some preliminary information about the design correctness could be done by performing ;ad-hoc; numerical simulations, for example via commercial finite element software (i.e. MSC Nastran). Usually these numerical tools face the shock solution in two ways: 1) a direct mode, by using a time dependent enforcement and by evaluating the time-response and space-response as well as the internal forces; 2) a modal basis approach, by considering a frequency dependent load and of course by evaluating internal forces in the frequency domain. This paper has the main aim to develop a numerical tool to synthetize the time dependent enforcement based on deterministic and/or genetic algorithm optimisers. In particular starting from a specified spectrum in terms of SRS (Shock Response Spectrum) a time dependent discrete function, typically an acceleration profile, will be obtained to force the equipment by simulating the shock event. The synthetizing time and the interface with standards numerical codes will be two of the main topics dealt with in the paper. In addition a congruity and consistency methodology will be presented to ensure that the identified time dependent loads fully match the specified spectrum.

Urgent Chemotherapy in Sepsis-Like Shock Related to Hematologic Malignancies.

PubMed

Cherruault, Marlène; Le Goff, Marielle; Tamburini, Jérôme; Pène, Frédéric

2018-05-01

Hematologic malignancies may result in multiple organ involvement including pulmonary and renal dysfunctions, and the less common acute circulatory failure. We herein addressed the outcome of patients with sepsis-like shock related to aggressive hematologic malignancies. A 10-year (2007-2016) monocenter retrospective study. A medical ICU in a tertiary care center. Patients with circulatory shock requiring vasopressors and who subsequently received chemotherapy. Shock was presumably related to the underlying malignancy after ruling out an ongoing or new-onset infectious process. The extent and time course of organ failures was assessed by a modified Sequential Organ Failure Assessment score devoid of the platelet component. None. Seventeen patients were included, including 13 with non-Hodgkin lymphoma, two with hyperleukocytic acute myeloid leukemia, and two with "Human Herpes virus 8"-associated multicentric Castleman's disease. The following associated conditions prompted urgent administration of chemotherapy: tumor lysis syndrome (n = 10), hemophagocytic lymphohistiocytosis (n = 3), compressive bulky tumor (n = 3), pulmonary involvement (n = 3), and disseminated intravascular coagulation (n = 1). Following the initiation of chemotherapy, a number of patients died rapidly from untractable multiple organ failure. In contrast, chemotherapy led to a fast and dramatic improvement in organ failures in early survivors, as shown by the decrease in the modified Sequential Organ Failure Assessment score. However, the overall outcome was poor since only four and three patients could be discharged alive from the ICU and the hospital, and three and two patients remained alive at 6 months and 1 year. Multiple organ dysfunction syndrome related to hematologic malignancies is associated with a dismal outcome. A chemotherapy trial may provide a fast prognostic assessment of the reversibility of organ failure.

Percutaneous Ventricular Assist Devices: A Health Technology Assessment.

PubMed

2017-01-01

Percutaneous coronary intervention (PCI)-using a catheter to place a stent to keep blood vessels open-is increasingly used for high-risk patients who cannot undergo surgery. Cardiogenic shock (when the heart suddenly cannot pump enough blood) is associated with a high mortality rate. The percutaneous ventricular assist device can help control blood pressure and increase blood flow in these high-risk conditions. This health technology assessment examined the benefits, harms, and budget impact of the Impella percutaneous ventricular assist device in high-risk PCI and cardiogenic shock. We also analyzed cost-effectiveness of the Impella device in high-risk PCI. We performed a systematic search of the literature for studies examining the effects of the Impella percutaneous ventricular assist device in high-risk PCI and cardiogenic shock, and appraised the evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria, focusing on hemodynamic stability, mortality, major adverse cardiac events, bleeding, and vascular complications. We developed a Markov decision-analytical model to assess the cost- effectiveness of Impella devices versus intra-aortic balloon pumps (IABPs), calculated incremental cost-effectiveness ratios (ICERs) using a 10-year time horizon, and conducted sensitivity analyses to examine the robustness of the estimates. The economic model was conducted from the perspective of the Ontario Ministry of Health and Long-Term Care. Eighteen studies (one randomized controlled trial and 10 observational studies for high-risk PCI, and one randomized controlled trial and six observational studies for cardiogenic shock) were included in the clinical review. Compared with IABPs, Impella 2.5, one model of the device, improved hemodynamic parameters (GRADE low-very low) but showed no significant difference in mortality (GRADE low), major adverse cardiac events (GRADE low), bleeding (GRADE low), or vascular complications (GRADE low) in high-risk PCI and cardiogenic shock. No randomized controlled trials or prospective observational studies with a control group have studied Impella CP and Impella 5.0 (other models of the device) in patients undergoing high-risk PCI or patients with cardiogenic shock. The economic model predicted that treatment with the Impella device would have fewer quality-adjusted life-years (QALYs) and higher costs than IABP in high-risk PCI patients. These observations were consistent even when uncertainty in model inputs and parameters was considered. We estimated that adopting Impella would increase costs by $2.9 to $11.5 million per year. On the basis of evidence of low to very low quality, Impella 2.5 devices were associated with improved hemodynamic stability, but had mortality rates and safety profile similar to IABPs in high-risk PCI and cardiogenic shock. Our cost-effectiveness analysis indicated that Impella 2.5 is likely associated with greater costs and fewer quality-adjusted life years than IABP.

Development of Jet Noise Power Spectral Laws

NASA Technical Reports Server (NTRS)

Khavaran, Abbas; Bridges, James

2011-01-01

High-quality jet noise spectral data measured at the Aero-Acoustic Propulsion Laboratory (AAPL) at NASA Glenn is used to develop jet noise scaling laws. A FORTRAN algorithm was written that provides detailed spectral prediction of component jet noise at user-specified conditions. The model generates quick estimates of the jet mixing noise and the broadband shock-associated noise (BBSN) in single-stream, axis-symmetric jets within a wide range of nozzle operating conditions. Shock noise is emitted when supersonic jets exit a nozzle at imperfectly expanded conditions. A successful scaling of the BBSN allows for this noise component to be predicted in both convergent and convergent-divergent nozzles. Configurations considered in this study consisted of convergent and convergent- divergent nozzles. Velocity exponents for the jet mixing noise were evaluated as a function of observer angle and jet temperature. Similar intensity laws were developed for the broadband shock-associated noise in supersonic jets. A computer program called sJet was developed that provides a quick estimate of component noise in single-stream jets at a wide range of operating conditions. A number of features have been incorporated into the data bank and subsequent scaling in order to improve jet noise predictions. Measurements have been converted to a lossless format. Set points have been carefully selected to minimize the instability-related noise at small aft angles. Regression parameters have been scrutinized for error bounds at each angle. Screech-related amplification noise has been kept to a minimum to ensure that the velocity exponents for the jet mixing noise remain free of amplifications. A shock-noise-intensity scaling has been developed independent of the nozzle design point. The computer program provides detailed narrow-band spectral predictions for component noise (mixing noise and shock associated noise), as well as the total noise. Although the methodology is confined to single streams, efforts are underway to generate a data bank and algorithm applicable to dual-stream jets. Shock-associated noise in high-powered jets such as military aircraft can benefit from these predictions.

A Multiscale Approach to Blast Neurotrauma Modeling: Part I – Development of Novel Test Devices for in vivo and in vitro Blast Injury Models

PubMed Central

Panzer, Matthew B.; Matthews, Kyle A.; Yu, Allen W.; Morrison, Barclay; Meaney, David F.; Bass, Cameron R.

2012-01-01

The loading conditions used in some current in vivo and in vitro blast-induced neurotrauma models may not be representative of real-world blast conditions. To address these limitations, we developed a compressed-gas driven shock tube with different driven lengths that can generate Friedlander-type blasts. The shock tube can generate overpressures up to 650 kPa with durations between 0.3 and 1.1 ms using compressed helium driver gas, and peak overpressures up to 450 kPa with durations between 0.6 and 3 ms using compressed nitrogen. This device is used for short-duration blast overpressure loading for small animal in vivo injury models, and contrasts the more frequently used long duration/high impulse blast overpressures in the literature. We also developed a new apparatus that is used with the shock tube to recreate the in vivo intracranial overpressure response for loading in vitro culture preparations. The receiver device surrounds the culture with materials of similar impedance to facilitate the propagation of a single overpressure pulse through the tissue. This method prevents pressure waves reflecting off the tissue that can cause unrealistic deformation and injury. The receiver performance was characterized using the longest helium-driven shock tube, and produced in-fluid overpressures up to 1500 kPa at the location where a culture would be placed. This response was well correlated with the overpressure conditions from the shock tube (R2 = 0.97). Finite element models of the shock tube and receiver were developed and validated to better elucidate the mechanics of this methodology. A demonstration exposing a culture to the loading conditions created by this system suggest tissue strains less than 5% for all pressure levels simulated, which was well below functional deficit thresholds for strain rates less than 50 s−1. This novel system is not limited to a specific type of culture model and can be modified to reproduce more complex pressure pulses. PMID:22470367

77 FR 70451 - Proposed Collection; Comment Request; Methodological Studies for the Population Assessment of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... Request; Methodological Studies for the Population Assessment of Tobacco and Health (PATH) Study SUMMARY... Collection: Title: Methodological Studies for Population Assessment of Tobacco and Health (PATH) Study. Type... methodological studies to improve the PATH study instrumentation and data collection procedures. These...

Clonidine Reduces Norepinephrine and Improves Bone Marrow Function in a Rodent Model of Lung Contusion, Hemorrhagic Shock and Chronic Stress

PubMed Central

Alamo, Ines G.; Kannan, Kolenkode B.; Ramos, Harry; Loftus, Tyler J.; Efron, Philip A.; Mohr, Alicia M.

2016-01-01

Background Propranolol has been shown previously to restore bone marrow function and improve anemia after lung contusion/hemorrhagic shock. We hypothesized that daily clonidine administration would inhibit central sympathetic outflow and restore bone marrow function in our rodent model of lung contusion/hemorrhagic shock with chronic stress. Methods Male Sprague-Dawley rats underwent six days of restraint stress after lung contusion/hemorrhagic shock during which the animals received clonidine (75μg/kg) after the restraint stress. On post-injury day seven, we assessed urine norepinephrine, blood hemoglobin, plasma granulocyte colony stimulating factor (G-CSF), and peripheral blood mobilization of hematopoietic progenitor cells (HPC), as well as bone marrow cellularity and erythroid progenitor cell growth. Results The addition of clonidine to lung contusion/hemorrhagic shock with chronic restraint stress, significantly decreased urine norepinephrine levels, improved bone marrow cellularity, restored erythroid progenitor colony growth, and improved hemoglobin (14.1±0.6 vs. 10.8±0.6 g/dL). The addition of clonidine to lung contusion/hemorrhagic shock with chronic restraint stress significantly decreased HPC mobilization and restored G-CSF levels. Conclusions After lung contusion/hemorrhagic shock with chronic restraint stress, daily administration of clonidine restored bone marrow function and improved anemia. Alleviating chronic stress and decreasing norepinephrine is a key therapeutic target to improve bone marrow function after severe injury. PMID:27742030

Enrollment into a time sensitive clinical study in the critical care setting: results from computerized septic shock sniffer implementation.

PubMed

Herasevich, Vitaly; Pieper, Matthew S; Pulido, Juan; Gajic, Ognjen

2011-01-01

Recruitment of patients into time sensitive clinical trials in intensive care units (ICU) poses a significant challenge. Enrollment is limited by delayed recognition and late notification of research personnel. The objective of the present study was to evaluate the effectiveness of the implementation of electronic screening (septic shock sniffer) regarding enrollment into a time sensitive (24 h after onset) clinical study of echocardiography in severe sepsis and septic shock. We developed and tested a near-real time computerized alert system, the septic shock sniffer, based on established severe sepsis/septic shock diagnostic criteria. A sniffer scanned patients' data in the electronic medical records and notified the research coordinator on call through an institutional paging system of potentially eligible patients. The performance of the septic shock sniffer was assessed. The septic shock sniffer performed well with a positive predictive value of 34%. Electronic screening doubled enrollment, with 68 of 4460 ICU admissions enrolled during the 9 months after implementation versus 37 of 4149 ICU admissions before sniffer implementation (p<0.05). Efficiency was limited by study coordinator availability (not available at nights or weekends). Automated electronic medical records screening improves the efficiency of enrollment and should be a routine tool for the recruitment of patients into time sensitive clinical trials in the ICU setting.

Enrollment into a time sensitive clinical study in the critical care setting: results from computerized septic shock sniffer implementation

PubMed Central

Pieper, Matthew S; Pulido, Juan; Gajic, Ognjen

2011-01-01

Objective Recruitment of patients into time sensitive clinical trials in intensive care units (ICU) poses a significant challenge. Enrollment is limited by delayed recognition and late notification of research personnel. The objective of the present study was to evaluate the effectiveness of the implementation of electronic screening (septic shock sniffer) regarding enrollment into a time sensitive (24 h after onset) clinical study of echocardiography in severe sepsis and septic shock. Design We developed and tested a near-real time computerized alert system, the septic shock sniffer, based on established severe sepsis/septic shock diagnostic criteria. A sniffer scanned patients' data in the electronic medical records and notified the research coordinator on call through an institutional paging system of potentially eligible patients. Measurement The performance of the septic shock sniffer was assessed. Results The septic shock sniffer performed well with a positive predictive value of 34%. Electronic screening doubled enrollment, with 68 of 4460 ICU admissions enrolled during the 9 months after implementation versus 37 of 4149 ICU admissions before sniffer implementation (p<0.05). Efficiency was limited by study coordinator availability (not available at nights or weekends). Conclusions Automated electronic medical records screening improves the efficiency of enrollment and should be a routine tool for the recruitment of patients into time sensitive clinical trials in the ICU setting. PMID:21508415

Spared Anterograde Memory for Shock-Probe Fear Conditioning After Inactivation of the Amygdala

PubMed Central

Lehmann, Hugo; Treit, Dallas; Parent, Marise B.

2003-01-01

Previous studies have shown that amygdala lesions impair avoidance of an electrified probe. This finding has been interpreted as indicating that amygdala lesions reduce fear. It is unclear, however, whether amygdala-lesioned rats learn that the probe is associated with shock. If the lesions prevent the formation of this association, then pretraining reversible inactivation of the amygdala should impair both acquisition and retention performance. To test this hypothesis, the amygdala was inactivated (tetrodotoxin; TTX; 1 ng/side) before a shock-probe acquisition session, and retention was tested 4 d later. The data indicated that, compared with rats infused with vehicle, rats infused with TTX received more shocks during the acquisition session, but more importantly, were not impaired on the retention test. In Experiment 2, we assessed whether the spared memory on the retention test was caused by overtraining during acquisition. We used the same procedure as in Experiment 1, with the exception that the number of shocks the rats received during the acquisition session was limited to four. Again the data indicated that amygdala inactivation did not impair performance on the retention test. These results indicate that amygdala inactivation does not prevent the formation of an association between the shock and the probe and that shock-probe deficits during acquisition likely reflect the amygdala's involvement in other processes. PMID:12888544

A spatial paradigm, the allothetic place avoidance alternation task, for testing visuospatial working memory and skill learning in rats.

PubMed

Dockery, Colleen A; Wesierska, Malgorzata J

2010-08-30

We present a paradigm for assessing visuospatial working memory and skill learning in a rodent model, based on the place avoidance test. In our allothetic place avoidance alternation task (APAAT) the paradigm is comprised of minimal training sessions, tests various aspects of learning and memory and provides a rich set of parameters. A single working memory session consists of four conditions: habituation (no shock), two place avoidance training intervals (shock activated) and a retrieval test (shock inactivated). The location of the shock sector is alternated for each training day which initially requires extinction of previous representations and further working memory to achieve effective place avoidance across sessions. Visuospatial skill memory was evaluated by the shock/entrance ratio by tracking locomotor activity which is essential to execute a place avoidance strategy. For each day rats learned to avoid a new place with shock, as shown by a decreased number of entrances, and an increased time to the first entrance and maximum avoidance time. Skill learning improved according to the decreased number of shocks per entrance across conditions. These results indicate that complex cognitive functions are captured by this behavioral method. This APAAT paradigm expands and complements existing tools for studying hippocampal-prefrontal dependent functions to support development of treatment interventions. Copyright (c) 2010 Elsevier B.V. All rights reserved.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 3: how to assess methodological limitations.

PubMed

Munthe-Kaas, Heather; Bohren, Meghan A; Glenton, Claire; Lewin, Simon; Noyes, Jane; Tunçalp, Özge; Booth, Andrew; Garside, Ruth; Colvin, Christopher J; Wainwright, Megan; Rashidian, Arash; Flottorp, Signe; Carlsen, Benedicte

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's methodological limitations component. We developed the methodological limitations component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual methodological limitations component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define methodological limitations as the extent to which there are concerns about the design or conduct of the primary studies that contributed evidence to an individual review finding. In this paper, we describe the methodological limitations component and its rationale and offer guidance on how to assess methodological limitations of a review finding as part of the CERQual approach. This guidance outlines the information required to assess methodological limitations component, the steps that need to be taken to assess methodological limitations of data contributing to a review finding and examples of methodological limitation assessments. This paper provides guidance for review authors and others on undertaking an assessment of methodological limitations in the context of the CERQual approach. More work is needed to determine which criteria critical appraisal tools should include when assessing methodological limitations. We currently recommend that whichever tool is used, review authors provide a transparent description of their assessments of methodological limitations in a review finding. We expect the CERQual approach and its individual components to develop further as our experiences with the practical implementation of the approach increase.

Casein Kinase II Induced Polymerization of Soluble TDP-43 into Filaments Is Inhibited by Heat Shock Proteins

PubMed Central

Davis, Mary; Lin, Wen-Lang; Cook, Casey; Dunmore, Judy; Tay, William; Menkosky, Kyle; Cao, Xiangkun; Petrucelli, Leonard; DeTure, Michael

2014-01-01

Background Trans-activation Response DNA-binding Protein-43 (TDP-43) lesions are observed in Amyotrophic Lateral Sclerosis (ALS), Frontotemporal Lobar Degeneration with ubiquitin inclusions (FTLD-TDP) and 25–50% of Alzheimer's Disease (AD) cases. These abnormal protein inclusions are composed of either amorphous TDP-43 aggregates or highly ordered filaments. The filamentous TDP-43 accumulations typically contain clean 10–12 nm filaments though wider 18–20 nm coated filaments may be observed. The TDP-43 present within these lesions is phosphorylated, truncated and ubiquitinated, and these modifications appear to be abnormal as they are linked to both a cellular heat shock response and microglial activation. The mechanisms associated with this abnormal TDP-43 accumulation are believed to result in a loss of TDP-43 function, perhaps due to the post-translational modifications or resulting from physical sequestration of the TDP-43. The formation of TDP-43 inclusions involves cellular translocation and conversion of TDP-43 into fibrillogenic forms, but the ability of these accumulations to sequester normal TDP-43 and propagate this behavior between neurons pathologically is mostly inferred. The lack of methodology to produce soluble full length TDP-43 and recapitulate this polymerization into filaments as observed in disease has limited our understanding of these pathogenic cascades. Results The protocols described here generate soluble, full-length and untagged TDP-43 allowing for a direct assessment of the impact of various posttranslational modifications on TDP-43 function. We demonstrate that Casein Kinase II (CKII) promotes the polymerization of this soluble TDP-43 into 10 nm diameter filaments that resemble the most common TDP-43 structures observed in disease. Furthermore, these filaments are recognized as abnormal by Heat Shock Proteins (HSPs) which can inhibit TDP-43 polymerization or directly promote TDP-43 filament depolymerization. Conclusion These findings demonstrate CKII induces polymerization of soluble TDP-43 into filaments and Hsp90 promotes TDP-43 filament depolymerization. These findings provide rational for potential therapeutic intervention at these points in TDP-43 proteinopathies. PMID:24595055

78 FR 12335 - Submission for OMB review; Comment Request: Methodological Studies for the Population Assessment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

...; Comment Request: Methodological Studies for the Population Assessment of Tobacco and Health (PATH) Study... approval from OMB for methodological studies to improve the PATH study instrumentation and data collection procedures. These methodological studies will support ongoing assessment and refinement of the PATH study's...

Comparative assessment of various lipid extraction protocols and optimization of transesterification process for microalgal biodiesel production.

PubMed

Mandal, Shovon; Patnaik, Reeza; Singh, Amit Kumar; Mallick, Nirupama

2013-01-01

Biodiesel, using microalgae as feedstocks, is being explored as the most potent form of alternative diesel fuel for sustainable economic development. A comparative assessment of various protocols for microalgal lipid extraction was carried out using five green algae, six blue-green algae and two diatom species treated with different single and binary solvents both at room temperature and using a soxhlet. Lipid recovery was maximum with chloroform-methanol in the soxhlet extractor. Pretreatments ofbiomass, such as sonication, homogenization, bead-beating, lyophilization, autoclaving, microwave treatment and osmotic shock did not register any significant rise in lipid recovery. As lipid recovery using chloroform-methanol at room temperature demonstrated a marginally lower value than that obtained under the soxhlet extractor, on economical point of view, the former is recommended for microalgal total lipid extraction. Transesterification process enhances the quality of biodiesel. Experiments were designed to determine the effects of catalyst type and quantity, methanol to oil ratio, reaction temperature and time on the transesterification process using response surface methodology. Fatty acid methyl ester yield reached up to 91% with methanol:HCl:oil molar ratio of 82:4:1 at 65 degrees C for 6.4h reaction time. The biodiesel yield relative to the weight of the oil was found to be 69%.

Prognostic value of adrenal gland volume after cardiac arrest: Association of CT-scan evaluation with shock and mortality.

PubMed

Mongardon, Nicolas; Savary, Guillaume; Geri, Guillaume; El Bejjani, Marie-Rose; Silvera, Stéphane; Dumas, Florence; Charpentier, Julien; Pène, Frédéric; Mira, Jean-Paul; Cariou, Alain

2018-05-28

Adrenal gland volume is associated with survival in septic shock. As sepsis and post-cardiac arrest syndrome share many pathophysiological features, we assessed the association between adrenal gland volume measured by computerized tomography (CT)-scan and post-cardiac arrest shock and intensive care unit (ICU) mortality, in a large cohort of out-of-hospital cardiac arrest (OHCA) patients. We also investigated the association between adrenal hormonal function and both adrenal gland volume and outcomes. Prospective analysis of CT-scan performed at hospital admission in patients admitted after OHCA (2007-2012). A pair of blinded radiologist calculated manually adrenal gland volume. In a subgroup of patients, plasma cortisol was measured at admission and 60 min after a cosyntropin test. Factors associated with post-cardiac arrest shock and ICU mortality were identified using multivariate logistic regression. Among 775 patients admitted during this period after OHCA, 138 patients were included: 72 patients (52.2%) developed a post-cardiac arrest shock, and 98 patients (71.1%) died. In univariate analysis, adrenal gland volume was not different between patients with and without post-cardiac arrest shock: 10.6 and 11.3 cm 3 , respectively (p = 0.9) and between patients discharged alive or dead: 10.2 and 11.8 cm 3 , respectively (p = 0.4). Multivariate analysis confirmed that total adrenal gland volume was associated neither with post-cardiac arrest shock nor mortality. Neither baseline cortisol level nor delta between baseline and after cosyntropin test cortisol levels were associated with adrenal volume, post-cardiac arrest shock onset or mortality. After OHCA, adrenal gland volume is not associated with post-cardiac arrest shock onset or ICU mortality. Adrenal gland volume does not predict adrenal gland hormonal response. Copyright © 2018 Elsevier B.V. All rights reserved.

End-tidal carbon dioxide and defibrillation success in out-of-hospital cardiac arrest.

PubMed

Savastano, Simone; Baldi, Enrico; Raimondi, Maurizio; Palo, Alessandra; Belliato, Mirko; Cacciatore, Elisa; Corazza, Valentina; Molinari, Simone; Canevari, Fabrizio; Danza, Aurora I; De Ferrari, Gaetano M; Iotti, Giorgio Antonio; Visconti, Luigi Oltrona

2017-12-01

Basing on the relationship between the quality of cardiopulmonary resuscitation (CPR) and the responsiveness of VF to the defibrillation we aimed to assess whether the values of ETCO2 in the minute before defibrillation could predict the effectiveness of the shock. We retrospectively evaluated the reports generated by the manual monitor/defibrillator (Corpuls by GS Elektromedizinische Geräte G. Stemple GmbH, Germany) used for cases of VF cardiac arrest from January 2015 to December 2016. The mean ETCO2 value of the minute preceding the shock (METCO2 60 ) was computed. A blind evaluation of the effectiveness of each shock was provided by three cardiologists. A total amount of 207 shocks were delivered for 62 patients. When considering the three tertiles of METCO2 60 (T1:METCO2 60 ≤ 20mmHg; T2: 20mmHg < METCO2 60 ≤ 31mmHg and T3: METCO2 60 > 31mmHg) a statistically significant difference between the percentages of shock success was found (T1: 50%; T2: 63%; T3: 78%; Chi square p=0.003; p for trend <0.001). When the METCO2 60 was lower than 7mmHg no shock was effective and when the METCO260 was higher than 45mmHg no shock was ineffective. Shocks followed by ROSC were preceded by higher values of METCO2 60 as compared either to ineffective shocks or effective ones without ROSC. This is the first demonstration of the relation between ETCO2 and defibrillation effectiveness. Our findings stress the pivotal role of High Quality CPR, monitored via ETCO2, and suggest ETCO2 monitoring as an additional weapon to guide defibrillation. Copyright © 2017 Elsevier B.V. All rights reserved.

The Saturnian Environment as a Unique Laboratory for Collisionless Shock Waves

NASA Astrophysics Data System (ADS)

Sulaiman, Ali; Masters, Adam; Dougherty, Michele; Burgess, David; Fujimoto, Masaki; Hospodarsky, George

2016-04-01

Collisionless shock waves are ubiquitous in the universe and fundamental to understanding the nature of collisionless plasmas. The interplay between particles (ions and electrons) and fields (electromagnetic) introduces a variety of both physical and geometrical parameters such as Mach numbers (e.g. MA, Mf), β, and θBn. These vary drastically from terrestrial to astrophysical regimes resulting in radically different characteristics of shocks. This poses two complexities. Firstly, separating the influences of these parameters on physical mechanisms such as energy dissipation. Secondly, correlating observations of shock waves over a wide range of each parameter, enough to span across different regimes. Investigating the latter has been restricted since the majority of studies on shocks at exotic regimes (such as supernova remnants) have been achieved either remotely or via simulations, but rarely by means of in-situ observations. It is not clear what happens in the higher MA regime. Here we show the parameter space of MA for all bow shock crossings from 2004-2012 as measured by the Cassini spacecraft. We found that the Saturnian bow shock exhibits characteristics akin to both terrestrial and astrophysical regimes (MA of order 100), which is principally controlled by the upstream magnetic field strength. Moreover, we estimated the θbn of each crossing and were able to further constrain the sample into categories of similar features. Our results demonstrate how MA plays a central role in controlling the onset of physical mechanisms in collisionless shocks, particularly reformation. While ongoing studies have investigated this process extensively both theoretically and via simulations, their observations remain few and far between. We show conclusive evidence for cyclic reformation controlled by specular ion reflection occurring at the predicted timescale of ˜0.3 τc, where τc is the ion gyroperiod. In addition, we experimentally underpin the relationship between reformation and MA and focus on the magnetic structure of such shocks to further show that for the same MA, a reforming shock exhibits stronger magnetic field amplification than a shock that is not reforming. We anticipate our comprehensive assessment to give deeper insight to high MA collisionless shocks and provide a broader scope for understanding the structures and mechanisms of collisionless shocks. This can potentially bridge the gap between more modest MA observed in near-Earth space and more exotic astrophysical regimes where shock processes play central roles.

A Multidisciplinary Clinical Pathway Decreases Rib Fracture-Associated Infectious Morbidity and Mortality in High-Risk Trauma Patients

DTIC Science & Technology

2006-01-01

cough. Pain was assessed during incentive spirometry or coughing using a visual analogue scale (score from 1 to 10) with failure being a score...fracture multidisciplinary clinical pathway. SIMU Surgical Intermediate Care Unit; STICU Shock Trauma Intensive Care Unit; IS incentive spirometry ...monitored bed (Surgical Intermediate Care Unit or Shock Trauma Intensive Care Unit) where they received patient-controlled analgesia and incentive

Large-scale fiber release and equipment exposure experiments. [aircraft fires

NASA Technical Reports Server (NTRS)

Pride, R. A.

1980-01-01

Outdoor tests were conducted to determine the amount of fiber released in a full scale fire and trace its dissemination away from the fire. Equipment vulnerability to fire released fibers was assessed through shock tests. The greatest fiber release was observed in the shock tube where the composite was burned with a continuous agitation to total consumption. The largest average fiber length obtained outdoors was 5 mm.

Update on Phelix Pulsed-Power Hydrodynamics Experiments and Modeling

DTIC Science & Technology

2013-06-01

underway to assess the feasibility of using the PHELIX driver as an electromagnetic launcher for planer shock-physics experiments. I. INTRODUCTION...inductance loads. Cylindrical liners or planer flyer plates can achieve km/s velocities and kbar pressures. A schematic of PHELIX is shown in Figure 1. Each...using the PHELIX driver as an electromagnetic launcher for planer shock-physics experiments. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17

Effects of operator splitting and low Mach-number correction in turbulent mixing transition simulations

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

Grinstein, F. F.; Saenz, J. A.; Dolence, J. C.

Inmore » this paper, transition and turbulence decay with the Taylor–Green vortex have been effectively used to demonstrate emulation of high Reynolds-number ( R e ) physical dissipation through numerical convective effects of various non-oscillatory finite-volume algorithms for implicit large eddy simulation (ILES), e.g. using the Godunov-based Eulerian adaptive mesh refinement code xRAGE. The inverse-chevron shock tube experiment simulations have been also used to assess xRAGE based ILES for shock driven turbulent mixing, compared with available simulation and laboratory data. The previous assessments are extended to evaluate new directionally-unsplit high-order algorithms in xRAGE, including a correction to address the well-known issue of excessive numerical diffusion of shock-capturing (e.g., Godunov-type) schemes for low Mach numbers. The unsplit options for hydrodynamics in xRAGE are discussed in detail, followed by fundamental tests with representative shock problems. Basic issues of transition to turbulence and turbulent mixing are discussed, and results of simulations of high- R e turbulent flow and mixing in canonical test cases are reported. Finally, compared to the directional-split cases, and for each grid resolution considered, unsplit results exhibit transition to turbulence with much higher effective R e —and significantly more so with the low Mach number correction.« less

Effects of operator splitting and low Mach-number correction in turbulent mixing transition simulations

DOE PAGES

Grinstein, F. F.; Saenz, J. A.; Dolence, J. C.; ...

2018-06-07

Inmore » this paper, transition and turbulence decay with the Taylor–Green vortex have been effectively used to demonstrate emulation of high Reynolds-number ( R e ) physical dissipation through numerical convective effects of various non-oscillatory finite-volume algorithms for implicit large eddy simulation (ILES), e.g. using the Godunov-based Eulerian adaptive mesh refinement code xRAGE. The inverse-chevron shock tube experiment simulations have been also used to assess xRAGE based ILES for shock driven turbulent mixing, compared with available simulation and laboratory data. The previous assessments are extended to evaluate new directionally-unsplit high-order algorithms in xRAGE, including a correction to address the well-known issue of excessive numerical diffusion of shock-capturing (e.g., Godunov-type) schemes for low Mach numbers. The unsplit options for hydrodynamics in xRAGE are discussed in detail, followed by fundamental tests with representative shock problems. Basic issues of transition to turbulence and turbulent mixing are discussed, and results of simulations of high- R e turbulent flow and mixing in canonical test cases are reported. Finally, compared to the directional-split cases, and for each grid resolution considered, unsplit results exhibit transition to turbulence with much higher effective R e —and significantly more so with the low Mach number correction.« less

On the shock response of Pisum Sativum (a.k.a the Common Pea)

NASA Astrophysics Data System (ADS)

Leighs, James; Hazell, Paul; Appleby-Thomas, Gareth

2011-06-01

The high strain-rate response of biological and organic structures is of interest to numerous fields ranging from the food industry (dynamic pasteurisation) to astrobiology (e.g. the theory of panspermia, which suggests that planets could be `seeded' with life `piggy-backing' of interplanetary bodies). Consequently, knowledge of the damage mechanisms and viability of shocked organic material is of paramount importance. In this study a single-stage gas-gun has been employed to subject samples of Pisum Sativum (the Common Pea) to semi-planar shock loading, corresponding to impact pressures of up to c.3 GPa. The experimental approach adopted is discussed along with results from Manganin gauges embedded in the target capsule which show the loading history. Further, the viability of the shock-loaded peas was investigated via attempts at germination. Finally, microscopic examination of the impacted specimens allowed a qualitative assessment of damage mechanisms to be made.

Who perceives what? A demographic analysis of subjective perception in rural Thailand

PubMed Central

Meijer-Irons, Jacqueline

2016-01-01

Rural households that rely on natural resources for their livelihoods are expected to face increased vulnerability due to climate variability. A number of empirical papers have assessed the impact of environmental shocks on these households, including demographic research that has investigated the impact of shocks on migration. To date, few studies have explicitly modeled how individual and household characteristics influence a household respondent’s subjective perceptions of environmental or other shocks. My paper uses a unique panel dataset from rural Thailand to predict a respondent’s probability of attributing a reduction in income to an environmental shock based on household composition and income, as well as on community-level effects. Preliminary results suggest that household composition influences respondents’ perceptions of environmental risk, and that policies aimed at vulnerable communities should consider the life courses of the households within a given community. PMID:28058054

Shock and Release Response of Unreacted Epon 828: Shot 2s-905

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

Pisa, Matthew Alexander; Fredenburg, David A.; Dattelbaum, Dana M.

This document summarizes the shock and release response of Epon 828 measured in the dynamic impact experiment 2s-905. Experimentally, a thin Kel-F impactor backed by a low impedance foam impacted an Epon 828 target with embedded electromagnetic gauges. Computationally, a one dimensional simulation of the impact event was performed, and tracer particles were located at the corresponding electromagnetic gauge locations. The experimental configuration was such that the Epon 828 target was initially shocked, and then allowed to release from the high-pressure state. Comparisons of the experimental gauge and computational tracer data were made to assess the performance of equation ofmore » state (EOS) 7603, a SESAME EOS for Epon 828, on and off the principal shock Hugoniot. Results indicate that while EOS 7603 can capture the Hugoniot response to better that 1%, while the sound speeds at pressure are under-predicted by 6 - 7%.« less

Synergistic Effects of Toxic Elements on Heat Shock Proteins

PubMed Central

Mahmood, Khalid; Mahmood, Qaisar; Irshad, Muhammad; Hussain, Jamshaid

2014-01-01

Heat shock proteins show remarkable variations in their expression levels under a variety of toxic conditions. A research span expanded over five decades has revealed their molecular characterization, gene regulation, expression patterns, vast similarity in diverse groups, and broad range of functional capabilities. Their functions include protection and tolerance against cytotoxic conditions through their molecular chaperoning activity, maintaining cytoskeleton stability, and assisting in cell signaling. However, their role as biomarkers for monitoring the environmental risk assessment is controversial due to a number of conflicting, validating, and nonvalidating reports. The current knowledge regarding the interpretation of HSPs expression levels has been discussed in the present review. The candidature of heat shock proteins as biomarkers of toxicity is thus far unreliable due to synergistic effects of toxicants and other environmental factors. The adoption of heat shock proteins as “suit of biomarkers in a set of organisms” requires further investigation. PMID:25136596

Shock-induced solitary waves in granular crystals.

PubMed

Hasan, M Arif; Nemat-Nasser, Sia

2018-02-01

Solitary waves (SWs) are generated in monoatomic (homogeneous) lightly contacting spherical granules by an applied input force of any time-variation and intensity. We consider finite duration shock loads on one-dimensional arrays of granules and focus on the transition regime that leads to the formation of SWs. Based on geometrical and material properties of the granules and the properties of the input shock, we provide explicit analytic expressions to calculate the peak value of the compressive contact force at each contact point in the transition regime that precedes the formation of a primary solitary wave. We also provide explicit expressions to estimate the number of granules involved in the transition regime and show its dependence on the characteristics of the input shock and material/geometrical properties of the interacting granules. Finally, we assess the accuracy of our theoretical results by comparing them with those obtained through numerical integration of the equations of motion.

Radiative cooling in shock-heated hydrogen-helium plasmas. [for planetary entry probe heat shields

NASA Technical Reports Server (NTRS)

Poon, P. T. Y.; Stickford, G. H., Jr.

1978-01-01

Axial and off-axis radiative cooling of cylindrical shock-heated hydrogen-helium plasmas is investigated theoretically and experimentally. The coupled fluid dynamic-radiative transfer equations are solved by a combination of approximation techniques aimed at simplifying the computation of the flux divergence term, namely, the quasi-isothermal approximation and the exponential approximation developed for the solid angle integration. The accuracy of the approximation schemes has been assessed and found acceptable for applying the methods to the rapid computation of the radiatively coupled flow problem. Radiative cooling experiments were conducted in a 6-inch annular arc accelerator shock tube (ANAA) for an initial pressure of 1 torr and shock speeds from 35 to 45 Km/sec. The results indicate that the lateral cooling is small compared with the axial cooling, and that better agreement is achieved between the data and the theoretical results by inclusion of the lateral temperature gradient.

Hydrocode simulations of air and water shocks for facility vulnerability assessments.

PubMed

Clutter, J Keith; Stahl, Michael

2004-01-02

Hydrocodes are widely used in the study of explosive systems but their use in routine facility vulnerability assessments has been limited due to the computational resources typically required. These requirements are due to the fact that the majority of hydrocodes have been developed primarily for the simulation of weapon-scale phenomena. It is not practical to use these same numerical frameworks on the large domains found in facility vulnerability studies. Here, a hydrocode formulated specifically for facility vulnerability assessments is reviewed. Techniques used to accurately represent the explosive source while maintaining computational efficiency are described. Submodels for addressing other issues found in typical terrorist attack scenarios are presented. In terrorist attack scenarios, loads produced by shocks play an important role in vulnerability. Due to the difference in the material properties of water and air and interface phenomena, there exists significant contrast in wave propagation phenomena in these two medium. These physical variations also require special attention be paid to the mathematical and numerical models used in the hydrocodes. Simulations for a variety of air and water shock scenarios are presented to validate the computational models used in the hydrocode and highlight the phenomenological issues.

Pharmacy Students' Retention of Knowledge and Skills Following Training in Automated External Defibrillator Use

PubMed Central

Dopp, Anna Legreid; Dopp, John M.; Vardeny, Orly; Sims, J. Jason

2010-01-01

Objectives To assess pharmacy students' retention of knowledge about appropriate automated external defibrillator use and counseling points following didactic training and simulated experience. Design Following a lecture on sudden cardiac arrest and automated external defibrillator use, second-year doctor of pharmacy (PharmD) students were assessed on their ability to perform basic life support and deliver a shock at baseline, 3 weeks, and 4 months. Students completed a questionnaire to evaluate recall of counseling points for laypeople/the public. Assessment Mean time to shock delivery at baseline was 74 ± 25 seconds, which improved significantly at 3 weeks (50 ± 17 seconds, p < 0.001) and was maintained at 4 months (47 ± 18 seconds, p < 0.001). Recall of all signs and symptoms of sudden cardiac arrest and automated external defibrillator counseling points was diminished after 4 months. Conclusion Pharmacy students can use automated external defibrillators to quickly deliver a shock and are able to retain this ability after 4 months. Refresher training/courses will be required to improve students' retention of automated external defibrillator counseling points to ensure their ability to deliver appropriate patient education. PMID:21045951

A comparison of base deficit and vital signs in the early assessment of patients with penetrating trauma in a high burden setting.

PubMed

Dunham, Mark Peter; Sartorius, Benn; Laing, Grant Llewellyn; Bruce, John Lambert; Clarke, Damian Luiz

2017-09-01

An assessment of physiological status is a key step in the early assessment of trauma patients with implications for triage, investigation and management. This has traditionally been done using vital signs. Previous work from large European trauma datasets has suggested that base deficit (BD) predicts clinically important outcomes better than vital signs (VS). A BD derived classification of haemorrhagic shock appeared superior to one based on VS derived from ATLS criteria in a population of predominantly blunt trauma patients. The initial aim of this study was to see if this observation would be reproduced in penetrating trauma patients. The power of each individual variable (BD, heart rate (HR), systolic blood pressure (SBP), shock index(SI) (HR/SBP) and Glasgow Coma Score (GCS)) to predict mortality was then also compared. A retrospective analysis of adult trauma patients presenting to the Pietermaritzburg Metropolitan Trauma Service was performed. Patients were classified into four "shock" groups using VS or BD and the outcomes compared. Receiver Operator Characteristic (ROC) curves were then generated to compare the predictive power for mortality of each individual variable. 1863 patients were identified. The overall mortality rate was 2.1%. When classified by BD, HR rose and SBP fell as the "shock class" increased but not to the degree suggested by the ATLS classification. The BD classification of haemorrhagic shock appeared to predict mortality better than that based on the ATLS criteria. Mortality increased from 0.2% (Class 1) to 19.7% (Class 4) based on the 4 level BD classification. Mortality increased from 0.3% (Class 1) to 12.6% (Class 4) when classified based by VS. Area under the receiver operator characteristic (AUROC) curve analysis of the individual variables demonstrated that BD predicted mortality significantly better than HR, GCS, SBP and SI. AUROC curve (95% Confidence Interval (CI)) for BD was 0.90 (0.85-0.95) compared to HR 0.67(0.56-0.77), GCS 0.70(0.62-0.79), SBP 0.75(0.65-0.85) and SI 0.77(0.68-0.86). BD appears superior to vital signs in the immediate physiological assessment of penetrating trauma patients. The use of BD to assess physiological status may help refine their early triage, investigation and management. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Physical Exercise and Depression in the Elderly : A Systematic Review].

PubMed

Patiño Villada, Fredy Alonso; Arango Vélez, Elkin Fernando; Baena, Lucidia Zuleta

2013-06-01

The literature supports the benefits of exercise in people with depressive disorders, but there is controversy over these benefits in depressed elderly. To determine the effect of different types of exercise on depression in older adults using a systematic review of clinical trials. The Cochrane Library; PubMed-MEDLINE (1966-dic 2010); EMBASE (1980-dic 2010); LILACS (1986-dic 2010); SCIELO (1998-dic 2010); Register of Controlled Trials; manual search in other sources. Clinical trials with people >60 years with diagnosis of depression were included, without restriction by year of publication, language and sex, with exercise intervention structures, controlled with usual care (medication, psychotherapy, electric shock therapy), placebo or non-intervention. Three independent reviewers conducted the search, applied inclusion and exclusion criteria, assessed methodological quality and extracted data; discrepancies were resolved by consensus. The primary outcome was the score for depressive symptoms. A total of 11 studies (n=7195) were identified. In general, exercise produces an improvement in depression in older adults with more evidence in the short-term (3 months) and strength training at high intensity. Exercise is beneficial for older persons with depression, but studies that support this are of low methodological quality and heterogeneous, which makes it necessary to develop clinical trials to clarify the magnitude of the effect and the levels at which it is beneficial. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Use of a novel hemoadsorption device for cytokine removal as adjuvant therapy in a patient with septic shock with multi-organ dysfunction: A case study.

PubMed

Basu, Reshma; Pathak, Sunjay; Goyal, Jyoti; Chaudhry, Rajeev; Goel, Rati B; Barwal, Anil

2014-12-01

CytoSorb(®) (CytoSorbents Corporation, USA) is a novel sorbent hemoadsorption device for cytokine removal. The aim of this study was to examine the clinical use of CytoSorb(®) in the management of patient with septic shock. We used this device as an adjuvant to stabilize a young patient with multi-organ failure and severe sepsis with septic shock. A 36-year-old female patient was hospitalized with the complaints of malaise, general body ache, and breathing difficulty and had a medical history of diabetes mellitus type II, hypertension, obstructive sleep apnea, hypothyroidism and morbid obesity. She was diagnosed to have septic shock with multi-organ dysfunction (MODS) and a low perfusion state. CytoSorb(®) hemoadsorption column was used as an attempt at blood purification. Acute physiology and chronic health evaluation score, MODS score, and sequential organ failure assessment score were measured before and after the device application. CytoSorb application as an adjuvant therapy could be considered in septic shock.

Use of a novel hemoadsorption device for cytokine removal as adjuvant therapy in a patient with septic shock with multi-organ dysfunction: A case study

PubMed Central

Basu, Reshma; Pathak, Sunjay; Goyal, Jyoti; Chaudhry, Rajeev; Goel, Rati B.; Barwal, Anil

2014-01-01

CytoSorb® (CytoSorbents Corporation, USA) is a novel sorbent hemoadsorption device for cytokine removal. The aim of this study was to examine the clinical use of CytoSorb® in the management of patient with septic shock. We used this device as an adjuvant to stabilize a young patient with multi-organ failure and severe sepsis with septic shock. A 36-year-old female patient was hospitalized with the complaints of malaise, general body ache, and breathing difficulty and had a medical history of diabetes mellitus type II, hypertension, obstructive sleep apnea, hypothyroidism and morbid obesity. She was diagnosed to have septic shock with multi-organ dysfunction (MODS) and a low perfusion state. CytoSorb® hemoadsorption column was used as an attempt at blood purification. Acute physiology and chronic health evaluation score, MODS score, and sequential organ failure assessment score were measured before and after the device application. CytoSorb application as an adjuvant therapy could be considered in septic shock. PMID:25538418

Pulsed Polarimetry and magnetic sensing on the Magnetized Shock Experiment (MSX)

NASA Astrophysics Data System (ADS)

Smith, R. J.; Hutchinson, T. M.; Weber, T. E.; Taylor, S. F.; Hsu, S. C.

2014-10-01

MSX is uniquely positioned to generate the conditions for collision-less magnetized supercritical shocks with Alvenic Mach numbers (MA) of the order 10 and higher. Significant operational strides have been made in forming plasmas over wide parameter ranges: (Te + Ti) of 10-200 eV, average neof 5-60×10+21 m-3, speeds up to 150 km/s and fields up to 1T with a highest plasma flow MA of 5 to date. The MSX plasma is unique in regards to large plasma size of 10 cm and average β higher than 0.8 making the FRC and the magnetized shock structure candidates for the application of Pulsed Polarimetry, a polarization sensitive Lidar technique. The shock dynamics are presently being investigated using internal probes, interferometry and imaging. Internal probe results and an assessment of the shock parameters will dictate the use of the UW pulsed polarimeter system in which internal ne, Teand B are to be measured. Recent results will be presented. Supported by DOE Office of Fusion Energy Sciences Funding DE-FOA-0000755.

Expression of a non-inactivating K+ channel driven by a rat heat shock promoter increased the resting potential in Aplysia silent neurons.

PubMed

Han, J H; Yim, S W; Lim, C S; Park, C W; Kaang, B K

1999-05-01

We assessed the role of a non-inactivating K+ channel (aKv5.1) in the resting potential by overexpressing this channel by heat shock in the neurons. A reporter gene lacZ linked to a promoter region spanning from the -285 to the +88 base of the rat HSP70ib gene was induced 62.5-fold when this DNA construct was microinjected into the neurons of the marine mollusk Aplysia and treated with heat shock at 30 degrees C for 3 h. Using this efficient induction system, we induced the expression of aKv5.1 by heat shock in cultured, electrically silent neurons of Aplysia and examined its effect on the resting potential. The channel expression increased the resting potential by approximately 10 mV. This increase was specific to heat shock induction and abolished by treatment with TEA, a specific K+ channel blocker. These results provide the direct evidence that a low voltage-activated, non-inactivating K+ channel can contribute to the resting potential.

Multiphase Modeling of Secondary Atomization in a Shock Environment

NASA Astrophysics Data System (ADS)

St. Clair, Jeffrey; McGrath, Thomas; Balachandar, Sivaramakrishnan

2017-06-01

Understanding and developing accurate modeling strategies for shock-particulate interaction remains a challenging and important topic, with application to energetic materials development, volcanic eruptions, and safety/risk assessment. This work presents computational modeling of compressible multiphase flows with shock-induced droplet atomization. Droplet size has a strong influence on the interphase momentum and heat transfer. A test case is presented that is sensitive to this, requiring the dynamic modeling of the secondary atomization process occurring when the shock impacts the droplets. An Eulerian-Eulerian computational model that treats all phases as compressible, is hyperbolic and satisfies the 2nd Law of Thermodynamics is applied. Four different breakup models are applied to the test case in which a planar shock wave encounters a cloud of water droplets. The numerical results are compared with both experimental and previously-generated modeling results. The effect of the drag relation used is also investigated. The computed results indicate the necessity of using a droplet breakup model for this application, and the relative accuracy of results obtained with the different droplet breakup and drag models is discussed.

Computational models for the analysis/design of hypersonic scramjet components. I - Combustor and nozzle models

NASA Technical Reports Server (NTRS)

Dash, S. M.; Sinha, N.; Wolf, D. E.; York, B. J.

1986-01-01

An overview of computational models developed for the complete, design-oriented analysis of a scramjet propulsion system is provided. The modular approach taken involves the use of different PNS models to analyze the individual propulsion system components. The external compression and internal inlet flowfields are analyzed by the SCRAMP and SCRINT components discussed in Part II of this paper. The combustor is analyzed by the SCORCH code which is based upon SPLITP PNS pressure-split methodology formulated by Dash and Sinha. The nozzle is analyzed by the SCHNOZ code which is based upon SCIPVIS PNS shock-capturing methodology formulated by Dash and Wolf. The current status of these models, previous developments leading to this status, and, progress towards future hybrid and 3D versions are discussed in this paper.

Perceptions of healthcare professionals' support, shock anxiety and device acceptance among implantable cardioverter defibrillator recipients.

PubMed

Morken, Ingvild M; Norekvål, Tone M; Bru, Edvin; Larsen, Alf I; Karlsen, Bjørg

2014-09-01

To investigate the extent to which perceived support from healthcare professionals and shock anxiety is related to device acceptance among implantable cardioverter defibrillator recipients. Device acceptance can be influenced by several factors, one of which is shock anxiety associated with poor device acceptance. Reduced shock anxiety, as well as increased device acceptance, has been reported after psycho-educational programmes. As healthcare professionals appear to play a significant role in providing support and education during regular follow-up visits, they may constitute an important social support system that could be another factor influencing device acceptance. However, little is known about the relationship between perceived support from healthcare professionals and device acceptance among recipients. A cross-sectional survey design. A sample comprising implantable cardioverter defibrillator recipients completed questionnaires assessing perceived support from healthcare professionals, shock anxiety and device acceptance. Demographic and clinical data were collected by self-report and from medical records in September-October 2010. The descriptive results indicated that approximately 85% of the recipients experienced high device acceptance. Regression analysis demonstrated that constructive support from healthcare professionals was positively associated with device acceptance and moderated the negative relationship between shock anxiety and device acceptance. Non-constructive support and shock anxiety had a negative statistical association with device acceptance. Healthcare professionals may represent a valuable constructive support system that can enhance device acceptance among implantable cardioverter defibrillator recipients, partly by preventing shock anxiety from leading to poor device acceptance. Non-constructive communication on the part of healthcare professionals could hinder device acceptance. © 2014 John Wiley & Sons Ltd.

Misfortunes never come singly: Structural change, multiple shocks and child malnutrition in rural Senegal.

PubMed

Lazzaroni, Sara; Wagner, Natascha

2016-12-01

This study considers the two most pronounced shocks Senegalese subsistence farmers struggle with, namely increasing purchase prices and droughts. We assess the relationship of these self-reported shocks with child health in a multi-shock approach to account for concomitance of adverse events from the natural, biological, economic and health sphere. We employ a unique farming household panel dataset containing information on children living in poor, rural households in eight regions of Senegal in 2009 and 2011 and account for structural changes occurring between survey periods due to the large scale, national Nutrition Enhancement Program. By zooming in to the micro level we demonstrate that Senegal as a Sahelian country, mainly reliant on subsistence agriculture, is very vulnerable to climate variability and international price developments: According to our conservative estimates, the occurrence of a drought explains 25% of the pooled weight-for-age standard deviation, income losses 31%. Our multi-shock analysis reveals that the shocks are perceived as more severe in 2011 with droughts explaining up to 44% of the standard deviation of child health, increased prices up to 21%. Yet, the concomitance of droughts and increased prices after the structural change, i.e. the Nutrition Enhancement Program, indicates that the health of children experiencing both shocks in 2011 has improved. We argue that these results are driven by the increase in rural household income as theoretically outlined in the agricultural household model. Thus, adequate policy responses to shocks do not only depend on the nature but also on the concomitance of hazardous events. Copyright © 2016 Elsevier B.V. All rights reserved.

B-type natriuretic peptide in the recognition of critical congenital heart disease in the newborn infant.

PubMed

Das, Srikant; Chanani, Nikhil K; Deshpande, Shriprasad; Maher, Kevin O

2012-08-01

Infants with congenital heart disease having obstruction to the left ventricular outflow and ductal-dependent systemic circulation can present critically ill with shock. Prompt disease recognition and initiation of prostaglandins are necessary to prevent excess morbidity and mortality. We assessed a large cohort of newborn infants with ductal-dependent systemic circulation to determine if B-type natriuretic peptide (BNP) is consistently elevated at presentation, potentially aiding in diagnosis and treatment. The clinical records of infants with left-sided obstructive lesions admitted from January 2005 to June 2009 were reviewed. Infants were divided into 2 groups: group 1 was diagnosed with cardiogenic/circulatory shock at presentation, and group 2 consisted of infants with ductal-dependent systemic circulation without evidence of shock. B-type natriuretic peptide levels and other variables between the groups were compared. All patients with critical congenital heart disease presenting with shock had elevated BNP levels, ranging from 553 to greater than 5000 pg/mL. Infants in group 1 (shock, n = 36) had significantly higher median BNP levels of 4100 pg/mL at presentation compared with group 2 patients (no shock, n = 86), who had a median BNP of 656 pg/mL (range, 30-3930 pg/mL; P < 0.001). Every 100 U of increase in BNP at presentation increased the likelihood of shock (odds ratio, 100; P < 0.001). B-type natriuretic peptide is markedly elevated in neonates presenting in shock secondary to left-sided obstructive heart disease and is an important diagnostic tool to aid in the rapid identification and treatment of these patients.

Mortality related to invasive infections, sepsis, and septic shock in critically ill children in Australia and New Zealand, 2002-13: a multicentre retrospective cohort study.

PubMed

Schlapbach, Luregn J; Straney, Lahn; Alexander, Janet; MacLaren, Graeme; Festa, Marino; Schibler, Andreas; Slater, Anthony

2015-01-01

Severe infections kill more than 4·5 million children every year. Population-based data for severe infections in children requiring admission to intensive care units (ICUs) are scarce. We assessed changes in incidence and mortality of severe infections in critically ill children in Australia and New Zealand. We did a retrospective multicentre cohort study of children requiring intensive care in Australia and New Zealand between 2002 and 2013, with data from the Australian and New Zealand Paediatric Intensive Care Registry. We included children younger than 16 years with invasive infection, sepsis, or septic shock. We assessed incidence and mortality in the ICU for 2002-07 versus 2008-13. During the study period, 97 127 children were admitted to ICUs, 11 574 (11·9%) had severe infections, including 6688 (6·9%) with invasive infections, 2847 (2·9%) with sepsis, and 2039 (2·1%) with septic shock. Age-standardised incidence increased each year by an average of 0·56 cases per 100 000 children (95% CI 0·41-0·71) for invasive infections, 0·09 cases per 100 000 children (0·00-0·17) for sepsis, and 0·08 cases per 100 000 children (0·04-0·12) for septic shock. 260 (3·9%) of 6688 patients with invasive infection died, 159 (5·6%) of 2847 with sepsis died, and 346 (17·0%) of 2039 with septic shock died, compared with 2893 (3·0%) of all paediatric ICU admissions. Children admitted with invasive infections, sepsis, and septic shock accounted for 765 (26·4%) of 2893 paediatric deaths in ICUs. Comparing 2008-13 with 2002-07, risk-adjusted mortality decreased significantly for invasive infections (odds ratio 0·72, 95% CI 0·56-0·94; p=0·016), and for sepsis (0·66, 0·47-0·93; p=0·016), but not significantly for septic shock (0·79, 0·61-1·01; p=0·065). Severe infections remain a major cause of mortality in paediatric ICUs, representing a major public health problem. Future studies should focus on patients with the highest risk of poor outcome, and assess the effectiveness of present sepsis interventions in children. National Medical Health and Research Council, Australian Resuscitation Outcomes Consortium, Centre of Research Excellence (1029983). Copyright © 2015 Elsevier Ltd. All rights reserved.

Speckle tracking echocardiography in patients with septic shock: a case control study (SPECKSS).

PubMed

Ng, Pauline Yeung; Sin, Wai Ching; Ng, Andrew Kei-Yan; Chan, Wai Ming

2016-05-14

Sepsis-induced myocardial dysfunction is a well-recognized condition and confers worse outcomes in septic patients. Echocardiographic assessment by conventional parameters such as left ventricular ejection fraction (LVEF) is often affected by ongoing changes in preload and afterload conditions. Novel echocardiographic technologies such as speckle tracking echocardiography (STE) have evolved for direct assessment of the myocardial function. We investigate the measurement of myocardial strain by speckle tracking echocardiography for the diagnosis of sepsis-induced myocardial dysfunction. This is a case-control study at a university-affiliated medical intensive care unit. Consecutive adult medical patients admitted with a diagnosis of septic shock were included. Patients with other causes of myocardial dysfunction were excluded. They were compared to age-matched, gender-matched, and cardiovascular risk-factor-matched controls, who were admitted to hospital for sepsis but did not develop septic shock. Transthoracic echocardiography was performed on all patients within 24 hours of diagnosis, and a reassessment echocardiogram was performed in the study group of patients upon recovery. Patients with septic shock (n = 33) (study group) and 29 matched patients with sepsis but no septic shock (control group) were recruited. The mean sequential organ failure assessment (SOFA) score for the study and control groups were 10.2 and 1.6, respectively (P < 0.001). In patients with septic shock, the mean arterial pressure was lower (76 mmHg vs 82 mmHg, P = 0.032), and the heart rate was higher (99 bpm vs 86 bpm, P = 0.008). The cardiac output (5.9 L/min vs 5.5 L/min, P = 0.401) and systemic vascular resistance (1090 dynes•sec/cm(5) vs 1194 dynes•sec/cm(5), P = 0.303) were similar. The study group had a greater degree of myocardial dysfunction measured by global longitudinal strain (GLS) (-14.5 % vs -18.3 %, P <0.001), and the myocardial strain differed upon diagnosis and recovery (-14.5 % vs -16.0 %, P = 0.010). Conventional echocardiographic measurements such as LVEF (59 % in the study group vs 61 % in the control group, P = 0.169) did not differ between the two groups. Speckle tracking echocardiography can detect significant left ventricular impairment in patients with septic shock, which was not otherwise detectable by conventional echocardiography. The reversible nature of myocardial dysfunction in sepsis was also demonstrable. This echocardiographic technique is useful in the diagnosis and monitoring of sepsis-induced myocardial dysfunction.

Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study.

PubMed

Baykara, Nur; Akalın, Halis; Arslantaş, Mustafa Kemal; Hancı, Volkan; Çağlayan, Çiğdem; Kahveci, Ferda; Demirağ, Kubilay; Baydemir, Canan; Ünal, Necmettin

2018-04-16

The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included. The presence of systemic inflammatory response syndrome (SIRS), severe sepsis, and septic shock were assessed and documented based on the consensus criteria of the American College of Chest Physicians and Society of Critical Care Medicine (SEPSIS-I) in infected patients. Patients with septic shock were also assessed using the SEPSIS-III definitions. Data regarding demographics, illness severity, comorbidities, microbiology, therapies, length of stay, and outcomes (dead/alive during 30 days) were recorded. Of the 1499 patients included in the analysis, 237 (15.8%) had infection without SIRS, 163 (10.8%) had infection with SIRS, 260 (17.3%) had severe sepsis without shock, and 203 (13.5%) had septic shock. The mortality rates were higher in patients with severe sepsis (55.7%) and septic shock (70.4%) than those with infection alone (24.8%) and infection + SIRS (31.2%) (p < 0.001). According to SEPSIS-III, 104 (6.9%) patients had septic shock (mortality rate, 75.9%). The respiratory system (71.6%) was the most common site of infection, and Acinetobacter spp. (33.7%) were the most common isolated pathogen. Approximately, 74.9%, 39.1%, and 26.5% of Acinetobacter, Klebsiella, and Pseudomonas spp. isolates, respectively, were carbapenem-resistant, which was not associated with a higher mortality risk. Age, acute physiology and chronic health evaluation II score at ICU admission, sequential organ failure assessment score on study day, solid organ malignancy, presence of severe sepsis or shock, Candida spp. infection, renal replacement treatment, and a nurse-to-patient ratio of 1:4 (compared with a nurse-to-patient ratio of 1:2) were independent predictors of mortality in infected patients. A high prevalence of sepsis and an unacceptably high mortality rate were observed in Turkish ICUs. Although the prevalence of carbapenem resistance was high in Turkish ICUs, it was not associated with a higher risk for mortality. ClinicalTrials.gov ID NCT03249246 . Date: August 15, 2017. Retrospectively registered.

Stress-based aftershock forecasts made within 24 h postmain shock: Expected north San Francisco Bay area seismicity changes after the 2014 M = 6.0 West Napa earthquake

NASA Astrophysics Data System (ADS)

Parsons, Tom; Segou, Margaret; Sevilgen, Volkan; Milner, Kevin; Field, Edward; Toda, Shinji; Stein, Ross S.

2014-12-01

We calculate stress changes resulting from the M = 6.0 West Napa earthquake on north San Francisco Bay area faults. The earthquake ruptured within a series of long faults that pose significant hazard to the Bay area, and we are thus concerned with potential increases in the probability of a large earthquake through stress transfer. We conduct this exercise as a prospective test because the skill of stress-based aftershock forecasting methodology is inconclusive. We apply three methods: (1) generalized mapping of regional Coulomb stress change, (2) stress changes resolved on Uniform California Earthquake Rupture Forecast faults, and (3) a mapped rate/state aftershock forecast. All calculations were completed within 24 h after the main shock and were made without benefit of known aftershocks, which will be used to evaluative the prospective forecast. All methods suggest that we should expect heightened seismicity on parts of the southern Rodgers Creek, northern Hayward, and Green Valley faults.

Optimal Mission Abort Policy for Systems Operating in a Random Environment.

PubMed

Levitin, Gregory; Finkelstein, Maxim

2018-04-01

Many real-world critical systems, e.g., aircrafts, manned space flight systems, and submarines, utilize mission aborts to enhance their survivability. Specifically, a mission can be aborted when a certain malfunction condition is met and a rescue or recovery procedure is then initiated. For systems exposed to external impacts, the malfunctions are often caused by the consequences of these impacts. Traditional system reliability models typically cannot address a possibility of mission aborts. Therefore, in this article, we first develop the corresponding methodology for modeling and evaluation of the mission success probability and survivability of systems experiencing both internal failures and external shocks. We consider a policy when a mission is aborted and a rescue procedure is activated upon occurrence of the mth shock. We demonstrate the tradeoff between the system survivability and the mission success probability that should be balanced by the proper choice of the decision variable m. A detailed illustrative example of a mission performed by an unmanned aerial vehicle is presented. © 2017 Society for Risk Analysis.

System-wide identification of wild-type SUMO-2 conjugation sites

PubMed Central

Hendriks, Ivo A.; D'Souza, Rochelle C.; Chang, Jer-Gung; Mann, Matthias; Vertegaal, Alfred C. O.

2015-01-01

SUMOylation is a reversible post-translational modification (PTM) regulating all nuclear processes. Identification of SUMOylation sites by mass spectrometry (MS) has been hampered by bulky tryptic fragments, which thus far necessitated the use of mutated SUMO. Here we present a SUMO-specific protease-based methodology which circumvents this problem, dubbed Protease-Reliant Identification of SUMO Modification (PRISM). PRISM allows for detection of SUMOylated proteins as well as identification of specific sites of SUMOylation while using wild-type SUMO. The method is generic and could be widely applied to study lysine PTMs. We employ PRISM in combination with high-resolution MS to identify SUMOylation sites from HeLa cells under standard growth conditions and in response to heat shock. We identified 751 wild-type SUMOylation sites on endogenous proteins, including 200 dynamic SUMO sites in response to heat shock. Thus, we have developed a method capable of quantitatively studying wild-type mammalian SUMO at the site-specific and system-wide level. PMID:26073453

A new approach for the design of hypersonic scramjet inlets

NASA Astrophysics Data System (ADS)

Raj, N. Om Prakash; Venkatasubbaiah, K.

2012-08-01

A new methodology has been developed for the design of hypersonic scramjet inlets using gas dynamic relations. The approach aims to find the optimal inlet geometry which has maximum total pressure recovery at a prescribed design free stream Mach number. The design criteria for inlet is chosen as shock-on-lip condition which ensures maximum capture area and minimum intake length. Designed inlet geometries are simulated using computational fluid dynamics analysis. The effects of 1D, 2D inviscid and viscous effects on performance of scramjet inlet are reported here. A correction factor in inviscid design is reported for viscous effects to obtain shock-on-lip condition. A parametric study is carried out for the effect of Mach number at the beginning of isolator for the design of scramjet inlets. Present results show that 2D and viscous effects are significant on performance of scramjet inlet. Present simulation results are matching very well with the experimental results available from the literature.

CFD Validation Experiment of a Mach 2.5 Axisymmetric Shock-Wave/Boundary-Layer Interaction

NASA Technical Reports Server (NTRS)

Davis, David O.

2015-01-01

Experimental investigations of specific flow phenomena, e.g., Shock Wave Boundary-Layer Interactions (SWBLI), provide great insight to the flow behavior but often lack the necessary details to be useful as CFD validation experiments. Reasons include: 1.Undefined boundary conditions Inconsistent results 2.Undocumented 3D effects (CL only measurements) 3.Lack of uncertainty analysis While there are a number of good subsonic experimental investigations that are sufficiently documented to be considered test cases for CFD and turbulence model validation, the number of supersonic and hypersonic cases is much less. This was highlighted by Settles and Dodsons [1] comprehensive review of available supersonic and hypersonic experimental studies. In all, several hundred studies were considered for their database.Of these, over a hundred were subjected to rigorous acceptance criteria. Based on their criteria, only 19 (12 supersonic, 7 hypersonic) were considered of sufficient quality to be used for validation purposes. Aeschliman and Oberkampf [2] recognized the need to develop a specific methodology for experimental studies intended specifically for validation purposes.

The self-built ecovillage in L'Aquila, Italy: community resilience as a grassroots response to environmental shock.

PubMed

Fois, Francesca; Forino, Giuseppe

2014-10-01

The paper applies the community resilience approach to the post-disaster case of Pescomaggiore, an Italian village affected by the L'Aquila earthquake in 2009. A group of residents refused to accept the housing recovery solutions proposed by the government, opting for autonomous recovery. They developed a housing project in the form of a self-built ecovillage, characterised by earthquake-proof buildings made of straw and wood. The project is a paradigmatic example of a community-based response to an external shock. It illustrates the concept of 'community resilience', which is widely explored in the scientific debate but still vaguely defined. Based on qualitative methodologies, the paper seeks to understand how the community resilience process can be enacted in alternative social practices such as ecovillages. The goal is to see under which conditions natural disasters can be considered windows of opportunity for sustainability. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Wedge Experiment Modeling and Simulation for Reactive Flow Model Calibration

NASA Astrophysics Data System (ADS)

Maestas, Joseph T.; Dorgan, Robert J.; Sutherland, Gerrit T.

2017-06-01

Wedge experiments are a typical method for generating pop-plot data (run-to-detonation distance versus input shock pressure), which is used to assess an explosive material's initiation behavior. Such data can be utilized to calibrate reactive flow models by running hydrocode simulations and successively tweaking model parameters until a match between experiment is achieved. Typical simulations are performed in 1D and typically use a flyer impact to achieve the prescribed shock loading pressure. In this effort, a wedge experiment performed at the Army Research Lab (ARL) was modeled using CTH (SNL hydrocode) in 1D, 2D, and 3D space in order to determine if there was any justification in using simplified models. A simulation was also performed using the BCAT code (CTH companion tool) that assumes a plate impact shock loading. Results from the simulations were compared to experimental data and show that the shock imparted into an explosive specimen is accurately captured with 2D and 3D simulations, but changes significantly in 1D space and with the BCAT tool. The difference in shock profile is shown to only affect numerical predictions for large run distances. This is attributed to incorrectly capturing the energy fluence for detonation waves versus flat shock loading. Portions of this work were funded through the Joint Insensitive Munitions Technology Program.

RNAi screen in Drosophila larvae identifies histone deacetylase 3 as a positive regulator of the hsp70 heat shock gene expression during heat shock.

PubMed

Achary, Bhavana G; Campbell, Katie M; Co, Ivy S; Gilmour, David S

2014-05-01

The transcription regulation of the Drosophila hsp70 gene is a complex process that involves the regulation of multiple steps, including the establishment of paused Pol II and release of Pol II into elongation upon heat shock activation. While the major players involved in the regulation of gene expression have been studied in detail, additional factors involved in this process continue to be discovered. To identify factors involved in hsp70 expression, we developed a screen that capitalizes on a visual assessment of heat shock activation using a hsp70-beta galactosidase reporter and publicly available RNAi fly lines to deplete candidate proteins. We validated the screen by showing that the depletion of HSF, CycT, Cdk9, Nurf 301, or ELL prevented the full induction of hsp70 by heat shock. Our screen also identified the histone deacetylase HDAC3 and its associated protein SMRTER as positive regulators of hsp70 activation. Additionally, we show that HDAC3 and SMRTER contribute to hsp70 gene expression at a step subsequent to HSF-mediated activation and release of the paused Pol II that resides at the promoter prior to heat shock induction. Copyright © 2014 Elsevier B.V. All rights reserved.

The Milky Way Project: A Citizen Science Catalog of Infrared Bow Shock Nebulae

NASA Astrophysics Data System (ADS)

Dixon, Don; Jayasinghe, Tharindu; Povich, Matthew S.

2017-01-01

We present preliminary results from the first citizen-science search for infrared stellar-wind bow shock candidates. This search uses the Milky Way project, hosted by the Zooniverse, an online platform with over 1 million volunteer citizen scientists. Milky Way Project volunteers examine 77,000 randomly-distributed Spitzer image cutouts at varying zoom levels. Volunteers mark the infrared arc of potential bow shock candidates as well as the star likely driving the nebula. We produce lists of candidates from bow shocks flagged by multiple volunteers, which after merging and final visual review form the basis for our catalog. Comparing our new catalog to a recently-published catalog of 709 infrared bow shock candidates identified by a small team of (primarily undergraduate) researchers will allow us to assess the effectiveness of citizen science for this type of search and should yield a more complete catalog. Planned studies using these large catalogs will improve constraints on the mass-loss rates for the massive stars that create these bow shock nebulae. Mass-loss rates are highly uncertain but are a critical component of evolutionary models for massive stars. This work is supported by the National Science Foundation under grants CAREER-1454334, AST-1411851 (RUI) and AST-1412845.

Integrated modeling/analyses of thermal-shock effects in SNS targets

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

Taleyarkhan, R.P.; Haines, J.

1996-06-01

In a spallation neutron source (SNS), extremely rapid energy pulses are introduced in target materials such as mercury, lead, tungsten, uranium, etc. Shock phenomena in such systems may possibly lead to structural material damage beyond the design basis. As expected, the progression of shock waves and interaction with surrounding materials for liquid targets can be quite different from that in solid targets. The purpose of this paper is to describe ORNL`s modeling framework for `integrated` assessment of thermal-shock issues in liquid and solid target designs. This modeling framework is being developed based upon expertise developed from past reactor safety studies,more » especially those related to the Advanced Neutron Source (ANS) Project. Unlike previous separate-effects modeling approaches employed (for evaluating target behavior when subjected to thermal shocks), the present approach treats the overall problem in a coupled manner using state-of-the-art equations of state for materials of interest (viz., mercury, tungsten and uranium). That is, the modeling framework simultaneously accounts for localized (and distributed) compression pressure pulse generation due to transient heat deposition, the transport of this shock wave outwards, interaction with surrounding boundaries, feedback to mercury from structures, multi-dimensional reflection patterns & stress induced (possible) breakup or fracture.« less

T-wave loop area from a pre-implant 12-lead ECG is associated with appropriate ICD shocks

PubMed Central

Hnatkova, Katerina; Friede, Tim; Malik, Marek; Zabel, Markus

2017-01-01

Aims In implantable cardioverter-defibrillator (ICD) patients, predictors of ICD shocks and mortality are needed to improve patient selection. Electrocardiographic (ECG) markers are simple to obtain and have been demonstrated to predict mortality. We aimed to assess the association of T-wave loop area and circularity with ICD shocks. Methods The study investigated patients with ICDs implanted between 1998 and 2010 for whom digital 12-lead ECGs (Schiller CS200 ECG-Network) of sufficient quality were obtained within 1 month prior to the implantation. T-wave loop area and circularity were calculated. Follow-up data of appropriate shocks were obtained during ICD clinic visits that included reviews of device stored electrograms. Results A total of 605 patients (82% males) were included; 68% had ischemic cardiomyopathy and 72% were treated for primary prevention. Over 3.8±1.4 years of follow-up, 114 patients (19%) experienced appropriate shock(s). Those with smaller T-wave loop area received fewer shocks (TLA, hazard ratio, HR, per increase of 1 technical unit, 0.71; [95% confidence interval, 0.53–0.94]; P = 0.02) and those with larger T-wave loop circularity (TLC) representing rounder T wave loop received more shocks (HR per 1% TLC increase 2.96; [0.85–10.36]; P = 0.09). When the quartile containing the largest TLA and TLC values, respectively, were compared to the remaining cases, TLA remained significantly associated with fewer and TLC with more frequent shocks also after multivariate adjustment for clinical variables (HR, 0.59 [0.35–0.99], P = 0.044; and 1.64 [1.08–2.49], P = 0.021, respectively). Conclusions The size and shape of the T-wave loop calculated from pre-implantation 12-lead ECGs are associated with appropriate ICD shocks. PMID:28291831

Dynamic Response Assessment for the MEMS Accelerometer Under Severe Shock Loads

NASA Technical Reports Server (NTRS)

Fan, Mark S.; Shaw, Harry C.

2001-01-01

NASA Goddard Space Flight Center (GSFC) has evaluated the dynamic response of a commercial-off-the-shelf (COTS) microelectromechanical systems (MEMS) device made by Analog Device, Inc. The device is designated as ADXL250 and is designed mainly for sensing dynamic acceleration. It is also used to measure the tilting angle of any system or component from its original level position. The device has been in commercial use (e.g., in automobile airbag deployment system as a dual-axial accelerometer and in the electronic game play-station as a tilting sensor) with success, but NASA needs an in-depth assessment of its performance under severe dynamic shock environments. It was realized while planning this evaluation task that two assessments would be beneficial to NASA's missions: (1) severe dynamic shock response under nominal thermal environments; and (2) general dynamic performance under cryogenic environments. The first evaluation aims at obtaining a good understanding of its micromachined structure within a framework of brittle fracture dynamics, while the second evaluation focuses on the structure integrity under cryogenic temperature conditions. The information we gathered from the manufacturer indicated that the environmental stresses under NASA's evaluation program have been far beyond what the device has experienced with commercial applications, for which the device was designed. Thus NASA needs the outcome of this evaluation in order to make the selection for possible use for its missions. This paper provides details of the first evaluation the dynamic response under severe multi-axial single-pulse shock load. It was performed using finite element tools with nonlinear dynamics procedures.

Hurricane Sandy Economic Impacts Assessment: A Computable General Equilibrium Approach and Validation

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

Boero, Riccardo; Edwards, Brian Keith

Economists use computable general equilibrium (CGE) models to assess how economies react and self-organize after changes in policies, technology, and other exogenous shocks. CGE models are equation-based, empirically calibrated, and inspired by Neoclassical economic theory. The focus of this work was to validate the National Infrastructure Simulation and Analysis Center (NISAC) CGE model and apply it to the problem of assessing the economic impacts of severe events. We used the 2012 Hurricane Sandy event as our validation case. In particular, this work first introduces the model and then describes the validation approach and the empirical data available for studying themore » event of focus. Shocks to the model are then formalized and applied. Finally, model results and limitations are presented and discussed, pointing out both the model degree of accuracy and the assessed total damage caused by Hurricane Sandy.« less

Material Protection, Accounting, and Control Technologies (MPACT): Modeling and Simulation Roadmap

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

Cipiti, Benjamin; Dunn, Timothy; Durbin, Samual

The development of sustainable advanced nuclear fuel cycles is a long-term goal of the Office of Nuclear Energy’s (DOE-NE) Fuel Cycle Technologies program. The Material Protection, Accounting, and Control Technologies (MPACT) campaign is supporting research and development (R&D) of advanced instrumentation, analysis tools, and integration methodologies to meet this goal. This advanced R&D is intended to facilitate safeguards and security by design of fuel cycle facilities. The lab-scale demonstration of a virtual facility, distributed test bed, that connects the individual tools being developed at National Laboratories and university research establishments, is a key program milestone for 2020. These tools willmore » consist of instrumentation and devices as well as computer software for modeling. To aid in framing its long-term goal, during FY16, a modeling and simulation roadmap is being developed for three major areas of investigation: (1) radiation transport and sensors, (2) process and chemical models, and (3) shock physics and assessments. For each area, current modeling approaches are described, and gaps and needs are identified.« less

Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter defibrillator in Swine.

PubMed

Killingsworth, Cheryl R; Melnick, Sharon B; Litovsky, Silvio H; Ideker, Raymond E; Walcott, Gregory P

2013-10-01

A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. During sinus rhythm, anesthetized pigs (38 ± 6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24 hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semiquantitative scoring. Troponin I was significantly elevated at 4 hours and 24 hours (22.6 ± 16.3 ng/mL and 3.1 ± 1.3 ng/mL; baseline 0.07 ± 0.09 ng/mL) in control pigs but not in S-ICD pigs (0.12 ± 0.11 ng/mL and 0.13 ± 0.13 ng/mL; baseline 0.06 ± 0.03 ng/mL). CK-MM was significantly elevated in S-ICD pigs after shocks (6,544 ± 1,496 U/L and 9,705 ± 6,240 U/L; baseline 704 ± 398 U/L) but not in controls. Electrocardiogram changes occurred postshock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

CE: Assessing Patients During Septic Shock Resuscitation.

PubMed

Bridges, Elizabeth

2017-10-01

: In 2015, the Surviving Sepsis Campaign six-hour bundle was updated. The revised version now recommends documenting the reassessment of volume status and tissue perfusion after initial fluid resuscitation through a repeated focused examination. This article addresses the practice and interpretation of two components of this examination in adults: capillary refill time and skin mottling score. It further discusses how to best integrate these noninvasive parameters into the care of patients undergoing resuscitation for septic shock.

Functional Assessment of Laser Irradiation.

DTIC Science & Technology

1988-03-01

shock altogether. Following shaping, threshold acuity testing was derived using a modification of the von Bekesy tracking technique (14). In this...burns produced by atomic flash. AMA Arch. Ophthal 53: 351-364 (1955) 2. Hawerth, R.S. and Sperling , H.G. Prolonged color blindness induced by intense...Swinnen, M.E.T., Brady, J.V. & Powell, M.G. A new device for the application of shock. Behav. Meth. & Instrum 1: 184 (1969) 14. Bekesy, G. von . A new

Comparison of Different Analgesia Drug Regimens for Pain Control During Extracorporeal Shock Wave Lithotripsy for Renal Stones: A Randomized Control Study

PubMed Central

Butt, Amna; Ayaz Khan, Mohammad; Khan, Ijaz; Saqib, Imad-ud-din; Hussain, Tariq; Akhter, Saeed

2017-01-01

Introduction With the increased use of extracorporeal shock wave lithotripsy (ESWL), the management of urolithiasis has become much convenient for the patients and the health care professionals alike. However, associated with the procedure is the common complaint of pain. No agreed upon pain management strategy has yet been developed for the procedure. We compared the effect of different analgesia drug regiments for pain control. Methodology A randomised controlled trial was carried out in Shifa International Hospital from between July 2015 to January 2016. A total of 135 patients were divided into three groups; group A received 30 g lidocaine 2% gel applied locally on corresponding lumber area 30 minutes before the procedure, group B received oral naproxen sodium 550 mg 45 minutes before the procedure, and group C received both oral naproxen and lidocaine gel. Patients were supplemented with intravenous nalbuphine during the procedure. The pain was assessed with 0-10 visual analogue scale. Both pre-procedure and post-procedure pain score was measured. Results Among 135 patients, 105 (77.8%) were male and 29 (21.5%) were female with mean age of 38.7 ± 1.31 years. There was no difference of mean pain score or need for supplemental intravenous nalbuphine between groups B and C but there was significantly decreased mean pain score and need for supplemental intravenous nalbuphine in groups B and C in comparison with group A. Conclusion The use of oral naproxen sodium with or without the addition of lidocaine gel during ESWL is a promising option for pain management during the procedure with significant improvement in comparison with lidocaine gel alone. PMID:28560121

Resuscitation Outcomes Consortium-Amiodarone, Lidocaine or Placebo Study (ROC-ALPS): Rationale and methodology behind an out-of-hospital cardiac arrest antiarrhythmic drug trial.

PubMed

Kudenchuk, Peter J; Brown, Siobhan P; Daya, Mohamud; Morrison, Laurie J; Grunau, Brian E; Rea, Tom; Aufderheide, Tom; Powell, Judy; Leroux, Brian; Vaillancourt, Christian; Larsen, Jonathan; Wittwer, Lynn; Colella, M Riccardo; Stephens, Shannon W; Gamber, Mark; Egan, Debra; Dorian, Paul

2014-05-01

Despite their wide use, whether antiarrhythmic drugs improve survival after out-of-hospital cardiac arrest (OHCA) is not known. The ROC-ALPS is evaluating the effectiveness of these drugs for OHCA due to shock-refractory ventricular fibrillation or pulseless ventricular tachycardia (VF/VT). ALPS will randomize 3,000 adults across North America with nontraumatic OHCA, persistent or recurring VF/VT after ≥1 shock, and established vascular access to receive up to 450 mg amiodarone, 180 mg lidocaine, or placebo in the field using a double-blind protocol, along with standard resuscitation measures. The designated target population is all eligible randomized recipients of any dose of ALPS drug whose initial OHCA rhythm was VF/VT. A safety analysis includes all randomized patients regardless of their eligibility, initial arrhythmia, or actual receipt of ALPS drug. The primary outcome of ALPS is survival to hospital discharge; a secondary outcome is functional survival at discharge assessed as a modified Rankin Scale score ≤3. The principal aim of ALPS is to determine if survival is improved by amiodarone compared with placebo; secondary aim is to determine if survival is improved by lidocaine vs placebo and/or by amiodarone vs lidocaine. Prioritizing comparisons in this manner acknowledges where differences in outcome are most expected based on existing knowledge. Each aim also represents a clinically relevant comparison between treatments that is worth investigating. Results from ALPS will provide important information about the choice and value of antiarrhythmic therapies for VF/VT arrest with direct implications for resuscitation guidelines and clinical practice. Copyright © 2014 Mosby, Inc. All rights reserved.

Clonidine reduces norepinephrine and improves bone marrow function in a rodent model of lung contusion, hemorrhagic shock, and chronic stress.

PubMed

Alamo, Ines G; Kannan, Kolenkode B; Ramos, Harry; Loftus, Tyler J; Efron, Philip A; Mohr, Alicia M

2017-03-01

Propranolol has been shown previously to restore bone marrow function and improve anemia after lung contusion/hemorrhagic shock. We hypothesized that daily clonidine administration would inhibit central sympathetic outflow and restore bone marrow function in our rodent model of lung contusion/hemorrhagic shock with chronic stress. Male Sprague-Dawley rats underwent 6 days of restraint stress after lung contusion/hemorrhagic shock during which the animals received clonidine (75 μg/kg) after the restraint stress. On postinjury day 7, we assessed urine norepinephrine, blood hemoglobin, plasma granulocyte colony stimulating factor, and peripheral blood mobilization of hematopoietic progenitor cells, as well as bone marrow cellularity and erythroid progenitor cell growth. The addition of clonidine to lung contusion/hemorrhagic shock with chronic restraint stress significantly decreased urine norepinephrine levels, improved bone marrow cellularity, restored erythroid progenitor colony growth, and improved hemoglobin (14.1 ± 0.6 vs 10.8 ± 0.6 g/dL). The addition of clonidine to lung contusion/hemorrhagic shock with chronic restraint stress significantly decreased hematopoietic progenitor cells mobilization and restored granulocyte colony stimulating factor levels. After lung contusion/hemorrhagic shock with chronic restraint stress, daily administration of clonidine restored bone marrow function and improved anemia. Alleviating chronic stress and decreasing norepinephrine is a key therapeutic target to improve bone marrow function after severe injury. Copyright © 2016 Elsevier Inc. All rights reserved.

Impacts into quartz sand: Crater formation, shock metamorphism, and ejecta distribution in laboratory experiments and numerical models

NASA Astrophysics Data System (ADS)

Wünnemann, Kai; Zhu, Meng-Hua; Stöffler, Dieter

2016-10-01

We investigated the ejection mechanics by a complementary approach of cratering experiments, including the microscopic analysis of material sampled from these experiments, and 2-D numerical modeling of vertical impacts. The study is based on cratering experiments in quartz sand targets performed at the NASA Ames Vertical Gun Range. In these experiments, the preimpact location in the target and the final position of ejecta was determined by using color-coded sand and a catcher system for the ejecta. The results were compared with numerical simulations of the cratering and ejection process to validate the iSALE shock physics code. In turn the models provide further details on the ejection velocities and angles. We quantify the general assumption that ejecta thickness decreases with distance according to a power-law and that the relative proportion of shocked material in the ejecta increase with distance. We distinguish three types of shock metamorphic particles (1) melt particles, (2) shock lithified aggregates, and (3) shock-comminuted grains. The agreement between experiment and model was excellent, which provides confidence that the models can predict ejection angles, velocities, and the degree of shock loading of material expelled from a crater accurately if impact parameters such as impact velocity, impactor size, and gravity are varied beyond the experimental limitations. This study is relevant for a quantitative assessment of impact gardening on planetary surfaces and the evolution of regolith layers on atmosphereless bodies.

Numerical and experimental investigation of VG flow control for a low-boom inlet

NASA Astrophysics Data System (ADS)

Rybalko, Michael

The application of vortex generators (VGs) for shock/boundary layer interaction flow control in a novel external compression, axisymmetric, low-boom concept inlet was studied using numerical and experimental methods. The low-boom inlet design features a zero-angle cowl and relaxed isentropic compression centerbody spike, resulting in defocused oblique shocks and a weak terminating normal shock. This allows reduced external gas dynamic waves at high mass flow rates but suffers from flow separation near the throat and a large hub-side boundary layer at the Aerodynamic Interface Plane (AIP), which marks the inflow to the jet engine turbo-machinery. Supersonic VGs were investigated to reduce the shock-induced flow separation near the throat while subsonic VGs were investigated to reduce boundary layer radial distortion at the AIP. To guide large-scale inlet experiments, Reynolds-Averaged Navier-Stokes (RANS) simulations using three-dimensional, structured, chimera (overset) grids and the WIND-US code were conducted. Flow control cases included conventional and novel types of vortex generators at positions both upstream of the terminating normal shock (supersonic VGs) and downstream (subsonic VGs). The performance parameters included incompressible axisymmetric shape factor, post-shock separation area, inlet pressure recovery, and mass flow ratio. The design of experiments (DOE) methodology was used to select device size and location, analyze the resulting data, and determine the optimal choice of device geometry. Based on the above studies, a test matrix of supersonic and subsonic VGs was adapted for a large-scale inlet test to be conducted at the 8'x6' supersonic wind tunnel at NASA Glenn Research Center (GRC). Comparisons of RANS simulations with data from the Fall 2010 8'x6' inlet test showed that predicted VG performance trends and case rankings for both supersonic and subsonic devices were consistent with experimental results. For example, experimental surface oil flow visualization revealed a significant post-shock separation bubble with flow recirculation for the baseline (no VG) case that was substantially broken up in the micro-ramp VG case, consistent with simulations. Furthermore, the predicted subsonic VG performance with respect to a reduction in radial distortion (quantified in terms of axisymmetric incompressible shape factor) was found to be consistent with boundary layer rake measurements. To investigate the unsteady turbulent flow features associated with the shock-induced flow separation and the hub-side boundary layer, a detached eddy simulation (DES) approach using the WIND-US code was employed to model the baseline inlet flow field. This approach yielded improved agreement with experimental data for time-averaged diffuser stagnation pressure profiles and allowed insight into the pressure fluctuations and turbulent kinetic energy distributions which may be present at the AIP. In addition, streamwise shock position statistics were obtained and compared with experimental Schlieren results. The predicted shock oscillations were much weaker than those seen experimentally (by a factor of four), which indicates that the mechanism for the experimental shock oscillations was not captured. In addition, the novel supersonic vortex generator geometries were investigated experimentally (prior to the large-scale inlet 8'x6' wind tunnel tests) in an inlet-relevant flow field containing a Mach 1.4 normal shock wave followed by a subsonic diffuser. A parametric study of device height and distance upstream of the normal shock was undertaken for split-ramp and ramped-vane geometries. Flow field diagnostics included high-speed Schlieren, oil flow visualization, and Pitot-static pressure measurements. Parameters including flow separation, pressure recovery, centerline incompressible boundary layer shape factor, and shock stability were analyzed and compared to the baseline uncontrolled case. While all vortex generators tested eliminated centerline flow separation, the presence of VGs also increased the significant three-dimensionality of the flow via increased side-wall interaction. The stronger streamwise vorticity generated by ramped-vanes also yielded improved pressure recovery and fuller boundary layer velocity profiles within the subsonic diffuser. (Abstract shortened by UMI.)

Long-term outcomes after severe shock.

PubMed

Pratt, Cristina M; Hirshberg, Eliotte L; Jones, Jason P; Kuttler, Kathryn G; Lanspa, Michael J; Wilson, Emily L; Hopkins, Ramona O; Brown, Samuel M

2015-02-01

Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Seventy-six patients who were alive 90 days after severe shock (received ≥1 μg/kg per minute of norepinephrine equivalent) were eligible for the study. We measured 3-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised, and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. The mean long-term survival was 5.1 years; 82% (62 of 76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of 5 years after hospital admission. The patients' Physical Functioning scores were below U.S. population norms (P < 0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety, and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full-time. Early survivors of severe shock had a high 3-year survival rate. Patients' long-term physical and psychological outcomes were similar to those reported for cohorts of less severely ill intensive care unit survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term outcomes. Even extremely critically ill patients have similar outcomes to general intensive care unit survivor populations.

U.S. Department of Energy worker health risk evaluation methodology for assessing risks associated with environmental restoration and waste management

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

Blaylock, B.P.; Legg, J.; Travis, C.C.

1995-06-01

This document describes a worker health risk evaluation methodology for assessing risks associated with Environmental Restoration (ER) and Waste Management (WM). The methodology is appropriate for estimating worker risks across the Department of Energy (DOE) Complex at both programmatic and site-specific levels. This document supports the worker health risk methodology used to perform the human health risk assessment portion of the DOE Programmatic Environmental Impact Statement (PEIS) although it has applications beyond the PEIS, such as installation-wide worker risk assessments, screening-level assessments, and site-specific assessments.

Implementation of a Cardiogenic Shock Team and Clinical Outcomes (INOVA-SHOCK Registry): Observational and Retrospective Study.

PubMed

Tehrani, Behnam; Truesdell, Alexander; Singh, Ramesh; Murphy, Charles; Saulino, Patricia

2018-06-28

The development and implementation of a Cardiogenic Shock initiative focused on increased disease awareness, early multidisciplinary team activation, rapid initiation of mechanical circulatory support, and hemodynamic-guided management and improvement of outcomes in cardiogenic shock. The objectives of this study are (1) to collect retrospective clinical outcomes for acute decompensated heart failure cardiogenic shock and acute myocardial infarction cardiogenic shock, and compare current versus historical survival rates and clinical outcomes; (2) to evaluate Inova Heart and Vascular Institute site specific outcomes before and after initiation of the Cardiogenic Shock team on January 1, 2017; (3) to compare outcomes related to early implementation of mechanical circulatory support and hemodynamic-guided management versus historical controls; (4) to assess survival to discharge rate in patients receiving intervention from the designated shock team and (5) create a clinical archive of Cardiogenic Shock patient characteristics for future analysis and the support of translational research studies. This is an observational, retrospective, single center study. Retrospective and prospective data will be collected in patients treated at the Inova Heart and Vascular Institute with documented cardiogenic shock as a result of acute decompensated heart failure or acute myocardial infarction. This registry will include data from patients prior to and after the initiation of the multidisciplinary Cardiogenic Shock team on January 1, 2017. Clinical outcomes associated with early multidisciplinary team intervention will be analyzed. In the study group, all patients evaluated for documented cardiogenic shock (acute decompensated heart failure cardiogenic shock, acute myocardial infarction cardiogenic shock) treated at the Inova Heart and Vascular Institute by the Cardiogenic Shock team will be included. An additional historical Inova Heart and Vascular Institute control group will be analyzed as a comparator. Means with standard deviations will be reported for outcomes. For categorical variables, frequencies and percentages will be presented. For continuous variables, the number of subjects, mean, standard deviation, minimum, 25th percentile, median, 75th percentile and maximum will be reported. Reported differences will include standard errors and 95% CI. Preliminary data analysis for the year 2017 has been completed. Compared to a baseline 2016 survival rate of 47.0%, from 2017 to 2018, CS survival rates were increased to 57.9% (58/110) and 81.3% (81/140), respectively (P=.01 for both). Study data will continue to be collected until December 31, 2018. The preliminary results of this study demonstrate that the INOVA SHOCK team approach to the treatment of Cardiogenic Shock with early team activation, rapid initiation of mechanical circulatory support, hemodynamic-guided management, and strict protocol adherence is associated with superior clinical outcomes: survival to discharge and overall survival when compared to 2015 and 2016 outcomes prior to Shock team initiation. What may limit the generalization of these results of this study to other populations are site specific; expertise of the team, strict algorithm adherence based on the INOVA SHOCK protocol, and staff commitment to timely team activation. Retrospective clinical outcomes (acute decompensated heart failure cardiogenic shock, acute myocardial infarction cardiogenic shock) demonstrated an increase in current survival rates when compared to pre-Cardiogenic Shock team initiation, rapid team activation and diagnosis and timely utilization of mechanical circulatory support. ClinicalTrials.gov NCT03378739; https://clinicaltrials.gov/ct2/show/NCT03378739 (Archived by WebCite at http://www.webcitation.org/701vstDGd). ©Behnam Tehrani, Alexander Truesdell, Ramesh Singh, Charles Murphy, Patricia Saulino. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 28.06.2018.

Scaling craters in carbonates: Electron paramagnetic resonance analysis of shock damage

NASA Technical Reports Server (NTRS)

Polanskey, Carol A.; Ahrens, Thomas J.

1994-01-01

Carbonate samples from the 8.9-Mt nuclear (near-surface explosion) crater, OAK, and a terrestrial impact crater, Meteor Crater, were analyzed for shock damage using electron paramagnetic resonance (EPR). Samples from below the OAK apparent crater floor were obtained from six boreholes, as well as ejecta recovered from the crater floor. The degree of shock damage in the carbonate material was assessed by comparing the sample spectra to the spectra of Solenhofen and Kaibab limestone, which had been skocked to known pressures. Analysis of the OAK Crater borehole samples has identified a thin zone of allocthonous highly shocked (10-13 GPa) carbonate material underneath the apparent crater floor. This approx. 5- to 15-m-thick zone occurs at a maximum depth of approx. 125 m below current seafloor at the borehole, sited at the initial position of the OAK explosive, and decreases in depth towards the apparent crater edge. Because this zone of allocthonous shocked rock delineates deformed rock below, and a breccia of mobilized sand and collapse debris above, it appears to outline the transient crater. The transient crater volume inferred in this way is found to by 3.2 +/- 0.2 times 10(exp 6)cu m, which is in good agreement with a volume of 5.3 times 10(exp 6)cu m inferred from gravity scaling of laboratory experiments. A layer of highly shocked material is also found near the surface outside the crater. The latter material could represent a fallout ejecta layer. The ejecta boulders recovered from the present crater floor experienced a range of shock pressures from approx. 0 to 15 GPa with the more heavily shocked samples all occurring between radii of 360 and approx. 600 m. Moreover, the fossil content, lithology and Sr isotopic composition all demonstrate that the initial position of the bulk of the heavily shocked rock ejecta sampled was originally near surface rock at initial depths in the 32 to 45-m depth (below sea level) range. The EPR technique is also sensitive to prehistoric shock damage. This is demonstrated by our study of shocked Kaibab limestone from the 49,000-year-old Meteor (Barringer) Crater Arizona.

Low Intensity Extracorporeal Shock Wave Therapy Improves Erectile Function in a Model of Type II Diabetes Independently of NO/cGMP Pathway.

PubMed

Assaly-Kaddoum, Rana; Giuliano, François; Laurin, Miguel; Gorny, Diane; Kergoat, Micheline; Bernabé, Jacques; Vardi, Yoram; Alexandre, Laurent; Behr-Roussel, Delphine

2016-09-01

Erectile dysfunction is highly prevalent in type II diabetes mellitus. Low intensity extracorporeal shock wave therapy improves erectile function in patients with erectile dysfunction of vasculogenic origin, including diabetes. However, its mode of action remains unknown. We investigated the effects of low intensity extracorporeal shock wave therapy compared to or combined with sildenafil on erectile dysfunction in a type II diabetes mellitus model. Our purpose was to test our hypothesis of a mode of action targeting the cavernous nitric oxide/cyclic guanosine monophosphate pathway. GK rats, a validated model of type II diabetes mellitus, and age matched Wistar rats were treated with low intensity extracorporeal shock wave therapy twice weekly for 3 weeks. Treatment was repeated after a 3-week no-treatment interval. The penis was stretched and dipped in a specifically designed water-filled cage. Shock waves were delivered by a calibrated probe yielding a controlled energy flux density (0.09 mJ/mm(2)). The probe was attached to an electrohydraulic unit with a focused shock wave source, allowing for accurate extrapolation to humans. Following a 4-week washout period erectile function was assessed as well as endothelium dependent and independent, and nitrergic relaxations of the corpus cavernosum of GK rats. Low intensity extracorporeal shock wave therapy significantly improved erectile function in GK rats to the same extent as sildenafil. Treatment effects were potentiated when combined with sildenafil. Shock wave effects were not associated with improved cavernous endothelium dependent or independent, or nitrergic reactivity. Low intensity extracorporeal shock wave therapy improved erectile function in GK rats. Unexpectedly, this was not mediated by a nitric oxide/cyclic guanosine monophosphate dependent mechanism. Sildenafil increased shock wave efficacy. This preclinical paradigm to deliver low intensity extracorporeal shock wave therapy to the rat penis should help further exploration of the mode of action of this therapy on erectile tissue. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[How to do Things with Metaphors: Reflections on the Role of Metaphors and Metaphor Theory for the History of Science Using the Example of Shock Metaphors in Medicine].

PubMed

Koch, Ulrich

2015-12-01

In recent decades, metaphors have attracted a great deal of interest within the history, philosophy, and sociology of science. The article takes the growing interest in epistemic metaphors as the starting point of a discussion of two conflicting motives prevalent in theories of metaphor and metaphoricity: On the one hand, metaphors are associated with the indeterminacy of scientific discovery and the emergence of new epistemic objects; and on the other hand, metaphors are said to provide a filter of possible meanings and vantage-points. It is argued that an approach, which aims to do justice to both tendencies, cannot exclusively rely on linguistic models but must expand its scope of inquiry to include the practical trajectories of a metaphor’s usage as well as the problematizations to which they respond, since both engender metaphorical meaning, albeit at the cost of semantic precision. The exemplary case discussed in the article, the psychologization of nervous shock in nineteenth century medical discourse, demonstrates that the incremental process of shock’s shifting semantics would be inadequately characterized as a metaphorical transfer. Instead, it is shown how the actualization of earlier meanings, in particular of shock as a state of altered consciousness, in novel professional and cultural contexts acted as a catalyst for the psychologization of shock and related nascent concepts such as psychic trauma. As a possible, and methodologically fruitful way of overcoming the one-sidedness of linguistic notions of metaphor, a combination of Jìrgen Link’s concept of inter-discourse with a philosophical metaphorology (Blumenberg) is discussed in the final section of the paper.

Environmental probabilistic quantitative assessment methodologies

USGS Publications Warehouse

Crovelli, R.A.

1995-01-01

In this paper, four petroleum resource assessment methodologies are presented as possible pollution assessment methodologies, even though petroleum as a resource is desirable, whereas pollution is undesirable. A methodology is defined in this paper to consist of a probability model and a probabilistic method, where the method is used to solve the model. The following four basic types of probability models are considered: 1) direct assessment, 2) accumulation size, 3) volumetric yield, and 4) reservoir engineering. Three of the four petroleum resource assessment methodologies were written as microcomputer systems, viz. TRIAGG for direct assessment, APRAS for accumulation size, and FASPU for reservoir engineering. A fourth microcomputer system termed PROBDIST supports the three assessment systems. The three assessment systems have different probability models but the same type of probabilistic method. The type of advantages of the analytic method are in computational speed and flexibility, making it ideal for a microcomputer. -from Author

Percutaneous Ventricular Assist Devices: A Health Technology Assessment

PubMed Central

Lee, Christine; Djalalov, Sandjar; Xie, Xuanqian; Holubowich, Corinne

2017-01-01

Background Percutaneous coronary intervention (PCI)—using a catheter to place a stent to keep blood vessels open—is increasingly used for high-risk patients who cannot undergo surgery. Cardiogenic shock (when the heart suddenly cannot pump enough blood) is associated with a high mortality rate. The percutaneous ventricular assist device can help control blood pressure and increase blood flow in these high-risk conditions. This health technology assessment examined the benefits, harms, and budget impact of the Impella percutaneous ventricular assist device in high-risk PCI and cardiogenic shock. We also analyzed cost-effectiveness of the Impella device in high-risk PCI. Methods We performed a systematic search of the literature for studies examining the effects of the Impella percutaneous ventricular assist device in high-risk PCI and cardiogenic shock, and appraised the evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria, focusing on hemodynamic stability, mortality, major adverse cardiac events, bleeding, and vascular complications. We developed a Markov decision-analytical model to assess the cost- effectiveness of Impella devices versus intra-aortic balloon pumps (IABPs), calculated incremental cost-effectiveness ratios (ICERs) using a 10-year time horizon, and conducted sensitivity analyses to examine the robustness of the estimates. The economic model was conducted from the perspective of the Ontario Ministry of Health and Long-Term Care. Results Eighteen studies (one randomized controlled trial and 10 observational studies for high-risk PCI, and one randomized controlled trial and six observational studies for cardiogenic shock) were included in the clinical review. Compared with IABPs, Impella 2.5, one model of the device, improved hemodynamic parameters (GRADE low–very low) but showed no significant difference in mortality (GRADE low), major adverse cardiac events (GRADE low), bleeding (GRADE low), or vascular complications (GRADE low) in high-risk PCI and cardiogenic shock. No randomized controlled trials or prospective observational studies with a control group have studied Impella CP and Impella 5.0 (other models of the device) in patients undergoing high-risk PCI or patients with cardiogenic shock. The economic model predicted that treatment with the Impella device would have fewer quality-adjusted life-years (QALYs) and higher costs than IABP in high-risk PCI patients. These observations were consistent even when uncertainty in model inputs and parameters was considered. We estimated that adopting Impella would increase costs by $2.9 to $11.5 million per year. Conclusions On the basis of evidence of low to very low quality, Impella 2.5 devices were associated with improved hemodynamic stability, but had mortality rates and safety profile similar to IABPs in high-risk PCI and cardiogenic shock. Our cost-effectiveness analysis indicated that Impella 2.5 is likely associated with greater costs and fewer quality-adjusted life years than IABP. PMID:28232854

Small Ground-Level Enhancement of 6 January 2014: Acceleration by CME-Driven Shock?

NASA Astrophysics Data System (ADS)

Li, C.; Miroshnichenko, L. I.; Sdobnov, V. E.

2016-03-01

Available spectral data for solar energetic particles (SEPs) measured near the Earth's orbit (GOES-13) and on the terrestrial surface (polar neutron monitors) on 6 January 2014 are analyzed. A feature of this solar proton event (SPE) and weak ground-level enhancement (GLE) is that the source was located behind the limb. For the purpose of comparison, we also use the Advanced Composition Explorer (ACE) data on sub-relativistic electrons and GOES-13 measurements of a strong and extended proton event on 8 - 9 January 2014. It was found that the surface observations at energies {>} 433 MeV and GOES-13 data at {>} 30 - {>} 700 MeV may be satisfactorily reconciled by a power-law time-of-maximum (TOM) spectrum with a characteristic exponential tail (cutoff). Some methodological difficulties of spectrum determination are discussed. Assuming that the TOM spectrum near the Earth is a proxy of the spectrum of accelerated particles in the source, we critically consider the possibility of shock acceleration to relativistic energies in the solar corona. Finally, it is suggested to interpret the observational features of this GLE under the assumption that small GLEs may be produced by shocks driven by coronal mass ejections. However, the serious limitations of such an approach to the problem of the SCR spectrum prevent drawing firm conclusions in this controversial field.

Ion Thermalization and Electron Heating across Quasi-Perpendicular Shocks Observed by the MMS Mission

NASA Astrophysics Data System (ADS)

Chen, L.-J.; Wilson, L. B., III; Wang, S.; Bessho, N.; Viñas, A. F.-; Lai, H.; Russell, C. T.; Schwartz, S. J.; Hesse, M.; Moore, T. E.; Burch, J. L.; Gershman, D. J.; Giles, B. L.; Torbert, R. B.; Ergun, R. E.; Dorelli, J.; Strangeway, R. J.; Paterson, W. R.; Lavraud, B.; Khotyaintsev, Yu. V.

2017-12-01

Collisionless shocks often involve intense plasma heating in space and astrophysical systems. Despite decades of research, a number of key questions concerning electron and ion heating across collisionless shocks remain unanswered. We 'image' 20 supercritical quasi-perpendicular bow shocks encountered by the Magnetospheric Multiscale (MMS) spacecraft with electron and ion distribution functions to address how ions are thermalized and how electrons are heated. The continuous burst measurements of 3D plasma distribution functions from MMS reveal that the primary thermalization phase of ions occurs concurrently with the main temperature increase of electrons as well as large-amplitude wave fluctuations. Approaching the shock from upstream, the ion temperature (Ti) increases due to the reflected ions joining the incoming solar wind population, as recognized by prior studies, and the increase of Ti precedes that of the electrons. Thermalization in the form of merging between the decelerated solar wind ions and the reflected component often results in a decrease in Ti. In most cases, the Ti decrease is followed by a gradual increase further downstream. Anisotropic, energy-dependent, and/or nongyrotropic electron energization are observed in association with large electric field fluctuations in the main electron temperature (Te) gradient, motivating a renewed scrutiny of the effects from the electrostatic cross-shock potential and wave fluctuations on electron heating. Particle-in-cell (PIC) simulations are carried out to assist interpretations of the MMS observations. We assess the roles of instabilities and the cross-shock potential in thermalizing ions and heating electrons based on the MMS measurements and PIC simulation results. Challenges will be posted for future computational studies and laboratory experiments on collisionless shocks.

Ion Thermalization and Electron Heating across Quasi-Perpendicular Shocks Observed by the MMS Mission

NASA Astrophysics Data System (ADS)

Chen, L. J.; Wilson, L. B., III; Wang, S.; Bessho, N.; Figueroa-Vinas, A.; Lai, H.; Russell, C. T.; Schwartz, S. J.; Hesse, M.; Moore, T. E.; Burch, J.; Gershman, D. J.; Giles, B. L.; Torbert, R. B.; Ergun, R.; Dorelli, J.; Strangeway, R. J.; Paterson, W. R.; Lavraud, B.; Khotyaintsev, Y. V.

2017-12-01

Collisionless shocks often involve intense plasma heating in space and astrophysical systems. Despite decades of research, a number of key questions concerning electron and ion heating across collisionless shocks remain unanswered. We `image' 20 supercritical quasi-perpendicular bow shocks encountered by the Magnetospheric Multiscale (MMS) spacecraft with electron and ion distribution functions to address how ions are thermalized and how electrons are heated. The continuous burst measurements of 3D plasma distribution functions from MMS reveal that the primary thermalization phase of ions occurs concurrently with the main temperature increase of electrons as well as large-amplitude wave fluctuations. Approaching the shock from upstream, the ion temperature (Ti) increases due to the reflected ions joining the incoming solar wind population, as recognized by prior studies, and the increase of Ti precedes that of the electrons. Thermalization in the form of merging between the decelerated solar wind ions and the reflected component often results in a decrease in Ti. In most cases, the Ti decrease is followed by a gradual increase further downstream. Anisotropic, energy-dependent, and/or nongyrotropic electron energization are observed in association with large electric field fluctuations in the main electron temperature (Te) gradient, motivating a renewed scrutiny of the effects from the electrostatic cross-shock potential and wave fluctuations on electron heating. Particle-in-cell (PIC) simulations are carried out to assist interpretations of the MMS observations. We assess the roles of instabilities and the cross-shock potential in thermalizing ions and heating electrons based on the MMS measurements and PIC simulation results. Challenges will be posted for future computational studies and laboratory experiments on collisionless shocks.

Risk Factors for Development of Septic Shock in Patients with Urinary Tract Infection

PubMed Central

Hsiao, Chih-Yen; Yang, Huang-Yu; Chang, Chih-Hsiang; Lin, Hsing-Lin; Wu, Chao-Yi; Hsiao, Meng-Chang; Hung, Peir-Haur; Liu, Su-Hsun; Weng, Cheng-Hao; Lee, Cheng-Chia; Chen, Yung-Chang; Wu, Tzu-Chin

2015-01-01

Introduction. Severe sepsis and septic shock are associated with substantial mortality. However, few studies have assessed the risk of septic shock among patients who suffered from urinary tract infection (UTI). Materials and Methods. This retrospective study recruited UTI cases from an acute care hospital between January 2006 and October 2012 with prospective data collection. Results. Of the 710 participants admitted for UTI, 80 patients (11.3%) had septic shock. The rate of bacteremia is 27.9%; acute kidney injury is 12.7%, and the mortality rate is 0.28%. Multivariable logistic regression analyses indicated that coronary artery disease (CAD) (OR: 2.521, 95% CI: 1.129–5.628, P = 0.024), congestive heart failure (CHF) (OR: 4.638, 95% CI: 1.908–11.273, P = 0.001), and acute kidney injury (AKI) (OR: 2.992, 95% CI: 1.610–5.561, P = 0.001) were independently associated with septic shock in patients admitted with UTI. In addition, congestive heart failure (female, OR: 4.076, 95% CI: 1.355–12.262, P = 0.012; male, OR: 5.676, 95% CI: 1.103–29.220, P = 0.038, resp.) and AKI (female, OR: 2.995, 95% CI: 1.355–6.621, P = 0.007; male, OR: 3.359, 95% CI: 1.158–9.747, P = 0.026, resp.) were significantly associated with risk of septic shock in both gender groups. Conclusion. This study showed that patients with a medical history of CAD or CHF have a higher risk of shock when admitted for UTI treatment. AKI, a complication of UTI, was also associated with septic shock. Therefore, prompt and aggressive management is recommended for those with higher risks to prevent subsequent treatment failure in UTI patients. PMID:26380292

Perceived support from healthcare professionals, shock anxiety and post-traumatic stress in implantable cardioverter defibrillator recipients.

PubMed

Morken, Ingvild M; Bru, Edvin; Norekvål, Tone M; Larsen, Alf I; Idsoe, Thormod; Karlsen, Bjørg

2014-02-01

To investigate (1) the extent to which shock anxiety and perceived support from healthcare professionals are related to post-traumatic stress disease (PTSD) symptoms and (2) the extent to which perceived support from healthcare professionals moderates the relationship between shock anxiety and PTSD symptoms in implantable cardioverter defibrillator recipients. An additional aim was to describe the level of PTSD symptoms and perceptions of support from healthcare professionals. Studies examining PTSD symptoms among implantable cardioverter defibrillator recipients are still sparse. In addition, little is known about how perceived support from healthcare professionals is related to PTSD symptoms. Cross-sectional survey design. Recipients (n = 167) with implantable cardioverter defibrillator attending an outpatient device clinic completed questionnaires assessing shock anxiety, PTSD symptoms and perceived support from healthcare professionals. The results indicated that between ten and 15% of the recipients experienced moderate to severe symptoms of PTSD. Although a majority perceived constructive support from healthcare professionals, 12% perceived nonconstructive support. Regression analysis demonstrated that shock anxiety and perceived nonconstructive support from healthcare professionals had a statistically significant (p < 0·01) association with PTSD symptoms. Moreover, the results suggest that associations between shock anxiety and PTSD symptoms were significantly (p < 0·01) moderated by perceived nonconstructive support from healthcare professionals. Young age, short time since implantation and secondary prevention indication were also significantly associated with PTSD symptoms. The results indicate that nonconstructive support from healthcare professionals can increase the tendency to develop PTSD symptoms, particularly in those who experience shock anxiety. Healthcare professionals should pay more attention to the way in which they communicate information to the recipients during follow-up visits. Clinically based strategies and interventions targeting shock anxiety and PTSD symptoms should be carried out. © 2013 John Wiley & Sons Ltd.

Early prediction of norepinephrine dependency and refractory septic shock with a multimodal approach of vascular failure.

PubMed

Conrad, Marie; Perez, Pierre; Thivilier, Carine; Levy, Bruno

2015-08-01

The purpose of the study is to improve our ability to detect catecholamine dependency and refractory septic shock. Fifty-one patients with septic shock were studied within the first 4 hours of norepinephrine administration. Patients were divided into 2 groups according to their evolution in the intensive care unit, namely, group A, shock reversal, and group B, no shock reversal. Reversal of shock was defined as the maintenance of a systolic blood pressure greater than or equal to 90 mm Hg without vasopressor support for 24 hours or more. Vascular reactivity was tested using incremental doses of phenylephrine. Muscle tissue oxygen saturation and its changes during a vascular occlusion test were measured. Group B patients had a higher Sequential Organ Failure Assessment (SOFA) score and lactate level and more frequently received norepinephrine and renal replacement. Overall mortality was 100% in group B (16/16) and 20% (7/35) in group A. Phenylephrine increased mean arterial pressure in a dose-dependent manner more significantly in group A patients than in group B (P = .0004). Basal tissue oxygen saturation and the recovery slope after vascular occlusion test were lower in group B. In multivariate analysis, 4 parameters remained independently associated with mortality: the increase in mean arterial pressure at phenylephrine 6 μg/kg per minute, the recovery slope, SOFA score, and norepinephrine doses at H0. The intensity of septic shock-induced vascular hyporesponsiveness to vasopressor is tightly linked to septic shock severity and evolution and may potentially be identified early with simple to obtain parameters such as near-infrared spectroscopy value, SOFA score, or norepinephrine dose. Copyright © 2015 Elsevier Inc. All rights reserved.

A multicenter, randomized, controlled trial of transureteral and shock wave lithotripsy--which is the best minimally invasive modality to treat distal ureteral calculi in children?

PubMed

Basiri, Abbas; Zare, Samad; Tabibi, Ali; Sharifiaghdas, Farzaneh; Aminsharifi, Alireza; Mousavi-Bahar, Seyed Habibollah; Ahmadnia, Hassan

2010-09-01

Since there is insufficient evidence to determine the best treatment modality in children with distal ureteral calculi, we designed a multicenter, randomized, controlled trial to evaluate the efficacy and complications of transureteral and shock wave lithotripsy in these patients. A total of 100 children with distal ureteral calculi were included in the study. Of the patients 50 were randomized consecutively to undergo shock wave lithotripsy using a Compact Delta II lithotriptor (Dornier MedTech, Kennesaw, Georgia), and 50 were randomized to undergo transureteral lithotripsy with holmium laser and pneumatic lithotriptor between February 2007 and October 2009. Stone-free, complication and efficiency quotient rates were assessed in each group. Mean +/- SD patient age was 6.5 +/- 3.7 years (range 1 to 13). Mean stone surface was 35 mm(2) in the transureteral group and 37 mm(2) in the shock wave lithotripsy group. Stone-free rates at 2 weeks after transureteral lithotripsy and single session shock wave lithotripsy differed significantly, at 78% and 56%, respectively (p = 0.004). With 2 sessions of shock wave lithotripsy the stone-free rate increased to 72%. Efficiency quotient was significantly higher for transureteral vs shock wave lithotripsy (81% vs 62%, p = 0.001). Minor complications were comparable and negligible between the groups. Two patients (4%) who underwent transureteral lithotripsy sustained a ureteral perforation. In the short term it seems that transureteral and shock wave lithotripsy are acceptable modalities for the treatment of distal ureteral calculi in children. However, transureteral lithotripsy has a higher efficacy rate when performed meticulously by experienced hands using appropriate instruments. 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Predictive value of low tube voltage and dual-energy CT for successful shock wave lithotripsy: an in vitro study.

PubMed

Largo, Remo; Stolzmann, Paul; Fankhauser, Christian D; Poyet, Cédric; Wolfsgruber, Pirmin; Sulser, Tullio; Alkadhi, Hatem; Winklhofer, Sebastian

2016-06-01

This study investigates the capabilities of low tube voltage computed tomography (CT) and dual-energy CT (DECT) for predicting successful shock wave lithotripsy (SWL) of urinary stones in vitro. A total of 33 urinary calculi (six different chemical compositions; mean size 6 ± 3 mm) were scanned using a dual-source CT machine with single- (120 kVp) and dual-energy settings (80/150, 100/150 Sn kVp) resulting in six different datasets. The attenuation (Hounsfield Units) of calculi was measured on single-energy CT images and the dual-energy indices (DEIs) were calculated from DECT acquisitions. Calculi underwent SWL and the number of shock waves for successful disintegration was recorded. The prediction of required shock waves regarding stone attenuation/DEI was calculated using regression analysis (adjusted for stone size and composition) and the correlation between CT attenuation/DEI and the number of shock waves was assessed for all datasets. The median number of shock waves for successful stone disintegration was 72 (interquartile range 30-361). CT attenuation/DEI of stones was a significant, independent predictor (P < 0.01) for the number of required shock waves with the best prediction at 80 kVp (β estimate 0.576) (P < 0.05). Correlation coefficients between attenuation/DEI and the number of required shock waves ranged between ρ = 0.31 and 0.68 showing the best correlation at 80 kVp (P < 0.001). The attenuation of urinary stones at low tube voltage CT is the best predictor for successful stone disintegration, being independent of stone composition and size. DECT shows no added value for predicting the success of SWL.

Association between transthoracic impedance and electrical cardioversion success with biphasic defibrillators: An analysis of 1055 shocks for atrial fibrillation and flutter.

PubMed

Sadek, Mouhannad M; Chaugai, Varsha; Cleland, Mark J; Zakutney, Timothy J; Birnie, David H; Ramirez, F Daniel

2018-03-13

The relevance of transthoracic impedance (TTI) to electrical cardioversion (ECV) success for atrial tachyarrhythmias when using biphasic waveform defibrillators is unknown. TTI is predictive of ECV success with contemporary defibrillators. De-identified data stored in biphasic defibrillator memory cards from ECV attempts for atrial fibrillation (AF) or atrial flutter (AFL) over a 2-year period at our center were evaluated. ECV success, defined as arrhythmia termination and ≥ 1 sinus beat, was adjudicated by 2 blinded cardiac electrophysiologists. The association between TTI and ECV success was assessed via Cochrane-Armitage trend and Spearman rank correlation tests, as well as simple and multivariable logistic regression. The influence of TTI on the number of shocks and on cumulative energy delivered per patient was also examined. 703 patients (593 with AF, 110 with AFL) receiving 1055 shocks were included. Last shock success was achieved in 88.0% and 98.2% of patients with AF and AFL, respectively. In patients with AF, TTI was positively associated with last shock failure (P trend  =0.019), the need for multiple shocks (P trend  <0.001), and cumulative energy delivered (ρ = 0.348; P < 0.001). After adjusting for first shock energy, 10-Ω increments in TTI were associated with odds ratios of 1.36 (95% CI: 1.24-1.49) and 1.22 (95% CI: 1.09-1.37) for first and last shock failure, respectively (P < 0.001 for both). Although contemporary defibrillators are designed to compensate for TTI, this variable continues to be associated with ECV failure in patients with AF. Strategies to lower TTI during ECV for AF may improve procedural success. © 2018 Wiley Periodicals, Inc.

Terlipressin: vasopressin analog and novel drug for septic shock.

PubMed

Pesaturo, Adam B; Jennings, Heath R; Voils, Stacy A

2006-12-01

To review and assess available literature on chemistry, pharmacology, pharmacodynamics, pharmacokinetics, clinical studies, adverse events, drug interactions, and dosing and administration of terlipressin in septic shock. A literature search of MEDLINE (1966-September 2006), International Pharmaceutical Abstracts (1970-September 2006), and Cochrane database (third quarter 2006) was conducted, using key terms of terlipressin, lypressin, triglycyl-lysine vasopressin, hemodynamic support, septic shock, vasopressor, and V1 receptor agonist. Bibliographies of relevant articles were reviewed for additional references. Available English-language literature, including abstracts, animal studies, preclinical studies, clinical trials, and review articles, were examined. Because of potentially favorable pharmacokinetics versus vasopressin and limited availability of vasopressin in some countries, the effects of terlipressin, a vasopressin analog, have been studied recently for the treatment of septic shock. When administered as a 1-2 mg intravenous dose in patients with septic shock, terlipressin increases mean arterial pressure, urine output, systemic vascular resistance index, pulmonary vascular resistance index, and left and right ventricular stroke work index while decreasing heart rate, cardiac output, lactate, and oxygen delivery and consumption index. It is unclear whether lower doses of terlipressin would produce a similar vasopressor response with fewer cardiopulmonary effects and whether the effects of the drug on oxygen transport indices are detrimental. Terlipressin is a promising investigational medication for treatment of septic shock. Small trials have shown terlipressin to have favorable effects on hemodynamics in patients with septic shock refractory to conventional vasopressor treatment. It should be used with extreme caution in patients with underlying cardiac or pulmonary dysfunction. Further studies are needed to verify safety, efficacy, and dosing of terlipressin in patients with septic shock, and its use cannot be recommended in lieu of vasopressin at this time.

Impact of remote monitoring on reducing the burden of inappropriate shocks related to implantable cardioverter-defibrillator lead fractures: insights from a French single-centre registry.

PubMed

Souissi, Zouheir; Guédon-Moreau, Laurence; Boulé, Stéphane; Kouakam, Claude; Finat, Loïc; Marquié, Christelle; Brigadeau, François; Wissocque, Ludivine; Mouton, Stéphanie; Montaigne, David; Klug, Didier; Kacet, Salem; Lacroix, Dominique

2016-06-01

Lead fractures in implantable cardioverter-defibrillator (ICD) patients may cause inappropriate shocks (ISs). An early diagnosis is essential to prevent adverse clinical events. Implantable cardioverter-defibrillator remote monitoring (RM) permits prompt detection of lead fracture. Limited data define the impact of RM on ISs specifically related to lead fracture. We sought to compare the number of ISs related to lead fracture in patients with vs. without RM follow-up. We checked the registry of our institution and collected, between July 2007 and June 2014, 115 cases of right ventricular lead fractures. All relevant data were documented from patients' files, device-interrogation printouts and electronic records, and remote transmissions databases when applicable. We assessed the ISs that were related to lead fracture. The first study endpoint was the number of ISs per shocked patient. Among the 82 patients with conventional follow-up (CFU) and the 33 patients with RM, a first IS occurred to 32.9% (n = 27) and 30.3% (n = 10, P = 0.83) of the patients, respectively. Shocked patients in the RM group underwent significantly fewer ISs with a mean of 6 ± 2 shocks per patient [median of 3.5 shocks (2-8)] than those in the CFU group with a mean of 18 ± 5 shocks per patient [median of 10 shocks (5-22), P = 0.03]. Remote monitoring helps to reduce the burden of ISs related to ICD lead fractures. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Shock wave treatment shows dose-dependent enhancement of bone mass and bone strength after fracture of the femur.

PubMed

Wang, Ching-Jen; Yang, Kuender D; Wang, Feng-Sheng; Hsu, Chia-Chen; Chen, Hsiang-Ho

2004-01-01

Shock wave treatment is believed to improve bone healing after fracture. The purpose of this study was to evaluate the effect of shock wave treatment on bone mass and bone strength after fracture of the femur in a rabbit model. A standardized closed fracture of the right femur was created with a three-point bending method in 24 New Zealand white rabbits. Animals were randomly divided into three groups: (1) control (no shock wave treatment), (2) low-energy (shock wave treatment at 0.18 mJ/mm2 energy flux density with 2000 impulses), and (3) high-energy (shock wave treatment at 0.47 mJ/mm2 energy flux density with 4000 impulses). Bone mass (bone mineral density (BMD), callus formation, ash and calcium contents) and bone strength (peak load, peak stress and modulus of elasticity) were assessed at 12 and 24 weeks after shock wave treatment. While the BMD values of the high-energy group were significantly higher than the control group (P = 0.021), the BMD values between the low-energy and control groups were not statistically significant (P = 0.358). The high-energy group showed significantly more callus formation (P < 0.001), higher ash content (P < 0.001) and calcium content (P = 0.003) than the control and low-energy groups. With regard to bone strength, the high-energy group showed significantly higher peak load (P = 0.012), peak stress (P = 0.015) and modulus of elasticity (P = 0.011) than the low-energy and control groups. Overall, the effect of shock wave treatment on bone mass and bone strength appears to be dose dependent in acute fracture healing in rabbits.

Simulation of hypersonic shock wave - laminar boundary layer interactions

NASA Astrophysics Data System (ADS)

Kianvashrad, N.; Knight, D.

2017-06-01

The capability of the Navier-Stokes equations with a perfect gas model for simulation of hypersonic shock wave - laminar boundary layer interactions is assessed. The configuration is a hollow cylinder flare. The experimental data were obtained by Calspan-University of Buffalo (CUBRC) for total enthalpies ranging from 5.07 to 21.85 MJ/kg. Comparison of the computed and experimental surface pressure and heat transfer is performed and the computed §ow¦eld structure is analyzed.

Investigating Non-Invasive Hemodynamic Monitoring Devices Using Severe Dengue as a Surrogate for Trauma-Induced Shock

DTIC Science & Technology

2014-12-01

dengue hemorrhagic fever. In future work we will continue to evaluate the use of pulse wave forms to predict shock and will assess other...Index Three laboratory Phase I clinical trials have been completed to support a 510(k) application for FDA approval of the first prototype Pulse ... Oximeter with the CRI algorithm and capability for real-time continuous collection of photoplethymographic (PPG) analog signals. An FDA-cleared

Rethinking the concept of sepsis and septic shock.

PubMed

A Cabrita, Joana; Pinheiro, Isabel; Menezes Falcão, L

2018-06-16

Sepsis is a major global health problem and represents a challenge for physicians all over the world. The knowledge of sepsis and septic shock is a topic of interest among the scientific community and society in general. New guidelines for management of sepsis and septic shock were developed in 2016, providing an update on this area. In Sepsis-3 new definitions for sepsis and septic shock were published. The purpose of this narrative review is to discuss and compare the new criteria of 2016 with the old criteria, purposing at the same time an alternative approach for this topic. SOFA criteria (Sequential Organ Failure Assessment Score) are more complete, but too extensive and usually difficult to apply outside the intensive care units, therefore inducing potentially delay in the proper treatment. We purpose combined criteria for the selection of sepsis patients. Initially, we could apply qSOFA (quick Sepsis Related Organ Failure Assessment) criteria, due to its easy application, associated with the SIRS (systemic inflammatory response syndrome) criteria, allowing to select the patients who are infected and need faster treatment. In that way we would use the best of old and newest criteria, allowing the early selection of patients who are infected and require faster treatment, while the search for a better and faster tool continues. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Assessment of Computational Fluid Dynamics (CFD) Models for Shock Boundary-Layer Interaction

NASA Technical Reports Server (NTRS)

DeBonis, James R.; Oberkampf, William L.; Wolf, Richard T.; Orkwis, Paul D.; Turner, Mark G.; Babinsky, Holger

2011-01-01

A workshop on the computational fluid dynamics (CFD) prediction of shock boundary-layer interactions (SBLIs) was held at the 48th AIAA Aerospace Sciences Meeting. As part of the workshop numerous CFD analysts submitted solutions to four experimentally measured SBLIs. This paper describes the assessment of the CFD predictions. The assessment includes an uncertainty analysis of the experimental data, the definition of an error metric and the application of that metric to the CFD solutions. The CFD solutions provided very similar levels of error and in general it was difficult to discern clear trends in the data. For the Reynolds Averaged Navier-Stokes methods the choice of turbulence model appeared to be the largest factor in solution accuracy. Large-eddy simulation methods produced error levels similar to RANS methods but provided superior predictions of normal stresses.

Neutron Resonance Spectrometry Shock Temperatures in Molybdenum

NASA Astrophysics Data System (ADS)

Swift, Damian; Seifter, Achim; Holtkamp, David; Yuan, Vincent; Clark, David; Buttler, William

2007-06-01

Neutron resonance spectrometry (NRS) has been used to measure the temperature in Mo during shock loading, giving temperatures higher than expected. The effect of plastic flow and non-ideal projectile behavior were assessed. Plastic flow was estimated to contribute a temperature rise of 55K compared with hydrodynamic flow, and 100-150K on release, consistent with pyrometry measurements. Simulations were performed of the HE flyer system used to induce the shock in the Mo sample. The simulations predicted that the flyer was slightly curved on impact. The resulting spatial variations in load, including radial components of velocity, were predicted to increase the apparent NRS temperature by 160K. These corrections are sufficient to reconcile the apparent temperatures deduced using NRS with the accepted properties of Mo.

The resolved layer of a collisionless, high beta, supercritical, quasi-perpendicular shock wave. I - Rankine-Hugoniot geometry, currents, and stationarity

NASA Technical Reports Server (NTRS)

Scudder, J. D.; Aggson, T. L.; Mangeney, A.; Lacombe, C.; Harvey, C. C.

1986-01-01

Data collected by the ISEE dual-spacecraft mission (on November 7, 1977) on a slowly moving, supercritical, high-beta, quasi-perpendicular bow shock are presented, and the local geometry, spatial scales, and stationarity of this shock wave are assessed in a self-consistent Rankine-Hugoniot-constrained frame of reference. Included are spatial profiles of the ac and dc magnetic and electric fields, electron and proton fluid velocities, current densities, electron and proton number densities, temperatures, pressures, and partial densities of the reflected protons. The observed layer profile is shown to be nearly phase standing and one-dimensional in a Rankine-Hugoniot frame, empirically determined by the magnetofluid parameters outside the layer proper.

Low-energy Shock Wave Therapy-A Novel Treatment Option for Erectile Dysfunction in Men With Cardiovascular Disease.

PubMed

Kałka, Dariusz; Gebala, Jana; Smoliński, Ryszard; Rusiecki, Lesław; Pilecki, Witold; Zdrojowy, Romuald

2017-11-01

Patients with cardiovascular disease (CVD) are prone to developing erectile dysfunction (ED) owing to the common risk factors and pathogenesis underlying ED and CVD. As a result, ED affects nearly 80% of male patients with CVD. The efficacy of phosphodiesterase type 5 inhibitors, vacuum erection devices, or intracavernosal injection of vasodilating agents is well established in the treatment of ED; however, their use is limited. Low-energy shock wave therapy is a novel modality that may become a causative treatment for ED. This review aims to assess the efficacy and safety of low-energy shock wave therapy in the treatment of ED in men with CVD. Copyright © 2017 Elsevier Inc. All rights reserved.

A viscous flow study of shock-boundary layer interaction, radial transport, and wake development in a transonic compressor

NASA Technical Reports Server (NTRS)

Hah, Chunill; Reid, Lonnie

1991-01-01

A numerical study based on the 3D Reynolds-averaged Navier-Stokes equation has been conducted to investigate the detailed flow physics inside a transonic compressor. 3D shock structure, shock-boundary layer interaction, flow separation, radial mixing, and wake development are all investigated at design and off-design conditions. Experimental data based on laser anemometer measurements are used to assess the overall quality of the numerical solution. An additional experimental study to investigate end-wall flow with a hot-film was conducted, and these results are compared with the numerical results. Detailed comparison with experimental data indicates that the overall features of the 3D shock structure, the shock-boundary layer interaction, and the wake development are all calculated very well in the numerical solution. The numerical results are further analyzed to examine the radial mixing phenomena in the transonic compressor. A thin sheet of particles is injected in the numerical solution upstream of the compressor. The movement of particles is traced with a 3D plotting package. This numerical survey of tracer concentration reveals the fundamental mechanisms of radial transport in this transonic compressor.

Plumbing system shock absorbers as a source of Legionella pneumophila.

PubMed

Memish, Z A; Oxley, C; Contant, J; Garber, G E

1992-12-01

Water distribution systems have been demonstrated to be a major source of nosocomial legionellosis. We describe an outbreak in our institution in which a novel source of Legionella pneumophila was identified in the plumbing system. After an outbreak of 10 cases of legionellosis in our hospital, recommended measures including superheating of the hot water to 80 degrees C, hyperchlorination to 2 ppm, and flushing resulted in no new cases in the following 5 years. Recently, despite these control measures, three new cases occurred. Surveillance cultures of shower heads and water tanks were negative; cultures of tap water samples remained positive. This prompted a search for another reservoir. Shock absorbers installed within water pipes to decrease noise were suspected. One hundred twenty-five shock absorbers were removed and cultured. A total of 13 (10%) yielded heavy growth of L. pneumophila (serogroup 1). Since their removal, no new cases have been found and the percentage of positive results of random tap water culture has dropped from 20% to 5%. This is the first report that identifies shock absorbers as a possible reservoir for L. pneumophila. We recommend that institutions with endemic legionellosis assess the water system for possible removal of shock absorbers.

Anhydrite EOS and Phase Diagram in Relation to Shock Decomposition

NASA Technical Reports Server (NTRS)

Ivanov, B. A.; Langenhorst, F.; Deutsch, A.; Hornemann, U.

2004-01-01

In the context of the Chicxulub impact, it became recently obvious that experimental and theoretical research on the shock behavior of sulfates is essential for an assessment of the role of shock-released gases in the K/T mass extinction. The Chicxulub crater is the most important large impact structure where the bolide penetrated a sedimentary layer with large amounts of interbedded anhydrite (Haughton has also significant anhydrite in the target). The sulfuric gas production by shock compression/decompression of anhydrite is an important issue, even if the size of Chicxulub crater is only half of the so far assumed size. The comparison of experimental data for anhydrite, shocked with different techniques at various laboratories, reveals large differences in the threshold pressures for melting and decomposition. To gain insight into this issue, we have made a theoretical investigation of the thermodynamic properties of anhydrite. The project includes the review of data published in the last 40 years - reasons to study anhydrite cover a wide field of interests: from industrial problems of cement and ceramic production to the analysis of nuclear underground explosions in salt domes, conducted in the USA and USSR in the 1970th.

Synergistic and Antagonistic Effects of Thermal Shock, Air Exposure, and Fishing Capture on the Physiological Stress of Squilla mantis (Stomatopoda)

PubMed Central

Raicevich, Saša; Minute, Fabrizio; Finoia, Maria Grazia; Caranfa, Francesca; Di Muro, Paolo; Scapolan, Lucia; Beltramini, Mariano

2014-01-01

This study is aimed at assessing the effects of multiple stressors (thermal shock, fishing capture, and exposure to air) on the benthic stomatopod Squilla mantis, a burrowing crustacean quite widespread in the Mediterranean Sea. Laboratory analyses were carried out to explore the physiological impairment onset over time, based on emersion and thermal shocks, on farmed individuals. Parallel field-based studies were carried out to also investigate the role of fishing (i.e., otter trawling) in inducing physiological imbalance in different seasonal conditions. The dynamics of physiological recovery from physiological disruption were also studied. Physiological stress was assessed by analysing hemolymph metabolites (L-Lactate, D-glucose, ammonia, and H+), as well as glycogen concentration in muscle tissues. The experiments were carried out according to a factorial scheme considering the three factors (thermal shock, fishing capture, and exposure to air) at two fixed levels in order to explore possible synergistic, additive, or antagonistic effects among factors. Additive effects on physiological parameters were mainly detected when the three factors interacted together while synergistic effects were found as effect of the combination of two factors. This finding highlights that the physiological adaptive and maladaptive processes induced by the stressors result in a dynamic response that may encounter physiological limits when high stress levels are sustained. Thus, a further increase in the physiological parameters due to synergies cannot be reached. Moreover, when critical limits are encountered, mortality occurs and physiological parameters reflect the response of the last survivors. In the light of our mortality studies, thermal shock and exposure to air have the main effect on the survival of S. mantis only on trawled individuals, while lab-farmed individuals did not show any mortality during exposure to air until after 2 hours. PMID:25133593

Testing conditions in shock-based contextual fear conditioning influence both the behavioral responses and the activation of circuits potentially involved in contextual avoidance.

PubMed

Viellard, Juliette; Baldo, Marcus Vinicius C; Canteras, Newton Sabino

2016-12-15

Previous studies from our group have shown that risk assessment behaviors are the primary contextual fear responses to predatory and social threats, whereas freezing is the main contextual fear response to physically harmful events. To test contextual fear responses to a predator or aggressive conspecific threat, we developed a model that involves placing the animal in an apparatus where it can avoid the threat-associated environment. Conversely, in studies that use shock-based fear conditioning, the animals are usually confined inside the conditioning chamber during the contextual fear test. In the present study, we tested shock-based contextual fear responses using two different behavioral testing conditions: confining the animal in the conditioning chamber or placing the animal in an apparatus with free access to the conditioning compartment. Our results showed that during the contextual fear test, the animals confined to the shock chamber exhibited significantly more freezing. In contrast, the animals that could avoid the conditioning compartment displayed almost no freezing and exhibited risk assessment responses (i.e., crouch-sniff and stretch postures) and burying behavior. In addition, the animals that were able to avoid the shock chamber had increased Fos expression in the juxtadorsomedial lateral hypothalamic area, the dorsomedial part of the dorsal premammillary nucleus and the lateral and dorsomedial parts of the periaqueductal gray, which are elements of a septo/hippocampal-hypothalamic-brainstem circuit that is putatively involved in mediating contextual avoidance. Overall, the present findings show that testing conditions significantly influence both behavioral responses and the activation of circuits involved in contextual avoidance. Copyright © 2016 Elsevier B.V. All rights reserved.

Design of Three-Dimensional Hypersonic Inlets with Rectangular to Elliptical Shape Transition

NASA Technical Reports Server (NTRS)

Smart, M. K.

1998-01-01

A methodology has been devised for the design of three-dimensional hypersonic inlets which include a rectangular to elliptical shape transition. This methodology makes extensive use of inviscid streamtracing techniques to generate a smooth shape transition from a rectangular-like capture to an elliptical throat. Highly swept leading edges and a significantly notched cowl enable use of these inlets in fixed geometry configurations. The design procedure includes a three dimensional displacement thickness calculation and uses established correlations to check for boundary layer separation due to shock wave interactions. Complete details of the design procedure are presented and the characteristics of a modular inlet with rectangular to elliptical shape transition and a design point of Mach 7.1 are examined. Comparison with a classical two-dimensional inlet optimized for maximum total pressure recovery indicates that this three-dimensional inlet demonstrates good performance even well below its design point.

Characterizing the Effects of Inorganic Acid and Alkaline Shock on the Staphylococcus aureus Transcriptome and Messenger RNA Turnover

PubMed Central

Anderson, Kelsi L.; Roux, Christelle M.; Olson, Matthew W.; Luong, Thanh T.; Lee, Chia Y.; Olson, Robert; Dunman, Paul M.

2010-01-01

Staphylococcus aureus pathogenesis can be partially attributed to its ability to adapt to otherwise deleterious host-associated stresses. Here, Affymetrix GeneChips® were used to examine the S. aureus responses to inorganic acid and alkaline shock and to assess whether stress dependent changes in mRNA turnover are likely to facilitate the organism’s ability to tolerate pH challenge. Results indicate that S. aureus adapts to pH shock by eliciting responses expected of cells coping with pH alteration, including neutralizing cellular pH, DNA repair, amino acid biosynthesis and virulence factor expression. Further, the S. aureus response to alkaline conditions is strikingly similar to that of stringent response induced cells. Indeed, we show that alkaline shock stimulates accumulation of the stringent response activator (p)ppGpp. Results also revealed that pH shock significantly alters the mRNA properties of the cell. A comparison of the mRNA degradation properties of transcripts whose titers either increased or decreased in response to sudden pH change revealed that alterations in mRNA degradation may, in part, account for the changes in the mRNA levels of factors predicted to mediate pH tolerance. A set of small stable RNA molecules were induced in response to acid or alkaline shock conditions and may mediate adaptation to pH stress. PMID:21039920

Major Depression Is Not Associated with Blunting of Aversive Responses; Evidence for Enhanced Anxious Anticipation

PubMed Central

Grillon, Christian; Franco-Chaves, Jose A.; Mateus, Camilo F.; Ionescu, Dawn F.; Zarate, Carlos A.

2013-01-01

According to the emotion-context insensitivity (ECI) hypothesis, major depressive disorder (MDD) is associated with a diminished ability to react emotionally to positive stimuli and with blunting of defensive responses to threat. That defensive responses are blunted in MDD seems inconsistent with the conceptualization and diagnostic nosology of MDD. The present study tested the ECI hypothesis in MDD using a threat of shock paradigm. Twenty-eight patients with MDD (35.5±10.4 years) were compared with 28 controls (35.1±7.4 years). Participants were exposed to three conditions: no shock, predictable shock, and unpredictable shock. Startle magnitude was used to assess defensive responses. Inconsistent with the ECI hypothesis, startle potentiation to predictable and unpredictable shock was not reduced in the MDD group. Rather, MDD patients showed elevated startle throughout testing as well as increased contextual anxiety during the placement of the shock electrodes and in the predictable condition. A regression analysis indicated that illness duration and Beck depression inventory scores explained 37% (p<.005) of the variance in patients’ startle reactivity. MDD is not associated with emotional blunting but rather enhanced defensive reactivity during anticipation of harm. These results do not support a strong version of the ECI hypothesis. Understanding the nature of stimuli or situations that lead to blunted or enhanced defensive reactivity will provide better insight into dysfunctional emotional experience in MDD. PMID:23951057

Shock wave energy dissipation behavior (SWED) in Network forming ionic liquids (NILs): A Molecular dynamics study

NASA Astrophysics Data System (ADS)

Guda Vishnu, Karthik; Strachan, Alejandro

2017-06-01

SWED materials play a crucial role in protecting both personnel and structures in close proximity to blasts or ballistic impact. Exposure to shock waves with intensities as low as 1 MPa can cause brain injury in personnel and, hence, it is extremely important to understand the mechanisms operating in SWED materials and help design improved formulations. Recent experimental studies show that NILs containing di-ammonium cations and citrate anions with glass transition temperatures (Tg) below room temperature exhibit shockwave absorption characteristics that outperform polyurea (PU), a benchmark SWED assessment material. The experimentalists further hypothesized that the increased SWED ability in NILs with longer side chains (in di-ammonium cation) is due to a permanent structural ordering and nano-scale segregation. We use molecular dynamics simulations with the Dreiding force field to study shock propagation mechanisms in NILs. Shock propagation mechanisms in these materials are explored by performing both Hugoniostat and large scale non-equilibrium molecular dynamics (NEMD) simulations at 300 K. The simulation results show that the NIL 5-6 (5 C atoms (back bone) and 6 C atoms (side chain)) attenuates shocks better than NIL 5-3 (3 C atoms (side chain) and higher Tg) and PMMA in agreement with experimental observation. The simulations show that under shock loading the structures lose long range order; we find no evidence of nano-segregation nor or permanent structural changes.

Using a gel/plastic surrogate to study the biomechanical response of the head under air shock loading: a combined experimental and numerical investigation.

PubMed

Zhu, Feng; Wagner, Christina; Dal Cengio Leonardi, Alessandra; Jin, Xin; Vandevord, Pamela; Chou, Clifford; Yang, King H; King, Albert I

2012-03-01

A combined experimental and numerical study was conducted to determine a method to elucidate the biomechanical response of a head surrogate physical model under air shock loading. In the physical experiments, a gel-filled egg-shaped skull/brain surrogate was exposed to blast overpressure in a shock tube environment, and static pressures within the shock tube and the surrogate were recorded throughout the event. A numerical model of the shock tube was developed using the Eulerian approach and validated against experimental data. An arbitrary Lagrangian-Eulerian (ALE) fluid-structure coupling algorithm was then utilized to simulate the interaction of the shock wave and the head surrogate. After model validation, a comprehensive series of parametric studies was carried out on the egg-shaped surrogate FE model to assess the effect of several key factors, such as the elastic modulus of the shell, bulk modulus of the core, head orientation, and internal sensor location, on pressure and strain responses. Results indicate that increasing the elastic modulus of the shell within the range simulated in this study led to considerable rise of the overpressures. Varying the bulk modulus of the core from 0.5 to 2.0 GPa, the overpressure had an increase of 7.2%. The curvature of the surface facing the shock wave significantly affected both the peak positive and negative pressures. Simulations of the head surrogate with the blunt end facing the advancing shock front had a higher pressure compared to the simulations with the pointed end facing the shock front. The influence of an opening (possibly mimicking anatomical apertures) on the peak pressures was evaluated using a surrogate head with a hole on the shell of the blunt end. It was revealed that the presence of the opening had little influence on the positive pressures but could affect the negative pressure evidently.

Effects of high- and low-energy radial shock waves therapy combined with physiotherapy in the treatment of rotator cuff tendinopathy: a retrospective study.

PubMed

Su, Xiangzheng; Li, Zhongli; Liu, Zhengsheng; Shi, Teng; Xue, Chao

2017-06-09

The aim of this study was to investigate the efficacy of high- and low-energy radial shock waves combined with physiotherapy for rotator cuff tendinopathy patients. Data from rotator cuff tendinopathy patients received high- or low-energy radial shock waves combined with physiotherapy or physiotherapy alone were collected. The Constant and Murley score and visual analog scale score were collected to assess the effectiveness of treatment in three groups at 4, 8, 12, and 24 weeks. In total, 94 patients were involved for our retrospective study. All groups showed remarkable improvement in the visual analog scale and Constant and Murley score compared to baseline at 24 weeks. The high-energy radial shock waves group had more marked improvement in the Constant and Murley score compared to the physiotherapy group at 4 and 8 weeks and at 4 weeks when compared with low-energy group. Furthermore, high-energy radial shock waves group had superior results on the visual analog scale at 4, 8, and 12 weeks compared to low-energy and physiotherapy groups. This retrospective study supported the usage of high-energy radial shock waves as a supplementary therapy over physiotherapy alone for rotator cuff tendinopathy by relieving the symptoms rapidly and maintaining symptoms at a satisfactory level for 24 weeks. Implications for Rehabilitation High-energy radial shock waves can be a supplemental therapy to physiotherapy for rotator cuff tendinopathy. We recommend the usage of high-energy radial shock waves during the first 5 weeks, at an interval of 7 days, of physiotherapy treatment. High-energy radial shock waves treatment combined with physiotherapy can benefit rotator cuff tendinopathy by relieving symptoms rapidly and maintain these improvements at a satisfactory level for quite a long time.

Shock wave-induced ATP release from osteosarcoma U2OS cells promotes cellular uptake and cytotoxicity of methotrexate.

PubMed

Qi, Baochang; Yu, Tiecheng; Wang, Chengxue; Wang, Tiejun; Yao, Jihang; Zhang, Xiaomeng; Deng, Pengfei; Xia, Yongning; Junger, Wolfgang G; Sun, Dahui

2016-10-03

Osteosarcoma is the most prevalent primary malignant bone tumor, but treatment is difficult and prognosis remains poor. Recently, large-dose chemotherapy has been shown to improve outcome but this approach can cause many side effects. Minimizing the dose of chemotherapeutic drugs and optimizing their curative effects is a current goal in the management of osteosarcoma patients. In our study, trypan blue dye exclusion assay was performed to investigate the optimal conditions for the sensitization of osteosarcoma U2OS cells. Cellular uptake of the fluorophores Lucifer Yellow CH dilithium salt and Calcein was measured by qualitative and quantitative methods. Human MTX ELISA Kit and MTT assay were used to assess the outcome for osteosarcoma U2OS cells in the present of shock wave and methotrexate. To explore the mechanism, P2X7 receptor in U2OS cells was detected by immunofluorescence and the extracellular ATP levels was detected by ATP assay kit. All data were analyzed using SPSS17.0 statistical software. Comparisons were made with t test between two groups. Treatment of human osteosarcoma U2OS cells with up to 450 shock wave pulses at 7 kV or up to 200 shock wave pulses at 14 kV had little effect on cell viability. However, this shock wave treatment significantly promoted the uptake of Calcein and Lucifer Yellow CH by osteosarcoma U2OS cells. Importantly, shock wave treatment also significantly enhanced the uptake of the chemotherapy drug methotrexate and increased the rate of methotrexate-induced apoptosis. We found that shock wave treatment increased the extracellular concentration of ATP and that KN62, an inhibitor of P2X7 receptor reduced the capacity methotrexate-induced apoptosis. Our results suggest that shock wave treatment promotes methotrexate-induced apoptosis by altering cell membrane permeability in a P2X7 receptor-dependent manner. Shock wave treatment may thus represent a possible adjuvant therapy for osteosarcoma.

Multidisciplinary design optimization for sonic boom mitigation

NASA Astrophysics Data System (ADS)

Ozcer, Isik A.

Automated, parallelized, time-efficient surface definition and grid generation and flow simulation methods are developed for sharp and accurate sonic boom signal computation in three dimensions in the near and mid-field of an aircraft using Euler/Full-Potential unstructured/structured computational fluid dynamics. The full-potential mid-field sonic boom prediction code is an accurate and efficient solver featuring automated grid generation, grid adaptation and shock fitting, and parallel processing. This program quickly marches the solution using a single nonlinear equation for large distances that cannot be covered with Euler solvers due to large memory and long computational time requirements. The solver takes into account variations in temperature and pressure with altitude. The far-field signal prediction is handled using the classical linear Thomas Waveform Parameter Method where the switching altitude from the nonlinear to linear prediction is determined by convergence of the ground signal pressure impulse value. This altitude is determined as r/L ≈ 10 from the source for a simple lifting wing, and r/L ≈ 40 for a real complex aircraft. Unstructured grid adaptation and shock fitting methodology developed for the near-field analysis employs an Hessian based anisotropic grid adaptation based on error equidistribution. A special field scalar is formulated to be used in the computation of the Hessian based error metric which enhances significantly the adaptation scheme for shocks. The entire cross-flow of a complex aircraft is resolved with high fidelity using only 500,000 grid nodes after only about 10 solution/adaptation cycles. Shock fitting is accomplished using Roe's Flux-Difference Splitting scheme which is an approximate Riemann type solver and by proper alignment of the cell faces with respect to shock surfaces. Simple to complex real aircraft geometries are handled with no user-interference required making the simulation methods suitable tools for product design. The simulation tools are used to optimize three geometries for sonic boom mitigation. The first is a simple axisymmetric shape to be used as a generic nose component, the second is a delta wing with lift, and the third is a real aircraft with nose and wing optimization. The objectives are to minimize the pressure impulse or the peak pressure in the sonic boom signal, while keeping the drag penalty under feasible limits. The design parameters for the meridian profile of the nose shape are the lengths and the half-cone angles of the linear segments that make up the profile. The design parameters for the lifting wing are the dihedral angle, angle of attack, non-linear span-wise twist and camber distribution. The test-bed aircraft is the modified F-5E aircraft built by Northrop Grumman, designated the Shaped Sonic Boom Demonstrator. This aircraft is fitted with an optimized axisymmetric nose, and the wings are optimized to demonstrate optimization for sonic boom mitigation for a real aircraft. The final results predict 42% reduction in bow shock strength, 17% reduction in peak Deltap, 22% reduction in pressure impulse, 10% reduction in foot print size, 24% reduction in inviscid drag, and no loss in lift for the optimized aircraft. Optimization is carried out using response surface methodology, and the design matrices are determined using standard DoE techniques for quadratic response modeling.

Microstructural fingerprints of phase transitions in shock-loaded iron

NASA Astrophysics Data System (ADS)

Wang, S. J.; Sui, M. L.; Chen, Y. T.; Lu, Q. H.; Ma, E.; Pei, X. Y.; Li, Q. Z.; Hu, H. B.

2013-01-01

The complex structural transformation in crystals under static pressure or shock loading has been a subject of long-standing interest to materials scientists and physicists. The polymorphic transformation is of particular importance for iron (Fe), due to its technological and sociological significance in the development of human civilization, as well as its prominent presence in the earth's core. The martensitic transformation α-->ɛ (bcc-->hcp) in iron under shock-loading, due to its reversible and transient nature, requires non-trivial detective work to uncover its occurrence. Here we reveal refined microstructural fingerprints, needle-like colonies and three sets of {112}<111> twins with a threefold symmetry, with tell-tale features that are indicative of two sequential martensitic transformations in the reversible α-->ɛ phase transition, even though no ɛ is retained in the post-shock samples. The signature orientation relationships are consistent with previously-proposed transformation mechanisms, and the unique microstructural fingerprints enable a quantitative assessment of the volume fraction transformed.

Pharmacy students' retention of knowledge and skills following training in automated external defibrillator use.

PubMed

Kopacek, Karen Birckelbaw; Dopp, Anna Legreid; Dopp, John M; Vardeny, Orly; Sims, J Jason

2010-08-10

To assess pharmacy students' retention of knowledge about appropriate automated external defibrillator use and counseling points following didactic training and simulated experience. Following a lecture on sudden cardiac arrest and automated external defibrillator use, second-year doctor of pharmacy (PharmD) students were assessed on their ability to perform basic life support and deliver a shock at baseline, 3 weeks, and 4 months. Students completed a questionnaire to evaluate recall of counseling points for laypeople/the public. Mean time to shock delivery at baseline was 74 ± 25 seconds, which improved significantly at 3 weeks (50 ± 17 seconds, p < 0.001) and was maintained at 4 months (47 ± 18 seconds, p < 0.001). Recall of all signs and symptoms of sudden cardiac arrest and automated external defibrillator counseling points was diminished after 4 months. Pharmacy students can use automated external defibrillators to quickly deliver a shock and are able to retain this ability after 4 months. Refresher training/courses will be required to improve students' retention of automated external defibrillator counseling points to ensure their ability to deliver appropriate patient education.

Examination of the Effect of Implantable Cardioverter-Defibrillators on Health-Related Quality of Life

PubMed Central

Noyes, Katia; Corona, Ethan; Veazie, Peter; Dick, Andrew W.; Zhao, Hongwei; Moss, Arthur J.

2015-01-01

Background While implantable cardioverter-defibrillators (ICDs) improve survival, their benefit in terms of health-related quality of life (HRQOL) is negligible. Objective To examine how shocks and congestive heart failure (CHF) mediate the effect of ICDs on HRQOL. Methods The US patients from the MADIT-II (Multicenter Automatic Defibrillator Trial-II) trial (n = 983) were randomized to receive an ICD or medical treatment only. HRQOL was assessed using the Health Utility Index 3 at baseline and 3, 12, 24, and 36 months following randomization. Logistic regressions were used to test for the effect of ICDs on the CHF indicator, and linear regressions were used to examine the effect of ICD shocks and CHF on HRQOL in living patients. We used a Monte Carlo simulation and a parametric Weibull distribution survival model to test for the effect of selective attrition. Observations were clustered by patients and robust standard errors (RSEs) were used to control for the non-independence of multiple observations provided by the same patient. Results Patients in the ICD arm had 41% higher odds of experiencing CHF since their last assessment compared with those in the control arm (RSE = 0.19, p = 0.01). Developing CHF reduced HRQOL at the subsequent visit by 0.07 (p < 0.01). Having ICD shocks reduced overall HRQOL by 0.04 (p = 0.04) at the subsequent assessment. The negative effect of ICD firing on HRQOL was an order of magnitude greater than the effect of CHF. Conclusions A higher prevalence of CHF and shocks among patients with ICDs and their negative effect on HRQOL may partially explain the lack of HRQOL benefit of ICD therapy. PMID:19929037

Protection of cerebral microcirculation, mitochondrial function, and electrocortical activity by small-volume resuscitation with terlipressin in a rat model of haemorrhagic shock.

PubMed

Ida, K K; Chisholm, K I; Malbouisson, L M S; Papkovsky, D B; Dyson, A; Singer, M; Duchen, M R; Smith, K J

2018-06-01

During early treatment of haemorrhagic shock, cerebral perfusion pressure can be restored by small-volume resuscitation with vasopressors. Whether this therapy is improved with additional fluid remains unknown. We assessed the value of terlipressin and lactated Ringer's solution (LR) on early recovery of microcirculation, tissue oxygenation, and mitochondrial and electrophysiological function in the rat cerebral cortex. Animals treated with LR replacing three times (3LR) the volume bled (n=26), terlipressin (n=27), terlipressin plus 1LR (n=26), 2LR (n=16), or 3LR (n=15) were compared with untreated (n=36) and sham-operated rats (n=17). In vivo confocal microscopy was used to assess cortical capillary perfusion, changes in tissue oxygen concentration, and mitochondrial membrane potential and redox state. Electrophysiological function was assessed by cortical somatosensory evoked potentials, spinal cord dorsum potential, and peripheral electromyography. Compared with sham treatment, haemorrhagic shock reduced the mean (SD) area of perfused vessels [82% (sd 10%) vs 38% (12%); P<0.001] and impaired oxygen concentration, mitochondrial redox state [99% (4%) vs 59% (15%) of baseline; P<0.001], and somatosensory evoked potentials [97% (13%) vs 27% (19%) of baseline]. Administration of terlipressin plus 1LR or 2LR was able to recover these measures, but terlipressin plus 3LR or 3LR alone were not as effective. Spinal cord dorsum potential was preserved in all groups, but no therapy protected electromyographic function. Resuscitation from haemorrhagic shock using terlipressin with small-volume LR was superior to high-volume LR, with regard to cerebral microcirculation, and mitochondrial and electrophysiological functions. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

[Methodological and operational notes for the assessment and management of the risk of work-related stress].

PubMed

De Ambrogi, Francesco; Ratti, Elisabetta Ceppi

2011-01-01

Today the Italian national debate over the Work-Related Stress Risk Assessment methodology is rather heated. Several methodological proposals and guidelines have been published in recent months, not least those by the "Commissione Consultiva". But despite this wide range of proposals, it appears that there is still a lack of attention to some of the basic methodological issues that must be taken into account in order to correctly implement the above-mentioned guidelines. The aim of this paper is to outline these methodological issues. In order to achieve this, the most authoritative methodological proposals and guidelines have been reviewed. The study focuses in particular on the methodological issues that could lead to important biases if not considered properly. The study leads to some considerations about the methodological validity of a Work-Related Stress Risk Assessment based exclusively on the literal interpretation of the considered proposals. Furthermore, the study provides some hints and working hypotheses on how to overcome these methodological limits. This study should be considered as a starting point for further investigations and debate on the Work-Related Stress Risk Assessment methodology on a national level.

Proper motions of five OB stars with candidate dusty bow shocks in the Carina Nebula

NASA Astrophysics Data System (ADS)

Kiminki, Megan M.; Smith, Nathan; Reiter, Megan; Bally, John

2017-06-01

We constrain the proper motions of five OB stars associated with candidate stellar wind bow shocks in the Carina Nebula using Hubble Space Telescope ACS imaging over 9-10 yr baselines. These proper motions allow us to directly compare each star's motion to the orientation of its candidate bow shock. Although these stars are saturated in our imaging, we assess their motion by the shifts required to minimize residuals in their airy rings. The results limit the direction of each star's motion to sectors less than 90° wide. None of the five stars are moving away from the Carina Nebula's central clusters as runaway stars would be, confirming that a candidate bow shock is not necessarily indicative of a runaway star. Two of the five stars are moving tangentially relative to the orientation of their candidate bow shocks, both of which point at the OB cluster Trumpler 14. In these cases, the large-scale flow of the interstellar medium, powered by feedback from the cluster, appears to dominate over the motion of the star in producing the observed candidate bow shock. The remaining three stars all have some component of motion towards the central clusters, meaning that we cannot distinguish whether their candidate bow shocks are indicators of stellar motion, of the flow of ambient gas or of density gradients in their surroundings. In addition, these stars' lack of outward motion hints that the distributed massive-star population in Carina's South Pillars region formed in place, rather than migrating out from the association's central clusters.

An Assessment of the Academic Impact of Shock Society Members.

PubMed

Milgrom, Daniel P; Koniaris, Leonidas G; Valsangkar, Nakul P; Lad, Neha; Bell, Teresa M; Wojcik, Brandon; Zimmers, Teresa A

2018-05-01

Professional society membership enhances career development and productivity by offering opportunities for networking and learning about recent advances in the field. The quality and contribution of such societies can be measured in part through the academic productivity, career status, and funding success rates of their members. Here, using Scopus, NIH RePORTER, and departmental websites, we compare characteristics of the Shock Society membership to those of the top 55 NIH-funded American university and hospital-based departments of surgery. Shock Society members' mean number of publications, citations and H-indices were all significantly higher than those of non-members in surgery departments (P < 0.001). A higher percentage of members also have received funding from the NIH (42.5% vs. 18.5%, P < 0.001). Regression analysis indicated that members were more likely to have NIH funding compared with non-members (OR 1.46, 95% CI 1.12-1.916). Trauma surgeons belonging to the Shock Society had a higher number of publications and greater NIH funding than those who did not (130.4 vs. 42.7, P < 0.001; 40.4% vs. 8.5%, P < 0.001). Aggregate academic metrics from the Shock Society were superior to those of the Association for Academic Surgery and generally for the Society of University Surgeons as well. These data indicate that the Shock Society represents a highly academic and productive group of investigators. For surgery faculty, membership is associated with greater academic productivity and career advancement. While it is difficult to ascribe causation, certainly the Shock Society might positively influence careers for its members.

Noninvasive optoacoustic system for rapid diagnosis and management of circulatory shock

NASA Astrophysics Data System (ADS)

Petrov, Irene Y.; Kinsky, Michael; Petrov, Yuriy; Petrov, Andrey; Henkel, S. N.; Seeton, Roger; Esenaliev, Rinat O.; Prough, Donald S.

2013-03-01

Circulatory shock can lead to death or severe complications, if not promptly diagnosed and effectively treated. Typically, diagnosis and management of circulatory shock are guided by blood pressure and heart rate. However, these variables have poor specificity, sensitivity, and predictive value. Early goal-directed therapy in septic shock patients, using central venous catheterization (CVC), reduced mortality from 46.5% to 30%. However, CVC is invasive and complication-prone. We proposed to use an optoacoustic technique for noninvasive, rapid assessment of peripheral and central venous oxygenation. In this work we used a medical grade optoacoustic system for noninvasive, ultrasound image-guided measurement of central and peripheral venous oxygenation. Venous oxygenation during shock declines more rapidly in the periphery than centrally. Ultrasound imaging of the axillary [peripheral] and internal jugular vein [central] was performed using the Vivid e (GE Healthcare). We built an optoacoustic interface incorporating an optoacoustic transducer and a standard ultrasound imaging probe. Central and peripheral venous oxygenations were measured continuously in healthy volunteers. To simulate shock-induced changes in central and peripheral oxygenation, we induced peripheral vasoconstriction in the upper extremity by using a cooling blanket. Central and peripheral venous oxygenations were measured before (baseline) and after cooling and after rewarming. During the entire experiment, central venous oxygenation was relatively stable, while peripheral venous oxygenation decreased by 5-10% due to cooling and recovered after rewarming. The obtained data indicate that noninvasive, optoacoustic measurements of central and peripheral venous oxygenation may be used for diagnosis and management of circulatory shock with high sensitivity and specificity.

CME Flux Rope and Shock Identifications and Locations: Comparison of White Light Data, Graduated Cylindrical Shell Model, and MHD Simulations

NASA Technical Reports Server (NTRS)

Schmidt, J. M.; Cairns, Iver H.; Xie, Hong; St. Cyr, O. C.; Gopalswamy, N.

2016-01-01

Coronal mass ejections (CMEs) are major transient phenomena in the solar corona that are observed with ground-based and spacecraft-based coronagraphs in white light or with in situ measurements by spacecraft. CMEs transport mass and momentum and often drive shocks. In order to derive the CME and shock trajectories with high precision, we apply the graduated cylindrical shell (GCS) model to fit a flux rope to the CME directed toward STEREO A after about 19:00 UT on 29 November 2013 and check the quality of the heliocentric distance-time evaluations by carrying out a three-dimensional magnetohydrodynamic (MHD) simulation of the same CME with the Block Adaptive Tree Solar-Wind Roe Upwind Scheme (BATS-R-US) code. Heliocentric distances of the CME and shock leading edges are determined from the simulated white light images and magnetic field strength data. We find very good agreement between the predicted and observed heliocentric distances, showing that the GCS model and the BATS-R-US simulation approach work very well and are consistent. In order to assess the validity of CME and shock identification criteria in coronagraph images, we also compute synthetic white light images of the CME and shock. We find that the outer edge of a cloud-like illuminated area in the observed and predicted images in fact coincides with the leading edge of the CME flux rope and that the outer edge of a faint illuminated band in front of the CME leading edge coincides with the CME-driven shock front.

Methodological Quality Assessment of Meta-Analyses of Hyperthyroidism Treatment.

PubMed

Qin, Yahong; Yao, Liang; Shao, Feifei; Yang, Kehu; Tian, Limin

2018-01-01

Hyperthyroidism is a common condition that is associated with increased morbidity and mortality. A number of meta-analyses (MAs) have assessed the therapeutic measures for hyperthyroidism, including antithyroid drugs, surgery, and radioiodine, however, the methodological quality has not been evaluated. This study evaluated the methodological quality and summarized the evidence obtained from MAs of hyperthyroidism treatments for radioiodine, antithyroid drugs, and surgery. We searched the PubMed, EMBASE, Cochrane Library, Web of Science, and Chinese Biomedical Literature Database databases. Two investigators independently assessed the meta-analyses titles and abstracts for inclusion. Methodological quality was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. A total of 26 MAs fulfilled the inclusion criteria. Based on the AMSTAR scores, the average methodological quality was 8.31, with large variability ranging from 4 to 11. The methodological quality of English meta-analyses was better than that of Chinese meta-analyses. Cochrane reviews had better methodological quality than non-Cochrane reviews due to better study selection and data extraction, the inclusion of unpublished studies, and better reporting of study characteristics. The authors did not report conflicts of interest in 53.8% meta-analyses, and 19.2% did not report the harmful effects of treatment. Publication bias was not assessed in 38.5% of meta-analyses, and 19.2% did not report the follow-up time. Large-scale assessment of methodological quality of meta-analyses of hyperthyroidism treatment highlighted methodological strengths and weaknesses. Consideration of scientific quality when formulating conclusions should be made explicit. Future meta-analyses should improve on reporting conflict of interest. © Georg Thieme Verlag KG Stuttgart · New York.

Comparative risk assessments for the city of Pointe-à-Pitre (French West Indies): earthquakes and storm surge

NASA Astrophysics Data System (ADS)

Reveillere, A. R.; Bertil, D. B.; Douglas, J. D.; Grisanti, L. G.; Lecacheux, S. L.; Monfort, D. M.; Modaressi, H. M.; Müller, H. M.; Rohmer, J. R.; Sedan, O. S.

2012-04-01

In France, risk assessments for natural hazards are usually carried out separately and decision makers lack comprehensive information. Moreover, since the cause of the hazard (e.g. meteorological, geological) and the physical phenomenon that causes damage (e.g. inundation, ground shaking) may be fundamentally different, the quantitative comparison of single risk assessments that were not conducted in a compatible framework is not straightforward. Comprehensive comparative risk assessments exist in a few other countries. For instance, the Risk Map Germany project has developed and applied a methodology for quantitatively comparing the risk of relevant natural hazards at various scales (city, state) in Germany. The present on-going work applies a similar methodology to the Pointe-à-Pitre urban area, which represents more than half of the population of Guadeloupe, an overseas region in the French West Indies. Relevant hazards as well as hazard intensity levels differ from continental Europe, which will lead to different conclusions. French West Indies are prone to a large number of hazards, among which hurricanes, volcanic eruptions and earthquakes dominate. Hurricanes cause damage through three phenomena: wind, heavy rainfall and storm surge, the latter having had a preeminent role during the largest historical event in 1928. Seismic risk is characterized by many induced phenomena, among which earthquake shocks dominate. This study proposes a comparison of earthquake and cyclonic storm surge risks. Losses corresponding to hazard intensities having the same probability of occurrence are calculated. They are quantified in a common loss unit, chosen to be the direct economic losses. Intangible or indirect losses are not considered. The methodology therefore relies on (i) a probabilistic hazard assessment, (ii) a loss ratio estimation for the exposed elements and (iii) an economic estimation of these assets. Storm surge hazard assessment is based on the selection of relevant historical cyclones and on the simulation of the associated wave and cyclonic surge. The combined local sea elevations, called "set-up", are then fitted with a statistical distribution in order to obtain its time return characteristics. Several run-ups are then extracted, the inundation areas are calculated and the relative losses of the affected assets are deduced. The Probabilistic Seismic Hazard Assessment and the exposed elements location and seismic vulnerability result from past public risk assessment studies. The loss estimations are computed for several return time periods, measured in percentage of buildings being in a given EMS-98 damage state per grid block, which are then converted into loss ratio. In parallel, an asset estimation is conducted. It is mainly focused on private housing, but it considers some major public infrastructures as well. The final outcome of this work is a direct economic loss-frequency plot for earthquake and storm surge. The Probable Maximum Loss and the Average Annual Loss derivate from this risk curve. In addition, different sources of uncertainty are identified through the loss estimation process. The full propagation of these uncertainties can provide an interval of confidence, which can be assigned to the risk-curve and we show how such additional information can be useful for risk comparison.

Validation of Automated Prediction of Blood Product Needs Algorithm Processing Continuous Non Invasive Vital Signs Streams (ONPOINT4)

DTIC Science & Technology

2018-01-25

ORGANIZATION NAME(S) AND ADDRESS(ES) University of Maryland, Baltimore 22 S. Greene St. R Adams Cowley Shock Trauma Center, T5R46 Baltimore, MD 21201 8...the revised trauma score, shock index (= heart rate/systolic blood pressure), and assessment of blood consumption, our M2 (bleeding risk index...11 4.2 Transfusion Prediction Model Evaluation in Special Subsets (Model Stress Test) ....... 15 4.3 Feature Sets and Model Stability

ASSESSMENT OF TOXICANT-INDUCED ALTERATIONS IN OVARIAN STEROIDOGENESIS: A METHODOLOGICAL OVERVIEW

EPA Science Inventory

RTD-03-035

Assessment of Toxicant-induced Alterations in Ovarian Steroidogenesis:
A Methodological Overview

Jerome M. Goldman, Susan C. Laws and Ralph L. Cooper

Abstract

A variety of methodological approaches have been used for the assessment of tox...

Clinical outcome comparison of patients with septic shock defined by the new sepsis-3 criteria and by previous criteria

PubMed Central

Ryoo, Seung Mok; Kang, Gu Hyun; Shin, Tae Gun; Hwang, Sung Yeon; Kim, Kyuseok; Jo, You Hwan; Park, Yoo Seok; Choi, Sung-Hyuk; Yoon, Young Hoon; Kwon, Woon Yong; Suh, Gil Joon; Lim, Tae Ho; Han, Kap Su; Choi, Han Sung; Chung, Sung Phil

2018-01-01

Background We compared the clinical characteristics and outcomes between the new definition of sepsis-3 septic shock and the definition previously used from 1991 until recently. Methods We conducted an observational study using a prospective, multi-center registry of septic shock from October 2015 to February 2017. Registry data were collected by 10 emergency departments (EDs) in tertiary hospitals that are members of the Korean Shock Society. Data on septic shock patients who met the previous septic shock definition were collected. The patients were divided into a sepsis-3 defined septic shock group, made up of those who met the new criteria for refractory hypotension with hyperlactatemia, and a group of those who met only the 1991 definition for septic shock. The primary outcome was 90-day mortality, and secondary outcomes were 28-day mortality and in-hospital mortality. Results Of all 1,028 included patients, 574 (55.8%) met the septic shock criteria for sepsis-3, leaving 454 patients who met only the previous definition. Those who met the sepsis-3 criteria demonstrated higher comorbidity than those who met the previous definition (83.1% vs. 75.3%, P<0.01), but there was no difference in infection focus. The sequential organ failure assessment (SOFA) (initial/maximal), the acute physiology, and the chronic health evaluation II scores were significantly higher in for those who met the sepsis-3 criteria [6.5±3.1 vs. 5.0±2.9, 9.3±3.8 vs. 6.6±3.4, and 20.0 (15.0–26.0) vs. 15.0 (10.0–20.3), respectively; P<0.01]. The 90-day mortality was significantly higher in the sepsis-3 group (32.1% vs. 23.3%; P<0.01). In-hospital and 28-day mortality were also higher in the sepsis-3 group (26.8% vs. 17.1% and 25.1% vs. 16.5%, respectively; P<0.01). Conclusions The new definition of septic shock successfully selected patients with greater severities and worse outcomes. PMID:29607156

A comparative analysis of analgesic efficacy of ultrasound and shock wave therapy in the treatment of patients with inflammation of the attachment of the plantar fascia in the course of calcaneal spurs.

PubMed

Krukowska, Jolanta; Wrona, Jacek; Sienkiewicz, Monika; Czernicki, Jan

2016-09-01

Troublesome heel spur is a nuisance condition that affects people of all ages. Treatment of patients with heel spur is a difficult and lengthy process requiring patience from both the patient and the therapist. Sometimes, the only and ultimate method of treatment is surgery, although spurs tend to recur. The aim of the study is a comparative analysis of the analgesic efficacy of ultrasound and shock wave therapy in patients with heel spur. The cause of pain in the course of calcaneal spur is inflammation of the attachment of the plantar fascia, which plays an important role in the process of walking and is seriously strained during different types of movement. Treatment of patients is a difficult and lengthy process. The study was conducted on a group of 47 patients of both sexes, aged 38-60 years (mean 51.3) with a plantar calcaneal spur confirmed by X-ray images. Patients were randomly assigned into two groups using a simple randomization: Group 1-ultrasound therapy group (a series of ten treatments) and Group 2-the radial shock wave group (series of four treatments). In all patients, pain intensity was assessed three times: before therapy, after the first and second weeks of treatment. A version of Laitinen's pain assessment questionnaire and the Huskisson visual analogue scale (VAS) were used. Of the group of studied respondents, 47 patients of both sexes and aged 38-60 years (mean age 51.3) with a heel spur (confirmed on X-rays), who had pain for at least a month, were randomly included in the study. The patients were classified into: Group 1-US therapeutic group (a series of ten treatments) and Group 2-with RSWT (a series of five treatments). Pain intensity was assessed three times: before the treatment, after the first and second week of the treatment with the application of the VAS and the Leitinen Pain Questionnaire. However, a decrease in pain sensation was reported in all test intervals, and its largest decrease occurred in both groups within 1 week of beginning treatment. More dynamic change in this period was recorded in Group 1. The conclusion is that while ultrasound and shock wave therapy show significant analgesic efficacy in patients with heel spur, fewer shock wave therapy sessions are needed than ultrasound sessions for effective relief, suggesting that the shock wave therapy has greater analgesic efficacy. A similar analgesic effect was achieved with the administration of a smaller number of shock wave treatments and a full series of ultrasound treatments.

Methodology for assessment of undiscovered oil and gas resources for the 2008 Circum-Arctic Resource Appraisal

USGS Publications Warehouse

Charpentier, Ronald R.; Moore, Thomas E.; Gautier, D.L.

2017-11-15

The methodological procedures used in the geologic assessments of the 2008 Circum-Arctic Resource Appraisal (CARA) were based largely on the methodology developed for the 2000 U.S. Geological Survey World Petroleum Assessment. The main variables were probability distributions for numbers and sizes of undiscovered accumulations with an associated risk of occurrence. The CARA methodology expanded on the previous methodology in providing additional tools and procedures more applicable to the many Arctic basins that have little or no exploration history. Most importantly, geologic analogs from a database constructed for this study were used in many of the assessments to constrain numbers and sizes of undiscovered oil and gas accumulations.

Variation in the use of renal replacement therapy in patients with septic shock: a substudy of the prospective multicenter observational FINNAKI study

PubMed Central

2014-01-01

Introduction Indications for renal replacement therapy (RRT) have not been generally standardized and vary among intensive care units (ICUs). We aimed to assess the proportion, indications, and modality of RRT, as well as the association between the proportion of RRT use and 90-day mortality in patients with septic shock in Finnish adult ICUs. Methods We identified patients with septic shock from the prospective observational multicenter FINNAKI study conducted between 1 September 2011 and 1 February 2012. We divided the ICUs into high-RRT and low-RRT ICUs according to the median of the proportion of RRT-treated patients with septic shock. Differences in indications, and modality of RRT between ICU groups were assessed. Finally, we performed an adjusted logistic regression analysis to evaluate the possible association of the ICU group (high vs. low-RRT) with 90-day mortality. Results Of the 726 patients with septic shock, 131 (18.0%, 95% CI 15.2 to 20.9%) were treated with RRT. The proportion of RRT-treated patients varied from 3% up to 36% (median 19%) among ICUs. High-RRT ICUs included nine ICUs (354 patients) and low-RRT ICUs eight ICUs (372 patients). In the high-RRT ICUs patients with septic shock were older (P = 0.04), had more cardiovascular (P <0.001) and renal failures (P = 0.003) on the first day in the ICU, were more often mechanically ventilated, and received higher maximum doses of norepinephrine (0.25 μg/kg/min vs. 0.18 μg/kg/min, P <0.001) than in the low-RRT ICUs. No significant differences in indications for or modality of RRT existed between the ICU groups. The crude 90-day mortality rate for patients with septic shock was 36.2% (95% CI 31.1 to 41.3%) in the high-RRT ICUs compared to 33.9% (95% CI 29.0 to 38.8%) in the low-RRT ICUs, P = 0.5. In an adjusted logistic regression analysis the ICU group (high-RRT or low-RRT ICUs) was not associated with 90-day mortality. Conclusions Patients with septic shock in ICUs with a high proportion of RRT had more severe organ dysfunctions and received more organ-supportive treatments. Importantly, the ICU group (high-RRT or low-RRT group) was not associated with 90-day mortality. PMID:24499547

Guiding principles of USGS methodology for assessment of undiscovered conventional oil and gas resources

USGS Publications Warehouse

Charpentier, R.R.; Klett, T.R.

2005-01-01

During the last 30 years, the methodology for assessment of undiscovered conventional oil and gas resources used by the Geological Survey has undergone considerable change. This evolution has been based on five major principles. First, the U.S. Geological Survey has responsibility for a wide range of U.S. and world assessments and requires a robust methodology suitable for immaturely explored as well as maturely explored areas. Second, the assessments should be based on as comprehensive a set of geological and exploration history data as possible. Third, the perils of methods that solely use statistical methods without geological analysis are recognized. Fourth, the methodology and course of the assessment should be documented as transparently as possible, within the limits imposed by the inevitable use of subjective judgement. Fifth, the multiple uses of the assessments require a continuing effort to provide the documentation in such ways as to increase utility to the many types of users. Undiscovered conventional oil and gas resources are those recoverable volumes in undiscovered, discrete, conventional structural or stratigraphic traps. The USGS 2000 methodology for these resources is based on a framework of assessing numbers and sizes of undiscovered oil and gas accumulations and the associated risks. The input is standardized on a form termed the Seventh Approximation Data Form for Conventional Assessment Units. Volumes of resource are then calculated using a Monte Carlo program named Emc2, but an alternative analytic (non-Monte Carlo) program named ASSESS also can be used. The resource assessment methodology continues to change. Accumulation-size distributions are being examined to determine how sensitive the results are to size-distribution assumptions. The resource assessment output is changing to provide better applicability for economic analysis. The separate methodology for assessing continuous (unconventional) resources also has been evolving. Further studies of the relationship between geologic models of conventional and continuous resources will likely impact the respective resource assessment methodologies. ?? 2005 International Association for Mathematical Geology.

Balancing benefit and risk of medicines: a systematic review and classification of available methodologies.

PubMed

Mt-Isa, Shahrul; Hallgreen, Christine E; Wang, Nan; Callréus, Torbjörn; Genov, Georgy; Hirsch, Ian; Hobbiger, Stephen F; Hockley, Kimberley S; Luciani, Davide; Phillips, Lawrence D; Quartey, George; Sarac, Sinan B; Stoeckert, Isabelle; Tzoulaki, Ioanna; Micaleff, Alain; Ashby, Deborah

2014-07-01

The need for formal and structured approaches for benefit-risk assessment of medicines is increasing, as is the complexity of the scientific questions addressed before making decisions on the benefit-risk balance of medicines. We systematically collected, appraised and classified available benefit-risk methodologies to facilitate and inform their future use. A systematic review of publications identified benefit-risk assessment methodologies. Methodologies were appraised on their fundamental principles, features, graphical representations, assessability and accessibility. We created a taxonomy of methodologies to facilitate understanding and choice. We identified 49 methodologies, critically appraised and classified them into four categories: frameworks, metrics, estimation techniques and utility survey techniques. Eight frameworks describe qualitative steps in benefit-risk assessment and eight quantify benefit-risk balance. Nine metric indices include threshold indices to measure either benefit or risk; health indices measure quality-of-life over time; and trade-off indices integrate benefits and risks. Six estimation techniques support benefit-risk modelling and evidence synthesis. Four utility survey techniques elicit robust value preferences from relevant stakeholders to the benefit-risk decisions. Methodologies to help benefit-risk assessments of medicines are diverse and each is associated with different limitations and strengths. There is not a 'one-size-fits-all' method, and a combination of methods may be needed for each benefit-risk assessment. The taxonomy introduced herein may guide choice of adequate methodologies. Finally, we recommend 13 of 49 methodologies for further appraisal for use in the real-life benefit-risk assessment of medicines. Copyright © 2014 John Wiley & Sons, Ltd.

Manual for the psychotherapeutic treatment of acute and post-traumatic stress disorders following multiple shocks from implantable cardioverter defibrillator (ICD)

PubMed Central

Jordan, Jochen; Titscher, Georg; Peregrinova, Ludmila; Kirsch, Holger

2013-01-01

Background: In view of the increasing number of implanted cardioverter defibrillators (ICD), the number of people suffering from so-called “multiple ICD shocks” is also increasing. The delivery of more than five shocks (appropriate or inappropriate) in 12 months or three or more shocks (so called multiple shocks) in a short time period (24 hours) leads to an increasing number of patients suffering from severe psychological distress (anxiety disorder, panic disorder, adjustment disorder, post-traumatic stress disorder). Untreated persons show chronic disease processes and a low rate of spontaneous remission and have an increased morbidity and mortality. Few papers have been published concerning the psychotherapeutic treatment for these patients. Objective: The aim of this study is to develop a psychotherapeutic treatment for patients with a post-traumatic stress disorder or adjustment disorder after multiple ICD shocks. Design: Explorative feasibility study: Treatment of 22 patients as a natural design without randomisation and without control group. The period of recruitment was three years, from March 2007 to March 2010. The study consisted of two phases: in the first phase (pilot study) we tested different components and dosages of psychotherapeutic treatments. The final intervention programme is presented in this paper. In the second phase (follow-up study) we assessed the residual post-traumatic stress symptoms in these ICD patients. The time between treatment and follow-up measurement was 12 to 30 months. Population: Thirty-one patients were assigned to the Department of Psychocardiology after multiple shocks. The sample consisted of 22 patients who had a post-traumatic stress disorder or an adjustment disorder and were willing and able to participate. They were invited for psychological treatment. 18 of them could be included into the follow-up study. Methods: After the clinical assessment at the beginning and at the end of the inpatient treatment a post-treatment assessment with questionnaires followed. In this follow-up measurement, minimum 12 months after inpatient treatment, posttraumatic stress was assessed using the “Impact of Event Scale” (IES-R). Setting: Inpatient treatment in a large Heart and Thorax Centre with a Department of Psychocardiology (Kerckhoff Heart Centre). Results: From the 18 patients in the follow-up study no one reported complaints of PTSD. 15 of them reported a high or even a very high decrease of anxiety and avoidance behaviour. Conclusions: The fist step of the treatment development seems to be successful. It shows encouraging results with an acceptable dosage. The second step of our work is in process now: we evaluate the treatment manual within other clinical institutions and a higher number of psychotherapists. This leads in the consequence to a controlled and randomised comparison study. PMID:24403967

Analysis of Alternatives for Risk Assessment Methodologies and Tools

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

Nachtigal, Noel M.; Fruetel, Julia A.; Gleason, Nathaniel J.

The purpose of this document is to provide a basic overview and understanding of risk assessment methodologies and tools from the literature and to assess the suitability of these methodologies and tools for cyber risk assessment. Sandia National Laboratories (SNL) performed this review in support of risk modeling activities performed for the Stakeholder Engagement and Cyber Infrastructure Resilience (SECIR) division of the Department of Homeland Security (DHS) Office of Cybersecurity and Communications (CS&C). The set of methodologies and tools covered in this document is not intended to be exhaustive; instead, it focuses on those that are commonly used in themore » risk assessment community. The classification of methodologies and tools was performed by a group of analysts with experience in risk analysis and cybersecurity, and the resulting analysis of alternatives has been tailored to address the needs of a cyber risk assessment.« less

A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

PubMed

Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

2017-01-01

This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

USGS Methodology for Assessing Continuous Petroleum Resources

USGS Publications Warehouse

Charpentier, Ronald R.; Cook, Troy A.

2011-01-01

The U.S. Geological Survey (USGS) has developed a new quantitative methodology for assessing resources in continuous (unconventional) petroleum deposits. Continuous petroleum resources include shale gas, coalbed gas, and other oil and gas deposits in low-permeability ("tight") reservoirs. The methodology is based on an approach combining geologic understanding with well productivities. The methodology is probabilistic, with both input and output variables as probability distributions, and uses Monte Carlo simulation to calculate the estimates. The new methodology is an improvement of previous USGS methodologies in that it better accommodates the uncertainties in undrilled or minimally drilled deposits that must be assessed using analogs. The publication is a collection of PowerPoint slides with accompanying comments.

Sepsis 2018: Definitions and Guideline Changes.

PubMed

Napolitano, Lena M

Sepsis is a global healthcare issue and continues to be the leading cause of death from infection. Early recognition and diagnosis of sepsis is required to prevent the transition into septic shock, which is associated with a mortality rate of 40% or more. New definitions for sepsis and septic shock (Third International Consensus Definitions for Sepsis and Septic Shock [Sepsis-3]) have been developed. A new screening tool for sepsis (quick Sequential Organ Failure Assessment [qSOFA]) has been proposed to predict the likelihood of poor outcome in out-of-intensive care unit (ICU) patients with clinical suspicion of sepsis. The Surviving Sepsis Campaign Guidelines were recently updated and include greater evidence-based recommendations for treatment of sepsis in attempts to reduce sepsis-associated mortality. This review discusses the new Sepsis-3 definitions and guidelines.

Fully-coupled analysis of jet mixing problems. Part 1. Shock-capturing model, SCIPVIS

NASA Technical Reports Server (NTRS)

Dash, S. M.; Wolf, D. E.

1984-01-01

A computational model, SCIPVIS, is described which predicts the multiple cell shock structure in imperfectly expanded, turbulent, axisymmetric jets. The model spatially integrates the parabolized Navier-Stokes jet mixing equations using a shock-capturing approach in supersonic flow regions and a pressure-split approximation in subsonic flow regions. The regions are coupled using a viscous-characteristic procedure. Turbulence processes are represented via the solution of compressibility-corrected two-equation turbulence models. The formation of Mach discs in the jet and the interactive analysis of the wake-like mixing process occurring behind Mach discs is handled in a rigorous manner. Calculations are presented exhibiting the fundamental interactive processes occurring in supersonic jets and the model is assessed via comparisons with detailed laboratory data for a variety of under- and overexpanded jets.

Investigation of Sustained Detonation Devices: the Pulse Detonation Engine-Crossover System and the Rotating Detonation Engine System

NASA Astrophysics Data System (ADS)

Driscoll, Robert B.

An experimental study is conducted on a Pulse Detonation Engine-Crossover System to investigate the feasibility of repeated, shock-initiated combustion and characterize the initiation performance. A PDE-crossover system can decrease deflagration-to-detonation transition length while employing a single spark source to initiate a multi-PDE system. Visualization of a transferred shock wave propagating through a clear channel reveals a complex shock train behind the leading shock. Shock wave Mach number and decay rate remains constant for varying crossover tube geometries and operational frequencies. A temperature gradient forms within the crossover tube due to forward flow of high temperature ionized gas into the crossover tube from the driver PDE and backward flow of ionized gas into the crossover tube from the driven PDE, which can cause intermittent auto-ignition of the driver PDE. Initiation performance in the driven PDE is strongly dependent on initial driven PDE skin temperature in the shock wave reflection region. An array of detonation tubes connected with crossover tubes is developed using optimized parameters and successful operation utilizing shock-initiated combustion through shock wave reflection is achieved and sustained. Finally, an air-breathing, PDE-Crossover System is developed to characterize the feasibility of shock-initiated combustion within an air-breathing pulse detonation engine. The initiation effectiveness of shock-initiated combustion is compared to spark discharge and detonation injection through a pre-detonator. In all cases, shock-initiated combustion produces improved initiation performance over spark discharge and comparable detonation transition run-up lengths relative to pre-detonator initiation. A computational study characterizes the mixing processes and injection flow field within a rotating detonation engine. Injection parameters including reactant flow rate, reactant injection area, placement of the fuel injection, and fuel injection distribution are varied to assess the impact on mixing. Decreasing reactant injection areas improves fuel penetration into the cross-flowing air stream, enhances turbulent diffusion of the fuel within the annulus, and increases local equivalence ratio and fluid mixedness. Staggering fuel injection holes produces a decrease in mixing when compared to collinear fuel injection. Finally, emulating nozzle integration by increasing annulus back-pressure increases local equivalence ratio in the injection region due to increased convection residence time.

Association of a Negative Wealth Shock With All-Cause Mortality in Middle-aged and Older Adults in the United States.

PubMed

Pool, Lindsay R; Burgard, Sarah A; Needham, Belinda L; Elliott, Michael R; Langa, Kenneth M; Mendes de Leon, Carlos F

2018-04-03

A sudden loss of wealth-a negative wealth shock-may lead to a significant mental health toll and also leave fewer monetary resources for health-related expenses. With limited years remaining to regain lost wealth in older age, the health consequences of these negative wealth shocks may be long-lasting. To determine whether a negative wealth shock was associated with all-cause mortality during 20 years of follow-up. The Health and Retirement Study, a nationally representative prospective cohort study of US adults aged 51 through 61 years at study entry. The study population included 8714 adults, first assessed for a negative wealth shock in 1994 and followed biennially through 2014 (the most recent year of available data). Experiencing a negative wealth shock, defined as a loss of 75% or more of total net worth over a 2-year period, or asset poverty, defined as 0 or negative total net worth at study entry. Mortality data were collected from the National Death Index and postmortem interviews with family members. Marginal structural survival methods were used to account for the potential bias due to changes in health status that may both trigger negative wealth shocks and act as the mechanism through which negative wealth shocks lead to increased mortality. There were 8714 participants in the study sample (mean [SD] age at study entry, 55 [3.2] years; 53% women), 2430 experienced a negative wealth shock during follow-up, 749 had asset poverty at baseline, and 5535 had continuously positive wealth without shock. A total of 2823 deaths occurred during 80 683 person-years of follow-up. There were 30.6 vs 64.9 deaths per 1000 person-years for those with continuously positive wealth vs negative wealth shock (adjusted hazard ratio [HR], 1.50; 95% CI, 1.36-1.67). There were 73.4 deaths per 1000 person-years for those with asset poverty at baseline (adjusted HR, 1.67; 95% CI, 1.44-1.94; compared with continuously positive wealth). Among US adults aged 51 years and older, loss of wealth over 2 years was associated with an increased risk of all-cause mortality. Further research is needed to better understand the possible mechanisms for this association and determine whether there is potential value for targeted interventions.

Validation methodology in publications describing epidemiological registration methods of dental caries: a systematic review.

PubMed

Sjögren, P; Ordell, S; Halling, A

2003-12-01

The aim was to describe and systematically review the methodology and reporting of validation in publications describing epidemiological registration methods for dental caries. BASIC RESEARCH METHODOLOGY: Literature searches were conducted in six scientific databases. All publications fulfilling the predetermined inclusion criteria were assessed for methodology and reporting of validation using a checklist including items described previously as well as new items. The frequency of endorsement of the assessed items was analysed. Moreover, the type and strength of evidence, was evaluated. Reporting of predetermined items relating to methodology of validation and the frequency of endorsement of the assessed items were of primary interest. Initially 588 publications were located. 74 eligible publications were obtained, 23 of which fulfilled the inclusion criteria and remained throughout the analyses. A majority of the studies reported the methodology of validation. The reported methodology of validation was generally inadequate, according to the recommendations of evidence-based medicine. The frequencies of reporting the assessed items (frequencies of endorsement) ranged from four to 84 per cent. A majority of the publications contributed to a low strength of evidence. There seems to be a need to improve the methodology and the reporting of validation in publications describing professionally registered caries epidemiology. Four of the items assessed in this study are potentially discriminative for quality assessments of reported validation.

Risk Assessment Methodology for Hazardous Waste Management (1998)

EPA Pesticide Factsheets

A methodology is described for systematically assessing and comparing the risks to human health and the environment of hazardous waste management alternatives. The methodology selects and links appropriate models and techniques for performing the process.

Published methodological quality of randomized controlled trials does not reflect the actual quality assessed in protocols

PubMed Central

Mhaskar, Rahul; Djulbegovic, Benjamin; Magazin, Anja; Soares, Heloisa P.; Kumar, Ambuj

2011-01-01

Objectives To assess whether reported methodological quality of randomized controlled trials (RCTs) reflect the actual methodological quality, and to evaluate the association of effect size (ES) and sample size with methodological quality. Study design Systematic review Setting Retrospective analysis of all consecutive phase III RCTs published by 8 National Cancer Institute Cooperative Groups until year 2006. Data were extracted from protocols (actual quality) and publications (reported quality) for each study. Results 429 RCTs met the inclusion criteria. Overall reporting of methodological quality was poor and did not reflect the actual high methodological quality of RCTs. The results showed no association between sample size and actual methodological quality of a trial. Poor reporting of allocation concealment and blinding exaggerated the ES by 6% (ratio of hazard ratio [RHR]: 0.94, 95%CI: 0.88, 0.99) and 24% (RHR: 1.24, 95%CI: 1.05, 1.43), respectively. However, actual quality assessment showed no association between ES and methodological quality. Conclusion The largest study to-date shows poor quality of reporting does not reflect the actual high methodological quality. Assessment of the impact of quality on the ES based on reported quality can produce misleading results. PMID:22424985

Increasing accuracy in the assessment of motion sickness: A construct methodology

NASA Technical Reports Server (NTRS)

Stout, Cynthia S.; Cowings, Patricia S.

1993-01-01

The purpose is to introduce a new methodology that should improve the accuracy of the assessment of motion sickness. This construct methodology utilizes both subjective reports of motion sickness and objective measures of physiological correlates to assess motion sickness. Current techniques and methods used in the framework of a construct methodology are inadequate. Current assessment techniques for diagnosing motion sickness and space motion sickness are reviewed, and attention is called to the problems with the current methods. Further, principles of psychophysiology that when applied will probably resolve some of these problems are described in detail.

Serum heat shock protein 70 level as a biomarker of exceptional longevity.

PubMed

Terry, Dellara F; Wyszynski, Diego F; Nolan, Vikki G; Atzmon, Gil; Schoenhofen, Emily A; Pennington, JaeMi Y; Andersen, Stacy L; Wilcox, Marsha A; Farrer, Lindsay A; Barzilai, Nir; Baldwin, Clinton T; Asea, Alexzander

2006-11-01

Heat shock proteins are highly conserved proteins that, when produced intracellularly, protect stress exposed cells. In contrast, extracellular heat shock protein 70 (Hsp70) has been shown to have both protective and deleterious effects. In this study, we assessed heat shock protein 70 for its potential role in human longevity. Because of the importance of HSP to disease processes, cellular protection, and inflammation, we hypothesized that: (1) Hsp70 levels in centenarians and centenarian offspring are different from controls and (2) alleles in genes associated with Hsp70 explain these differences. In this cross-sectional study, we assessed serum Hsp70 levels from participants enrolled in either the New England Centenarian Study (NECS) or the Longevity Genes Project (LGP): 87 centenarians (from LGP), 93 centenarian offspring (from NECS), and 126 controls (43 from NECS, 83 from LGP). We also examined genotypic and allelic frequencies of polymorphisms in HSP70-A1A and HSP70-A1B in 347 centenarians (266 from the NECS, 81 from the LGP), 260 NECS centenarian offspring, and 238 controls (NECS: 53 spousal controls and 106 septuagenarian offspring controls; LGP: 79 spousal controls). The adjusted mean serum Hsp70 levels (ng/mL) for the NECS centenarian offspring, LGP centenarians, LGP spousal controls, and NECS controls were 1.05, 1.13, 3.07, 6.93, respectively, suggesting that a low serum Hsp70 level is associated with longevity; however, no genetic associations were found with two SNPs within two hsp70 genes.

An assessment of the common carrier shipping environment

Treesearch

F. E. Ostrem; W. D. Godshall

1979-01-01

An assessment of available data and information describing the common carrier shipping environment was conducted. The assesment included the major shipping hazards of shock, vibration, impact, temperature, and humidity associated with the handling, transportation, and warehousing operations of typical distribution cycles. Previous environmental studies and current data...

Most systematic reviews of high methodological quality on psoriasis interventions are classified as high risk of bias using ROBIS tool.

PubMed

Gómez-García, Francisco; Ruano, Juan; Gay-Mimbrera, Jesus; Aguilar-Luque, Macarena; Sanz-Cabanillas, Juan Luis; Alcalde-Mellado, Patricia; Maestre-López, Beatriz; Carmona-Fernández, Pedro Jesús; González-Padilla, Marcelino; García-Nieto, Antonio Vélez; Isla-Tejera, Beatriz

2017-12-01

No gold standard exists to assess methodological quality of systematic reviews (SRs). Although Assessing the Methodological Quality of Systematic Reviews (AMSTAR) is widely accepted for analyzing quality, the ROBIS instrument has recently been developed. This study aimed to compare the capacity of both instruments to capture the quality of SRs concerning psoriasis interventions. Systematic literature searches were undertaken on relevant databases. For each review, methodological quality and bias risk were evaluated using the AMSTAR and ROBIS tools. Descriptive and principal component analyses were conducted to describe similarities and discrepancies between both assessment tools. We classified 139 intervention SRs as displaying high/moderate/low methodological quality and as high/low risk of bias. A high risk of bias was detected for most SRs classified as displaying high or moderate methodological quality by AMSTAR. When comparing ROBIS result profiles, responses to domain 4 signaling questions showed the greatest differences between bias risk assessments, whereas domain 2 items showed the least. When considering SRs published about psoriasis, methodological quality remains suboptimal, and the risk of bias is elevated, even for SRs exhibiting high methodological quality. Furthermore, the AMSTAR and ROBIS tools may be considered as complementary when conducting quality assessment of SRs. Copyright © 2017 Elsevier Inc. All rights reserved.

A database and probabilistic assessment methodology for carbon dioxide enhanced oil recovery and associated carbon dioxide retention in the United States

USGS Publications Warehouse

Warwick, Peter D.; Verma, Mahendra K.; Attanasi, Emil; Olea, Ricardo A.; Blondes, Madalyn S.; Freeman, Philip; Brennan, Sean T.; Merrill, Matthew; Jahediesfanjani, Hossein; Roueche, Jacqueline; Lohr, Celeste D.

2017-01-01

The U.S. Geological Survey (USGS) has developed an assessment methodology for estimating the potential incremental technically recoverable oil resources resulting from carbon dioxide-enhanced oil recovery (CO2-EOR) in reservoirs with appropriate depth, pressure, and oil composition. The methodology also includes a procedure for estimating the CO2 that remains in the reservoir after the CO2-EOR process is complete. The methodology relies on a reservoir-level database that incorporates commercially available geologic and engineering data. The mathematical calculations of this assessment methodology were tested and produced realistic results for the Permian Basin Horseshoe Atoll, Upper Pennsylvanian-Wolfcampian Play (Texas, USA). The USGS plans to use the new methodology to conduct an assessment of technically recoverable hydrocarbons and associated CO2 sequestration resulting from CO2-EOR in the United States.

Overview of the Aeroelastic Prediction Workshop

NASA Technical Reports Server (NTRS)

Heeg, Jennifer; Chwalowski, Pawel; Florance, Jennifer P.; Wieseman, Carol D.; Schuster, David M.; Perry, Raleigh B.

2013-01-01

The Aeroelastic Prediction Workshop brought together an international community of computational fluid dynamicists as a step in defining the state of the art in computational aeroelasticity. This workshop's technical focus was prediction of unsteady pressure distributions resulting from forced motion, benchmarking the results first using unforced system data. The most challenging aspects of the physics were identified as capturing oscillatory shock behavior, dynamic shock-induced separated flow and tunnel wall boundary layer influences. The majority of the participants used unsteady Reynolds-averaged Navier Stokes codes. These codes were exercised at transonic Mach numbers for three configurations and comparisons were made with existing experimental data. Substantial variations were observed among the computational solutions as well as differences relative to the experimental data. Contributing issues to these differences include wall effects and wall modeling, non-standardized convergence criteria, inclusion of static aeroelastic deflection, methodology for oscillatory solutions, post-processing methods. Contributing issues pertaining principally to the experimental data sets include the position of the model relative to the tunnel wall, splitter plate size, wind tunnel expansion slot configuration, spacing and location of pressure instrumentation, and data processing methods.

Modeling compressible multiphase flows with dispersed particles in both dense and dilute regimes

NASA Astrophysics Data System (ADS)

McGrath, T.; St. Clair, J.; Balachandar, S.

2018-05-01

Many important explosives and energetics applications involve multiphase formulations employing dispersed particles. While considerable progress has been made toward developing mathematical models and computational methodologies for these flows, significant challenges remain. In this work, we apply a mathematical model for compressible multiphase flows with dispersed particles to existing shock and explosive dispersal problems from the literature. The model is cast in an Eulerian framework, treats all phases as compressible, is hyperbolic, and satisfies the second law of thermodynamics. It directly applies the continuous-phase pressure gradient as a forcing function for particle acceleration and thereby retains relaxed characteristics for the dispersed particle phase that remove the constituent material sound velocity from the eigenvalues. This is consistent with the expected characteristics of dispersed particle phases and can significantly improve the stable time-step size for explicit methods. The model is applied to test cases involving the shock and explosive dispersal of solid particles and compared to data from the literature. Computed results compare well with experimental measurements, providing confidence in the model and computational methods applied.

Shock treatment: using immersive digital realism to restage and re-examine milgram's 'obedience to authority' research.

PubMed

Haslam, S Alexander; Reicher, Stephen D; Millard, Kathryn

2015-01-01

Attempts to revisit Milgram's 'Obedience to Authority' (OtA) paradigm present serious ethical challenges. In recent years new paradigms have been developed to circumvent these challenges but none involve using Milgram's own procedures and asking naïve participants to deliver the maximum level of shock. This was achieved in the present research by using Immersive Digital Realism (IDR) to revisit the OtA paradigm. IDR is a dramatic method that involves a director collaborating with professional actors to develop characters, the strategic withholding of contextual information, and immersion in a real-world environment. 14 actors took part in an IDR study in which they were assigned to conditions that restaged Milgrams's New Baseline ('Coronary') condition and four other variants. Post-experimental interviews also assessed participants' identification with Experimenter and Learner. Participants' behaviour closely resembled that observed in Milgram's original research. In particular, this was evidenced by (a) all being willing to administer shocks greater than 150 volts, (b) near-universal refusal to continue after being told by the Experimenter that "you have no other choice, you must continue" (Milgram's fourth prod and the one most resembling an order), and (c) a strong correlation between the maximum level of shock that participants administered and the mean maximum shock delivered in the corresponding variant in Milgram's own research. Consistent with an engaged follower account, relative identification with the Experimenter (vs. the Learner) was also a good predictor of the maximum shock that participants administered.

Characterizing the effects of inorganic acid and alkaline shock on the Staphylococcus aureus transcriptome and messenger RNA turnover.

PubMed

Anderson, Kelsi L; Roux, Christelle M; Olson, Matthew W; Luong, Thanh T; Lee, Chia Y; Olson, Robert; Dunman, Paul M

2010-12-01

Staphylococcus aureus pathogenesis can be attributed partially to its ability to adapt to otherwise deleterious host-associated stresses. Here, Affymetrix GeneChips® were used to examine the S. aureus responses to inorganic acid and alkaline shock and to assess whether stress-dependent changes in mRNA turnover are likely to facilitate the organism's ability to tolerate a pH challenge. The results indicate that S. aureus adapts to pH shock by eliciting responses expected of cells coping with pH alteration, including neutralizing cellular pH, DNA repair, amino acid biosynthesis, and virulence factor expression. Further, the S. aureus response to alkaline conditions is strikingly similar to that of stringent response-induced cells. Indeed, we show that alkaline shock stimulates the accumulation of the stringent response activator (p)ppGpp. The results also revealed that pH shock significantly alters the mRNA properties of the cell. A comparison of the mRNA degradation properties of transcripts whose titers either increased or decreased in response to a sudden pH change revealed that alterations in mRNA degradation may, in part, account for the changes in the mRNA levels of factors predicted to mediate pH tolerance. A set of small stable RNA molecules were induced in response to acid- or alkaline-shock conditions and may mediate adaptation to pH stress. © 2010 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

Pelvic fracture in multiple trauma: A 67-case series.

PubMed

Caillot, M; Hammad, E; Le Baron, M; Villes, V; Leone, M; Flecher, X

2016-12-01

Severe pelvic trauma remains associated with elevated mortality, largely due to hemorrhagic shock. The main study objective was to test for correlation between fracture type and mortality. The secondary objective was to assess the efficacy in terms of mortality of multidisciplinary management following a decision-tree in multiple trauma victims admitted to a level 1 trauma center. Between July 2011 and July 2013, 534 severe trauma patients were included in a single-center continuous prospective observational study. All patients with hemorrhagic shock received early treatment by pelvic binder. Patients with active bleeding on full-body CT or persisting hemorrhagic shock underwent arteriography with or without embolization. Pelvic trauma was graded on the Tile classification. The principle end-point was mortality. Median age was 40 years (range, 26-48 years), with a 79% male/female sex ratio. Thirty-two of the 67 patients with pelvic trauma (48%) were in hemorrhagic shock at admission. Median injury severity score (ISS) was 36 (range, 24-43). On the Tile classification, 22 patients (33%) were grade A, 33 (49%) grade B and 12 (18%) grade C. Overall mortality was 19%, and 42% in case of hemorrhagic shock. Mortality was significantly higher with Tile C than A or B (58% vs. 9.1% and 12.1%, respectively; P=0.001). Vertical shear fracture (Tile C) was associated with greater mortality from hemorrhagic shock. IV, case series. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Acceleration from short-duration blast

NASA Astrophysics Data System (ADS)

Ritzel, D. V.; Van Albert, S.; Sajja, V.; Long, J.

2018-01-01

The blast-induced motion of spheres has been studied experimentally where the shock wave is rapidly decaying during the period that quasi-steady acceleration would be developed in the case of a step-function shock wave as considered in most shock-tube studies. The motion of sphere models ranging from 39 to 251 mm in diameter and having a range of densities was assessed using the "free-flight" method in a simulator specially designed to replicate the decaying shock wave profile of spherical blast including negative phase and positive entropy gradient. A standardized blast-wave simulation of 125 kPa and 6-ms positive-phase duration was applied for all experiments. In all cases, there are three phases to the motion: a relatively low "kickoff" velocity from the shock diffraction, acceleration or deceleration during the positive duration, then deceleration through the negative phase and subsequent quiescent air. The unexpected deceleration of larger spheres after their kickoff velocity during the decaying yet high-speed flow of the blast wave seems associated with the persistence of a ring vortex on the downstream side of the sphere. The flow is entirely unsteady with initial forces dominated by the shock diffraction; therefore, the early motion of spheres under such conditions is not governed by quasi-steady drag as in classical aerodynamics. The work will help establish scaling rules for model studies of blast-induced motion relevant to improvised explosive devices, and preliminary results are shown for motion imparted to a human skull surrogate.

Macroeconomic evidence suggests that asylum seekers are not a “burden” for Western European countries

PubMed Central

d’Albis, Hippolyte

2018-01-01

This paper aims to evaluate the economic and fiscal effects of inflows of asylum seekers into Western Europe from 1985 to 2015. It relies on an empirical methodology that is widely used to estimate the macroeconomic effects of structural shocks and policies. It shows that inflows of asylum seekers do not deteriorate host countries’ economic performance or fiscal balance because the increase in public spending induced by asylum seekers is more than compensated for by an increase in tax revenues net of transfers. As asylum seekers become permanent residents, their macroeconomic impacts become positive.

Hsp72 release: mechanisms and methodologies.

PubMed

Asea, Alexzander

2007-11-01

To date there are two mechanisms that are recognized by which heat shock proteins (HSP) are released from cells; a passive release mechanism, including necrotic cell death, severe blunt trauma, surgery and following infection with lytic viruses, and an active release mechanism which involves the non classical protein release pathway in which HSPs are released within highly immunologically potent exosomes and as free HSP. This chapter describes the experimental procedures that have been developed to study the mechanism by which stress induces the release of HSP72 into the circulation and addresses the biological significance of circulating HSP72 to host defense against disease.

Treatment of chronic plantar fasciopathy with extracorporeal shock waves (review)

PubMed Central

2013-01-01

There is an increasing interest by doctors and patients in extracorporeal shock wave therapy (ESWT) for chronic plantar fasciopathy (PF), particularly in second generation radial extracorporeal shock wave therapy (RSWT). The present review aims at serving this interest by providing a comprehensive overview on physical and medical definitions of shock waves and a detailed assessment of the quality and significance of the randomized clinical trials published on ESWT and RSWT as it is used to treat chronic PF. Both ESWT and RSWT are safe, effective, and technically easy treatments for chronic PF. The main advantages of RSWT over ESWT are the lack of need for any anesthesia during the treatment and the demonstrated long-term treatment success (demonstrated at both 6 and 12 months after the first treatment using RSWT, compared to follow-up intervals of no more than 12 weeks after the first treatment using ESWT). In recent years, a greater understanding of the clinical outcomes in ESWT and RSWT for chronic PF has arisen in relationship not only in the design of studies, but also in procedure, energy level, and shock wave propagation. Either procedure should be considered for patients 18 years of age or older with chronic PF prior to surgical intervention. PMID:24004715

Laboratory study of effects of sonic boom shaping on subjective loudness and acceptability

NASA Technical Reports Server (NTRS)

Leatherwood, Jack D.; Sullivan, Brenda M.

1992-01-01

A laboratory study was conducted to determine the effects of sonic boom signature shaping on subjective loudness and acceptability. The study utilized the sonic boom simulator at the Langley Research Center. A wide range of symmetrical, front-shock-minimized signature shapes were investigated together with a limited number of asymmetrical signatures. Subjective loudness judgments were obtained from 60 test subjects by using an 11-point numerical category scale. Acceptability judgments were obtained using the method of constant stimuli. Results were used to assess the relative predictive ability of several noise metrics, determine the loudness benefits of detailed boom shaping, and derive laboratory sonic boom acceptability criteria. These results indicated that the A-weighted sound exposure level, the Stevens Mark 7 Perceived Level, and the Zwicker Loudness Level metrics all performed well. Significant reductions in loudness were obtained by increasing front-shock rise time and/or decreasing front-shock overpressure of the front-shock minimized signatures. In addition, the asymmetrical signatures were rated to be slightly quieter than the symmetrical front-shock-minimized signatures of equal A-weighted sound exposure level. However, this result was based on a limited number of asymmetric signatures. The comparison of laboratory acceptability results with acceptability data obtained in more realistic situations also indicated good agreement.

The interaction of moderately strong shock waves with thick perforated walls of low porosity

NASA Technical Reports Server (NTRS)

Grant, D. J.

1972-01-01

A theoretical prediction is given of the flow through thick perforated walls of low porosity resulting from the impingement of a moderately strong traveling shock wave. The model was a flat plate positioned normal to the direction of the flow. Holes bored in the plate parallel to the direction of the flow provided nominal hole length-to-diameter ratios of 10:1 and an axial porosity of 25 percent of the flow channel cross section. The flow field behind the reflected shock wave was assumed to behave as a reservoir producing a quasi-steady duct flow through the model. Rayleigh and Fanno duct flow theoretical computations for each of three possible auxiliary wave patterns that can be associated with the transmitted shock (to satisfy contact surface compatibility) were used to provide bounding solutions as an alternative to the more complex influence coefficients method. Qualitative and quantitative behavior was verified in a 1.5- by 2.0-in. helium shock tube. High speed Schlieren photography, piezoelectric pressure-time histories, and electronic-counter wave speed measurements were used to assess the extent of correlation with the theoretical flow models. Reduced data indicated the adequacy of the bounding theory approach to predict wave phenomena and quantitative response.

Investigations on GSK-3β/NF-kB signaling in stress and stress adaptive behavior in electric foot shock subjected mice.

PubMed

Bali, Anjana; Jaggi, Amteshwar Singh

2016-04-01

The present study was designed to explore the role of GSK-3β and NF-kB signaling in electric foot shock-induced stress and stress adaptation. Mice were subjected to foot shocks of 0.5mA intensity and 1s duration of 1h to produce acute stress. Animals were exposed to the same stressor for 5 days to induce stress adaptation. The behavioral alterations were assessed using the actophotometer, hole board, open field and social interaction tests. The serum corticosterone levels were assessed as a marker of the HPA axis. The levels of total GSK-3β, p-GSK-3β-S9 and p-NF-kB were determined in the hippocampus, frontal cortex and amygdala. Acute electric foot shock stress produced behavioral and biochemical changes; decreased the levels of p-GSK-3β-S9, produced no change in total GSK-3β levels and increased p-NF-kB levels in the brain. However, repeated exposure of foot shock stress restored the behavioral and biochemical changes along with normalization of p-GSK-3β-S9 and p-NF-kB levels. Administration of AR-A01, a selective GSK-3β inhibitor, or diethyldithiocarbamic acid (DDTC), a selective NF-kB inhibitor, diminished acute stress-induced behavioral and biochemical changes. Furthermore, AR-A014418 normalized acute stress-induced alterations in p-GSK-3β-S9 and p-NF-kB levels, however, DDTC selectively restored NF-kB levels without any change in p-GSK-3β-S9 levels. It probably suggests that NF-kB is a downstream mediator of the GSK-3 signaling cascade. It may conclude that acute stress associated decrease in p-GSK-3β-S9 and increase in p-NF-kB levels in the brain contribute in the development of behavioral and biochemical alterations and normalization of GSK-3β/NF-kB signaling may contribute in stress adaptive behavior in response to repeated electric foot shock-subjected mice. Copyright © 2016 Elsevier B.V. All rights reserved.

Heat Shock Protein 90 Inhibitor Decreases Collagen Synthesis of Keloid Fibroblasts and Attenuates the Extracellular Matrix on the Keloid Spheroid Model.

PubMed

Lee, Won Jai; Lee, Ju Hee; Ahn, Hyo Min; Song, Seung Yong; Kim, Yong Oock; Lew, Dae Hyun; Yun, Chae-Ok

2015-09-01

The 90-kDa heat-shock protein (heat-shock protein 90) is an abundant cytosolic chaperone, and inhibition of heat-shock protein 90 by 17-allylamino-17-demethoxygeldanamycin (17-AAG) compromises transforming growth factor (TGF)-β-mediated transcriptional responses by enhancing TGF-β receptor I and II degradation, thus preventing Smad2/3 activation. In this study, the authors evaluated whether heat-shock protein 90 regulates TGF-β signaling in the pathogenesis and treatment of keloids. Keloid fibroblasts were treated with 17-AAG (10 μM), and mRNA levels of collagen types I and III were determined by real-time reverse- transcriptase polymerase chain reaction. Also, secreted TGF-β1 was assessed by enzyme-linked immunosorbent assay. The effect of 17-AAG on protein levels of Smad2/3 complex was determined by Western blot analysis. In addition, in 17-AAG-treated keloid spheroids, the collagen deposition and expression of major extracellular matrix proteins were investigated by means of Masson trichrome staining and immunohistochemistry. The authors found that heat-shock protein 90 is overexpressed in human keloid tissue compared with adjacent normal tissue, and 17-AAG decreased mRNA levels of type I collagen, secreted TGF-ß1, and Smad2/3 complex protein expression in keloid fibroblasts. Masson trichrome staining revealed that collagen deposition was decreased in 17-AAG-treated keloid spheroids, and immunohistochemical analysis showed that expression of collagen types I and III, elastin, and fibronectin was markedly decreased in 17-AAG-treated keloid spheroids. These results suggest that the antifibrotic action of heat-shock protein 90 inhibitors such as 17-AAG may have therapeutic effects on keloids.

Loss of Syndecan-1 Abrogates the Pulmonary Protective Phenotype Induced by Plasma After Hemorrhagic Shock.

PubMed

Wu, Feng; Peng, Zhanglong; Park, Pyong Woo; Kozar, Rosemary A

2017-09-01

Syndecan-1 (Sdc1) is considered a biomarker of injury to the endothelial glycocalyx following hemorrhagic shock, with shedding of Sdc1 deleterious. Resuscitation with fresh frozen plasma (FFP) has been correlated with restitution of pulmonary Sdc1 and reduction of lung injury, but the precise contribution of Sdc1 to FFPs protection in the lung remains unclear. Human lung endothelial cells were used to assess the time and dose-dependent effect of FFP on Sdc1 expression and the effect of Sdc1 silencing on in vitro endothelial cell permeability and actin stress fiber formation. Wild-type and Sdc1 mice were subjected to hemorrhagic shock followed by resuscitation with lactated Ringers (LR) or FFP and compared with shock alone and shams. Lungs were harvested after 3 h for analysis of permeability, histology, and inflammation and for measurement of syndecan- 2 and 4 expression. In vitro, FFP enhanced pulmonary endothelial Sdc1 expression in time- and dose-dependent manners and loss of Sdc1 in pulmonary endothelial cells worsened permeability and stress fiber formation by FFP. Loss of Sdc1 in vivo led to equivalency between LR and FFP in restoring pulmonary injury, inflammation, and permeability after shock. Lastly, Sdc1 mice demonstrated a significant increase in pulmonary syndecan 4 expression after hemorrhagic shock and FFP-based resuscitation. Taken together, our findings support a key role for Sdc1 in modulating pulmonary protection by FFP after hemorrhagic shock. Our results also suggest that other members of the syndecan family may at least be contributing to FFP's effects on the endothelium, an area that warrants further investigation.

Is Thrombocytopenia an Early Prognostic Marker in Septic Shock?

PubMed

Thiery-Antier, Nadiejda; Binquet, Christine; Vinault, Sandrine; Meziani, Ferhat; Boisramé-Helms, Julie; Quenot, Jean-Pierre

2016-04-01

To assess whether early thrombocytopenia during septic shock is associated with an increased risk of death at day 28 and to identify risk factors associated with a low platelet count. Prospective, multicenter, observational cohort study. Fourteen ICUs from 10 French university teaching and nonacademic hospitals. Consecutive adult patients with septic shock admitted between November 2009 and September 2011 were eligible. None. Of the 1,495 eligible patients, 1,486 (99.4%) were included. Simplified Acute Physiology Score II score of greater than or equal to 56, immunosuppression, age of more than 65 years, cirrhosis, bacteremia (p ≤ 0.001 for each), and urinary sepsis (p = 0.005) were globally associated with an increased risk of thrombocytopenia within the first 24 hours following the onset of septic shock. Survival at day 28 estimated by the Kaplan-Meier method was lower in patients with thrombocytopenia and decreased with thrombocytopenia severity. By multivariate Cox regression, a platelet count of less than or equal to 100,000/mm3 was independently associated with a significantly increased risk of death within the 28 days following septic shock onset. The risk of death increased with the severity of thrombocytopenia (hazard ratio, 1.65; 95% CI, 1.31-2.08 for a platelet count below 50,000/mm3 vs > 150,000/mm3; p < 0.0001). This is the first study to investigate thrombocytopenia within the first 24 hours of septic shock onset as a prognostic marker of survival at day 28 in a large cohort of ICU patients. Measuring platelet count is inexpensive and easily feasible for the physician in routine practice, and thus, it could represent an easy "alert system" among patients in septic shock.

Microparticle-associated tissue factor activity correlates with plasma levels of bacterial lipopolysaccharides in meningococcal septic shock.

PubMed

Hellum, Marit; Øvstebø, Reidun; Brusletto, Berit S; Berg, Jens P; Brandtzaeg, Petter; Henriksson, Carola E

2014-03-01

The plasma level of bacterial lipopolysaccharides (LPS) is associated with activation of the coagulation system, inhibition of fibrinolysis and the nature of the clinical presentation and outcome in patients with meningococcal disease. Tissue factor (TF)-bearing microparticles (MPs) appear to contribute to the pathogenesis of disseminated intravascular coagulation (DIC). The aim of this study was to investigate the relationship between MP-associated TF activity and the level of bacterial LPS in plasma from patients with meningococcal septic shock and meningitis. MPs isolated from citrated plasmas were assessed for TF-dependent activity with both a plasma-based thrombin generation assay (CAT) and whole blood-based thromboelastometry (ROTEM). The LPS level was measured using a chromogenic Limulus amebocyte lysate assay. MPs obtained from patients with meningococcal septic shock initiated significantly more efficient and TF-dependent thrombin generation in the CAT assay compared to MPs from patients with meningococcal meningitis. Differences in MP-associated TF activity between the septic shock patients and the meningitis patients were also evident when MPs were added to whole blood using ROTEM. The level of plasma LPS in patients with septic shock (range 2-2,100 EU/mL) was correlated with thrombogram parameters in the CAT assay; lagtime (r(s)=-0.84), time to peak (rs=-0.83), peak (r(s)=0.85) and ETP (r(s)=0.83). MPs obtained from patients with meningococcal septic shock displayed more efficient TF-dependent thrombin generation and clot formation compared to MPs from meningitis patients. MP-associated TF activity was closely associated with plasma LPS levels in the septic shock group. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Impact of the Sepsis-3 Septic Shock Definition on Previously Defined Septic Shock Patients.

PubMed

Sterling, Sarah A; Puskarich, Michael A; Glass, Andrew F; Guirgis, Faheem; Jones, Alan E

2017-09-01

The Third International Consensus Definitions Task Force (Sepsis-3) recently recommended changes to the definitions of sepsis. The impact of these changes remains unclear. Our objective was to determine the outcomes of patients meeting Sepsis-3 septic shock criteria versus patients meeting the "old" (1991) criteria of septic shock only. Secondary analysis of two clinical trials of early septic shock resuscitation. Large academic emergency departments in the United States. Patients with suspected infection, more than or equal to two systemic inflammatory response syndrome criteria, and systolic blood pressure less than 90 mm Hg after fluid resuscitation. Patients were further categorized as Sepsis-3 septic shock if they demonstrated hypotension, received vasopressors, and exhibited a lactate greater than 2 mmol/L. We compared in-hospital mortality in patients who met the old definition only with those who met the Sepsis-3 criteria. Four hundred seventy patients were included in the present analysis. Two hundred (42.5%) met Sepsis-3 criteria, whereas 270 (57.4%) met only the old definition. Patients meeting Sepsis-3 criteria demonstrated higher severity of illness by Sequential Organ Failure Assessment score (9 vs 5; p < 0.001) and mortality (29% vs 14%; p < 0.001). Subgroup analysis of 127 patients meeting only the old definition demonstrated significant mortality benefit following implementation of a quantitative resuscitation protocol (35% vs 10%; p = 0.006). In this analysis, 57% of patients meeting old definition for septic shock did not meet Sepsis-3 criteria. Although Sepsis-3 criteria identified a group of patients with increased organ failure and higher mortality, those patients who met the old criteria and not Sepsis-3 criteria still demonstrated significant organ failure and 14% mortality rate.

A Methodology for the Assessment of Experiential Learning Lean: The Lean Experience Factory Study

ERIC Educational Resources Information Center

De Zan, Giovanni; De Toni, Alberto Felice; Fornasier, Andrea; Battistella, Cinzia

2015-01-01

Purpose: The purpose of this paper is to present a methodology to assess the experiential learning processes of learning lean in an innovative learning environment: the lean model factories. Design/methodology/approach: A literature review on learning and lean management literatures was carried out to design the methodology. Then, a case study…

A general higher-order remap algorithm for ALE calculations

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

Chiravalle, Vincent P

2011-01-05

A numerical technique for solving the equations of fluid dynamics with arbitrary mesh motion is presented. The three phases of the Arbitrary Lagrangian Eulerian (ALE) methodology are outlined: the Lagrangian phase, grid relaxation phase and remap phase. The Lagrangian phase follows a well known approach from the HEMP code; in addition the strain rate andflow divergence are calculated in a consistent manner according to Margolin. A donor cell method from the SALE code forms the basis of the remap step, but unlike SALE a higher order correction based on monotone gradients is also added to the remap. Four test problemsmore » were explored to evaluate the fidelity of these numerical techniques, as implemented in a simple test code, written in the C programming language, called Cercion. Novel cell-centered data structures are used in Cercion to reduce the complexity of the programming and maximize the efficiency of memory usage. The locations of the shock and contact discontinuity in the Riemann shock tube problem are well captured. Cercion demonstrates a high degree of symmetry when calculating the Sedov blast wave solution, with a peak density at the shock front that is similar to the value determined by the RAGE code. For a flyer plate test problem both Cercion and FLAG give virtually the same velocity temporal profile at the target-vacuum interface. When calculating a cylindrical implosion of a steel shell, Cercion and FLAG agree well and the Cercion results are insensitive to the use of ALE.« less

Comparisons of CTH simulations with measured wave profiles for simple flyer plate experiments

DOE PAGES

Thomas, S. A.; Veeser, L. R.; Turley, W. D.; ...

2016-06-13

We conducted detailed 2-dimensional hydrodynamics calculations to assess the quality of simulations commonly used to design and analyze simple shock compression experiments. Such simple shock experiments also contain data where dynamic properties of materials are integrated together. We wished to assess how well the chosen computer hydrodynamic code could do at capturing both the simple parts of the experiments and the integral parts. We began with very simple shock experiments, in which we examined the effects of the equation of state and the compressional and tensile strength models. We increased complexity to include spallation in copper and iron and amore » solid-solid phase transformation in iron to assess the quality of the damage and phase transformation simulations. For experiments with a window, the response of both the sample and the window are integrated together, providing a good test of the material models. While CTH physics models are not perfect and do not reproduce all experimental details well, we find the models are useful; the simulations are adequate for understanding much of the dynamic process and for planning experiments. However, higher complexity in the simulations, such as adding in spall, led to greater differences between simulation and experiment. Lastly, this comparison of simulation to experiment may help guide future development of hydrodynamics codes so that they better capture the underlying physics.« less

Technical Letter Report Development of Flaw Size Distribution Tables Including Effects of Flaw Depth Sizing Errors for Draft 10CFR 50.61a (Alternate PTS Rule) JCN-N6398, Task 4

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

Simonen, Fredric A.; Gosselin, Stephen R.; Doctor, Steven R.

2013-04-22

This document describes a new method to determine whether the flaws in a particular reactor pressure vessel are consistent with the assumptions regarding the number and sizes of flaws used in the analyses that formed the technical justification basis for the new voluntary alternative Pressurized Thermal Shock (PTS) rule (Draft 10 CFR 50.61a). The new methodology addresses concerns regarding prior methodology because ASME Code Section XI examinations do not detect all fabrication flaws, they have higher detection performance for some flaw types, and there are flaw sizing errors always present (e.g., significant oversizing of small flaws and systematic under sizingmore » of larger flaws). The new methodology allows direct comparison of ASME Code Section XI examination results with values in the PTS draft rule Tables 2 and 3 in order to determine if the number and sizes of flaws detected by an ASME Code Section XI examination are consistent with those assumed in the probabilistic fracture mechanics calculations performed in support of the development of 10 CFR 50.61a.« less

Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study

PubMed Central

2014-01-01

Introduction Selenoenzymes can modulate the extent of oxidative stress, which is recognized as a key feature of septic shock. The pathophysiologic role of erythrocyte selenium concentration in patients with septic shock remains unknown. Therefore, the objective of this study was to evaluate the association of erythrocyte selenium concentration with glutathione peroxidase (GPx1) activity, GPx1 polymorphisms and with ICU and hospital mortality in septic shock patients. Methods This prospective study included all patients older than 18 years with septic shock on admission or during their ICU stay, admitted to one of the three ICUs of our institution, from January to August 2012. At the time of the patients’ enrollment, demographic information was recorded. Blood samples were taken within the first 72 hours of the patients’ admission or within 72 hours of the septic shock diagnosis for determination of selenium status, protein carbonyl concentration, GPx1 activity and GPx1 Pro198Leu polymorphism (rs 1050450) genotyping. Results A total of 110 consecutive patients were evaluated. The mean age was 57.6 ± 15.9 years, 63.6% were male. Regarding selenium status, only erythrocyte selenium concentration was lower in patients who died in the ICU. The frequencies for GPx1 Pro198Leu polymorphism were 55%, 38% and 7% for Pro/Pro, Pro/Leu and Leu/Leu, respectively. In the logistic regression models, erythrocyte selenium concentration was associated with ICU and hospital mortality in patients with septic shock even after adjustment for protein carbonyl concentration and acute physiology and chronic health evaluation II score (APACHE II) or sequential organ failure assessment (SOFA). Conclusions Erythrocyte selenium concentration was a predictor of ICU and hospital mortality in patients with septic shock. However, this effect was not due to GPx1 activity or Pro198Leu polymorphism. PMID:24887198

Mechanism of biological effects observed in honey bees (Apis mellifera, L. ) hived under extra-high-voltage transmission lines: implications derived from bee exposure to simulated intense electric fields and shocks

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

Bindokas, V.P.; Gauger, J.R.; Greenberg, B.

This work explores mechanisms for disturbance of honey bee colonies under a 765 kV, 60-Hz transmission line (electric (E) field = 7 kV/m) observed in previous studies. Proposed mechanisms fell into two categories: direct bee perception of enhanced in-hive E fields and perception of shock from induced currents. The adverse biological effects could be reproduced in simulations where only the worker bees were exposed to shock or to E field in elongated hive entranceways (= tunnels). We now report the results of full-scale experiments using the tunnel exposure scheme, which assesses the contribution of shock and intense E field tomore » colony disturbance. Exposure of worker bees (1400 h) to 60-Hz E fields including 100 kV/m under moisture-free conditions within a nonconductive tunnel causes no deleterious affect on colony behavior. Exposure of bees in conductive (e.g., wet) tunnels produces bee disturbance, increased mortality, abnormal propolization, and possible impairment of colony growth. We propose that this substrate dependence of bee disturbance is the result of perception of shock from coupled body currents and enhanced current densities postulated to exist in the legs and thorax of bees on conductors. Similarly, disturbance occurs when bees are exposed to step-potential-induced currents. At 275-350 nA single bees are disturbed; at 600 nA bees begin abnormal propolization behavior; and stinging occurs at 900 nA. We conclude that biological effects seen in bee colonies under a transmission line are primarily the result of electric shock from induced hive currents. This evaluation is based on the limited effects of E-field exposure in tunnels, the observed disturbance thresholds caused by shocks in tunnels, and the ability of hives exposed under a transmission line to source currents 100-1,000 times the shock thresholds.« less

ACTIVATION OF COMMON ANTIVIRAL PATHWAYS CAN POTENTIATE INFLAMMATORY RESPONSES TO SEPTIC SHOCK

PubMed Central

Doughty, Lesley A.; Carlton, Stacey; Galen, Benjamin; Cooma-Ramberan, Indranie; Chung, Chung-Shiang; Ayala, Alfred

2006-01-01

Induction of the antiviral cytokine interferon α/β (IFN-α/β) is common in many viral infections. The impact of ongoing antiviral responses on subsequent bacterial infection is not well understood. In human disease, bacterial superinfection complicating a viral infection can result in significant morbidity and mortality. We injected mice with polyinosinic-polycytidylic (PIC) acid, a TLR3 ligand and known IFN-α/β inducer as well as nuclear factor κB (NF-κB) activator to simulate very early antiviral pathways. We then challenged mice with an in vivo septic shock model characterized by slowly evolving bacterial infection to simulate bacterial superinfection early during a viral infection. Our data demonstrated robust induction of IFN-α in serum within 24 h of PIC injection with IFN-α/β–dependent major histocompatibility antigen class II up-regulation on peritoneal macrophages. PIC pretreatment before septic shock resulted in augmented tumor necrosis factor alpha and interleukins 6 and 10 and heightened lethality compared with septic shock alone. Intact IFN-α/β signaling was necessary for augmentation of the inflammatory response to in vivo septic shock and to both TLR2 and TLR4 agonists in vitro. To assess the NF-κB contribution to PIC-modulated inflammatory responses to septic shock, we treated with parthenolide an NF-κB inhibitor before PIC and septic shock. Parthenolide did not inhibit IFN-α induction by PIC. Inhibition of NF-κB by parthenolide did reduce IFN-α–mediated potentiation of the cytokine response and lethality from septic shock. Our data demonstrate that pathways activated early during many viral infections can have a detrimental impact on the outcome of subsequent bacterial infection. These pathways may be critical to understanding the heightened morbidity and mortality from bacterial superinfection after viral infection in human disease. PMID:16878028

In Vitro Comparison of a Novel Single Probe Dual-Energy Lithotripter to Current Devices.

PubMed

Carlos, Evan C; Wollin, Daniel A; Winship, Brenton B; Jiang, Ruiyang; Radvak, Daniela; Chew, Ben H; Gustafson, Michael R; Simmons, W Neal; Zhong, Pei; Preminger, Glenn M; Lipkin, Michael E

2018-06-01

The LithoClast Trilogy is a novel single probe, dual-energy lithotripter with ultrasonic (US) vibration and electromagnetic impact forces. ShockPulse and LithoClast Select are existing lithotripters that also use a combination of US and mechanical impact energies. We compared the efficacy and tip motion of these devices in an in vitro setting. Begostones, in the ratio 15:3, were used in all trials. Test groups were Trilogy, ShockPulse, Select ultrasound (US) only, and Select ultrasound with pneumatic (USP). For clearance testing, a single investigator facile with each lithotripter fragmented 10 stones per device. For drill testing, a hands-free apparatus with a submerged balance was used to apply 1 or 2 lbs of pressure on a stone in contact with the device tip. High-speed photography was used to assess Trilogy and ShockPulse's probe tip motion. Select-USP was slowest and Trilogy fastest on clearance testing (p < 0.01). On 1 lbs drill testing, Select-US was slowest (p = 0.001). At 2 lbs, ShockPulse was faster than Select US (p = 0.027), but did not significantly outpace Trilogy nor Select-USP. At either weight, there was no significant difference between Trilogy and ShockPulse. During its US function, Trilogy's maximum downward tip displacement was 0.041 mm relative to 0.0025 mm with ShockPulse. Trilogy had 0.25 mm of maximum downward displacement during its impactor function while ShockPulse had 0.01 mm. Single probe dual-energy devices, such as Trilogy and ShockPulse, represent the next generation of lithotripters. Trilogy more efficiently cleared stone than currently available devices, which could be explained by its larger probe diameter and greater downward tip displacement during both US and impactor functions.

National Children's Study Dietary Assessment Workshop

Cancer.gov

The National Children's Study dietary assessment workshop was an opportunity for experts in dietary assessment methodology to gather and discuss the current state of knowledge about methodologies used to assess dietary intake during pregnancy, lactation, infancy, childhood, and adolescence.

Analysis of Alaska transportation sectors to assess energy use and impacts of price shocks and climate change legislation.

DOT National Transportation Integrated Search

2013-04-01

We analyzed the use of energy by Alaskas transportation sectors to assess the impact of sudden fuel prices changes. : We conducted three types of analysis: 1) Development of broad energy use statistics for each transportation sector, : including t...

The shock synthesis of complex organics from impacts into cometary analogue mixtures

NASA Astrophysics Data System (ADS)

Price, M.; Wozniakiewicz, P.; Cole, M.; Martins, Z.; Burchell, M.

2014-07-01

Introduction: If amino acids are required for the evolution of life, what was their source? Many different theories abound as to the source of amino acids on the early Earth including exogenous delivery from comets/asteroids (for example, glycine was found recently on comet Wild-2 [1]), formation in the protoplanetary nebula [2], or UV catalysed reactions of gases [3]. An alternative explanation is that amino acids can be shock-synthesised during the impact on an icy body onto a rocky body (or, equivalently, the impact of rocky body onto an icy surface). This theory is supported by computer simulations [4] and by very recent experimental data, which demonstrated the formation of simple (including abiotic) amino acids from shocks into ice mixtures mimicking the composition of comets and the surfaces of the icy Jovian and Saturnian satellites. Although the results from these experiments are fundamentally important, the yield of synthesised amino acids was low (nano-grams of material), complicating their detection and identification. In order to increase the collected yield of complex organics, and aid in their detection and identification, we have implemented a new collection technique within our hypervelocity impact facility. Experimental Methodology: Figure 1A) shows a low-resolution high-speed photograph of an impact plasma generated from an impact of a stainless-steel sphere into a mixture of water, CO_{2}, ammonia, and methanol ices. The plasma has an intense blue colour, and lasted for < 1 msec (the frame-rate of the camera). It is during and within this flash that complex organics are most likely synthesised, and thus to maximise the collection of these materials, we have implemented a new collection mechanism. Figure 1B) shows the prototype collection mechanism. Here an aluminium cold-plate (˜150 K) is placed in front of the target holder containing the ice mixtures. The plate has a central hole which allows the projectile to pass through to impact the ice mix. The plate also has two brass holders (Fig. 1C) which contain 10-mm diameter discs of high purity, sterilised gold foil (also at low temperature). During the impact, the plasma will condense onto the cold surfaces of the gold foil. One of the gold foils is pointed directly at the ice mixture, the other is pointed backwards into the gun's target chamber (and thus acts as a control). The gold discs can then be removed (Fig. 1D) and mounted onto stubs for analyses using Raman spectroscopy, SEM-EDX, GC-MS as required. Preliminary Results: Several trial shots have been performed using this system and residues have been found. The initial analysis of these residues is now underway and the results will be presented at the conference. If successful, this collection and analysis methodology will greatly speed up the number of experiments that can be done, allowing us to explore a large parameter space and determine the efficiency of shock syntheses of complex organics as a function of impact speed (peak shock pressure) and target composition.

Using terlipressin in a pediatric patient with septic shock resistant to catecholamines

PubMed Central

Erdogan, Seher; Bosnak, Mehmet

2017-01-01

Sepsis and septic shock are important causes of morbidity and mortality in critically ill children. The goal of treatment is to ensure adequate mean arterial pressure to maintain organ perfusion. The growing number of instances of peripheral vascular hyporeactivity to catecholamines has necessitated the search for alternative vasopressors. A 14-year-old boy had septic shock, with a high cardiac index and low systemic vascular resistance index (SVRI) measurements according to pulse contour analysis, despite treatment with dopamine, dobutamine, adrenaline, and noradrenaline infusions. A terlipressin (TP) 10 μg/kg intravenous bolus was administered, followed by a 1 μg/kg/minute continuous infusion. The response to TP treatment was assessed using pulse contour analysis. The mean arterial pressure and SVRI increased, and the cardiac index and heart rate decreased within 10 minutes after bolus administration of TP. Noradrenaline infusion could be reduced to 0.7 μg/kg/minute within 5 hours. The goal in presenting this case was to evaluate the vasoconstrictor effects of TP, a long-acting vasopressin analogue, in septic shock. PMID:29270582

Using terlipressin in a pediatric patient with septic shock resistant to catecholamines.

PubMed

Erdogan, Seher; Bosnak, Mehmet

2017-01-01

Sepsis and septic shock are important causes of morbidity and mortality in critically ill children. The goal of treatment is to ensure adequate mean arterial pressure to maintain organ perfusion. The growing number of instances of peripheral vascular hyporeactivity to catecholamines has necessitated the search for alternative vasopressors. A 14-year-old boy had septic shock, with a high cardiac index and low systemic vascular resistance index (SVRI) measurements according to pulse contour analysis, despite treatment with dopamine, dobutamine, adrenaline, and noradrenaline infusions. A terlipressin (TP) 10 μg/kg intravenous bolus was administered, followed by a 1 μg/kg/minute continuous infusion. The response to TP treatment was assessed using pulse contour analysis. The mean arterial pressure and SVRI increased, and the cardiac index and heart rate decreased within 10 minutes after bolus administration of TP. Noradrenaline infusion could be reduced to 0.7 μg/kg/minute within 5 hours. The goal in presenting this case was to evaluate the vasoconstrictor effects of TP, a long-acting vasopressin analogue, in septic shock.

Comparisons of Air Radiation Model with Shock Tube Measurements

NASA Technical Reports Server (NTRS)

Bose, Deepak; McCorkle, Evan; Bogdanoff, David W.; Allen, Gary A., Jr.

2009-01-01

This paper presents an assessment of the predictive capability of shock layer radiation model appropriate for NASA s Orion Crew Exploration Vehicle lunar return entry. A detailed set of spectrally resolved radiation intensity comparisons are made with recently conducted tests in the Electric Arc Shock Tube (EAST) facility at NASA Ames Research Center. The spectral range spanned from vacuum ultraviolet wavelength of 115 nm to infrared wavelength of 1400 nm. The analysis is done for 9.5-10.5 km/s shock passing through room temperature synthetic air at 0.2, 0.3 and 0.7 Torr. The comparisons between model and measurements show discrepancies in the level of background continuum radiation and intensities of atomic lines. Impurities in the EAST facility in the form of carbon bearing species are also modeled to estimate the level of contaminants and their impact on the comparisons. The discrepancies, although large is some cases, exhibit order and consistency. A set of tests and analyses improvements are proposed as forward work plan in order to confirm or reject various proposed reasons for the observed discrepancies.

Numerical modeling of an experimental shock tube for traumatic brain injury studies

NASA Astrophysics Data System (ADS)

Phillips, Michael; Regele, Jonathan D.

2015-11-01

Unfortunately, Improvised Explosive Devices (IEDs) are encountered commonly by both civilians and military soldiers throughout the world. Over a decade of medical history suggests that traumatic brain injury (TBI) may result from exposure to the blast waves created by these explosions, even if the person does not experience any immediate injury or lose consciousness. Medical researchers study the exposure of mice and rats to blast waves created in specially designed shock tubes to understand the effect on brain tissue. A newly developed table-top shock tube with a short driver section has been developed for mice experiments to reduce the time necessary to administer the blast radiation and increase the amount of statistical information available. In this study, numerical simulations of this shock tube are performed to assess how the blast wave takes its shape. The pressure profiles obtained from the numerical results are compared with the pressure histories from the experimental pressure transducers. The results show differences in behavior from what was expected, but the blast wave may still be an effective means of studying TBI.

Control of recollection by slow gamma dominating mid-frequency gamma in hippocampus CA1

PubMed Central

Dvorak, Dino; Radwan, Basma; Sparks, Fraser T.; Talbot, Zoe Nicole

2018-01-01

Behavior is used to assess memory and cognitive deficits in animals like Fmr1-null mice that model Fragile X Syndrome, but behavior is a proxy for unknown neural events that define cognitive variables like recollection. We identified an electrophysiological signature of recollection in mouse dorsal Cornu Ammonis 1 (CA1) hippocampus. During a shocked-place avoidance task, slow gamma (SG) (30–50 Hz) dominates mid-frequency gamma (MG) (70–90 Hz) oscillations 2–3 s before successful avoidance, but not failures. Wild-type (WT) but not Fmr1-null mice rapidly adapt to relocating the shock; concurrently, SG/MG maxima (SGdom) decrease in WT but not in cognitively inflexible Fmr1-null mice. During SGdom, putative pyramidal cell ensembles represent distant locations; during place avoidance, these are avoided places. During shock relocation, WT ensembles represent distant locations near the currently correct shock zone, but Fmr1-null ensembles represent the formerly correct zone. These findings indicate that recollection occurs when CA1 SG dominates MG and that accurate recollection of inappropriate memories explains Fmr1-null cognitive inflexibility. PMID:29346381

Methodology for assessing the effectiveness of access management techniques : executive summary.

DOT National Transportation Integrated Search

1998-09-14

A methodology for assessing the effectiveness of access management techniques on suburban arterial highways is developed. The methodology is described as a seven-step process as follows: (1) establish the purpose of the analysis (2) establish the mea...

Assessing importance and satisfaction judgments of intermodal work commuters with electronic survey methodology.

DOT National Transportation Integrated Search

2013-09-01

Recent advances in multivariate methodology provide an opportunity to further the assessment of service offerings in public transportation for work commuting. We offer methodologies that are alternative to direct rating scale and have advantages in t...

Extracorporeal membrane oxygenation for refractory septic shock in adults.

PubMed

Park, Taek Kyu; Yang, Jeong Hoon; Jeon, Kyeongman; Choi, Seung-Hyuk; Choi, Jin-Ho; Gwon, Hyeon-Cheol; Chung, Chi Ryang; Park, Chi Min; Cho, Yang Hyun; Sung, Kiick; Suh, Gee Young

2015-02-01

The role of extracorporeal membrane oxygenation (ECMO) remains controversial in adult patients with refractory septic shock. We sought to describe the clinical outcomes of adult patients supported by ECMO during septic shock refractory to conventional treatment. We analysed consecutive adult patients with refractory septic shock, assisted by an ECMO system between January 2005 and December 2013 in a single-centre registry. The primary outcome was survival to hospital discharge. A total of 32 patients (21 males) received ECMO support for refractory septic shock. Of these, 14 patients (43.8%) had undergone cardiopulmonary resuscitation (CPR) and 7 patients (21.9%) did not achieve the return of spontaneous circulation until initiation of ECMO flow. ECMO was weaned off successfully in 13 patients (40.6%) and 7 patients (21.9%) survived to hospital discharge. The survivors had lower peak lactate (4.5 vs 15.1 mmol/l, P = 0.03), lower Sepsis-related Organ Failure Assessment day 3 score (15 vs 18, P = 0.01) and higher peak troponin I (32.8 vs 3.7 ng/ml, P = 0.02) than the non-survivors. None of the patients (31.3%) in whom ECMO was initiated more than 30.5 h after onset of septic shock, survived. In multivariable-adjusted models, CPR [adjusted hazard ratio (HR), 4.61; 95% confidence interval (CI), 1.55-13.69; P = 0.006] was an independent predictor of in-hospital mortality after ECMO in patients with refractory septic shock. Higher peak troponin I > 15 ng/ml (adjusted HR, 0.34; 95% CI, 0.12-0.97; P = 0.04) was associated with a lower risk of in-hospital mortality. Survival to hospital discharge remained low in adult patients with refractory septic shock despite ECMO support. Our findings suggest that implantation of ECMO during refractory septic shock could be considered in patients with severe myocardial injury but should be avoided in patients who have received CPR. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Tracer methodology: an appropriate tool for assessing compliance with accreditation standards?

PubMed

Bouchard, Chantal; Jean, Olivier

2017-10-01

Tracer methodology has been used by Accreditation Canada since 2008 to collect evidence on the quality and safety of care and services, and to assess compliance with accreditation standards. Given the importance of this methodology in the accreditation program, the objective of this study is to assess the quality of the methodology and identify its strengths and weaknesses. A mixed quantitative and qualitative approach was adopted to evaluate consistency, appropriateness, effectiveness and stakeholder synergy in applying the methodology. An online questionnaire was sent to 468 Accreditation Canada surveyors. According to surveyors' perceptions, tracer methodology is an effective tool for collecting useful, credible and reliable information to assess compliance with Qmentum program standards and priority processes. The results show good coherence between methodology components (appropriateness of the priority processes evaluated, activities to evaluate a tracer, etc.). The main weaknesses are the time constraints faced by surveyors and management's lack of cooperation during the evaluation of tracers. The inadequate amount of time allowed for the methodology to be applied properly raises questions about the quality of the information obtained. This study paves the way for a future, more in-depth exploration of the identified weaknesses to help the accreditation organization make more targeted improvements to the methodology. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Published methodological quality of randomized controlled trials does not reflect the actual quality assessed in protocols.

PubMed

Mhaskar, Rahul; Djulbegovic, Benjamin; Magazin, Anja; Soares, Heloisa P; Kumar, Ambuj

2012-06-01

To assess whether the reported methodological quality of randomized controlled trials (RCTs) reflects the actual methodological quality and to evaluate the association of effect size (ES) and sample size with methodological quality. Systematic review. This is a retrospective analysis of all consecutive phase III RCTs published by eight National Cancer Institute Cooperative Groups up to 2006. Data were extracted from protocols (actual quality) and publications (reported quality) for each study. Four hundred twenty-nine RCTs met the inclusion criteria. Overall reporting of methodological quality was poor and did not reflect the actual high methodological quality of RCTs. The results showed no association between sample size and actual methodological quality of a trial. Poor reporting of allocation concealment and blinding exaggerated the ES by 6% (ratio of hazard ratio [RHR]: 0.94; 95% confidence interval [CI]: 0.88, 0.99) and 24% (RHR: 1.24; 95% CI: 1.05, 1.43), respectively. However, actual quality assessment showed no association between ES and methodological quality. The largest study to date shows that poor quality of reporting does not reflect the actual high methodological quality. Assessment of the impact of quality on the ES based on reported quality can produce misleading results. Copyright © 2012 Elsevier Inc. All rights reserved.

An improved approach for flight readiness certification: Methodology for failure risk assessment and application examples. Volume 2: Software documentation

NASA Technical Reports Server (NTRS)

Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.

1992-01-01

An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with engineering analysis to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in engineering analyses of failure phenomena, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which engineering analysis models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes, These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. Conventional engineering analysis models currently employed for design of failure prediction are used in this methodology. The PFA methodology is described and examples of its application are presented. Conventional approaches to failure risk evaluation for spaceflight systems are discussed, and the rationale for the approach taken in the PFA methodology is presented. The statistical methods, engineering models, and computer software used in fatigue failure mode applications are thoroughly documented.

An improved approach for flight readiness certification: Methodology for failure risk assessment and application examples, volume 1

NASA Technical Reports Server (NTRS)

Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.

1992-01-01

An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with engineering analysis to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in engineering analyses of failure phenomena, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which engineering analysis models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes. These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. Conventional engineering analysis models currently employed for design of failure prediction are used in this methodology. The PFA methodology is described and examples of its application are presented. Conventional approaches to failure risk evaluation for spaceflight systems are discussed, and the rationale for the approach taken in the PFA methodology is presented. The statistical methods, engineering models, and computer software used in fatigue failure mode applications are thoroughly documented.

How to choose the therapeutic goals to improve tissue perfusion in septic shock

PubMed Central

de Assuncao, Murillo Santucci Cesar; Corrêa, Thiago Domingos; Bravim, Bruno de Arruda; Silva, Eliézer

2015-01-01

The early recognition and treatment of severe sepsis and septic shock is the key to a successful outcome. The longer the delay in starting treatment, the worse the prognosis due to persistent tissue hypoperfusion and consequent development and worsening of organ dysfunction. One of the main mechanisms responsible for the development of cellular dysfunction is tissue hypoxia. The adjustments necessary for adequate tissue blood flow and therefore of oxygen supply to metabolic demand according to the assessment of the cardiac index and oxygen extraction rate should be performed during resuscitation period, especially in high complexity patients. New technologies, easily handled at the bedside, and new studies that directly assess the impact of macro-hemodynamic parameter optimization on microcirculation and in the clinical outcome of septic patients, are needed. PMID:26313438

An Assessment of Recent Results on Pseudo-Stationary Oblique-Shock-Wave Reflections.

DTIC Science & Technology

1982-11-01

DATE AIR FORCE OFFICE-OF SCIENTIFIC RESEARCH/NA November 1982 BOLLING A&B, DC 20332 13. NUMBER OF PAGES 1.MONITORING AGENCY NAME A AODRESS~if differennt...equilibrium gas analysis would not be required for shock Mach numbers MN9 in N2, M84 6 in 029 M <Sin air andMC3in CO.. Yetatheavailahle experimeAaldata in S...2’ CO and very recent results for air , which are based on the criterion (consistent with relaxation lengths) of angle 6. between the incident and

Modeling of turbulent separated flows for aerodynamic applications

NASA Technical Reports Server (NTRS)

Marvin, J. G.

1983-01-01

Steady, high speed, compressible separated flows modeled through numerical simulations resulting from solutions of the mass-averaged Navier-Stokes equations are reviewed. Emphasis is placed on benchmark flows that represent simplified (but realistic) aerodynamic phenomena. These include impinging shock waves, compression corners, glancing shock waves, trailing edge regions, and supersonic high angle of attack flows. A critical assessment of modeling capabilities is provided by comparing the numerical simulations with experiment. The importance of combining experiment, numerical algorithm, grid, and turbulence model to effectively develop this potentially powerful simulation technique is stressed.

FINDING A METHOD FOR THE MADNESS: A COMPARATIVE ANALYSIS OF STRATEGIC DESIGN METHODOLOGIES

DTIC Science & Technology

2017-06-01

FINDING A METHOD FOR THE MADNESS: A COMPARATIVE ANALYSIS OF STRATEGIC DESIGN METHODOLOGIES BY AMANDA DONNELLY A THESIS...work develops a comparative model for strategic design methodologies, focusing on the primary elements of vision, time, process, communication and...collaboration, and risk assessment. My analysis dissects and compares three potential design methodologies including, net assessment, scenarios and

Bleak Present, Bright Future: Online Episodic Future Thinking, Scarcity, Delay Discounting, and Food Demand.

PubMed

Sze, Yan Yan; Stein, Jeffrey S; Bickel, Warren K; Paluch, Rocco A; Epstein, Leonard H

2017-07-01

Obesity is associated with steep discounting of the future and increased food reinforcement. Episodic future thinking (EFT), a type of prospective thinking, has been observed to reduce delay discounting (DD) and improve dietary decision making. In contrast, negative income shock (i.e., abrupt transitions to poverty) has been shown to increase discounting and may worsen dietary decision-making. Scalability of EFT training and protective effects of EFT against simulated negative income shock on DD and demand for food were assessed. In two experiments we showed online-administered EFT reliably reduced DD. Furthermore, EFT reduced DD and demand for fast foods even when challenged by negative income shock. Our findings suggest EFT is a scalable intervention that has implications for improving public health by reducing discounting of the future and demand for high energy dense food.

Assessment of the effects of azimuthal mode number perturbations upon the implosion processes of fluids in cylinders

NASA Astrophysics Data System (ADS)

Lindstrom, Michael

2017-06-01

Fluid instabilities arise in a variety of contexts and are often unwanted results of engineering imperfections. In one particular model for a magnetized target fusion reactor, a pressure wave is propagated in a cylindrical annulus comprised of a dense fluid before impinging upon a plasma and imploding it. Part of the success of the apparatus is a function of how axially-symmetric the final pressure pulse is upon impacting the plasma. We study a simple model for the implosion of the system to study how imperfections in the pressure imparted on the outer circumference grow due to geometric focusing. Our methodology entails linearizing the compressible Euler equations for mass and momentum conservation about a cylindrically symmetric problem and analysing the perturbed profiles at different mode numbers. The linearized system gives rise to singular shocks and through analysing the perturbation profiles at various times, we infer that high mode numbers are dampened through the propagation. We also study the Linear Klein-Gordon equation in the context of stability of linear cylindrical wave formation whereby highly oscillatory, bounded behaviour is observed in a far field solution.

CFD on hypersonic flow geometries with aeroheating

NASA Astrophysics Data System (ADS)

Sohail, Muhammad Amjad; Chao, Yan; Hui, Zhang Hui; Ullah, Rizwan

2012-11-01

The hypersonic flowfield around a blunted cone and cone-flare exhibits some of the major features of the flows around space vehicles, e.g. a detached bow shock in the stagnation region and the oblique shock wave/boundary layer interaction at the cone-flare junction. The shock wave/boundary layer interaction can produce a region of separated flow. This phenomenon may occur, for example, at the upstream-facing corner formed by a deflected control surface on a hypersonic entry vehicle, where the length of separation has implications for control effectiveness. Computational fluid-dynamics results are presented to show the flowfield around a blunted cone and cone-flare configurations in hypersonic flow with separation. This problem is of particular interest since it features most of the aspects of the hypersonic flow around planetary entry vehicles. The region between the cone and the flare is particularly critical with respect to the evaluation of the surface pressure and heat flux with aeroheating. Indeed, flow separation is induced by the shock wave boundary layer interaction, with subsequent flow reattachment, that can dramatically enhance the surface heat transfer. The exact determination of the extension of the recirculation zone is a particularly delicate task for numerical codes. Laminar flow and turbulent computations have been carried out using a full Navier-Stokes solver, with freestream conditions provided by the experimental data obtained at Mach 6, 8, and 16.34 wind tunnel. The numerical results are compared with the measured pressure and surface heat flux distributions in the wind tunnel and a good agreement is found, especially on the length of the recirculation region and location of shock waves. The critical physics of entropy layer, boundary layers, boundary layers and shock wave interaction and flow behind shock are properly captured and elaborated.. Hypersonic flows are characterized by high Mach number and high total enthalpy. An elevated temperature often results in thermo-chemical reactions in the gas, which play a major role in aero thermodynamic characterization of high-speed aerospace vehicles. Computational simulation of such flows, therefore, needs to account for a range of physical phenomena. Further, the numerical challenges involved in resolving strong gradients and discontinuities add to the complexity of computational fluid dynamics (CFD) simulation. In this article, physical modeling and numerical methodology-related issues involved in hypersonic flow simulation are highlighted. State-of-the-art CFD challenges are discussed in the context of many prominent applications of hypersonic flows. In the first part of paper, hypersonic flow is simulated and aerodynamics characteristics are calculated. Then aero heating with chemical reactions are added in the simulations and in the end part heat transfer with turbulence modeling is simulated. Results are compared with available data.

10 CFR 766.102 - Calculation methodology.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Calculation methodology. 766.102 Section 766.102 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.102 Calculation methodology. (a...

10 CFR 766.102 - Calculation methodology.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Calculation methodology. 766.102 Section 766.102 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.102 Calculation methodology. (a...

10 CFR 766.102 - Calculation methodology.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Calculation methodology. 766.102 Section 766.102 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.102 Calculation methodology. (a...

10 CFR 766.102 - Calculation methodology.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Calculation methodology. 766.102 Section 766.102 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.102 Calculation methodology. (a...

Computational Analyses in Support of Sub-scale Diffuser Testing for the A-3 Facility. Part 2; Unsteady Analyses and Risk Assessment

NASA Technical Reports Server (NTRS)

Ahuja, Vineet; Hosangadi, Ashvin; Allgood, Daniel

2008-01-01

Simulation technology can play an important role in rocket engine test facility design and development by assessing risks, providing analysis of dynamic pressure and thermal loads, identifying failure modes and predicting anomalous behavior of critical systems. This is especially true for facilities such as the proposed A-3 facility at NASA SSC because of a challenging operating envelope linked to variable throttle conditions at relatively low chamber pressures. Design Support of the feasibility of operating conditions and procedures is critical in such cases due to the possibility of startup/shutdown transients, moving shock structures, unsteady shock-boundary layer interactions and engine and diffuser unstart modes that can result in catastrophic failure. Analyses of such systems is difficult due to resolution requirements needed to accurately capture moving shock structures, shock-boundary layer interactions, two-phase flow regimes and engine unstart modes. In a companion paper, we will demonstrate with the use of CFD, steady analyses advanced capability to evaluate supersonic diffuser and steam ejector performance in the sub-scale A-3 facility. In this paper we will address transient issues with the operation of the facility especially at startup and shutdown, and assess risks related to afterburning due to the interaction of a fuel rich plume with oxygen that is a by-product of the steam ejectors. The primary areas that will be addressed in this paper are: (1) analyses of unstart modes due to flow transients especially during startup/ignition, (2) engine safety during the shutdown process (3) interaction of steam ejectors with the primary plume i.e. flow transients as well as probability of afterburning. In this abstract we discuss unsteady analyses of the engine shutdown process. However, the final paper will include analyses of a staged startup, drawdown of the engine test cell pressure, and risk assessment of potential afterburning in the facility. Unsteady simulations have been carried out to study the engine shutdown process in the facility and understand the physics behind the interactions between the steam ejectors, the test cell and the supersonic diffuser. As a first approximation, to understand the dominant unsteady mechanisms in the engine test cell and the supersonic diffuser, the turning duct in the facility was removed. As the engine loses power a rarefaction wave travels downstream that disrupts the shock cell structure in the supersonic diffuser. Flow from the test cell is seen to expand into the supersonic diffuser section and re-pressurizes the area around the nozzle along with a upstream traveling compression wave that emanates from near the first stage ejectors. Flow from the first stage ejector expands to the center of the duct and a new shock train is formed between the first and second stage ejectors. Both stage ejectors keep the facility pressurized and prevent any large amplitude pressure fluctuations from affecting the engine nozzle. The resultant pressure loads the nozzle experiences in the shutdown process are small.

Validating a human model for anxiety using startle potentiated by cue and context: the effects of alprazolam, pregabalin, and diphenhydramine

PubMed Central

Mol, N.; Kenemans, J. L.; Prinssen, E. P.; Niklson, I.; Xia-Chen, C.; Broeyer, F.; van Gerven, J.

2009-01-01

Background Fear-potentiated startle has been suggested as a translational model for evaluating efficacy of anxiolytic compounds in humans. Several known anxiolytic compounds have been tested as well as several putative anxiolytics. Because results of these studies have been equivocal, the aim of the present study was to examine another pharmacological permutation of the human potentiated startle model by comparing two anxiolytic agents to a non-anxiolytic sedative and placebo. Methods Twenty healthy volunteers participated in a double-blind, placebo-controlled, cross-over study with four sessions in which they received single doses of the anxiolytics alprazolam (1 mg) and pregabalin (200 mg), as well as diphenhydramine (50 mg) as a non-anxiolytic sedative control and placebo. The design included a cued shock condition that presumably evokes fear and an unpredictable shock context condition presumably evoking anxiety. Results None of the treatments reliably reduced either fear- or anxiety-potentiated startle. Alprazolam and diphenhydramine reduced overall baseline startle. Alprazolam was found to only affect contextual anxiety in a statistical significant way after two subjects who failed to show a contextual anxiety effect in the placebo condition were excluded from the analysis. Pregabalin did not significantly affect any of the physiological measures. Discussion The negative findings from this study are discussed in terms of methodological differences between designs and in variability of startle both between and within study participants. Conclusion Even though fear-potentiated startle may be used to translate preclinical evidence to human populations, methodological issues still hamper the application of this model to early screening of putative anxiolytic drugs. PMID:19415242

[Mild therapeutic hypothermia in cardiogenic shock : Retrospective analysis of 80 patients with preclinical cardiac arrest due to cardiac causes].

PubMed

Adler, C; Pfister, R; Baldus, S; Reuter, H

2017-02-01

The mortality in patients with cardiogenic shock after out-of-hospital cardiac arrest (OHCA) remains high despite advances in resuscitation and early revascularization strategies. The use of mild therapeutic hypothermia (MTH) for improvement of survival and neurological outcome in patients with cardiogenic shock is currently subject to renewed discussion. The aim of this study was the detection of risk factors for mortality and morbidity in patients under MTH in cardiogenic shock following preclinical resuscitation for OHCA. A total of 80 consecutive patients in cardiogenic shock after successful resuscitation (mean age 60 ± 3.2 years) treated with MTH were retrospectively analyzed. Patients were cooled to 33 °C for 24 h using an endovascular cooling device. Neurological outcome was assessed after 2 months based on the Glasgow-Pittsburgh cerebral performance category (CPC) and correlated with various blood parameter values. After 2 months 31 patients (39 %) showed a good neurological recovery with CPC scores of 1-2, 20 patients (25 %) had a poor neurological outcome with CPC scores of 3-4 and 29 (36 %) patients enrolled in the trial died (CPC 5). Patients with a poor outcome showed significantly higher mean serum levels for lactate, creatinine and urea. In addition, these patients showed a continuous increase of serum neuron-specific enolase (NSE) values in contrast to patients with a good outcome (∆ NSE from admission to day 1, CPC 1 and 2: - 10.6 ± 3 µg/l and CPC 3-5: 33 ± 12 µg/l, p = 0.02). Changes in the course of serum creatinine, urea and NSE levels within the first 72 h after OHCA could provide valuable additional information for the early assessment of the neurological prognosis in patients treated with MTH.

Methodology for assessing the effectiveness of access management techniques : final report, September 14, 1998.

DOT National Transportation Integrated Search

1998-09-14

A methodology for assessing the effectiveness of access management techniques on suburban arterial highways is developed. The methodology is described as a seven-step process as follows: (1) establish the purpose of the analysis (2) establish the mea...

Shock Treatment: Using Immersive Digital Realism to Restage and Re-examine Milgram’s ‘Obedience to Authority’ Research

PubMed Central

Haslam, S. Alexander; Reicher, Stephen D.; Millard, Kathryn

2015-01-01

Attempts to revisit Milgram’s ‘Obedience to Authority’ (OtA) paradigm present serious ethical challenges. In recent years new paradigms have been developed to circumvent these challenges but none involve using Milgram’s own procedures and asking naïve participants to deliver the maximum level of shock. This was achieved in the present research by using Immersive Digital Realism (IDR) to revisit the OtA paradigm. IDR is a dramatic method that involves a director collaborating with professional actors to develop characters, the strategic withholding of contextual information, and immersion in a real-world environment. 14 actors took part in an IDR study in which they were assigned to conditions that restaged Milgrams’s New Baseline (‘Coronary’) condition and four other variants. Post-experimental interviews also assessed participants’ identification with Experimenter and Learner. Participants’ behaviour closely resembled that observed in Milgram’s original research. In particular, this was evidenced by (a) all being willing to administer shocks greater than 150 volts, (b) near-universal refusal to continue after being told by the Experimenter that “you have no other choice, you must continue” (Milgram’s fourth prod and the one most resembling an order), and (c) a strong correlation between the maximum level of shock that participants administered and the mean maximum shock delivered in the corresponding variant in Milgram’s own research. Consistent with an engaged follower account, relative identification with the Experimenter (vs. the Learner) was also a good predictor of the maximum shock that participants administered. PMID:25730318

Effects of Carnosine (Beta-Alanyl-L-Histidine) in an Experimental Rat Model of Acute Kidney Injury Due to Septic Shock

PubMed Central

Sahin, Sabiha; Donmez, Dilek Burukoglu

2018-01-01

Background Acute kidney injury (AKI) secondary to sepsis is a major cause of morbidity and mortality in the human intensive care unit (ICU). Kidney function and the histological findings of AKI were investigated in an experimental rat model with sepsis induced by cecal ligation and puncture (CLP) and compared with and without treatment with carnosine (beta-alanyl-L-histidine). Material/Methods Twenty-four Sprague-Dawley rats were randomly divided into three groups consisting eight rats in each: Group 1 – control; Group 2 – septic shock; and Group 3 – septic shock treated with carnosine. Femoral vein and artery catheterization were applied in all rats. Rats in Group 1 underwent laparotomy and catheterization. The other two groups with septic shock underwent laparotomy, CLP, catheterization, and bladder cannulation. Rats in Group 3 received an intraperitoneal (IP) injection of 250 mg/kg carnosine, 60 min following CLP. Rats were monitored for blood pressure, pulse rate, and body temperature to assess responses to postoperative sepsis, and 10 mL/kg saline replacement was administered. Twenty-four hours following CLP, rats were sacrificed, and blood and renal tissue samples were collected. Results Statistically significant improvements were observed in kidney function, tissue and serum malondialdehyde levels, routine blood values, biochemical indices, and in histopathological findings in rats in Group 3 who were treated with carnosine, compared with Group 2 exposed to septic shock without carnosine treatment. Conclusions Carnosine (beta-alanyl-L-histidine) has been shown to have beneficial effects in reducing AKI due to septic shock in a rat model of septicemia. PMID:29334583

PROTOPLANETARY DISK HEATING AND EVOLUTION DRIVEN BY SPIRAL DENSITY WAVES

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

Rafikov, Roman R., E-mail: rrr@ias.edu

2016-11-10

Scattered light imaging of protoplanetary disks often reveals prominent spiral arms, likely excited by massive planets or stellar companions. Assuming that these arms are density waves, evolving into spiral shocks, we assess their effect on the thermodynamics, accretion, and global evolution of the disk. We derive analytical expressions for the direct (irreversible) heating, angular momentum transport, and mass accretion rate induced by disk shocks of arbitrary amplitude. These processes are very sensitive to the shock strength. We show that waves of moderate strength (density jump at the shock ΔΣ/Σ ∼ 1) result in negligible disk heating (contributing at the ∼1%more » level to the energy budget) in passive, irradiated protoplanetary disks on ∼100 au scales, but become important within several au. However, shock heating is a significant (or even dominant) energy source in disks of cataclysmic variables, stellar X-ray binaries, and supermassive black hole binaries, heated mainly by viscous dissipation. Mass accretion induced by the spiral shocks is comparable to (or exceeds) the mass inflow due to viscous stresses. Protoplanetary disks featuring prominent global spirals must be evolving rapidly, in ≲0.5 Myr at ∼100 au. A direct upper limit on the evolution timescale can be established by measuring the gravitational torque due to the spiral arms from the imaging data. We find that, regardless of their origin, global spiral waves must be important agents of the protoplanetary disk evolution. They may serve as an effective mechanism of disk dispersal and could be related to the phenomenon of transitional disks.« less

Health shocks adversely impact participation in the labour force in a working age population: a longitudinal analysis.

PubMed

Carter, Kristie N; Gunasekara, Fiona Imlach; Blakely, Tony; Richardson, Ken

2013-06-01

It is well understood that health affects labour force participation (LFP). However, much of the published research has been on older (retiring age) populations and using subjective health measures. This paper aims to assess the impact of an objective measure of 'health shock' (cancer registration or hospitalisation) on LFP in a working age population using longitudinal panel study data and fixed effect regression analyses. Seven waves of data from 2002-09 from the longitudinal Survey of Family, Income and Employment (SoFIE) were used, including working aged individuals who consented to have their survey information linked to health records (n=6,780). Fixed effect conditional logistic regression was used to model the impact of health shocks (hospitalisation or cancer registration) in the previous year on labour force participation at date of annual interview. Models were stratified by gender, age group (25-39 years, 40-54 years) and gender by age group. A health shock was associated with a significantly increased risk of subsequent non-participation in the labour force (odds ratio 1.54, 95%CI 1.30-1.82). Although interactions of age, sex and age by sex with health shock were not statistically significant, the association was largest in younger men and women. Using an objective measure of health, we have shown that a health shock adversely affects subsequent labour force participation. There are a number of policy and practice implications relating to support for working age people who have hospitalisations. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Interaction between a pulsating jet and a surrounding disk wind. A hydrodynamical perspective

NASA Astrophysics Data System (ADS)

Tabone, B.; Raga, A.; Cabrit, S.; Pineau des Forêts, G.

2018-06-01

Context. The molecular richness of fast protostellar jets within 20-100 au of their source, despite strong ultraviolet irradiation, remains a challenge for the models investigated so far. Aim.We aim to investigate the effect of interaction between a time-variable jet and a surrounding steady disk wind, to assess the possibility of jet chemical enrichement by the wind, and the characteristic signatures of such a configuration. Methods: We have constructed an analytic model of a jet bow shock driven into a surrounding slower disk wind in the thin shell approximation. The refilling of the post bow shock cavity from below by the disk wind is also studied. An extension of the model to the case of two or more successive internal working surfaces (IWS) is made. We then compared this analytic model with numerical simulations with and without a surrounding disk wind. Results: We find that at early times (of order the variability period), jet bow shocks travel in refilled pristine disk wind material, before interacting with the cocoon of older bow shocks. This opens the possibility of bow shock chemical enrichment (if the disk wind is molecular and dusty) and of probing the unperturbed disk wind structure near the jet base. Several distinctive signatures of the presence of a surrounding disk wind are identified, in the bow shock morphology and kinematics. Numerical simulations validate our analytical approach and further show that at large scale, the passage of many jet IWS inside a disk wind produces a stationary V-shaped cavity, closing down onto the axis at a finite distance from the source.

Enhancement of the Effectiveness of Extracorporeal Shock Wave Therapy with Topical Corticosteroid in Treatment of Chronic Plantar Fasciitis: A Randomized Control Clinical Trial

PubMed Central

Vahdatpour, Babak; Mokhtarian, Arghavan; Raeissadat, Seyed Ahmad; Dehghan, Farnaz; Nasr, Nafiseh; Mazaheri, Mahsa

2018-01-01

Background: Chronic recalcitrant plantar fasciitis is a disabling condition. We presumed if shock wave could increase the permeability of skin and facilitate penetration of topical corticosteroid through the skin; the combinational therapeutic effect would be stronger than using shock wave alone. The study purpose was to utilize the synergistic effect of shock wave and topical corticosteroid in treatment of plantar fasciitis. Materials and Methods: Patients in both groups (n = 40) received four sessions of shock wave with the same protocol at weekly intervals. At 30 min before each session, we used an occlusive dressing of topical clobetasol for the intervention group and Vaseline oil for the control group. Pain severity was assessed with visual analog scale (VAS) and modified Roles and Maudsley score (RMS) at baseline and 1 month and 3 months after intervention. Plantar fascia (PF) thickness was measured with ultrasonography at baseline and 3 months after intervention. Results: One month after intervention, VAS morning showed significant improvement in intervention group (P = 0.006) and RMS showed better improvement in intervention group (P = 0.026). There was no significant difference between the two groups after 3 months in RMS or VAS score. PF thickness was decreased significantly in both groups, but it was not significant between the two groups (P = 0.292). Conclusions: This combinational therapy yielded earlier pain reduction and functional improvement than using shock wave alone; topical corticosteroid could enhance the effectiveness of shockwave in short-term in the treatment of recalcitrant plantar fasciitis. PMID:29862211

Enhancement of the Effectiveness of Extracorporeal Shock Wave Therapy with Topical Corticosteroid in Treatment of Chronic Plantar Fasciitis: A Randomized Control Clinical Trial.

PubMed

Vahdatpour, Babak; Mokhtarian, Arghavan; Raeissadat, Seyed Ahmad; Dehghan, Farnaz; Nasr, Nafiseh; Mazaheri, Mahsa

2018-01-01

Chronic recalcitrant plantar fasciitis is a disabling condition. We presumed if shock wave could increase the permeability of skin and facilitate penetration of topical corticosteroid through the skin; the combinational therapeutic effect would be stronger than using shock wave alone. The study purpose was to utilize the synergistic effect of shock wave and topical corticosteroid in treatment of plantar fasciitis. Patients in both groups ( n = 40) received four sessions of shock wave with the same protocol at weekly intervals. At 30 min before each session, we used an occlusive dressing of topical clobetasol for the intervention group and Vaseline oil for the control group. Pain severity was assessed with visual analog scale (VAS) and modified Roles and Maudsley score (RMS) at baseline and 1 month and 3 months after intervention. Plantar fascia (PF) thickness was measured with ultrasonography at baseline and 3 months after intervention. One month after intervention, VAS morning showed significant improvement in intervention group ( P = 0.006) and RMS showed better improvement in intervention group ( P = 0.026). There was no significant difference between the two groups after 3 months in RMS or VAS score. PF thickness was decreased significantly in both groups, but it was not significant between the two groups ( P = 0.292). This combinational therapy yielded earlier pain reduction and functional improvement than using shock wave alone; topical corticosteroid could enhance the effectiveness of shockwave in short-term in the treatment of recalcitrant plantar fasciitis.

Role of DNA protection and repair in resistance of Bacillus subtilis spores to ultrahigh shock pressures simulating hypervelocity impacts.

PubMed

Moeller, Ralf; Horneck, Gerda; Rabbow, Elke; Reitz, Günther; Meyer, Cornelia; Hornemann, Ulrich; Stöffler, Dieter

2008-11-01

Impact-induced ejections of rocks from planetary surfaces are frequent events in the early history of the terrestrial planets and have been considered as a possible first step in the potential interplanetary transfer of microorganisms. Spores of Bacillus subtilis were used as a model system to study the effects of a simulated impact-caused ejection on rock-colonizing microorganisms using a high-explosive plane wave setup. Embedded in different types of rock material, spores were subjected to extremely high shock pressures (5 to 50 GPa) lasting for fractions of microseconds to seconds. Nearly exponential pressure response curves were obtained for spore survival and linear dependency for the induction of sporulation-defective mutants. Spores of strains defective in major small, acid-soluble spore proteins (SASP) (alpha/beta-type SASP) that largely protect the spore DNA and spores of strains deficient in nonhomologous-end-joining DNA repair were significantly more sensitive to the applied shock pressure than were wild-type spores. These results indicate that DNA may be the sensitive target of spores exposed to ultrahigh shock pressures. To assess the nature of the critical physical parameter responsible for spore inactivation by ultrahigh shock pressures, the resulting peak temperature was varied by lowering the preshock temperature, changing the rock composition and porosity, or increasing the water content of the samples. Increased peak temperatures led to increased spore inactivation and reduced mutation rates. The data suggested that besides the potential mechanical stress exerted by the shock pressure, the accompanying high peak temperatures were a critical stress parameter that spores had to cope with.

Effects of lesions to the dorsal noradrenergic bundle on counterconditioning of punished barpressing.

PubMed

Tsaltas, E; Gray, J A; Preston, G C

1987-01-01

The possible contribution of the dorsal noradrenergic bundle (DB) to the development of a simple form of counterconditioning (an associative mechanism leading to behavioural tolerance for stress) was assessed by comparison of the performance of animals with 6-hydroxydopamine-induced lesions of the DB to that of sham-operated (SH) animals. Animals engaging in barpressing for food reward on a random-interval (RI) 64 sec schedule were presented with a stimulus signalling the concurrent operation of an RI-64 sec schedule of response-contingent shock. In the control condition (punishment), shock and reward never occurred as a result of the same barpress. In the experimental condition (counterconditioning), the frequency of shock and reward were the same as for the punishment condition but the two events always occurred in succession, with food following shock, as a consequence of the same barpress. DB lesions had no effect on the acquisition of rewarded barpressing or on the initial acquisition of the discrimination between the shock-free and shock-containing (signalled) components of the schedule. However, once performance on the discrimination had reached asymptote, DB animals in the punishment control group showed significantly less suppression to the signal than SH animals. The counterconditioning schedule used was effective, leading to significantly reduced response suppression in the SH animals in comparison to the SH group subjected to punishment. The pattern of findings in the DB groups was consistent with a blockade by the lesion of the development of counterconditioning. These results suggest, therefore, that the DB is involved in at least one associative mechanism leading to tolerance for stress.

Architecture, Design, and System; Performance Assessment and Development Methodology for Computer-Based Systems. Volume 1. Methodology Description, Discussion, and Assessment,

DTIC Science & Technology

1983-12-30

AD-Ri46 57? ARCHITECTURE DESIGN AND SYSTEM; PERFORMANCE ASSESSMENT i/i AND DEVELOPMENT ME..(U) NAVAL SURFACE WEAPONS CENTER SILYER SPRING MD J...AD-A 146 577 NSIWC TR 83-324 ARCHITECTURE , DESIGN , AND SYSTEM; PERFORMANCE ASSESSMENT AND DEVELOPMENT METHODOLOGY...REPORT NUMBER 12. GOVT ACCESSION NO.3. RECIPIENT’S CATALOG NUMBER NSWC TR 83-324 10- 1 1 51’ 4. ?ITLE (and subtitle) ARCHITECTURE , DESIGN , AND SYSTEM; S

Global Omori law decay of triggered earthquakes: large aftershocks outside the classical aftershock zone

USGS Publications Warehouse

Parsons, Tom

2002-01-01

Triggered earthquakes can be large, damaging, and lethal as evidenced by the 1999 shocks in Turkey and the 2001 earthquakes in El Salvador. In this study, earthquakes with Ms ≥ 7.0 from the Harvard centroid moment tensor (CMT) catalog are modeled as dislocations to calculate shear stress changes on subsequent earthquake rupture planes near enough to be affected. About 61% of earthquakes that occurred near (defined as having shear stress change ∣Δτ∣ ≥ 0.01 MPa) the Ms ≥ 7.0 shocks are associated with calculated shear stress increases, while ∼39% are associated with shear stress decreases. If earthquakes associated with calculated shear stress increases are interpreted as triggered, then such events make up at least 8% of the CMT catalog. Globally, these triggered earthquakes obey an Omori law rate decay that lasts between ∼7–11 years after the main shock. Earthquakes associated with calculated shear stress increases occur at higher rates than background up to 240 km away from the main shock centroid. Omori's law is one of the few time-predictable patterns evident in the global occurrence of earthquakes. If large triggered earthquakes habitually obey Omori's law, then their hazard can be more readily assessed. The characteristic rate change with time and spatial distribution can be used to rapidly assess the likelihood of triggered earthquakes following events of Ms ≥ 7.0. I show an example application to the M = 7.7 13 January 2001 El Salvador earthquake where use of global statistics appears to provide a better rapid hazard estimate than Coulomb stress change calculations.