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Sample records for intermittent negative pressure

  1. Evaluation of continuous and intermittent myocardial topical negative pressure

    DEFF Research Database (Denmark)

    Lindstedt, Sandra; Malmsjö, Malin; Gesslein, Bodil

    2008-01-01

    Topical negative pressure, commonly used in wound therapy, has been shown to increase blood flow and stimulate angiogenesis in subcutaneous tissue and skeletal muscle. In wound therapy, intermittent negative pressure is often preferred to continuous negative pressure as tissue exposed to intermit...

  2. Intermittent negative pressure wound therapy with instillation for the treatment of persistent periprosthetic hip infections: a report of two cases

    Directory of Open Access Journals (Sweden)

    Söylemez MS

    2016-02-01

    Full Text Available Mehmet Salih Söylemez,1 Korhan Özkan,2 Bülent Kılıç,3 Samet Erinç41Department of Orthopaedics and Traumatology, Bingöl State Hospital, Bingöl, 2Department of Orthopaedics and Traumatology, Faculty of Medicine, Medeniyet University, Istanbul, 3Department of Orthopaedics and Traumatology, Orthopaedic Surgery Clinic, Istanbul Gelişim University, Tekirdağ, 4Department of Orthopaedics and Traumatology, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, TurkeyAbstract: Intermittent negative pressure wound therapy with instillation (NPWTi is starting to be used successfully to treat early periprosthetic infections of endoprostheses. However, few articles have reported the outcome of treatment with intermittent NPWTi for late persistent periprosthetic infections of the hip. In this study, we report two cases who underwent several rounds of radical wound debridement for the treatment of a late persistent periprosthetic infection of the hip. Intermittent NPWTi was used in both cases. Patients were treated successfully and there was no recurrence after 3 and 1 years of follow-up, respectively.Keywords: negative pressure, vacuum-assisted, periprosthetic infection, hip

  3. The acute effects of lower limb intermittent negative pressure on foot macro- and microcirculation in patients with peripheral arterial disease.

    Directory of Open Access Journals (Sweden)

    Øyvind Heiberg Sundby

    Full Text Available Intermittent negative pressure (INP applied to the lower leg and foot increases foot perfusion in healthy volunteers. The aim of the present study was to describe the effects of INP to the lower leg and foot on foot macro- and microcirculation in patients with lower extremity peripheral arterial disease (PAD.In this experimental study, we analyzed foot circulation during INP in 20 patients [median (range: 75 (63-84yrs] with PAD. One leg was placed inside an air-tight vacuum chamber connected to an INP-generator. During application of INP (alternating 10s of -40mmHg/7s of atmospheric pressure, we continuously recorded blood flow velocity in a distal foot artery (ultrasound Doppler, skin blood flow on the pulp of the first toes (laser Doppler, heart rate (ECG, and systemic blood pressure (Finometer. After a 5-min baseline sequence (no pressure, a 10-min INP sequence was applied, followed by 5-min post-INP (no pressure. To compare and quantify blood flow fluctuations between sequences, we calculated cumulative up-and-down fluctuations in arterial blood flow velocity per minute.Onset of INP induced an increase in arterial flow velocity and skin blood flow. Peak blood flow velocity was reached 3s after the onset of negative pressure, and increased 46% [(95% CI 36-57, P<0.001] above baseline. Peak skin blood flow was reached 2s after the onset of negative pressure, and increased 89% (95% CI 48-130, P<0.001 above baseline. Cumulative fluctuations per minute were significantly higher during INP-sequences compared to baseline [21 (95% CI 12-30cm/s/min to 41 (95% CI 32-51cm/s/min, P<0.001]. Mean INP blood flow velocity increased significantly ~12% above mean baseline blood flow velocity [(6.7 (95% CI 5.2-8.3cm/s to 7.5 (95% CI 5.9-9.1cm/s, P = 0.03].INP increases foot macro- and microcirculatory flow pulsatility in patients with PAD. Additionally, application of INP resulted in increased mean arterial blood flow velocity.

  4. The effects of intermittent negative pressure on the lower extremities' peripheral circulation and wound healing in four patients with lower limb ischemia and hard-to-heal leg ulcers: a case report.

    Science.gov (United States)

    Sundby, Øyvind H; Høiseth, Lars Ø; Mathiesen, Iacob; Jørgensen, Jørgen J; Sundhagen, Jon O; Hisdal, Jonny

    2016-10-01

    Peripheral circulation is severely compromised in the advanced stages of peripheral arterial disease. Recently, it was shown that the application of -40 mmHg intermittent negative pressure (INP) to the lower leg and foot enhances macro- and microcirculation in healthy volunteers. In this case report, we describe the effects of INP treatment on four patients with lower limb ischemia and hard-to-heal leg and foot ulcers. We hypothesized that INP therapy may have beneficial hemodynamic and clinical effects in the patients. Four patients (age range: 61-79 years) with hard-to-heal leg and foot ulcers (6-24 months) and ankle-brachial pressure indices of ≤0.60 on the affected side were included. They were treated with an 8-week intervention period of -40 mmHg INP (10 sec negative pressure and 7 sec atmospheric pressure) on the lower limbs. A custom-made vacuum chamber was used to apply INP to the affected lower leg and foot for 2 h per day. After 8 weeks of INP therapy, one ulcer healed completely, while the other three ulcers were almost completely healed. These cases suggest that INP may facilitate wound healing. The theoretical foundation is that INP assists wound healing by improving blood flow to the small blood vessels in the affected limb, increasing the flow of oxygen and nutrients to the cells. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  5. Thermodynamics of negative absolute pressures

    International Nuclear Information System (INIS)

    Lukacs, B.; Martinas, K.

    1984-03-01

    The authors show that the possibility of negative absolute pressure can be incorporated into the axiomatic thermodynamics, analogously to the negative absolute temperature. There are examples for such systems (GUT, QCD) processing negative absolute pressure in such domains where it can be expected from thermodynamical considerations. (author)

  6. Randomized, controlled trial comparing synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in preterm infants.

    Science.gov (United States)

    Reyes, Zenaida C; Claure, Nelson; Tauscher, Markus K; D'Ugard, Carmen; Vanbuskirk, Silvia; Bancalari, Eduardo

    2006-10-01

    Prolonged mechanical ventilation is associated with lung injury in preterm infants. In these infants, weaning from synchronized intermittent mandatory ventilation may be delayed by their inability to cope with increased respiratory loads. The addition of pressure support to synchronized intermittent mandatory ventilation can offset these loads and may facilitate weaning. The purpose of this work was to compare synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in weaning from mechanical ventilation and the duration of supplemental oxygen dependency in preterm infants with respiratory failure. Preterm infants weighing 500 to 1000 g at birth who required mechanical ventilation during the first postnatal week were randomly assigned to synchronized intermittent mandatory ventilation or synchronized intermittent mandatory ventilation plus pressure support. In both groups, weaning followed a set protocol during the first 28 days. Outcomes were assessed during the first 28 days and until discharge or death. There were 107 infants enrolled (53 synchronized intermittent mandatory ventilation plus pressure support and 54 synchronized intermittent mandatory ventilation). Demographic and perinatal data, mortality, and morbidity did not differ between groups. During the first 28 days, infants in the synchronized intermittent mandatory ventilation plus pressure support group reached minimal ventilator settings and were extubated earlier than infants in the synchronized intermittent mandatory ventilation group. Total duration of mechanical ventilation, duration of oxygen dependency, and oxygen need at 36 weeks' postmenstrual age alone or combined with death did not differ between groups. However, infants in synchronized intermittent mandatory ventilation plus pressure support within the 700- to 1000-g birth weight strata had a shorter oxygen dependency. The results of this study suggest that the addition of

  7. Beneficial effects of intermittent suction and pressure treatment in intermittent claudication

    DEFF Research Database (Denmark)

    Mehlsen, J; Himmelstrup, H; Himmelstrup, Bodil

    1993-01-01

    administration. The treatment caused significant increments in the ADP thresholds for platelet aggregation, while the effects on fibrinolysis were uncertain. It is concluded that intermittent suction and pressure treatment offers a new approach for conservative treatment of intermittent claudication....... participated in an open trial investigating the possible effects of the treatment on platelet aggregation and fibrinolysis. Pain-free and maximal walking distances were measured on a treadmill, and systolic blood pressure was measured on the upper limb, the ankle, and the first toe bilaterally. The threshold...... for adenosine diphosphate (ADP)-induced platelet aggregation was tested, and the fibrinolytic activity was estimated from the euglobulin clot lysis time. Active treatment resulted in significant improvements in pain-free and maximal walking distances, whereas no changes could be found during placebo...

  8. Intermittent pressure decreases human keratinocyte proliferation in vitro.

    Science.gov (United States)

    Nasca, Maria R; Shih, Alan T; West, Dennis P; Martinez, Wanda M; Micali, Giuseppe; Landsman, Adam S

    2007-01-01

    The aim of this study was to investigate the correlation between pressure changes and keratinocyte proliferation by determining whether keratinocytes exposed to altered mechanical pressures would proliferate at different rates compared to control cells not subjected to pressure changes. Tissue culture flasks of human keratinocytes plated at an approximate density of 15,000 cells/cm(2) undergoing an intermittent cyclic pressure of 362 mm Hg at a frequency of 2.28 or 5.16 cycles/min (0.038 or 0.086 Hz) for 8 h were compared to control flasks grown at ambient room pressure. An in-line pressure transducer was used to monitor and adjust pressure within the cell chambers, using a solenoid valve. A thymidine incorporation assay assessed the amount of cell proliferation in each set of experiments. Differences in proliferation between keratinocytes subjected to cyclic pressure changes and control cells were found to be statistically significant (p < 0.05) in 4 out of 5 proliferation assays. Also, a higher frequency of pressure changes consistently generated a reduced proliferation rate compared to that seen in cells exposed to a lower frequency of pressure changes. These data indicate that keratinocytes undergoing intermittent pressure changes exhibit decreased proliferation rates compared to controls. Furthermore, an increased frequency rate seems to have a greater effect on proliferation than low-frequency rate pressure changes, suggesting that the stress caused by frequently changed pressure may play a greater role in reducing keratinocyte proliferation than the actual magnitude of load applied to the cells. Our results support the current treatment protocol of reducing speed and duration of walking on the site of the wound to promote healing of foot ulcers. (c) 2007 S. Karger AG, Basel.

  9. Negative-Pressure Pulmonary Edema.

    Science.gov (United States)

    Bhattacharya, Mallar; Kallet, Richard H; Ware, Lorraine B; Matthay, Michael A

    2016-10-01

    Negative-pressure pulmonary edema (NPPE) or postobstructive pulmonary edema is a well-described cause of acute respiratory failure that occurs after intense inspiratory effort against an obstructed airway, usually from upper airway infection, tumor, or laryngospasm. Patients with NPPE generate very negative airway pressures, which augment transvascular fluid filtration and precipitate interstitial and alveolar edema. Pulmonary edema fluid collected from most patients with NPPE has a low protein concentration, suggesting hydrostatic forces as the primary mechanism for the pathogenesis of NPPE. Supportive care should be directed at relieving the upper airway obstruction by endotracheal intubation or cricothyroidotomy, institution of lung-protective positive-pressure ventilation, and diuresis unless the patient is in shock. Resolution of the pulmonary edema is usually rapid, in part because alveolar fluid clearance mechanisms are intact. In this review, we discuss the clinical presentation, pathophysiology, and management of negative-pressure or postobstructive pulmonary edema. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  10. Inspiratory time and tidal volume during intermittent positive pressure ventilation.

    OpenAIRE

    Field, D; Milner, A D; Hopkin, I E

    1985-01-01

    We measured the tidal volume achieved during intermittent positive pressure ventilation using various inspiratory times with a minimum of 0.2 seconds. Results indicate that tidal volume shows no reduction with inspiratory times down to 0.4 seconds. An inspiratory time of 0.3 seconds, however, is likely to reduce tidal volume by 8%, and at 0.2 seconds a 22% fall may be anticipated.

  11. Peripheral Chemoreception and Arterial Pressure Responses to Intermittent Hypoxia

    OpenAIRE

    Prabhakar, Nanduri R.; Peng, Ying-Jie; Kumar, Ganesh K.; Nanduri, Jayasri

    2015-01-01

    Carotid bodies are the principal peripheral chemoreceptors for detecting changes in arterial blood oxygen levels, and the resulting chemoreflex is a potent regulator of blood pressure. Recurrent apnea with intermittent hypoxia (IH) is a major clinical problem in adult humans and infants born preterm. Adult patients with recurrent apnea exhibit heightened sympathetic nerve activity and hypertension. Adults born preterm are predisposed to early onset of hypertension. Available evidence suggests...

  12. Incisional Negative Pressure Wound Therapy

    DEFF Research Database (Denmark)

    Hyldig, Nana

    the rate of surgical wound infection and wound exudate post-caesarean and that wound infection had a negative impact on quality of life one month after surgery. Alongside the clinical trial, a trial-based cost-effectiveness analysis demonstrated that the treatment is cost-effective in a high......Women with a pre-gestational body mass index (BMI) above 30 kg/m2 giving birth by caesarean section are at high risk of surgical wound infection compared with women with a BMI below 30 kg/m2. Incisional Negative Pressure Wound Therapy (iNPWT) is one strategy to reduce the rate of surgical wound...... a randomised controlled trial in two tertiary and three teaching hospitals in three regions of Denmark, the Happy Belly Study, investigating the effectiveness of iNPWT in a population of obese women after caesarean section. The Happy Belly Study has demonstrated that prophylactic iNPWT significantly reduced...

  13. Pressure Autoregulation Measurement Techniques in Adult Traumatic Brain Injury, Part I: A Scoping Review of Intermittent/Semi-Intermittent Methods.

    Science.gov (United States)

    Zeiler, Frederick A; Donnelly, Joseph; Calviello, Leanne; Menon, David K; Smielewski, Peter; Czosnyka, Marek

    2017-12-01

    The purpose of this study was to perform a systematic, scoping review of commonly described intermittent/semi-intermittent autoregulation measurement techniques in adult traumatic brain injury (TBI). Nine separate systematic reviews were conducted for each intermittent technique: computed tomographic perfusion (CTP)/Xenon-CT (Xe-CT), positron emission tomography (PET), magnetic resonance imaging (MRI), arteriovenous difference in oxygen (AVDO 2 ) technique, thigh cuff deflation technique (TCDT), transient hyperemic response test (THRT), orthostatic hypotension test (OHT), mean flow index (Mx), and transfer function autoregulation index (TF-ARI). MEDLINE ® , BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library (inception to December 2016), and reference lists of relevant articles were searched. A two tier filter of references was conducted. The total number of articles utilizing each of the nine searched techniques for intermittent/semi-intermittent autoregulation techniques in adult TBI were: CTP/Xe-CT (10), PET (6), MRI (0), AVDO 2 (10), ARI-based TCDT (9), THRT (6), OHT (3), Mx (17), and TF-ARI (6). The premise behind all of the intermittent techniques is manipulation of systemic blood pressure/blood volume via either chemical (such as vasopressors) or mechanical (such as thigh cuffs or carotid compression) means. Exceptionally, Mx and TF-ARI are based on spontaneous fluctuations of cerebral perfusion pressure (CPP) or mean arterial pressure (MAP). The method for assessing the cerebral circulation during these manipulations varies, with both imaging-based techniques and TCD utilized. Despite the limited literature for intermittent/semi-intermittent techniques in adult TBI (minus Mx), it is important to acknowledge the availability of such tests. They have provided fundamental insight into human autoregulatory capacity, leading to the development of continuous and more commonly applied techniques in the intensive care unit (ICU). Numerous methods of

  14. Peripheral Chemoreception and Arterial Pressure Responses to Intermittent Hypoxia

    Science.gov (United States)

    Prabhakar, Nanduri R.; Peng, Ying-Jie; Kumar, Ganesh K.; Nanduri, Jayasri

    2015-01-01

    Carotid bodies are the principal peripheral chemoreceptors for detecting changes in arterial blood oxygen levels, and the resulting chemoreflex is a potent regulator of blood pressure. Recurrent apnea with intermittent hypoxia (IH) is a major clinical problem in adult humans and infants born preterm. Adult patients with recurrent apnea exhibit heightened sympathetic nerve activity and hypertension. Adults born preterm are predisposed to early onset of hypertension. Available evidence suggests that carotid body chemoreflex contributes to hypertension caused by IH in both adults and neonates. Experimental models of IH provided important insights into cellular and molecular mechanisms underlying carotid body chemoreflex-mediated hypertension. This article provides a comprehensive appraisal of how IH affects carotid body function, underlying cellular, molecular, and epigenetic mechanisms, and the contribution of chemoreflex to the hypertension. PMID:25880505

  15. Peripheral chemoreception and arterial pressure responses to intermittent hypoxia.

    Science.gov (United States)

    Prabhakar, Nanduri R; Peng, Ying-Jie; Kumar, Ganesh K; Nanduri, Jayasri

    2015-04-01

    Carotid bodies are the principal peripheral chemoreceptors for detecting changes in arterial blood oxygen levels, and the resulting chemoreflex is a potent regulator of blood pressure. Recurrent apnea with intermittent hypoxia (IH) is a major clinical problem in adult humans and infants born preterm. Adult patients with recurrent apnea exhibit heightened sympathetic nerve activity and hypertension. Adults born preterm are predisposed to early onset of hypertension. Available evidence suggests that carotid body chemoreflex contributes to hypertension caused by IH in both adults and neonates. Experimental models of IH provided important insights into cellular and molecular mechanisms underlying carotid body chemoreflex-mediated hypertension. This article provides a comprehensive appraisal of how IH affects carotid body function, underlying cellular, molecular, and epigenetic mechanisms, and the contribution of chemoreflex to the hypertension. © 2015 American Physiological Society.

  16. Negative Pressure Wound Therapy in Maxillofacial Applications

    Directory of Open Access Journals (Sweden)

    Adam J. Mellott

    2016-09-01

    Full Text Available Negative pressure wound therapy has greatly advanced the field of wound healing for nearly two decades, by providing a robust surgical adjunct technique for accelerating wound closure in acute and chronic wounds. However, the application of negative pressure wound therapy in maxillofacial applications has been relatively under utilized as a result of the physical articulations and contours of the head and neck that make it challenging to obtain an airtight seal for different negative pressure wound therapy systems. Adapting negative pressure wound therapies for maxillofacial applications could yield significant enhancement of wound closure in maxillofacial applications. The current review summarizes the basic science underlying negative pressure wound therapy, as well as specific maxillofacial procedures that could benefit from negative pressure wound therapy.

  17. Negative pressure pulmonary oedema after septoplasty.

    Science.gov (United States)

    García de Hombre, Alina M; Cuffini, Alejandro; Bonadeo, Alejandro

    2013-01-01

    Negative pressure pulmonary oedema (NPPO) is an anaesthetic complication due to acute obstruction of the upper airway, whose main cause is laryngospasm. The pathophysiology involves a strong negative intrapleural pressure during inspiration against a closed glottis, which triggers excessive pressure in the pulmonary microvasculature. Although its diagnosis can be difficult, its recognition helps to minimise morbidity and mortality. This article presents a case of NPPO due to postextubation laryngospasm. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  18. Ice nucleation triggered by negative pressure.

    Science.gov (United States)

    Marcolli, Claudia

    2017-11-30

    Homogeneous ice nucleation needs supercooling of more than 35 K to become effective. When pressure is applied to water, the melting and the freezing points both decrease. Conversely, melting and freezing temperatures increase under negative pressure, i.e. when water is stretched. This study presents an extrapolation of homogeneous ice nucleation temperatures from positive to negative pressures as a basis for further exploration of ice nucleation under negative pressure. It predicts that increasing negative pressure at temperatures below about 262 K eventually results in homogeneous ice nucleation while at warmer temperature homogeneous cavitation, i. e. bubble nucleation, dominates. Negative pressure occurs locally and briefly when water is stretched due to mechanical shock, sonic waves, or fragmentation. The occurrence of such transient negative pressure should suffice to trigger homogeneous ice nucleation at large supercooling in the absence of ice-nucleating surfaces. In addition, negative pressure can act together with ice-inducing surfaces to enhance their intrinsic ice nucleation efficiency. Dynamic ice nucleation can be used to improve properties and uniformity of frozen products by applying ultrasonic fields and might also be relevant for the freezing of large drops in rainclouds.

  19. Negative Ions in low pressure discharges

    NARCIS (Netherlands)

    Stoffels - Adamowicz, E.; Stoffels, W.W.; Vender, D.; Haverlag, M.; Kroesen, G.M.W.; Hoog, de F.J.

    1995-01-01

    Several aspects of negative ions in low pressure discharges are treated. The elementary processes, in which negative ions are produced and destroyed, are summarized. The influence of negative ions on plasma operation is analyzed in terms of transport equations. It is shown that diffusion, electric

  20. Influence of intermittent pressure, fluid flow, and mixing on the regenerative properties of articular chondrocytes.

    Science.gov (United States)

    Carver, S E; Heath, C A

    1999-11-05

    Equine articular chondrocytes, embedded within a polyglycolic acid nonwoven mesh, were cultured with various combinations of intermittent pressure, fluid flow, and mixing to examine the effects of different physical stimuli on neochondrogenesis from young cells. The cell/polymer constructs were cultured first in 125 ml spinner flasks for 1, 2, or 4 weeks and then in a perfusion system with intermittent pressure for a total of up to 6 weeks. Additional constructs were either cultured for all 6 weeks in the spinner flasks or for 1 week in spinners followed by 5 weeks in the perfusion system without intermittent pressure. Tissue constructs cultivated for 2 or 4 weeks in spinner flasks followed by perfusion with intermittent pressure had significantly higher concentrations of both sulfated glycosaminoglycan and collagen than constructs cultured entirely in spinners or almost entirely in the pressure/perfusion system. Initial cultivation in the spinner flasks, with turbulent mixing, enhanced both cell attachment and early development of the extracellular matrix. Subsequent culture with perfusion and intermittent pressure appeared to accelerate matrix formation. While the correlation was much stronger in the pressurized constructs, the compressive modulus was directly proportional to the concentration of sulfated glycosaminoglycan in all physically stressed constructs. Constructs that were not stressed beyond the 1-week seeding period lost mechanical integrity upon harvest, suggesting that physical stimulation, particularly with intermittent pressure, of immature tissue constructs during their development may contribute to their ultimate biomechanical functionality. Copyright 1999 John Wiley & Sons, Inc.

  1. Variations of Negative Pressure Wound Therapy

    African Journals Online (AJOL)

    a living reaction which serves to eradicate necrotic tissue and suppress bacterial propagation. In order to gain maximum advantages from NPWT, not only the negative pressure environment, but also the selection of the most suitable dressing material will be necessary. Regarding the treatment of diabetic foot ulcers, there.

  2. An audit of pressure sores caused by intermittent compression devices used to prevent venous thromboembolism.

    Science.gov (United States)

    Skillman, Joanna; Thomas, Sunil

    2011-12-01

    When intermittent compression devices (ICDs) are used to prevent venous thromboembolism (VTE) they can cause pressure sores in a selected group of women, undergoing long operations. A prospective audit pre and post intervention showed a reduced risk with an alternative device, without increasing the risk of VTE.

  3. CT changes in children with drained hydrocephalus and intermittently raised intracranial pressure

    International Nuclear Information System (INIS)

    Schmidt, H.; Korinthenberg, R.; Erlemann, R.; Lengerke, H.J. von; Muenster Univ.

    1987-01-01

    Seven children with drained hydrocephalus are described who showed increasingly severe and frequent episodes of intermittently raised intracranial pressure. CT examinations during symptom-free intervals, or after conservative treatment, showed collapsed slit-like ventricles. Examination during attacks of raised pressure showed relative dilatation of the ventricles as compared with earlier examinations. Children with ventricular shunts of long duration may develop a shunt-dependent syndrome; CT may show normal or narrow ventricles and this does not exclude the possibility of a rise of intracranial pressure. These findings may help in making the diagnosis by means of CT without any further invasive procedure. (orig.) [de

  4. Negative pressure wound therapy and nurse education.

    Science.gov (United States)

    Cray, Amy

    2017-08-10

    there can be serious consequences for patients if negative pressure wound therapy (NPWT) is performed incorrectly and patient safety must be paramount. The existing literature was found to mainly concentrate on the use of the technology from the patient perspective. This article examines the opinions of nurses who apply the therapy. five staff nurses from different areas with differing experience levels were interviewed in a semi-structured manner. The transcribed interviews were coded, sorted into themes and analysed. the themes were: enhancing knowledge and understanding, managing problematic pumps, formalised and interactive training, and efficacy and healing. There was a lack of standardised training provided for the nurses interviewed. Overall the nurses were aware of the basic evidence behind the treatment but would have liked additional support in this area as well as some practical, less pressured training. This complements the existing literature. nurses are expected to learn difficult and highly specialised skills quickly within a busy ward environment, often with no prior training or preparation. As things can go wrong, with the potential for patient harm, it is vital that nurses get these skills right first time, but it is difficult to do this in a practical, fast and cost-effective way. There is scope for future research in the area and perhaps the development of an online training tool to assist nurses in understanding and undertaking a new procedure.

  5. outcome of foam versus gauze dressings in negative pressure

    African Journals Online (AJOL)

    2013-07-30

    Jul 30, 2013 ... Negative pressure wound therapy (NPWT) is one of .... Presence of necrotic material. If present ..... an alternative dressing interface and other vacuum sources .... edge micro-vascular blood flow: Effects of negative pressure ...

  6. The effect of intermittent fasting on blood pressure variability in patients with newly diagnosed hypertension or prehypertension.

    Science.gov (United States)

    Erdem, Yunus; Özkan, Gülsüm; Ulusoy, Şükrü; Arıcı, Mustafa; Derici, Ülver; Şengül, Şule; Sindel, Şükrü; Ertürk, Şehsuvar

    2018-01-01

    Intermittent fasting is a phenomenon which can be observed in most humans. The effect of intermittent fasting on blood pressure variability (BPV) has not previously been investigated. The purpose of this study was to assess the effect of fasting on blood pressure (BP) (with office, home, central, and ambulatory blood pressure monitoring [ABPM]) and on BPV. Sixty individuals were included in the study. Office, home, ABPM, and central BP measurements were performed before and during intermittent fasting. Standard deviation and coefficient variation were used for office and home BPV measurement, while the smoothness index was used to calculate ABPM variability. Patients' BP and BPV values before and during intermittent fasting were then compared. Intermittent fasting resulted in a significant decrease in office BP values and ABPM measurements but caused no significant change in home and central BP measurements. Twenty-four hour urinary sodium excretion decreased. Smoothness values obtained from ABPM measurements were low; in other words, BPV was greater. BPV was higher in patients who woke up to eat before sunrise, but BPV was low in patients with high body mass index. Intermittent fasting produced a significant decrease in BP values in terms of office and ABPM measurements in this study but caused no significant change in central BP and home measurements. We also identified an increase in BPV during intermittent fasting, particularly in patients who rose before sunrise. Copyright © 2017 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  7. Intermittent operation of ultra-low pressure ultrafiltration for decentralized drinking water treatment.

    Science.gov (United States)

    Peter-Varbanets, Maryna; Gujer, Willi; Pronk, Wouter

    2012-06-15

    River water was treated by ultrafiltration at a relatively low transmembrane pressure (40 mbar). As observed before, flux stabilization occurred after several days of operation although no back-flushing or cross flow was applied. Interruptions in flux were applied by temporary offset of the transmembrane pressure. After restoration of the transmembrane pressure, the initial flux was higher than the stable flux level, and the flux recovery depended on the standstill time. Furthermore, if a short cross flow was applied after standstill, the flux was restored to an even higher level. In all cases, the flux decreased again during operation to reach finally the same stable level as before standstill. In order to evaluate the influence of intermittent operation as practiced for water treatment on a household level, daily interruptions of flux were applied. An optimum of total daily water production rate was obtained at 21 h of operation and 3 h of standstill per day. A model was developed which can describe the impact of intermittent operation on the flux depending on the duration of the standstill and operating periods. This enables the prediction of production capacity of the system operated intermittently. The flux increase during standstill could be explained by a relaxation and expansion of the biofouling layer, while the higher flux after forward-flushing was caused by this layer being partially sloughed off. Household water treatment with the process presented here will generally be operated on a discontinuous basis. The results show that such operation schemes do not compromise the permeability of the system, but actually lead to higher fluxes after standstill. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Capillarity Induced Negative Pressure of Water Plugs in Nanochannels

    NARCIS (Netherlands)

    Tas, Niels Roelof; Mela, P.; Kramer, Tobias; Berenschot, Johan W.; van den Berg, Albert

    2003-01-01

    We have found evidence that water plugs in hydrophilic nanochannels can be at significant negative pressure due to tensile capillary forces. The negative pressure of water plugs in nanochannels induces bending of the thin channel capping layer, which results in a visible curvature of the liquid

  9. An Affordable Custom-Built Negative Pressure Wound Therapy

    African Journals Online (AJOL)

    Negative pressure wound therapy (NPWT) is a well- established modality for treating complex wounds (1). ... a negative pressure which causes a characteristic shrinking of the gauze, indicating that the device ... We have applied this simplified technique of NPWT in patients with diabetic foot ulcers and open fractures.

  10. 21 CFR 868.5935 - External negative pressure ventilator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External negative pressure ventilator. 868.5935 Section 868.5935 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... ventilator. (a) Identification. An external negative pressure ventilator (e.g., iron lung, cuirass) is a...

  11. Pressure Field Around Underwater Negative Streamers

    Czech Academy of Sciences Publication Activity Database

    Hoffer, Petr; Koláček, Karel; Lukeš, Petr; Stelmashuk, Vitaliy

    2015-01-01

    Roč. 43, č. 5 (2015), s. 1787-1792 ISSN 0093-3813 R&D Projects: GA ČR(CZ) GA15-12987S Grant - others:Rada Programu interní podpory projektů mezinárodní spolupráce AV ČR(CZ) M100431203 Program:M Institutional support: RVO:61389021 Keywords : Interferometry * plasma generation * pressure measurement * water Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 0.958, year: 2015

  12. SIMULATION OF NEGATIVE PRESSURE WAVE PROPAGATION IN WATER PIPE NETWORK

    Directory of Open Access Journals (Sweden)

    Tang Van Lam

    2017-11-01

    Full Text Available Subject: factors such as pipe wall roughness, mechanical properties of pipe materials, physical properties of water affect the pressure surge in the water supply pipes. These factors make it difficult to analyze the transient problem of pressure evolution using simple programming language, especially in the studies that consider only the magnitude of the positive pressure surge with the negative pressure phase being neglected. Research objectives: determine the magnitude of the negative pressure in the pipes on the experimental model. The propagation distance of the negative pressure wave will be simulated by the valve closure scenarios with the help of the HAMMER software and it is compared with an experimental model to verify the quality the results. Materials and methods: academic version of the Bentley HAMMER software is used to simulate the pressure surge wave propagation due to closure of the valve in water supply pipe network. The method of characteristics is used to solve the governing equations of transient process of pressure change in the pipeline. This method is implemented in the HAMMER software to calculate the pressure surge value in the pipes. Results: the method has been applied for water pipe networks of experimental model, the results show the affected area of negative pressure wave from valve closure and thereby we assess the largest negative pressure that may appear in water supply pipes. Conclusions: the experiment simulates the water pipe network with a consumption node for various valve closure scenarios to determine possibility of appearance of maximum negative pressure value in the pipes. Determination of these values in real-life network is relatively costly and time-consuming but nevertheless necessary for identification of the risk of pipe failure, and therefore, this paper proposes using the simulation model by the HAMMER software. Initial calibration of the model combined with the software simulation results and

  13. Flow-synchronized nasal intermittent positive pressure ventilation in the preterm infant: development of a project

    Directory of Open Access Journals (Sweden)

    Corrado Moretti

    2013-06-01

    Full Text Available This manuscript describes the experience of our team in developing a flow-triggered nasal respiratory support for the neonate and its related clinical applications. Although mechanical ventilation (MV via an endotracheal tube has undoubtedly led to improvement in neonatal survival in the last 40 years, the prolonged use of this technique may predispose the infant to the development of many possible complications, first of all, bronchopulmonary dysplasia (BPD. Avoiding mechanical ventilation is thought to be a critical goal, and different modes of non invasive respiratory support may reduce the intubation rate: nasal continuous positive airway pressure (NCPAP, nasal intermittent positive pressure ventilation (NIPPV and its more advantageous form, synchronized nasal intermittent positive pressure ventilation (SNIPPV. SNIPPV was initially performed by a capsule placed on the baby’s abdomen. To overcome the disadvantages of the abdominal capsule, our team decided to create a flow-sensor that could be interposed between the nasal prongs and the Y piece. Firstly we developed a hot-wire flow-sensor to trigger the ventilator and we showed that flow-SNIPPV can support the inspiratory effort in the post-extubation period more effectively than NCPAP. But, although accurate, the proper functioning of the hot-wire flow-sensor was easily compromised by secretions or moisture, and therefore we started to use as flow-sensor a simpler differential pressure transducer. In a following trial using the new device, we were able to demonstrate that flow-SNIPPV was more effective than conventional NCPAP in decreasing extubation failure in preterm infants who had been ventilated for respiratory distress syndrome (RDS. More recently we used flow-SNIPPV as the primary mode of ventilation, after surfactant replacement, reducing MV need and favorably affecting short-term morbidities of treated premature infants. We also successfully applied SNIPPV to treat apnea of

  14. Beneficial effects of intermittent fluid pressure of low physiological magnitude on cartilage and inflammation in osteoarthritis. An in vitro study

    NARCIS (Netherlands)

    van Valburg, A. A.; van Roy, H. L.; Lafeber, F. P.; Bijlsma, J. W.

    1998-01-01

    To investigate the in vitro effects of low physiological levels of intermittent fluid pressure (0-13 kPa; 0.33 Hz), in the absence of mechanical stress, on articular cartilage, inflammatory cells, and on the combination of these components, present in the osteoarthritic (OA) joint. Normal and OA

  15. Why use Finapres or Portapres rather than intra-arterial or intermittent non-invasive techniques of blood pressure measurement?

    NARCIS (Netherlands)

    Langewouters, G. J.; Settels, J. J.; Roelandt, R.; Wesseling, K. H.

    1998-01-01

    In the clinic, blood pressure is measured almost exclusively using non-invasive intermittent techniques, of which the auscultatory (Riva-Rocci/Korotkoff, RRK) and the computerized oscillometric method are most often used. However, both methods only provide a momentary value. In addition, the

  16. The phase diagram of water at negative pressures: virtual ices.

    Science.gov (United States)

    Conde, M M; Vega, C; Tribello, G A; Slater, B

    2009-07-21

    The phase diagram of water at negative pressures as obtained from computer simulations for two models of water, TIP4P/2005 and TIP5P is presented. Several solid structures with lower densities than ice Ih, so-called virtual ices, were considered as possible candidates to occupy the negative pressure region of the phase diagram of water. In particular the empty hydrate structures sI, sII, and sH and another, recently proposed, low-density ice structure. The relative stabilities of these structures at 0 K was determined using empirical water potentials and density functional theory calculations. By performing free energy calculations and Gibbs-Duhem integration the phase diagram of TIP4P/2005 was determined at negative pressures. The empty hydrates sII and sH appear to be the stable solid phases of water at negative pressures. The phase boundary between ice Ih and sII clathrate occurs at moderate negative pressures, while at large negative pressures sH becomes the most stable phase. This behavior is in reasonable agreement with what is observed in density functional theory calculations.

  17. Using portable negative pressure wound therapy devices in the home care setting

    Directory of Open Access Journals (Sweden)

    Burke JR

    2014-12-01

    Full Text Available Joshua R Burke, Rachael Morley, Mustafa Khanbhai Academic Surgery Unit, Education and Research Centre, University Hospital of South Manchester, Manchester, UK Abstract: Negative pressure wound therapy (NPWT is the continuous or intermittent application of subatmospheric pressure to the surface of a wound that improves the wound environment, accelerates healing, and reduces wound closure time. Since its first documented use, this technology has lent itself to a number of adaptations, most notably, the development of portable devices facilitating treatment in the home care setting. With advancing surgical standards, wound healing is an important rate-limiting factor in early patient discharge and often a major cost of inpatient treatment. The efficacy of NPWT in the home care setting has been investigated through rate of wound closure, time in care, and patient experience. Rate of wound closure is the most appropriate primary end point. Much can be gleaned from patient experience, but the future success of portable NPWT will be measured on time in care and therefore cost effectiveness. However, there is a lack of level 1a evidence demonstrating increased efficacy of portable over inpatient NPWT. The development of portable NPWT is an encouraging innovation in wound care technology, and extending the benefits to the home care setting is both possible and potentially more beneficial. Keywords: portable, negative pressure wound therapy, vacuum-assisted closure, topical negative pressure therapy

  18. Inhibitory Effect of Nasal Intermittent Positive Pressure Ventilation on Gastroesophageal Reflux.

    Directory of Open Access Journals (Sweden)

    Danny Cantin

    Full Text Available Non-invasive intermittent positive pressure ventilation can lead to esophageal insufflations and in turn to gastric distension. The fact that the latter induces transient relaxation of the lower esophageal sphincter implies that it may increase gastroesophageal refluxes. We previously reported that nasal Pressure Support Ventilation (nPSV, contrary to nasal Neurally-Adjusted Ventilatory Assist (nNAVA, triggers active inspiratory laryngeal closure. This suggests that esophageal insufflations are more frequent in nPSV than in nNAVA. The objectives of the present study were to test the hypotheses that: i gastroesophageal refluxes are increased during nPSV compared to both control condition and nNAVA; ii esophageal insufflations occur more frequently during nPSV than nNAVA. Polysomnographic recordings and esophageal multichannel intraluminal impedance pHmetry were performed in nine chronically instrumented newborn lambs to study gastroesophageal refluxes, esophageal insufflations, states of alertness, laryngeal closure and respiration. Recordings were repeated without sedation in control condition, nPSV (15/4 cmH2O and nNAVA (~ 15/4 cmH2O. The number of gastroesophageal refluxes recorded over six hours, expressed as median (interquartile range, decreased during both nPSV (1 (0, 3 and nNAVA [1 (0, 3] compared to control condition (5 (3, 10, (p < 0.05. Meanwhile, the esophageal insufflation index did not differ between nPSV (40 (11, 61 h-1 and nNAVA (10 (9, 56 h-1 (p = 0.8. In conclusion, nPSV and nNAVA similarly inhibit gastroesophageal refluxes in healthy newborn lambs at pressures that do not lead to gastric distension. In addition, the occurrence of esophageal insufflations is not significantly different between nPSV and nNAVA. The strong inhibitory effect of nIPPV on gastroesophageal refluxes appears identical to that reported with nasal continuous positive airway pressure.

  19. Responses to negative pressure surrounding the neck in anesthetized animals.

    Science.gov (United States)

    Wolin, A D; Strohl, K P; Acree, B N; Fouke, J M

    1990-01-01

    Continuous positive pressure applied at the nose has been shown to cause a decrease in upper airway resistance. The present study was designed to determine whether a similar positive transmural pressure gradient, generated by applying a negative pressure at the body surface around the neck, altered upper airway patency. Studies were performed in nine spontaneously breathing anesthetized supine dogs. Airflow was measured with a pneumotachograph mounted on an airtight muzzle placed over the nose and mouth of each animal. Upper airway pressure was measured as the differential pressure between the extrathoracic trachea and the inside of the muzzle. Upper airway resistance was monitored as an index of airway patency. Negative pressure (-2 to -20 cmH2O) was applied around the neck by using a cuirass extending from the jaw to the thorax. In each animal, increasingly negative pressures were transmitted to the airway wall in a progressive, although not linear, fashion. Decreasing the pressure produced a progressive fall in upper airway resistance, without causing a significant change in respiratory drive or respiratory timing. At -5 cmH2O pressure, there occurred a significant fall in upper airway resistance, comparable with the response of a single, intravenous injection of sodium cyanide (0.5-3.0 mg), a respiratory stimulant that produces substantial increases in respiratory drive. We conclude that upper airway resistance is influenced by the transmural pressure across the airway wall and that such a gradient can be accomplished by making the extraluminal pressure more negative.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Negative pressure pulmonary edema revisited: Pathophysiology and review of management

    Directory of Open Access Journals (Sweden)

    Balu Bhaskar

    2011-01-01

    Full Text Available Negative pressure pulmonary edema (NPPE is a dangerous and potentially fatal condition with a multifactorial pathogenesis. Frequently, NPPE is a manifestation of upper airway obstruction, the large negative intrathoracic pressure generated by forced inspiration against an obstructed airway is thought to be the principal mechanism involved. This negative pressure leads to an increase in pulmonary vascular volume and pulmonary capillary transmural pressure, creating a risk of disruption of the alveolar-capillary membrane. The early detection of the signs of this syndrome is vital to the treatment and to patient outcome. The purpose of this review is to highlight the available literature on NPPE, while probing the pathophysiological mechanisms relevant in both the development of this condition and that involved in its resolution.

  1. Intermittent cardiac overload results in adaptive hypertrophy and provides protection against left ventricular acute pressure overload insult.

    Science.gov (United States)

    Moreira-Gonçalves, Daniel; Henriques-Coelho, Tiago; Fonseca, Hélder; Ferreira, Rita; Padrão, Ana Isabel; Santa, Cátia; Vieira, Sara; Silva, Ana Filipa; Amado, Francisco; Leite-Moreira, Adelino; Duarte, José Alberto

    2015-09-01

    The present study aimed to test whether a chronic intermittent workload could induce an adaptive cardiac phenotype Chronic intermittent workload induced features of adaptive hypertrophy This was paralleled by protection against acute pressure overload insult The heart may adapt favourably to balanced demands, regardless of the nature of the stimuli. The present study aimed to test whether submitting the healthy heart to intermittent and tolerable amounts of workload, independently of its nature, could result in an adaptive cardiac phenotype. Male Wistar rats were subjected to treadmill running (Ex) (n = 20), intermittent cardiac overload with dobutamine (ITO) (2 mg kg(-1) , s.c.; n = 20) or placebo administration (Cont) (n = 20) for 5 days week(-1) for 8 weeks. Animals were then killed for histological and biochemical analysis or subjected to left ventricular haemodynamic evaluation under baseline conditions, in response to isovolumetric contractions and to sustained LV acute pressure overload (35% increase in peak systolic pressure maintained for 2 h). Baseline cardiac function was enhanced only in Ex, whereas the response to isovolumetric heartbeats was improved in both ITO and Ex. By contrast to the Cont group, in which rats developed diastolic dysfunction with sustained acute pressure overload, ITO and Ex showed increased tolerance to this stress test. Both ITO and Ex developed cardiomyocyte hypertrophy without fibrosis, no overexpression of osteopontin-1 or β-myosin heavy chain, and increased expression of sarcoplasmic reticulum Ca(2+) protein. Regarding hypertrophic pathways, ITO and Ex showed activation of the protein kinase B/mammalian target of rapamycin pathway but not calcineurin. Mitochondrial complex IV and V activities were also increased in ITO and Ex. Chronic submission to controlled intermittent cardiac overload, independently of its nature, results in an adaptive cardiac phenotype. Features of the cardiac overload, such as the duration and

  2. Response of Preterm Infants to 2 Noninvasive Ventilatory Support Systems: Nasal CPAP and Nasal Intermittent Positive-Pressure Ventilation.

    Science.gov (United States)

    Silveira, Carmen Salum Thomé; Leonardi, Kamila Maia; Melo, Ana Paula Carvalho Freire; Zaia, José Eduardo; Brunherotti, Marisa Afonso Andrade

    2015-12-01

    Noninvasive ventilation (NIV) in preterm infants is currently applied using intermittent positive pressure (2 positive-pressure levels) or in a conventional manner (one pressure level). However, there are no studies in the literature comparing the chances of failure of these NIV methods. The aim of this study was to evaluate the occurrence of failure of 2 noninvasive ventilatory support systems in preterm neonates over a period of 48 h. A randomized, prospective, clinical study was conducted on 80 newborns (gestational age CPAP and 40 infants with nasal intermittent positive-pressure ventilation (NIPPV). The occurrence of apnea, progression of respiratory distress, nose bleeding, and agitation was defined as ventilation failure. The need for intubation and re-intubation after failure was also observed. There were no significant differences in birth characteristics between groups. Ventilatory support failure was observed in 25 (62.5%) newborns treated with nasal CPAP and in 12 (30%) newborns treated with NIPPV, indicating an association between NIV failure and the absence of intermittent positive pressure (odds ratio [OR] 1.22, P CPAP failure. After failure, 25% (OR 0.33) of the newborns receiving nasal CPAP and 12.5% (OR 0.14) receiving NIPPV required invasive mechanical ventilation. Ventilatory support failure was significantly more frequent when nasal CPAP was used. Copyright © 2015 by Daedalus Enterprises.

  3. Timer switch to convert suction apparatus for negative pressure wound therapy application

    Directory of Open Access Journals (Sweden)

    Surath Amarnath

    2014-01-01

    Full Text Available Background: Negative pressure wound therapy (NPWT is an established modality in the treatment of chronic wounds, open fractures, and post-operative wound problems. This method has not been widely used due to the high cost of equipment and consumables. This study demonstrates an indigenously developed apparatus which gives comparable results at a fraction of the cost. Readily available materials are used for the air-tight dressing. Materials and Methods: Equipment consists of suction apparatus with adjustable pressure valve set to a pressure 125-150 mmHg. An electronic timer switch with a sequential working time of 5 min and a standby time of 3 min provides the required intermittent negative pressure. Readily available materials such as polyvinyl alcohol sponge, suction drains and steridrapes were used to provide an air tight wound cover. Results: A total of 90 cases underwent 262 NPWT applications from 2009 to 2014. This series, comprised of 30 open fractures, 21 post-operative and 39 chronic wounds. The wound healing rate in our study was comparable to other published studies using NPWT. Conclusion: The addition of electronic timer switch will convert a suction apparatus into NPWT machine, and the results are equally effective compared to more expensive counter parts. The use of indigenous dressing materials reduces the cost significantly.

  4. Negative pressure characteristics of an evaporating meniscus at nanoscale

    Directory of Open Access Journals (Sweden)

    Maroo Shalabh

    2011-01-01

    Full Text Available Abstract This study aims at understanding the characteristics of negative liquid pressures at the nanoscale using molecular dynamics simulation. A nano-meniscus is formed by placing liquid argon on a platinum wall between two nano-channels filled with the same liquid. Evaporation is simulated in the meniscus by increasing the temperature of the platinum wall for two different cases. Non-evaporating films are obtained at the center of the meniscus. The liquid film in the non-evaporating and adjacent regions is found to be under high absolute negative pressures. Cavitation cannot occur in these regions as the capillary height is smaller than the critical cavitation radius. Factors which determine the critical film thickness for rupture are discussed. Thus, high negative liquid pressures can be stable at the nanoscale, and utilized to create passive pumping devices as well as significantly enhance heat transfer rates.

  5. Mechanisms of sympathetic activation and blood pressure elevation by intermittent hypoxia.

    Science.gov (United States)

    Prabhakar, Nanduri R; Kumar, Ganesh K

    2010-11-30

    Sleep disordered breathing with recurrent apneas is one of the most frequently encountered breathing disorder in adult humans and preterm infants. Recurrent apnea patients exhibit several co-morbidities including hypertension and persistent sympathetic activation. Intermittent hypoxia (IH) resulting from apneas appears to be the primary stimulus for evoking autonomic changes. The purpose of this article is to briefly review the effects of IH on chemo- and baro-reflexes and circulating vasoactive hormones and their contribution to sympathetic activation and blood pressures. Sleep apnea patients and IH-treated rodents exhibit exaggerated arterial chemo-reflex. Studies on rodent models demonstrated that IH leads to hyperactive carotid body response to hypoxia. On the other hand, baro-reflex function is attenuated in patients with sleep apnea and in IH-treated rodents. Circulating vasoactive hormone levels are elevated in sleep apnea patients and in rodent models of IH. Thus, persistent sympathetic activation and hypertension associated with sleep apneas seems to be due to a combination of altered chemo- and baro-reflexes resulting in sympathetic activation and action of elevated circulating levels of vasoactive hormones on vasculature. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. The effects of acebutolol and metoprolol on walking distances and distal blood pressure in hypertensive patients with intermittent claudication

    DEFF Research Database (Denmark)

    Svendsen, T L; Jelnes, Rolf; Tønnesen, K H

    1986-01-01

    The effects of acebutolol (with intrinsic sympathomimetic activity (ISA] and metoprolol (without ISA) on arm blood pressure, ankle systolic blood pressure, claudication distances (CD) and maximal walking distances (MWD) were compared in patients with essential hypertension and intermittent...... claudication. Fourteen patients participated in a long-term, open, randomized cross-over study. After randomization the patients received either acebutolol, 200 mg b.i.d., or metoprolol, 100 mg b.i.d. After eight weeks the drugs were shifted and after another eight weeks they were withdrawn. Arm and ankle...... pressure there were no significant changes in ankle blood pressure, CD or MWD after the two drugs. After withdrawal of the drugs and after the arm blood pressure had returned to the control value no significant changes were seen in CD, MWD or ankle blood pressure. It is concluded that beta-blockers have...

  7. Negative pressure dressing combined with a traditional approach for ...

    African Journals Online (AJOL)

    2011-07-21

    Jul 21, 2011 ... Deep burns of the calvarium due to high-voltage electrical current present serious therapeutic challenges in the healing. In this study, as an alternative approach to the treatment of burned skull, negative pressure dressing is used to facilitate separation of the necrotic bones from healthy margins of the ...

  8. Negative interstitial pressure in the peritendinous region during exercise

    DEFF Research Database (Denmark)

    Langberg, Henning; Skovgaard, D; Bülow, J

    1999-01-01

    of these observations, microdialysis was performed in the peritendinous region with a colloid osmotic active substance (Dextran 70, 0.1 g/ml) added to the perfusate with the aim of counteracting the negative tissue pressure. Dialysate volume was found to be fully restored (100 +/- 4%) during exercise. It is concluded...

  9. The use of negative pressure wave treatment in athlete recovery ...

    African Journals Online (AJOL)

    Background: Athletes need to recover fully to maximise performance in competitive sport. Athletes who replenish more quickly and more efficiently are able to train harder and more intensely. Elite athletes subjectively report positive results using lower body negative pressure (LBNP) treatment as an alternate method for ...

  10. Controlling a negative loaded hydraulic cylinder using pressure feedback

    DEFF Research Database (Denmark)

    Hansen, M.R.; Andersen, T.O.

    2010-01-01

    This paper is concerned with the inherent oscillatory nature of pressure compensated velocity control of a hydraulic cylinder subjected to a negative load and suspended by means of an over-center valve. Initially, a linearized stability analysis of such a hydraulic circuit is carried out clearly ...... in a nonlinear time domain simulation model validating the linear stability analysis....

  11. The protracted demise of medical technology. The case of intermittent positive pressure breathing.

    Science.gov (United States)

    Duffy, S Q; Farley, D E

    1992-08-01

    In this study, the effects of hospital, staff, and patient characteristics on the rates of use and abandonment of an outmoded medical technology, intermittent positive pressure breathing (IPPB) are analyzed. The study focuses specifically on the use of IPPB to treat inpatients with chronic obstructive pulmonary disease in a national sample of more than 500 community hospitals from 1980 to 1987. Cross-sectionally, hospitals with shorter case-mix-adjusted lengths of stay, private nonprofit or investor-owned hospitals, and hospitals located outside of the north central United States were more likely to abandon IPPB by 1980. Teaching status, location, ownership, volume, and source of payment all appeared to affect rates of IPPB use in 1980. The longitudinal analysis examines both the probability a hospital abandoned IPPB and declines in rates of IPPB use over the study period, conditioned on the availability of IPPB in 1980. The results show that changes in the characteristics of hospitals, patients, and physicians all help to explain variations in the abandonment of IPPB. These findings contrast with previous studies of technological change, which find hospital size to be the most important variable. Size is important in explaining the rate of use in 1980, but it has no effect on the rate of decline in use or abandonment after 1980. In general, the analysis demonstrates that a combination of factors, economic incentives as well as information, contribute to the abandonment of outmoded medical technologies. Given the surprisingly long time periods required for this process to occur, the analysis underscores the need to strengthen financial incentives that encourage appropriate medical decisions and to disseminate information about the efficacy of specific procedures more widely and effectively.

  12. Hemodynamic differences between continual positive and two types of negative pressure ventilation.

    Science.gov (United States)

    Lockhat, D; Langleben, D; Zidulka, A

    1992-09-01

    In seven anesthetized dogs, ventilated with matching lung volumes, tidal volumes, and respiratory rates, we compared the effects on cardiac output (CO), arterial venous oxygen saturation difference (SaO2 - SVO2), and femoral and inferior vena cava pressure (1) intermittent positive pressure ventilation with positive end-expiratory pressure (CPPV); (2) iron-lung ventilation with negative end-expiratory pressure (ILV-NEEP); (3) grid and wrap ventilation with NEEP applied to the thorax and upper abdomen (G&W-NEEP). The values of CO and SaO2 - SVO2 with ILV-NEEP were similar to those with CPPV. However, with G&W-NEEP as compared with ILV-NEEP, mean CO was greater (2.9 versus 2.6 L/min, p = 0.02) and mean (SaO2 - SVO2) was lower (26.6% versus 28.3%, p = NS). Mean PFEM-IVC was higher with G&W-NEEP than with the other types of ventilation. We conclude that (1) ILV-NEEP is hemodynamically equivalent to CPPV and (2) G&W-NEEP has less adverse hemodynamic consequences. has less adverse hemodynamic consequences.

  13. Intermittent fasting dietary restriction regimen negatively influences reproduction in young rats: a study of hypothalamo-hypophysial-gonadal axis.

    Directory of Open Access Journals (Sweden)

    Sushil Kumar

    Full Text Available Nutritional infertility is very common in societies where women fail to eat enough to match their energy expenditure and such females often present as clinical cases of anorexia nervosa. The cellular and molecular mechanisms that link energy balance and central regulation of reproduction are still not well understood. Peripheral hormones such as estradiol, testosterone and leptin, as well as neuropeptides like kisspeptin and neuropeptides Y (NPY play a potential role in regulation of reproduction and energy balance with their primary target converging on the hypothalamic median eminence-arcuate region. The present study was aimed to explore the effects of negative energy state resulting from intermittent fasting dietary restriction (IF-DR regimen on complete hypothalamo-hypophysial-gonadal axis in Wistar strain young female and male rats. Significant changes in body weight, blood glucose, estrous cyclicity and serum estradiol, testosterone and LH level indicated the negative role of IF-DR regimen on reproduction in these young animals. Further, it was elucidated whether serum level of metabolic hormone, leptin plays a mechanistic role in suppressing hypothalamo-hypophysial-gonadal (HPG axis via energy regulators, kisspeptin and NPY in rats on IF-DR regimen. We also studied the effect of IF-DR regimen on structural remodeling of GnRH axon terminals in median eminence region of hypothalamus along with the glial cell marker, GFAP and neuronal plasticity marker, PSA-NCAM using immunostaining, Western blotting and RT-PCR. Together these data suggest that IF-DR regimen negatively influences reproduction in young animals due to its adverse effects on complete hypothalamus-hypophysial-gonadal axis and may explain underlying mechanism(s to understand the clinical basis of nutritional infertility.

  14. Intermittent fasting dietary restriction regimen negatively influences reproduction in young rats: a study of hypothalamo-hypophysial-gonadal axis.

    Science.gov (United States)

    Kumar, Sushil; Kaur, Gurcharan

    2013-01-01

    Nutritional infertility is very common in societies where women fail to eat enough to match their energy expenditure and such females often present as clinical cases of anorexia nervosa. The cellular and molecular mechanisms that link energy balance and central regulation of reproduction are still not well understood. Peripheral hormones such as estradiol, testosterone and leptin, as well as neuropeptides like kisspeptin and neuropeptides Y (NPY) play a potential role in regulation of reproduction and energy balance with their primary target converging on the hypothalamic median eminence-arcuate region. The present study was aimed to explore the effects of negative energy state resulting from intermittent fasting dietary restriction (IF-DR) regimen on complete hypothalamo-hypophysial-gonadal axis in Wistar strain young female and male rats. Significant changes in body weight, blood glucose, estrous cyclicity and serum estradiol, testosterone and LH level indicated the negative role of IF-DR regimen on reproduction in these young animals. Further, it was elucidated whether serum level of metabolic hormone, leptin plays a mechanistic role in suppressing hypothalamo-hypophysial-gonadal (HPG) axis via energy regulators, kisspeptin and NPY in rats on IF-DR regimen. We also studied the effect of IF-DR regimen on structural remodeling of GnRH axon terminals in median eminence region of hypothalamus along with the glial cell marker, GFAP and neuronal plasticity marker, PSA-NCAM using immunostaining, Western blotting and RT-PCR. Together these data suggest that IF-DR regimen negatively influences reproduction in young animals due to its adverse effects on complete hypothalamus-hypophysial-gonadal axis and may explain underlying mechanism(s) to understand the clinical basis of nutritional infertility.

  15. Extubation success in premature infants with respiratory distress syndrome treated with bi-level nasal continuous positive airway pressure versus nasal intermittent positive pressure ventilation.

    Science.gov (United States)

    Thomas, Patricia E; LeFlore, Judy

    2013-01-01

    Infants born prematurely with respiratory distress syndrome are at high risk for complications from mechanical ventilation. Strategies are needed to minimize their days on the ventilator. The purpose of this study was to compare extubation success rates in infants treated with 2 different types of continuous positive airway pressure devices. A retrospective cohort study design was used. Data were retrieved from electronic medical records for patients in a large, metropolitan, level III neonatal intensive care unit. A sample of 194 premature infants with respiratory distress syndrome was selected, 124 of whom were treated with nasal intermittent positive pressure ventilation and 70 with bi-level variable flow nasal continuous positive airway pressure (bi-level nasal continuous positive airway pressure). Infants in both groups had high extubation success rates (79% of nasal intermittent positive pressure ventilation group and 77% of bi-level nasal continuous positive airway pressure group). Although infants in the bi-level nasal continuous positive airway pressure group were extubated sooner, there was no difference in duration of oxygen therapy between the 2 groups. Promoting early extubation and extubation success is a vital strategy to reduce complications of mechanical ventilation that adversely affect premature infants with respiratory distress syndrome.

  16. Proposed application of lower body negative pressure to cardiology

    Science.gov (United States)

    Schmidt, E. V.; Debusk, R. F.; Popp, R. L.

    1975-01-01

    Potential medical applications are presented of lower body negative pressure to the evaluation and treatment of cardiac patients. The essential features of an LBNP unit and the basic cardiovascular physiology of lower body negative pressure (LBNP) testing are described. Some of the results of previous spaceflight experiences and bedrest studies are summarized. The deconditioning effects of weightlessness experienced by orbiting astronauts are compared with the effects of bedrest restrictions prescribed for convalescing cardiac patients. The potential of LBNP for evaluating both pharmacological and physical activity regimens was examined, particularly in relation to post-myocardial infarction and coronary artery bypass patients. Applications of LBNP to the cardiac catheterization laboratory and the out-patient follow-up of cardiac patients are proposed.

  17. Rapid Onset Acute Epiglottitis Leading to Negative Pressure Pulmonary Edema

    Directory of Open Access Journals (Sweden)

    V Saraswat

    2007-01-01

    Full Text Available Pulmonary edema is a potentially life-threatening complication of acute airway obstruction. It develops rapidly, without warning, in young healthy individuals. Two forms of post-obstructive pulmonary edema (POPE (also known as negative pressure pulmonary edema, NPPE have been identified. POPE I follows sudden, severe upper airway obstruction. POPE II occurs following surgical relief of chronic upper airway obstruction. Treatment for both is supportive. Full and rapid recovery can be expected with appropriate management. A case report of a middle aged man with acute onset epiglottitis who developed negative pressure pulmonary edema after intubation is presented. The report includes a brief discussion on etiology, clinical features and management dilemma of acute upper airway obstruction.

  18. Rapid Onset Acute Epiglottitis Leading to Negative Pressure Pulmonary Edema

    OpenAIRE

    V Saraswat; P V Madhu; Suresh S Kumar

    2007-01-01

    Pulmonary edema is a potentially life-threatening complication of acute airway obstruction. It develops rapidly, without warning, in young healthy individuals. Two forms of post-obstructive pulmonary edema (POPE) (also known as negative pressure pulmonary edema, NPPE) have been identified. POPE I follows sudden, severe upper airway obstruction. POPE II occurs following surgical relief of chronic upper airway obstruction. Treatment for both is supportive. Full and rapid recovery can be expecte...

  19. Negative-pressure wound therapy with instillation: international consensus guidelines.

    Science.gov (United States)

    Kim, Paul J; Attinger, Christopher E; Steinberg, John S; Evans, Karen K; Lehner, Burkhard; Willy, Christian; Lavery, Larry; Wolvos, Tom; Orgill, Dennis; Ennis, William; Lantis, John; Gabriel, Allen; Schultz, Gregory

    2013-12-01

    Negative-pressure wound therapy with instillation is increasingly utilized as an adjunct therapy for a wide variety of wounds. Despite its growing popularity, there is a paucity of evidence and lack of guidance to provide effective use of this therapy. A panel of experts was convened to provide guidance regarding the appropriate use of negative-pressure wound therapy with instillation. A face-to-face meeting was held where the available evidence was discussed and individual clinical experience with this therapy was shared. Follow-up communication among the panelists continued until consensus was achieved. The final consensus recommendations were derived through more than 80 percent agreement among the panelists. Nine consensus statements were generated that address the appropriate use of negative-pressure wound therapy with instillation. The question of clinical effectiveness of this therapy was not directly addressed by the consensus panel. This document serves as preliminary guidelines until more robust evidence emerges that will support or modify these consensus recommendations.

  20. Long-term intermittent pharmacological therapy of uterine fibroids – a possibility to avoid hysterectomy and its negative consequences

    Directory of Open Access Journals (Sweden)

    Anita Olejek

    2016-03-01

    Full Text Available Uterine fibroids are found in almost 20-40% of women of reproductive age. For each woman an individualised treatment method should be applied because the hysterectomy procedure is not a good option in every case. The uterus is an organ necessary not only in reproduction. Its removal may result in: pelvic floor dysfunction and stress urinary incontinence, negative impair on life quality, depressive disorders, increased risk of cardiovascular and neurodegenerative diseases, and higher incidence of neoplastic disease. According to the last scientific reports, selective progesterone receptor modulators are the effective therapeutic option in uterine fibroids in women of reproductive age because progesterone is an important factor in their pathogenesis. Ulipristal acetate (UPA is a progesterone receptor antagonist. It inhibits cell proliferation and angiogenesis in uterine fibroids and also reduces collagen deposits in extracellular matrix. Significant data concerning ulipristal acetate efficacy have been provided by scientific research, especially from the consecutive PEARL studies. Oral ulipristal acetate effectively and safely controls bleeding and pain in patients with symptomatic fibroids. It reduces fibroid volume and restores quality of life. The results of UPA long-term intermittent treatment are largely maintained during the off-treatment periods.

  1. Perceived social pressure not to experience negative emotion is linked to selective attention for negative information.

    Science.gov (United States)

    Bastian, Brock; Pe, Madeline Lee; Kuppens, Peter

    2017-02-01

    Social norms and values may be important predictors of how people engage with and regulate their negative emotional experiences. Previous research has shown that social expectancies (the perceived social pressure not to feel negative emotion (NE)) exacerbate feelings of sadness. In the current research, we examined whether social expectancies may be linked to how people process emotional information. Using a modified classical flanker task involving emotional rather than non-emotional stimuli, we found that, for those who experienced low levels of NE, social expectancies were linked to the selective avoidance of negative emotional information. Those who experienced high levels of NE did not show a selective avoidance of negative emotional information. The findings suggest that, for people who experience many NEs, social expectancies may lead to discrepancies between how they think they ought to feel and the kind of emotional information they pay attention to.

  2. Why does intermittent hydrostatic pressure enhance the mineralization process in fetal cartilage?

    NARCIS (Netherlands)

    Tanck, E.; van Driel, W. D.; Hagen, J. W.; Burger, E. H.; Blankevoort, L.; Huiskes, R.

    1999-01-01

    The purpose of this study was to determine which factor is the most likely one to have stimulated the mineralization process in the in vitro experiments of Klein-Nulend et al. (Arth. Rheum., 29, 1002-1009, 1986), in which fetal cartilaginous metatarsals were externally loaded with an intermittent

  3. An anesthetic management of negative pressure pulmonary edema

    Directory of Open Access Journals (Sweden)

    Dipti Raj

    2016-01-01

    Full Text Available Negative pressure pulmonary edema (NPPE is one of the common complications of upper airway obstruction seen by anesthesiologist during either in induction or emergence sometimes both. Patients who have experienced NPPE are generally healthy without comorbidities. NPPE is a result of marked decrease in intrathoracic pressure caused by ventilator efforts against a closed glottis resulting in disruption of normal intravascular Starling mechanism, leading to transudation of intravascular protein, and fluids into the pulmonary interstitium. The onset of NPPE is usually rapid and without prompt recognition and intervention, the outcome can be fatal. This case report is of a 40-year-old female adult, who underwent right-sided percutaneous nephrolithotomy for stone in the right kidney otherwise uncomplicated surgical procedure.

  4. Negative pressure therapy for the treatment of complex wounds

    Directory of Open Access Journals (Sweden)

    RENAN VICTOR KÜMPEL SCHMIDT LIMA

    Full Text Available ABSTRACT The objective of this study is to evaluate the effectiveness of negative pressure therapy (NPT in the treatment of complex wounds, with emphasis on its mechanisms of action and main therapeutic indications. We searched the Pubmed / Medline database for articles published from 1997 to 2016, and selected the most relevant ones. The mechanisms of action of NPT involveboth physical effects, such as increased perfusion, control of edema and exudate, reduction of wound dimensions and bacterial clearance, and biological ones, such as the stimulation of granulation tissue formation, microdeformations and reduction of Inflammatory response. The main indications of NPT are complex wounds, such as pressure ulcers, traumatic wounds, operative wound dehiscences, burns, necrotizing wounds, venous ulcers, diabetic wounds, skin grafts, open abdomen, prevention of complications in closed incisions and in the association with instillation of solutions in infected wounds.

  5. Study on the hydrogen negative ion in low pressure discharges

    International Nuclear Information System (INIS)

    Bruneteau, A.M.

    1983-07-01

    A new use of negative hydrogen ions is the production of intense fast neutral atom beams useful in plasma heating in thermonuclear heating. That is one of the reasons that started this study. The density of negative hydrogen ions in diffusion, and multipole-type low pressure (10 -3 - 10-2 Torr) discharges is deduced from the various formation and destruction processes of the species present in these discharges. The H - ions are essentially produced by dissociative attachment to vibrationally excited molecules and destroyed by processes the relative importance of which is discussed as a function of the discharge parameters. The experimental study of the density of the H - ions, measured by photodetachment, as a function of these parameters, coroborates the theoretical model [fr

  6. Dynamic isolation technologies in negative pressure isolation wards

    CERN Document Server

    Xu, Zhonglin

    2017-01-01

    This book presents novel design principles and technologies for dynamic isolation based on experimental studies. These approaches have now become the local standard in Beijing and are currently being promoted for use nationwide. Further, the book provides details of measures and guidelines for the design process. Departing from the traditional understanding that isolation wards should be designed with high negative pressure, airtight doors and fresh air, it establishes the basis for designing biological clean rooms, including isolation wards, using a simple and convenient scientific approach. This book is intended for designers, engineers, researchers, hospital management staff and graduate students in heating ventilation air conditioning (HVAC), air cleaning technologies and related areas.

  7. Mechanisms of Sympathetic Activation and Blood Pressure Elevation by Intermittent Hypoxia

    OpenAIRE

    Prabhakar, Nanduri R.; Kumar, Ganesh K.

    2010-01-01

    Sleep disordered breathing with recurrent apneas is one of the most frequently encountered breathing disorder in adult humans and preterm infants. Recurrent apnea patients exhibit several co-morbidities including hypertension and persistent sympathetic activation. Intermittent hypoxia (IH) resulting from apneas appears to be the primary stimulus for evoking autonomic changes. The purpose of this article is to briefly review the effects of IH on chemo-and baro-reflexes and circulating vasoacti...

  8. Management of Pharyngocutaneous Fistula With Negative-Pressure Wound Therapy.

    Science.gov (United States)

    Teixeira, Sérgio; Costa, Joana; Bartosch, Isabel; Correia, Bernardo; Silva, Álvaro

    2017-06-01

    Pharyngocutaneous fistula is a common complication of laryngopharyngeal surgery and is associated with increased morbidity and mortality. Beyond the classical management, negative-pressure wound therapy (NPWT) can be an alternative and effective treatment. Two patients with pT3N0M0 squamous cell carcinoma of pyriform sinus were subjected to total laryngectomy and pharyngoesophageal reconstruction of a circular (patient 1) and an anterior wall defect (patient 2) with radial forearm free flap and pectoralis major muscle flap, respectively. Both developed a pharyngocutaneous fistula and NPWT was used.A significant decrease of the fistula aperture and exudate was observed after 22 and 21 days of NPWT in patients 1 and 2, respectively. After that standard wound care was instituted and closure of the fistulae was accomplished in 5 and 7 days, respectively. Negative-pressure wound therapy can be an effective treatment for pharyngocutaneous fistula closure, either in the setting of fistulae that persist besides multiple surgical revisions using muscle flaps or as a first-line therapy when fistulae develops.

  9. Solvation pressure as real pressure: I. Ethanol and starch under negative pressure

    CERN Document Server

    Uden, N W A V; Faux, D A; Tanczos, A C; Howlin, B; Dunstan, D J

    2003-01-01

    The reality of the solvation pressure generated by the cohesive energy density of liquids is demonstrated by three methods. Firstly, the Raman spectrum of ethanol as a function of cohesive energy density (solvation pressure) in ethanol-water and ethanol-chloroform mixtures is compared with the Raman spectrum of pure ethanol under external hydrostatic pressure and the solvation pressure and hydrostatic pressure are found to be equivalent for some transitions. Secondly, the bond lengths of ethanol are calculated by molecular dynamics modelling for liquid ethanol under pressure and for ethanol vapour. The difference in bond lengths between vapour and liquid are found to be equivalent to the solvation pressure for the C-H sub 3 , C-H sub 2 and O-H bond lengths, with discrepancies for the C-C and C-O bond lengths. Thirdly, the pressure-induced gelation of potato starch is measured in pure water and in mixtures of water and ethanol. The phase transition pressure varies in accordance with the change in solvation pre...

  10. Physical fitness and cardiovascular response to lower body negative pressure

    Science.gov (United States)

    Raven, P. B.; Rohm-Young, D.; Blomqvist, C. G.

    1984-01-01

    Klein et al. (1977) have questioned the concept of endurance training as an appropriate means of preparing for prolonged space flights. Their opinion was mainly based on reports of endurance athletes who had a decreased tolerance to orthostatic or gravitational stress induced by lower body negative pressure (LBNP), upright tilt, or whole body water immersion. The present investigation had the objective to determine if the hemodynamic response to LBNP is different between a high and average fit group of subjects. In addition, the discrete aspect of cardiovascular function which had been altered by chronic training was to be identified. On the basis of the results of experiments conducted with 14 young male volunteers, it is concluded that the reflex response to central hypovolemia is altered by endurance exercise training.

  11. Distribution of internal pressure around bony prominences: implications to deep tissue injury and effectiveness of intermittent electrical stimulation.

    Science.gov (United States)

    Solis, Leandro R; Liggins, Adrian; Uwiera, Richard R E; Poppe, Niek; Pehowich, Enid; Seres, Peter; Thompson, Richard B; Mushahwar, Vivian K

    2012-08-01

    The overall goal of this project is to develop interventions for the prevention of deep tissue injury (DTI), a form of pressure ulcers that originates in deep tissue around bony prominences. The present study focused on: (1) obtaining detailed measures of the distribution of pressure experienced by tissue around the ischial tuberosities, and (2) investigating the effectiveness of intermittent electrical stimulation (IES), a novel strategy for the prevention of DTI, in alleviating pressure in regions at risk of breakdown due to sustained loading. The experiments were conducted in adult pigs. Five animals had intact spinal cords and healthy muscles and one had a spinal cord injury that led to substantial muscle atrophy at the time of the experiment. A force-controlled servomotor was used to load the region of the buttocks to levels corresponding to 25%, 50% or 75% of each animal's body weight. A pressure transducer embedded in a catheter was advanced into the tissue to measure pressure along a three dimensional grid around the ischial tuberosity of one hind leg. For all levels of external loading in intact animals, average peak internal pressure was 2.01 ± 0.08 times larger than the maximal interfacial pressure measured at the level of the skin. In the animal with spinal cord injury, similar absolute values of internal pressure as that in intact animals were recorded, but the substantial muscle atrophy produced larger maximal interfacial pressures. Average peak internal pressure in this animal was 1.43 ± 0.055 times larger than the maximal interfacial pressure. Peak internal pressure was localized within a ±2 cm region medio-laterally and dorso-ventrally from the bone in intact animals and ±1 cm in the animal with spinal cord injury. IES significantly redistributed internal pressure, shifting the peak values away from the bone in spinally intact and injured animals. These findings provide critical information regarding the relationship between internal and

  12. High frequency jet ventilation and intermittent positive pressure ventilation. Effect of cerebral blood flow in patients after open heart surgery

    International Nuclear Information System (INIS)

    Pittet, J.F.; Forster, A.; Suter, P.M.

    1990-01-01

    Attenuation of ventilator-synchronous pressure fluctuations of intracranial pressure has been demonstrated during high frequency ventilation in animal and human studies, but the consequences of this effect on cerebral blood flow have not been investigated in man. We compared the effects of high frequency jet ventilation and intermittent positive pressure ventilation on CBF in 24 patients investigated three hours after completion of open-heart surgery. The patients were investigated during three consecutive periods with standard sedation (morphine, pancuronium): a. IPPV; b. HFJV; c. IPPV. Partial pressure of arterial CO 2 (PaCO 2 : 4.5-5.5 kPa) and rectal temperature (35.5 to 37.5 degree C) were maintained constant during the study. The CBF was measured by intravenous 133 Xe washout technique. The following variables were derived from the cerebral clearance of 133 Xe: the rapid compartment flow, the initial slope index, ie, a combination of the rapid and the slow compartment flows, and the ratio of fast compartment flow over total CBF (FF). Compared to IPPV, HFJV applied to result in the same mean airway pressure did not produce any change in pulmonary gas exchange, mean systemic arterial pressure, and cardiac index. Similarly, CBF was not significantly altered by HFJV. However, important variations of CBF values were observed in three patients, although the classic main determinants of CBF (PaCO 2 , cerebral perfusion pressure, Paw, temperature) remained unchanged. Our results suggest that in patients with normal systemic hemodynamics, the effects of HFJV and IPPV on CBF are comparable at identical levels of mean airway pressure

  13. Homogeneous nucleation in liquid nitrogen at negative pressures

    Energy Technology Data Exchange (ETDEWEB)

    Baidakov, V. G., E-mail: baidakov@itp.uran.ru; Vinogradov, V. E.; Pavlov, P. A. [Russian Academy of Sciences, Institute of Thermal Physics, Ural Branch (Russian Federation)

    2016-10-15

    The kinetics of spontaneous cavitation in liquid nitrogen at positive and negative pressures has been studied in a tension wave formed by a compression pulse reflected from the liquid–vapor interface on a thin platinum wire heated by a current pulse. The limiting tensile stresses (Δp = p{sub s}–p, where p{sub s} is the saturation pressure), the corresponding bubble nucleation frequencies J (10{sup 20}–10{sup 22} s{sup –1} m{sup –3}), and temperature induced nucleation frequency growth rate G{sub T} = dlnJ/dT have been experimentally determined. At T = 90 K, the limiting tensile stress was Δp = 8.3 MPa, which was 4.9 MPa lower than the value corresponding to the boundary of thermodynamic stability of the liquid phase (spinodal). The measurement results were compared to classical (homogeneous) nucleation theory (CNT) with and without neglect of the dependence of the surface tension of critical bubbles on their dimensions. In the latter case, the properties of new phase nuclei were described in terms of the Van der Waals theory of capillarity. The experimental data agree well with the CNT theory when it takes into account the “size effect.”.

  14. Incisional Negative Pressure Wound Therapy in High Risk Patients Undergoing Panniculectomy: A Prospective Randomized Controlled Trial

    Science.gov (United States)

    2018-01-16

    Complications Wounds; Negative Pressure Wound Therapy; Wound Healing Delayed; Incisional; Panniculectomy; Incisional Negative Pressure Wound Therapy; Incisional Vac; Wound Vac; Obese; Renal Failure; Kidney Transplant; Complications; Wound Healing Complication

  15. Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-negative women: a multicentre randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Raquel González

    2014-09-01

    Full Text Available Intermittent preventive treatment in pregnancy (IPTp with sulfadoxine-pyrimethamine (SP is recommended by WHO to prevent malaria in African pregnant women. The spread of SP parasite resistance has raised concerns regarding long-term use for IPT. Mefloquine (MQ is the most promising of available alternatives to SP based on safety profile, long half-life, and high efficacy in Africa. We evaluated the safety and efficacy of MQ for IPTp compared to those of SP in HIV-negative women.A total of 4,749 pregnant women were enrolled in an open-label randomized clinical trial conducted in Benin, Gabon, Mozambique, and Tanzania comparing two-dose MQ or SP for IPTp and MQ tolerability of two different regimens. The study arms were: (1 SP, (2 single dose MQ (15 mg/kg, and (3 split-dose MQ in the context of long lasting insecticide treated nets. There was no difference on low birth weight prevalence (primary study outcome between groups (360/2,778 [13.0%] for MQ group and 177/1,398 (12.7% for SP group; risk ratio [RR], 1.02 (95% CI 0.86-1.22; p=0.80 in the ITT analysis. Women receiving MQ had reduced risks of parasitemia (63/1,372 [4.6%] in the SP group and 88/2,737 [3.2%] in the MQ group; RR, 0.70 [95% CI 0.51-0.96]; p=0.03 and anemia at delivery (609/1,380 [44.1%] in the SP group and 1,110/2743 [40.5%] in the MQ group; RR, 0.92 [95% CI 0.85-0.99]; p=0.03, and reduced incidence of clinical malaria (96/551.8 malaria episodes person/year [PYAR] in the SP group and 130/1,103.2 episodes PYAR in the MQ group; RR, 0.67 [95% CI 0.52-0.88]; p=0.004 and all-cause outpatient attendances during pregnancy (850/557.8 outpatients visits PYAR in the SP group and 1,480/1,110.1 visits PYAR in the MQ group; RR, 0.86 [0.78-0.95]; p=0.003. There were no differences in the prevalence of placental infection and adverse pregnancy outcomes between groups. Tolerability was poorer in the two MQ groups compared to SP. The most frequently reported related adverse events were dizziness

  16. Negative pressure wound therapy for partial-thickness burns.

    Science.gov (United States)

    Dumville, Jo C; Munson, Christopher; Christie, Janice

    2014-12-15

    A burn wound is a complex and evolving injury, with both local and systemic consequences. Burn treatments include a variety of dressings, as well as newer strategies, such as negative pressure wound therapy (NPWT), which, by means of a suction force that drains excess fluids from the burn, tries to promote the wound healing process and minimise progression of the burn wound. To assess the effectiveness of NPWT for people with partial-thickness burns. We searched the Cochrane Wounds Group Specialised Register (searched 04 September 2014); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 8). All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) that evaluated the safety and effectiveness of NPWT for partial-thickness burns. Two review authors used standardised forms, and extracted the data independently. We assessed each trial for risk of bias, and resolved differences by discussion. One RCT, that was an interim report, satisfied the inclusion criteria. We undertook a narrative synthesis of results, as the absence of data and poor reporting precluded us from carrying out any formal statistical analysis. The trial was at high risk of bias. There was not enough evidence available to permit any conclusions to be drawn regarding the use of NPWT for treatment of partial-thickness burn wounds.

  17. Negative pressure wound therapy in patients with diabetic foot.

    Science.gov (United States)

    Ulusal, Ali Engin; Sahin, M Sükrü; Ulusal, Betül; Cakmak, Gökhan; Tuncay, Cengiz

    2011-01-01

    In this study our aim was to compare the results of standard dressing treatment to negative pressure wound therapy (NPWT) performed with a vacuum-assisted closure (VAC) device in patients with diabetic foot ulcers. We assessed the results of 35 patients treated for diabetic foot ulcer between 2006 and 2008. Of these cases, 20 (4 women and 16 men; mean age: 66 years; range: 52-90 years) were treated with standard wet dressings and 16 feet in 15 patients (10 men, 5 women; mean age: 58.9 years; range: 42-83 years) with VAC therapy. The success of treatment was evaluated in terms of hospitalization length and rate of limb salvation. The average hospitalization period with VAC treatment was 32 days compared to 59 days with standard dressing treatment. All patients treated with standard dressings eventually had to undergo amputation. However, the amputation rate was 37% in the VAC treated group and 88% of patients had a functional extremity at the end of treatment. VAC therapy, together with debridement and appropriate antibiotic therapy, enables a higher rate of limb salvage, especially in Wagner Grade 3 and Grade 4 ulcers.

  18. Pressure-controlled intermittent coronary sinus occlusion (PICSO) in acute ST-segment elevation myocardial infarction: results of the Prepare RAMSES safety and feasibility study

    NARCIS (Netherlands)

    van de Hoef, Tim P.; Nijveldt, Robin; van der Ent, Martin; Neunteufl, Thomas; Meuwissen, Martijn; Khattab, Ahmed; Berger, Rudolf; Kuijt, Wichert J.; Wykrzykowska, Joanna; Tijssen, Jan G. P.; van Rossum, Albert C.; Stone, Gregg W.; Piek, Jan J.

    2015-01-01

    Pressure-controlled intermittent coronary sinus occlusion (PICSO) may improve myocardial perfusion after pPCI. We evaluated the safety and feasibility of PICSO after pPCI for STEMI, and explored its effects on infarct size and myocardial function. Thirty patients were enrolled following successful

  19. [Clinical analysis of 4 children with negative pressure pulmonary edema].

    Science.gov (United States)

    Chen, Jiehua; Wang, Shu; Ma, Hongling; Wang, Wenjian; Fu, Dan; Huang, Wenxian; Deng, Jikui; Tang, Huiying; He, Yanxia; Zheng, Yuejie

    2014-02-01

    To analyze the clinical characteristics of negative pressure pulmonary edema (NPPE). A retrospective investigation of the clinical manifestation, imageology, clinical course and outcome of 4 children with NPPE seen between June 2012 and July 2013 in a children's hospital. The causation of the airway obstruction was also explored. All the 4 cases were boys, the range of age was 40 days to 9 years. They had no history of respiratory and circulatory system disease. In 3 cases the disease had a sudden onset after the obstruction of airway, and in one the onset occurred 1.5 hours after removing the airway foreign body. All these cases presented with tachypnea, dyspnea, and cyanosis, none had fever. Three cases had coarse rales. Chest radiography was performed in 3 cases and CT scan was performed in 1 case, in all of them both lungs displayed diffuse ground-glass-like change and patchy consolidative infiltrates. Three cases were admitted to the ICU, duration of mechanical ventilation was less than 24 hours in 2 cases and 39 hours in one. Oxygen was given by mask to the remaining one in emergency department, whose symptoms were obviously improved in 10 hours. None was treated with diuretics, glucocorticoids or inotropic agents. Chest radiographs were taken within 24 hours of treatment in 2 cases and 24-48 hours in the other 2; almost all the pulmonary infiltrates were resolved. All the 4 cases were cured. The causes of airway obstruction were airway foreign bodies in two cases, laryngospasm in one and laryngomalacia in the other. NPPE is a life-threatening emergency, which is manifested by rapid onset of respiratory distress rapidly (usually in several minutes, but might be hours later) after relief of the airway obstruction, with findings of pulmonary edema in chest radiograph. The symptoms resolve rapidly by oxygen therapy timely with or without mechanical ventilation. In children with airway obstruction, NPPE should be considered.

  20. Contrastive Analysis and Research on Negative Pressure Beam Tube System and Positive Pressure Beam Tube System for Mine Use

    Science.gov (United States)

    Wang, Xinyi; Shen, Jialong; Liu, Xinbo

    2018-01-01

    Against the technical defects of universally applicable beam tube monitoring system at present, such as air suction in the beam tube, line clogging, long sampling time, etc., the paper analyzes the current situation of the spontaneous combustion fire disaster forecast of mine in our country and these defects one by one. On this basis, the paper proposes a research thought that improving the positive pressure beam tube so as to substitute the negative pressure beam tube. Then, the paper introduces the beam tube monitoring system based on positive pressure technology through theoretical analysis and experiment. In the comparison with negative pressure beam tube, the paper concludes the advantage of the new system and draws the conclusion that the positive pressure beam tube is superior to the negative pressure beam tube system both in test result and test time. At last, the paper proposes prospect of the beam tube monitoring system based on positive pressure technology.

  1. Role of Negative Pressure Wound Therapy in Healing of Diabetic ...

    African Journals Online (AJOL)

    Journal of Surgical Technique and Case Report | Jan-Jun 2011 | Vol-3 | Issue-1. 10. Role of Negative ... case of any difficulty faced in the application of VAC dressings. BLEEDING ISSUE ... show exposed bone, tendon, joint capsule or fascia.

  2. Energy intermittency

    CERN Document Server

    Sorensen, Bent

    2014-01-01

    The first book to consider intermittency as a key point of an energy system, Energy Intermittency describes different levels of variability for traditional and renewable energy sources, presenting detailed solutions for handling energy intermittency through trade, collaboration, demand management, and active energy storage. Addressing energy supply intermittency systematically, this practical text:Analyzes typical time-distributions and intervals between episodes of demand-supply mismatch and explores their dependence on system layouts and energy source characteristicsSimulates scenarios regar

  3. The therapeutic effect of negative pressure in treating femoral head necrosis in rabbits.

    Science.gov (United States)

    Zhang, Yin-gang; Wang, Xuezhi; Yang, Zhi; Zhang, Hong; Liu, Miao; Qiu, Yushen; Guo, Xiong

    2013-01-01

    Because negative pressure can stimulate vascular proliferation, improve blood circulation and promote osteogenic differentiation of bone marrow stromal cells, we investigated the therapeutic effect of negative pressure on femoral head necrosis (FHN) in a rabbit model. Animals were divided into four groups (n = 60/group): [1] model control, [2] core decompression, [3] negative pressure and [4] normal control groups. Histological investigation revealed that at 4 and 8 weeks postoperatively, improvements were observed in trabecular bone shape, empty lacunae and numbers of bone marrow hematopoietic cells and fat cells in the negative pressure group compared to the core decompression group. At week 8, there were no significant differences between the negative pressure and normal control groups. Immunohistochemistry staining revealed higher expression of vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) in the femoral heads in the negative pressure group compared with the core decompression group. Transmission electron microscopy revealed that cell organelles were further developed in the negative pressure group compared with the core decompression group. Microvascular ink staining revealed an increased number of bone marrow ink-stained blood vessels, a thicker vascular lumen and increased microvascular density in the negative pressure group relative to the core decompression group. Real-time polymerase chain reaction revealed that expression levels of both VEGF and BMP-2 were higher in the negative pressure group compared with the core decompression group. In summary, negative pressure has a therapeutic effect on FHN. This effect is superior to core decompression, indicating that negative pressure is a potentially valuable method for treating early FHN.

  4. Comparison of intermittent positive pressure breathing and temporary positive expiratory pressure in patients with severe chronic obstructive pulmonary disease.

    Science.gov (United States)

    Nicolini, Antonello; Mollar, Elena; Grecchi, Bruna; Landucci, Norma

    2014-01-01

    Results supporting the use and the effectiveness of positive expiratory, pressure devices in chronic obstructive pulmonary disease (COPD) patients are still controversial, We have tested the hypothesis that adding TPEP or IPPB to standard pharmacological therapy may provide additional clinical benefit over, pharmacological therapy only in patients with severe COPD. Fourty-five patients were randomized in three groups: a group was treated; with IPPB,a group was treated with TPEP and a group with pharmacological; therapy alone (control group). Primary outcome measures included the measurement of scale or, questionnaire concerning dyspnea (MRC scale),dyspnea,cough, and, sputum (BCSS) and quality of life (COPD assessment test) (CAT). Secondary, outcome measures were respiratory function testing,arterial blood gas,analysis,and hematological examinations. Both patients in the IPPB group and in the TPEP group showed a significant, improvement in two of three tests (MRC,CAT) compared to the control, group.However,in the group comparison analysis for, the same variables between IPPB group and TPEP group we observed a, significant improvement in the IPPB group (P≤.05 for MRC and P≤.01 for, CAT). The difference of action of the two techniques are evident in the results of, pulmonary function testing: IPPB increases FVC, FEV1, and MIP; this reflects, its capacity to increase lung volume. Also TPEP increases FVC and FEV1 (less, than IPPB), but increases MEP, while decreasing total lung capacity and, residual volume. The two techniques (IPPB and TPEP) improves significantly dyspnea; quality of; life tools and lung function in patients with severe COPD. IPPB demonstrated a greater effectiveness to improve dyspnea and quality of life tools (MRC, CAT) than TPEP. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  5. Topical negative pressure therapy Recent experience of the department of plastic surgery at Ibn Sina University Hospital, Rabat, Morocco

    Directory of Open Access Journals (Sweden)

    Abdelmoughit Echchaoui

    2014-12-01

    Full Text Available IntroductionThe topical negative pressure therapy (TNP is a non-invasive method to treat chronic and acute wounds locally, using a continuous or intermittent negative pressure.The objective of this study is to present the first experience of this type of treatment used in clinical cases in our department. By presenting these cases, we highlight indication and efficiency of this new technique applied in relatively complicated situations, at the same time it also allows a significant improvement in treating injuries and chronic wounds.Materials and methodsIn this study, we present the recent experience of the Department of Reconstructive and Plastic Surgery of the University Hospital Center of Avicenne in Rabat. This therapy was used for the first time this year (in 2014, in three young patients who presented with chronic wounds associated with local and general factors that are unfavorable for the healing process.ResultsIn all three of our cases we obtained highly satisfactory clinical results.TNP allows wounds to bud in a shorter time, as well as a fast healing by second intention due to controlled wound healing or split-skin graft without using flaps. This enables to decrease the margin of error, the time and the number of dressing replacements, and to reduce the length of hospital stay.ConclusionThis is an expensive and specific equipment. However, the cost-benefit ratio analysis shows that it is an essential method that should be part of our therapeutic strategies.Keywords: loss of substance, negative pressure, budding, healing.  

  6. Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

    Directory of Open Access Journals (Sweden)

    Daniela Franco Rizzo Komatsu

    Full Text Available Summary Objective: To analyze the frequency of extubation failure in premature infants using conventional mechanical ventilation (MV after extubation in groups subjected to nasal intermittent positive pressure ventilation (nIPPV and continuous positive airway pressure (nCPAP. Method: Seventy-two premature infants with respiratory failure were studied, with a gestational age (GA ≤ 36 weeks and birth weight (BW > 750 g, who required tracheal intubation and mechanical ventilation. The study was controlled and randomized in order to ensure that the members of the groups used in the research were chosen at random. Randomization was performed at the time of extubation using sealed envelopes. Extubation failure was defined as the need for re-intubation and mechanical ventilation during the first 72 hours after extubation. Results: Among the 36 premature infants randomized to nIPPV, six (16.6% presented extubation failure in comparison to 11 (30.5% of the 36 premature infants randomized to nCPAP. There was no statistical difference between the two study groups regarding BW, GA, classification of the premature infant, and MV time. The main cause of extubation failure was the occurrence of apnea. Gastrointestinal and neurological complications did not occur in the premature infants participating in the study. Conclusion: We found that, despite the extubation failure of the group of premature infants submitted to nIPPV being numerically smaller than in premature infants submitted to nCPAP, there was no statistically significant difference between the two modes of ventilatory support after extubation.

  7. Dynamic Leg Exercise Improves Tolerance to Lower Body Negative Pressure

    Science.gov (United States)

    Watenpaugh, D. E.; Ballard, R. E.; Stout, M. S.; Murthy, G.; Whalen, R. T.; Hargens, A. R.

    1994-01-01

    These results clearly demonstrate that dynamic leg exercise against the footward force produced by LBNP substantially improves tolerance to LBNP, and that even cyclic ankle flexion without load bearing also increases tolerance. This exercise-induced increase of tolerance was actually an underestimate, because subjects who completed the tolerance test while exercising could have continued for longer periods. Exercise probably increases LBNP tolerance by multiple mechanisms. Tolerance was increased in part by skeletal muscle pumping venous blood from the legs. Rosenhamer and Linnarsson and Rosenhamer also deduced this for subjects cycling during centrifugation, although no measurements of leg volume were made in those studies: they found that male subjects cycling at 98 W could endure 3 Gz centrifugation longer than when they remained relaxed during centrifugation. Skeletal muscle pumping helps maintain cardiac filling pressure by opposing gravity-, centrifugation-, or LBNP-induced accumulation of blood and extravascular fluid in the legs.

  8. Mechanisms of lower body negative pressure-induced syncope

    Science.gov (United States)

    Davrath, Linda Ruble

    Although extensively investigated, the mechanisms of post-spaceflight orthostatic intolerance have not been elucidated. The working hypothesis was that a markedly reduced left ventricular end-systolic volume (LVESV) would be achieved during progressive, presyncopal-limited LBNP and would cause bradycardia and a fall in blood pressure, thus triggering syncope. Eight healthy men, age 25.1 ± 1.3 years, volunteered for the study. Subjects were exposed to graded levels of LBNP on two separate occasions. Changes in left ventricular end-diastolic volume and LVESV were measured, using two-dimensional echocardiography, at each stage of LBNP from rest to presyncope. Plasma venous blood samples were withdrawn at the end of each stage of the LBNP protocol for the measurement of plasma venous catecholamines and plasma renin activity (PRA). Catecholamines were analyzed by HPLC with electro-chemical detection, and PRA was determined by radioimmunoassay. All subjects reached presyncope during the LBNP. LVESV decreased by 28% at presyncope with no evidence of ventricular cavity obliteration. Norepinephrine (NE) increased by 44% from rest to presyncope, but no epinephrine surge was detected (35% increase from rest to presyncope). These data indicate that it is possible to initiate syncope with only a 28% decrease in LVESV, and that sympatho-inhibition and bradycardia are not required elements for syncope to occur. To investigate the effect of moderate sodium restriction on cardiovascular hemodynamics and orthostatic tolerance, presyncopal LBNP testing was performed. Urinary sodium excretion was significantly higher on the normal-sodium diet when compared with the sodium-restricted diet, but urinary potassium was not different. Cumulative stress index (655 ± 460 on normal-sodium diet vs. 639 ± 388 on sodium-restricted diet) scores were not different. Cardiac volumes, blood pressure and total peripheral resistance were not different at any stage of the LBNP between the diets, nor

  9. Negative-Pressure Hydrocephalus: A Case Report on Successful Treatment Under Intracranial Pressure Monitoring with Bilateral Ventriculoperitoneal Shunts.

    Science.gov (United States)

    Pandey, Sajan; Jin, Yi; Gao, Liang; Zhou, Cheng Cheng; Cui, Da Ming

    2017-03-01

    Negative-pressure hydrocephalus (NegPH), a very rare condition of unknown etiology and optimal treatment, usually presents postneurosurgery with clinical and imaging features of hydrocephalus, but with negative cerebrospinal fluid pressure. We describe a NegPH case of -3 mm Hg intracranial pressure that was successfully treated to achieve 5 mm Hg under continuous intracranial pressure monitoring with horizontal positioning, head down and legs elevated to 10°-15°, neck wrapping for controlled venous drainage, chest and abdomen bandages, infusion of 5% dextrose fluid to lower plasma osmolarity (Na + , 130-135 mmol/L), daily cerebrospinal fluid drainage >200 mL, and arterial blood gas partial pressure of carbon dioxide >40 mm Hg. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Intermittent degradation and schizotypy

    Directory of Open Access Journals (Sweden)

    Matthew W. Roché

    2015-06-01

    Full Text Available Intermittent degradation refers to transient detrimental disruptions in task performance. This phenomenon has been repeatedly observed in the performance data of patients with schizophrenia. Whether intermittent degradation is a feature of the liability for schizophrenia (i.e., schizotypy is an open question. Further, the specificity of intermittent degradation to schizotypy has yet to be investigated. To address these questions, 92 undergraduate participants completed a battery of self-report questionnaires assessing schizotypy and psychological state variables (e.g., anxiety, depression, and their reaction times were recorded as they did so. Intermittent degradation was defined as the number of times a subject’s reaction time for questionnaire items met or exceeded three standard deviations from his or her mean reaction time after controlling for each item’s information processing load. Intermittent degradation scores were correlated with questionnaire scores. Our results indicate that intermittent degradation is associated with total scores on measures of positive and disorganized schizotypy, but unrelated to total scores on measures of negative schizotypy and psychological state variables. Intermittent degradation is interpreted as potentially derivative of schizotypy and a candidate endophenotypic marker worthy of continued research.

  11. Intermittent hypobaric hypoxia exposure does not cause sustained alterations in autonomic control of blood pressure in young athletes.

    NARCIS (Netherlands)

    Fu, Q.; Townsend, N.E.; Shiller, S.M.; Martini, E.R.; Okazaki, K.; Shibata, S.; Truijens, M.J.; Rodriquez, F.A.; Gore, C.J.; Stray-Gundersen, J.; Levine, B.D.

    2007-01-01

    Intermittent hypoxia (IH), which refers to the discontinuous use of hypoxia to reproduce some key features of altitude acclimatization, is commonly used in athletes to improve their performance. However, variations of IH are also used as a model for sleep apnea, causing sustained sympathoexcitation

  12. Treatment Experience of Continuous Negative Pressure Drainage in the Acute Anterior Mediastinal Infection of Oropharyngeal Origined

    Directory of Open Access Journals (Sweden)

    Anping CHEN

    2018-04-01

    Full Text Available Background and objective Mediastinal infection is a serious infection of mediastinal connective tissue, with more complications and higher mortality. Application of broad-spectrum antibiotics and nutritional support, early sufficient drainage is the key to successful treatment. In the mode of drainage, this paper discusses the application of continuous negative pressure drainage technique to treat acute anterior mediastinal infection of severe mouth pharynx source, and the good results are summarized and shared. Methods In January to December in 2017, a total of 17 cases treated acute mediastinal infection is derived from the throat, has formed a mediastinal abscess, surgery adopts retrosternal counterpart negative pressure drainage way, namely the sternum nest and free sternum xiphoid process under the incision on the first mediastinal clearance, make breakthrough and placed drainage device, suture closed wound, continuous negative pressure drainage, negative pressure using 3 cm-5 cm water column. Results Among the 17 patients, 14 patients were relieved by continuous negative pressure drainage, and then the drainage tube was removed. In 2 cases, the infection broke into the right thoracic cavity, and the closed drainage caused the negative pressure to disappear, and the negative pressure drainage was replaced by the conventional drainage, and the drainage tube was removed after the drainage tube was clear. One patient had formed a mediastinal abscess incision drainage time later, complicated with septic shock and sepsis, resulting in the death of multiple organ failure. Conclusion The traditional treatment of severe acute mediastinal infection is sternal incision and drainage. Continuous negative pressure drainage adequate drainage of mediastinal can relieve patients' pain, effusion, and avoid the dressing out repeatedly. It is an effective method. However, there are limitations in this method, which need to be further optimized.

  13. Negative Pressure Pulmonary Edema after Reversing Rocuronium-Induced Neuromuscular Blockade by Sugammadex

    Directory of Open Access Journals (Sweden)

    Manzo Suzuki

    2014-01-01

    Full Text Available Negative pressure pulmonary edema (NPPE is a rare complication that accompanies general anesthesia, especially after extubation. We experienced a case of negative pressure pulmonary edema after tracheal extubation following reversal of rocuronium-induced neuromuscular blockade by sugammadex. In this case, the contribution of residual muscular block on the upper airway muscle as well as large inspiratory forces created by the respiratory muscle which has a low response to muscle relaxants, is suspected as the cause.

  14. Empirical Formulas for Calculation of Negative Pressure Difference in Vacuum Pipelines

    Directory of Open Access Journals (Sweden)

    Marek Kalenik

    2015-10-01

    Full Text Available The paper presents the analysis of results of empirical investigations of a negative pressure difference in vacuum pipelines with internal diameters of 57, 81, 102 mm. The investigations were performed in an experimental installation of a vacuum sewage system, built in a laboratory hall on a scale of 1:1. The paper contains a review of the literature concerning two-phase flows (liquid-gas in horizontal, vertical and diagonal pipelines. It presents the construction and working principles of the experimental installation of vacuum sewage system in steady and unsteady conditions during a two-phase flow of water and air. It also presents a methodology for determination of formula for calculation of a negative pressure difference in vacuum pipelines. The results obtained from the measurements of the negative pressure difference Δpvr in the vacuum pipelines were analyzed and compared with the results of calculations of the negative pressure difference Δpvr, obtained from the determined formula. The values of the negative pressure difference Δpvr calculated for the vacuum pipelines with internal diameters of 57, 81, and 102 mm with the use of Formula (19 coincide with the values of Δpvr measured in the experimental installation of a vacuum sewage system. The dependence of the negative pressure difference Δpvr along the length of the vacuum pipelines on the set negative pressure in the vacuum container pvzp is linear. The smaller the vacuum pipeline diameter, the greater the negative pressure difference Δpvr is along its length.

  15. Management of High-Voltage Burns of the Hand and Wrist with Negative Pressure Dressing

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    Nazım Gümüş

    2017-12-01

    Full Text Available Objective: Negative pressure dressing stimulates wound healing by promoting cellular proliferation and regeneration. It also removes interstitial edema and increases local blood flow, resulting in rapid growth of the granulation tissue. We used the dressing method in deep hand and wrist burns caused by high-voltage electrical current, which leads to progressive tissue necrosis, elevated compartment pressure, and deep tissue edema, to reveal if subatmospheric pressure could limit the zone of injury or ongoing tissue necrosis after electrical burn. Material and Methods: Six hands of five patients, who came in contact with high-voltage electrical wire carrying more than 1000 volts, are presented in this study. Hands and wrists were seriously injured and contracted. After the initial treatment involving fluid resuscitation, fasciotomy, carpal tunnel release, and debridement, a negative pressure dressing was applied to the wounds of hand, wrist, and forearm with 125 mm Hg continuous pressure, and maintained for 20 days. Results: When negative pressure dressing was stopped on the 20th day, significant granulation tissue developed over the hand and forearm wounds. However, wrist wounds needed more debridement and repeated dressings because of the presence of necrosis. Edema of the hands subsided significantly during the use of negative pressure dressing. Time to closure for hand and forearm wounds decreased considerably. Moreover, in one wrist, spontaneous closure was achieved at about one month. All hands except one treated with negative pressure dressing could be saved from amputation; however, significant tissue loss developed, needing complex reconstruction procedures. One hand was amputated because of the permanent loss of blood perfusion. Conclusion: The management of high-voltage burns of hand and wrist with subatmospheric pressure appears to be capable of reducing hand edema and accelerating closure of the wounds. It seems that negative

  16. Comparison of efficacy of the intermittent pneumatic compression with a high- and low-pressure application in reducing the lower limbs phlebolymphedema

    Directory of Open Access Journals (Sweden)

    Taradaj J

    2015-10-01

    Full Text Available Jakub Taradaj,1 Joanna Rosińczuk,2 Robert Dymarek,2 Tomasz Halski,3 Winfried Schneider4 1Department of Physiotherapy Basics, Academy School of Physical Education in Katowice, Katowice, 2Department of Nervous System Diseases, University of Medicine in Wroclaw, Wroclaw, 3Institute of Physiotherapy, Public Higher Medical Professional School in Opole, Opole, Poland; 4Lymphology Center in Bad Berleburg, Bad Berleburg, Germany Introduction: The primary lymphedema and chronic venous insufficiency present an important medical problem, and effective physical therapeutic methods to treat this problem are still at the search phase. The aim of this study was to compare the efficacy of intermittent pneumatic compression (IPC of a high- or low-pressure level in the treatment of primary phlebolymphedema of the lower limbs.Methods: The study included 81 patients with chronic venous insufficiency and primary lymphedema of the lower limbs. Group A consisted of 28 patients who underwent a monthly antiedematous therapy including a manual lymphatic drainage, multilayer bandaging, and IPC with the output pressure of 120 mmHg. Group B consisted of 27 patients who underwent the same basic treatment as group A and IPC with the output pressure of 60 mmHg. Group C (control consisted of 26 patients who underwent only a basic treatment – without IPC.Results: After completion of the study, it was found that the greatest reduction of edema occurred in patients who underwent treatment with a pressure of 120 mmHg. The comparison of percentage reduction of edema showed a statistically significant advantage of the group A over groups B and C, both for the changes in the right (P=0.01 and the left limb (P=0.01. Results in patients undergoing intermittent compression of the lower pressure (60 mmHg were similar to those obtained in the control group.Conclusion: The IPC with the pressure of 120 mmHg inside the chambers effectively helps to reduce a phlebolymphedema

  17. The effects of superimposed tilt and lower body negative pressure on anterior and posterior cerebral circulations

    OpenAIRE

    Tymko, Michael M.; Rickards, Caroline A.; Skow, Rachel J.; Ingram?Cotton, Nathan C.; Howatt, Michael K.; Day, Trevor A.

    2016-01-01

    Abstract Steady?state tilt has no effect on cerebrovascular reactivity to increases in the partial pressure of end?tidal carbon dioxide (PETCO 2). However, the anterior and posterior cerebral circulations may respond differently to a variety of stimuli that alter central blood volume, including lower body negative pressure (LBNP). Little is known about the superimposed effects of head?up tilt (HUT; decreased central blood volume and intracranial pressure) and head?down tilt (HDT; increased ce...

  18. Optimal Dynamics of Intermittent Water Supply

    Science.gov (United States)

    Lieb, Anna; Wilkening, Jon; Rycroft, Chris

    2014-11-01

    In many urban areas of the developing world, piped water is supplied only intermittently, as valves direct water to different parts of the water distribution system at different times. The flow is transient, and may transition between free-surface and pressurized, resulting in complex dynamical features with important consequences for water suppliers and users. These consequences include degradation of distribution system components, compromised water quality, and inequitable water availability. The goal of this work is to model the important dynamics and identify operating conditions that mitigate certain negative effects of intermittent water supply. Specifically, we will look at valve parameters occurring as boundary conditions in a network model of transient, transition flow through closed pipes. Optimization will be used to find boundary values to minimize pressure gradients and ensure equitable water availability.

  19. Application of vacuum-assisted closure in seawater-immersed wound treatment under different negative pressures.

    Science.gov (United States)

    Cao, L; Peng, M M; Sun, J J; Yu, X C; Shi, B

    2015-06-11

    The therapeutic effect of vacuum-assisted closure (VAC) has been confirmed in many types of complex wounds, but there are few relevant reports regarding seawater-immersed wounds. The aim of this study was to determine the effect of VAC on seawater-immersed wound healing under different negative pressures and explore the optimal negative pressure value. Four purebred miniature pigs were used as the experimental animal models. Four acute, symmetrical wounds were made on each side of the spine and designated as the experimental group (wounds with 2 h of seawater immersion) and the control group (wounds without seawater immersion). Wounds were divided into a conventional dressing group and 3 further groups with different VAC therapies (negative pressure at either 120, 180, or 240 mmHg). The extent of wound healing, and speed of granulation growth and re-epithelialization were measured. Bacterial flora distribution in the wounds was observed, and fibronectin levels in the exudate of the wounds were tested. Results showed that seawater immersion aggravated wound injury and that VAC therapy with 180 mmHg negative pressure induced the fastest epidermis migration, obvious edema elimination, significant capillary proliferation, and the highest level of fibronectin, and that in wounds, the proportion of Gram-negative bacteria tended to decrease and that of Gram-positive bacteria tended to increase. Our results show that VAC promotes seawater-immersed wound healing and that 180 mmHg negative pressure may be optimal for wound healing.

  20. Measurement of negative ion mobilities in O2 and O3 mixtures at atmospheric pressure

    International Nuclear Information System (INIS)

    Itoh, H.; Norimoto, K.; Hayashi, T.

    1998-01-01

    Mobility measurements of negative molecular oxygen ions in pure oxygen and in an oxygen-ozone mixture are reported. A cascaded gap consisting of an ion drift gap and an ion detection gap was used in the experiment. The ion detection gap was formed by a positive point and a grounded plane electrode was operated at atmospheric pressure. The zero field mobility of negative molecular oxygen ions was determined to be 2.07+-0.02 cm 2 /V.s. A somewhat higher value of oxygen mobility was found at higher electric field/pressure ratios; this is presumed to be due to negative ozone ions. When changing the electric field/pressure ratio the mobility of negative oxygen ions in oxygen-ozone mixtures becomes smaller than that in pure oxygen; this is probably due to the cumulative effect of other particles produced by silent discharges. (J.U.)

  1. A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure

    Directory of Open Access Journals (Sweden)

    Chang SC

    2016-05-01

    Full Text Available Suchi Chang,1 Jindong Shi,2 Cuiping Fu,1 Xu Wu,1 Shanqun Li1 1Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, 2Department of Respiratory Medicine, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai, People’s Republic of China Background: COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. Objective: We evaluated pressure-regulated volume control (PRVC ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Patients and methods: Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation – volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2–4 hours and 48 hours. Results: Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2, and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2 levels. The pH and PaCO2 levels at 2–4 hours were lower and higher, respectively, in the test group than those in the control group (P<0.05 for both; after 48 hours, blood gas analyses showed no statistical difference in any marker (P>0.05. Vital signs during 2–4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05. The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2–4 hours and 48

  2. Multidimensional intermittency in hadronic collisions

    International Nuclear Information System (INIS)

    Pan, J.; Hwa, R.C.

    1992-06-01

    The study of intermittency in high-energy hadronic collisions by the Monte Carlo code ECCO is extended to 3-dimensional phase space. Strong intermittency is found in agreement with the data. Fluctuation in the impact parameter is responsible for the intermittency in lnp T , and the transverse-momentum conservation leads to negative intermittency slopes in the azimuthal angle φ. The Ochs-Wosiek plots are linear in all dimensions having universal slopes. An exponent ν = 1.448 emerges to characterize multiparticle production in pp collisions. The properties of G moments are also examined, and the fractal dimensions determined

  3. A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure.

    Science.gov (United States)

    Chang, Suchi; Shi, Jindong; Fu, Cuiping; Wu, Xu; Li, Shanqun

    2016-01-01

    COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. We evaluated pressure-regulated volume control (PRVC) ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation - volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2-4 hours and 48 hours. Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2), and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2) levels. The pH and PaCO2 levels at 2-4 hours were lower and higher, respectively, in the test group than those in the control group (P0.05). Vital signs during 2-4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05). The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2-4 hours and 48 hours was significantly lower than that in the control group (P0.05). Among elderly COPD patients with respiratory failure, application of PRVC resulted in rapid improvement in arterial blood gas analyses while maintaining a low peak inspiratory pressure. PRVC can reduce pulmonary barotrauma risk, making it a safer protective ventilation mode than synchronized intermittent mandatory ventilation - volume control.

  4. The paradox of negative pressure wound therapy--in vitro studies.

    Science.gov (United States)

    Kairinos, Nicolas; Solomons, Michael; Hudson, Donald A

    2010-01-01

    Negative-pressure wound therapy (NPWT) has revolutionised wound care. Yet, it is still not understood how hypobaric tissue pressure accelerates wound healing. There is very little reported on the relevant physics of any substance subjected to suction in this manner. The common assumption is that applying suction to a substance is likely to result in a reduction of pressure in that substance. Although more than 250 research articles have been published on NPWT, there are little data verifying whether suction increases or decreases the pressure of the substance it is applied to. Clarifying this basic question of physics is the first step in understanding the mechanism of action of these dressings. In this study, pressure changes were recorded in soft plasticene and processed meat, using an intracranial tissue pressure microsensor. Circumferential, non-circumferential and cavity NPWT dressings were applied, and pressure changes within the underlying substance were recorded at different suction pressures. Pressures were also measured at 1cm, 2 cm and 3 cm from the NPWT placed in a cavity. In all three types of NPWT dressings, the underlying substance pressure was increased (hyperbaric) as suction pressure increased. Although there was a substantial pressure increase at 1cm, the rise in pressure at the 2-cm and 3-cm intervals was minimal. Substance pressure beneath all types of NPWT dressing is hyperbaric in inanimate substances. Higher suction pressures generate greater substance pressures; however, the increased pressure rapidly dissipates as the distance from the dressing is increased. The findings of this study on inanimate objects suggest that we may need to review our current perception of the physics underlying NPWT dressings. Further research of this type on living tissues is warranted. Copyright (c) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Asymmetric Fuzzy Control of a Positive and Negative Pneumatic Pressure Servo System

    Science.gov (United States)

    Yang, Gang; Du, Jing-Min; Fu, Xiao-Yun; Li, Bao-Ren

    2017-11-01

    The pneumatic pressure control systems have been used in some fields. However, the researches on pneumatic pressure control mainly focus on constant pressure regulation. Poor dynamic characteristics and strong nonlinearity of such systems limit its application in the field of pressure tracking control. In order to meet the demand of generating dynamic pressure signal in the application of the hardware-in-the-loop simulation of aerospace engineering, a positive and negative pneumatic pressure servo system is provided to implement dynamic adjustment of sealed chamber pressure. A mathematical model is established with simulation and experiment being implemented afterwards to discuss the characteristics of the system, which shows serious asymmetry in the process of charging and discharging. Based on the analysis of the system dynamics, a fuzzy proportional integral derivative (PID) controller with asymmetric fuzzy compensator is proposed. Different from conventional adjusting mechanisms employing the error and change in error of the controlled variable as input parameters, the current chamber pressure and charging or discharging state are chosen as inputs of the compensator, which improves adaptability. To verify the effectiveness and performance of the proposed controller, the comparison experiments tracking sinusoidal and square wave commands are conducted. Experimental results show that the proposed controller can obtain better dynamic performance and relatively consistent control performance across the scope of work (2-140 kPa). The research proposes a fuzzy control method to overcome asymmetry and enhance adaptability for the positive and negative pneumatic pressure servo system.

  6. A pressure-amplifying framework material with negative gas adsorption transitions.

    Science.gov (United States)

    Krause, Simon; Bon, Volodymyr; Senkovska, Irena; Stoeck, Ulrich; Wallacher, Dirk; Többens, Daniel M; Zander, Stefan; Pillai, Renjith S; Maurin, Guillaume; Coudert, François-Xavier; Kaskel, Stefan

    2016-04-21

    Adsorption-based phenomena are important in gas separations, such as the treatment of greenhouse-gas and toxic-gas pollutants, and in water-adsorption-based heat pumps for solar cooling systems. The ability to tune the pore size, shape and functionality of crystalline porous coordination polymers--or metal-organic frameworks (MOFs)--has made them attractive materials for such adsorption-based applications. The flexibility and guest-molecule-dependent response of MOFs give rise to unexpected and often desirable adsorption phenomena. Common to all isothermal gas adsorption phenomena, however, is increased gas uptake with increased pressure. Here we report adsorption transitions in the isotherms of a MOF (DUT-49) that exhibits a negative gas adsorption; that is, spontaneous desorption of gas (methane and n-butane) occurs during pressure increase in a defined temperature and pressure range. A combination of in situ powder X-ray diffraction, gas adsorption experiments and simulations shows that this adsorption behaviour is controlled by a sudden hysteretic structural deformation and pore contraction of the MOF, which releases guest molecules. These findings may enable technologies using frameworks capable of negative gas adsorption for pressure amplification in micro- and macroscopic system engineering. Negative gas adsorption extends the series of counterintuitive phenomena such as negative thermal expansion and negative refractive indices and may be interpreted as an adsorptive analogue of force-amplifying negative compressibility transitions proposed for metamaterials.

  7. Early use of negative pressure therapy in combination with silver dressings in a difficult breast abscess.

    Science.gov (United States)

    Richards, Alastair J; Hagelstein, Sue M; Patel, Girish K; Ivins, Nicola M; Sweetland, Helen M; Harding, Keith G

    2011-12-01

    Combining silver-based dressings with negative pressure therapy after radical excision of chronically infected breast disease is a novel application of two technologies. One patient with complex, chronic, infected breast disease underwent radical excision of the affected area and was treated early with a combination of silver-based dressings and topical negative pressure therapy. The wound was then assessed sequentially using clinical measurements of wound area and depth, pain severity scores and level of exudation. It is possible to combine accepted techniques with modern dressing technologies that result in a positive outcome. In this case, the combination of a silver-based dressing with negative pressure therapy following radical excision proved safe and was well tolerated by the patient. Full epithelisation of the wound was achieved and there was no recurrence of the infection for the duration of the treatment. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  8. Negative pressure wound therapy and external fixation device: a simple way to seal the dressing.

    Science.gov (United States)

    Bulla, Antonio; Farace, Francesco; Uzel, André-Pierre; Casoli, Vincent

    2014-07-01

    Negative pressure therapy is widely applied to treat lower limb trauma. However, sealing a negative pressure dressing in the presence of an external fixation device may be difficult and time consuming. Therefore, screws, pins, wires, etc, may preclude the vacuum, preventing the plastic drape to perfectly adhere to the foam. To maintain the vacuum, we tried to prevent air leaking around the screws putting bone wax at the junction between the pins and the plastic drape. This solution, in our hands, avoids air leakage and helps maintain vacuum in a fast and inexpensive way.

  9. Negative Pressure Pulmonary Edema Following use of Laryngeal Mask Airway (LMA

    Directory of Open Access Journals (Sweden)

    Yesim Bayraktar

    2013-06-01

    Full Text Available Negative pressure pulmonary edema (NPPE following upper airway obstruction is a non-cardiogenic pulmonary edema. The first cause in the etiology of NPPE is developed laryngospasm after intubation or extubation, while the other causes are epiglotitis, croup, hiccups, foreign body aspiration, pharyngeal hematoma and oropharyngeal tumors.The Late diagnosis and treatment causes high morbidity and mortality. The protection of the airway and maintainance of arterial oxygenation will be life saving.In this article we aimed to report  a case of negative pressure pulmonary edema, resolved succesfully after treatment, following use of laryngeal mask airway (LMA.

  10. Relaxation effects in ionic mobility and cluster formation: negative ions in SF6 at high pressures

    International Nuclear Information System (INIS)

    Juarez, A M; De Urquijo, J; Hinojosa, G; Hernandez-Avila, J L; Basurto, E

    2010-01-01

    The relaxation effects of the ionic mobility and the formation of negative-ion clusters in SF 6 are studied in this work. For this purpose, we have measured the mobility of negative ions in SF 6 over the pressure range 100-800 Torr at a fixed value of density-normalized electric field, E/N, of 20 Td (1 Townsend = 10 -17 V cm 2 ). The data obtained show a clear dependence of the negative-ion drift velocity on drift distance. It is observed that the drift velocity (mobility) reaches a steady-state value only for drift distances above 2 cm, over the studied pressure range. In addition to this, we have observed that the ionic mobility depends strongly on the gas pressure. An explanation of this dependence of the ionic mobility on gas pressure is given in terms of a negative-ion clustering formation process. It was found that the assumption of a linear dependence of the cluster ion mass on pressure provides a satisfactory explanation for the observed mobilities.

  11. Stress and Negative Relationship Quality among Older Couples: Implications for Blood Pressure.

    Science.gov (United States)

    Birditt, Kira S; Newton, Nicky J; Cranford, James A; Ryan, Lindsay H

    2016-09-01

    The cardiovascular system may represent a significant pathway by which marriage and stress influence health, but research has focused on married individuals cross-sectionally. This study examined associations among chronic stress, negative spousal relationship quality, and systolic blood pressure over time among middle-aged and older husbands and wives. Participants were from the nationally representative longitudinal Health and Retirement Study. A total of 1,356 (N = 2,712) married and cohabitating couples completed psychosocial and biomeasure assessments in waves 2006 and 2010. Analyses examined whether Wave 1 (2006) relationship quality and stress were associated with changes in blood pressure over time. The effects of stress and negative relationship quality were dyadic and varied by gender. Husbands had increased blood pressure when wives reported greater stress, and this link was exacerbated by negative spousal relationship quality. Negative relationship quality predicted increased blood pressure when both members of the couple reported negative quality relations. Findings support the dyadic biopsychosocial model of marriage and health indicating: (a) stress and relationship quality directly effect the cardiovascular system, (b) relationship quality moderates the effect of stress, and (c) the dyad rather than only the individual should be considered when examining marriage and health. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Perceiving social pressure not to feel negative predicts depressive symptoms in daily life.

    Science.gov (United States)

    Dejonckheere, Egon; Bastian, Brock; Fried, Eiko I; Murphy, Sean C; Kuppens, Peter

    2017-09-01

    Western societies often overemphasize the pursuit of happiness, and regard negative feelings such as sadness or anxiety as maladaptive and unwanted. Despite this emphasis on happiness, the amount of people suffering from depressive complaints is remarkably high. To explain this apparent paradox, we examined whether experiencing social pressure not to feel sad or anxious could in fact contribute to depressive symptoms. A sample of individuals (n = 112) with elevated depression scores (Patient Health Questionnaire [PHQ-9] ≥ 10) took part in an online daily diary study in which they rated their depressive symptoms and perceived social pressure not to feel depressed or anxious for 30 consecutive days. Using multilevel VAR models, we investigated the temporal relation between this perceived social pressure and depressive symptoms to determine directionality. Primary analyses consistently indicated that experiencing social pressure predicts increases in both overall severity scores and most individual symptoms of depression, but not vice versa. A set of secondary analyses, in which we adopted a network perspective on depression, confirmed these findings. Using this approach, centrality analysis revealed that perceived social pressure not to feel negative plays an instigating role in depression, reflected by the high out- and low instrength centrality of this pressure in the various depression networks. Together, these findings indicate how perceived societal norms may contribute to depression, hinting at a possible malignant consequence of society's denouncement of negative emotions. Clinical implications are discussed. © 2017 Wiley Periodicals, Inc.

  13. Negative magnetoresistance of pitch-based carbon fibers Temperature and pressure dependence

    Science.gov (United States)

    Hambourger, P. D.

    1986-01-01

    The negative transverse magnetoresistance of high-modulus pitch-based carbon fibers has been measured over the temperature range 1.3-4.2 K at ambient pressure and at 4.2 K under hydrostatic pressure up to 16 kbar. At low fields (less than 0.5 torr) the magnitude of the magnetoresistance increases markedly as the temperature is lowered from 4.2 K to 1.3 K, in disagreement with Bright's theoretical model, and decreases with pressure at the rate -0.6 percent/kbar.

  14. Negative Binomial Fits to Multiplicity Distributions from Central Collisions of (16)O+Cu at 14.6A GeV/c and Intermittency

    Science.gov (United States)

    Tannenbaum, M. J.

    1994-01-01

    The concept of "Intermittency" was introduced by Bialas and Peschanski to try to explain the "large" fluctuations of multiplicity in restricted intervals of rapidity or pseudorapidity. A formalism was proposed to to study non-statistical (more precisely, non-Poisson) fluctuations as a function of the size of rapidity interval, and it was further suggested that the "spikes" in the rapidity fluctuations were evidence of fractal or intermittent behavior, in analogy to turbulence in fluid dynamics which is characterized by self-similar fluctuations at all scales-the absence of well defined scale of length.

  15. Using the Solving Problems Together Psychoeducational Group Counseling Model as an Intervention for Negative Peer Pressure

    Science.gov (United States)

    Hall, Kimberly R.; Rushing, Jeri Lynn; Khurshid, Ayesha

    2011-01-01

    Problem-focused interventions are considered to be one of the most effective group counseling strategies with adolescents. This article describes a problem-focused group counseling model, Solving Problems Together (SPT), that focuses on working with students who struggle with negative peer pressure. Adapted from the teaching philosophy of…

  16. Cost study of dermal substitutes and topical negative pressure in the surgical treatment of burns

    NARCIS (Netherlands)

    Hop, M.J.; Bloemen, M.C.T.; van Baar, M.E.; Nieuwenhuis, M.K.; van Zuijlen, P.P.M.; Polinder, S.; Middelkoop, E.

    2014-01-01

    AbstractBackground A recently performed randomised controlled trial investigated the clinical effectiveness of dermal substitutes (DS) and split skin grafts (SSG) in combination with topical negative pressure (TNP) in the surgical treatment of burn wounds. In the current study, medical and

  17. Pulse Waveform and Transcranial Doppler Analysis during Lower Body Negative Pressure

    Science.gov (United States)

    1993-04-01

    26, 23]. The application of negative pressure to the body for scientific or medical purposes was first used in 1841 by Junod , who used it to create a...localized hyperemia [26]. Junod also suggested that it could be used prior to invasive surgical procedures, since the syncope it was able to produce

  18. A systematic review of topical negative pressure therapy for acute and chronic wounds

    NARCIS (Netherlands)

    Ubbink, D. T.; Westerbos, S. J.; Nelson, E. A.; Vermeulen, H.

    2008-01-01

    Topical negative pressure (TNP) therapy is becoming increasingly popular for all kinds of wounds. Its clinical and cost effectiveness is unclear. A search of randomized controlled trials (RCTs) on TNP in adult patients with all kinds of wounds in all settings was undertaken in Medline, Embase,

  19. Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment

    Directory of Open Access Journals (Sweden)

    Moris Topaz

    2012-01-01

    Full Text Available Regulated negative pressure-assisted wound therapy (RNPT should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound′s environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review.

  20. Intermittent hydronephrosis

    International Nuclear Information System (INIS)

    Knop, J.; Vogel, H.; Hupe, W.

    1981-01-01

    An intermittent hydronephrosis was observed in a 40-year old patient. This disease pattern is due to an incongruity between the formation of urine and the transport capacity in the ureteropelvic junction. The latent impediment of flow becomes manifest with increased urine secretion. Irreversible renal damage can be the result of the repeatedly occurring hydronephrotic crises. (orig.) [de

  1. Novel cavitation fluid jet polishing process based on negative pressure effects.

    Science.gov (United States)

    Chen, Fengjun; Wang, Hui; Tang, Yu; Yin, Shaohui; Huang, Shuai; Zhang, Guanghua

    2018-04-01

    Traditional abrasive fluid jet polishing (FJP) is limited by its high-pressure equipment, unstable material removal rate, and applicability to ultra-smooth surfaces because of the evident air turbulence, fluid expansion, and a large polishing spot in high-pressure FJP. This paper presents a novel cavitation fluid jet polishing (CFJP) method and process based on FJP technology. It can implement high-efficiency polishing on small-scale surfaces in a low-pressure environment. CFJP uses the purposely designed polishing equipment with a sealed chamber, which can generate a cavitation effect in negative pressure environment. Moreover, the collapse of cavitation bubbles can spray out a high-energy microjet and shock wave to enhance the material removal. Its feasibility is verified through researching the flow behavior and the cavitation results of the negative pressure cavitation machining of pure water in reversing suction flow. The mechanism is analyzed through a computational fluid dynamics simulation. Thus, its cavitation and surface removal mechanisms in the vertical CFJP and inclined CFJP are studied. A series of polishing experiments on different materials and polishing parameters are conducted to validate its polishing performance compared with FJP. The maximum removal depth increases, and surface roughness gradually decreases with increasing negative outlet pressures. The surface becomes smooth with the increase of polishing time. The experimental results confirm that the CFJP process can realize a high material removal rate and smooth surface with low energy consumption in the low-pressure environment, together with compatible surface roughness to FJP. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Cyclooxygenases 1 and 2 differentially regulate blood pressure and cerebrovascular responses to acute and chronic intermittent hypoxia: implications for sleep apnea.

    Science.gov (United States)

    Beaudin, Andrew E; Pun, Matiram; Yang, Christina; Nicholl, David D M; Steinback, Craig D; Slater, Donna M; Wynne-Edwards, Katherine E; Hanly, Patrick J; Ahmed, Sofia B; Poulin, Marc J

    2014-05-09

    Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular and cerebrovascular disease resulting from intermittent hypoxia (IH)-induced inflammation. Cyclooxygenase (COX)-formed prostanoids mediate the inflammatory response, and regulate blood pressure and cerebral blood flow (CBF), but their role in blood pressure and CBF responses to IH is unknown. Therefore, this study's objective was to determine the role of prostanoids in cardiovascular and cerebrovascular responses to IH. Twelve healthy, male participants underwent three, 6-hour IH exposures. For 4 days before each IH exposure, participants ingested a placebo, indomethacin (nonselective COX inhibitor), or Celebrex(®) (selective COX-2 inhibitor) in a double-blind, randomized, crossover study design. Pre- and post-IH blood pressure, CBF, and urinary prostanoids were assessed. Additionally, blood pressure and urinary prostanoids were assessed in newly diagnosed, untreated OSA patients (n=33). Nonselective COX inhibition increased pre-IH blood pressure (P ≤ 0.04) and decreased pre-IH CBF (P=0.04) while neither physiological variable was affected by COX-2 inhibition (P ≥ 0.90). Post-IH, MAP was elevated (P ≤ 0.05) and CBF was unchanged with placebo and nonselective COX inhibition. Selective COX-2 inhibition abrogated the IH-induced MAP increase (P=0.19), but resulted in lower post-IH CBF (P=0.01). Prostanoids were unaffected by IH, except prostaglandin E2 was elevated with the placebo (P=0.02). Finally, OSA patients had elevated blood pressure (P ≤ 0.4) and COX-1 formed thromboxane A2 concentrations (P=0.02). COX-2 and COX-1 have divergent roles in modulating vascular responses to acute and chronic IH. Moreover, COX-1 inhibition may mitigate cardiovascular and cerebrovascular morbidity in OSA. www.clinicaltrials.gov. Unique identifier: NCT01280006.

  3. The evidence-based principles of negative pressure wound therapy in trauma & orthopedics.

    Science.gov (United States)

    A, Novak; Khan, Wasim S; J, Palmer

    2014-01-01

    Negative pressure wound therapy is a popular treatment for the management of both acute and chronic wounds. Its use in trauma and orthopedics is diverse and includes the acute traumatic setting as well as chronic troublesome wounds associated with pressure sores and diabetic foot surgery. Efforts have been made to provide an evidence base to guide its use however this has been limited by a lack of good quality evidence. The following review article explores the available evidence and describes future developments for its use in trauma and orthopaedic practice.

  4. Early activation of the coagulation system during lower body negative pressure

    DEFF Research Database (Denmark)

    Zaar, M; Johansson, P I; Nielsen, L B

    2009-01-01

    We considered that a moderate reduction of the central blood volume (CBV) may activate the coagulation system. Lower body negative pressure (LBNP) is a non-invasive means of reducing CBV and, thereby, simulates haemorrhage. We tested the hypothesis that coagulation markers would increase following...... moderate hypovolemia by exposing 10 healthy male volunteers to 10 min of 30 mmHg LBNP. Thoracic electrical impedance increased during LBNP (by 2.6 +/- 0.7 Omega, mean +/- SD; P pressure decreased (84 +/- 5 to 80...

  5. Intermittency '93

    International Nuclear Information System (INIS)

    Bialas, A.

    1993-01-01

    The existing data definitely indicate the existence of intermittency, i.e. of self similar structures in the systems of particles created in high-energy collisions. The effect seems universal: it was found in most of the processes investigated and its measures parameters depend only weakly (if at all) on the process in question. Strong HBT effect was found, suggesting that intermittency is related to space-time structure of the pion source rather than to detailed momentum structure of the production amplitudes. There are indications that this space time structure may be fractal, but more data is needed to establish this. The theoretical explanation remains obscure: it seems that both parton cascade and hadronization play an important role. Their interrelation, however, remains a mystery. 5 figs., 19 refs

  6. Head holder using negative pressure bag packed with plastic beads in xenon CT CBF study

    International Nuclear Information System (INIS)

    Araki, Yuzo; Sakai, Noboru

    2003-01-01

    Employing analysis of cerebral blood flow (CBF) confidence maps, we investigated the usefulness of a head holder using a negative pressure bag packed with plastic beads in a xenon CT CBF study. A total of 272 consecutive patients for the CBF study were enrolled and classified into 3 groups: 88 patients with a negative pressure bag (M group), 87 patients with an air pillow (A group), and 97 patients with a sponge pillow (S group). The degree of effect of head movements on the CBF measurement in each patient was expressed as a confidence value (mean of the confidence values at one CT slice). The mean of confidence value in the M group (0.461) was statistically lower than that in the A group (0.866) and that in the S group (1.043). These findings showed that the head holder described here was useful for obtaining CBF maps of high quality in a xenon CT CBF study. (author)

  7. Negative pressure darwinism: survival of the fittest paradigm.

    Science.gov (United States)

    Miller, Michael; Bybordi, Farhad

    2009-07-01

    The use of negative pressure for wound healing has been based on a set of parameters and devices that until recently were combined into a single paradigm. Despite historical and more recent evidence providing viable alternative considerations, it is only recently that this paradigm and its tenets have come into question. As the understanding of the limits of the current paradigm and specific instances of its benefits and drawbacks are identified, shifts in the paradigm must take place if the therapy is to evolve, develop, and continue to be efficacious. The pertinence of the concept of survival of the fittest is used to explore the need for a paradigm shift in negative pressure wound therapy.

  8. Negative Gauge Pressure Moisture Management and Secure Adherence Device for Prosthetic Limbs

    Science.gov (United States)

    2013-03-01

    prosthesis feels like it is sliding up and down or falling off when I am active. D. I have been more active than normal as a result of this prosthesis ...temperature. 3. My prosthesis feels like it is sliding up and down or falling off when I am active. 4. I have been more active than normal as a result of...objective of this research was to develop and test a novel prosthesis incorporating a negative gauge pressure moisture management and secure

  9. Histomorphological observation of surgical debridement combined with negative pressure therapy in treatment of diabetic foot

    Directory of Open Access Journals (Sweden)

    Jiao-Yun Dong

    2017-08-01

    Conclusion: Epidermal cells on the fascia side of the flap could be derived from the stem cells. Negative pressure wound therapy would attract not only cells but also other elements such as growth factors, cytokines, some nutrients and extracellular matrix. With the formation of the appropriate microenvironment after debridement, the migrated cells can grow, differentiate and spread, eventually leading to the epithelization on the fascia side of the flap in diabetic foot.

  10. Negative binomial fits to multiplicity distributions from central collisions of 16O + Cu at 14.6A GeV/c and intermittency

    International Nuclear Information System (INIS)

    Tannenbaum, M.J.

    1994-01-01

    An 'intermittency' analysis of charged particle multiplicity data from the target multiplicy array (TMA) in central collisions of 16 O+Cu at 14.6 AxGeV/c has been published by the AGS-E802 collaboration. The centrality cut was made using the Zero degree Calorimeter and requiring that the forward energy be less than one projectile nucleon (i.e. T ZCAL 16 O+Cu collisions is found to exhibit an apparently linear increase with the δη interval, albeit with a much steeper slope than for the other reactions, and a non-zero intercept, k(0)≠0. True intermittency, ξ→0, would occur if the intercept k(0)→0, which is not observed in any experiment. The correlation length for central 16 O+Cu collisions, although smaller than expected, is quite finite and can be measured - which means that a length scale exists in these collisions and therefore there is no intermittency in the multiplicity fluctuations

  11. Facets of negative affectivity and blood pressure in middle-aged men

    Directory of Open Access Journals (Sweden)

    Cornel V. Igna

    2013-04-01

    Full Text Available Research results suggesting that facets of negative affectivity, i.e. anxiety, anger-hostility, and depression, relate to incident cardiovascular diseases have been steadily increasing. Evidence for depression has been especially extensive. Elevated blood pressure, a major risk factor of cardiovascular diseases, is one probable mediator in this context. The purpose of this study was to clarify the relationship of specific key elements of depressive disposition, i.e. depressive symptoms, hopelessness and vital exhaustion, with health behavior and blood pressure. Study sample was comprised of 710 middle-aged men. Participants completed self-report questionnaires assessing health behavior, depressive symptoms, vital exhaustion and hopelessness. Statistical analyses involved descriptive analyses, correlations and path analysis. Depressive symptoms and vital exhaustion associated with several unfavorable lifestyles such as smoking, alcohol consumption, and inactivity (standardized solution coefficients: 0.10, 0.14, 0.17, accordingly. However, no significant direct associations with blood pressure could be found for depressive symptoms or vital exhaustion. Hopelessness associated only with unhealthy diet (standardized solution coefficient -0.10 Moreover, for hopelessness, results showed a direct but inverse association with systolic blood pressure (standardized solution coefficient -0.08. Results suggest that the previously reported relations of depression and vital exhaustion with blood pressure could be mediated by unfavorable lifestyles. The relation of hopelessness with adverse health behaviors seems to be less significant. Also, the role of hopelessness as a risk factor of elevated blood pressure is not supported by the results of this study.

  12. Angiotensin II type 1a receptors in subfornical organ contribute towards chronic intermittent hypoxia-associated sustained increase in mean arterial pressure.

    Science.gov (United States)

    Saxena, Ashwini; Little, Joel T; Nedungadi, T Prashant; Cunningham, J Thomas

    2015-03-01

    Sleep apnea is associated with hypertension. The mechanisms contributing to a sustained increase in mean arterial pressure (MAP) even during normoxic awake-state remain unknown. Rats exposed to chronic intermittent hypoxia for 7 days, a model of the hypoxemia associated with sleep apnea, exhibit sustained increases in MAP even during the normoxic dark phase. Activation of the renin-angiotensin system (RAS) has been implicated in chronic intermittent hypoxia (CIH) hypertension. Since the subfornical organ (SFO) serves as a primary target for the central actions of circulating ANG II, we tested the effects of ANG II type 1a receptor (AT1aR) knockdown in the SFO on the sustained increase in MAP in this CIH model. Adeno-associated virus carrying green fluorescent protein (GFP) and small-hairpin RNA against either AT1aR or a scrambled control sequence (SCM) was stereotaxically injected in the SFO of rats. After recovery, MAP, heart rate, respiratory rate, and activity were continuously recorded using radiotelemetry. In the normoxic groups, the recorded variables did not deviate from the baseline values. Both CIH groups exhibited significant increases in MAP during CIH exposures (P < 0.05). During the normoxic dark phase in the CIH groups, only the SCM-injected group exhibited a sustained increase in MAP (P < 0.05). The AT1aR-CIH group showed significant decreases in FosB/ΔFosB staining in the median preoptic nucleus and the paraventricular nuclei of the hypothalamus compared with the SCM-CIH group. Our data indicate that AT1aRs in the SFO are critical for the sustained elevation in MAP and increased FosB/ΔFosB expression in forebrain autonomic nuclei associated with CIH. Copyright © 2015 the American Physiological Society.

  13. Using negative pressure therapy for improving skin graft taking on genital area defects following Fournier gangrene.

    Science.gov (United States)

    Orhan, Erkan; Şenen, Dilek

    2017-09-01

    Fournier's gangrene is an infective necrotizing fasciitis of the perineal, genital and perianal regions. Treatment includes aggressive surgical debridement that often results in extensive loss of genital skin. Skin grafts may be used for reconstruction but skin grafting of the male genitalia is diffucult because the penis and scrotum are mobile and deformable. A variety of methods are used to secure skin graft to recipient beds. We used negative pressure therapy (NPT) to secure skin grafts and improve skin graft taking. We used negative pressure therapy for graft fixation in 13 male patients who underwent debridements with the indication of Fournier gangrene, and whose defects formed were reconstructed with grafts between January 2009, and January 2014. Information about age of the patients, sessions of negative pressure therapy applied before, and after reconstruction, duration of hospital stay, and graft losses during postoperative period were recorded. Median age of the patients was 56.15 (46-72) years. NPT was applied to patients for an average of 6.64 sessions (4-12) before and 1 sessions after graft reconstruction. Patients were hospitalized for an average of 26.7 (20-39) days. Any graft loss was not seen after NPT. Because of the peculiar anatomy of the genital region, anchoring of grafts is difficult so graft losses are often encountered. Use of NPT for ensuring graft fixation on the genital region prevents skin graft shearing.

  14. Negative pressure pulmonary edema after nasal fracture reduction in an obese female patient: a case report

    Directory of Open Access Journals (Sweden)

    Choi EK

    2015-08-01

    Full Text Available Eunkyung Choi,1 Junggu Yi,1 Younghoon Jeon,2 1Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; 2Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea Abstract: Postoperative negative pressure pulmonary edema (NPPE is a rare, but well-known life-threatening complication of acute upper airway obstruction (UAO which develops after general anesthesia. The pronounced inspiratory efforts following UAO lead to excessive negative inspiratory pressure, which may cause acute pulmonary edema. Early recognition and prompt treatment of NPPE is necessary to prevent patient morbidity and mortality. In addition, the physician should carefully manage the patient who has risk factors of UAO to prevent this situation. We experienced a case of NPPE following laryngospasm after tracheal extubation in an obese patient who underwent open reduction of orbital wall and nasal bone surgery. Keywords: airway obstruction, negative pressure pulmonary edema, laryngospasm, nasal surgery, obese

  15. Negative Pressures and the First Water Siphon Taller than 10.33 Meters.

    Directory of Open Access Journals (Sweden)

    Francisco Vera

    Full Text Available A siphon is a device that is used to drain a container, with water rising inside a hose in the form of an inverted U and then going down towards a discharge point placed below the initial water level. The siphon is the first of a number of inventions of the ancients documented about 2.000 years ago by Hero of Alexandria in his treatise Pneumatics, and although the explanation given by Hero was essentially correct, there is nowadays a controversy about the underlying mechanism that explains the working of this device. Discussions concerning the physics of a siphon usually refer to concepts like absolute negative pressures, the strength of liquid's cohesion and the possibility of a siphon working in vacuum or in the presence of bubbles. Torricelli understood the working principle of the barometer and the impossibility of pumping water out of wells deeper than 10.33 m. Following Torricelli's ideas it would also not be possible to build a siphon that drives pure water to ascend higher than 10.33 m. In this work, we report the first siphon that drives water (with surfactant to ascend higher than the Torricellian limit. Motivated by the rising of sap in trees, we built a 15.4 m siphon that shows that absolute negative pressures are not prohibited, that cohesion plays an important role in transmitting forces through a fluid, and that surfactants can help to the transport of water in a metastable regime of negative pressures.

  16. A pilot randomised controlled trial of negative pressure wound therapy to treat grade III/IV pressure ulcers [ISRCTN69032034

    Science.gov (United States)

    2012-01-01

    Background Negative pressure wound therapy (NPWT) is widely promoted as a treatment for full thickness wounds; however, there is a lack of high-quality research evidence regarding its clinical and cost effectiveness. A trial of NPWT for the treatment of grade III/IV pressure ulcers would be worthwhile but premature without assessing whether such a trial is feasible. The aim of this pilot randomised controlled trial was to assess the feasibility of conducting a future full trial of NPWT for the treatment of grade III and IV pressure ulcers and to pilot all aspects of the trial. Methods This was a two-centre (acute and community), pilot randomised controlled trial. Eligible participants were randomised to receive either NPWT or standard care (SC) (spun hydrocolloid, alginate or foam dressings). Outcome measures were time to healing of the reference pressure ulcer, recruitment rates, frequency of treatment visits, resources used and duration of follow-up. Results Three hundred and twelve patients were screened for eligibility into this trial over a 12-month recruitment period and 12/312 participants (3.8%) were randomised: 6 to NPWT and 6 to SC. Only one reference pressure ulcer healed (NPWT group) during follow-up (time to healing 79 days). The mean number of treatment visits per week was 3.1 (NPWT) and 5.7 (SC); 6/6 NPWT and 1/6 SC participants withdrew from their allocated trial treatment. The mean duration of follow-up was 3.8 (NPWT) and 5.0 (SC) months. Conclusions This pilot trial yielded vital information for the planning of a future full study including projected recruitment rate, required duration of follow-up and extent of research nurse support required. Data were also used to inform the cost-effectiveness and value of information analyses, which were conducted alongside the pilot trial. Trial registration Current Controlled Trials ISRCTN69032034. PMID:22839453

  17. A pilot randomised controlled trial of negative pressure wound therapy to treat grade III/IV pressure ulcers [ISRCTN69032034

    Directory of Open Access Journals (Sweden)

    Ashby Rebecca L

    2012-07-01

    Full Text Available Abstract Background Negative pressure wound therapy (NPWT is widely promoted as a treatment for full thickness wounds; however, there is a lack of high-quality research evidence regarding its clinical and cost effectiveness. A trial of NPWT for the treatment of grade III/IV pressure ulcers would be worthwhile but premature without assessing whether such a trial is feasible. The aim of this pilot randomised controlled trial was to assess the feasibility of conducting a future full trial of NPWT for the treatment of grade III and IV pressure ulcers and to pilot all aspects of the trial. Methods This was a two-centre (acute and community, pilot randomised controlled trial. Eligible participants were randomised to receive either NPWT or standard care (SC (spun hydrocolloid, alginate or foam dressings. Outcome measures were time to healing of the reference pressure ulcer, recruitment rates, frequency of treatment visits, resources used and duration of follow-up. Results Three hundred and twelve patients were screened for eligibility into this trial over a 12-month recruitment period and 12/312 participants (3.8% were randomised: 6 to NPWT and 6 to SC. Only one reference pressure ulcer healed (NPWT group during follow-up (time to healing 79 days. The mean number of treatment visits per week was 3.1 (NPWT and 5.7 (SC; 6/6 NPWT and 1/6 SC participants withdrew from their allocated trial treatment. The mean duration of follow-up was 3.8 (NPWT and 5.0 (SC months. Conclusions This pilot trial yielded vital information for the planning of a future full study including projected recruitment rate, required duration of follow-up and extent of research nurse support required. Data were also used to inform the cost-effectiveness and value of information analyses, which were conducted alongside the pilot trial. Trial registration Current Controlled Trials ISRCTN69032034.

  18. Lower body negative pressure as a tool for research in aerospace physiology and military medicine

    Science.gov (United States)

    Convertino, V. A.

    2001-01-01

    Lower body negative pressure (LBNP) has been extensively used for decades in aerospace physiological research as a tool to investigate cardiovascular mechanisms that are associated with or underlie performance in aerospace and military environments. In comparison with clinical stand and tilt tests, LBNP represents a relatively safe methodology for inducing highly reproducible hemodynamic responses during exposure to footward fluid shifts similar to those experienced under orthostatic challenge. By maintaining an orthostatic challenge in a supine posture, removal of leg support (muscle pump) and head motion (vestibular stimuli) during LBNP provides the capability to isolate cardiovascular mechanisms that regulate blood pressure. LBNP can be used for physiological measurements, clinical diagnoses and investigational research comparisons of subject populations and alterations in physiological status. The applications of LBNP to the study of blood pressure regulation in spaceflight, groundbased simulations of low gravity, and hemorrhage have provided unique insights and understanding for development of countermeasures based on physiological mechanisms underlying the operational problems.

  19. Negative-pressure and low-pressure hydrocephalus: the role of cerebrospinal fluid leaks resulting from surgical approaches to the cranial base.

    Science.gov (United States)

    Filippidis, Aristotelis S; Kalani, M Yashar S; Nakaji, Peter; Rekate, Harold L

    2011-11-01

    Negative-pressure and low-pressure hydrocephalus are rare clinical entities that are frequently misdiagnosed. They are characterized by recurrent episodes of shunt failure because the intracranial pressure is lower than the opening pressure of the valve. In this report the authors discuss iatrogenic CSF leaks as a cause of low- or negative-pressure hydrocephalus after approaches to the cranial base. The authors retrospectively reviewed cases of low-pressure or negative-pressure hydrocephalus presenting after cranial approaches complicated with a CSF leak at their institution. Three patients were identified. Symptoms of high intracranial pressure and ventriculomegaly were present, although the measured pressures were low or negative. A blocked communication between the ventricles and the subarachnoid space was documented in 2 of the cases and presumed in the third. Shunt revisions failed repeatedly. In all cases, temporary clinical and radiographic improvement resulted from external ventricular drainage at subatmospheric pressures. The CSF leaks were sealed and CSF communication was reestablished operatively. In 1 case, neck wrapping was used with temporary success. Negative-pressure or low-pressure hydrocephalus associated with CSF leaks, especially after cranial base approaches, is difficult to treat. The solution often requires the utilization of subatmospheric external ventricular drains to establish a lower ventricular drainage pressure than the drainage pressure created in the subarachnoid space, where the pressure is artificially lowered by the CSF leak. Treatment involves correction of the CSF leak, neck wrapping to increase brain turgor and allow the pressure in the ventricles to rise to the level of the opening pressure of the valve, and reestablishing the CSF route.

  20. Evaluation of negative pressure vacuum-assisted system in acute and chronic wounds closure: our experience.

    Science.gov (United States)

    Chiummariello, S; Guarro, G; Pica, A; Alfano, C

    2012-10-01

    Negative-pressure therapy or vacuum-assisted closure (VAC) has been used in clinical applications since the 1940's and has increased in popularity over the past decade. This dressing technique consists of an open cell foam dressing put into the wound cavity, a vacuum pump produces a negative pressure and an adhesive drape. A controlled sub atmospheric pressure from 75 to 150 mmHg is applied. The vacuum-assisted closure has been applied by many clinicians to chronic wounds in humans; however it cannot be used as a replacement for surgical debridement. The initial treatment for every contaminated wound should be the necrosectomy. The VAC therapy has a complementary function and the range of its indications includes pressure sores, stasis ulcers, chronic wounds such as diabetic foot ulcers, post traumatic and post operative wounds, infected wounds such as necrotizing fasciitis or sternal wounds, soft-tissue injuries, bone exposed injuries, abdominal open wounds and for securing a skin graft. We describe our experience with the VAC dressing used to manage acute and chronic wounds in a series of 135 patients, with excellent results together with satisfaction of the patients.

  1. Differential effects of lower body negative pressure and upright tilt on splanchnic blood volume

    Science.gov (United States)

    Taneja, Indu; Moran, Christopher; Medow, Marvin S.; Glover, June L.; Montgomery, Leslie D.; Stewart, Julian M.

    2015-01-01

    Upright posture and lower body negative pressure (LBNP) both induce reductions in central blood volume. However, regional circulatory responses to postural changes and LBNP may differ. Therefore, we studied regional blood flow and blood volume changes in 10 healthy subjects undergoing graded lower-body negative pressure (−10 to −50 mmHg) and 8 subjects undergoing incremental head-up tilt (HUT; 20°, 40°, and 70°) on separate days. We continuously measured blood pressure (BP), heart rate, and regional blood volumes and blood flows in the thoracic, splanchnic, pelvic, and leg segments by impedance plethysmography and calculated regional arterial resistances. Neither LBNP nor HUT altered systolic BP, whereas pulse pressure decreased significantly. Blood flow decreased in all segments, whereas peripheral resistances uniformly and significantly increased with both HUT and LBNP. Thoracic volume decreased while pelvic and leg volumes increased with HUT and LBNP. However, splanchnic volume changes were directionally opposite with stepwise decreases in splanchnic volume with LBNP and stepwise increases in splanchnic volume during HUT. Splanchnic emptying in LBNP models regional vascular changes during hemorrhage. Splanchnic filling may limit the ability of the splanchnic bed to respond to thoracic hypovolemia during upright posture. PMID:17085534

  2. Patients' experiences of negative pressure wound therapy for the treatment of wounds: a review.

    Science.gov (United States)

    Upton, D; Stephens, D; Andrews, A

    2013-01-01

    To review the research on patients' experiences of undergoing negative pressure wound therapy (NPWT). A literature search was carried out using the following databases: Academic Search Complete, CINAHL, PsychINFO, MEDLINE, PubMed and PsyARTICLES. The search covered the period from 2001 to 2012, using the key words: ['negative pressure wound therapy' OR 'vacuum-assisted closure' OR 'topical negative therapy'] AND ['patients' experiences' OR 'psychological' OR 'stress' OR 'anxiety' OR 'wellbeing' OR 'pain' OR 'quality of life' OR 'physical']. Twenty-five relevant articles were included. NPWT is generally considered to be successful in reducing wound depth and facilitating healing. However, studies have highlighted a number of issues that need to be considered. For example, the type of dressing used during treatment can have a significant effect on patients' experience of pain. Furthermore, the NPWT system can cause patients to feel anxious due to both the patient and the health professional being unfamiliar with this form of treatment. It can also restrict patients' daily care and wider social life, which may result in a negative self-image and low self-esteem. Despite this, some studies have reported positive improvements to patients' quality of life. Additionally, since NPWT can lead to faster healing, any detrimental impact upon patients' wellbeing may be short-term and less prolonged than that of other treatments. Compared with other treatments, there is evidence to show that NPWT can lead to faster wound healing, and a reduced frequency of dressing changes and other treatments. However, there are a number of challenges with the use of NPWT, which need to be explored further so that improvements can be made. Specifically, certain aspects of NPWT may impact negatively on patients' wellbeing, albeit short-term. Therefore, research needs to explore patients' experience of NPWT throughout the treatment process and to consider how this can be improved to minimise any

  3. Negative pressure wound therapy for the treatment of infected wounds with exposed knee joint after patellar fracture.

    Science.gov (United States)

    Lee, Sang Yang; Niikura, Takahiro; Miwa, Masahiko; Sakai, Yoshitada; Oe, Keisuke; Fukazawa, Takahiro; Kawakami, Yohei; Kurosaka, Masahiro

    2011-06-14

    Treatment of soft tissue defects with exposed bones and joints, resulting from trauma, infection, and surgical complications, represents a major challenge. The introduction of negative pressure wound therapy has changed many wound management practices. Negative pressure wound therapy has recently been used in the orthopedic field for management of traumatic or open wounds with exposed bone, nerve, tendon, and orthopedic implants. This article describes a case of a patient with a large soft tissue defect and exposed knee joint, in which negative pressure wound therapy markedly improved wound healing. A 50-year-old man presented with an ulceration of his left knee with exposed joint, caused by severe wound infections after open reduction and internal fixation of a patellar fracture. After 20 days of negative pressure wound therapy, a granulated wound bed covered the exposed bones and joint.To our knowledge, this is the first report of negative pressure wound therapy used in a patient with a large soft tissue defect with exposed knee joint. Despite the chronic wound secondary to infection, healing was achieved through the use of the negative pressure wound therapy, thus promoting granulation tissue formation and closing the joint. We suggest negative pressure wound therapy as an alternative option for patients with lower limb wounds containing exposed bones and joints when free flap transfer is contraindicated. Our result added to the growing evidence that negative pressure wound therapy is a useful adjunctive treatment for open wounds around the knee joint. Copyright 2011, SLACK Incorporated.

  4. Relationship between chronic intermittent hypoxia and intraoperative mean arterial pressure in obstructive sleep apnea patients having laparoscopic bariatric surgery.

    Science.gov (United States)

    Turan, Alparslan; You, Jing; Egan, Cameron; Fu, Alex; Gazmuri, Ignazia; Khanna, Ashish; Eshraghi, Yashar; Ghosh, Raktim; Bose, Somnath; Qavi, Shahbaz; Arora, Lovkesh; Sessler, Daniel I; Doufas, Anthony G

    2015-01-01

    Recurrent nocturnal hypoxemia in obstructive sleep apnea enhances sympathetic function, decreases baroreceptor sensitivity, and weakens peripheral vascular responses to adrenergic signals. The authors hypothesized that the percentage of total sleep time spent at oxyhemoglobin saturation (SaO2) less than 90% and minimum nocturnal SaO2 on preoperative polysomnography are associated with decreased intraoperative mean arterial pressure. The authors examined the records of all patients who had laparoscopic bariatric surgery at Cleveland Clinic between 2005 and 2009 and an available polysomnography study. The authors assessed the relationships between the percentage of total sleep time spent at SaO2 less than 90% and minimum nocturnal SaO2, and the time-weighted average of mean arterial pressure. The authors used multivariable regression models to adjust for prespecified clinical confounders. Two hundred eighty-one patients were included in the analysis. The average change in the time-weighted average of mean arterial pressure was -0.02 (97.5% CI, -0.08, 0.04) mmHg for each 1% absolute increase in the percentage of sleep time spent at SaO2 less than 90% (P = 0.50). The average change was -0.13 (97.5% CI, -0.27, 0.01) mmHg, for each 1% absolute decrease in the minimum SaO2 (P = 0.04 > significance criterion of 0.025, Bonferroni correction). An unplanned analysis estimated 1% absolute decrease in minimum SaO2 was associated with -0.22 (98.75% CI, -0.39, -0.04) mmHg, change in mean arterial pressure (P = 0.002) in the time period between endotracheal intubation and trocar insertion. Recurrent nocturnal hypoxemia in obstructive sleep apnea is not a risk marker for intraoperative hypotension.

  5. Continuous versus intermittent endotracheal cuff pressure control for the prevention of ventilator-associated respiratory infections in Vietnam: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Dat, Vu Quoc; Geskus, Ronald B; Wolbers, Marcel; Loan, Huynh Thi; Yen, Lam Minh; Binh, Nguyen Thien; Chien, Le Thanh; Mai, Nguyen Thi Hoang; Phu, Nguyen Hoan; Lan, Nguyen Phu Huong; Hao, Nguyen Van; Long, Hoang Bao; Thuy, Tran Phuong; Kinh, Nguyen Van; Trung, Nguyen Vu; Phu, Vu Dinh; Cap, Nguyen Trung; Trinh, Dao Tuyet; Campbell, James; Kestelyn, Evelyne; Wertheim, Heiman F L; Wyncoll, Duncan; Thwaites, Guy Edward; van Doorn, H Rogier; Thwaites, C Louise; Nadjm, Behzad

    2018-04-04

    Ventilator-associated respiratory infection (VARI) comprises ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT). Although their diagnostic criteria vary, together these are the most common hospital-acquired infections in intensive care units (ICUs) worldwide, responsible for a large proportion of antibiotic use within ICUs. Evidence-based strategies for the prevention of VARI in resource-limited settings are lacking. Preventing the leakage of oropharyngeal secretions into the lung using continuous endotracheal cuff pressure control is a promising strategy. The aim of this study is to investigate the efficacy of automated, continuous endotracheal cuff pressure control in preventing the development of VARI and reducing antibiotic use in ICUs in Vietnam. This is an open-label randomised controlled multicentre trial. We will enrol 600 adult patients intubated for ≤ 24 h at the time of enrolment. Eligible patients will be stratified according to admission diagnosis (180 tetanus, 420 non-tetanus) and site and will be randomised in a 1:1 ratio to receive either (1) automated, continuous control of endotracheal cuff pressure or (2) intermittent measurement and control of endotracheal cuff pressure using a manual cuff pressure meter. The primary outcome is the occurrence of VARI, defined as either VAP or VAT during the ICU admission up to a maximum of 90 days after randomisation. Patients in both groups who are at risk for VARI will receive a standardised battery of investigations if their treating physician feels a new infection has occurred, the results of which will be used by an endpoint review committee, blinded to the allocated arm and independent of patient care, to determine the primary outcome. All enrolled patients will be followed for mortality and endotracheal tube cuff-related complications at 28 days and 90 days after randomisation. Other secondary outcomes include antibiotic use; days ventilated, in ICU and in hospital

  6. Abdominal compartment syndrome and open abdomen management with negative pressure devices.

    Science.gov (United States)

    Surace, Alessandra; Ferrarese, Alessia; Marola, Silvia; Cumbo, Jacopo; Valentina, Gentile; Borello, Alessandro; Solej, Mario; Martino, Valter; Nano, Mario

    2015-01-01

    Abdominal compartment syndrome (ACS) is defined as an increase of intra-abdominal pressure (IAH) to values higher than 20 mmHg, associated with reduced perfusion and organ dysfunction. There is a classification of open abdomen which stratifies patients according to the natural history of improvement or clinical deterioration. The aim of treatment is to maintain the open abdomen at the lowest level and to prevent progression to a more complex level. Surgical treatment essentially consists in abdominal decompression by leaving the abdomen open. Analysis of the literature shows that negative pressure increases the rate of primary fascial closure; entero-cutaneous fistulas are seen in a minority of cases, without seeming consequence of the application of the dressing. Open abdomen management consists of three treatment stages: acute (24-48 hours), intermediate (from 48 hours to 10 days) and late or reconstruction (from 10 days to the final closure). It's important to recognize patients at risk of IAH and the first signs of ACS and intervene early with abdominal decompression if this will establish itself. Management of the open abdomen is now facilitated by negative pressure devices, which positively affect the morbidity and mortality of patients with ACS.

  7. Intermittent hyperthyreosis

    International Nuclear Information System (INIS)

    Sulman, F.G.; Tal, E.; Pfeifer, Y.; Superstine, E.

    1975-01-01

    Intermittent hyperthyreosis occurs under various forms of stress, especially heat stress. The clinician may diagnose such cases as masked or apathetic hyperthyroidism or 'forme fruste' hyperthyreosis or thyroid autonomy. As most routine and standard tests may here yield inconsistent results, it is the patients' anamnesis which may provide the clue. Our Bioclimatology Unit has now seen over 100 cases in which thyroid hypersensitivity towards heat was the most prominent syndrome: 10-15% of weather-sensitive patients are affected. The patients complain before or during heat spells of such contradictory symptoms as insomnia, irritability, tension, tachycardia, palpitations, precordial pain, dyspnoe, flushes with sweating or chills, tremor, abdominal pain or diarrhea, polyuria or pollakisuria, weight loss in spite of ravenous appetite, fatigue, exhaustion, depression, adynamia, lack of concentration and confusion. Determination of urinary neurohormones allows a differential diagnosis, intermittent hyperthyreosis being characterized by three cardinal symptoms: tachycardia - every case with more than 80 pulse beats being suspect (not specific); urinary histamine - every case excreting more than 90 μg/day being suspect. Again the drawback of this test is its lack of specificity, as histamine may also be increased in cases of allergy and spondylitis; urinary thyroxine - every case excreting more than 20 μg/day T-4 being suspect. This is the only specific test. Therapy should make use of lithium carbonate and betablockers. Propyl thiouracil is rarely required. (orig.) [de

  8. Fate in intermittent claudication

    DEFF Research Database (Denmark)

    Jelnes, Rolf; Gaardsting, O; Hougaard Jensen, K

    1986-01-01

    , or an ankle/arm pressure index below 50% were individually significantly associated with progression of the arteriosclerotic disease. These findings show the importance of peripheral blood pressure measurements in the management of patients with intermittent claudication due to arteriosclerotic disease........ The rate of clinical progression of the arteriosclerotic disease (that is, rest pain or gangrene) of the worst affected leg was 7.5% in the first year after referral. Thereafter the rate was 2.2% a year. An ankle systolic blood pressure below 70 mm Hg, a toe systolic blood pressure below 40 mm Hg...... 113 of the patients (44%) had died. Causes of death were no different from those in the general population. Mortality was twice that of the general population matched for age and sex. Mortality among the men was twice that among the women. In men under 60 mortality was four times that expected...

  9. Increased serum urea to creatinine ratio and its negative correlation with arterial pressure in canine babesiosis.

    Science.gov (United States)

    Zygner, Wojciech; Gójska-Zygner, Olga

    2014-09-01

    The increase of the serum urea to creatinine ratio (UCR) was observed in dogs infected with Babesia canis. Previous studies have suggested that decrease of blood pressure can be one of the reasons for this phenomenon. In this work statistically significant increase of the UCR was observed in dogs with babesiosis. Comparison of the UCR between 23 azotaemic dogs and 25 non-azotaemic dogs infected with Babesia canis showed statistically significantly higher mean of the UCR in azotaemic dogs. Correlations between UCR and systolic, diastolic and mean arterial pressure (SAP, DAP and MAP) in 48 dogs infected with B. canis were negative (UCR and SAP: r = -0.3909; UCR and DAP: r = -0.3182; UCR and MAP: r = -0.3682) and statistically significant (p high, and there was no statistically significant correlation between UCR and arterial pressures in azotaemic dogs. Thus, it seems that decrease of blood pressure in dogs with babesiosis explains only partially the cause of increased UCR in infected dogs. The other authors suggested hyperureagenesis and myocardial injury as a potential reason for the increased UCR in canine babesiosis. Thus, further studies are needed to determine causes of increased UCR in dogs with babesiosis, especially on the connection between UCR changes and the concentrations of plasma cardiac troponins and ammonia, and the occurrence of occult blood on fecal examination.

  10. Interrogative pressure in simulated forensic interviews: the effects of negative feedback.

    Science.gov (United States)

    McGroarty, Allan; Baxter, James S

    2007-08-01

    Much experimental research on interrogative pressure has concentrated on the effects of leading questions, and the role of feedback in influencing responses in the absence of leading questions has been neglected by comparison. This study assessed the effect of negative feedback and the presence of a second interviewer on interviewee responding in simulated forensic interviews. Participants viewed a videotape of a crime, answered questions about the clip and were requestioned after receiving feedback. Compared with neutral feedback, negative feedback resulted in more response changes, higher reported state anxiety and higher ratings of interview difficulty. These results are consistent with Gudjonsson and Clark's (1986) model of interrogative suggestibility. The presence and involvement of a second interviewer did not significantly affect interviewee responding, although trait anxiety scores were elevated when a second interviewer was present. The theoretical and applied implications of these findings are considered.

  11. Technical specifications of variable speed motors for negative pressure control in hot cell area

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seon Duk; Bang, H. S.; Cho, W. K

    2002-01-01

    Hot cells are the facilities for handling the high radioactive materials and various R and D activities are performed using hot cells. Therefore the control of air flow in hot cell area is very important technology and it is started with the variable speed motor(VSM) controlling the air handling system in that area. This report describes various technical aspects of VS motors and will be useful for understanding the practical technologies of VS motors and also for optimization of the negative pressure controls in hot cell area.

  12. Which factors make clean intermittent (self) catheterisation successful?

    NARCIS (Netherlands)

    Cobussen-Boekhorst, H.; Beekman, J.; Wijlick, E. van; Schaafstra, J.; Kuppevelt, D. van; Heesakkers, J.P.

    2016-01-01

    AIMS AND OBJECTIVES: To explore which factors determine successful intermittent catheterisation. BACKGROUND: Intermittent catheterisation is a safe, effective treatment and is associated with improved quality of life, although negative issues are reported. Factors which determine adherence are

  13. Effect of Intermittent Positive Pressure Ventilation on Depth of Anaesthesia during and after Isoflurane Anaesthesia in Sulphur-Crested Cockatoos (Cacatua galerita galerita

    Directory of Open Access Journals (Sweden)

    Saul Chemonges

    2014-01-01

    Full Text Available This study aimed to determine the effect of intermittent positive pressure ventilation (IPPV on the depth of inhalation anaesthesia in parrots. Anaesthesia was induced with 3.0% isoflurane in six Sulphur-crested Cockatoos (Cacatua galerita galerita and maintained using either 1.5% or 3.0% during spontaneous ventilation (SV or IPPV at 6 (IPPV-6 or 12 (IPPV-12 breaths per minute. The time taken for the appearance of somatic reflexes and the return of SV after IPPV was recorded. During recovery, the body jerk, beak, eye, and shivering reflexes appeared after 126 ± 27 s, 133 ± 26 s, 165 ± 34 s, and 165 ± 44 s, respectively. All cockatoos developed apnoea after IPPV-12 and only some did after IPPV-6. Return of SV after IPPV-12 was delayed compared to IPPV-6. Recovery times after the SV runs were significantly different between 1.5% and 3.0% isoflurane anaesthesia. Similarly, after IPPV, the recovery times were significantly different between 1.5% and 3.0% isoflurane anaesthesia. Recovery times after 3.0% inhaled isoflurane were longer than those of 1.5% inhaled isoflurane. In conclusion, cockatoos recovering from isoflurane anaesthesia are likely to exhibit body jerk, beak, eye, and shivering reflexes in that order. IPPV increases the depth of anaesthesia in a rate and dose-related manner and prolongs recovery.

  14. Temporal evolution of atmosphere pressure plasma jets driven by microsecond pulses with positive and negative polarities

    Science.gov (United States)

    Shao, Tao; Yang, Wenjin; Zhang, Cheng; Fang, Zhi; Zhou, Yixiao; Schamiloglu, Edl

    2014-09-01

    Current-voltage characteristics, discharge images, and optical spectra of atmospheric pressure plasma jets (APPJs) are studied using a microsecond pulse length generator producing repetitive output pulses with different polarities. The experimental results show that the APPJs excited by the pulses with positive polarity have longer plume, faster propagation speed, higher power, and more excited species, such as \\text{N}2 , O, He, \\text{N}2+ , than that with the negatively excited APPJs. The images taken using an intensified charge-coupled device show that the APPJs excited by pulses with positive polarity are characterized by a bullet-like structure, while the APPJs excited by pulses with negative polarity are continuous. The propagation speed of the APPJs driven by a microsecond pulse length generator is about tens of km/s, which is similar to the APPJs driven by a kHz frequency sinusoidal voltage source. The analysis shows that the space charge accumulation effect plays an important role during the discharge. The transient enhanced electric field induced by the accumulated ions between the needle-like electrode and the nozzle in the APPJs excited by pulses with negative polarity enhances electron field emission from the cathode, which is illustrated by the bright line on the time-integrated images. This makes the shape of the APPJ excited using pulses with negative polarity different from the bullet-like shape of the APPJs excited by pulses with positive polarity.

  15. Flame Atmospheric Pressure Chemical Ionization Coupled with Negative Electrospray Ionization Mass Spectrometry for Ion Molecule Reactions.

    Science.gov (United States)

    Cheng, Sy-Chyi; Bhat, Suhail Muzaffar; Shiea, Jentaie

    2017-07-01

    Flame atmospheric pressure chemical ionization (FAPCI) combined with negative electrospray ionization (ESI) mass spectrometry was developed to detect the ion/molecule reactions (IMRs) products between nitric acid (HNO 3 ) and negatively charged amino acid, angiotensin I (AI) and angiotensin II (AII), and insulin ions. Nitrate and HNO 3 -nitrate ions were detected in the oxyacetylene flame, suggesting that a large quantity of nitric acid (HNO 3 ) was produced in the flame. The HNO 3 and negatively charged analyte ions produced by a negative ESI source were delivered into each arm of a Y-shaped stainless steel tube where they merged and reacted. The products were subsequently characterized with an ion trap mass analyzer attached to the exit of the Y-tube. HNO 3 showed the strongest affinity to histidine and formed (M histidine -H+HNO 3 ) - complex ions, whereas some amino acids did not react with HNO 3 at all. Reactions between HNO 3 and histidine residues in AI and AII resulted in the formation of dominant [M AI -H+(HNO 3 )] - and [M AII -H+(HNO 3 )] - ions. Results from analyses of AAs and insulin indicated that HNO 3 could not only react with basic amino acid residues, but also with disulfide bonds to form [M-3H+(HNO 3 ) n ] 3- complex ions. This approach is useful for obtaining information about the number of basic amino acid residues and disulfide bonds in peptides and proteins. Graphical Abstract ᅟ.

  16. Decrease in delivery room intubation rates after use of nasal intermittent positive pressure ventilation in the delivery room for resuscitation of very low birth weight infants.

    Science.gov (United States)

    Biniwale, Manoj; Wertheimer, Fiona

    2017-07-01

    The literature supports minimizing duration of invasive ventilation to decrease lung injury in premature infants. Neonatal Resuscitation Program recommended use of non-invasive ventilation (NIV) in delivery room for infants requiring prolonged respiratory support. To evaluate the impact of implementation of non-invasive ventilation (NIV) using nasal intermittent positive pressure ventilation (NIPPV) for resuscitation in very low birth infants. Retrospective study was performed after NIPPV was introduced in the delivery room and compared with infants receiving face mask to provide positive pressure ventilation for resuscitation of very low birth weight infants prior to its use. Data collected from 119 infants resuscitated using NIPPV and 102 infants resuscitated with a face mask in a single institution. The primary outcome was the need for endotracheal intubation in the delivery room. Data was analyzed using IBM SPSS Statistics software version 24. A total of 31% of infants were intubated in the delivery room in the NIPPV group compared to 85% in the Face mask group (p=rates were 11% in the NIPPV group and 31% in the Face mask group (p<0.001). Epinephrine administration was also lower in NIPPV group (2% vs. 8%; P=0.03). Only 38% infants remained intubated at 24hours of age in the NIPPV group compared to 66% in the Face mask group (p<0.001). Median duration of invasive ventilation in the NIPPV group was shorter (2days) compared to the Face mask group (11days) (p=0.01). The incidence of air-leaks was not significant between the two groups. NIPPV was safely and effectively used in the delivery room settings to provide respiratory support for VLBW infants with less need for intubation, chest compressions, epinephrine administration and subsequent invasive ventilation. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Formation and Morphology Evolution of Anodic TiO2 Nanotubes under Negative Pressure

    International Nuclear Information System (INIS)

    Lu, Hongyan; Fan, Haowen; Jin, Rong; Chong, Bin; Shen, Xiaoping; Yan, Shuo; Zhu, Xufei

    2016-01-01

    Highlights: • Nernst equation is applied to explain electrochemical reactions during anodization. • Longer nanotubes were obtained under 0.02 MPa, as compared to atmospheric conditions. • The total anodizing current was separated into ionic current and electronic current. • Explanation for the particularity of nanotubes obtained under 0.02 MPa is presented. - Abstract: Anodic TiO 2 nanotubes (ATNTs) have attracted extensive interest in the past decade. ATNTs are generally fabricated by anodization of Ti foils under atmospheric conditions (0.1 MPa). To date, the growth kinetics of ATNTs remains unclear. Herein anodizations of Ti foils under negative pressure are designed to overcome this challenge. Longer nanotubes were fabricated under negative pressure, as compared to atmospheric conditions. Variations of the nanotube length and surface morphology of ATNTs provide evidences for oxygen bubble mould, in which the ionic current contributes to nanotube growth while the electronic current gives rise to the oxygen evolution. Nernst equation was firstly applied to simulate variations of electronic current and ionic current during anodization. The in-depth analysis of the morphology variations could help elucidate the formation mechanism, thus paving the way for the optimization of the synthesis process of ATNTs.

  18. Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect

    Directory of Open Access Journals (Sweden)

    Fabio Caviggioli

    2014-01-01

    Full Text Available Reconstruction of open abdominal defects is a clinical problem which general and plastic surgeons have to address in cooperation. We report the case of a 66-year-old man who presented an abdominal dehiscence after multiple laparotomies for a sigmoid-rectal adenocarcinoma that infiltrated into the abdominal wall, subsequently complicated by peritonitis and enteric fistula. A cutaneous dehiscence and an incontinent abdominal wall resulted after the last surgery. The abdominal wall was reconstructed using a biological porcine cross-linked mesh Permacol (Covidien Inc., Norwalk, CT. Negative Pressure Wound Therapy (NPWT, instead, was used on the mesh in order to reduce wound dimensions, promote granulation tissue formation, and obtain secondary closure of cutaneous dehiscence which was finally achieved with a split-thickness skin graft. Biological mesh behaved like a scaffold for the granulation tissue that was stimulated by the negative pressure. The biological mesh was rapidly integrated in the abdominal wall restoring abdominal wall continence, while the small dehiscence, still present in the central area, was subsequently covered with a split-thickness skin graft. The combination of these different procedures led us to solve this complicated case obtaining complete wound closure after less than 2 months.

  19. An Alternative Treatment Strategy for Complicated Chronic Wounds: Negative Pressure Therapy over Mesh Skin Graft

    Directory of Open Access Journals (Sweden)

    Michele Maruccia

    2017-01-01

    Full Text Available Extensive skin defect represents a real problem and major challenge in plastic and reconstructive surgery. On one hand, skin grafts offer a practical method to deal with skin defects despite their unsuitability for several complicated wounds. On the other hand, negative pressure wound therapy (NPWT, applied before skin grafting, promotes granulation tissue growth. The aim of the study is to evaluate the improvement in wound healing given by the merger of these two different approaches. We treated 23 patients for large wounds of multiple factors. Of these, 15 were treated with the application of V.A.C.® Therapy (KCI Medical S.r.l., Milan, Italy, in combination with skin grafts after a prior unsuccessful treatment of 4 weeks with mesh skin grafts and dressings. Another 8 were treated with only mesh skin graft. Pain reduction and wound area reduction were found statistically significant (p<0.0009, p<0.0001. Infection was resolved in almost all patients. According to our study, the use of the negative pressure wound therapy over mesh skin grafts is significantly effective especially in wounds resistant to conventional therapies, thereby improving the rate of skin graft take.

  20. Negative pressure therapy (vacuum for wound bed preparation among diabetic patients: case series

    Directory of Open Access Journals (Sweden)

    Marcus Castro Ferreira

    Full Text Available CONTEXT: Complications from diabetes mellitus affecting the lower limbs occur in 40 to 70% of such patients. Neuropathy is the main cause of ulceration and may be associated with vascular impairment. The wound evolves with necrosis and infection, and if not properly treated, amputation may be the end result. Surgical treatment is preferred in complex wounds without spontaneous healing. After debridement of the necrotic tissue, the wound bed needs to be prepared to receive a transplant of either a graft or a flap. Dressings can be used to prepare the wound bed, but this usually leads to longer duration of hospitalization. Negative pressure using a vacuum system has been proposed for speeding up the treatment. This paper had the objective of analyzing the effects of this therapy on wound bed preparation among diabetic patients. CASE SERIES: Eighty-four diabetic patients with wounds in their lower limbs were studied. A commercially available vacuum system was used for all patients after adequate debridement of necrotic tissues. For 65 patients, skin grafts completed the treatment and for the other 19, skin flaps were used. Wound bed preparation was achieved over an average time of 7.51 days for 65 patients and 10 days for 12 patients, and in only one case was not achieved. CONCLUSIONS: This experience suggests that negative pressure therapy may have an important role in wound bed preparation and as part of the treatment for wounds in the lower limbs of diabetic patients.

  1. Modeling and Optimization for Management of Intermittent Water Supply

    Science.gov (United States)

    Lieb, A. M.; Wilkening, J.; Rycroft, C.

    2014-12-01

    In many urban areas, piped water is supplied only intermittently, as valves direct water to different parts of the water distribution system at different times. The flow is transient, and may transition between free-surface and pressurized, resulting in complex dynamical features with important consequences for water suppliers and users. These consequences include degradation of distribution system components, compromised water quality, and inequitable water availability. The goal of this work is to model the important dynamics and identify operating conditions that mitigate certain negative effects of intermittent water supply. Specifically, we will look at controlling valve parameters occurring as boundary conditions in a network model of transient, transition flow through closed pipes. Gradient-based optimization will be used to find boundary values to minimize pressure gradients and ensure equitable water availability at system endpoints.

  2. Increase in vagal activity during hypotensive lower-body negative pressure in humans

    DEFF Research Database (Denmark)

    Sander-Jensen, K; Mehlsen, J; Stadeager, C

    1988-01-01

    Progressive central hypovolemia is characterized by a normotensive, tachycardic stage followed by a reversible, hypotensive stage with slowing of the heart rate (HR). We investigated circulatory changes and arterial hormone concentrations in response to lower-body negative pressure (LBNP) in six...... volunteers before and after atropine administration. LBNP of 55 mmHg initially resulted in an increase in HR from 55 +/- 4 to 90 +/- 5 beats/min and decreases in mean arterial pressure (MAP) from 94 +/- 4 to 81 +/- 5 mmHg, in central venous pressure from 7 +/- 1 to -3 +/- 1 mmHg, and in cardiac output from 6.......1 +/- 0.5 to 3.7 +/- 0.11/min. Concomitantly, epinephrine and norepinephrine levels increased. After 8.2 +/- 2.3 min of LBNP, the MAP had decreased to 41 +/- 7 mmHg and HR had decreased to 57 +/- 3 beats/min. Vasopressin increased from 1.2 +/- 0.3 to 137 +/- 45 pg/ml and renin activity increased from 1...

  3. Negative pressure driven phase transformation in Sr doped SmCoO₃.

    Science.gov (United States)

    Arshad Farhan, M; Javed Akhtar, M

    2010-02-24

    Atomistic computer simulation techniques based on energy minimization procedures are utilized for the structural investigation of perovskite-type SmCoO(3). A reliable potential model is derived which reproduces both cubic as well as orthorhombic phases of SmCoO(3). We observe a negative chemical pressure induced structural phase transformation from distorted perovskite (orthorhombic) to perfect perovskite (cubic) due to the substitution of Sr(2 + ) at the Sm(3 + ) sites. However, external hydrostatic pressure shows isotropic compression and no pressure-induced structural transformation is observed up to 100 GPa. To maintain the electroneutrality of the system, charge compensation is through oxygen vacancies which results in the brownmillerite-type structure. A defect model is proposed, which is consistent with experimental results. The solution energies for divalent and trivalent cations are also calculated. These results show that the cations having ionic radii less than 0.75 Å will occupy the Co sites and those with ionic radii larger than 0.75 Å will substitute at the Sm sites.

  4. Negative pressure wound therapy versus standard wound care on quality of life: a systematic review.

    Science.gov (United States)

    Janssen, A H J; Mommers, E H H; Notter, J; de Vries Reilingh, T S; Wegdam, J A

    2016-03-01

    Negative pressure wound therapy (NPWT) is a widely accepted treatment modality for open or infected wounds. Premature ending of NPWT occasionally occurs due to negative effects on the quality of life (QoL), however, the actual impact on QoL is unknown. The aim of this review is to analyse the effect of NPWT versus standard wound care (SWC) on QoL when used for the treatment of open or infected wounds. A systematic literature search in a range of databases (PubMed, CINAHL, Medline, Web of Science, Science Direct Freedom Collection, SwetsWise, PSYCArticles and Infrotrac Custom Journals) using the following search terms; 'standard wound care', 'wound dressing', 'dressing', 'treatment', OR 'negative pressure wound therapy [MESH]', OR 'vacuum assisted closure' AND 'quality of life [MESH]', 'patient-satisfaction', OR 'experiences' was performed. Methodological quality was assessed using the methodological index for non-randomised studies (MINORS) checklist. There were 42 studies identified, five matched the inclusion criteria: two randomised clinical trials (RCTs), one clinical comparative study, one exploratory prospective cohort study and one quasi experimental pilot study. Median MINORS-score was 75% (58%-96%). There were seven different questionnaires used to measure QoL or a subsidiary outcome. QoL in the NPWT group was lower in the first week, though no difference in QoL was observed thereafter. This systematic review observed that QoL improved at the end of therapy independent of which therapy was used. NPWT led to a lower QoL during the first week of treatment, possible due to aniexty, after which a similar or better QoL was reported when compared with SWC. It could be suggested that NPWT might be associated with increased anxiety. All authors of this publication have received no financial support or have personal interests conflicting with the objectivity of this manuscript.

  5. Magnetosphere and ionosphere response to a positive-negative pulse pair of solar wind dynamic pressure

    Science.gov (United States)

    Tian, A.; Degeling, A. W.

    2017-12-01

    Simulations and observations had shown that single positive/negative solar wind dynamic pressure pulse would excite geomagnetic impulsive events along with ionosphere and/or magnetosphere vortices which are connected by field aligned currents(FACs). In this work, a large scale ( 9min) magnetic hole event in solar wind provided us with the opportunity to study the effects of positive-negative pulse pair (△p/p 1) on the magnetosphere and ionosphere. During the magnetic hole event, two traveling convection vortices (TCVs, anti-sunward) first in anticlockwise then in clockwise rotation were detected by geomagnetic stations located along the 10:30MLT meridian. At the same time, another pair of ionospheric vortices azimuthally seen up to 3 MLT first in clockwise then in counter-clockwise rotation were also appeared in the afternoon sector( 14MLT) and centered at 75 MLAT without obvious tailward propagation feature. The duskside vortices were also confirmed in SuperDARN radar data. We simulated the process of magnetosphere struck by a positive-negative pulse pair and it shows that a pair of reversed flow vortices in the magnetosphere equatorial plane appeared which may provide FACs for the vortices observed in ionosphere. Dawn dusk asymmetry of the vortices as well as the global geomagnetism perturbation characteristics were also discussed.

  6. Supine exercise during lower body negative pressure effectively simulates upright exercise in normal gravity

    Science.gov (United States)

    Murthy, G.; Watenpaugh, D. E.; Ballard, R. E.; Hargens, A. R.

    1994-01-01

    Exercise within a lower body negative pressure (LBNP) chamber in supine posture was compared with similar exercise against Earth's gravity (without LBNP) in upright posture in nine healthy male volunteers. We measured footward force with a force plate, pressure in soleus and tibialis anterior muscles of the leg with transducer-tipped catheters, calf volume by strain gauge plethysmography, heart rate, and systolic and diastolic blood pressures during two conditions: 1) exercise in supine posture within an LBNP chamber during 100-mmHg LBNP (exercise-LBNP) and 2) exercise in upright posture against Earth's gravity without LBNP (exercise-1 G). Subjects exercised their ankle joints (dorsi- and plantarflexions) for 5 min during exercise-LBNP and for 5 min during exercise-1 G. Mean footward force produced during exercise-LBNP (743 +/- 37 N) was similar to that produced during exercise-1 G (701 +/- 24 N). Peak contraction pressure in the antigravity soleus muscle during exercise-LBNP (115 +/- 10 mmHg) was also similar to that during exercise-1 G (103 +/- 13 mmHg). Calf volume increased significantly by 3.3 +/- 0.5% during exercise-LBNP compared with baseline values. Calf volume did not increase significantly during exercise-1 G. Heart rate was significantly higher during exercise-LBNP (99 +/- 5 beats/min) than during exercise-1 G (81 +/- 3 beats/min). These results indicate that exercise in supine posture within an LBNP chamber can produce similar musculoskeletal stress in the legs and greater systemic cardiovascular stress than exercise in the upright posture against Earth's gravity.

  7. The effects of superimposed tilt and lower body negative pressure on anterior and posterior cerebral circulations.

    Science.gov (United States)

    Tymko, Michael M; Rickards, Caroline A; Skow, Rachel J; Ingram-Cotton, Nathan C; Howatt, Michael K; Day, Trevor A

    2016-09-01

    Steady-state tilt has no effect on cerebrovascular reactivity to increases in the partial pressure of end-tidal carbon dioxide (PETCO2). However, the anterior and posterior cerebral circulations may respond differently to a variety of stimuli that alter central blood volume, including lower body negative pressure (LBNP). Little is known about the superimposed effects of head-up tilt (HUT; decreased central blood volume and intracranial pressure) and head-down tilt (HDT; increased central blood volume and intracranial pressure), and LBNP on cerebral blood flow (CBF) responses. We hypothesized that (a) cerebral blood velocity (CBV; an index of CBF) responses during LBNP would not change with HUT and HDT, and (b) CBV in the anterior cerebral circulation would decrease to a greater extent compared to posterior CBV during LBNP when controlling PETCO2 In 13 male participants, we measured CBV in the anterior (middle cerebral artery, MCAv) and posterior (posterior cerebral artery, PCAv) cerebral circulations using transcranial Doppler ultrasound during LBNP stress (-50 mmHg) in three body positions (45°HUT, supine, 45°HDT). PETCO2 was measured continuously and maintained at constant levels during LBNP through coached breathing. Our main findings were that (a) steady-state tilt had no effect on CBV responses during LBNP in both the MCA (P = 0.077) and PCA (P = 0.583), and (b) despite controlling for PETCO2, both the MCAv and PCAv decreased by the same magnitude during LBNP in HUT (P = 0.348), supine (P = 0.694), and HDT (P = 0.407). Here, we demonstrate that there are no differences in anterior and posterior circulations in response to LBNP in different body positions. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  8. Cardiovascular response to lower body negative pressure stimulation before, during, and after space flight

    Science.gov (United States)

    Baisch, F.; Beck, L.; Blomqvist, G.; Wolfram, G.; Drescher, J.; Rome, J. L.; Drummer, C.

    2000-01-01

    BACKGROUND: It is well known that space travel cause post-flight orthostatic hypotension and it was assumed that autonomic cardiovascular control deteriorates in space. Lower body negative pressure (LBNP) was used to assess autonomic function of the cardiovascular system. METHODS: LBNP tests were performed on six crew-members before and on the first days post-flight in a series of three space missions. Additionally, two of the subjects performed LBNP tests in-flight. LBNP mimics fluid distribution of upright posture in a gravity independent way. It causes an artificial sequestration of blood, reduces preload, and filtrates plasma into the lower part of the body. Fluid distribution was assessed by bioelectrical impedance and anthropometric measurements. RESULTS: Heart rate, blood pressure, and total peripheral resistance increased significantly during LBNP experiments in-flight. The decrease in stroke volume, the increased pooling of blood, and the increased filtration of plasma into the lower limbs during LBNP indicated that a plasma volume reduction and a deficit of the interstitial volume of lower limbs rather than a change in cardiovascular control was responsible for the in-flight response. Post-flight LBNP showed no signs of cardiovascular deterioration. The still more pronounced haemodynamic changes during LBNP reflected the expected behaviour of cardiovascular control faced with less intravascular volume. In-flight, the status of an intra-and extravascular fluid deficit increases sympathetic activity, the release of vasoactive substances and consequently blood pressure. Post-flight, blood pressure decreases significantly below pre-flight values after restoration of volume deficits. CONCLUSION: We conclude that the cardiovascular changes in-flight are a consequence of a fluid deficit rather than a consequence of changes in autonomic signal processing.

  9. Validation of lower body negative pressure as an experimental model of hemorrhage

    Science.gov (United States)

    Shade, Robert E.; Muniz, Gary W.; Bauer, Cassondra; Goei, Kathleen A.; Pidcoke, Heather F.; Chung, Kevin K.; Cap, Andrew P.; Convertino, Victor A.

    2013-01-01

    Lower body negative pressure (LBNP), a model of hemorrhage (Hem), shifts blood to the legs and elicits central hypovolemia. This study compared responses to LBNP and actual Hem in sedated baboons. Arterial pressure, pulse pressure (PP), central venous pressure (CVP), heart rate, stroke volume (SV), and +dP/dt were measured. Hem steps were 6.25%, 12.5%, 18.75%, and 25% of total estimated blood volume. Shed blood was returned, and 4 wk after Hem, the same animals were subjected to four LBNP levels which elicited equivalent changes in PP and CVP observed during Hem. Blood gases, hematocrit (Hct), hemoglobin (Hb), plasma renin activity (PRA), vasopressin (AVP), epinephrine (EPI), and norepinephrine (NE) were measured at baseline and maximum Hem or LBNP. LBNP levels matched with 6.25%, 12.5%, 18.75%, and 25% hemorrhage were −22 ± 6, −41 ± 7, −54 ± 10, and −71 ± 7 mmHg, respectively (mean ± SD). Hemodynamic responses to Hem and LBNP were similar. SV decreased linearly such that 25% Hem and matching LBNP caused a 50% reduction in SV. Hem caused a decrease in Hct, Hb, and central venous oxygen saturation (ScvO2). In contrast, LBNP increased Hct and Hb, while ScvO2 remained unchanged. Hem caused greater elevations in AVP and NE than LBNP, while PRA, EPI, and other hematologic indexes did not differ between studies. These results indicate that while LBNP does not elicit the same effect on blood cell loss as Hem, LBNP mimics the integrative cardiovascular response to Hem, and validates the use of LBNP as an experimental model of central hypovolemia associated with Hem. PMID:24356525

  10. Diabetic foot wounds: the value of negative pressure wound therapy with instillation.

    Science.gov (United States)

    Dalla Paola, Luca

    2013-12-01

    Chronic wounds such as diabetic foot wounds are a tremendous burden to the health care system and often require a multidisciplinary approach to prevent amputations. Advanced technologies such as negative pressure wound therapy (NPWT) and bioengineered tissues have been successfully used in the treatment of these types of complex wounds. However, the introduction of NPWT with instillation (NPWTi) has provided an alternative treatment for treating complex and difficult-to-heal wounds. This article provides an overview of NPWT and the new NPWTi system and describes preliminary experience using NPWTi on patients with complicated infected diabetic foot wounds after surgical debridement and in a multidisciplinary setting. © 2013 The Author. International Wound Journal © 2013 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

  11. Electrical admittance for filling of the heart during lower body negative pressure in humans

    DEFF Research Database (Denmark)

    Cai, Yujia; Holm, S; Jenstrup, M

    2000-01-01

    To evaluate whether electrical admittance of intracellular water is applicable for monitoring filling of the heart, we determined the difference in intracellular water in the thorax (Thorax(ICW)), measured as the reciprocal value of the electrical impedance for the thorax at 1.5 and 100 kHz during...... lower body negative pressure (LBNP) in humans. Changes in Thorax(ICW) were compared with positron emission tomography-determined C(15)O-labeled erythrocytes over the heart. During -40 mmHg LBNP, the blood volume of the heart decreased by 21 +/- 3% as the erythrocyte volume was reduced by 20 +/- 2.......6 to 40.9 +/- 5.0 S. 10(-4); P = 0.08). The correlation between Thorax(ICW) and heart erythrocyte volume was 0.84 (P electrical admittance of intracellular water can be applied to evaluate changes in blood volume of the heart during LBNP in humans....

  12. Negative pressure pulmonary oedema following use of ProSeal LMA

    Directory of Open Access Journals (Sweden)

    Richa Jain

    2013-01-01

    Full Text Available Negative pressure pulmonary oedema (NPPO is a life threatening condition, manifested due to upper airway obstruction in a spontaneously breathing patient. Upper airway obstruction caused by classic laryngeal mask airway (cLMA and ProSeal laryngeal mask airway (PLMA has been reported, and NPPO has also been reported following the use of cLMA. Search of literature did not confirm NPPO following the use of PLMA. We encountered a female patient of NPPO scheduled for incision and drainage of an abscess who had signs of airway obstruction following PLMA insertion. Multiple attempts were made to get patent airway without success. PLMA was replaced with endotracheal tube following which pink frothy secretion appeared in breathing circuit. Patient was managed successfully with ICU care.

  13. Negative ion molecule reactions of WF6: evidence for a pressure dependent branching ratio

    International Nuclear Information System (INIS)

    Viggiano, A.A.; Paulson, J.F.

    1984-01-01

    Rate coefficients have been measured in a selected ion flow tube (SIFT) for reactions of several negative ions with WF 6 . With the exception of SF - 5 , all the reactant ions studied having an electron detachment energy less than 3.36 eV reacted rapidly by charge exchange. SF - 5 transferred a fluoride ion producing WF - 7 . Ions with detachment energies greater than 3.36 eV associated rapidly with WF - 6 . Br - , with a detachment energy of 3.36 eV, reacted with WF 6 both by ion-neutral association and by charge exchange. The branching ratio for these two channels was found to depend on temperature and pressure. All these data indicate that the electron affinity of WF 6 is nearly equal to that of Br

  14. Negative-Pressure Cavitation Extraction of Secoisolariciresinol Diglycoside from Flaxseed Cakes

    Directory of Open Access Journals (Sweden)

    Hao Tian

    2015-06-01

    Full Text Available The negative-pressure cavitation extraction (NPCE technique was applied firstly to extract secoisolariciresinol diglucoside (SDG from flaxseed cakes. The significant extraction parameters were screened by fractional factorial design (FFD. The optimal parameters were determined using the central composite design (CCD with the two variables, NaOH amount and the liquid/solid ratio. The conditions of the extraction were optimized by using response surface methodology (RSM. Under the optimal conditions, the extraction yield and the extraction purity of SDG was 16.25 mg/g and 3.86%, respectively. The efficiency of NPCE was compared with that of conventional extraction methods. Our results demonstrated that NPCE was comparable to the well-known ultrasound-assisted extraction in term of extraction yield and purity. This extraction technique has advantages of less time-consuming, low solvent usage and high throughput capability.

  15. Negative pressure wound therapy in pediatric surgery: How and when to use.

    Science.gov (United States)

    de Jesus, Lisieux Eyer; Martins, Alana Bandeira; Oliveira, Pablo Baptista; Gomes, Fernanda; Leve, Thais; Dekermacher, Samuel

    2018-04-01

    Negative pressure wound therapy (NPWT) has been widely adopted to treat laparostomy, abdominal compartment syndrome (ACS) and complicated wounds associated with tissue loss. The method presents specific aspects, advantages and indications in Pediatrics. Our aim is to review the evidence available about NPWT in children. Active search for papers about NPWT in Pediatric patients. Papers referring to orthopedic problems, wound complications after Cardiac Surgery or burns were excluded. The method shows good results to treat ACS, complicated wounds and abdominal wall malformations in neonates, including prematures. Periwound skin protection, monitoring of fluid losses and fine tuning of negative pressure levels according to age are necessary. Less pain, quicker recovery, less frequent dressing changes, possible recovery of exposed surgical hardware, granulation and shrinkage of the wound are advantages of the method over other kinds of dressing. NPWT is contraindicated over blood vessels and exposed nerves. Debridement is needed before usage over necrotic areas. Enteric fistulae are not contraindications. Complications are rare, mainly foam retention and dermatitis/skin maceration. The possibility of fistulae being caused by NPWT remains debatable. NPWT is widely used in Pediatrics, including neonates and premature, but the evidence available about the method is scarce and low quality. Complications are uncommon and mostly manageable. A possible causal relationship between NPWY and enteric fistula remains unclear. Adult devices and parameters have been adapted to children's use. Extra care is needed to protect the delicate tissues of Pediatric patients. Comparative research to define differential costs, indications and advantages of the method, specific indications and limits of NWTP in Pediatrics is needed. Review. IV. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Intrarectal negative pressure system in the management of open abdomen with colorectal fistula: A case report☆

    Science.gov (United States)

    Yetişir, Fahri; Salman, A. Ebru; Mamedov, Ruslan; Aksoy, Mustafa; Yalcin, Abdussamet; Kayaalp, Cüneyt

    2014-01-01

    INTRODUCTION To present the management of open abdomen with colorectal fistula by application of intrarectal negative pressure system (NPS) in addition to abdominal NPS. PRESENTATION OF CASE Twenty-year old man had a history of injuries by a close-range gunshot to the abdomen eight days ago and he had been treated by bowel repairs, resections, jejunal anastomosis and Hartman's procedure. He was referred to our center after deterioration, evisceration with open abdomen and enteric fistula in septic shock. There were edematous, fibrinous bowels and large multiple fistulas from the edematous rectal stump. APACHE II, Mannheim Peritoneal Index and Björck scores were 18, 33 and 3, respectively (expected mortality 100%). After intensive care for 5 days, he was treated by abdominal and intrarectal NPS. NPS repeated for 5 times and the fistula was recovered on day 18 completely. Fascial closure was facilitated with a dynamic abdominal closure system (ABRA) and he was discharged on day 33 uneventfully. There was no herniation and any other problem after 12 months follow-up. DISCUSSION Management of fistula in OA can be extremely challenging. Floating stoma, fistula VAC, nipple VAC, ring and silo VAC, fistula intubation systems are used for isolation of the enteric effluent from OA. Several biologic dressings such as acellular dermal matrix, pedicled flaps have been used to seal the fistula opening with various success. Resection of the involved enteric loop and a new anastomosis of the intestine is very hard and rarely possible. In all of these reports, usually patients are left to heal with a giant hernia. In contrast to this, there is no hernia in our case during one year follow up period. CONCLUSION Combination of intra and extra luminal negative pressure systems and ABRA is a safe and successful method to manage open abdomen with colorectal fistula. PMID:24584042

  17. Intrarectal negative pressure system in the management of open abdomen with colorectal fistula: A case report.

    Science.gov (United States)

    Yetişir, Fahri; Salman, A Ebru; Mamedov, Ruslan; Aksoy, Mustafa; Yalcin, Abdussamet; Kayaalp, Cüneyt

    2014-01-01

    To present the management of open abdomen with colorectal fistula by application of intrarectal negative pressure system (NPS) in addition to abdominal NPS. Twenty-year old man had a history of injuries by a close-range gunshot to the abdomen eight days ago and he had been treated by bowel repairs, resections, jejunal anastomosis and Hartman's procedure. He was referred to our center after deterioration, evisceration with open abdomen and enteric fistula in septic shock. There were edematous, fibrinous bowels and large multiple fistulas from the edematous rectal stump. APACHE II, Mannheim Peritoneal Index and Björck scores were 18, 33 and 3, respectively (expected mortality 100%). After intensive care for 5 days, he was treated by abdominal and intrarectal NPS. NPS repeated for 5 times and the fistula was recovered on day 18 completely. Fascial closure was facilitated with a dynamic abdominal closure system (ABRA) and he was discharged on day 33 uneventfully. There was no herniation and any other problem after 12 months follow-up. Management of fistula in OA can be extremely challenging. Floating stoma, fistula VAC, nipple VAC, ring and silo VAC, fistula intubation systems are used for isolation of the enteric effluent from OA. Several biologic dressings such as acellular dermal matrix, pedicled flaps have been used to seal the fistula opening with various success. Resection of the involved enteric loop and a new anastomosis of the intestine is very hard and rarely possible. In all of these reports, usually patients are left to heal with a giant hernia. In contrast to this, there is no hernia in our case during one year follow up period. Combination of intra and extra luminal negative pressure systems and ABRA is a safe and successful method to manage open abdomen with colorectal fistula. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Comparison of compensatory reserve during lower-body negative pressure and hemorrhage in nonhuman primates.

    Science.gov (United States)

    Hinojosa-Laborde, Carmen; Howard, Jeffrey T; Mulligan, Jane; Grudic, Greg Z; Convertino, Victor A

    2016-06-01

    Compensatory reserve was measured in baboons (n = 13) during hemorrhage (Hem) and lower-body negative pressure (LBNP) using a machine-learning algorithm developed to estimate compensatory reserve by detecting reductions in central blood volume during LBNP. The algorithm calculates compensatory reserve index (CRI) from normovolemia (CRI = 1) to cardiovascular decompensation (CRI = 0). The hypothesis was that Hem and LBNP will elicit similar CRI values and that CRI would have higher specificity than stroke volume (SV) in predicting decompensation. Blood was removed in four steps: 6.25%, 12.5%, 18.75%, and 25% of total blood volume. Four weeks after Hem, the same animals were subjected to four levels of LBNP that was matched on the basis of their central venous pressure. Data (mean ± 95% confidence interval) indicate that CRI decreased (P AUC in Hem (0.94 vs. 0.84) and LBNP (0.94 vs. 0.92). These data support the hypothesis that Hem and LBNP elicited the same CRI response, suggesting that measurement of compensatory reserve is superior to SV as a predictor of cardiovascular decompensation.

  19. Development of micropump-actuated negative pressure pinched injection for parallel electrophoresis on array microfluidic chip.

    Science.gov (United States)

    Li, Bowei; Jiang, Lei; Xie, Hua; Gao, Yan; Qin, Jianhua; Lin, Bingcheng

    2009-09-01

    A micropump-actuated negative pressure pinched injection method is developed for parallel electrophoresis on a multi-channel LIF detection system. The system has a home-made device that could individually control 16-port solenoid valves and a high-voltage power supply. The laser beam is excitated and distributes to the array separation channels for detection. The hybrid Glass-PDMS microfluidic chip comprises two common reservoirs, four separation channels coupled to their respective pneumatic micropumps and two reference channels. Due to use of pressure as a driving force, the proposed method has no sample bias effect for separation. There is only one high-voltage supply needed for separation without relying on the number of channels, which is significant for high-throughput analysis, and the time for sample loading is shortened to 1 s. In addition, the integrated micropumps can provide the versatile interface for coupling with other function units to satisfy the complicated demands. The performance is verified by separation of DNA marker and Hepatitis B virus DNA samples. And this method is also expected to show the potential throughput for the DNA analysis in the field of disease diagnosis.

  20. Tolerance of Lower Body Negative Pressure (LBNP) in endurance runners, weightlifters, swimmers and nonathletes

    Science.gov (United States)

    1980-01-01

    Thirteen endurance runners (R), 12 weightlifters (WL), 12 swimmers (SW) and 10 nonathletes (NA) were tested for their tolerance of lower body negative pressure (LBNP) in consecutive 5 minute stages at -20, -30, -40, -50 and -60 torr. Each subject also performed an exercise test on a bicycle ergometer with progressive workloads to exhaustion to determined aerobic capacity. The R had a much higher aerobic capacity than any of the other groups, but a significantly lower LBNP tolerance. While responses in heart rate and pulse pressure were quite similar in all 4 groups, the rate of increase in leg volume relative to LBNP stress (leg compliance, LC) was considerably greater in R than in the other athletes and NA. The greater LC in R could be attributed not only to a more rapid shift of blood to the lower extremities but also to a greater tendency for edema formation, both contributing to a more rapid loss in effective central blood volume for a given LBNP stress. These results substantiate earlier observations which led to the conclusion that endurance running is not advisable as a training regimen for astronauts.

  1. Effect of aerobic capacity on Lower Body Negative Pressure (LBNP) tolerance in females

    Science.gov (United States)

    Moore, Alan D., Jr.; Fortney, Suzanne M.; Siconolfi, Steven F.

    1993-01-01

    This investigation determined whether a relationship exists in females between: (1) aerobic capacity and Lower Body Negative Pressure (LBNP); and (2) aerobic capacity and change in LBNP tolerance induced by bed rest. Nine females, age 27-47 (34.6 plus or minus 6.0 (Mean plus or minus SD)), completed a treadmill-graded exercise test to establish aerobic capacity. A presyncopal-limited LBNP test was performed prior to and after 13 days of bed rest at a 6 deg head-down tilt. LBNP tolerance was quantified as: (1) the absolute level of negative pressure (NP) tolerated for greater than or equal to 60 sec; and (2) Luft's Cumulative Stress Index (CSI). Aerobic capacity was 33.3 plus or minus 5.0 mL/kg/min and ranged from 25.7 to 38.7. Bed rest was associated with a decrease in NP tolerance (-9.04 1.6 kPa(-67.8 plus or minus 12.0 mmHg) versus -7.7 1.1 kPa(-57.8 plus or minus 8.33 mmHg); p = 0.028) and in CSI (99.4 27.4 kPa min(745.7 plus or minus 205.4 mmHg min) versus 77.0 16.9 kPa min (577.3 plus or minus mmHg min); p = 0.008). The correlation between aerobic capacity and absolute NP or CSI pre-bed rest did not differ significantly from zero (r = -0.56, p = 0.11 for NP; and r = -0.52, p = 0.16 for CSI). Also, no significant correlation was observed between aerobic and pre- to post-rest change for absolute NP tolerance (r = -0.35, p = 0.35) or CSI (r = -0.32, p = 0.40). Therefore, a significant relationship does not exist between aerobic capacity and orthostatic function or change in orthostatic function induced by bed rest.

  2. Skin graft fixation in severe burns: use of topical negative pressure.

    Science.gov (United States)

    Kamolz, L P; Lumenta, D B; Parvizi, D; Wiedner, M; Justich, I; Keck, M; Pfurtscheller, K; Schintler, M

    2014-09-30

    Over the last 50 years, the evolution of burn care has led to a significant decrease in mortality. The biggest impact on survival has been the change in the approach to burn surgery. Early excision and grafting has become a standard of care for the majority of patients with deep burns; the survival of a given patient suffering from major burns is invariably linked to the take rate and survival of skin grafts. The application of topical negative pressure (TNP) therapy devices has demonstrated improved graft take in comparison to conventional dressing methods alone. The aim of this study was to analyze the impact of TNP therapy on skin graft fixation in large burns. In all patients, we applied TNP dressings covering a %TBSA of >25. The following parameters were recorded and documented using BurnCase 3D: age, gender, %TBSA, burn depth, hospital length-of-stay, Baux score, survival, as well as duration and incidence of TNP dressings. After a burn depth adapted wound debridement, coverage was simultaneously performed using split-thickness skin grafts, which were fixed with staples and covered with fatty gauzes and TNP foam. The TNP foam was again fixed with staples to prevent displacement and finally covered with the supplied transparent adhesive film. A continuous subatmospheric pressure between 75-120 mm Hg was applied (VAC®, KCI, Vienna, Austria). The first dressing change was performed on day 4. Thirty-six out of 37 patients, suffering from full thickness burns, were discharged with complete wound closure; only one patient succumbed to their injuries. The overall skin graft take rate was over 95%. In conclusion, we consider that split thickness skin graft fixation by TNP is an efficient method in major burns, notably in areas with irregular wound surfaces or subject to movement (e.g. joint proximity), and is worth considering for the treatment of aged patients.

  3. Comparison of compensatory reserve during lower-body negative pressure and hemorrhage in nonhuman primates

    Science.gov (United States)

    Howard, Jeffrey T.; Mulligan, Jane; Grudic, Greg Z.; Convertino, Victor A.

    2016-01-01

    Compensatory reserve was measured in baboons (n = 13) during hemorrhage (Hem) and lower-body negative pressure (LBNP) using a machine-learning algorithm developed to estimate compensatory reserve by detecting reductions in central blood volume during LBNP. The algorithm calculates compensatory reserve index (CRI) from normovolemia (CRI = 1) to cardiovascular decompensation (CRI = 0). The hypothesis was that Hem and LBNP will elicit similar CRI values and that CRI would have higher specificity than stroke volume (SV) in predicting decompensation. Blood was removed in four steps: 6.25%, 12.5%, 18.75%, and 25% of total blood volume. Four weeks after Hem, the same animals were subjected to four levels of LBNP that was matched on the basis of their central venous pressure. Data (mean ± 95% confidence interval) indicate that CRI decreased (P < 0.001) from baseline during Hem (0.69 ± 0.10, 0.57 ± 0.09, 0.36 ± 0.10, 0.16 ± 0.08, and 0.08 ± 0.03) and LBNP (0.76 ± 0.05, 0.66 ± 0.08, 0.36 ± 0.13, 0.23 ± 0.11, and 0.14 ± 0.09). CRI was not different between Hem and LBNP (P = 0.20). Linear regression analysis between Hem CRI and LBNP CRI revealed a slope of 1.03 and a correlation coefficient of 0.96. CRI exhibited greater specificity than SV in both Hem (92.3 vs. 82.1) and LBNP (94.8 vs. 83.1) and greater ROC AUC in Hem (0.94 vs. 0.84) and LBNP (0.94 vs. 0.92). These data support the hypothesis that Hem and LBNP elicited the same CRI response, suggesting that measurement of compensatory reserve is superior to SV as a predictor of cardiovascular decompensation PMID:27030667

  4. Initial treatment of respiratory distress syndrome with nasal intermittent mandatory ventilation versus nasal continuous positive airway pressure: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Amir-Mohammad Armanian

    2014-01-01

    Full Text Available Background: Neonatal respiratory distress syndrome (RDS in premature infants who survived and its complications are a common problem. Due to high morbidity and mechanical ventilation (MV nowadays researchers in interested minimizing MV. To determine, in very low birth weight (BW preterm neonates with RDS, if initial treatment with nasal intermittent mandatory ventilation (early NIMV compared with early nasal continuous positive airway pressure (early NCPAP obtains more favorable outcomes in terms of the duration of treatment, and the need for endotracheal tube ventilation. Methods: In this single-center randomized control trial study, infants (BW ≤ 1500 g and/or gestational age ≤ 34 weeks with respiratory distress were considered eligible. Forty-four infants were randomly assigned to receive early-NIMV and 54 comparable infants to early-NCPAP. Surfactants were given, when FIO 2 requirement was of >30%. Primary outcomes were failure of noninvasive respiratory support, that is, the need for MV in the first 48 h of life and for the duration of noninvasive respiratory support in each group. Results: 98 infants were enrolled (44 in the NIMV and 54 in the NCPAP group. The Preventive power of MV of NIMV usage (95.5% was not lower than the NCPAP (98.1% strength (hazard ratio: 0.21 (95% confidence interval: 0.02-2.66; P: 0.23. The duration of noninvasive respiratory support in the NIMV group was significantly shorter than NCPAP (the median (range was 24 (18.00-48.00 h versus 48.00 (22.00-120.00 h in NIMV versus NCPAP groups; P < 0.001. Similarly, the duration of dependency on oxygen was less, for NIMV (the median (range was 96.00 (41.00-504.00 h versus144.00 (70.00-1130.00 h in NIMV versus NCPAP groups; P: 0.009. Interestingly, time to full enteral feeds and length of hospital stay were more favorable in the NIMV versus the NCPAP group. Conclusions: Initial treatment of RDS with NIMV was safe, and well tolerated. Furthermore, NIMV had excellent

  5. Cost study of dermal substitutes and topical negative pressure in the surgical treatment of burns.

    Science.gov (United States)

    Hop, M Jenda; Bloemen, Monica C T; van Baar, Margriet E; Nieuwenhuis, Marianne K; van Zuijlen, Paul P M; Polinder, Suzanne; Middelkoop, Esther

    2014-05-01

    A recently performed randomised controlled trial investigated the clinical effectiveness of dermal substitutes (DS) and split skin grafts (SSG) in combination with topical negative pressure (TNP) in the surgical treatment of burn wounds. In the current study, medical and non-medical costs were investigated, to comprehensively assess the benefits of this new treatment. The primary outcome was mean total costs of the four treatment strategies: SSG with or without DS, and with or without TNP. Costs were studied from a societal perspective. Findings were evaluated in light of the clinical effects on scar elasticity. Eighty-six patients were included. Twelve months post-operatively, highest elasticity was measured in scars treated with DS and TNP (p=0.027). The initial cost price of treatment with DS and TNP was €2912 compared to treatment with SSG alone €1703 (ptreatment contributed maximal 7% to the total costs and total costs varied widely within and between groups, but were not significantly different. Therefore, in the selection of the most optimal type of surgical intervention, cost considerations should not play an important role. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  6. Evidence for negative effects of elevated intra-abdominal pressure on pulmonary mechanics and oxidative stress.

    Science.gov (United States)

    Davarcı, I; Karcıoğlu, M; Tuzcu, K; İnanoğlu, K; Yetim, T D; Motor, S; Ulutaş, K T; Yüksel, R

    2015-01-01

    To compare the effects of pneumoperitoneum on lung mechanics, end-tidal CO2 (ETCO2), arterial blood gases (ABG), and oxidative stress markers in blood and bronchoalveolar lavage fluid (BALF) during laparoscopic cholecystectomy (LC) by using lung-protective ventilation strategy. Forty-six patients undergoing LC and abdominal wall hernia (AWH) surgery were assigned into 2 groups. Measurements and blood samples were obtained before, during pneumoperitoneum, and at the end of surgery. BALF samples were obtained after anesthesia induction and at the end of surgery. Peak inspiratory pressure, ETCO2, and pCO2 values at the 30th minute were significantly increased, while there was a significant decrease in dynamic lung compliance, pH, and pO2 values in LC group. In BALF samples, total oxidant status (TOS), arylesterase, paraoxonase, and malondialdehyde levels were significantly increased; the glutathione peroxidase levels were significantly decreased in LC group. The serum levels of TOS and paraoxonase were significantly higher at the end of surgery in LC group. In addition, arylesterase level in the 30th minute was increased compared to baseline. Serum paraoxonase level at the end of surgery was significantly increased when compared to AWH group. Our study showed negative effects of pneumoperitoneum in both lung and systemic levels despite lung-protective ventilation strategy.

  7. Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress

    Directory of Open Access Journals (Sweden)

    I. Davarcı

    2015-01-01

    Full Text Available Objective. To compare the effects of pneumoperitoneum on lung mechanics, end-tidal CO2 (ETCO2, arterial blood gases (ABG, and oxidative stress markers in blood and bronchoalveolar lavage fluid (BALF during laparoscopic cholecystectomy (LC by using lung-protective ventilation strategy. Materials and Methods. Forty-six patients undergoing LC and abdominal wall hernia (AWH surgery were assigned into 2 groups. Measurements and blood samples were obtained before, during pneumoperitoneum, and at the end of surgery. BALF samples were obtained after anesthesia induction and at the end of surgery. Results. Peak inspiratory pressure, ETCO2, and pCO2 values at the 30th minute were significantly increased, while there was a significant decrease in dynamic lung compliance, pH, and pO2 values in LC group. In BALF samples, total oxidant status (TOS, arylesterase, paraoxonase, and malondialdehyde levels were significantly increased; the glutathione peroxidase levels were significantly decreased in LC group. The serum levels of TOS and paraoxonase were significantly higher at the end of surgery in LC group. In addition, arylesterase level in the 30th minute was increased compared to baseline. Serum paraoxonase level at the end of surgery was significantly increased when compared to AWH group. Conclusions. Our study showed negative effects of pneumoperitoneum in both lung and systemic levels despite lung-protective ventilation strategy.

  8. Use of a risk assessment method to improve the safety of negative pressure wound therapy.

    Science.gov (United States)

    Lelong, Anne-Sophie; Martelli, Nicolas; Bonan, Brigitte; Prognon, Patrice; Pineau, Judith

    2014-06-01

    To conduct a risk analysis of the negative pressure wound therapy (NPWT) care process and to improve the safety of NPWT, a working group of nurses, hospital pharmacists, physicians and hospital managers performed a risk analysis for the process of NPWT care. The failure modes, effects and criticality analysis (FMECA) method was used for this analysis. Failure modes and their consequences were defined and classified as a function of their criticality to identify priority actions for improvement. By contrast to classical FMECA, the criticality index (CI) of each consequence was calculated by multiplying occurrence, severity and detection scores. We identified 13 failure modes, leading to 20 different consequences. The CI of consequences was initially 712, falling to 357 after corrective measures were implemented. The major improvements proposed included the establishment of 6-monthly training cycles for nurses, physicians and surgeons and the introduction of computerised prescription for NPWT. The FMECA method also made it possible to prioritise actions as a function of the criticality ranking of consequences and was easily understood and used by the working group. This study is, to our knowledge, the first to use the FMECA method to improve the safety of NPWT. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  9. The use of negative pressure wound therapy in the treatment of infected wounds. Case studies

    Directory of Open Access Journals (Sweden)

    Daniel de Alcântara Jones

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the results and benefits obtained from the topical use of negative pressure wound therapy (NPWT in patients with infected wounds. METHODS: This was a retrospective study of 20 patients (17 males and three females, mean age 42 years with infected wounds treated using NPWT. The infected wounds were caused by trauma. The treatment system used was VAC.(r (Vacuum Assisted Closure, KCI, San Antonio, United States applied to the wound in continuous mode from 100 to 125 mmHg. The parameters related to the wounds (location, number of VAC changes, the size of the defects in the soft parts, and the evolution of the state of the wound, length of hospital stay, length of intravenous antibiotic therapy, and complications related to the use of this therapy were evaluated. RESULTS: The mean length of the hospital stay, use of NPWT, and antibacterial therapy were 41 days, 22.5 days, and 20 days respectively. The use of the VAC led to a mean reduction of 29% in the wound area (95.65-68.1 cm2; p < 0.05. Only one patient did not show any improvement in the final appearance of the wound with complete eradication of the infection. No complication directly caused by NPWT was observed. CONCLUSION: NPWT stimulates infection-free scar tissue formation in a short time, and is a quick and comfortable alternative to conventional infected wounds treatment methods.

  10. Takotsubo cardiomyopathy precipitated by negative pressure pulmonary oedema following total thyroidectomy

    Directory of Open Access Journals (Sweden)

    K S Bharathi

    2016-01-01

    Full Text Available 'Takotsubo cardiomyopathy (TCM' or 'stress cardiomyopathy' is a reversible cardiomyopathy that is precipitated by intense emotional or physical stress. This syndrome is characterised by symptoms mimicking acute coronary syndrome with transient systolic dysfunction associated with regional wall motion abnormalities, which extend beyond a single coronary vascular bed in the absence of obstructive coronary vascular disease. The presentation of TCM and myocardial infarction is similar with sudden onset of chest pain, breathlessness as well as abnormalities in both the electrocardiogram and cardiac enzymes. It is difficult to differentiate between the two until cardiac catheterisation establishes the diagnosis. We report a case of TCM in a post-menopausal female, precipitated by negative pressure pulmonary oedema following total thyroidectomy in whom timely cardiac catheterisation established the diagnosis and influenced the management. Heightened awareness of this unique cardiomyopathy is essential to have a high index of suspicion in at-risk population for the prompt diagnosis of stress-related cardiomyopathy syndromes occurring in the perioperative period.

  11. Comparing negative pressure wound treatment with honey dressing in healing of foot ulcers in diabetics

    International Nuclear Information System (INIS)

    Bashir, U.; Maqsood, R.; Shabbir, H.

    2018-01-01

    To evaluate and compare the effectiveness of vacuum assisted treatment with that of honey dressing in duration of healing of foot ulcers in diabetics. Study Design: Randomized control study. Place and Duration of Study: Combined Military Hospital Multan and Nishtar Hospital Multan, from Aug 2016 till Feb 2017. Patients and Methods: A total of 95 patients with ages between 30-60 years of both sexes, who presented with diabetic ulcers of foot involving subcutaneous tissue and skin. Patients were divided randomly into two groups; Group V and H. Group V was subjected to Vacuum Pack closure (negative pressure wound treatment) and group H was treated with honey dressing, follow up was done till the appearance of healthy tissue after initial debridement, suitable for STSG (Split Thickness Skin Graft) or primary closure. Results: Healthy tissue appeared much faster in Vacuum assisted treatment, then with honey dressing with mean of 18.2 days for V.A.C and 28.8 days for honey dressing. Conclusion: Vacuum assisted closure was more effective in the treatment of foot ulcers in diabetics. It promotes healthy granulation tissue in the wound bed at a faster rate in comparison to honey dressing. (author)

  12. Effect of negative pressure wound therapy on molecular markers in diabetic foot ulcers.

    Science.gov (United States)

    Karam, Rehab A; Rezk, Noha A; Abdel Rahman, Tamer M; Al Saeed, Mohamed

    2018-08-15

    Diabetic foot ulcers are one of the most common complications of diabetes with high morbidity and mortality. Negative pressure wound therapy (NPWT) is one of the treatment modalities that facilitates the wound healing process; however, its molecular mechanism remains unclear. The aim of this study was to investigate the mechanism of action of NPWT in the treatment of diabetic foot ulcers via measuring the tissue expression of genes related to the wound healing process. The study included 40 patients with diabetic foot ulceration, 20 of them received NPWT and the other 20 were a control group treated with advanced moist therapy. Granulation tissue biopsies were obtained before and 10 days after treatment in both groups and subjected to real-time polymerase chain reaction to measure the mRNA expression of TGF-β1, VEGF, TNF-α, IL-1β, MMP-1, MMP-9 and TIMP-1 which are involved in the wound healing pathway. After 10 days of treatment with NPWT, the mRNA levels of IL-1β, TNF-α, MMP-1, and MMP-9 were significantly downregulated, while the levels of VEGF, TGF-β1 and TIMP-1 were significantly increased. Our study demonstrated that NPWT promotes wound healing in diabetic foot ulcers possibly by affecting growth factors, inflammatory cytokines, and matrix metalloproteinases. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Efficacy of Negative Pressure Wound Treatment in Preventing Surgical Site Infections after Whipple Procedures.

    Science.gov (United States)

    Gupta, Ryan; Darby, Geoffrey C; Imagawa, David K

    2017-10-01

    Surgical site infections (SSIs) occur at an average rate of 21.1 per cent after Whipple procedures per NSQIP data. In the setting of adherence to standard National Surgery Quality Improvement Program (NSQIP) Hepatopancreatobiliary recommendations including wound protector use and glove change before closing, this study seeks to evaluate the efficacy of using negative pressure wound treatment (NPWT) over closed incision sites after a Whipple procedure to prevent SSI formation. We retrospectively examined consecutive patients from January 2014 to July 2016 who met criteria of completing Whipple procedures with full primary incision closure performed by a single surgeon at a single institution. Sixty-one patients were included in the study between two cohorts: traditional dressing (TD) (n = 36) and NPWT dressing (n = 25). There was a statistically significant difference (P = 0.01) in SSI formation between the TD cohort (n = 15, SSI rate = 0.41) and the NPWT cohort (n = 3, SSI rate = 0.12). The adjusted odds ratio (OR) of SSI formation was significant for NPWT use [OR = 0.15, P = 0.036] and for hospital length of stay [OR = 1.21, P = 0.024]. Operative length, operative blood loss, units of perioperative blood transfusion, intraoperative gastrojejunal tube placement, preoperative stent placement, and postoperative antibiotic duration did not significantly impact SSI formation (P > 0.05).

  14. Oscillatory lower body negative pressure impairs working memory task-related functional hyperemia in healthy volunteers.

    Science.gov (United States)

    Merchant, Sana; Medow, Marvin S; Visintainer, Paul; Terilli, Courtney; Stewart, Julian M

    2017-04-01

    Neurovascular coupling (NVC) describes the link between an increase in task-related neural activity and increased cerebral blood flow denoted "functional hyperemia." We previously showed induced cerebral blood flow oscillations suppressed functional hyperemia; conversely functional hyperemia also suppressed cerebral blood flow oscillations. We used lower body negative pressure (OLBNP) oscillations to force oscillations in middle cerebral artery cerebral blood flow velocity (CBFv). Here, we used N-back testing, an intellectual memory challenge as a neural activation task, to test the hypothesis that OLBNP-induced oscillatory cerebral blood flow can reduce functional hyperemia and NVC produced by a working memory task and can interfere with working memory. We used OLBNP (-30 mmHg) at 0.03, 0.05, and 0.10 Hz and measured spectral power of CBFv at all frequencies. Neither OLBNP nor N-back, alone or combined, affected hemodynamic parameters. 2-Back power and OLBNP individually were compared with 2-back power during OLBNP. 2-Back alone produced a narrow band increase in oscillatory arterial pressure (OAP) and oscillatory cerebral blood flow power centered at 0.0083 Hz. Functional hyperemia in response to 2-back was reduced to near baseline and 2-back memory performance was decreased by 0.03-, 0.05-, and 0.10-Hz OLBNP. OLBNP alone produced increased oscillatory power at frequencies of oscillation not suppressed by added 2-back. However, 2-back preceding OLBNP suppressed OLBNP power. OLBNP-driven oscillatory CBFv blunts NVC and memory performance, while memory task reciprocally interfered with forced CBFv oscillations. This shows that induced cerebral blood flow oscillations suppress functional hyperemia and functional hyperemia suppresses cerebral blood flow oscillations. NEW & NOTEWORTHY We show that induced cerebral blood flow oscillations suppress functional hyperemia produced by a working memory task as well as memory task performance. We conclude that oscillatory

  15. Clinical Features of Patients with Diffuse Alveolar Hemorrhage due to Negative-Pressure Pulmonary Edema.

    Science.gov (United States)

    Contou, Damien; Voiriot, Guillaume; Djibré, Michel; Labbé, Vincent; Fartoukh, Muriel; Parrot, Antoine

    2017-08-01

    Diffuse alveolar hemorrhage (DAH) with negative-pressure pulmonary edema (NPPE) is an uncommon yet life-threatening condition. We aimed at describing the circumstances, clinical, radiological, and bronchoscopic features, as well as the outcome of patients with NPPE-related DAH. We performed a retrospective, observational cohort study, using data prospectively collected over 35 years in an intensive care unit (ICU). Of the 149 patients admitted for DAH, we identified 18 NPPE episodes in 15 patients, one admitted four times for recurrent NPPE-related DAH. The patients were primarily young, male, and athletic. The NPPE setting was postoperative (n = 12/18, 67%) or following generalized tonic-clonic seizures (n = 6/18, 33%). Hemoptysis was almost constant (n = 17/18, 94%), yet rarely massive (>200 cc, n = 1/18, 6%), with anemia observed in 10 (56%) episodes. The DAH triad (hemoptysis, anemia, and pulmonary infiltrates) was observed in 50% of episodes (n = 9/18), and acute respiratory failure in 94% (n = 17/18). Chest computed tomography revealed diffuse bilateral ground glass opacities (n = 10/10, 100%), while bronchoscopy detected bilateral hemorrhage (n = 12/12, 100%) and macroscopically bloody bronchoalveolar lavage, with siderophage absence in most (n = 7/8, 88%), indicating acute DAH. While one episode proved fatal, the other 17 recovered rapidly, with a mean ICU stay lasting 4.6 (2-15) days. Typically, the evolution was rapidly favorable under supportive care. NPPE-related DAH is a rare life-threatening condition occurring primarily after tonic-clonic generalized seizure or generalized anesthesia. Clinical circumstances are a key to its diagnosis. Early diagnosis and recognition likely allow for successful management of this potentially serious complication, whereas ictal-DAH appears ominous in epileptic patients.

  16. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial.

    Science.gov (United States)

    Armstrong, David G; Lavery, Lawrence A

    2005-11-12

    Diabetic foot wounds, particularly those secondary to amputation, are very complex and difficult to treat. We investigated whether negative pressure wound therapy (NPWT) improves the proportion and rate of wound healing after partial foot amputation in patients with diabetes. We enrolled 162 patients into a 16-week, 18-centre, randomised clinical trial in the USA. Inclusion criteria consisted of partial foot amputation wounds up to the transmetatarsal level and evidence of adequate perfusion. Patients who were randomly assigned to NPWT (n=77) received treatment with dressing changes every 48 h. Control patients (n=85) received standard moist wound care according to consensus guidelines. NPWT was delivered through the Vacuum Assisted Closure (VAC) Therapy System. Wounds were treated until healing or completion of the 112-day period of active treatment. Analysis was by intention to treat. This study has been registered with , number NCT00224796. More patients healed in the NPWT group than in the control group (43 [56%] vs 33 [39%], p=0.040). The rate of wound healing, based on the time to complete closure, was faster in the NPWT group than in controls (p=0.005). The rate of granulation tissue formation, based on the time to 76-100% formation in the wound bed, was faster in the NPWT group than in controls (p=0.002). The frequency and severity of adverse events (of which the most common was wound infection) were similar in both treatment groups. NPWT delivered by the VAC Therapy System seems to be a safe and effective treatment for complex diabetic foot wounds, and could lead to a higher proportion of healed wounds, faster healing rates, and potentially fewer re-amputations than standard care.

  17. A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds.

    Science.gov (United States)

    Eginton, Mark T; Brown, Kellie R; Seabrook, Gary R; Towne, Jonathan B; Cambria, Robert A

    2003-11-01

    Optimal treatment for large diabetic foot wounds is ill defined. The purpose of this study was to compare the rate of wound healing with the Vacuum Assisted Closure device trade mark (VAC) to conventional moist dressings in the treatment of large diabetic foot wounds. Diabetics with significant soft tissue defects of the foot were considered for enrollment. Patients were randomized to receive either moist gauze dressings or VAC treatments for 2 weeks, after which they were treated with the alternative dressing for an additional 2 weeks. Wounds were photographed weekly and wound dimensions calculated in a blinded fashion with spatial analysis software. Percent change in wound dimensions were calculated and compared for each weekly assessment and over 2 weeks of therapy with each dressing type. Ten patients were enrolled in the trial, but two were lost to follow-up and two were withdrawn. Complete data were available for analysis on seven wounds in six patients. Average length, width, and depth of the wounds at initiation of the trial was 7.7, 3.5, and 3.1 cm, respectively. Only the wound depth was significantly decreased over the weeks of the trial to 1.2 cm ( p VAC dressings decreased the wound volume and depth significantly more than moist gauze dressings (59% vs. 0% and 49% vs. 8%, respectively). VAC dressings were associated with a decrease in all wound dimensions while wound length and width increased with moist dressings. In summary, over the first several weeks of therapy, VAC dressings decreased wound depth and volume more effectively than moist gauze dressings. Negative-pressure wound treatment may accelerate closure of large foot wounds in the diabetic patient.

  18. Cost-Utility Analysis: Sartorius Flap versus Negative Pressure Therapy for Infected Vascular Groin Graft Managment.

    Science.gov (United States)

    Chatterjee, Abhishek; Macarios, David; Griffin, Leah; Kosowski, Tomasz; Pyfer, Bryan J; Offodile, Anaeze C; Driscoll, Daniel; Maddali, Sirish; Attwood, John

    2015-11-01

    Sartorius flap coverage and adjunctive negative pressure wound therapy (NPWT) have been described in managing infected vascular groin grafts with varying cost and clinical success. We performed a cost-utility analysis comparing sartorius flap with NPWT in managing an infected vascular groin graft. A literature review compiling outcomes for sartorius flap and NPWT interventions was conducted from peer-reviewed journals in MEDLINE (PubMed) and EMBASE. Utility scores were derived from expert opinion and used to estimate quality-adjusted life years (QALYs). Medicare current procedure terminology and diagnosis-related groups codes were used to assess the costs for successful graft salvage with the associated complications. Incremental cost-effectiveness was assessed at $50,000/QALY, and both univariate and probabilistic sensitivity analyses were conducted to assess robustness of the conclusions. Thirty-two studies were used pooling 384 patients (234 sartorius flaps and 150 NPWT). NPWT had better clinical outcomes (86.7% success rate, 0.9% minor complication rate, and 13.3% major complication rate) than sartorius flap (81.6% success rate, 8.0% minor complication rate, and 18.4% major complication rate). NPWT was less costly ($12,366 versus $23,516) and slightly more effective (12.06 QALY versus 12.05 QALY) compared with sartorius flap. Sensitivity analyses confirmed the robustness of the base case findings; NPWT was either cost-effective at $50,000/QALY or dominated sartorius flap in 81.6% of all probabilistic sensitivity analyses. In our cost-utility analysis, use of adjunctive NPWT, along with debridement and antibiotic treatment, for managing infected vascular groin graft wounds was found to be a more cost-effective option when compared with sartorius flaps.

  19. Cost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy.

    Science.gov (United States)

    Heard, Christopher; Chaboyer, Wendy; Anderson, Vinah; Gillespie, Brigid M; Whitty, Jennifer A

    2017-02-01

    Negative pressure wound therapy (NPWT) is increasingly used prophylactically following surgery despite limited evidence of clinical or cost-effectiveness. To evaluate whether NPWT is cost-effective compared to standard care, for the prevention of surgical site infection (SSI) in obese women undergoing elective caesarean section, and inform development of a larger trial. An economic evaluation was conducted alongside a pilot randomised controlled trial at one Australian hospital, in which women were randomised to NPWT (n = 44) or standard care (n = 43). A public health care provider perspective and time horizon to four weeks post-discharge was adopted. Cost-effectiveness assessment was based on incremental cost per SSI prevented and per quality-adjusted life year (QALY) gained. Patients receiving NPWT each received health care costing AU$5887 (±1038) and reported 0.069 (±0.010) QALYs compared to AU$5754 (±1484) and 0.066 (±0.010) QALYs for patients receiving standard care. NPWT may be slightly more costly and more effective than standard care, with estimated incremental cost-effectiveness ratios (ICERs) of AU$1347 (95%CI dominant- $41,873) per SSI prevented and AU$42,340 (95%CI dominant- $884,019) per QALY gained. However, there was considerable uncertainty around these estimates. NPWT may be cost-effective in the prophylactic treatment of surgical wounds following elective caesarean section in obese women. Larger trials could clarify the cost-effectiveness of NPWT as a prophylactic treatment for SSI. Sensitive capture of QALYs and cost offsets will be important given the high level of uncertainty around the point estimate cost-effectiveness ratio which was close to conventional thresholds. ACTRN12612000171819. Copyright © 2016 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  20. Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures.

    Science.gov (United States)

    Park, Chul Hyun; Shon, Oog Jin; Kim, Gi Beom

    2016-09-01

    Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study. The clinical results were assessed using a Puno scoring system for severe open fractures of the tibia at the last followup. The range of motion (ROM) of the knee and ankle joints and postoperative complication were evaluated at the last followup. The radiographic results were assessed using time to bone union, coronal and sagittal angulations and a shortening at the last followup. The mean score of Puno scoring system was 87.4 (range 67-94). The mean ROM of the knee and ankle joints was 121.3° (range 90°-130°) and 37.7° (range 15°-50°), respectively. Bone union developed in all patients and the mean time to union was 25.3 weeks (range 16-42 weeks). The mean coronal angulation was 2.1° (range 0-4°) and sagittal was 2.7° (range 1-4°). The mean shortening was 4.1 mm (range 0-8 mm). Three patients had partial flap necrosis and 1 patient had total flap necrosis. There was no superficial and deep wound infection. Staged treatment using NPWT decreased the risks of infection and requirement of flap surgeries in Gustilo Anderson grade IIIb open tibial fractures. Therefore, staged treatment using NPWT could be a useful treatment option for Gustilo Anderson grade IIIb open tibial fractures.

  1. Expression of HIF-1{alpha} in irradiated tissue is altered by topical negative-pressure therapy

    Energy Technology Data Exchange (ETDEWEB)

    Grimm, A.; Stange, S.; Labanaris, A.; Horch, R.E. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Plastic and Hand Surgery; Dimmler, A. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Pathology; Sauer, R.; Grabenbauer, G. [Erlangen-Nuernberg Univ. (Germany). Dept. of Radiation Oncology

    2007-03-15

    Background and Purpose: Despite the enormous therapeutic potential of modern radiotherapy, common side effects such as radiation-induced wound healing disorders remain a well-known clinical phenomenon. Topical negative pressure therapy (TNP) is a novel tool to alleviate intraoperative, percutaneous irradiation or brachytherapy. Since TNP has been shown to positively influence the perfusion of chronic, poorly vascularized wounds, the authors applied this therapeutic method to irradiated wounds and investigated the effect on tissue oxygenation in irradiated tissue in five patients. Material and Methods: With informed patients' consent, samples prior to and 4 and 8 days after continuous TNP with -125 mmHg were obtained during routine wound debridements. Granulation tissue was stained with hematoxylin-eosin, and additionally with CD31, HIF-1{alpha} (hypoxia-inducible factor-1{alpha}), and D2-40 to detect blood vessels, measure indirect signs of hypoxia, and lymph vessel distribution within the pre- and post-TNP samples. Results: In this first series of experiments, a positive influence of TNP onto tissue oxygenation in radiation-induced wounds could be demonstrated. TNP led to a significant decrease of 53% HIF-1{alpha}-positive cell nuclei. At the same time, a slight reduction of CD31-stained capillaries was seen in comparison to samples before TNP. Immunostaining with D2-40 revealed an increased number of lymphatic vessels with distended lumina and an alteration of the parallel orientation within the post-TNP samples. Conclusion: This study is, to the authors' knowledge, the first report on a novel previously not described histological marker to demonstrate the effects of TNP on HIF-1{alpha} expression as an indirect marker of tissue oxygenation in irradiated wounds, as demonstrated by a reduction of HIF-1{alpha} concentration after TNP. Since this observation may be of significant value to develop possible new strategies to treat radiation-induced tissue

  2. Expression of HIF-1α in irradiated tissue is altered by topical negative-pressure therapy

    International Nuclear Information System (INIS)

    Grimm, A.; Stange, S.; Labanaris, A.; Horch, R.E.; Dimmler, A.; Sauer, R.; Grabenbauer, G.

    2007-01-01

    Background and Purpose: Despite the enormous therapeutic potential of modern radiotherapy, common side effects such as radiation-induced wound healing disorders remain a well-known clinical phenomenon. Topical negative pressure therapy (TNP) is a novel tool to alleviate intraoperative, percutaneous irradiation or brachytherapy. Since TNP has been shown to positively influence the perfusion of chronic, poorly vascularized wounds, the authors applied this therapeutic method to irradiated wounds and investigated the effect on tissue oxygenation in irradiated tissue in five patients. Material and Methods: With informed patients' consent, samples prior to and 4 and 8 days after continuous TNP with -125 mmHg were obtained during routine wound debridements. Granulation tissue was stained with hematoxylin-eosin, and additionally with CD31, HIF-1α (hypoxia-inducible factor-1α), and D2-40 to detect blood vessels, measure indirect signs of hypoxia, and lymph vessel distribution within the pre- and post-TNP samples. Results: In this first series of experiments, a positive influence of TNP onto tissue oxygenation in radiation-induced wounds could be demonstrated. TNP led to a significant decrease of 53% HIF-1α-positive cell nuclei. At the same time, a slight reduction of CD31-stained capillaries was seen in comparison to samples before TNP. Immunostaining with D2-40 revealed an increased number of lymphatic vessels with distended lumina and an alteration of the parallel orientation within the post-TNP samples. Conclusion: This study is, to the authors' knowledge, the first report on a novel previously not described histological marker to demonstrate the effects of TNP on HIF-1α expression as an indirect marker of tissue oxygenation in irradiated wounds, as demonstrated by a reduction of HIF-1α concentration after TNP. Since this observation may be of significant value to develop possible new strategies to treat radiation-induced tissue injury, further investigations of HIF

  3. Suture Technique to Prevent Air Leakage during Negative-Pressure Wound Therapy in Fournier Gangrene.

    Science.gov (United States)

    Chang, Feng-Shu; Chou, Chieh; Hu, Chuan-Yu; Huang, Shu-Hung

    2018-01-01

    The use of negative-pressure wound therapy (NPWT) for Fournier gangrene management is well documented; however, it is difficult to fixate GranuFoam dressings and maintain an airtight seal over the perineum area. We developed a simple method to facilitate GranuFoam fixation and improve airtight sealing. The Fournier's gangrene severity index (FGSI) score less than 9 was collected in from January 2015 to October 2016. All 13 patients underwent fasciotomy, and NPWT was applied directly on fasciotomy wounds after the debridement of infected tissue. Partial wound closure was performed, and a portion of GranuFoam was inserted to facilitate fixation. The seal check was converted to a 0-10 scale score that was recorded every 4 hours during NPWT. Patient profiles including medical history, FGSI, method of wound closure, and length of stay were collected in this study. The median age of the patients was 62 (38-76) years. The mean FGSI score was 4.3 ± 3.1. The average duration of NPWT was 17.5 ± 11.5 days, and the average seal check score was 0.8 ± 0.5. No seal check alarms were noted during the study. Successful wound closure was achieved in all patients without using additional reconstruction methods such as skin grafting or muscle flap coverage. The present results suggest that partial wound-edge closure and in situ GranuFoam fixation improve the NPWT leaks in Fournier gangrene wounds. Furthermore, this method is simple to learn and can be useful in applying NPWT to anatomically difficult areas.

  4. Water quality effects of intermittent water supply in Arraiján, Panama.

    Science.gov (United States)

    Erickson, John J; Smith, Charlotte D; Goodridge, Amador; Nelson, Kara L

    2017-05-01

    Intermittent drinking water supply is common in low- and middle-income countries throughout the world and can cause water quality to degrade in the distribution system. In this study, we characterized water quality in one study zone with continuous supply and three zones with intermittent supply in the drinking water distribution network in Arraiján, Panama. Low or zero pressures occurred in all zones, and negative pressures occurred in the continuous zone and two of the intermittent zones. Despite hydraulic conditions that created risks for backflow and contaminant intrusion, only four of 423 (0.9%) grab samples collected at random times were positive for total coliform bacteria and only one was positive for E. coli. Only nine of 496 (1.8%) samples had turbidity >1.0 NTU and all samples had ≥0.2 mg/L free chlorine residual. In contrast, water quality was often degraded during the first-flush period (when supply first returned after an outage). Still, routine and first-flush water quality under intermittent supply was much better in Arraiján than that reported in a previous study conducted in India. Better water quality in Arraiján could be due to better water quality leaving the treatment plant, shorter supply outages, higher supply pressures, a more consistent and higher chlorine residual, and fewer contaminant sources near pipes. The results illustrate that intermittent supply and its effects on water quality can vary greatly between and within distribution networks. The study also demonstrated that monitoring techniques designed specifically for intermittent supply, such as continuous pressure monitoring and sampling the first flush, can detect water quality threats and degradation that would not likely be detected with conventional monitoring. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Evaluation of a Decision-Making Curriculum for Teaching Adolescents with Disabilities to Resist Negative Peer Pressure

    Science.gov (United States)

    Khemka, Ishita; Hickson, Linda; Mallory, Sarah B.

    2016-01-01

    This study was designed to assess the impact of a decision-making curriculum (PEER-DM) on the social peer relationship knowledge and self-protective decision-making skills of adolescents with disabilities in hypothetical situations involving negative peer pressure. A randomized design was used to assign students with disabilities from…

  6. Major bleeding during negative pressure wound/VAC (R) - therapy for postsurgical deep sternal wound infection - a critical appraisal

    NARCIS (Netherlands)

    van Wingerden, J.J.; Segers, P.; Jekel, L.

    2011-01-01

    Negative-pressure wound therapy, commercially known as vacuum-assisted closure (V.A.C.(R)) therapy, has become one of the most popular (and efficacious) interim (prior to flap reconstruction) or definite methods of managing deep sternal wound infection. Complications such as profuse bleeding, which

  7. A comparative study of the efficacy of topical negative pressure moist dressings and conventional moist dressings in chronic wounds

    Directory of Open Access Journals (Sweden)

    Tauro Leo

    2007-01-01

    Full Text Available Aim: To assess the efficacy of topical negative pressure moist wound dressing as compared to conventional moist wound dressings in improving the healing process in chronic wounds and to prove that negative pressure dressings can be used as a much better treatment option in the management of chronic wounds. Materials and Methods: This is a prospective comparative study of data from 112 patients with chronic wounds, of which 56 patients underwent topical negative pressure dressings (17 diabetic, 10 pressure sores, nine ischemic, two varicose, 10 post-infective raw areas and eight traumatic - six had bone exposed, two orthopaedic prosthesis exposed. The remaining 56 patients underwent conventional moist dressings (20 diabetic, two ischemic, 15 pressure sores, three varicose, eight post-infective raw areas and eight traumatic - five had bone exposed, three orthopaedic prosthesis exposed. The results were compared after 10 days. The variables compared were, rate of granulation tissue formation as a percentage of ulcer area covered, skin graft take up as the percentage of ulcer surface area and duration of hospital stay. The variables were compared using Unpaired Student′s t test. A " P" value < 0.05 was considered significant. Results: Out of 56 patients who underwent topical negative pressure dressings, six (10.71% were failures, due to failure in maintaining topical negative pressure due to defective sealing technique; these were included into the study group. After 10 days, the mean rate of granulation tissue formation was 71.43% of ulcer surface area. All these 56 cases underwent split-thickness skin grafting. The mean graft take-up was 79.29%. The mean hospital stay was 32.64 days. In the remaining 56 patients, the mean rate of granulation tissue formation was 52.85% of ulcer surface area. The mean graft take-up was only 60.45% of the total ulcer surface area. The mean hospital stay was 60.45 days. Conclusion: To conclude, topical negative

  8. Cervical spine disease may result in a negative lumbar spinal drainage trial in normal pressure hydrocephalus: case report.

    Science.gov (United States)

    Komotar, Ricardo J; Zacharia, Brad E; Mocco, J; Kaiser, Michael G; Frucht, Stephen J; McKhann, Guy M

    2008-10-01

    In this case report, we present a patient with normal pressure hydrocephalus in whom a lumbar drainage trial yielded a false-negative result secondary to cervical spondylosis. An 80-year-old woman presented with classic symptoms of normal pressure hydrocephalus as well as evidence of cervical myelopathy. Magnetic resonance imaging of the brain and spine showed enlarged ventricles and single-level cervical canal narrowing. An initial lumbar drainage trial was performed, which revealed negative results. The patient then underwent cervical decompression and fusion. Despite this procedure, the patient's symptoms continued to worsen. A repeat lumbar drainage trial was performed with positive results. Subsequently, a ventriculoperitoneal shunt was placed, resulting in significant improvement of her symptoms. This case report illustrates how altered cerebrospinal fluid flow dynamics may impact the accuracy of the lumbar spinal drainage trial in patients with normal pressure hydrocephalus.

  9. The partitioning of nanoparticles to endothelium or interstitium during ultrasound-microbubble-targeted delivery depends on peak-negative pressure

    International Nuclear Information System (INIS)

    Hsiang, Y.-H.; Song, J.; Price, R. J.

    2015-01-01

    Patients diagnosed with advanced peripheral arterial disease often face poor prognoses and have limited treatment options. For some patient populations, the therapeutic growth of collateral arteries (i.e. arteriogenesis) that bypass regions affected by vascular disease may become a viable treatment option. Our group and others are developing therapeutic approaches centered on the ability of ultrasound-activated microbubbles to permeabilize skeletal muscle capillaries and facilitate the targeted delivery of pro-arteriogenic growth factor-bearing nanoparticles. The development of such approaches would benefit significantly from a better understanding of how nanoparticle diameter and ultrasound peak-negative pressure affect both total nanoparticle delivery and the partitioning of nanoparticles to endothelial or interstitial compartments. Toward this goal, using Balb/C mice that had undergone unilateral femoral artery ligation, we intra-arterially co-injected nanoparticles (50 and 100 nm) with microbubbles, applied 1 MHz ultrasound to the gracilis adductor muscle at peak-negative pressures of 0.7, 0.55, 0.4, and 0.2 MPa, and analyzed nanoparticle delivery and distribution. As expected, total nanoparticle (50 and 100 nm) delivery increased with increasing peak-negative pressure, with 50 nm nanoparticles exhibiting greater tissue coverage than 100 nm nanoparticles. Of particular interest, increasing peak-negative pressure resulted in increased delivery to the interstitium for both nanoparticle sizes, but had little influence on nanoparticle delivery to the endothelium. Thus, we conclude that alterations to peak-negative pressure may be used to adjust the fraction of nanoparticles delivered to the interstitial compartment. This information will be useful when designing ultrasound protocols for delivering pro-arteriogenic nanoparticles to skeletal muscle

  10. The partitioning of nanoparticles to endothelium or interstitium during ultrasound-microbubble-targeted delivery depends on peak-negative pressure

    Energy Technology Data Exchange (ETDEWEB)

    Hsiang, Y.-H.; Song, J.; Price, R. J., E-mail: rprice@virginia.edu [University of Virginia, Department of Biomedical Engineering (United States)

    2015-08-15

    Patients diagnosed with advanced peripheral arterial disease often face poor prognoses and have limited treatment options. For some patient populations, the therapeutic growth of collateral arteries (i.e. arteriogenesis) that bypass regions affected by vascular disease may become a viable treatment option. Our group and others are developing therapeutic approaches centered on the ability of ultrasound-activated microbubbles to permeabilize skeletal muscle capillaries and facilitate the targeted delivery of pro-arteriogenic growth factor-bearing nanoparticles. The development of such approaches would benefit significantly from a better understanding of how nanoparticle diameter and ultrasound peak-negative pressure affect both total nanoparticle delivery and the partitioning of nanoparticles to endothelial or interstitial compartments. Toward this goal, using Balb/C mice that had undergone unilateral femoral artery ligation, we intra-arterially co-injected nanoparticles (50 and 100 nm) with microbubbles, applied 1 MHz ultrasound to the gracilis adductor muscle at peak-negative pressures of 0.7, 0.55, 0.4, and 0.2 MPa, and analyzed nanoparticle delivery and distribution. As expected, total nanoparticle (50 and 100 nm) delivery increased with increasing peak-negative pressure, with 50 nm nanoparticles exhibiting greater tissue coverage than 100 nm nanoparticles. Of particular interest, increasing peak-negative pressure resulted in increased delivery to the interstitium for both nanoparticle sizes, but had little influence on nanoparticle delivery to the endothelium. Thus, we conclude that alterations to peak-negative pressure may be used to adjust the fraction of nanoparticles delivered to the interstitial compartment. This information will be useful when designing ultrasound protocols for delivering pro-arteriogenic nanoparticles to skeletal muscle.

  11. Negative pressure wound therapy in complex cranio-maxillofacial and cervical wounds.

    Science.gov (United States)

    Novelli, Giorgio; Daleffe, Francesco; Birra, Gisella; Canzi, Gabriele; Mazzoleni, Fabio; Boni, Pietro; Maino, Clara; Giussani, Carlo; Sozzi, Davide; Bozzetti, Alberto

    2018-02-01

    The care and the management of the healing of difficult wounds at the level of the skull-facial face many problems related to patient compliance and the need to perform multiple dressings, with long periods of healing and, occasionally, a very long hospitalisation period. The introduction and evolution of negative pressure wound therapy (NPWT) in the treatment of difficult wounds has resulted in better healing, with a drastic reduction in terms of time and biological costs to the patient and cost to the health care system. The main aim of this study is to describe and discuss, using out our experience, the usefulness of NPWT in the cranial-facial-cervical region. We studied 16 patients with complex wounds of the cranial-facial-cervical region treated with NPWT. We divided clinical cases in four groups: cervicofacial infectious disease, healing complications in oncological-reconstructive surgery, healing complications of injury with exposure of bone and/or internal fixations and healing complications in traumatic injury with loss of substance. We evaluated complete or incomplete wound healing; application time, related also to hospitalisation time; days of intensive care unit (ICU) stay; management of the upper airways; timing of medication renewal; and patient comfort and compliance (on a scale of 1-5). Depression values were always between -75 and -125 mmHg in a continuous aspiration pattern. For every patient, we used the ActiVAC Therapy Unit, derived from the vacuum-assisted closure system (Kinetic Concepts Inc., San Antonio, TX). Medication renewals were performed every 48-72 hours. The NPWT application time ranged from 4 to 22 days (mean of 11·57 day). Therapy was effective to gain a complete restitutio ad integrum in every patient included in the group of cervicofacial infectious disease. Therapy has, however, been well tolerated in our series; this is probably due to the decreased number of applications, the ease of use and the comfort of the system

  12. Cost analysis of Topical Negative Pressure (TNP Therapy for traumatic acquired wounds

    Directory of Open Access Journals (Sweden)

    Freytag, Sebastian

    2010-01-01

    Full Text Available Extended traumatic wounds require extended reconstructive operations and are accompanied by long hospitalizations and risks of infection, thrombosis and flap loss. In particular, the frequently used Topical Negative Pressure (TNP Therapy is regarded as cost-intensive. The costs of TNP in the context of traumatic wounds is analyzed using the method of health economic evaluation.All patients (n=67: 45 male, 22 female; average age 54 y with traumatically acquired wounds being treated with TNP at the university hospital of Goettingen in the period 01/01/2005–31/12/2007 comprise the basis for this analysis. The concept of activity-based costing based on clinical pathways according to InEK (National Institute for the Hospital Remuneration System systematic calculations was chosen for cost accounting. In addition, a special module system adaptable for individual courses of disease was developed. The treated wounds were located on a lower extremity in 83.7% of cases (n=56 and on an upper extremity in 16.3% of cases (n=11. The average time of hospitalization of the patients was 54 days. Twenty-five patients (37.31% exceeded the „maximum length of stay“ of their associated DRG (Diagnosis Related Groups. The total PCCL (patient clinical complexity level = patient severity score of 2.99 reflects the seriousness of disease. For the treatment of the 67 patients, total costs were $1,729,922.32 (1,249,176.91 €. The cost calculation showed a financial deficit of $–210,932.50 (–152,314.36 €. Within the entire treatment costs of $218,848.07 (158,030.19 €, 12.65% per case were created by TNP with material costs of $102,528.74 (74,036 €, representing 5.92% of entire costs. The cost of TNP per patient averaged $3,266.39 (2,358.66 €. The main portion of the costs was not – as is often expected – due to high material costs of TNP but instead to long-term treatments. Because of their complexity, the cases are insufficiently represented in the

  13. Insomnia complaints in lean patients with obstructive sleep apnea negatively affect positive airway pressure treatment adherence.

    Science.gov (United States)

    Eysteinsdottir, Bjorg; Gislason, Thorarinn; Pack, Allan I; Benediktsdottir, Bryndís; Arnardottir, Erna S; Kuna, Samuel T; Björnsdottir, Erla

    2017-04-01

    The objective of this study was to evaluate the determinants of long-term adherence to positive airway pressure treatment among patients with obstructive sleep apnea, with special emphasis on patients who stop positive airway pressure treatment within 1 year. This is a prospective long-term follow-up of subjects in the Icelandic Sleep Apnea Cohort who were diagnosed with obstructive sleep apnea between 2005 and 2009, and started on positive airway pressure treatment. In October 2014, positive airway pressure adherence was obtained by systematically evaluating available clinical files (n = 796; 644 males, 152 females) with moderate to severe obstructive sleep apnea (apnea-hypopnea index ≥15 events per h). The mean follow-up time was 6.7 ± 1.2 years. In total, 123 subjects (15.5%) returned their positive airway pressure device within the first year, 170 (21.4%) returned it later and 503 (63.2%) were still using positive airway pressure. The quitters within the first year had lower body mass index, milder obstructive sleep apnea, less sleepiness, and more often had symptoms of initial and late insomnia compared with long-term positive airway pressure users at baseline. Both initial and late insomnia were after adjustment still significantly associated with being an early quitter among subjects with body mass index insomnia are associated with early quitting on positive airway pressure among non-obese subjects. © 2016 European Sleep Research Society.

  14. Changes in subcutaneous blood flow during locally applied negative pressure to the skin

    DEFF Research Database (Denmark)

    Skagen, K; Henriksen, O

    1983-01-01

    The effect of locally applied subatmospheric pressure on subcutaneous blood flow was studied in 12 healthy subjects. Blood flow was measured on the forearm by the local 133Xe wash-out technique. Air suction between 10 mmHg and 250 mmHg was applied to the skin. Subatmospheric pressure of 20 mm...

  15. [Efficacy observation on application of negative pressure therapy in the treatment of superficial partial-thickness scald wound in children].

    Science.gov (United States)

    Shen, Chuan-an; Chai, Jia-ke; Tuo, Xiao-ye; Cai, Jian-hua; Li, Dong-jie; Zhang, Lin; Zhu, Hua; Cai, Jin-dong

    2013-02-01

    To observe the effect of negative pressure therapy in the treatment of superficial partial-thickness scald in children. Three hundred and seven children with superficial partial-thickness scald hospitalized from August 2009 to May 2012 were divided into negative pressure therapy group (NPT, n = 145) and control group (C, n = 162) according to the random number table. Patients in group NPT were treated with negative pressure from within post injury day (PID) 3 to PID 9 (with -16 kPa pressure), while traditional occlusive dressing method was used in group C. Changes in body temperature, wound healing condition, frequency of dressing change were compared between group NPT and group C. Bacterial culture results of wounds were compared before and after treatment in group NPT. Volume of drained transudate per one percent of wound area was recorded in group NPT on PID 1 to PID 3. Data were processed with t test or chi-square test. The incidence of high fever was significantly lower in group NPT (26.9%, 39/145) than in group C (63.6%, 103/162, χ(2) = 41.419, P partial-thickness scald.

  16. Negative-pressure in treatment of persistent post-traumatic subcutaneous emphysema with respiratory failure: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Jakov Mihanović

    2018-02-01

    Full Text Available Subcutaneous emphysema may aggravate traumatic pneumothorax treatment, especially when mechanical ventilation is required. Expectative management usually suffices, but when respiratory function is impaired surgical treatment might be indicated. Historically relevant methods are blowhole incisions and placement of various drains, often with related wound complications. Since the first report of negative pressure wound therapy for the treatment of severe subcutaneous emphysema in 2009, only few publications on use of commercially available sets were published. We report on patient injured in a motor vehicle accident who had serial rib fractures and bilateral pneumothorax managed initially in another hospital. Due to respiratory deterioration, haemodynamic instability and renal failure patient was transferred to our Intensive Care Unit. Massive and persistent subcutaneous emphysema despite adequate thoracic drainage with respiratory deterioration and potentially injurious mechanical ventilation with high airway pressures was the indication for active surgical treatment. Negative-pressure wound therapy dressing was applied on typical blowhole incisions which resulted in swift emphysema regression and respiratory improvement. Negative pressure wound therapy for decompression of severe subcutaneous emphysema represents simple, effective and relatively unknown technique that deserves wider attention.

  17. Use of dynamic CT in acute respiratory distress syndrome (ARDS) with comparison of positive and negative pressure ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Helm, Emma; Babyn, Paul [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Talakoub, Omid; Alirezaie, Javad [Ryerson University, Department of Electrical and Computer Engineering, Toronto, ON (Canada); Grasso, Francesco; Engelberts, Doreen; Kavanagh, Brian P. [Hospital for Sick Children and the University of Toronto, Departments of Anesthesia and Critical Care Medicine and the Program in Pulmonary and Experimental Medicine, Toronto (Canada)

    2009-01-15

    Negative pressure ventilation via an external device ('iron lung') has the potential to provide better oxygenation with reduced barotrauma in patients with ARDS. This study was designed to see if oxygenation differences between positive and negative ventilation could be explained by CT. Six anaesthetized rabbits had ARDS induced by repeated saline lavage. Rabbits were ventilated with positive pressure ventilation (PPV) and negative pressure ventilation (NPV) in turn. Dynamic CT images were acquired over the respiratory cycle. A computer-aided method was used to segment the lung and calculate the range of CT densities within each slice. Volumes of ventilated lung and atelectatic lung were measured over the respiratory cycle. NPV was associated with an increased percentage of ventilated lung and decreased percentage of atelectatic lung. The most significant differences in ventilation and atelectasis were seen at mid-inspiration and mid-expiration (ventilated lung NPV=61%, ventilated lung PPV=47%, p<0.001; atelectatic lung NPV=10%, atelectatic lung PPV 19%, p<0.001). Aeration differences were not significant at end-inspiration. Dynamic CT can show differences in lung aeration between positive and negative ventilation in ARDS. These differences would not be appreciated if only static breath-hold CT was used. (orig.)

  18. Intermittent search strategies

    Science.gov (United States)

    Bénichou, O.; Loverdo, C.; Moreau, M.; Voituriez, R.

    2011-01-01

    This review examines intermittent target search strategies, which combine phases of slow motion, allowing the searcher to detect the target, and phases of fast motion during which targets cannot be detected. It is first shown that intermittent search strategies are actually widely observed at various scales. At the macroscopic scale, this is, for example, the case of animals looking for food; at the microscopic scale, intermittent transport patterns are involved in a reaction pathway of DNA-binding proteins as well as in intracellular transport. Second, generic stochastic models are introduced, which show that intermittent strategies are efficient strategies that enable the minimization of search time. This suggests that the intrinsic efficiency of intermittent search strategies could justify their frequent observation in nature. Last, beyond these modeling aspects, it is proposed that intermittent strategies could also be used in a broader context to design and accelerate search processes.

  19. Effects of topical negative pressure therapy on tissue oxygenation and wound healing in vascular foot wounds.

    Science.gov (United States)

    Chiang, Nathaniel; Rodda, Odette A; Sleigh, Jamie; Vasudevan, Thodur

    2017-08-01

    Topical negative pressure (TNP) therapy is widely used in the treatment of acute wounds in vascular patients on the basis of proposed multifactorial benefits. However, numerous recent systematic reviews have concluded that there is inadequate evidence to support its benefits at a scientific level. This study evaluated the changes in wound volume, surface area, depth, collagen deposition, and tissue oxygenation when using TNP therapy compared with traditional dressings in patients with acute high-risk foot wounds. This study was performed with hospitalized vascular patients. Forty-eight patients were selected with an acute lower extremity wound after surgical débridement or minor amputation that had an adequate blood supply without requiring further surgical revascularization and were deemed suitable for TNP therapy. The 22 patients who completed the study were randomly allocated to a treatment group receiving TNP or to a control group receiving regular topical dressings. Wound volume and wound oxygenation were analyzed using a modern stereophotographic wound measurement system and a hyperspectral transcutaneous oxygenation measurement system, respectively. Laboratory analysis was conducted on wound biopsy samples to determine hydroxyproline levels, a surrogate marker to collagen. Differences in clinical or demographic characteristics or in the location of the foot wounds were not significant between the two groups. All patients, with the exception of two, had diabetes. The two patients who did not have diabetes had end-stage renal failure. There was no significance in the primary outcome of wound volume reduction between TNP and control patients on day 14 (44.2% and 20.9%, respectively; P = .15). Analyses of secondary outcomes showed a significant result of better healing rates in the TNP group by demonstrating a reduction in maximum wound depth at day 14 (36.0% TNP vs 17.6% control; P = .03). No significant findings were found for the other outcomes of changes

  20. The efficacy of negative pressure wound therapy in treating sacroiliac joint tuberculosis with a chronic sinus tract: a case series.

    Science.gov (United States)

    Luo, Xiaobo; Tang, Xiangyu; Ma, Yuanzheng; Zhang, Yonggang; Fang, Shuzhi

    2015-08-06

    Tuberculous sacroiliitis with abscess accounts for approximately 50 % of all sacroiliac joint tuberculosis cases. Tuberculous abscesses spread into the sacroiliac joint capsule, subcutaneous tissue, and the skin, and finally becomes a skin sinus. As there are no previous reports about sacroiliac joint tuberculosis with a chronic sinus, we evaluated its clinical characteristics and management by negative pressure wound therapy. A retrospective analysis of 12 patients with sacroiliac joint tuberculosis with chronic sinuses treated between January 2005 and January 2010 was conducted. Patients were treated with negative pressure wound therapy (NPWT). Treatment was divided into three phases: control phase, standard dressing changes daily for 4 weeks; interphase washout period, dressing changes every 3 days for 1 week; and intervention phase, no dressing changes until minimal sinus tract drainage (sacroiliac joint tuberculosis with a chronic sinus can be difficult. NPWT provides better healing of sacroiliac joint tuberculosis with a chronic sinus than standard dressing changes.

  1. Papineau debridement, Ilizarov bone transport, and negative-pressure wound closure for septic bone defects of the tibia.

    Science.gov (United States)

    Karargyris, Orestis; Polyzois, Vasilios D; Karabinas, Panayiotis; Mavrogenis, Andreas F; Pneumaticos, Spyros G

    2014-08-01

    Ilizarov pioneered bone transport using a circular external fixator. Papineau described a staged technique for the treatment for infected pseudarthrosis of the long bones. This article presents a single-stage Papineau technique and Ilizarov bone transport, and postoperative negative-pressure wound dressing changes for septic bone defects of the tibia. We studied the files of seven patients (mean age, 32 years) with septic bone defects of the tibia treated with a Papineau technique and Ilizarov bone transport in a single stage, followed by postoperative negative-pressure wound dressing changes. All patients had septic pseudarthrosis and skin necrosis of the tibia. The technique included a single-stage extensive surgical debridement of necrotic bone, open bone grafting with cancellous bone autograft and bone transport, and postoperative negative-pressure wound dressing changes for wound closure. The mean time from the initial injury was 6 months (range, 4-8 months). The mean follow-up was 14 months (range, 10-17 months). All patients experienced successful wound healing at a mean of 29 days. Six patients experienced successful bone regeneration and union at the docking side at a mean of 6 months. One patient experienced delayed union at the docking site, which was treated with autologous cancellous bone grafting. Two patients experienced pin track infection, which was successfully treated with antibiotics and pin site dressing changes. All patients were able to return to their work and previous levels of activity, except one patient who had a stiff ankle joint and had to change his job. No patient experienced recurrence of infection, or fracture of the regenerated or transported bone segment until the period of this study. The combined Papineau and Ilizarov bone transport technique with negative-pressure wound closure provides for successful eradication of the infection, reconstruction of the bone defect, and soft-tissue closure. A single-stage surgical treatment is

  2. Comparison of Outcomes for Normal Saline and an Antiseptic Solution for Negative-Pressure Wound Therapy with Instillation.

    Science.gov (United States)

    Kim, Paul J; Attinger, Christopher E; Oliver, Noah; Garwood, Caitlin; Evans, Karen K; Steinberg, John S; Lavery, Larry A

    2015-11-01

    Negative-pressure wound therapy with instillation is an adjunctive treatment that uses periodic instillation of a solution and negative pressure for a wide diversity of wounds. A variety of solutions have been reported, with topical antiseptics as the most frequently chosen option. The objective of this study was to compare the outcomes of normal saline versus an antiseptic solution for negative-pressure wound therapy with instillation for the adjunctive treatment of infected wounds. This was a prospective, randomized, effectiveness study comparing 0.9% normal saline versus 0.1% polyhexanide plus 0.1% betaine for the adjunctive treatment of infected wounds that required hospital admission and operative débridement. One hundred twenty-three patients were eligible, with 100 patients randomized for the intention-to-treat analysis and 83 patients for the per-protocol analysis. The surrogate outcomes measured were number of operative visits, length of hospital stay, time to final surgical procedure, proportion of closed or covered wounds, and proportion of wounds that remained closed or covered at the 30-day follow-up. There were no statistically significant differences in the demographic profiles in the two cohorts except for a larger proportion of male patients (p = 0.004). There was no statistically significant difference in the surrogate outcomes with the exception of the time to final surgical procedure favoring normal saline (p = 0.038). The authors' results suggest that 0.9% normal saline may be as effective as an antiseptic (0.1% polyhexanide plus 0.1% betaine) for negative-pressure wound therapy with instillation for the adjunctive inpatient management of infected wounds. Therapeutic, II.

  3. [The influence of oxygen partial pressure change and vascularization of rabbit wound through negative pressure wound therapy].

    Science.gov (United States)

    Yang, Fan; Hu, Duan; Bai, Xiang-jun; Zhang, Kun; Li, Ren-jie; Xue, Chen-chen

    2012-07-01

    To investigate the effect of vacuum sealing drainage (VSD) on variation of oxygen partial pressure (PtO2) and vascularization. The 12 cases of rabbit's wound models were undergoing the VSD (vacuum group, n = 6) or conventional therapy (conventional group, n = 6). Variation of PtO2 was measured by oxygen partial pressure admeasuring apparatus, expression of hypoxia inducible factor 1α (HIF-1α) mRNA was measured by real-time fluorescent quantitative PCR, content of vascular endothelial growth factor (VEGF) was measured by ELISA after tissue homogenate in 7 days. Vascular endothelial cell (VEC) and new blood capillary (NBC) of hematoxylin-eosin slice of tissue were counted by using light microscope. Average value of PtO2 of vacuum group was significant lower than conventional group (t = -99.780 to -5.305, P < 0.01). Expression of HIF-1α (30 minutes, 1, 6, 12 hours were 3.11 ± 0.07, 3.68 ± 0.26, 4.16 ± 0.13 and 3.91 ± 0.26 respectively) and content of VEGF (30 minutes, 1, 6, 12 hours were 103.3 ± 2.4, 134.2 ± 9.0, 167.8 ± 3.8 and 232.1 ± 9.5 respectively) of vacuum group were increased after 30 minutes and significant lower than conventional group (t = 13.038 - 80.208, P < 0.01), and both of them were reduced after 24 hours (P < 0.05). Counting numbers of VEC (2.47 ± 0.45 to 4.70 ± 0.38) and NBC (1.33 ± 0.49 to 4.33 ± 0.68) of vacuum group were increased at the same time-point and significant higher than conventional group (t = -0.670 to 16.500, P < 0.05). PtO2 of wound surface could be reduced significantly by VSD. Expression of HIF-1α and content of VEGF were increased by VSD for enhancing differentiated state of VEC and construction of NBC, which were better for vascularization and wound healing.

  4. EURAMET.M.P-S9: comparison in the negative gauge pressure range -950 to 0 hPa

    Science.gov (United States)

    Saxholm, S.; Otal, P.; AltintaS, A.; Bermanec, L. G.; Durgut, Y.; Hanrahan, R.; Kocas, I.; Lefkopoulos, A.; Pražák, D.; Sandu, I.; Åetina, J.; Spohr, I.; Steindl, D.; Tammik, K.; Testa, N.

    2016-01-01

    A comparison in the negative gauge pressure range was arranged in the period 2011 - 2012. A total of 14 laboratories participated in this comparison: BEV (Austria), CMI (Czech Republic), DANIAmet-FORCE (Denmark), EIM (Greece), HMI/FSB-LPM (Croatia), INM (Romania), IPQ (Portugal), LNE (France), MCCAA (Malta), METROSERT (Estonia), MIKES (Finland), MIRS/IMT/LMT (Slovenia), NSAI (Ireland) and UME (Turkey). The project was divided into two loops: Loop1, piloted by MIKES, and Loop2, piloted by LNE. The results of the two loops are reported separately: Loop1 results are presented in this paper. The transfer standard was Beamex MC5 no. 25516865 with internal pressure module INT1C, resolution 0.01 hPa. The nominal pressure range of the INT1C is -1000 hPa to +1000 hPa. The nominal pressure points for the comparison were 0 hPa, -200 hPa, -400 hPa, -600 hPa, -800 hPa and -950 hPa. The reference values and their uncertainties as well as the difference uncertainty between the laboratory results and the reference values were determined from the measurement data by Monte Carlo simulations. Stability uncertainty of the transfer standard was included in the final difference uncertainty. Degrees of equivalences and mutual equivalences between the laboratories were calculated. Each laboratory reported results for all twelve measurement points, which means that there were 168 reported values in total. Some 163 of the 168 values (97 %) agree with the reference values within the expanded uncertainties, with a coverage factor k = 2. Among the laboratories, four different methods were used to determine negative gauge pressure. It is concluded that special attention must be paid to the measurements and methods when measuring negative gauge pressures. There might be a need for a technical guide or a workshop that provides information about details and practices related to the measurements of negative gauge pressure, as well as differences between the different methods. The comparison is

  5. A direct method for determining complete positive and negative capillary pressure curves for reservoir rock using the centrifuge

    Energy Technology Data Exchange (ETDEWEB)

    Spinler, E.A.; Baldwin, B.A. [Phillips Petroleum Co., Bartlesville, OK (United States)

    1997-08-01

    A method is being developed for direct experimental determination of capillary pressure curves from saturation distributions produced during centrifuging fluids in a rock plug. A free water level is positioned along the length of the plugs to enable simultaneous determination of both positive and negative capillary pressures. Octadecane as the oil phase is solidified by temperature reduction while centrifuging to prevent fluid redistribution upon removal from the centrifuge. The water saturation is then measured via magnetic resonance imaging. The saturation profile within the plug and the calculation of pressures for each point of the saturation profile allows for a complete capillary pressure curve to be determined from one experiment. Centrifuging under oil with a free water level into a 100 percent water saturated plug results in the development of a primary drainage capillary pressure curve. Centrifuging similarly at an initial water saturation in the plug results in the development of an imbibition capillary pressure curve. Examples of these measurements are presented for Berea sandstone and chalk rocks.

  6. Nonlinear transient dynamic response of pressure relief valves for a negative containment system

    International Nuclear Information System (INIS)

    Aziz, T.S.; Duff, C.G.; Tang, J.H.K.

    1979-01-01

    The response of the piston for the postulated simultaneous effect of pressure and an earthquake is obtained for different parameters and accident conditions. Response quantities such as accelerations, displacements, rotations, diaphragm forces as well as opening time during a design basis earthquake are obtained. The results of the different analyses, as related to the functional operability of the valves, are evaluated and discussed. (orig.)

  7. Perceiving social pressure not to feel negative predicts depressive symptoms in daily life

    NARCIS (Netherlands)

    Dejonckheere, E.; Bastian, B.; Fried, E.I.; Murphy, S.C.; Kuppens, P.

    Background Western societies often overemphasize the pursuit of happiness, and regard negative feelings such as sadness or anxiety as maladaptive and unwanted. Despite this emphasis on happiness, the amount of people suffering from depressive complaints is remarkably high. To explain this apparent

  8. The Ambivalence of Challenge Stressors: Time Pressure Associated with Both Negative and Positive Well-Being

    Science.gov (United States)

    Widmer, Pascale S.; Semmer, Norbert K.; Kalin, Wolfgang; Jacobshagen, Nicola; Meier, Laurenz L.

    2012-01-01

    According to the challenge-hindrance model, challenge stressors contain both stressful and challenging aspects, hindrance stressors only stressful aspects. Typically, negative outcomes of challenge stressors refer to well-being (strain), positive outcomes to so-called work outcomes (e.g., productivity, intention to quit). As both effects occur…

  9. Intermittency in branching models

    International Nuclear Information System (INIS)

    Chiu, C.B.; Texas Univ., Austin; Hwa, R.C.; Oregon Univ., Eugene

    1990-01-01

    The intermittency properties of three branching models have been investigated. The factorial moments show power-law behavior as function of small rapidity width. The slopes and energy dependences reveal different characteristics of the models. The gluon model has the weakest intermittency. (orig.)

  10. Negative pressure of the environmental air in the cleaning area of the materials and sterilization center: a systematic review

    Directory of Open Access Journals (Sweden)

    Caroline Lopes Ciofi-Silva

    Full Text Available ABSTRACT Objective: to analyze the scientific evidence on aerosols generated during cleaning activities of health products in the Central Service Department (CSD and the impact of the negative pressure of the ambient air in the cleaning area to control the dispersion of aerosols to adjacent areas. Method: for this literature systematic review the following searches were done: search guidelines, manuals or national and international technical standards given by experts; search in the portal and databases PubMed, Scopus, CINAHL and Web of Science; and a manual search of scientific articles. Results: the five technical documents reviewed recommend that the CSD cleaning area should have a negative differential ambient air pressure, but scientific articles on the impact of this intervention were not found. The four articles included talked about aerosols formed after the use of a ultrasonic cleaner (an increased in the contamination especially during use and pressurized water jet (formation of smaller aerosols 5μm. In a study, the aerosols formed from contaminated the hot tap water with Legionella pneumophila were evaluated. Conclusions: there is evidence of aerosol formation during cleanup activities in CSD. Studies on occupational diseases of respiratory origin of workers who work in CSD should be performed.

  11. The Influence of the Bed with a Semiopen Hood on Bacteria Removal in a Negative-Pressure Isolation Room

    Directory of Open Access Journals (Sweden)

    Jeng-Min Huang

    2014-06-01

    Full Text Available This study numerically investigates the influence of a sickbed with a semiopened hood on bacteria removal in a negative-pressure isolation room. The parameters include air change rate, lying style, the length and height of hood, flow rate allotments, and the positions of outlets. The results show that the hood has excellent effect on the removal of contaminated air, which is much better than the case without hood. The flow field of patient's face up cough is very different from face side cough, and the contaminated air cannot be removed properly through one air outlet. There are three outlets on the hood, set straight above the patient's face and at both sides. The allotment of the exhaust flow rate of the upper outlet to that of side outlets is suggested to be 4: 6. When the total air change rate is above 6 ACH, the hood length has slight influence on pollutant removal. The increase of hood height has a negative impact when the patient coughs lying on back. When the side exhaust flow rate is high, the hood height has a slight impact for face side cough. The recommended air change rate for the negative-pressure ward with sickbed hood is above 5 ACH.

  12. Impact of microarousal associated with increased negative esophageal pressure in sleep-disordered breathing.

    Science.gov (United States)

    Sukegawa, Mayo; Noda, Akiko; Yasuda, Yoshinari; Nakata, Seiichi; Sugiura, Tatsuki; Miyata, Seiko; Honda, Kumiko; Hasegawa, Yoshinori; Nakashima, Tsutomu; Koike, Yasuo

    2009-11-01

    "Microarousals" during sleep have not been analyzed systematically. We investigated the importance of "microarousals" (lasting 1.5-3 s). Standard polysomnography including esophageal pressure (Pes) assessment was performed on ten patients (aged 54.0 +/- 5.0 years) with respiratory effort-related arousal > or =5/h. We measured the number of arousals per hour (American Sleep Disorders Association (ASDA) arousal index) and the number of microarousals lasting 1.5-3 s per hour (mASDA arousal index). On the night after the baseline sleep study, we performed overnight continuous positive airway pressure (CPAP) titration. mASDA arousals, characterized by lower Pes values, were observed more frequently in patients with sleep-disordered breathing. The Pes results did not differ significantly between ASDA and mASDA arousals (-15.6 +/- -5.0 vs -15.0 +/- -4.4 cmH(2)O). mASDA arousals were significantly improved by CPAP treatment (mASDA arousals, 82.6 +/- 60.1 vs 6.0 +/- 1.4/h). mASDA arousals were characterized by an increase in Pes. mASDA arousals are thus key to our understanding of clinical manifestations in patients with sleep-disordered breathing.

  13. Comparisons of negative pressure wound therapy and ultrasonic debridement for diabetic foot ulcers: a network meta-analysis.

    Science.gov (United States)

    Wang, Ruran; Feng, Yanhua; Di, Bo

    2015-01-01

    a network meta-analysis was performed to compare the strength and weakness of negative pressure wound therapy (NPWT) with ultrasound debridement (UD) as for diabetic foot ulcers (DFU). PubMed, Ovid EMBASE, Web of Science, Cochrane library databases, and Chinese Biomedical Literature Database were searched till February 2015. Clinical compared studies of negative pressure wound therapy and ultrasound debridement were enrolled. The primary efficacy outcomes included healed ulcers, reduction of ulcer areas and time to closure. Secondary amputation including major and minor amputations was used to assess the safety profile. Out of 715 studies, 32 were selected which enrolled 2880 diabetic patients. The pooled analysis revealed that NPWT including vacuum assisted closure (VAC) and vacuum sealing drainage (VSD) were as efficacious as ultrasound debridement improving healed ulcers, odds ratio, 0.86; 95% CI 0.28 to 2.6 and 1.2; 95% CI 0.38 to 4, respectively. However, both were better to standard wound care in wound healing patients. Compared with the standard wound care treated diabetic foot ulcers, NPWT and UD resulted in a significantly superior efficacy in time to wound closure and decrement in area of wound. No significances were observed between NPWT and UD groups in both indicators. Fewer patients tended to receive amputation in NPWT and UD groups compared to standard wound care group. The results of the network meta-analysis indicated that negative pressure wound therapy was similar to ultrasound debridement for diabetic foot ulcers, but better than standard wound care both in efficacy and safety profile.

  14. Comparisons of negative pressure wound therapy and ultrasonic debridement for diabetic foot ulcers: a network meta-analysis

    Science.gov (United States)

    Wang, Ruran; Feng, Yanhua; Di, Bo

    2015-01-01

    Objective: a network meta-analysis was performed to compare the strength and weakness of negative pressure wound therapy (NPWT) with ultrasound debridement (UD) as for diabetic foot ulcers (DFU). Methods: PubMed, Ovid EMBASE, Web of Science, Cochrane library databases, and Chinese Biomedical Literature Database were searched till February 2015. Clinical compared studies of negative pressure wound therapy and ultrasound debridement were enrolled. The primary efficacy outcomes included healed ulcers, reduction of ulcer areas and time to closure. Secondary amputation including major and minor amputations was used to assess the safety profile. Results: Out of 715 studies, 32 were selected which enrolled 2880 diabetic patients. The pooled analysis revealed that NPWT including vacuum assisted closure (VAC) and vacuum sealing drainage (VSD) were as efficacious as ultrasound debridement improving healed ulcers, odds ratio, 0.86; 95% CI 0.28 to 2.6 and 1.2; 95% CI 0.38 to 4, respectively. However, both were better to standard wound care in wound healing patients. Compared with the standard wound care treated diabetic foot ulcers, NPWT and UD resulted in a significantly superior efficacy in time to wound closure and decrement in area of wound. No significances were observed between NPWT and UD groups in both indicators. Fewer patients tended to receive amputation in NPWT and UD groups compared to standard wound care group. Conclusions: The results of the network meta-analysis indicated that negative pressure wound therapy was similar to ultrasound debridement for diabetic foot ulcers, but better than standard wound care both in efficacy and safety profile. PMID:26550165

  15. Negative Pressure Wound Therapy in Infected Wound following Posterior Spinal Instrumentation using Simple Self-assembled System: A Case Report

    Directory of Open Access Journals (Sweden)

    CW Chang

    2014-07-01

    Full Text Available Postoperative wound infection in an instrumented spine patient is often disastrous. Management includes implant removal leading to spine instability. Negative pressure wound therapy (NPWT applied to the spine surgical wound is one of the wound care technique with successful results. We report a case of a man who sustained Chance fracture of Lumbar 1 (L1 vertebra treated with long segment posterior instrumentation, who unfortunately developed Extended-spectrum beta-lactamase (ESBL positive E. coli infection one month after the operation. After careful debridement of the wound, the implant became exposed. Three cycles of NPWT were applied and the wound healed with granulation tissue completely covering the implant, and thus negating the need to remove the implant. In conclusion, the NPWT is a good alternative in postoperative wound management especially in an instrumented spine patient.

  16. The Influence of the Bed with a Semiopen Hood on Bacteria Removal in a Negative-Pressure Isolation Room

    OpenAIRE

    Jeng-Min Huang; Hsiang-Tai Cheng

    2014-01-01

    This study numerically investigates the influence of a sickbed with a semiopened hood on bacteria removal in a negative-pressure isolation room. The parameters include air change rate, lying style, the length and height of hood, flow rate allotments, and the positions of outlets. The results show that the hood has excellent effect on the removal of contaminated air, which is much better than the case without hood. The flow field of patient's face up cough is very different from face side coug...

  17. A Unique Application of Negative Pressure Wound Therapy Used to Facilitate Patient Engagement in the Amputation Recovery Process.

    Science.gov (United States)

    Wise, Jessica; White, Alicia; Stinner, Daniel J; Fergason, John R

    2017-08-01

    Amputation rates during recent military conflicts were at an all-time high, but medical treatment of those amputations and attitudes of service members to get back to duty are also surging ahead. We present the cases of an active duty rescue C130 pilot with an above-the-knee amputation and a retired army sergeant with a below-the-knee amputation. Successful rehabilitation was augmented in both cases by using negative pressure incorporated in a custom prosthetic socket to accelerate incision closure, improve self-efficacy in wound care, and self-management, ultimately leading to faster recovery times, full engagement of the rehabilitation process, and return to active duty.

  18. Cost-effectiveness of negative pressure wound therapy in patients with many comorbidities and severe wounds of various etiology.

    Science.gov (United States)

    Driver, Vickie R; Eckert, Kristen A; Carter, Marissa J; French, Michael A

    2016-11-01

    This study analyzed a cross-section of patients with severe chronic wounds and multiple comorbidities at an outpatient wound clinic, with regard to the cost-effectiveness and cost-benefit of negative pressure wound therapy (intervention) vs. no negative pressure wound therapy (control) at 1 and 2 years. Medicare reimbursement charges for wound care were used to calculate costs. Amputation charges were assessed using diagnosis-related groups. Cost-benefit analysis was based on ulcer-free months and cost-effectiveness on quality-adjusted life-years. Undiscounted costs, benefits, quality-adjusted life-years, undiscounted and discounted incremental net health benefits, and incremental cost-effectiveness ratios were calculated for unmatched and matched cohorts. There were 150 subjects in the intervention group and 154 controls before matching and 103 subjects in each of the matched cohorts. Time to heal for the intervention cohort was significantly shorter compared to the controls (270 vs. 635 days, p = 1.0 × 10 -7 , matched cohorts). The intervention cohort had higher benefits and quality-adjusted life-year gains compared to the control cohort at years 1 and 2; by year 2, the gains were 68-73% higher. In the unmatched cohorts, the incremental net health benefit was $9,933 per ulcer-free month at year 2 for the intervention; the incremental cost-effectiveness ratio was -825,271 per quality-adjusted life-year gained (undiscounted costs and benefits). For the matched cohorts, the incremental net health benefits was only $1,371 per ulcer-free month for the intervention, but the incremental cost-effectiveness ratio was $366,683 per quality-adjusted life-year gained for year 2 (discounted costs and benefits). In a patient population with severe chronic wounds and serious comorbidities, negative pressure wound therapy resulted in faster healing wounds and was more cost-effective with greater cost-benefits than not using negative pressure wound therapy. Regarding overall

  19. Hemodynamic responses to seated and supine lower body negative pressure - Comparison with +Gz acceleration

    Science.gov (United States)

    Polese, Alvese; Sandler, Harold; Montgomery, Leslie D.

    1992-01-01

    The hemodynamic responses to LBNP in seated subjects and in subjects in supine body positions were compared and were correlated with hemodynamic changes which occurred during a simulated (by centrifugation) Shuttle reentry acceleration with a slow onset rate of 0.002 G/s and during gradual onset exposures to +3 Gz and +4 Gz. Results demonstrate that seated LBNP at a level of -40 mm Hg can serve as a static simulator for changes in the heart rate and in mean blood pressure induced by gradual onset acceleration stress occurring during Shuttle reentry. The findings also provide a rationale for using LBNP during weightlessness as a means of imposing G-loading on the circulation prior to reentry.

  20. Hemolysis During Open-Heart Surgery With Vacuum-Assisted Venous Drainage at Different Negative Pressures in Pediatric Patients Weighing Less Than 10 kilograms.

    Science.gov (United States)

    Kwak, Jae Gun; Lee, Jinkwon; Park, Minkyoung; Seo, Yu-Jin; Lee, Chang-Ha

    2017-03-01

    This study examined the degree of hemolysis during vacuum-assisted venous drainage at different negative pressures to identify an adequate negative pressure that provides effective venous drainage without significant hemolysis in open-heart surgery in children weighing less than 10 kg. Patients weighing less than 10 kg who underwent surgery for ventricular septal defect or atrial septal defect from 2011 to 2014 were enrolled. We used one of four negative pressures (20, 30, 40, or 60 mm Hg) for each patient. We measured haptoglobin, plasma hemoglobin, aspartate aminotransferase, and lactate dehydrogenase levels in the patients' blood three times perioperatively and determined the potential correlation between the change in each parameter with the level of negative pressure. Forty-six patients were enrolled in this study (mean age: 7.1 ± 7.0 months, mean body weight: 6.1 ± 1.8 kg). There were no significant differences according to the degree of negative pressure with respect to patient age, body weight, cardiopulmonary bypass (CPB) time, aorta cross-clamping time, blood flow during CPB, or lowest body temperature. All parameters that we measured reflected progression of hemolysis during CPB; however, the degree of change in the parameters did not correlate with negative pressure. In pediatric patients weighing less than 10 kg, the change in the degree of hemolysis did not differ with the amount of negative pressure. We may apply negative pressures up to 60 mm Hg without increasing the risk of hemolysis, with almost same the level of hemolysis using negative pressures of 20, 30, and 40 mm Hg for effective venous drainage and an ideal operative field during open-heart surgery.

  1. Impact of chemical peeling combined with negative pressure on human skin.

    Science.gov (United States)

    Kim, S J; Kang, I J; Shin, M K; Jeong, K H; Baek, J H; Koh, J S; Lee, S J

    2016-10-01

    In vivo changes in skin barrier function after chemical peeling with alpha hydroxyacids (AHAs) have been previously reported. However, the additional effects of physical treatment with chemical agents on skin barrier function have not been adequately studied. This study measured the degree of acute skin damage and the time required for skin barrier repair using non-invasive bioengineering methods in vivo with human skin to investigate the additional effect of a 4% AHA chemical jet accelerated at supersonic velocities. Thirteen female subjects (average age: 29.54 ± 4.86 years) participated in this study. The faces of the subjects were divided into half according to the block randomization design and were then assigned to receive AHA peeling alone or AHA peeling combined with pneumatic pressure on each side of the face. Transepidermal water loss (TEWL), skin colour and skin blood flow were evaluated at baseline and at 30 min, 2, 5 and 7 days after treatment. The TEWL and skin blood flow were significantly increased after 30 min in chemodermabrasion compared with chemical peeling alone (P peeling alone (P < 0.05). Chemodermabrasion can temporarily impair skin barriers, but it is estimated that it can enhance the skin barrier function after 7 days compared to the use of a chemical agent alone. In addition, chemodermabrasion has a more effective impact in the dermis and relatively preserves the skin barrier. © 2016 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

  2. Intermittent Explosive Disorder

    Directory of Open Access Journals (Sweden)

    Lut Tamam

    2011-09-01

    Full Text Available Intermittent explosive disorder is an impulse control disorder characterized by the occurrence of discrete episodes of failure to resist aggressive impulses that result in violent assault or destruction of property. Though the prevalence intermittent explosive disorder has been reported to be relatively rare in frontier studies on the field, it is now common opinion that intermittent explosive disorder is far more common than previously thought especially in clinical psychiatry settings. Etiological studies displayed the role of both psychosocial factors like childhood traumas and biological factors like dysfunctional neurotransmitter systems and genetics. In differential diagnosis of the disorder, disorders involving agression as a symptom such as alcohol and drug intoxication, antisocial and borderline personality disorders, personality changes due to general medical conditions and behavioral disorder should be considered. A combination of pharmacological and psychotherapeutic approaches are suggested in the treatment of the disorder. This article briefly reviews the historical background, diagnostic criteria, epidemiology, etiology and treatment of intermittent explosive disorder.

  3. Intermittent heating of buildings

    Energy Technology Data Exchange (ETDEWEB)

    Kohonen, K

    1983-02-01

    Conditions for intermittent heating of buildings are considered both theoretically and experimentally. Thermal behaviour of buildings adn rooms in intermittent heating is simulated by a program based on the convective heat balance equation and by simplified RC-models. The preheat times and the heating energy savings compared with continuous heating are presented for typical lightweight, mediumweight and heavyweight classroom and office modules. Formulaes for estimating the oversizing of the radiator network, the maximum heat output of heat exchangers in district heating and the efficiency of heating boilers in intermittent heating are presented. The preheat times and heating energy savings with different heating control systems are determined also experimentally in eight existing buildings. In addition some principles for the planning and application of intermittent heating systems are suggested.

  4. The efficacy of negative pressure wound therapy in the management of lower extremity trauma: review of clinical evidence.

    Science.gov (United States)

    Kanakaris, N K; Thanasas, C; Keramaris, N; Kontakis, G; Granick, Mark S; Giannoudis, P V

    2007-12-01

    A large number of aids have been conceived and introduced into clinical practice (nutritional supplements, local dressings, technical innovations) aimed at facilitating and optimising wound healing in both acute and chronic wound settings. Among these advances, negative pressure wound therapy (NPWT) has been introduced during the last 30 years, and has been analysed in over 400 manuscripts of the English, Russian and German literature. Until very recently, vacuum assisted closure (VAC) (KCI, TX, USA) has been the only readily available commercial device that provides localised negative pressure to the wound and is the predominant agent used to deliver NPWT featured in this review. We conducted a comprehensive review of the existing clinical evidence of the English literature on the applications of NPWT in the acute setting of trauma and burns of the lower extremity. Overall, 16 clinical studies have been evaluated and scrutinised as to the safety and the efficacy of this adjunct therapy in the specific environment of trauma. Effectiveness was comparable to the standard dressing and wound coverage methods. The existing clinical evidence justifies its application in lower limb injuries associated with soft tissue trauma.

  5. Measurement of negative ion mobility in O2 at high pressures using a point plate gap as an ion detector

    International Nuclear Information System (INIS)

    Okuyama, Y; Kimura, T; Suzuki, S; Itoh, H

    2012-01-01

    This paper describes the experimental results for negative ion mobility in O 2 at 0.5-2.0 atm. The ion mobility is observed using a high-pressure ion drift tube with a positive corona gap (Geiger counter), which is constructed from a point plate gap and acts as a negative ion detector. The variation of waveforms in the burst pulse is observed by varying the voltage applied to the ion detector to find the optimum voltage that must be applied across the ion detector in O 2 . This is investigated carefully to ensure the precise determination of mobility. The distortion of the electric field near the mesh electrode, which operates as the cathode of the ion detector and as the anode of the ion drift gap, is then examined to determine the optimum applied voltage to suppress its effect on the measurement of mobility. The mobility is subsequently measured at a reduced electric field intensity of 2.83 × 10 -3 to 2.83. The observed mobility of 2.31 ± 0.03 cm 2 V -1 s -1 in O 2 is concluded to be that of O 2 - . This value is also obtained in experiments over a wide range of gas pressures (0.5-2.0 atm) and drift lengths (1.00-9.00 cm). The mobilities of O 3 - and O - are also obtained experimentally. (paper)

  6. Optimal intermittent search strategies

    International Nuclear Information System (INIS)

    Rojo, F; Budde, C E; Wio, H S

    2009-01-01

    We study the search kinetics of a single fixed target by a set of searchers performing an intermittent random walk, jumping between different internal states. Exploiting concepts of multi-state and continuous-time random walks we have calculated the survival probability of a target up to time t, and have 'optimized' (minimized) it with regard to the transition probability among internal states. Our model shows that intermittent strategies always improve target detection, even for simple diffusion states of motion

  7. Relationship quality: effects on ambulatory blood pressure and negative affect in a biracial sample of men and women.

    Science.gov (United States)

    Grewen, Karen M; Girdler, Susan S; Light, Kathleen C

    2005-06-01

    Prospective studies link marriage to better cardiovascular health, but marital dissatisfaction and discord predict increased rates of hypertension, higher blood pressure (BP), greater reactivity to stress, and left ventricular mass. To determine and compare effects of partner status and relationship quality on 24-h BP, urinary norepinephrine and cortisol, and self-reported stress and negative affect. Ambulatory BP (ABP) and 24-h urine collections were obtained during a typical work day in 325 adults, including 139 African Americans (AAs). Participants cohabiting with a spouse or partner were classified into high, intermediate and low relationship quality (RQ) groups and compared to those without partners (Alone). Mean ABP was nearly identical in participants with versus without partners (125.7/76.9 versus 125.9/76.7 mmHg). High RQ subjects had lower mean waking ABP than intermediate/low RQ and Alone groups [systolic blood pressure (SBP), F=3.45; diastolic blood pressure (DBP), F=3.38, P-values affect and stress than all other groups (Paffect and stress than partner status. High RQ is linked to lower ABP across race and gender. This reduced ABP may be due, in part, to the stress buffering effects of better RQ and/or the stress enhancing effects of poor RQ.

  8. Effect of Negative Pressure on Proliferation, Virulence Factor Secretion, Biofilm Formation, and Virulence-Regulated Gene Expression of Pseudomonas aeruginosa In Vitro

    Directory of Open Access Journals (Sweden)

    Guo-Qi Wang

    2016-01-01

    Full Text Available Objective. To investigate the effect of negative pressure conditions induced by NPWT on P. aeruginosa. Methods. P. aeruginosa was cultured in a Luria–Bertani medium at negative pressure of −125 mmHg for 24 h in the experimental group and at atmospheric pressure in the control group. The diameters of the colonies of P. aeruginosa were measured after 24 h. ELISA kit, orcinol method, and elastin-Congo red assay were used to quantify the virulence factors. Biofilm formation was observed by staining with Alexa Fluor® 647 conjugate of concanavalin A (Con A. Virulence-regulated genes were determined by quantitative RT-PCR. Results. As compared with the control group, growth of P. aeruginosa was inhibited by negative pressure. The colony size under negative pressure was significantly smaller in the experimental group than that in the controls (p<0.01. Besides, reductions in the total amount of virulence factors were observed in the negative pressure group, including exotoxin A, rhamnolipid, and elastase. RT-PCR results revealed a significant inhibition in the expression level of virulence-regulated genes. Conclusion. Negative pressure could significantly inhibit the growth of P. aeruginosa. It led to a decrease in the virulence factor secretion, biofilm formation, and a reduction in the expression level of virulence-regulated genes.

  9. DC negative corona discharge in atmospheric pressure helium: transition from the corona to the ‘normal’ glow regime

    International Nuclear Information System (INIS)

    Hasan, Nusair; Farouk, Bakhtier; Antao, Dion S

    2014-01-01

    Direct current (dc) negative corona discharges in atmospheric pressure helium are simulated via detailed numerical modeling. Simulations are conducted to characterize the discharges in atmospheric helium for a pin plate electrode configuration. A self-consistent two-dimensional hybrid model is developed to simulate the discharges and the model predictions are validated with experimental measurements. The discharge model considered consists of momentum and energy conservation equations for a multi-component (electrons, ions, excited species and neutrals) gas mixture, conservation equations for each component of the mixture and state relations. A drift–diffusion approximation for the electron and the ion fluxes is used. A model for the external circuit driving the discharge is also considered and solved along with the discharge model. Many of the key features of a negative corona discharge, namely non-linear current–voltage characteristics, spatially flat cathode current density and glow-like discharge in the high current regime are displayed in the predictions. A transition to the ‘normal’ glow discharge from the corona discharge regime is also observed. The transition is identified from the calculated current–voltage characteristic curve and is characterized by the radial growth of the negative glow and the engulfment of the cathode wire. (paper)

  10. Effect of Reynolds Number and Periodic Unsteady Wake Flow Condition on Boundary Layer Development, Separation, and Intermittency Behavior Along the Suction Surface of a Low Pressure Turbine Blade

    Science.gov (United States)

    Schobeiri, M. T.; Ozturk, B.; Ashpis, David E.

    2007-01-01

    The paper experimentally studies the effects of periodic unsteady wake flow and different Reynolds numbers on boundary layer development, separation and re-attachment along the suction surface of a low pressure turbine blade. The experimental investigations were performed on a large scale, subsonic unsteady turbine cascade research facility at Turbomachinery Performance and Flow Research Laboratory (TPFL) of Texas A&M University. The experiments were carried out at Reynolds numbers of 110,000 and 150,000 (based on suction surface length and exit velocity). One steady and two different unsteady inlet flow conditions with the corresponding passing frequencies, wake velocities, and turbulence intensities were investigated. The reduced frequencies chosen cover the operating range of LP turbines. In addition to the unsteady boundary layer measurements, surface pressure measurements were performed. The inception, onset, and the extent of the separation bubble information collected from the pressure measurements were compared with the hot wire measurements. The results presented in ensemble-averaged, and the contour plot forms help to understand the physics of the separation phenomenon under periodic unsteady wake flow and different Reynolds number. It was found that the suction surface displayed a strong separation bubble for these three different reduced frequencies. For each condition, the locations defining the separation bubble were determined carefully analyzing and examining the pressure and mean velocity profile data. The location of the boundary layer separation was dependent of the Reynolds number. It is observed that starting point of the separation bubble and the re-attachment point move further downstream by increasing Reynolds number from 110,000 to 150,000. Also, the size of the separation bubble is smaller when compared to that for Re=110,000.

  11. The concept of negative pressure wound therapy (NPWT after poststernotomy mediastinitis – a single center experience with 54 patients

    Directory of Open Access Journals (Sweden)

    Vogt Peter M

    2009-01-01

    Full Text Available Abstract Deep sternal infections, also known as poststernotomy mediastinitis, are a rare but often fatal complication in cardiac surgery. They are a cause of increased morbidity and mortality and have a significant socioeconomic aspect concerning the health system. Negative pressure wound therapy (NPWT followed by muscular pectoralis plasty is a quite new technique for the treatment of mediastinitis after sternotomy. Although it could be demonstrated that this technique is at least as safe and reliable as other techniques for the therapy of deep sternal infections, complications are not absent. We report about our experiences and complications using this therapy in a set of 54 patients out of 3668 patients undergoing cardiac surgery in our institution between January 2005 and April 2007.

  12. The concept of negative pressure wound therapy (NPWT) after poststernotomy mediastinitis--a single center experience with 54 patients.

    Science.gov (United States)

    Ennker, Ina C; Malkoc, Anita; Pietrowski, Detlef; Vogt, Peter M; Ennker, Juergen; Albert, Alexander

    2009-01-12

    Deep sternal infections, also known as poststernotomy mediastinitis, are a rare but often fatal complication in cardiac surgery. They are a cause of increased morbidity and mortality and have a significant socioeconomic aspect concerning the health system. Negative pressure wound therapy (NPWT) followed by muscular pectoralis plasty is a quite new technique for the treatment of mediastinitis after sternotomy. Although it could be demonstrated that this technique is at least as safe and reliable as other techniques for the therapy of deep sternal infections, complications are not absent. We report about our experiences and complications using this therapy in a set of 54 patients out of 3668 patients undergoing cardiac surgery in our institution between January 2005 and April 2007.

  13. Experience with the vacuum assisted closure negative pressure technique in the treatment of non-healing diabetic and dysvascular wounds.

    Science.gov (United States)

    Clare, Michael P; Fitzgibbons, Timothy C; McMullen, Scott T; Stice, R Colleen; Hayes, Dennis F; Henkel, Loree

    2002-10-01

    The purpose of this study is to report our experience with the Vacuum Assisted Closure (VAC) negative pressure technique in patients with non-healing wounds of the foot, ankle, and lower limb. We retrospectively reviewed 17 patients with non-healing wounds of the lower extremity who underwent treatment using the Vacuum Assisted Closure (VAC) device. Thirteen of 17 (76%) had diabetes mellitus, nine of whom were insulin-dependent, and 10 of whom had associated peripheral neuropathy. Eight of 17 (47%) had severe peripheral vascular disease. All had failed previous management with serial wound debridements and dressing changes; 15 of 17 (88%) had previously completed at least one course of oral antibiotics. Thirteen of 17 (76%) had previously undergone operative irrigation and debridement of the wounds; six of 17 (35%) had previously undergone revascularization procedures of the involved extremity. Five of 17 (29%) had wounds necessitating an amputation procedure prior to the present treatment; seven of 17 (41%) had failed treatment with local growth factors prior to the present treatment. Average length of treatment with the VAC device was 8.2 weeks. Fourteen of 17 (82%) wounds successfully healed; four underwent split-thickness skin grafting for wound closure; four were briefly treated with local growth factors; six were treated with only dressing changes following VAC treatment. Three of 17 (18%) wounds failed VAC treatment; all three patients had diabetes and had wounds located in the midfoot or forefoot; two of three had severe peripheral vascular disease. Our results indicate that the Vacuum Assisted Closure negative pressure technique is emerging as an acceptable option for wound care of the lower extremity. Not all patients are candidates for such treatment; those patients with severe peripheral vascular disease or smaller forefoot wounds may be best treated by other modalities. Larger wounds seem to be better suited for skin grafting or two-stage primary

  14. Apical negative pressure irrigation versus syringe irrigation: a systematic review of cleaning and disinfection of the root canal system.

    Science.gov (United States)

    Konstantinidi, E; Psimma, Z; Chávez de Paz, L E; Boutsioukis, C

    2017-11-01

    The aim of this study was to systematically review and critically analyse the published data on the treatment outcome (primary outcome) and on the cleaning and disinfection of root canals (secondary outcomes) achieved by negative pressure irrigation as compared to syringe irrigation. An electronic search was conducted in EMBASE, LILACS, PubMed, SciELO, Scopus and Web of Knowledge using both free-text keywords and controlled vocabulary. Additional studies were sought through hand searching of endodontic journals and of the relevant chapters of endodontic textbooks. No language restriction was imposed. The retrieved studies were screened by two reviewers according to predefined criteria. Included studies were critically appraised and the extracted data were arranged in tables. The electronic search and hand search retrieved 489 titles. One clinical study and 14 in vitro studies were finally included in the review; none of these studies assessed treatment outcome, four studies assessed the antimicrobial effect, seven studies evaluated the removal of pulp tissue remnants, and four studies investigated the removal of hard tissue debris or both hard tissue debris and pulp tissue remnants. Poor standardization and description of the protocols was evident. Inconclusive results were reported about the cleaning and disinfection accomplished by the two irrigation methods. Negative pressure irrigation was more effective under certain conditions when compared to suboptimal syringe irrigation; however, the variability of the protocols hindered quantitative synthesis. There is insufficient evidence to claim general superiority of any one of these methods. The level of the available evidence is low, and the conclusions should be interpreted with caution. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  15. Experimental evidence for negative turgor pressure in small leaf cells of Robinia pseudoacacia L versus large cells of Metasequoia glyptostroboides Hu et W.C.Cheng. 1. Evidence from pressure-volume curve analysis of dead tissue.

    Science.gov (United States)

    Yang, Dongmei; Pan, Shaoan; Ding, Yiting; Tyree, Melvin T

    2017-03-01

    This paper provides a mini-review of evidence for negative turgor pressure in leaf cells starting with experimental evidence in the late 1950s and ending with biomechanical models published in 2014. In the present study, biomechanical models were used to predict how negative turgor pressure might be manifested in dead tissue, and experiments were conducted to test the predictions. The main findings were as follows: (i) Tissues killed by heating to 60 or 80 °C or by freezing in liquid nitrogen all became equally leaky to cell sap solutes and all seemed to pass freely through the cell walls. (ii) Once cell sap solutes could freely pass the cell walls, the shape of pressure-volume curves was dramatically altered between living and dead cells. (iii) Pressure-volume curves of dead tissue seem to measure negative turgor defined as negative when inside minus outside pressure is negative. (iv) Robinia pseudoacacia leaves with small palisade cells had more negative turgor than Metasequoia glyptostroboides with large cells. (v) The absolute difference in negative turgor between R. pseudoacacia and M. glyptostroboides approached as much as 1.0 MPa in some cases. The differences in the manifestation of negative turgor in living versus dead tissue are discussed. © 2016 John Wiley & Sons Ltd.

  16. The effect of blood volume loss on cardiovascular response to lower body negative pressure using a mathematical model

    Science.gov (United States)

    Karam, E. H.; Srinivasan, R. S.; Charles, J. B.; Fortney, S. M.

    1994-01-01

    Different mathematical models of varying complexity have been proposed in recent years to study the cardiovascular (CV) system. However, only a few of them specifically address the response to lower body negative pressure (LBNP), a stress that can be applied in weightlessness to predict changes in orthostatic tolerance. Also, the simulated results produced by these models agree only partially with experimental observations. In contrast, the model proposed by Melchior et al., and modified by Karam et al. is a simple representation of the CV system capable of accurately reproducing observed LBNP responses up to presyncopal levels. There are significant changes in LBNP response due to a loss of blood volume and other alterations that occur in weightlessness and related one-g conditions such as bedrest. A few days of bedrest can cause up to 15% blood volume loss (BVL), with consequent decreases in both stroke volume and cardiac output, and increases in heart rate, mean arterial pressure, and total peripheral resistance. These changes are more pronounced at higher levels of LBNP. This paper presents the results of a simulation study using our CV model to examine the effect of BVL on LBNP response.

  17. Origin of superconductivity in KFe2As2 under positive and negative pressures and relation to other Fe-based families

    Science.gov (United States)

    Valenti, Roser

    KFe2As2 shows an intricate behavior as a function of pressure. At ambient pressure the system is superconductor with a low critical temperature Tc=3.4 K and follows a V-shaped pressure dependence of Tc for moderate pressures with a local minimum at a pressure of 1.5 GPa. Under high pressures Pc=15 GPa, KFe2As2 exhibits a structural phase transition from a tetragonal to a collapsed tetragonal phase accompanied by a boost of the superconducting critical temperature up to 12 K. On the other hand, negative pressures realized through substitution of K by Cs or Rb decrease Tc down to 2.25K. In this talk we will discuss recent progress on the understanding of the microscopic origin of this pressure-dependent behavior by considering a combination of ab initio density functional theory with dynamical mean field theory and spin fluctuation theory calculations. We will argue that a Lifshitz transition associated with the structural collapse changes the pairing symmetry from d-wave (tetragonal) to s+/- (collapsed tetragonal) at high pressures while at ambient and negative pressures correlation effects appear to be detrimental for superconductivity. Further, we shall establish cross-links to the chalcogenide family, in particular FeSe under pressure. The Deutsche Forschungsgemeinschaft (DFG) is gratefully acknowledged for financial support.

  18. Optimal intermittent search strategies

    Energy Technology Data Exchange (ETDEWEB)

    Rojo, F; Budde, C E [FaMAF, Universidad Nacional de Cordoba, Ciudad Universitaria, X5000HUA Cordoba (Argentina); Wio, H S [Instituto de Fisica de Cantabria, Universidad de Cantabria and CSIC E-39005 Santander (Spain)

    2009-03-27

    We study the search kinetics of a single fixed target by a set of searchers performing an intermittent random walk, jumping between different internal states. Exploiting concepts of multi-state and continuous-time random walks we have calculated the survival probability of a target up to time t, and have 'optimized' (minimized) it with regard to the transition probability among internal states. Our model shows that intermittent strategies always improve target detection, even for simple diffusion states of motion.

  19. Intermittency and random matrices

    Science.gov (United States)

    Sokoloff, Dmitry; Illarionov, E. A.

    2015-08-01

    A spectacular phenomenon of intermittency, i.e. a progressive growth of higher statistical moments of a physical field excited by an instability in a random medium, attracted the attention of Zeldovich in the last years of his life. At that time, the mathematical aspects underlying the physical description of this phenomenon were still under development and relations between various findings in the field remained obscure. Contemporary results from the theory of the product of independent random matrices (the Furstenberg theory) allowed the elaboration of the phenomenon of intermittency in a systematic way. We consider applications of the Furstenberg theory to some problems in cosmology and dynamo theory.

  20. Global model analysis of negative ion generation in low-pressure inductively coupled hydrogen plasmas with bi-Maxwellian electron energy distributions

    International Nuclear Information System (INIS)

    Huh, Sung-Ryul; Kim, Nam-Kyun; Jung, Bong-Ki; Chung, Kyoung-Jae; Hwang, Yong-Seok; Kim, Gon-Ho

    2015-01-01

    A global model was developed to investigate the densities of negative ions and the other species in a low-pressure inductively coupled hydrogen plasma with a bi-Maxwellian electron energy distribution. Compared to a Maxwellian plasma, bi-Maxwellian plasmas have higher populations of low-energy electrons and highly vibrationally excited hydrogen molecules that are generated efficiently by high-energy electrons. This leads to a higher reaction rate of the dissociative electron attachment responsible for negative ion production. The model indicated that the bi-Maxwellian electron energy distribution at low pressures is favorable for the creation of negative ions. In addition, the electron temperature, electron density, and negative ion density calculated using the model were compared with the experimental data. In the low-pressure regime, the model results of the bi-Maxwellian electron energy distributions agreed well quantitatively with the experimental measurements, unlike those of the assumed Maxwellian electron energy distributions that had discrepancies

  1. Impact of intermittent hypoxia and exercise on blood pressure and metabolic features from obese subjects suffering sleep apnea-hypopnea syndrome.

    Science.gov (United States)

    González-Muniesa, P; Lopez-Pascual, A; de Andrés, J; Lasa, A; Portillo, M P; Arós, F; Durán, J; Egea, C J; Martinez, J A

    2015-09-01

    Strategies designed to reduce adiposity and cardiovascular-accompanying manifestations have been based on nutritional interventions conjointly with physical activity programs. The aim of this 13-week study was to investigate the putative benefits associated to hypoxia plus exercise on weight loss and relevant metabolic and cardiorespiratory variables, when prescribed to obese subjects with sleep apnea syndrome following dietary advice. The participants were randomly distributed in the following three groups: control, normoxia, and hypoxia. All the subjects received dietary advice while, additionally, normoxia group was trained under normal oxygen concentration and Hypoxia group under hypoxic conditions. There was a statistically significant decrease in fat-free mass (Kg) and water (%) on the control compared to normoxia group (p hypoxia compared to control group (p hypoxia group showed some specific benefits concerning appetite and cardiometabolic-related measurements as exertion time and diastolic blood pressure, with a therapeutical potential.

  2. Intermittent Testicular Torsion

    African Journals Online (AJOL)

    2017-06-02

    Jun 2, 2017 ... had prior episodes of testicular pain, suggesting that they may have had intermittent torsion before .... None of the patients had antecedent history of sexual exposure, fever, or urinary tract infection .... torsion of the spermatic cord portends an increased risk of acute testicular infarction. J Urol 2008;180 4 ...

  3. Evaluation of negative-pressure wound therapy for patients with diabetic foot ulcers: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Liu S

    2017-04-01

    Full Text Available Si Liu,1 Chao-zhu He,1 Yan-ting Cai,1 Qiu-ping Xing,1 Ying-zhen Guo,1 Zhi-long Chen,1 Ji-liang Su,1 Li-ping Yang2 1School of Nursing, Nanchang University, 2Department of Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China Objectives: The aim of this study was to perform an updated systematic review and meta-analysis to assess the clinical efficacy, safety, and cost-effectiveness of negative-pressure wound therapy (NPWT in the treatment of diabetic foot ulcers (DFUs.Methods: We searched the Cochrane Library, MEDLINE, EMBASE, Ovid, and Chinese Biological Medicine databases up to June 30, 2016. We also manually searched the articles from reference lists of the retrieved articles, which used the NPWT system in studies of vacuum-assisted closure therapy. Studies were identified and selected, and two independent reviewers extracted data from the studies.Results: A total of eleven randomized controlled trials, which included a total of 1,044 patients, were selected from 691 identified studies. Compared with standard dressing changes, NPWT had a higher rate of complete healing of ulcers (relative risk, 1.48; 95% confidence interval [CI]: 1.24–1.76; P<0.001, shorter healing time (mean difference, −8.07; 95% CI: −13.70–−2.45; P=0.005, greater reduction in ulcer area (mean difference, 12.18; 95% CI: 8.50–15.86; P<0.00001, greater reduction in ulcer depth (mean difference, 40.82; 95% CI: 35.97–45.67; P<0.00001, fewer amputations (relative risk, 0.31; 95% CI: 0.15–0.62; P=0.001, and no effect on the incidence of treatment-related adverse effects (relative risk, 1.12; 95% CI: 0.66–1.89; P=0.68. Meanwhile, many analyses showed that the NPWT was more cost-effective than standard dressing changes.Conclusion: These results indicate that NPWT is efficacious, safe, and cost-effective in treating DFUs. Keywords: diabetic foot ulcers, negative-pressure wound therapy, complete wound closure, amputation, meta

  4. RESTING SYMPATHETIC BAROREFLEX SENSITIVITY IN SUBJECTS WITH LOW AND HIGH TOLERANCE TO CENTRAL HYPOVOLEMIA INDUCED BY LOWER BODY NEGATIVE PRESSURE

    Directory of Open Access Journals (Sweden)

    Carmen eHinojosa-Laborde

    2014-06-01

    Full Text Available Central hypovolemia elicited by orthostasis or hemorrhage triggers sympathetically-mediated baroreflex responses to maintain organ perfusion; these reflexes are less sensitive in patients with orthostatic intolerance, and during conditions of severe blood loss, may result in cardiovascular collapse (decompensatory or circulatory shock. The ability to tolerate central hypovolemia is variable and physiological factors contributing to tolerance are emerging. We tested the hypothesis that resting muscle sympathetic nerve activity (MSNA and sympathetic baroreflex sensitivity (BRS are attenuated in male and female subjects who have low tolerance (LT to central hypovolemia induced by lower body negative pressure (LBNP. MSNA and diastolic arterial pressure (DAP were recorded in 47 human subjects who subsequently underwent LBNP to tolerance (onset of presyncopal symptoms. LT subjects experienced presyncopal symptoms prior to completing LBNP of -60 mm Hg, and subjects with high tolerance (HT experienced presyncopal symptoms after completing LBNP after -60 mmHg. Contrary to our hypothesis, resting MSNA burst incidence was not different between LT and HT subjects, and was not related to time to presyncope. BRS was assessed as the slope of the relationship between spontaneous fluctuations in DAP and MSNA during 5 min of supine rest. MSNA burst incidence/DAP correlations were greater than or equal to 0.5 in 37 subjects (LT: n= 9; HT: n=28, and BRS was not different between LT and HT (-1.8 ± 0.3 vs. -2.2 ± 0.2 bursts•(100 beats-1•mmHg-1, p=0.29. We conclude that tolerance to central hypovolemia is not related to either resting MSNA or sympathetic BRS.

  5. In-flight Assessment of Lower Body Negative Pressure as a Countermeasure for Post-flight Orthostatic Intolerance

    Science.gov (United States)

    Charles, J. B.; Stenger, M. B.; Phillips, T. R.; Arzeno, N. M.; Lee, S. M. C.

    2009-01-01

    Introduction. We investigated the efficacy of combining fluid loading with sustained lower body negative pressure (LBNP) to reverse orthostatic intolerance associated with weightlessness during and immediately after Space Shuttle missions. Methods. Shuttle astronauts (n=13) underwent 4 hours of LBNP at -30 mm(Hg) and ingested water and salt ( soak treatment) during flight in two complementary studies. In the first study (n=8), pre-flight heart rate (HR) and blood pressure (BP) responses to an LBNP ramp (5-min stages of -10 mm(Hg) steps to -50 mm(Hg) were compared to responses in-flight one and two days after LBNP soak treatment. In the second study (n=5), the soak was performed 24 hr before landing, and post-flight stand test results of soak subjects were compared with those of an untreated cohort (n=7). In both studies, the soak was scheduled late in the mission and was preceded by LBNP ramp tests at approximately 3-day intervals to document the in-flight loss of orthostatic tolerance. Results. Increased HR and decreased BP responses to LBNP were evident early in-flight. In-flight, one day after LBNP soak, HR and BP responses to LBNP were not different from pre-flight, but the effect was absent the second day after treatment. Post-flight there were no between-group differences in HR and BP responses to standing, but all 5 treatment subjects completed the 5-minute stand test whereas 2 of 7 untreated cohort subjects did not. Discussion. Exaggerated HR and BP responses to LBNP were evident within the first few days of space flight, extending results from Skylab. The combined LBNP and fluid ingestion countermeasure restored in-flight LBNP HR and BP responses to pre-flight levels and provided protection of post-landing orthostatic function. Unfortunately, any benefits of the combined countermeasure were offset by the complexity of its implementation, making it inappropriate for routine application during Shuttle flights.

  6. Treatment of hardware infection after osteosynthesis of lower leg using negative pressure wound therapy and transforming powder dressing.

    Science.gov (United States)

    Marinović, Marin; Ivandcić, Aldo; Spanjol, Josip; Pina, Maja; Bakota, Bore; Bandalović, Ante; Cukeljs, Fabijan

    2014-12-01

    Fractures of the distal part of the lower leg are more common in everyday practice and traumatology. In young and active patients these injuries are mainly caused by high energy trauma. They are treated with external fixator in first step, and in second step, after sanation of the soft tissue, with open reduction and internal fixation (ORIF). It is very safe and effective method of treatment. Treatment of the infections that occur in the early postoperative period after open reduction and internal fixation represents a great problem and challenge for surgeons. It is widely accepted that the presence of deep infection can't be cured in the presence of hardware. However, removal of hardware in the presence of unhealed fractures significantly complicates sanation of infection and fracture itself We have decided to present a 35-years-old patient with a hardware infection with present chronic wound with hardware exposed eight months after the first operation and six months after second operation. The wound measured one centimeter in diameter with cell detritus and bad granulations tissue inside the wound. Hardwre was exposed in the depth of the wound.The secretion was minimal. Negative Pressure Wound Therapy (NPWT) was applicated after debridemet and lavage performed in ambulatory conditions. The starting therapy was continuously -125 mm Hg of vacuum. After five days of NPWT the defect was partially filled with granula- tion tissue. For another five days we continue with NPWT with the same values of-125 mm Hg pressure but in the inter- mitent mode. After that period we used transforming powder dressing for covering and protection of the wound with was filled with granulation tissue. Five days later, wound was completely healed with epithelisation. After four months of patient follow-up, we found the wound is completely repaired. The patient denies pain and has continued orderly flow of fracture healing, with no signs of infection.

  7. Role of different negative pressure values in the process of infected wounds treated by vacuum-assisted closure: an experimental study.

    Science.gov (United States)

    Zhou, Min; Yu, Aixi; Wu, Gang; Xia, Chengyan; Hu, Xiang; Qi, Baiwen

    2013-10-01

    Vacuum-assisted closure (VAC) device is widely used to treat infected wounds in clinical work. Although the effect of VAC with different negative pressure values is well established, whether different negative pressures could result in varying modulation of wound relative cytokines was not clear. We hypothesise that instead of the highest negative pressure value the suitable value for VAC is the one which is the most effective on regulating wound relative cytokines. Infected wounds created on pigs' back were used to investigate the effects of varying negative pressure values of VAC devices. Wounds were treated with VAC of different negative pressure values or moist gauze, which was set as control. The VAC foam, semiocclusive dresses and moist gauze were changed on days 3, 5, 7 and 9 after wounds were created. When changing dressings, tissues from wounds were harvested for bacteria count and histology examination including Masson's trichrome stain and immunohistochemistry for microvessels. Western blot was carried out to test the expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). Results showed that on days 3 and 5 the number of bacteria in wounds treated by VAC with 75, 150, 225 and 300 mmHg was significantly decreased compared with that in wounds treated by gauze and 0 mmHg pressure value. However, there was no difference in wounds treated with negative pressure values of 75 , 150, 225 and 300 mmHg at any time spot. Immunohistochemistry showed that more microvessels were generated in wounds treated by VAC using 75 and 150 mmHg negative pressure comparing with that using 225 and 300 mmHg on days 3 and 5. However this difference vanished on days 7 and 9. Morphological evaluation by Masson's trichrome staining showed increased collagen deposition in VAC of 75 and 150 mmHg compared with that in VAC of 225 and 300 mmHg. Western blot showed that the expression of VEGF and bFGF significantly increased when the wounds

  8. Intermittent subglottic secretion drainage may cause tracheal damage in patients with few oropharyngeal secretions.

    Science.gov (United States)

    Suys, E; Nieboer, K; Stiers, W; De Regt, J; Huyghens, L; Spapen, H

    2013-12-01

    Injurious prolapse of tracheal mucosa into the suction port has been reported in up to 50% of intubated patients receiving continuous aspiration of subglottic secretions. We investigated whether similar injury could be inflicted by automated intermittent aspiration. Six consecutive patients, intubated with the Mallinckrodt TaperGuard Evac™ endotracheal tube, were studied. A flow sensor was placed between the vacuum regulating system and the mucus collector. Intermittent suctioning was performed at a pressure of -125 mmHg with a 25s interval and duration of 15s. After 24h, a CT scan of the tracheal region was performed. Excessive negative suction pressure, a fast drop in aspiration flow to zero, and important "swinging" movements of secretions in the evacuation line were observed in all patients. Oral instillation of antiseptic mouthwash restored normal aspiration flow and secretion mobility. CT imaging showed marked entrapment of tracheal mucosa into the suction port in all patients. In patients with few oropharyngeal secretions, automated intermittent subglottic aspiration may result in significant and potential harmful invagination of tracheal mucosa into the suction lumen. A critical amount of fluid must be present in the oropharynx to assure adequate and safe aspiration. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Psychomotor performance during a 28 day head-down tilt with and without lower body negative pressure

    Science.gov (United States)

    Traon, A. Pavy-le; de Feneyrols, A. Rous; Cornac, A.; Abdeseelam, R.; N'uygen, D.; Lazerges, M.; Güell, A.; Bes, A.

    Several factors may affect psychomotor performance in space: sensory-motor changes, sleep disturbances, psychological modifications induced by the social isolation and confinement. However, psychomotor performance is difficult to assess. A battery of standardized and computerized tests, so-called "Automated Portable Test System" (APTS) was devised to ascertain the cognitive, perceptive and motor abilities and their possible fluctuations according to environmental effects. Antiorthostatic bedrest, often used to simulate weightlessness, (particularly cardiovascular modifications) also constitutes a situation of social confinement and isolation. During two bedrest experiments (with head-down tilt of -6°) of 28 days each, we intended to assess psychomotor performance of 6 males so as to determine whether: —on the one hand, it could be altered by remaining in decubitus; —on the other, the Lower Body Negative Pressure sessions, designed to prevent orthostatic intolerance back on Earth, could improve the performance. To accomplish this, part of the APTS tests as well as an automated perceptive attention test were performed. No downgrading of psychomotor performance was observed. On the contrary, the tasks were more accurately performed over time. In order to assess the experimental conditions on the acquisition phase, the learning curves were modelled. A beneficial effect of the LBNP sessions on simple tests involving the visual-motor coordination and attention faculties can only be regarded as a mere trend. Methods used in this experiment are also discussed.

  10. Negative pressure driven valence instability of Eu in cubic Eu0.4La0.6Pd3

    International Nuclear Information System (INIS)

    Pandey, Abhishek; Mazumdar, Chandan; Ranganathan, R

    2009-01-01

    We report the change in the valency of Eu-ions in the binary intermetallic cubic compound EuPd 3 induced by La doping at rare-earth sites. Doping of La generates negative chemical pressure in the lattice, resulting in a significant increase of the lattice parameter without altering the simple-cubic structure of the compound. Results of dc-magnetic measurements suggest that this increase in the lattice parameter is associated with the valence transition of Eu-ions from Eu 3+ to a mixed-valent state. As Eu 2+ -ions possess a large magnetic moment, this valence transition significantly modifies the magnetic behavior of the compound. In contrast to introducing boron at the vacant body center site of the unit cell to change the valency of Eu-ions, as in the case of EuPd 3 B, our results suggest it can also be altered by doping a rare-earth ion of larger size at the lattice site of Eu in EuPd 3 .

  11. Working in a danger zone: A qualitative study of Taiwanese nurses' work experiences in a negative pressure isolation ward.

    Science.gov (United States)

    Chen, Shu-Ling; Chen, Kuei-Ling; Lee, Li-Hung; Yang, Cheng-I

    2016-07-01

    Hospital nurses are frontline health care workers in controlling the spread of infectious diseases. It is not known if nurses working in negative pressure isolation wards (NPIWs) are better prepared than before to safely care for patients with common infectious diseases. For this qualitative descriptive study, 10 nurses were interviewed in depth about their experiences caring for patients in an NPIW. Tape recordings were transcribed verbatim and analyzed by qualitative content analysis. The following 5 themes were identified: (1) complexity of patient care, (2) dissatisfaction with the quantity and quality of protective equipment, (3) shortage of nursing staff, (4) continued worries about being infected, and (5) sensitivity to self-protection. Our participants' anxiety and uncertainty about being infected in the NPIW were increased by the complexity of patients' health problems and organizational factors. To protect themselves against infection before and during patient care, participants also developed sensitivity to, concepts about, and strategies to improve self-protection. NPIW administrators should pay more attention to nurses' concerns about improving the NPIW working environment, supply good quality protective equipment, and provide appropriate psychologic support and ongoing education to ensure that nurses feel safe while working. This ongoing education should refresh and update nurses' knowledge about disease transmission, therefore decreasing unnecessary anxiety based on misunderstandings about becoming infected. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Negative pressure wound therapy using polyvinyl alcohol foam to bolster full-thickness mesh skin grafts in dogs.

    Science.gov (United States)

    Or, Matan; Van Goethem, Bart; Kitshoff, Adriaan; Koenraadt, Annika; Schwarzkopf, Ilona; Bosmans, Tim; de Rooster, Hilde

    2017-04-01

    To report the use of negative pressure wound therapy (NPWT) with polyvinyl alcohol (PVA) foam to bolster full-thickness mesh skin grafts in dogs. Retrospective case series. Client-owned dogs (n = 8). Full-thickness mesh skin graft was directly covered with PVA foam. NPWT was maintained for 5 days (in 1 or 2 cycles). Grafts were evaluated on days 2, 5, 10, 15, and 30 for graft appearance and graft take, granulation tissue formation, and complications. Firm attachment of the graft to the recipient bed was accomplished in 7 dogs with granulation tissue quickly filling the mesh holes, and graft take considered excellent. One dog had bandage complications after cessation of the NPWT, causing partial graft loss. The PVA foam did not adhere to the graft or damage the surrounding skin. The application of NPWT with a PVA foam after full-thickness mesh skin grafting in dogs provides an effective method for securing skin grafts, with good graft acceptance. PVA foam can be used as a primary dressing for skin grafts, obviating the need for other interposing materials to protect the graft and the surrounding skin. © 2017 The American College of Veterinary Surgeons.

  13. Coverage of Deep Cutaneous Wounds Using Dermal Template in Combination with Negative-pressure Therapy and Subsequent Skin Graft

    Science.gov (United States)

    Chang, Alexandre A.; Lobato, Rodolfo C.; Nakamoto, Hugo A.; Tuma, Paulo; Ferreira, Marcus C.

    2014-01-01

    Background: We consider the use of dermal matrix associated with a skin graft to cover deep wounds in the extremities when tendon and bone are exposed. The objective of this article was to evaluate the efficacy of covering acute deep wounds through the use of a dermal regeneration template (Integra) associated with vacuum therapy and subsequent skin grafting. Methods: Twenty patients were evaluated prospectively. All of them had acute (up to 3 weeks) deep wounds in the limbs. We consider a deep wound to be that with exposure of bone, tendon, or joint. Results: The average area of integration of the dermal regeneration template was 86.5%. There was complete integration of the skin graft over the dermal matrix in 14 patients (70%), partial integration in 5 patients (25%), and total loss in 1 case (5%). The wound has completely closed in 95% of patients. Conclusions: The use of Integra dermal template associated with negative-pressure therapy and skin grafting showed an adequate rate of resolution of deep wounds with low morbidity. PMID:25289363

  14. Negative Pressure Wound Therapy Applied Before and After Split-Thickness Skin Graft Helps Healing of Fournier Gangrene

    Science.gov (United States)

    Ye, Junna; Xie, Ting; Wu, Minjie; Ni, Pengwen; Lu, Shuliang

    2015-01-01

    Abstract Fournier gangrene is a rare but highly infectious disease characterized by fulminant necrotizing fasciitis involving the genital and perineal regions. Negative pressure wound therapy (NPWT; KCI USA Inc, San Antonio, TX) is a widely adopted technique in many clinical settings. Nevertheless, its application and effect in the treatment of Fournier gangrene are unclear. A 47-year-old male patient was admitted with an anal abscess followed by a spread of the infection to the scrotum, which was caused by Pseudomonas aeruginosa. NPWT was applied on the surface of the scrotal area and continued for 10 days. A split-thickness skin graft from the scalp was then grafted to the wound, after which, NPWT utilizing gauze sealed with an occlusive dressing and connected to a wall suction was employed for 7 days to secure the skin graft. At discharge, the percentage of the grafted skin alive on the scrotum was 98%. The wound beside the anus had decreased to 4 × 0.5 cm with a depth of 1 cm. Follow-up at the clinic 1 month later showed that both wounds had healed. The patient did not complain of any pain or bleeding, and was satisfied with the outcome. NPWT before and after split-thickness skin grafts is safe, well tolerated, and efficacious in the treatment of Fournier gangrene. PMID:25654376

  15. Anomalous thermal expansion, negative linear compressibility, and high-pressure phase transition in ZnAu2(CN) 4 : Neutron inelastic scattering and lattice dynamics studies

    Science.gov (United States)

    Gupta, Mayanak K.; Singh, Baltej; Mittal, Ranjan; Zbiri, Mohamed; Cairns, Andrew B.; Goodwin, Andrew L.; Schober, Helmut; Chaplot, Samrath L.

    2017-12-01

    We present temperature-dependent inelastic-neutron-scattering measurements, accompanied by ab initio calculations of the phonon spectra and elastic properties as a function of pressure to quantitatively explain an unusual combination of negative thermal expansion and negative linear compressibility behavior of ZnAu2(CN) 4 . The mechanism of the negative thermal expansion is identified in terms of specific anharmonic phonon modes that involve bending of the -Zn-NC-Au-CN-Zn- linkage. The soft phonon at the L point at the Brillouin zone boundary quantitatively relates to the high-pressure phase transition at about 2 GPa. The ambient pressure structure is also found to be close to an elastic instability that leads to a weakly first-order transition.

  16. Use of negative-pressure dressings and split-thickness skin grafts following penile shaft reduction and reduction scrotoplasty in the management of penoscrotal elephantiasis.

    Science.gov (United States)

    Stokes, Tracey H; Follmar, Keith E; Silverstein, Ari D; Weizer, Alon Z; Donatucci, Craig F; Anderson, Everett E; Erdmann, Detlev

    2006-06-01

    From 1988 to 2005, 8 men who presented with penoscrotal elephantiasis underwent penile shaft degloving and reduction scrotoplasty, followed by transplantation of a split-thickness skin graft (STSG) to the penile shaft. The etiology of elephantiasis in these patients included self-injection of viscous fluid and postsurgical obstructive lymphedema. In the 6 most recent cases, negative-pressure dressings were applied over the STSG to promote graft take, and STSG take rate was 100%. The results of our series corroborate those of a previous report, which showed circumferential negative-pressure dressings to be safe and efficacious in bolstering STSGs to the penile shaft. Furthermore, these results suggest that the use of negative-pressure dressings may improve graft take in this patient population.

  17. How bacterial cell division might cheat turgor pressure - a unified mechanism of septal division in Gram-positive and Gram-negative bacteria.

    Science.gov (United States)

    Erickson, Harold P

    2017-08-01

    An important question for bacterial cell division is how the invaginating septum can overcome the turgor force generated by the high osmolarity of the cytoplasm. I suggest that it may not need to. Several studies in Gram-negative bacteria have shown that the periplasm is isoosmolar with the cytoplasm. Indirect evidence suggests that this is also true for Gram-positive bacteria. In this case the invagination of the septum takes place within the uniformly high osmotic pressure environment, and does not have to fight turgor pressure. A related question is how the V-shaped constriction of Gram-negative bacteria relates to the plate-like septum of Gram-positive bacteria. I collected evidence that Gram-negative bacteria have a latent capability of forming plate-like septa, and present a model in which septal division is the basic mechanism in both Gram-positive and Gram-negative bacteria. © 2017 WILEY Periodicals, Inc.

  18. Quasistatic Dynamics with Intermittency

    International Nuclear Information System (INIS)

    Leppänen, Juho; Stenlund, Mikko

    2016-01-01

    We study an intermittent quasistatic dynamical system composed of nonuniformly hyperbolic Pomeau–Manneville maps with time-dependent parameters. We prove an ergodic theorem which shows almost sure convergence of time averages in a certain parameter range, and identify the unique physical family of measures. The theorem also shows convergence in probability in a larger parameter range. In the process, we establish other results that will be useful for further analysis of the statistical properties of the model.

  19. Quasistatic Dynamics with Intermittency

    Energy Technology Data Exchange (ETDEWEB)

    Leppänen, Juho; Stenlund, Mikko, E-mail: mikko.stenlund@helsinki.fi [University of Helsinki, Department of Mathematics and Statistics (Finland)

    2016-06-15

    We study an intermittent quasistatic dynamical system composed of nonuniformly hyperbolic Pomeau–Manneville maps with time-dependent parameters. We prove an ergodic theorem which shows almost sure convergence of time averages in a certain parameter range, and identify the unique physical family of measures. The theorem also shows convergence in probability in a larger parameter range. In the process, we establish other results that will be useful for further analysis of the statistical properties of the model.

  20. Negative pressure wound therapy via vacuum-assisted closure following partial foot amputation: what is the role of wound chronicity?

    Science.gov (United States)

    Armstrong, David G; Lavery, Lawrence A; Boulton, Andrew J M

    2007-03-01

    Randomised clinical trials (RCTs) to evaluate diabetic foot wound therapies have systematically eliminated large acute wounds from evaluation, focusing only on smaller chronic wounds. The purpose of this study was to evaluate the proportion and rate of wound healing in acute and chronic wounds after partial foot amputation in individuals with diabetes treated with negative pressure wound therapy (NPWT) delivered by the vacuum-assisted closure (VAC) device or with standard wound therapy (SWT). This study constitutes a secondary analysis of patients enrolled in a 16-week RCT of NPWT: 162 open foot amputation wounds (mean wound size = 20.7 cm(2)) were included. Acute wounds were defined as the wounds less than 30 days after amputation, whereas chronic wounds as the wounds greater than 30 days. Inclusion criteria consisted of individuals older than 18 years, presence of a diabetic foot amputation wound up to the transmetatarsal level and adequate perfusion. Wound size and healing were confirmed by independent, blinded wound evaluators. Analyses were done on an intent-to-treat basis. There was a significantly higher proportion of acute wounds (SWT = 59; NPWT = 63) than chronic wounds (SWT = 26; NPWT = 14), evaluated in this clinical trial (P = 0.001). There was no significant difference in the proportion of acute and chronic wounds achieving complete wound closure in either treatment group. Despite this finding, the Kaplan-Meier curves demonstrated statistically significantly faster healing in the NPWT group in both acute (P = 0.030) and chronic wounds (P = 0.033). Among the patients treated with NPWT via the VAC, there was not a significant difference in healing as a function of chronicity. In both the acute and the chronic wound groups, results for patients treated with NPWT were superior to those for the patients treated with SWT. These results appear to indicate that wound duration should not deter the clinician from using this modality to treat complex wounds.

  1. Negative pressure wound therapy in the management of late deep infections after open reconstruction of achilles tendon rupture.

    Science.gov (United States)

    Mosser, Philipp; Kelm, Jens; Anagnostakos, Konstantinos

    2015-01-01

    Infection is a major complication after open reconstruction of Achilles tendon ruptures. We report on the use of vacuum-assisted closure (VAC) therapy in the treatment of late deep infections after open Achilles tendon reconstruction. Six patients (5 males [83.33%], 1 female [16.67%]; mean age, 52.8 [range 37 to 66] years) were been treated using an identical protocol. Surgical management consisted of debridement, lavage, and necrectomy of infected tendon parts. The VAC therapy was used for local wound preconditioning and infection management. A continuous negative pressure of 125 mm Hg was applied on each wound. For final wound closure, a split-thickness skin graft was performed. The skin graft healing process was also supported by VAC therapy during the first 5 days. The VAC dressings were changed a mean average of 3 (range 1 to 4) times until split-thickness skin grafting could be performed. The mean total duration of the VAC therapy was 13.6 ± 5.9 days. The mean hospital stay was 31.2 ± 15.9 days. No complications with regard to bleeding, seroma, or hematoma formation beneath the skin graft were observed. At a mean follow-up duration of 29.9 (range 4 to 65) months, no re-infection or infection persistence was observed. The VAC device seems to be a valuable tool in the treatment of infected tendons. The generalization of these conclusions should await the results of future studies with larger patient series. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. A compare between myocardial topical negative pressure levels of -25 mmHg and -50 mmHg in a porcine model

    DEFF Research Database (Denmark)

    Lindstedt, Sandra; Paulsson, Per; Mokhtari, Arash

    2008-01-01

    Topical negative pressure (TNP), widely used in wound therapy, is known to stimulate wound edge blood flow, granulation tissue formation, angiogenesis, and revascularization. We have previously shown that application of a TNP of -50 mmHg to the myocardium significantly increases microvascular blo...

  3. Major bleeding during negative pressure wound/V.A.C.®--therapy for postsurgical deep sternal wound infection--a critical appraisal

    NARCIS (Netherlands)

    van Wingerden, Jan J.; Segers, Patrique; Jekel, Lilian

    2011-01-01

    Negative-pressure wound therapy, commercially known as vacuum-assisted closure (V.A.C.®) therapy, has become one of the most popular (and efficacious) interim (prior to flap reconstruction) or definite methods of managing deep sternal wound infection. Complications such as profuse bleeding, which

  4. Negative pressure of the environmental air in the cleaning area of the materials and sterilization center: a systematic review.

    Science.gov (United States)

    Ciofi-Silva, Caroline Lopes; Hansen, Lisbeth Lima; Almeida, Alda Graciele Claudio Dos Santos; Kawagoe, Julia Yaeko; Padoveze, Maria Clara; Graziano, Kazuko Uchikawa

    2016-09-01

    to analyze the scientific evidence on aerosols generated during cleaning activities of health products in the Central Service Department (CSD) and the impact of the negative pressure of the ambient air in the cleaning area to control the dispersion of aerosols to adjacent areas. for this literature systematic review the following searches were done: search guidelines, manuals or national and international technical standards given by experts; search in the portal and databases PubMed, Scopus, CINAHL and Web of Science; and a manual search of scientific articles. the five technical documents reviewed recommend that the CSD cleaning area should have a negative differential ambient air pressure, but scientific articles on the impact of this intervention were not found. The four articles included talked about aerosols formed after the use of a ultrasonic cleaner (an increased in the contamination especially during use) and pressurized water jet (formation of smaller aerosols 5μm). In a study, the aerosols formed from contaminated the hot tap water with Legionella pneumophila were evaluated. there is evidence of aerosol formation during cleanup activities in CSD. Studies on occupational diseases of respiratory origin of workers who work in CSD should be performed. analisar as evidências científicas sobre aerossóis gerados durante atividades de limpeza dos produtos para saúde no Centro de Material e Esterilização (CME) e o impacto da pressão negativa do ar ambiente na área de limpeza para controle da dispersão de aerossóis para áreas adjacentes. para essa revisão sistemática de literatura foram realizadas: busca de diretrizes, manuais ou normas técnicas nacionais e internacionais indicadas por especialistas; busca no portal e bases de dados PUBMED, SCOPUS, Cinahl e Web of Science; e busca manual de artigos científicos. Os cinco documentos técnicos analisados preconizam que na área de limpeza do CME haja diferencial negativo de pressão do ar ambiente

  5. The Challenge of Providing Safe Water with an Intermittently Supplied Piped Water Distribution System

    Science.gov (United States)

    Kumpel, E.; Nelson, K. L.

    2012-12-01

    An increasing number of urban residents in low- and middle-income countries have access to piped water; however, this water is often not available continuously. 84% of reporting utilities in low-income countries provide piped water for fewer than 24 hours per day (van den Berg and Danilenko, 2010), while no major city in India has continuous piped water supply. Intermittent water supply leaves pipes vulnerable to contamination and forces households to store water or rely on alternative unsafe sources, posing a health threat to consumers. In these systems, pipes are empty for long periods of time and experience low or negative pressure even when water is being supplied, leaving them susceptible to intrusion from sewage, soil, or groundwater. Households with a non-continuous supply must collect and store water, presenting more opportunities for recontamination. Upgrading to a continuous water supply, while an obvious solution to these challenges, is currently out of reach for many resource-constrained utilities. Despite its widespread prevalence, there are few data on the mechanisms causing contamination in an intermittent supply and the frequency with which it occurs. Understanding the impact of intermittent operation on water quality can lead to strategies to improve access to safe piped water for the millions of people currently served by these systems. We collected over 100 hours of continuous measurements of pressure and physico-chemical water quality indicators and tested over 1,000 grab samples for indicator bacteria over 14 months throughout the distribution system in Hubli-Dharwad, India. This data set is used to explore and explain the mechanisms influencing water quality when piped water is provided for a few hours every 3-5 days. These data indicate that contamination occurs along the distribution system as water travels from the treatment plant to reservoirs and through intermittently supplied pipes to household storage containers, while real

  6. Intermittency in Complex Flows

    Science.gov (United States)

    Ben Mahjoub, Otman; Redondo, Jose M.

    2017-04-01

    Experimental results of the complex turbulent wake of a cilinder in 2D [1] and 3D flows [2] were used to investigate the scaling of structure functions, similar research was also performed on wave propagation and breaking in the Ocean [3], in the the stratified Atmosphere (ABL) [4] and in a 100large flume (UPC) for both regular and irregular waves, where long time series of waves propagating and generating breaking turbulence velocity rms and higher order measurements were taken in depth. [3,5] by means of a velocimeter SONTEK3-D. The probability distribution functions of the velocity differences and their non Gaussian distribution related to the energy spectrum indicate that irregularity is an important source of turbulence. From Kolmogorov's K41 and K61 intermittency correction: the p th-order longitudinal velocity structure function δul at scale l in the inertial range of three-dimensional fully developed turbulence is related by ⟨δup⟩ = ⟨(u(x+ l)- u(x))p⟩ ˜ ɛp0/3lp/3 l where ⟨...⟩ represents the spatial average over flow domain, with ɛ0 the mean energy dissipation per unit mass and l is the separation distance. The importance of the random nature of the energy dissipation led to the K62 theory of intermittency, but locality and non-homogeneity are key issues. p p/3 p/3 ξd ⟨δul⟩ ˜ ⟨ɛl ⟩l ˜ l and ξp = p 3 + τp/3 , where now ɛl is a fractal energy dissipation at scale l, τp/3 is the scaling of and ξp is the scaling exponent of the velocity structure function of order p. Both in K41 and K62, the structure functions of third order related to skewness is ξ3 = 1. But this is not true either. We show that scaling exponents ξp do deviate from early studies that only investigated homogeneous turbulence, where a large inertial range dominates. The use of multi-fractal analysis and improvements on Structure function calculations on standard Enhanced mixing is an essential property of turbulence and efforts to alter and to control

  7. Intermittency in nuclear multifragmentation

    International Nuclear Information System (INIS)

    Ploszajczak, M.; Tucholski, A.

    1990-07-01

    Fluctuations of the fragment size distribution in a percolation model and in nuclear multifragmentation following the breakup of high energy nuclei in the nuclear emulsion are studied using the method of scaled factorial moments. An intermittent patern of fluctuations is found in the data as well as in the percolation lattice calculation. This is a consequence of both a self-similarity in the fragment size distribution and a random character for the scaling law. These fluctuations are in general well-described by percolation model. The multifractal dimensions are calculated and their relevance to the study of possible critical behaviour is pointed out. (orig.)

  8. Economic and organizational sustainability of a negative-pressure portable device for the prevention of surgical-site complications

    Directory of Open Access Journals (Sweden)

    Foglia E

    2017-06-01

    Full Text Available Emanuela Foglia,1 Lucrezia Ferrario,1 Elisabetta Garagiola,1 Giuseppe Signoriello,2 Gianluca Pellino,3 Davide Croce,1,4 Silvestro Canonico3 1Centre for Health Economics, Social and Health Care Management - LIUC University, Castellanza, Italy; 2Department of Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy; 3School of Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy; 4School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South \tAfrica Purpose: Surgical-site complications (SSCs affect patients’ clinical pathway, prolonging their hospitalization and incrementing their management costs. The present study aimed to assess the economic and organizational implications of a portable device for negative-pressure wound therapy (NPWT implementation, compared with the administration of pharmacological therapies alone for preventing surgical complications in patients undergoing general, cardiac, obstetrical–gynecological, or orthopedic surgical procedures.Patients and methods: A total of 8,566 hospital procedures, related to the year 2015 from one hospital, were evaluated considering infection risk index, occurrence rates of SSCs, drug therapies, and surgical, diagnostic, and specialist procedures and hematological exams. Activity-based costing and budget impact analyses were implemented for the economic assessment.Results: Patients developing an SSC absorbed i 64.27% more economic resources considering the length of stay (€ 8,269±2,096 versus € 5,034±2,901, p<0.05 and ii 42.43% more economic resources related to hematological and diagnostic procedures (€ 639±117 versus € 449±72, p<0.05. If the innovative device had been used over the 12-month time period, it would have decreased the risk of developing SSCs; the hospital would have realized an average reduction in health care expenditure equal to −0.69% (−€ 483

  9. [Can Topical Negative Pressure Therapy be Performed as a Cost-Effective General Surgery Procedure in the German DRG System?].

    Science.gov (United States)

    Hirche, Z; Xiong, L; Hirche, C; Willis, S

    2016-04-01

    Topical negative pressure therapy (TNPT) has been established for surgical wound therapy with different indications. Nevertheless, there is only sparse evidence regarding its therapeutic superiority or cost-effectiveness in the German DRG system (G-DRG). This study was designed to analyse the cost-effectiveness of TNPT in the G-DRG system with a focus on daily treatment costs and reimbursement in a general surgery care setting. In this retrospective study, we included 176 patients, who underwent TNPT between 2007 and 2011 for general surgery indications. Analysis of the cost-effectiveness involved 149 patients who underwent a simulation to calculate the reimbursement with or without TNPT by a virtual control group in which the TNP procedure was withdrawn for DRG calculation. This was followed by a calculation of costs for wound dressings and TNPT rent and material costs. Comparison between the "true" and the virtual group enabled calculation of the effective remaining surplus per case. Total reimbursement by included TNPT cases was 2,323 ,70.04 €. Costs for wound dressings and TNPT rent were 102,669.20 €. In 41 cases there was a cost-effectiveness (27.5%) with 607,422.03 € with TNP treatment, while the control group without TNP generated revenues of 442,015.10 €. Costs for wound dressings and TNPT rent were 47,376.68 €. In the final account we could generate a cost-effectiveness of 6759 € in 5 years per 149 patients by TNPT. In 108 cases there was no cost-effectiveness (72.5%). TNPT applied in a representative general surgery setting allows for wound therapy without a major financial burden. Based on the costs for wound dressings and TNPT rent, a primarily medically based decision when to use TNPT can be performed in a balanced product cost accounting. This study does not analyse the superiority of TNPT in wound care, so further prospective studies are required which focus on therapeutic superiority and cost-effectiveness. Georg Thieme

  10. Effects of negative pressure wound therapy on the expression of EDA+ FN in granulation tissues of human diabetic foot wounds

    Directory of Open Access Journals (Sweden)

    Shao-ling YANG

    2017-04-01

    Full Text Available Objective  To investigate the effects of negative pressure wound therapy (NPWT on the expression of EDA+ FN in granulation tissues of human diabetic foot wounds. Methods  Forty patients with diabetic foot wounds fitting the inclusion criteria, admitted from Jan. 2014 to Jun. 2016, were randomly and equally apportioned to receive either NPWT or conventional gauze therapy (control for 14 days. Granulated tissue biopsies were collected before (0 day and after (14 day treatment in both groups. All biopsies were subdivided into two parts. One part was preserved in 4% paraformaldehyde for immunocytochemical staining of EDA+ FN, and the other part was stored at –80℃for Western blotting and PCR analysis of EDA+ FN. Results  The immunohistochemical analysis revealed that the mean area density of EDA+ FN increased in both NPWT group and control group at day 14 relative to day 0, but the change value of mean area density was higher in NPWT group than in control group (P<0.01. Western blotting showed that the relative protein levels of EDA+ FN increased in both NPWT group and control group at day 14 relative to day 0, but the change value of relative protein levels of EDA+ FN was higher in NPWT group than in control group (P<0.01. The real time PCR analysis demonstrated that the relative mRNA levels of EDA+ FN increased in both NPWT group and control group at day 14 relative to day 0, but the change value of relative mRNA levels of EDA+ FN was higher in NPWT group than in control group (P<0.01. The results demonstrated the higher protein and mRNA levels of EDA+ FN in NPWT group than that in control group. Conclusion  NPWT obviously enhances EDA+ FN expression in granulation tissue of diabetic foot wound, as a result promotes wound healing. DOI: 10.11855/j.issn.0577-7402.2017.03.09

  11. Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs' teeth with apical periodontitis.

    Science.gov (United States)

    da Silva, Lea Assed Bezerra; Nelson-Filho, Paulo; da Silva, Raquel Assed Bezerra; Flores, Daniel Silva Herzog; Heilborn, Carlos; Johnson, James D; Cohenca, Nestor

    2010-05-01

    The objective of this study was to evaluate in vivo the revascularization and the apical and periapical repair after endodontic treatment using 2 techniques for root canal disinfection (apical negative pressure irrigation versus apical positive pressure irrigation plus triantibiotic intracanal dressing) in immature dogs' teeth with apical periodontitis. Two test groups of canals with experimentally induced apical periodontitis were evaluated according to the disinfection technique: Group 1, apical negative pressure irrigation (EndoVac system), and Group 2, apical positive pressure irrigation (conventional irrigation) plus triantibiotic intracanal dressing. In Group 3 (positive control), periapical lesions were induced, but no endodontic treatment was done. Group 4 (negative control) was composed of sound teeth. The animals were killed after 90 days and the maxillas and mandibles were subjected to histological processing. The sections were stained with hematoxylin and eosin and Mallory Trichrome and examined under light microscopy. A description of the apical and periapical features was done and scores were attributed to the following histopathological parameters: newly formed mineralized apical tissue, periapical inflammatory infiltrate, apical periodontal ligament thickness, dentin resorption, and bone tissue resorption. Intergroup comparisons were done by the Kruskal-Wallis and Dunn's tests (alpha = 0.05). Although statistically significant difference was found only for the inflammatory infiltrate (P irrigation with the EndoVac system can be considered as a promising disinfection protocol in immature teeth with apical periodontitis, suggesting that the use of intracanal antibiotics might not be necessary. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  12. Cracked rocks with positive and negative Poisson's ratio: real-crack properties extracted from pressure dependence of elastic-wave velocities

    Science.gov (United States)

    Zaitsev, Vladimir Y.; Radostin, Andrey V.; Dyskin, Arcady V.; Pasternak, Elena

    2017-04-01

    We report results of analysis of literature data on P- and S-wave velocities of rocks subjected to variable hydrostatic pressure. Out of about 90 examined samples, in more than 40% of the samples the reconstructed Poisson's ratios are negative for lowest confining pressure with gradual transition to the conventional positive values at higher pressure. The portion of rocks exhibiting negative Poisson's ratio appeared to be unexpectedly high. To understand the mechanism of negative Poisson's ratio, pressure dependences of P- and S-wave velocities were analyzed using the effective medium model in which the reduction in the elastic moduli due to cracks is described in terms of compliances with respect to shear and normal loading that are imparted to the rock by the presence of cracks. This is in contrast to widely used descriptions of effective cracked medium based on a specific crack model (e.g., penny-shape crack) in which the ratio between normal and shear compliances of such a crack is strictly predetermined. The analysis of pressure-dependences of the elastic wave velocities makes it possible to reveal the ratio between pure normal and shear compliances (called q-ratio below) for real defects and quantify their integral content in the rock. The examination performed demonstrates that a significant portion (over 50%) of cracks exhibit q-ratio several times higher than that assumed for the conventional penny-shape cracks. This leads to faster reduction of the Poisson's ratio with increasing the crack concentration. Samples with negative Poisson's ratio are characterized by elevated q-ratio and simultaneously crack concentration. Our results clearly indicate that the traditional crack model is not adequate for a significant portion of rocks and that the interaction between the opposite crack faces leading to domination of the normal compliance and reduced shear displacement discontinuity can play an important role in the mechanical behavior of rocks.

  13. Metabolic Effects of Intermittent Fasting.

    Science.gov (United States)

    Patterson, Ruth E; Sears, Dorothy D

    2017-08-21

    The objective of this review is to provide an overview of intermittent fasting regimens, summarize the evidence on the health benefits of intermittent fasting, and discuss physiological mechanisms by which intermittent fasting might lead to improved health outcomes. A MEDLINE search was performed using PubMed and the terms "intermittent fasting," "fasting," "time-restricted feeding," and "food timing." Modified fasting regimens appear to promote weight loss and may improve metabolic health. Several lines of evidence also support the hypothesis that eating patterns that reduce or eliminate nighttime eating and prolong nightly fasting intervals may result in sustained improvements in human health. Intermittent fasting regimens are hypothesized to influence metabolic regulation via effects on (a) circadian biology, (b) the gut microbiome, and (c) modifiable lifestyle behaviors, such as sleep. If proven to be efficacious, these eating regimens offer promising nonpharmacological approaches to improving health at the population level, with multiple public health benefits.

  14. Major bleeding during negative pressure wound/V.A.C.® - therapy for postsurgical deep sternal wound infection - a critical appraisal

    Directory of Open Access Journals (Sweden)

    Segers Patrique

    2011-09-01

    Full Text Available Abstract Negative-pressure wound therapy, commercially known as vacuum-assisted closure (V.A.C.® therapy, has become one of the most popular (and efficacious interim (prior to flap reconstruction or definite methods of managing deep sternal wound infection. Complications such as profuse bleeding, which may occur during negative-pressure therapy but not necessarily due to it, are often attributed to a single factor and reported as such. However, despite the wealth of clinical experience internationally available, information regarding certain simple considerations is still lacking. Garnering information on all the factors that could possibly influence the outcome has become more difficult due to a (fortunate decrease in the incidence of deep sternal wound infection. If more insight is to be gained from fewer clinical cases, then various potentially confounding factors should be fully disclosed before complications can be attributed to the technique itself or improvements to negative-pressure wound therapy for deep sternal wound infection can be accepted as evidence-based and the guidelines for its use adapted. The authors propose the adoption of a simple checklist in such cases.

  15. Effect of negative pressure therapy on repair of soft tissues of the lower extremities in patients with neuropathic and neuroischaemic forms of diabetic foot syndrome

    Directory of Open Access Journals (Sweden)

    Ekaterina Leonidovna Zaytseva

    2014-06-01

    Full Text Available Aim. To evaluate the efficiency of topical negative pressure wound therapy (NPWT compared with standard therapy for the regeneration of the soft tissues of the lower extremities in patients with diabetic foot syndrome. Materials and Methods. The effects of negative pressure therapy on the clinical (size, tissue oxygenation, histological (light microscopy and immunohistochemical (CD68, MMP-9, TIMP-1 aspects of repair of the soft tissue of the lower extremities in patients with diabetes mellitus were compared with those of standard treatment. Thirty-one patients with diabetic foot ulcers were included in the study from the moment of debridement until the plastic closure of the wound. During the perioperative period, 13 patients received NPWT (-90 to -120 mmHg and 18 patients received standard therapy. Results. A reduction of the wound area (26.6%?17.2% and the depth of the defects (40.5%?25.6% were achieved with negative pressure therapy compared with baseline data. In the control group, the corresponding values were 25.3%?19.4% and 21.8%?21.6%, respectively. The results of transcutaneous oximetry showed a greater increase in the level of local hemodynamics in the study group (p

  16. Stability of the geometrically frustrated magnetic state of Ca3CoRhO6 to applications of positive and negative pressure

    International Nuclear Information System (INIS)

    Mohapatra, Niharika; Iyer, Kartik K; Jammalamadaka, S Narayana; Sampathkumaran, E V; Rayaprol, Sudhindra

    2008-01-01

    The influence of negative chemical pressure induced by gradual replacement of Ca by Sr as well as of external pressure (up to 10 kbar) on the magnetism of Ca 3 CoRhO 6 has been investigated by magnetization studies. It is found that the solid solution, Ca 3-x Sr x CoRhO 6 , exists at least until about x = 1.0 without any change in the crystal structure. Apart from insensitivity of the spin-chain feature to volume expansion, the characteristic features of geometrical frustration interestingly appear at the same temperatures for all compositions, in sharp contrast to the response to Y substitution for Ca (reported previously). Interestingly, the huge frequency dependence of ac susceptibility known for the parent compound persists for all compositions. We do not find a change in the properties under external pressure. The stability of the magnetic anomalies of this compound to volume change (about 4%) is puzzling

  17. Robust high pressure stability and negative thermal expansion in sodium-rich antiperovskites Na{sub 3}OBr and Na{sub 4}OI{sub 2}

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yonggang, E-mail: yyggwang@gmail.com, E-mail: yangwg@hpstar.ac.cn, E-mail: yusheng.zhao@unlv.edu [High Pressure Science and Engineering Center, University of Nevada, Las Vegas, Nevada 89154 (United States); Institute of Nanostructured Functional Materials, Huanghe Science and Technology College, Zhengzhou, Henan 450006 (China); High Pressure Synergetic Consortium (HPSynC), Geophysical Laboratory, Carnegie Institution of Washington, Argonne, Illinois 60439 (United States); Wen, Ting [Institute of Nanostructured Functional Materials, Huanghe Science and Technology College, Zhengzhou, Henan 450006 (China); Park, Changyong; Kenney-Benson, Curtis [High Pressure Collaborative Access Team (HPCAT), Geophysical Laboratory, Carnegie Institution of Washington, Argonne, Illinois 60439 (United States); Pravica, Michael; Zhao, Yusheng, E-mail: yyggwang@gmail.com, E-mail: yangwg@hpstar.ac.cn, E-mail: yusheng.zhao@unlv.edu [High Pressure Science and Engineering Center, University of Nevada, Las Vegas, Nevada 89154 (United States); Yang, Wenge, E-mail: yyggwang@gmail.com, E-mail: yangwg@hpstar.ac.cn, E-mail: yusheng.zhao@unlv.edu [High Pressure Synergetic Consortium (HPSynC), Geophysical Laboratory, Carnegie Institution of Washington, Argonne, Illinois 60439 (United States); Center for High Pressure Science and Technology Advanced Research (HPSTAR), Shanghai 201203 (China)

    2016-01-14

    The structure stability under high pressure and thermal expansion behavior of Na{sub 3}OBr and Na{sub 4}OI{sub 2}, two prototypes of alkali-metal-rich antiperovskites, were investigated by in situ synchrotron X-ray diffraction techniques under high pressure and low temperature. Both are soft materials with bulk modulus of 58.6 GPa and 52.0 GPa for Na{sub 3}OBr and Na{sub 4}OI{sub 2}, respectively. The cubic Na{sub 3}OBr structure and tetragonal Na{sub 4}OI{sub 2} with intergrowth K{sub 2}NiF{sub 4} structure are stable under high pressure up to 23 GPa. Although being a characteristic layered structure, Na{sub 4}OI{sub 2} exhibits nearly isotropic compressibility. Negative thermal expansion was observed at low temperature range (20–80 K) in both transition-metal-free antiperovskites for the first time. The robust high pressure structure stability was examined and confirmed by first-principles calculations among various possible polymorphisms qualitatively. The results provide in-depth understanding of the negative thermal expansion and robust crystal structure stability of these antiperovskite systems and their potential applications.

  18. Robust high pressure stability and negative thermal expansion in sodium-rich antiperovskites Na3OBr and Na4OI2

    International Nuclear Information System (INIS)

    Wang, Yonggang; Wen, Ting; Park, Changyong; Kenney-Benson, Curtis; Pravica, Michael; Zhao, Yusheng; Yang, Wenge

    2016-01-01

    The structure stability under high pressure and thermal expansion behavior of Na 3 OBr and Na 4 OI 2 , two prototypes of alkali-metal-rich antiperovskites, were investigated by in situ synchrotron X-ray diffraction techniques under high pressure and low temperature. Both are soft materials with bulk modulus of 58.6 GPa and 52.0 GPa for Na 3 OBr and Na 4 OI 2 , respectively. The cubic Na 3 OBr structure and tetragonal Na 4 OI 2 with intergrowth K 2 NiF 4 structure are stable under high pressure up to 23 GPa. Although being a characteristic layered structure, Na 4 OI 2 exhibits nearly isotropic compressibility. Negative thermal expansion was observed at low temperature range (20–80 K) in both transition-metal-free antiperovskites for the first time. The robust high pressure structure stability was examined and confirmed by first-principles calculations among various possible polymorphisms qualitatively. The results provide in-depth understanding of the negative thermal expansion and robust crystal structure stability of these antiperovskite systems and their potential applications

  19. A Risk Analysis Methodology to Address Human and Organizational Factors in Offshore Drilling Safety: With an Emphasis on Negative Pressure Test

    Science.gov (United States)

    Tabibzadeh, Maryam

    According to the final Presidential National Commission report on the BP Deepwater Horizon (DWH) blowout, there is need to "integrate more sophisticated risk assessment and risk management practices" in the oil industry. Reviewing the literature of the offshore drilling industry indicates that most of the developed risk analysis methodologies do not fully and more importantly, systematically address the contribution of Human and Organizational Factors (HOFs) in accident causation. This is while results of a comprehensive study, from 1988 to 2005, of more than 600 well-documented major failures in offshore structures show that approximately 80% of those failures were due to HOFs. In addition, lack of safety culture, as an issue related to HOFs, have been identified as a common contributing cause of many accidents in this industry. This dissertation introduces an integrated risk analysis methodology to systematically assess the critical role of human and organizational factors in offshore drilling safety. The proposed methodology in this research focuses on a specific procedure called Negative Pressure Test (NPT), as the primary method to ascertain well integrity during offshore drilling, and analyzes the contributing causes of misinterpreting such a critical test. In addition, the case study of the BP Deepwater Horizon accident and their conducted NPT is discussed. The risk analysis methodology in this dissertation consists of three different approaches and their integration constitutes the big picture of my whole methodology. The first approach is the comparative analysis of a "standard" NPT, which is proposed by the author, with the test conducted by the DWH crew. This analysis contributes to identifying the involved discrepancies between the two test procedures. The second approach is a conceptual risk assessment framework to analyze the causal factors of the identified mismatches in the previous step, as the main contributors of negative pressure test

  20. Intermittent claudication in a professional rugby player.

    Science.gov (United States)

    Bray, A E; Lewis, W A

    1992-04-01

    Intermittent claudication in a professional rugby player is described. The typical features of a delayed and difficult diagnosis of an external iliac artery stenosis were found. The noninvasive diagnostic protocol used to investigate this young patient with a minimal arterial lesion enabled accurate localization and angioplasty to be performed at the same time as diagnostic angiography. The patient was symptom free with normal arterial pressures on follow-up. It is suggested that appropriate noninvasive investigations should be performed before angiography in young people with minimal lesions.

  1. Naftidrofuryl for intermittent claudication.

    Science.gov (United States)

    De Backer, T L M; Vander Stichele, R; Lehert, P; Van Bortel, L

    2008-04-16

    Lifestyle changes and cardiovascular prevention measures are a primary treatment for intermittent claudication (IC). Symptomatic treatment with vasoactive agents (Anatomic Therapeutic Chemical Classification (ATC) for medicines from the World Health Organisation class CO4A) is controversial. To evaluate evidence on the efficacy and safety of oral naftidrofuryl (ATC CO4 21) versus placebo on the pain-free walking distance (PFWD) of people with IC by using a meta-analysis based on individual patient data (IPD). The Cochrane Peripheral Vascular Diseases Group searched their Trials Register (last searched December 2007) and CENTRAL (last searched 2007, Issue 4). We searched MEDLINE, EMBASE, International Pharmaceutical Abstracts, the Science Citation Index and contacted the authors and checked the reference lists of retrieved articles. We asked the manufacturing company for IPD. We included only randomized controlled trials (RCTs) with low or moderate risk of bias for which the IPD were available. We collected data from the electronic data file or from the case report form and checked the data by a statistical quality control procedure. All randomized patients were analyzed following the intention-to-treat (ITT) principle. The geometric mean of the relative improvement in PFWD was calculated for both treatment groups in all identified studies. The effect of the drug was assessed compared with placebo on final walking distance (WDf) using multilevel and random-effect models and adjusting for baseline walking distance (WD0). For the responder analysis, therapeutic success was defined as an improvement of walking distance of at least 50%. We included seven studies in the IPD (n = 1266 patients). One of these studies (n = 183) was only used in the sensitivity analysis so that the main analysis included 1083 patients. The ratio of the relative improvement in PFWD (naftidrofuryl compared with placebo) was 1.37 (95% confidence interval (CI) 1.32 to 1.51, P < 0.001). The

  2. Peripheral Microvascular Responses to Whole-Body Tilting, G(z) Centrifugation, and Lower Body Negative Pressure Stresses in Humans

    Science.gov (United States)

    Breit, G. A.; Watenpaugh, D. E.; Buckley, T. M.; Ballard, R. E.; Murthy, G.; Hargens, A. R.

    1994-01-01

    The response of the cutaneous microcirculation to orthostatic stress varies along the length of the body due to the interaction of central controls with regional responses to local blood pressure. We hypothesize that artificial orthostatic stresses such as Gz centrifugation and LBNP differ from whole-body tilting in terms of the distribution of microvascular blood flow. Cutaneous microvascular flows were measured by laser Doppler flowmetry at the neck, thigh, and leg of 15 normal subjects. Volunteers underwent stepwise head-up tilt (HUT) and short- and long-arm centrifugation protocols from supine control (0 Gz) to 0.2, 0.4, 0.6, 0.8, 1.0, 0.8, 0.6, 0.4, 0.2, and 0 Gz at the feet, for 30-s periods with 10-s transitions between levels. The same subjects underwent a corresponding supine LBNP protocol, up to 100 mmHg (in 20 mmHg increments) and back to zero pressure, which produced transmural pressure across blood vessels in the foot approximately equal to the HUT protocol. In general, application of all orthostatic stresses produced significant flow reductions in the lower body (p less than 0.05) and inconsistent changes in the neck. At low levels of each stress (0.4 Gz, 40 mmHg), LBNP generated the greatest relative reduction in flow in the lower body (-66.9+/-5.7%, thigh; -60.6 +/-5.7%, leg, mean +/- SE). HUT caused a less severe flow reduction than LBNP at the thigh and leg (-39.9 +/- 8.1% and -55.9+/-4.8%), while the effects induced by both forms of centrifugation were the least profound. Higher levels of each stress generally resulted in similar responses. These responses exhibit a consistent relationship to hypothesized changes in local microvascular transmural pressure, suggesting that myogenic and veno-arteriolar reflexes play a significant role in determining microvascular perfusion during orthostatic stress.

  3. Combined non-adaptive light and smell stimuli lowered blood pressure, reduced heart rate and reduced negative affect.

    Science.gov (United States)

    Dong, Shan; Jacob, Tim J C

    2016-03-15

    Bright light therapy has been shown to have a positive impact on seasonal affective disorder (SAD), depression and anxiety. Smell has also has been shown to have effects on mood, stress, anxiety and depression. The objective of this study was to investigate the effect of the combination of light and smell in a non-adaptive cycle. Human subjects were given smell (lemon, lavender or peppermint) and light stimuli in a triangular wave (60scycle) for 15min. Blood pressure and heart rate were monitored before and after each session for 5 consecutive days and a Profile of Mood States (POMS) test was administered before and after the sensory stimulation on days 1, 3 and 5. The light-smell stimulus lowered blood pressure, both systolic and diastolic, and reduced heart rate for all odours compared to control. Of the two sensory stimuli, the odour stimulus contributed most to this effect. The different aromas in the light-smell combinations could be distinguished by their different effects on the mood factors with lemon inducing the greatest mood changes in Dejection-Depression, Anger-Hostility, Tension-Anxiety. In conclusion, combined light and smell stimulation was effective in lowering blood pressure, reducing heart rate and improving mood. The combination was more effective than either smell or light stimuli alone, suggesting that a light-smell combination would be a more robust and efficacious alternative treatment for depression, anxiety and stress. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Intermedia and Intermittency

    Directory of Open Access Journals (Sweden)

    Veres Bálint

    2014-12-01

    Full Text Available It is commonly known that medial reflections have been initiated by attempts to secure the borders of discrete medial forms and to define the modus operandi of each essentialized medial area. Later on, the focus of study has shifted to plurimedial formations and the interactions between predefined medial genres. In the last few decades, taxonomic approaches to various multi-, inter-, and transmedial phenomena dominated the discussions, which offered invaluable support in mapping the terrain, but at the same time hindered the analysis of the ephemeral, time-dependent aspects of plurimedial operations. While we explore the properties of each medial configuration, we lose sight of the actual historical drivers that produce ever-new configurations. My thesis is that any discourse on intermediality should be paralleled by a discourse on cultural intermittency, and consequently, media studies should involve an approach that focuses on the “ecosystem” of the constantly renewing media configurations from the point of view of their vitalizing potential and capability to trigger heightened experiences. This approach draws much inspiration from K. Ludwig Pfeiffer’s media anthropology that gives orientation in my paper.

  5. Chronic Intermittent Hypoxia Induces Atherosclerosis

    OpenAIRE

    Savransky, Vladimir; Nanayakkara, Ashika; Li, Jianguo; Bevans, Shannon; Smith, Philip L.; Rodriguez, Annabelle; Polotsky, Vsevolod Y.

    2007-01-01

    Rationale: Obstructive sleep apnea, a condition leading to chronic intermittent hypoxia (CIH), is associated with hyperlipidemia, atherosclerosis, and a high cardiovascular risk. A causal link between obstructive sleep apnea and atherosclerosis has not been established.

  6. Dynamic characterizers of spatiotemporal intermittency

    OpenAIRE

    Gupte, Neelima; Jabeen, Zahera

    2006-01-01

    Systems of coupled sine circle maps show regimes of spatiotemporally intermittent behaviour with associated scaling exponents which belong to the DP class, as well as regimes of spatially intermittent behaviour (with associated regular dynamical behaviour) which do not belong to the DP class. Both types of behaviour are seen along the bifurcation boundaries of the synchronized solutions, and contribute distinct signatures to the dynamical characterizers of the system, viz. the distribution of...

  7. Intermittency in multihadron production: An analysis using stochastic theories

    International Nuclear Information System (INIS)

    Biyajima, M.

    1989-01-01

    Multiplicity data of the NA22, KLM, and UA1 collaborations are analysed by means of probability distributions derived in the framework of pure birth stochastic equations. The intermittent behaviour of the KLM and UA1 data is well reproduced by the theory. A comparison with the negative binomial distribution is also made. 19 refs., 3 figs., 1 tab. (Authors)

  8. Management of intermittent angle closure glaucoma with Nd: yag laser iridotomy as a primary procedure

    International Nuclear Information System (INIS)

    Ahmed, M.

    2006-01-01

    To assess the efficacy and complications of Nd: YAG laser iridotomy in patients with intermittent (sub-acute) angle closure glaucoma. Twenty-five eyes of twenty-three patients with periodic (intermittent) angle closure, selected in outpatient department, were kept on pilocarpine until YAG laser iridotomy was performed. After YAG laser iridotomy oral acetazolamide and topical dexamethasone was used to control post laser rise of IOP and inflammation respectively. Patency of iridotomy was confirmed and intra-ocular pressure was measured one hour after the procedure. Immediate complication, if any, was noted. Follow-up was done for six months. Prophylactic laser iridotomy was done in fellow eye with occludable angle. Levene's test for equality of variance and t-test for equality of means were used for statistical analysis. This study revealed a significant difference in IOP before and after YAG laser iridotomy (p = .002). Complete follow-up of 6 months was possible in 25 eyes of 23 subjects. After YAG Laser iridotomy, 21 (84%) eyes showed negative provocative test, intraocular pressure below 19mm Hg without medication and anterior chamber angle no more occludable and were labeled successful. Iridotomy remained patent in 96% of eyes. Iridotomy failed to reduce IOP in 4 (16%) eyes. The complications were minimal and transient. (author)

  9. Mechanisms affecting water quality in an intermittent piped water supply.

    Science.gov (United States)

    Kumpel, Emily; Nelson, Kara L

    2014-01-01

    Drinking water distribution systems throughout the world supply water intermittently, leaving pipes without pressure between supply cycles. Understanding the multiple mechanisms that affect contamination in these intermittent water supplies (IWS) can be used to develop strategies to improve water quality. To study these effects, we tested water quality in an IWS system with infrequent and short water delivery periods in Hubli-Dharwad, India. We continuously measured pressure and physicochemical parameters and periodically collected grab samples to test for total coliform and E. coli throughout supply cycles at 11 sites. When the supply was first turned on, water with elevated turbidity and high concentrations of indicator bacteria was flushed out of pipes. At low pressures (water was delivered with a chlorine residual and at pressures >17 psi.

  10. Intermittent Testicular Torsion

    African Journals Online (AJOL)

    2017-12-05

    , presence of abnormal testicular lie in otherwise normal testes, absence of urinary symptoms, and negative urine cultures. This diagnosis was confirmed by resolution of symptoms following bilateral orchidopexy. All patients ...

  11. Fundamentals of negative refractive index optical trapping: forces and radiation pressures exerted by focused Gaussian beams using the generalized Lorenz-Mie theory.

    Science.gov (United States)

    Ambrosio, Leonardo A; Hernández-Figueroa, Hugo E

    2010-11-04

    Based on the generalized Lorenz-Mie theory (GLMT), this paper reveals, for the first time in the literature, the principal characteristics of the optical forces and radiation pressure cross-sections exerted on homogeneous, linear, isotropic and spherical hypothetical negative refractive index (NRI) particles under the influence of focused Gaussian beams in the Mie regime. Starting with ray optics considerations, the analysis is then extended through calculating the Mie coefficients and the beam-shape coefficients for incident focused Gaussian beams. Results reveal new and interesting trapping properties which are not observed for commonly positive refractive index particles and, in this way, new potential applications in biomedical optics can be devised.

  12. Effect of negative pressure therapy on repair of soft tissues of the lower extremities in patients with neuropathic and neuroischaemic forms of diabetic foot syndrome

    Directory of Open Access Journals (Sweden)

    Ekaterina Leonidovna Zaytseva

    2014-06-01

    Full Text Available AimTo evaluate the efficiency of topical negative pressure wound therapy (NPWT compared with standard therapy for the regeneration of the soft tissues of the lower extremities in patients with diabetic foot syndrome.Materials and MethodsThe effects of negative pressure therapy on the clinical (size, tissue oxygenation, histological (light microscopy and immunohistochemical (CD68, MMP-9, TIMP-1 aspects of repair of the soft tissue of the lower extremities in patients with diabetes mellitus were compared with those of standard treatment. Thirty-one patients with diabetic foot ulcers were included in the study from the moment of debridement until the plastic closure of the wound. During the perioperative period, 13 patients received NPWT (-90 to -120 mmHg and 18 patients received standard therapy.ResultsA reduction of the wound area (26.6%±17.2% and the depth of the defects (40.5%±25.6% were achieved with negative pressure therapy compared with baseline data. In the control group, the corresponding values were 25.3%±19.4% and 21.8%±21.6%, respectively. The results of transcutaneous oximetry showed a greater increase in the level of local hemodynamics in the study group (p <0.04. An important criterion for wound preparation for a plastic closure is filling it with granulation tissue by more than 75%. In the study group, 95% of patients had wounds filled with 89.9%±17% of abundant granulation tissue. The histological data of the study group show a significant reduction of oedema by 80% (p <0.05, improved extracellular matrix organization (p <0.05, 90% (p <0.05 dissolution of inflammatory infiltrate and the formation of healthy granulation tissue (p <0.05. Immunohistochemical analysis demonstrated a significant decrease in the number of macrophages in the dermis (CD68 expression (p <0.05. In both groups, the level of MMP-9 was decreased. However, the ratio of MMP-9:TIMP-1 was lower in the study group (p <0.05.ConclusionThe findings suggest that

  13. Mechanism of Intermittent Atomization

    Science.gov (United States)

    1993-06-01

    6] and Dolenc [7] that the dynamic pressure input to the nozzle is very important to engine efficiency. In their dis- cussion of optimizing fuel...Injection in Diesel Engines." Proceedings of the Institute of Mechanical Engineers, Vol. 199 No. D3, 1985, ppl6l-174. [7] Dolenc , A. "The Injection

  14. Effect of Leaf Water Potential on Internal Humidity and CO2 Dissolution: Reverse Transpiration and Improved Water Use Efficiency under Negative Pressure.

    Science.gov (United States)

    Vesala, Timo; Sevanto, Sanna; Grönholm, Tiia; Salmon, Yann; Nikinmaa, Eero; Hari, Pertti; Hölttä, Teemu

    2017-01-01

    The pull of water from the soil to the leaves causes water in the transpiration stream to be under negative pressure decreasing the water potential below zero. The osmotic concentration also contributes to the decrease in leaf water potential but with much lesser extent. Thus, the surface tension force is approximately balanced by a force induced by negative water potential resulting in concavely curved water-air interfaces in leaves. The lowered water potential causes a reduction in the equilibrium water vapor pressure in internal (sub-stomatal/intercellular) cavities in relation to that over water with the potential of zero, i.e., over the flat surface. The curved surface causes a reduction also in the equilibrium vapor pressure of dissolved CO 2 , thus enhancing its physical solubility to water. Although the water vapor reduction is acknowledged by plant physiologists its consequences for water vapor exchange at low water potential values have received very little attention. Consequences of the enhanced CO 2 solubility to a leaf water-carbon budget have not been considered at all before this study. We use theoretical calculations and modeling to show how the reduction in the vapor pressures affects transpiration and carbon assimilation rates. Our results indicate that the reduction in vapor pressures of water and CO 2 could enhance plant water use efficiency up to about 10% at a leaf water potential of -2 MPa, and much more when water potential decreases further. The low water potential allows for a direct stomatal water vapor uptake from the ambient air even at sub-100% relative humidity values. This alone could explain the observed rates of foliar water uptake by e.g., the coastal redwood in the fog belt region of coastal California provided the stomata are sufficiently open. The omission of the reduction in the water vapor pressure causes a bias in the estimates of the stomatal conductance and leaf internal CO 2 concentration based on leaf gas exchange

  15. Intermittency in 197Au fragmentation

    International Nuclear Information System (INIS)

    Dabrowska, A.; Holynski, R.; Olszewski, A.; Szarska, M.; Wilczynska, B.; Wolter, W.; Wosiek, B.; Cherry, M.L.; Deines-Jones, P.; Jones, W.V.; Sengupta, K.; Wefel, B.

    1995-07-01

    The concept of factorial moments was applied to an analysis of the dynamical fluctuations in the charge distributions of the fragments emitted from gold nuclei with energies 10.6 and < 1.0 GeV/n interacting with emulsion nuclei. Clear evidence for intermittent fluctuations has been found in an analysis using all the particles released from the gold projectile, with a stronger effect observed below 1 GeV/n than at 10.6 GeV/n. For the full data sets, however, the intermittency effect was found to be very sensitive to the singly charged particles, and neglecting these particles strongly reduces the intermittency signal. When the analysis is restricted to the multiply charged fragments, an intermittency effect is revealed only for multifragmentation events, although one that is enhanced as compared to the analysis of all, singly and multiply charged, particles. The properties of the anomalous fractal dimensions suggest a sequential decay mechanism, rather than the existence of possible critical behaviour in the process of nuclear fragmentation. The likely influence of the charge conservation effects and the finite size of decaying systems on the observed intermittency signals was pointed out. (author). 37 refs, 9 figs, 5 tabs

  16. Intermittency in e+e- and lepton-hadron collisions

    International Nuclear Information System (INIS)

    Sugano, K.

    1990-01-01

    The intermittency data in e + e - and lepton-hadron collisions are reviewed. The power-law behavior of the moments has been established by various e + e - experiments and a μp experiment. The intermittency in the two-dimensional space of rapidity and azimuthal angle is much stronger than in the rapidity space only. The neutrino-nucleus data indicate significant effects from nuclear reinteractions. The LUND parton shower model fits the data better than the matrix element model without special retuning. The relations among the moments of different orders are in good agreement with the predictions by the negative binomial and pure birth distributions. The origin of the intermittency in e + e - and μp collisions is consistent with the self-similar cascade mechanism of jet formation. 11 refs., 7 figs

  17. Spectroscopic diagnosis of plasma in atmospheric pressure negative pulsed gas-liquid discharge with nozzle-cylinder electrode

    Science.gov (United States)

    Ming, SUN; Zhan, TAO; Zhipeng, ZHU; Dong, WANG; Wenjun, PAN

    2018-05-01

    The plasma characteristics of a gas-liquid phase discharge reactor were investigated by optical and electrical methods. The nozzle-cylinder electrode in the discharge reactor was supplied with a negative nanosecond pulsed generator. The optical emission spectrum diagnosis revealed that OH (A2∑+ → X2Π, 306–309 nm), N2 (C3Π→B3Πg, 337 nm), O (3p5p→3s5s0, 777.2 nm) and O (3p3p→3s3s0, 844.6 nm) were produced in the discharge plasma channels. The electron temperature (T e) was calculated from the emission relative intensity ratio between the atomic O 777.2 nm and 844.6 nm, and it increased with the applied voltage and the pulsed frequency and fell within the range of 0.5–0.8 eV. The gas temperature (T g) that was measured by Lifbase was in a range from 400 K to 600 K.

  18. Abdominal Cavity Eventration Treated by Means of the "Open Abdomen" Technique Using the Negative Pressure Therapy System--Case Report and Literature Review.

    Science.gov (United States)

    Trzeciak, Piotr W; Porzeżyńska, Joanna; Ptasińska, Karolina; Walczak, Dominik A

    2015-11-01

    Wound dehiscence is a surgical complication in which the wound ruptures along the surgical suture with abdominal cavity bowel displacement. It is observed in 0.2-6% of operated patients. The extensive wound is a gateway for infection. Moreover, increased secretion of serous fluid induces a hygienic problem and may lead to secondary skin infections or bedsores. The negative pressure wound therapy (NPWT) system is an innovative therapeutic method. It perfectly executes the TIME strategy, receiving more and more recognition. The study presented a case of a 62-year old male patient after several consecutive wound dehiscence episodes who was primarily treated for rectal cancer by means of low anterior resection of the rectum. Due to acute respiratory insufficiency after several operations, wound necrosis with dehiscence was observed. Considering the high risk of perioperative death we abandoned surgical treatment and introduced conservative management using negative pressure wound therapy until the patient's health improved. Literature regarding the above-mentioned issue was also reviewed.

  19. The SNaP™ Wound Care System: A Case Series Using a Novel Ultraportable Negative Pressure Wound Therapy Device for the Treatment of Diabetic Lower Extremity Wounds

    Science.gov (United States)

    Lerman, Bruce; Oldenbrook, Leslie; Ryu, Justin; Fong, Kenton D.; Schubart, Peter J.

    2010-01-01

    Although there is significant evidence supporting the use of negative pressure wound therapy (NPWT) for the treatment of lower extremity diabetic ulcers, currently available electrically powered NPWT systems are not ideally suited for treating smaller diabetic foot ulcers. The Smart Negative Pressure (SNaP™) Wound Care System is a novel, ultraportable device that delivers NPWT without the use of an electrically powered pump. It was specifically designed to meet the wound care needs of patients with diabetes. The SNaP System is compact, silent, mobile, easy-to-use, and available off-the-shelf. It is fully disposable and may offer other important benefits over electrically powered systems to both the clinician and patient. We review the evidence for use of NPWT for the treatment of diabetic wounds and discuss the potential benefits of this new NPWT technology for patients with diabetes. We also present a case series of four difficult lower extremity diabetic ulcers that were successfully treated with the SNaP System. This study suggests that the SNaP System may be a useful addition to the armamentarium of the diabetic wound care clinician. PMID:20663444

  20. Stagnations of increasing trends in negative pressure with repeated cavitation in water/metal Berthelot tubes as a result of mechanical sealing

    International Nuclear Information System (INIS)

    Hiro, Kazuki; Ohde, Yoshihito; Tanzawa, Yasutoshi

    2003-01-01

    To investigate effects of mechanical sealing on negative pressures in water/metal tube Berthelot systems, trends in negative pressure are observed through runs of temperature cycles below 90 deg. C in two systems made of metals having small amounts of gas inclusions. The first system is a pre-degassed all-stainless-steel tube/plug system. The steel is a special product for vacuum engineering. The second is the same tube sealed with plugs made of silver solidified one-dimensionally in a vacuum furnace. A new type of trend, stagnation for intermediate cycles is found in both systems so long as sealing distortion of each plug is small in amount. The stagnation period for the first system is longer than that for the second one. A metallurgical mechanism of a gas-being-replenished crevice model is proposed: distorted parts of metals undergo heat-treatment during runs of temperature cycles, and the heat-treatment enhances the rates of impurity gas transports to crevices on the metal surface where cavitation occurs, and the transport causes the stagnation for cycles during which the rates are still high

  1. Tissue Oxygenation and Negative-Pressure Wound Therapy When Applied to the Feet of Persons With Diabetes Mellitus: An Observational Study.

    Science.gov (United States)

    Lee, Ye-Na; Lee, Jong Seok; Han, Seung-Kyu; Jung, Hye-Kyung

    Our group has reported that negative-pressure wound therapy (NPWT) decreases tissue oxygenation by 84% in the foot of diabetic patients because the pad of the connecting drainage tube and foam sponge of the NPWT system compress the wound bed. The purpose of this study was to determine whether an NPWT modified dressing application reduces tissue oxygenation in the feet of persons with diabetes mellitus. A prospective, clinical, observational study. We enrolled 30 patients with diabetic mellitus; their mean age was 63.9 ± 11.2 years (mean ± standard deviation). All were cared for at the diabetic wound center at an academic tertiary medical center in South Korea between 2014 and January 2015. Transcutaneous partial oxygen pressures (TcpO2) were measured to determine tissue oxygenation levels beneath modified NPWT dressings. A TcpO2 sensor was fixed at the tarsometatarsal area of the contralateral unwounded foot. A negative pressure of -125 mm Hg was applied until TcpO2 reached a plateau state; values were measured before, during, and after the modified NPWT. The Wilcoxon' and Mann-Whitney U tests were used to compare differences between these measurements. TcpO2 levels decreased by 26% during the modified NPWT. Mean TcpO2 values before, during, and after turning off the therapy were 54.3 ± 15.3 mm Hg, 41.6 ± 16.3 mm Hg, and 53.3 ± 15.6 mm Hg (P drainage tube significantly reduces the amount of tissue oxygenation loss beneath foam dressings on the skin of the foot dorsum in diabetic patients.

  2. The effect of positive and negative message framing on short term continuous positive airway pressure compliance in patients with obstructive sleep apnea.

    Science.gov (United States)

    Pengo, Martino F; Czaban, Marcin; Berry, Marc P; Nirmalan, Prajeshan; Brown, Richard; Birdseye, Adam; Woroszyl, Asia; Chapman, Julia; Kent, Brian D; Hart, Nicholas; Rossi, Gian Paolo; Steier, Joerg

    2018-01-01

    Continuous positive airway pressure (CPAP), the best available treatment for obstructive sleep apnea (OSA), requires long-term compliance to be effective. Behavioral interventions may be used to improve adherence to CPAP. We aimed to investigate whether positive or negative message framing impacts on CPAP compliance in patients with OSA, when compared to standard care. Consenting patients with confirmed OSA were randomly allocated to receive along with their CPAP either positively or negatively framed messages (Pos; Neg), or standard care (Con). Standardized motivational messages were read out to patients during an initial teaching session and through weekly telephone calls. Patients' compliance data were reviewed 2 and 6 weeks following CPAP initiation. We randomized 112 patients to groups that were matched for age, BMI, and OSA severity. The positively framed group (Pos) showed greater CPAP usage after 2 weeks (total use 53.7±31.4 hours) as compared to the negatively framed and the control group (35.6±27.4 and 40.8±33.5 hours, Pframed groups (Pos n=5; Neg n=8; Con n=11; Pframed messages can improve CPAP adherence in patients with OSA in the short-term; however, strategies for implementing its long-term use need to be developed.

  3. High negative pressure subcutaneous suction drain for managing debilitating subcutaneous emphysema secondary to tube thoracostomy for an iatrogenic post computed tomography guided transthoracic needle biopsy pneumothorax: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Zeeshan Ahmed

    2016-01-01

    Conclusion: Debilitating subcutaneous emphysema which causes distress, anxiety, palpebral closure, dyspnoea or dysphagia requires intervention. High negative pressure subcutaneous suction drain provides immediate and sustained relief in extensive and debilitating SE.

  4. The use of isoprene as a novel dopant in negative ion atmospheric pressure photoionization mass spectrometry coupled to high-performance liquid chromatography.

    Science.gov (United States)

    Dousty, Faezeh; O'Brien, Rob

    2015-06-15

    As in the case with positive ion atmospheric pressure photoionization (PI-APPI), the addition of dopants significantly improves the sensitivity of negative ion APPI (NI-APPI). However, the research on dopant-assisted-NI-APPI has been quite limited compared to the studies on dopant-assisted PI-APPI. This work presents the potential of isoprene as a novel dopant for NI-APPI. Thirteen compounds, possessing suitable gas-phase ion energetic properties in order to make stable negative ions, were selected. Dopants were continuously introduced into a tee junction prior to the ion source through a fused-silica capillary, while analytes were directly injected into the same tee. Then both were mixed with the continuous solvent from high-performance liquid chromatography (HPLC), nebulized, and entered the source. The nebulized stream was analyzed by APPI tandem quadrupole mass spectrometry in the negative ion mode. The results obtained using isoprene were compared with those obtained by using toluene as a dopant and dopant-free NI-APPI. Isoprene enhanced the ionization intensities of the studied compounds, which were found to be comparable and, in some cases, more effective than toluene. The mechanisms leading to the observed set of negative analyte ions were also discussed. Because in NI-APPI, thermal electrons, which are produced during the photoionization of a dopant, are considered the main reagent ions, both isoprene and toluene promoted the ionization of analytes through the same mechanisms, as expected. Isoprene was shown to perform well as a novel dopant for NI-APPI. Isoprene has a high photoabsorption cross section in the VUV region; therefore, its photoionization leads to a highly effective production of thermal electrons, which further promotes the ionization of analytes. In addition, isoprene is environmentally benign and less toxic compared to currently used dopants. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Management of the open abdomen using negative pressure wound therapy with instillation in severe abdominal sepsis: A review of 48 cases in Hospital Mexico, Costa Rica.

    Science.gov (United States)

    Sibaja, Pablo; Sanchez, Alfredo; Villegas, Guillermo; Apestegui, Alvaro; Mora, Esteban

    2017-01-01

    Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen. To explore if the concept of active two-way therapy (Negative pressure wound therapy with instillation or NPWT-I) yields superior control of underlying, life-threatening abdominal infections and its effects on survival and morbidity in patients with severe abdominal sepsis when management with an open abdomen is required. A retrospective review of 48 patients with severe abdominal sepsis, who were managed with and open abdomen and NPWT-I was performed. NPWT-I was initiated utilizing the same parameters on all patients, this consisted of cycles of instillation of saline solution, which was removed through negative pressure after a short dwell period. We observed the effects on primary fascia closure rate, mortality, hospital and SICU length of stay and associated complications. Our patient group consisted of 20 (42%) males and 28 (58%) females. Average age was 48 years. Mortality in these patients was attributed to pulmonary embolism (n=1), acute renal failure (n=2) and cardiopulmonary arrest (n=1). Average total hospital stay was 24days, and stay in the SICU (n=26) averaged 7.5days. No acute complications related to the NPWT-I. All patients presenting with abdominal compartment syndrome resolved after initiation of the NPWT-I. A total of 46 patients (96%) patients achieved fascia closure after NPWT-I therapy after an average of 6days. Four patients (8%) died

  6. TRANSPORT BY INTERMITTENCY IN THE BOUNDARY OF THE DIII-D TOKAMAK

    International Nuclear Information System (INIS)

    BOEDO, JA; RUDAKOV, DL; MOYER, RA; MCKEE, GR; COLCHIN, RJ; SCHAFFER, MJ; STANGEBY, PG; WEST, WP; ALLEN, SL; EVANS, TE; FONCK, RJ; HOLLMANN, EM; KRASHENINNIKOV, S; LEONARD, AW; NEVINS, W; MAHDAVI, MA; PORTER, GD; TYNAN, GR; WHYTE, DG; XU, X

    2002-01-01

    A271 TRANSPORT BY INTERMITTENCY IN THE BOUNDARY OF THE DIII-D TOKAMAK. Intermittent plasma objectives (IPOs) featuring higher pressure than the surrounding plasma, are responsible for ∼ 50% of the E x B T radial transport in the scrape off layer (SOL) of the DIII-D tokamak in L- and H-mode discharges. Conditional averaging reveals that the IPOs are positively charged and feature internal poloidal electric fields of up to 4000 V/m. The IPOs move radially with E x B T /B 2 velocities of ∼ 2600 m/s near the last closed flux surface (LCFS), and ∼ 330 m/s near the wall. The IPOs slow down as they shrink in radial size from 4 cm at the LCFS to 0.5 cm near the wall. The skewness (i.e. asymmetry of fluctuations from the average) of probe and beam emission spectroscopy (BES) data indicate IPO formation at or near the LCFS and the existence of positive and negative IPOs which move in opposite directions. The particle content of the IPOs at the LCFS is linearly dependent on the local density and decays over ∼ 3 cm into the SOL while their temperature decays much faster (∼ 1 cm)

  7. Aerial medical evacuation of health workers with suspected Ebola virus disease in Guinea Conakry-interest of a negative pressure isolation pod-a case series.

    Science.gov (United States)

    Dindart, Jean-Michel; Peyrouset, Olivier; Palich, Romain; Bing, Abdoul; Kojan, Richard; Barbe, Solenne; Harouna, Souley; Blackwell, Nikki

    2017-03-11

    We report 4 cases of Health Workers (HW) suspected of having contracted Ebola Virus Disease (EVD), transported from the Alliance for International Medical Action (ALIMA) Ebola Treatment Centre (ETC) in N'Zerekore, Guinea to the Treatment Centre for Carers run by the medical corps of the French army in Conakry, the capital of Guinea, which was established on 17 January 2015 and closed on 7 July 2015. In total more than 500 HWs have died from EVD since the epidemic began. This mortality has had significant effects on the ability of local services to respond appropriately to the disaster. The HWs were transported by air in the "Human Stretcher Transit Isolator-Total Containment (Oxford) Limited" (HSTI-TCOL) negative pressure isolation pod. Medical evacuation of patients with suspected, potentially fatal, infectious diseases is feasible with the use of a light isolator for patients without critical dysfunctions.

  8. Towards an intermittency-friendly energy system

    DEFF Research Database (Denmark)

    Blarke, Morten

    2012-01-01

    Distributed cogeneration has played a key role in the implementation of sustainable energy policies for three decades. However, increasing penetration levels of intermittent renewables is challenging that position. The paradigmatic case of West Denmark indicates that distributed operators...... are capitulating as wind power penetration levels are moving above 25%; some operators are retiring cogeneration units entirely, while other operators are making way for heat-only boilers. This development is jeopardizing the system-wide energy, economic, and environmental benefits that distributed cogeneration...... still has to offer. The solution is for distributed operators to adapt their technology and operational strategies to achieve a better co-existence between cogeneration and wind power. Four options for doing so are analysed including a new concept that integrates a high pressure compression heat pump...

  9. Foliar δ13C Showed No Altitudinal Trend in an Arid Region and Atmospheric Pressure Exerted a Negative Effect on Plant δ13C

    Directory of Open Access Journals (Sweden)

    Zixun Chen

    2017-07-01

    Full Text Available Previous studies have suggested foliar δ13C generally increases with altitude. However, some observations reported no changes or even decreased trends in foliar δ13C. We noted that all the studies in which δ13C increased with elevation were conducted in the human regions, whereas those investigations in which δ13C did not vary or decreased were conducted in areas with water stress. Thus, we proposed that the pattern of increasing δ13C with elevation is not a general one, and that δ13C may remain unchanged or decrease in plants grown in arid environments. To test the hypothesis, we sampled plants along altitude gradients on the shady and sunny slopes of Mount Tianshan characterized by arid and semiarid climates. The measurements of foliar δ13C showed no altitudinal trends for the plants grown on either of the slopes. Therefore, this study supported our hypothesis. In addition, the present study addressed the effect of atmospheric pressure on plant δ13C by accounting for the effects of temperature and precipitation on δ13C. This study found that the residual foliar δ13C increased with increasing altitude, suggesting that atmospheric pressure played a negative role in foliar δ13C.

  10. Incisional Negative Pressure Wound Therapy

    DEFF Research Database (Denmark)

    Hyldig, Nana; Birke-Sorensen, Hanne; Kruse, Marie

    and meta-analysis of randomized controlled trials of NPWT compared to standard postoperative dressings on closed incisions. Results: Ten studies met the inclusion criteria, reporting on 1344 incisions (1121 patients). NPWT was associated with a significant reduction of wound infection (46%), and seroma...... formation (52%) compared to standard care. The reduction in wound dehiscence was not statistically significant. The numbers needed to treat were 3 (seroma), 17 (dehiscence), and 25 (infection). Methodical heterogeneity across studies led to downgrading quality of evidence to moderate for infection...

  11. Effects of Intermittent Fasting, Caloric Restriction, and Ramadan Intermittent Fasting on Cognitive Performance at Rest and During Exercise in Adults.

    Science.gov (United States)

    Cherif, Anissa; Roelands, Bart; Meeusen, Romain; Chamari, Karim

    2016-01-01

    The aim of this review was to highlight the potent effects of intermittent fasting on the cognitive performance of athletes at rest and during exercise. Exercise interacts with dietary factors and has a positive effect on brain functioning. Furthermore, physical activity and exercise can favorably influence brain plasticity. Mounting evidence indicates that exercise, in combination with diet, affects the management of energy metabolism and synaptic plasticity by affecting molecular mechanisms through brain-derived neurotrophic factor, an essential neurotrophin that acts at the interface of metabolism and plasticity. The literature has also shown that certain aspects of physical performance and mental health, such as coping and decision-making strategies, can be negatively affected by daylight fasting. However, there are several types of intermittent fasting. These include caloric restriction, which is distinct from fasting and allows subjects to drink water ad libitum while consuming a very low-calorie food intake. Another type is Ramadan intermittent fasting, which is a religious practice of Islam, where healthy adult Muslims do not eat or drink during daylight hours for 1 month. Other religious practices in Islam (Sunna) also encourage Muslims to practice intermittent fasting outside the month of Ramadan. Several cross-sectional and longitudinal studies have shown that intermittent fasting has crucial effects on physical and intellectual performance by affecting various aspects of bodily physiology and biochemistry that could be important for athletic success. Moreover, recent findings revealed that immunological variables are also involved in cognitive functioning and that intermittent fasting might impact the relationship between cytokine expression in the brain and cognitive deficits, including memory deficits.

  12. Fluid Redistribution and Heart Rate in Humans During Whole-Body Tilting, G(z) Centrifugation, and Lower Body Negative Pressure

    Science.gov (United States)

    Watenpaugh, D. E.; Breit, G. A.; Ballard, R. E.; Murthy, G.; Hargens, A. R.

    1994-01-01

    Gravity creates blood pressure gradients which redistribute body fluids towards the feet. Positive G(z) centrifugation and lower body negative pressure (LBNP) have been proposed to simulate these and other effects of gravity during long-term existence in microgravity. We hypothesized that the magnitude of upper-to-lower body fluid redistribution would increase according to the following order: short-arm centrifugation (SAC), long-arm centrifugation (LAC), head-up tilt (HUT), and LBNP. To test this hypothesis, we employed strain gauge plethysmography of the neck, thigh and calf during HUT and supine SAC and LAC up to lG(z) at the feet, and during supine LBNP to 100 mm Hg. Supine 100 mm Hg LBNP generates footward force and produces transmural blood pressures in the foot approximately equal to 1 G(z) (90 deg) HUT. Heart rate was measured via cardiotachometry. Control measurements were made while supine. SAC and LAC elicited similar increases in thigh volume at 1 G(z) (2.3 +/- 0.4 and 2.1 +/- 0.1%, respectively; mean +/- se, n greater than or equal to 7). At 100 mm Hg LBNP, thigh volume increased (3.4 +/- 0.3%) significantly more than during l G(z) centrifugation (p less than 0.05). Surprisingly, due to a paradoxical 0.6% reduction of thigh volume between 0.8 and 1.0 G(z) HUT, thigh volume was increased only 0.6 +/- 0.3% at 1 G(z) HUT. The calf demonstrated similar, although less definitive, responses to the various gravitational stimuli. Neck volume tended to decrease less during HUT than during the other stimuli. Heart rate increased similarly during HUT (18 +/- 2 beats/min) and LAC (12 +/- 2 beats/min), and exhibited still greater elevation during LBNP (29 +/- 4 beats/min), yet did not increase during SAC. These results suggest upright posture activates mechanisms that counteract footward fluid redistribution which are not activated during supine applications of simulated gravity. LAC more closely approximated effects of normal gravity (HUT) than LBNP. Therefore

  13. Negative pressure driven valence instability of Eu in cubic Eu{sub 0.4}La{sub 0.6}Pd{sub 3}

    Energy Technology Data Exchange (ETDEWEB)

    Pandey, Abhishek [S N Bose National Centre for Basic Sciences, Block-JD, Sector-III, Salt Lake, Kolkata-700098 (India); Mazumdar, Chandan; Ranganathan, R [Experimental Condensed Matter Physics Division, Saha Institute of Nuclear Physics, 1/AF, Bidhannagar, Kolkata-700064 (India)], E-mail: abhishek.phy@gmail.com, E-mail: chandan.mazumar@saha.ac.in

    2009-05-27

    We report the change in the valency of Eu-ions in the binary intermetallic cubic compound EuPd{sub 3} induced by La doping at rare-earth sites. Doping of La generates negative chemical pressure in the lattice, resulting in a significant increase of the lattice parameter without altering the simple-cubic structure of the compound. Results of dc-magnetic measurements suggest that this increase in the lattice parameter is associated with the valence transition of Eu-ions from Eu{sup 3+} to a mixed-valent state. As Eu{sup 2+}-ions possess a large magnetic moment, this valence transition significantly modifies the magnetic behavior of the compound. In contrast to introducing boron at the vacant body center site of the unit cell to change the valency of Eu-ions, as in the case of EuPd{sub 3}B, our results suggest it can also be altered by doping a rare-earth ion of larger size at the lattice site of Eu in EuPd{sub 3}.

  14. Laparostomy management using the ABThera™ open abdomen negative pressure therapy system in a grade IV open abdomen secondary to acute pancreatitis.

    Science.gov (United States)

    Fitzgerald, James E F; Gupta, Shradha; Masterson, Sarah; Sigurdsson, Helgi H

    2013-04-01

    Wound control in laparostomy for the treatment of intra-abdominal hypertension remains challenging and numerous techniques have been described. We report the first UK experience with a new commercially available device specifically designed to facilitate management of the open abdomen. A 44-year-old gentleman presented with a 3-day history of constant severe epigastric pain and associated vomiting. Amylase was markedly elevated and he was admitted for supportive management of pancreatitis, with subsequent transfer to intensive care due to severe systemic inflammatory syndrome. The patient decompensated, developing intra-abdominal hypertension with renal and respiratory failure. This was successfully managed by performing a laparostomy and using an ABThera™ Open Abdomen Negative Pressure Therapy System (KCI, San Antonio, TX). We describe its use to facilitate wound control, including enteroatmospheric fistula, allowing granulation and eventual restoration of gastrointestinal continuity 383-days after admission. We found the ABThera™ System proved to be a useful treatment adjunct, protecting intra-abdominal contents while removing large volumes of exudate and infected material from within the abdominal cavity. Complex cases such as this remain infrequent and this article provides a summary of our experience, including a review of indications for laparostomy and the underlying basic science in this difficult area. © 2012 The Authors. International Wound Journal © 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  15. Negative pressure wound therapy using a portable single-use device for free skin grafts on the distal extremity in seven dogs.

    Science.gov (United States)

    Miller, A J; Cashmore, R G; Marchevsky, A M; Havlicek, M; Brown, P M; Fearnside, S M

    2016-09-01

    Retrospective study to describe clinical experience with a portable single-use negative pressure wound therapy device after application of full-thickness meshed skin grafts to wounds on the distal extremities of seven dogs. Seven dogs were treated with portable NPWT after receiving skin grafts; six as the result of tumour resection and one for traumatic injury. Medical records were reviewed and data recorded on patient signalment, cause and location of wound, surgical technique, application and maintenance of portable NPWT, graft survival and outcome, and complications encountered with the system. NPWT was provided for between 4 and 7 days. Five patients were discharged from hospital during the treatment period. Application and maintenance of the portable device was technically easy and no major complications were encountered. Minor complications consisted of fluid accumulation in the evacuation tubing. All dogs achieved 100% graft survival. Application and maintenance of the portable device was technically straightforward. All dogs receiving portable NPWT after transfer of a free skin graft to the distal extremity had a successful outcome. © 2016 Australian Veterinary Association.

  16. Negative pressure wound therapy literature review of efficacy, cost effectiveness, and impact on patients' quality of life in chronic wound management and its implementation in the United kingdom.

    Science.gov (United States)

    Othman, Diaa

    2012-01-01

    This is a paper reviewing the National Health Service (NHS) agenda in relation to the use of Negative Pressure Wound Therapy (NPWT) in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients' satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients' satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.

  17. A case of deep infection after instrumentation in dorsal spinal surgery: the management with antibiotics and negative wound pressure without removal of fixation.

    Science.gov (United States)

    Dobran, Mauro; Mancini, Fabrizio; Nasi, Davide; Scerrati, Massimo

    2017-07-28

    Until today the role of spinal instrumentation in the presence of a wound infection has been widely discussed and recently many authors leave the hardware in place with appropriate antibiotic therapy. This is a case of a 65-year-old woman suffering from degenerative scoliosis and osteoporotic multiple vertebral collapses treated with posterior dorsolumbar stabilisation with screws and rods. Four months later, skin necrosis and infection appeared in the cranial wound with exposure of the rods. A surgical procedure of debridement of the infected tissue and package with a myocutaneous trapezius muscle flap was performed. One week after surgery, negative pressure wound therapy was started on the residual skin defect. The wound healed after 2 months. The aim of this case report is to focus on the utility of this method even in the case of hardware exposure and infection. This may help avoid removing instrumentation and creating instability. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Ultra pressure liquid chromatography-negative electrospray ionization mass spectrometry determination of twelve halobenzoquinones at ng/L levels in drinking water.

    Science.gov (United States)

    Huang, Rongfu; Wang, Wei; Qian, Yichao; Boyd, Jessica M; Zhao, Yuli; Li, Xing-Fang

    2013-05-07

    We report here the characterization of twelve halobenzoquinones (HBQs) using electrospray ionization (ESI) high resolution quadrupole time-of-flight mass spectrometry. The high resolution negative ESI spectra of the twelve HBQs formed two parent ions, [M + H(+) + 2e(-)], and the radical M(-•). The intensities of these two parent ions are dependent on their chemical structures and on instrumental parameters such as the source temperature and flow rate. The characteristic ions of the HBQs were used to develop an ultra pressure liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method. At the UPLC flow rate (400 μL/min) and under the optimized ESI conditions, eleven HBQs showed the stable and abundant transitions [M + H(+) + 2e(-)] → X(-) (X(-) representing Cl(-), Br(-), or I(-)), while dibromo-dimethyl-benzoquinone (DBDMBQ) showed only the transition of M(-•) → Br(-). The UPLC efficiently separates all HBQs including some HBQ isomers, while the MS/MS offers exquisite limits of detection (LODs) at subng/mL levels for all HBQs except DBDMBQ. Combined with solid phase extraction (SPE), the method LOD is down to ng/L. The results from analysis of authentic samples demonstrated that the SPE-UPLC-MS/MS method is reliable, fast, and sensitive for the identification and quantification of the twelve HBQs in drinking water.

  19. Combing a novel device and negative pressure wound therapy for managing the wound around a colostomy in the open abdomen: A case report.

    Science.gov (United States)

    Sun, Xiaofang; Wu, Shaohan; Xie, Ting; Zhang, Jianping

    2017-12-01

    An open abdomen complicated with small-bowel fistulae becomes a complex wound for local infection, systemic sepsis and persistent soiling irritation by intestinal content. While controlling the fistulae drainage, protecting surrounding skin, healing the wound maybe a challenge. In this paper we described a 68-year-old female was admitted to emergency surgery in general surgery department with severe abdomen pain. Resection part of the injured small bowel, drainage of the intra-abdominal abscess, and fashioning of a colostomy were performed. She failed to improve and ultimately there was tenderness and lot of pus under the skin around the fistulae. The wound started as a 3-cm lesion and progressed to a 6 ×13  (78 cm) around the stoma. In our case we present a novel device for managing colostomy wound combination with negative pressure wound therapy. This tube allows for an effective drainage of small-bowel secretion and a safe build-up of granulation tissue. Also it could be a barrier between the bowel suction point and foam. Management of open abdomen wound involves initial dressing changes, antibiotic use and cutaneous closure. When compared with traditional dressing changes, the NPWT offers several advantages including increased granulation tissue formation, reduction in bacterial colonization, decreased of bowel edema and wound size, and enhanced neovascularization. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  20. Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Diaa Othman

    2012-01-01

    Full Text Available This is a paper reviewing the National Health Service (NHS agenda in relation to the use of Negative Pressure Wound Therapy (NPWT in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients’ satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients’ satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.

  1. Antimicrobial-impregnated dressing combined with negative-pressure wound therapy increases split-thickness skin graft engraftment: a simple effective technique.

    Science.gov (United States)

    Wu, Cheng-Chun; Chew, Khong-Yik; Chen, Chien-Chang; Kuo, Yur-Ren

    2015-01-01

    Immobilization and adequate surface contact to wounds are critical for skin graft take. Techniques such as the tie-over dressing, cotton bolster, and vacuum-assisted closure are used to address this, but each has its limitations. This study is designed to assess the effect of antimicrobial-impregnated dressing (AMD) combined with negative-pressure wound therapy (NPWT) on skin graft survival. Retrospective case-control study : Patients with chronic or contaminated wounds treated with split-thickness skin graft. A broad spectrum of wounds was included, from causes such as trauma, burns, chronic diabetic ulcers, and infection. Antimicrobial-impregnated dressing, which contains 0.2% polyhexamethylene biguanide, with NPWT MAIN OUTCOME MEASURE:: Success of skin graft : In the AMD group, all skin grafts achieved 100% take without secondary intervention. No infection or graft failure was observed in any patients, and no complications, such as hematoma or seroma formation, were noted, although in the control group partial loss of skin grafts was noted in 3 patients. Infection and inadequate immobilization were thought to be the main reasons. There were no hematoma or seroma formations in the control group. Use of an AMD dressing with NPWT after split-thickness skin grafting can be an effective method to ensure good graft to wound contact and enhances skin graft take in chronic and contaminated wounds.

  2. The Effect of Negative Pressure Wound Therapy With Antiseptic Instillation on Biofilm Formation in a Porcine Model of Infected Spinal Instrumentation.

    Science.gov (United States)

    Singh, Devinder P; Gowda, Arvind U; Chopra, Karan; Tholen, Michael; Chang, Sarah; Mavrophilipos, Vasilios; Semsarzadeh, Nina; Rasko, Yvonne; Holton Iii, Luther

    2017-06-01

    This study evaluates the effect of negative pressure wound therapy with antiseptic instillation (NPWTi) in the clearance of infection and biofilm formation in an in vivo model of infected spinal implants compared to traditional treatment modalities. Five pigs underwent titanium rod implantation of their spinous processes followed by injection of 1 x 106 CFUs/100μL of methicillin-resistant Staphylococcus aureus through the fascia at each site. At 1 week postoperatively, an experimental arm of 3 pigs received NPWTi, and a control arm of 2 pigs received wet-to-dry dressings. The persistence of local infection in the experimental group was compared to the control group using tissue cultures. Biofilm development on spinal implants was evaluated using scanning electron microscopy. Mean bacterial count showed a statistical difference between the experimental and the control groups (P < .05). Scanning electron microscopy revealed the presence of uniform biofilm formation across the surface of control group instrumentation, whereas the experimental group showed interrupted areas between biofilm formations. The authors concluded that NPWTi is associated with decreased bacterial load and biofilm formation compared to wet-to-dry dressings in an in vivo porcine model of infected spinal instrumentation.

  3. Negative pressure wound therapy applied before and after split-thickness skin graft helps healing of Fournier gangrene: a case report (CARE-Compliant).

    Science.gov (United States)

    Ye, Junna; Xie, Ting; Wu, Minjie; Ni, Pengwen; Lu, Shuliang

    2015-02-01

    Fournier gangrene is a rare but highly infectious disease characterized by fulminant necrotizing fasciitis involving the genital and perineal regions. Negative pressure wound therapy (NPWT; KCI USA Inc, San Antonio, TX) is a widely adopted technique in many clinical settings. Nevertheless, its application and effect in the treatment of Fournier gangrene are unclear. A 47-year-old male patient was admitted with an anal abscess followed by a spread of the infection to the scrotum, which was caused by Pseudomonas aeruginosa. NPWT was applied on the surface of the scrotal area and continued for 10 days. A split-thickness skin graft from the scalp was then grafted to the wound, after which, NPWT utilizing gauze sealed with an occlusive dressing and connected to a wall suction was employed for 7 days to secure the skin graft. At discharge, the percentage of the grafted skin alive on the scrotum was 98%. The wound beside the anus had decreased to 4 × 0.5 cm with a depth of 1 cm. Follow-up at the clinic 1 month later showed that both wounds had healed. The patient did not complain of any pain or bleeding, and was satisfied with the outcome. NPWT before and after split-thickness skin grafts is safe, well tolerated, and efficacious in the treatment of Fournier gangrene.

  4. Effect of Negative Pressure Wound Therapy on Cellular Fibronectin and Transforming Growth Factor-β1 Expression in Diabetic Foot Wounds.

    Science.gov (United States)

    Yang, Shao Ling; Zhu, Lv Yun; Han, Rui; Sun, Lei Lei; Dou, Jing Tao

    2017-08-01

    Chronic diabetic foot wounds are a leading cause of amputation, morbidity, and hospitalization for patients with diabetes. Negative-pressure wound therapy (NPWT) can putatively facilitate wound healing, but the underlying mechanisms remain unclear. Cellular fibronectin (cFN) and transforming growth factor-β1 (TGF-β1) play an important role in wound healing. This prospective randomized controlled trial evaluated the effects of NPWT on the production of cFN and the expression of TGF-β1 in diabetic foot wounds of patients. From January 2012 to January 2015, 40 patients with diabetic foot wounds were randomly and equally apportioned to receive either NPWT or advanced moist wound therapy (control) for 7 days. Granulation tissue was harvested before and after treatment. Immunohistochemistry and Western blot were performed to evaluate protein levels of cFN and TGF-β1, and real-time polymerase chain reaction (PCR) to measure corresponding mRNA expressions. NPWT facilitated the expression of cFN and TGF-β1 in diabetic foot wounds. Immunohistochemical analysis revealed higher levels of cFN and TGF-β1 in the NPWT group than in the control group. Western blot and real-time PCR analysis further showed that protein and mRNA levels of cFN or TGF-β1 were higher in the NPWT group than that in the control group ( P diabetic foot ulcers. Level I, randomized controlled study.

  5. Inactivation of gram-negative bacteria in milk and banana juice by hen egg white and lambda lysozyme under high hydrostatic pressure.

    Science.gov (United States)

    Nakimbugwe, Dorothy; Masschalck, Barbara; Anim, Grace; Michiels, Chris W

    2006-10-15

    The effect of hen egg white lysozyme (HEWL) and bacteriophage lambda lysozyme (LaL) in combination with high pressure (HP) treatment on the inactivation of four gram-negative bacteria (Escherichia coli O157:H7, Shigella flexneri, Yersinia enterocolitica and Salmonella typhimurium), was studied in skim milk (pH 6.8; a(w) 0.997) and in banana juice (pH 3.8; a(w) 0.971). In the absence of lysozymes, S. flexneri was more sensitive to HP in milk than in banana juice, while the opposite was observed for the other three bacteria. In combination with HP treatment, LaL was more effective than HEWL on all bacteria in both milk and banana juice. Depending on the bacteria, inactivation levels in banana juice were increased from 0.4-2.7 log units by HP treatment alone to 3.6-6.5 log units in the presence of 224 U/ml LaL. Bacterial inactivation in milk was also enhanced by LaL but only by 0.5-2.1 log units. Under the experimental conditions used, LaL was more effective in banana juice than in milk, while the effectiveness of HEWL under the same conditions was not significantly affected by the food matrix. This effect could be ascribed to the low pH of the banana juice since LaL was also more effective on E. coli in buffer at pH 3.8 than at pH 6.8. Since neither LaL nor HEWL are enzymatically active at pH 3.8, we analysed bacterial lysis after HP treatment in the presence of these enzymes, and found that inactivation proceeds through a non-lytic mechanism at pH 3.8 and a lytic mechanism at pH 6.8. Based on these results, LaL may offer interesting perspectives for use as an extra hurdle in high pressure food preservation.

  6. Negative Pressure Wound Therapy With Instillation (NPWTi) Better Reduces Post-debridement Bioburden in Chronically Infected Lower Extremity Wounds Than NPWT Alone.

    Science.gov (United States)

    Goss, S G; Schwartz, J A; Facchin, F; Avdagic, E; Gendics, C; Lantis, J C

    2012-12-01

    An overabundance of bacteria in the chronic wound plays a significant role in the decreased ability for primary closure. One means of decreasing the bioburden in a wound is to operatively debride the wound for wound bed optimization prior to application of other therapy, such as Negative Pressure Wound Therapy (NPWT). We undertook a prospective pilot study to assess the efficacy of wound bed preparation for a standard algorithm (sharp surgical debridement followed by NPWT) versus one employing sharp surgical debridement followed by Negative Pressure Wound Therapy with Instillation (NPWTi). Thirteen patients, corresponding to 16 chronic lower leg and foot wounds were taken to the operating room for debridement. The patients were sequentially enrolled in 2 treatment groups: the first receiving treatment with operative debridement followed by 1 week of NPWT with the instillation of quarter strength bleach solution; the other receiving a standard algorithm consisting of operative debridement and 1 week of NPWT. Quantitative cultures were taken pre-operatively after sterile preparation and draping of the wound site (POD # 0, pre-op), post-operatively once debridement was completed (POD # 0, post-op), and on post-operative day 7 after operative debridement (POD # 7, post-op). After operative debridement (post-operative day 0) there was a mean of 3 (±1) types of bacteria per wound. The mean CFU/gram tissue culture was statistically greater - 3.7 × 10(6) (±4 × 10(6)) in the NPWTi group, while in the standard group (NPWT) the mean was 1.8 × 10(6) (±2.36 × 10(6)) CFU/gram tissue culture (p = 0.016); at the end of therapy there was no statistical difference between the two groups (p = 0.44). Wounds treated with NPWTi had a mean of 2.6 × 10(5) (±3 × 10(5)) CFU/gram of tissue culture while wounds treated with NPWT had a mean of 2.79 × 10(6) (±3.18 × 10(6)) CFU/gram of tissue culture (p = 0.43). The mean absolute reduction in bacteria for the

  7. Comparison of Negative Pressure Wound Therapy Using Vacuum-Assisted Closure with Advanced Moist Wound Therapy in the Treatment of Diabetic Foot Ulcers.

    Science.gov (United States)

    Sajid, Muhammad Tanveer; Mustafa, Qurat ul Ain; Shaheen, Neelofar; Hussain, Syed Mukarram; Shukr, Irfan; Ahmed, Muhammad

    2015-11-01

    To evaluate the clinical efficacy of Negative Pressure Wound Therapy (NPWT) using Vacuum Assisted Closure (VAC) compared with Advanced Moist Wound Therapy (AMWT) to treat Diabetic Foot Ulcer (DFU). Randomized control trial. Surgical Department, Combined Military Hospital (CMH) / Military Hospital (MH), Rawalpindi, from November 2010 to June 2012. The study consisted of 278 patients, with 139 patients each in Group 'A' and 'B', who were subjected to AMWT and NPWT, respectively. Wound was assessed digitally every week for 2 weeks. Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio (UTHCSA) image tool version 3.0. Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks. Mean age of presentation in group A was 55.88 ± 10.97 years while in group B, it was 56.83 ± 11.3 (p=0.48). Mean duration of diabetes at presentation was 15.65 ± 4.86 and 15.96 ± 5.79 years in group A and B, respectively (p=0.74). Majority of patients had Wagner's grade 2 ulcer (82% in group A and 87.8% in group B, p= 0.18). Initial wound size in group A was 15.07 ± 2.92 cm2 and in group B 15.09 ± 2.81 cm2 (p = 0.95). Wound size measured after 2 weeks, treatment was in group A13.70 ± 2.92 cm2 and in group B 11.53 ± 2.78 cm2 (p VAC was more efficacious than AMWT in the management of diabetic foot ulcers.

  8. Does treatment of split-thickness skin grafts with negative-pressure wound therapy improve tissue markers of wound healing in a porcine experimental model?

    Science.gov (United States)

    Ward, Christopher; Ciraulo, David; Coulter, Michael; Desjardins, Steven; Liaw, Lucy; Peterson, Sarah

    2012-08-01

    Negative-pressure wound therapy (NPWT) has been used for to treat wounds for more than 15 years and, more recently, has been used to secure split-thickness skin grafts. There are some data to support this use of NPWT, but the actual mechanism by which NPWT speeds healing or improves skin graft take is not entirely known. The purpose of this project was to assess whether NPWT improved angiogenesis, wound healing, or graft survival when compared with traditional bolster dressings securing split-thickness skin grafts in a porcine model. We performed two split-thickness skin grafts on each of eight 30 kg Yorkshire pigs. We took graft biopsies on postoperative days 2, 4, 6, 8, and 10 and submitted the samples for immunohistochemical staining, as well as standard hematoxylin and eosin staining. We measured the degree of vascular ingrowth via immunohistochemical staining for von Willenbrand's factor to better identify blood vessel epithelium. We determined the mean cross-sectional area of blood vessels present for each representative specimen, and then compared the bolster and NPWT samples. We also assessed each graft for incorporation and survival at postoperative day 10. Our analysis of the data revealed that there was no statistically significant difference in the degree of vascular ingrowth as measured by mean cross-sectional capillary area (p = 0.23). We did not note any difference in graft survival or apparent incorporation on a macroscopic level, although standard hematoxylin and eosin staining indicated that microscopically, there seemed to be better subjective graft incorporation in the NPWT samples and a nonsignificant trend toward improved graft survival in the NPWT group. We were unable to demonstrate a significant difference in vessel ingrowth when comparing NPWT and traditional bolster methods for split-thickness skin graft fixation. More studies are needed to elucidate the manner by which NPWT exerts its effects and the true clinical magnitude of these

  9. Health Technology Assessment of the Negative Pressure Wound Therapy for the treatment of acute and chronic wounds: efficacy, safety, cost effectiveness, organizational and ethical impact

    Directory of Open Access Journals (Sweden)

    Paolo Giorgi Rossi

    2012-06-01

    Full Text Available

    Background: the aim of the study was to assess the safety, efficacy and cost-effectiveness of negative Pressure wound therapy (nPT for people with chronic and acute wounds.

    Methods: the scope and the final draft of the report have been submitted to the stakeholders (producers, payers and patients. safety issues were addressed through a systematic review of the meta-literature. efficacy was addressed through a systematic review and meta-analysis of randomized controlled trials (rcTs comparing nPT and other standard therapies in patients with chronic or acute lesions. cost-consequence was analyzed through a systematic review of the existing studies.

    Results: we retrieved 19 studies, 13 of which were included in the meta-analysis. Many studies had biases that may have resulted in a better performance for nPT. nPT showed: a slightly shorter healing time (-10.4 days, p=0.001, with no heterogeneity, apart from one small study with very positive results, and 40% more patients healed (p=0.002, no heterogeneity.We identified 15 original research papers on nPT costs and cost per outcome. The costs-per-patient- treated varied from +29% to -60%, with several studies reporting savings for nPT.

    Conclusions: despite serious methodological flaws, the body of evidence available was sufficient to prove some clinical benefit of nPT in severe chronic and acute wound treatment. There is a need for independent and contextualized cost analyses....

  10. Negative pressure wound therapy, staged excision and definitive closure with split-thickness skin graft for axillary hidradenitis suppurativa: a retrospective study.

    Science.gov (United States)

    Pearce, F B; Richardson, K A

    2017-01-02

    Bilateral axillary hidradenitis is a chronic, suppurative, and scarring disease that is most effectively treated by complete excision of all hair-bearing tissues. We assessed our staged procedure for excision and placement of a split-thickness skin graft for bilateral axillary hidradenitis in terms of costs, outcomes, and timing of excision. An IRB approved retrospective case analysis was performed on patients that underwent bilateral axillary hidradenitis skin excision with eventual placement of split-thickness skin grafting using the current LSUHSC/University Health hidradenitis surgical treatment protocol. Using ICD-9 codes (705.83) and CPT codes (11041, 11042, 11451, 11600, 11601, 11602, 11603, 11604) we reviewed cases performed at our institution from 1 January 2008 to 24 Febuary 2014 and we selected patients based on bilateral axillary involvement (alone) and >1 year history of active disease. Patients were excluded if resection of tissue encompassed regions outside of the immediately adjacent axillary. A total of seven patients matching criteria for bilateral axillary hidradenitis were selected for analysis. Clinical course, cost and surgical techniques were assessed. Of the seven patients, six required admission throughout their treatment due to lack of funding making use of negative pressure wound therapy at home not possible. These patients stayed an average of 10 days with a mean hospital charge of $35,178 and a mean hospital provider charge of $10,019. No recurrence was demonstrated. All patients attained full range of motion, post grafting. No patient required a further operation due to graft failure. Split-thickness skin grafting without use of bilayer dermal regenerative templates yielded definitive results with acceptable cosmesis and functionality, without the added cost of treatments such as a bilayer dermal regenerative template.

  11. Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers

    International Nuclear Information System (INIS)

    Sajid, M.T.; Mustafa, Q.U.A.

    2015-01-01

    Objective: To evaluate the clinical efficacy of Negative Pressure Wound Therapy (NPWT) using Vacuum Assisted Closure (VAC) compared with Advanced Moist Wound Therapy (AMWT) to treat Diabetic Foot Ulcer (DFU). Study Design: Randomized control trial. Place and Duration of Study: Surgical Department, Combined Military Hospital (CMH) / Military Hospital (MH), Rawalpindi, from November 2010 to June 2012. Methodology: The study consisted of 278 patients, with 139 patients each in Group A and B, who were subjected to AMWT and NPWT, respectively. Wound was assessed digitally every week for 2 weeks. Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio (UTHCSA) image tool version 3.0. Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks. Results: Mean age of presentation in group Awas 55.88 10.97 years while in group B, it was 56.83 ± 11.3 (p=0.48). Mean duration of diabetes at presentation was 15.65 ± 4.86 and 15.96 ± 5.79 years in group A and B, respectively (p=0.74). Majority of patients had Wagner's grade 2 ulcer (82% in group A and 87.8% in group B, p= 0.18). Initial wound size in group A was 15.07 ± 2.92 cm2and in group B 15.09 ± 2.81 cm2(p = 0.95). Wound size measured after 2 weeks, treatment was in group A13.70 ± 2.92 cm2 and in group B 11.53 ± 2.78 cm2 (p < 0.001). Wound area reduction in both groups revealed statistically significant faster healing in group B as compared to group A(p < 0.001). Conclusion: NPWT using VAC was more efficacious than AMWT in the management of diabetic foot ulcers. (author)

  12. Use of collagenase ointment in conjunction with negative pressure wound therapy in the care of diabetic wounds: a case series of six patients

    Directory of Open Access Journals (Sweden)

    John D. Miller

    2015-01-01

    Full Text Available Background: Diabetic wounds with additional comorbidities are costly, time intensive, and difficult to heal. Often, multiple modalities may be necessary to achieve wound resolution, relying on the synergistic advantage of each therapy to affect wound healing. The selectivity of Clostridium collagenase is physiologically effective at degrading non-viable collagen fibers while preserving living collagen tissue. Additionally, negative pressure wound therapy (NPWT has long been used to aid wound healing while concurrently depreciating biological wound burden time. Methods: Six patients were selected from those appearing to our university based limb salvage service. Inclusion criteria included patients with a recurrent mixed fibrotic and granular wound base, in which NPWT was indicated, without exclusion criteria. Patients enrolled were administered clostridial collagenase ointment at each regularly scheduled NPWT dressing change. Patients were followed until healing, with visual representations of wound progression and time to full healing recorded. Results: Tandem application of these therapies appeared to expedite wound healing by clearing degenerative fibrous tissue and expediting wound granulation without additional complication. Unfortunately, not all patients were able to reach full healing; with two patients experiencing ulcer recurrence, likely a result of their significant comorbid nature. Conclusion: In our experience, we have noticed a specific subgroup of patients who benefit greatly when collagenase enzymatic debridement therapy is combined with NPWT. It is our belief that this combination therapy combines the molecular clearing of non-viable collagen with the wound granulation necessary to advance complex wounds to the next step in healing despite the current paucity in literature discussing this specific pairing.

  13. Basal electric and magnetic fields of celestial bodies come from positive-negative charge separation caused by gravitation of quasi-Casimir pressure in weak interaction

    Science.gov (United States)

    Chen, Shao-Guang

    According to f =d(mv)/dt=m(dv/dt)+ v(dm/dt), a same gravitational formula had been de-duced from the variance in physical mass of QFT and from the variance in mass of inductive energy-transfer of GR respectively: f QF T = f GR = -G (mM/r2 )((r/r)+(v/c)) when their interaction-constants are all taken the experimental values (H05-0029-08, E15-0039-08). f QF T is the quasi-Casimir pressure. f GR is equivalent to Einstein's equation, then more easy to solve it. The hypothesis of the equivalent principle is not used in f QF T , but required by f GR . The predictions of f QF T and f GR are identical except that f QF T has quantum effects but f GR has not and f GR has Lense-Thirring effect but f QF T has not. The quantum effects of gravitation had been verified by Nesvizhevsky et al with the ultracold neutrons falling in the earth's gravitational field in 2002. Yet Lense-Thirring effect had not been measured by GP-B. It shows that f QF T is essential but f GR is phenomenological. The macro-f QF T is the statistic average pressure collided by net virtual neutrinos ν 0 flux (after self-offset in opposite directions) and in direct proportion to the mass. But micro-f QF T is in direct proportion to the scattering section. The electric mass (in inverse proportion to de Broglie wavelength λ) far less than nucleonic mass and the electric scattering section (in direct proportion to λ2 ) far large than that of nucleon, then the net ν 0 flux pressure exerted to electron far large than that to nucleon and the electric displacement far large than that of nucleon, it causes the gravitational polarization of positive-negative charge center separation. Because the gravity far less than the electromagnetic binding force, in atoms the gravitational polarization only produces a little separation. But the net ν 0 flux can press a part freedom electrons in plasma of ionosphere into the earth's surface, the static electric force of redundant positive ions prevents electrons from further

  14. The Yo-Yo intermittent recovery test

    DEFF Research Database (Denmark)

    Bangsbo, Jens; Iaia, F. Marcello; Krustrup, Peter

    2008-01-01

    The two Yo-Yo intermittent recovery (IR) tests evaluate an individual's ability to repeatedly perform intense exercise. The Yo-Yo IR level 1 (Yo-Yo IR1) test focuses on the capacity to carry out intermittent exercise leading to a maximal activation of the aerobic system, whereas Yo-Yo IR level 2...

  15. Intermittent behavior of the logistic system

    Science.gov (United States)

    Mayer-Kress, G.; Haken, H.

    1981-03-01

    In the discrete logistic model a transition to chaotic behavior via intermittency occurs in a neighborhood of periodic bands. Intermittent behavior is also induced if a stable periodic orbit is perturbed by low-level external noise, whereas alterations due to computer digitalisation produce remarkable periodicities. We compare our numerical results with the predictions of Pomeau and Manneville for the Lorenz system.

  16. Cosmic Rays in Intermittent Magnetic Fields

    International Nuclear Information System (INIS)

    Shukurov, Anvar; Seta, Amit; Bushby, Paul J.; Wood, Toby S.; Snodin, Andrew P.

    2017-01-01

    The propagation of cosmic rays in turbulent magnetic fields is a diffusive process driven by the scattering of the charged particles by random magnetic fluctuations. Such fields are usually highly intermittent, consisting of intense magnetic filaments and ribbons surrounded by weaker, unstructured fluctuations. Studies of cosmic-ray propagation have largely overlooked intermittency, instead adopting Gaussian random magnetic fields. Using test particle simulations, we calculate cosmic-ray diffusivity in intermittent, dynamo-generated magnetic fields. The results are compared with those obtained from non-intermittent magnetic fields having identical power spectra. The presence of magnetic intermittency significantly enhances cosmic-ray diffusion over a wide range of particle energies. We demonstrate that the results can be interpreted in terms of a correlated random walk.

  17. Cosmic Rays in Intermittent Magnetic Fields

    Energy Technology Data Exchange (ETDEWEB)

    Shukurov, Anvar; Seta, Amit; Bushby, Paul J.; Wood, Toby S. [School of Mathematics and Statistics, Newcastle University, Newcastle Upon Tyne NE1 7RU (United Kingdom); Snodin, Andrew P., E-mail: a.seta1@ncl.ac.uk, E-mail: amitseta90@gmail.com [Department of Mathematics, Faculty of Applied Science, King Mongkut’s University of Technology North Bangkok, Bangkok 10800 (Thailand)

    2017-04-10

    The propagation of cosmic rays in turbulent magnetic fields is a diffusive process driven by the scattering of the charged particles by random magnetic fluctuations. Such fields are usually highly intermittent, consisting of intense magnetic filaments and ribbons surrounded by weaker, unstructured fluctuations. Studies of cosmic-ray propagation have largely overlooked intermittency, instead adopting Gaussian random magnetic fields. Using test particle simulations, we calculate cosmic-ray diffusivity in intermittent, dynamo-generated magnetic fields. The results are compared with those obtained from non-intermittent magnetic fields having identical power spectra. The presence of magnetic intermittency significantly enhances cosmic-ray diffusion over a wide range of particle energies. We demonstrate that the results can be interpreted in terms of a correlated random walk.

  18. Metabolic syndrome in patients with prostate cancer undergoing intermittent androgen-deprivation therapy.

    Science.gov (United States)

    Rezaei, Mohammadali Mohammadzadeh; Rezaei, Mohammadhadi Mohammadzadeh; Ghoreifi, Alireza; Kerigh, Behzad Feyzzadeh

    2016-01-01

    The presence of metabolic syndrome in men with prostate cancer (PCa) undergoing androgen-deprivation therapy (ADT), especially intermittent type, has not been completely evaluated. The aim of this study is to evaluate metabolic syndrome in men with PCa undergoing intermittent ADT. In this longitudinal study, we studied the prevalence of metabolic syndrome and its components in 190 patients who were undergoing intermittent ADT. The metabolic syndrome was defined according to the Adult Treatment Panel III criteria. All metabolic parameters, including lipid profile, blood glucose, blood pressures, and waist circumferences of the patients were measured six and 12 months after treatment. Mean age of the patients was 67.5 ± 6.74 years. The incidence of metabolic syndrome after six and 12 months was 6.8% and 14.7%, respectively. Analysis of various components of the metabolic syndrome revealed that patients had significantly higher overall prevalence of hyperglycemia, abdominal obesity, and hypertriglyceridemia in their six- and 12-month followups, but blood pressure has not been changed in the same period except for diastolic blood pressure after six months. Although there was an increased risk of metabolic syndrome in patients receiving intermittent ADT, it was lower than other studies that treated the same patients with continuous ADT. Also it seems that intermittent ADT has less metabolic complications than continuous ADT and could be used as a safe alternative in patients with advanced and metastatic PCa.

  19. Clan structure as a source of intermittency in high energy multihadron production

    International Nuclear Information System (INIS)

    Hove, L. van

    1989-01-01

    Recently the systematic study of charged hadron multiplicity distributions in high energy hadronic and leptonic collisions has revealed the general occurrence of negative binomial regularities in symmetric CM rapidity windows and of intermittency in very small windows in the central region. The negative binomial regularities imply a particular form of clustering called clan structure, which embodies all Mueller multiparticle correlations. We show that this clan structure leads to intermittency when the simplest assumptions are made on the behaviour of the clans in very small windows. (orig.)

  20. Negative pressure wound treatment improves Acute Physiology and Chronic Health Evaluation II score in mediastinitis allowing a successful elective pectoralis muscle flap closure: six-year experience of a single protocol.

    Science.gov (United States)

    Salica, Andrea; Weltert, Luca; Scaffa, Raffaele; Guerrieri Wolf, Lorenzo; Nardella, Saverio; Bellisario, Alessandro; De Paulis, Ruggero

    2014-11-01

    Optimal management of poststernotomy mediastinitis is controversial. Negative pressure wound treatment improves wound environment and sternal stability with low surgical invasiveness. Our protocol was based on negative pressure followed by delayed surgical closure. The aim of this study was to provide the results at early follow-up and to identify the risk factors for adverse outcome. In 5400 cardiac procedures, 44 consecutive patients with mediastinitis were enrolled in the study. Mediastinitis treatment was based on urgent debridement and negative pressure as the first-line approach. After wound sterilization, chest closure was achieved by elective pectoralis muscle advancement flap. Each patient's hospital data were collected prospectively. Variables included patient demographics and clinical and biological data. Acute Physiology and Chronic Health Evaluation (APACHE) II score was calculated at the time of diagnosis and 48 hours after debridement. Focus outcome measures were mediastinitis-related death and need for reintervention after pectoralis muscle closure. El Oakley type I and type IIIA mediastinitis were the most frequent types (63.6%). Methicillin-resistant Staphylococcus aureus was present in 25 patients (56.8%). Mean APACHE II score was 19.4±4 at the time of diagnosis, and 30 patients (68.2%) required intensive care unit transfer before surgical debridement. APACHE II score improved 48 hours after wound debridement and negative pressure application (mean value, 19.4±4 vs 7.2±2; P=.005) independently of any other variables included in the study. One patient in septic shock at the time of diagnosis died (2.2%). Negative pressure promotes a significant improvement in clinical status according to APACHE II score and allows a successful elective surgical closure. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  1. ANISOTROPIC INTERMITTENCY OF MAGNETOHYDRODYNAMIC TURBULENCE

    International Nuclear Information System (INIS)

    Osman, K. T.; Kiyani, K. H.; Chapman, S. C.; Hnat, B.

    2014-01-01

    A higher-order multiscale analysis of spatial anisotropy in inertial range magnetohydrodynamic turbulence is presented using measurements from the STEREO spacecraft in fast ambient solar wind. We show for the first time that, when measuring parallel to the local magnetic field direction, the full statistical signature of the magnetic and Elsässer field fluctuations is that of a non-Gaussian globally scale-invariant process. This is distinct from the classic multiexponent statistics observed when the local magnetic field is perpendicular to the flow direction. These observations are interpreted as evidence for the weakness, or absence, of a parallel magnetofluid turbulence energy cascade. As such, these results present strong observational constraints on the statistical nature of intermittency in turbulent plasmas

  2. Prolonged Intermittent Renal Replacement Therapy.

    Science.gov (United States)

    Edrees, Fahad; Li, Tingting; Vijayan, Anitha

    2016-05-01

    Prolonged intermittent renal replacement therapy (PIRRT) is becoming an increasingly popular alternative to continuous renal replacement therapy in critically ill patients with acute kidney injury. There are significant practice variations in the provision of PIRRT across institutions, with respect to prescription, technology, and delivery of therapy. Clinical trials have generally demonstrated that PIRRT is non-inferior to continuous renal replacement therapy regarding patient outcomes. PIRRT offers cost-effective renal replacement therapy along with other advantages such as early patient mobilization and decreased nursing time. However, due to lack of standardization of the procedure, PIRRT still poses significant challenges, especially pertaining to appropriate drug dosing. Future guidelines and clinical trials should work toward developing consensus definitions for PIRRT and ensure optimal delivery of therapy. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  3. Experimental evidence for negative turgor pressure in small leaf cells of Robinia pseudoacacia L versus large cells of Metasequoia glyptostroboides Hu et W.C. Cheng. 2. Höfler diagrams below the volume of zero turgor and the theoretical implication for pressure-volume curves of living cells.

    Science.gov (United States)

    Yang, Dongmei; Li, Junhui; Ding, Yiting; Tyree, Melvin T

    2017-03-01

    The physiological advantages of negative turgor pressure, P t , in leaf cells are water saving and homeostasis of reactants. This paper advances methods for detecting the occurrence of negative P t in leaves. Biomechanical models of pressure-volume (PV) curves predict that negative P t does not change the linearity of PV curve plots of inverse balance pressure, P B , versus relative water loss, but it does predict changes in either the y-intercept or the x-intercept of the plots depending on where cell collapse occurs in the P B domain because of negative P t . PV curve analysis of Robinia leaves revealed a shift in the x-intercept (x-axis is relative water loss) of PV curves, caused by negative P t of palisade cells. The low x-intercept of the PV curve was explained by the non-collapse of palisade cells in Robinia in the P B domain. Non-collapse means that P t smoothly falls from positive to negative values with decreasing cell volume without a dramatic change in slope. The magnitude of negative turgor in non-collapsing living cells was as low as -1.3 MPa and the relative volume of the non-collapsing cell equaled 58% of the total leaf cell volume. This study adds to the growing evidence for negative P t . © 2016 John Wiley & Sons Ltd.

  4. Optimal Intermittent Operation of Water Distribution Networks under Water Shortage

    Directory of Open Access Journals (Sweden)

    mohamad Solgi

    2017-07-01

    Full Text Available Under water shortage conditions, it is necessary to exercise water consumption management practices in water distribution networks (WDN. Intermittent supply of water is one such practice that makes it possible to supply consumption nodal demands with the required pressure via water cutoff to some consumers during certain hours of the day. One of the most important issues that must be observed in this management practice is the equitable and uniform water distribution among the consumers. In the present study, uniformity in water distribution and minimum supply of water to all consumers are defined as justice and equity, respectively. Also, an optimization model has been developed to find an optimal intermittent supply schedule that ensures maximum number of demand nodes are supplied with water while the constraints on the operation of water distribution networks are also observed. To show the efficiency of the proposed model, it has been used in the Two-Loop distribution network under several different scenarios of water shortage. The optimization model has been solved using the honey bee mating optimization algorithm (HBMO linked to the hydraulic simulator EPANET. The results obtained confirm the efficiency of the proposed model in achieving an optimal intermittent supply schedule. Moreover, the model is found capable of distributing the available water in an equitable and just manner among all the consumers even under severe water shoratges.

  5. High pressure studies of A2Mo3O12 negative thermal expansion materials (A2=Al2, Fe2, FeAl, AlGa)

    International Nuclear Information System (INIS)

    Young, Lindsay; Gadient, Jennifer; Gao, Xiaodong; Lind, Cora

    2016-01-01

    High pressure powder X-ray diffraction studies of several A 2 Mo 3 O 12 materials (A 2 =Al 2 , Fe 2 , FeAl, and AlGa) were conducted up to 6–7 GPa. All materials adopted a monoclinic structure under ambient conditions, and displayed similar phase transition behavior upon compression. The initial isotropic compressibility first became anisotropic, followed by a small but distinct drop in cell volume. These patterns could be described by a distorted variant of the ambient pressure polymorph. At higher pressures, a distinct high pressure phase formed. Indexing results confirmed that all materials adopted the same high pressure phase. All changes were reversible on decompression, although some hysteresis was observed. The similarity of the high pressure cells to previously reported Ga 2 Mo 3 O 12 suggested that this material undergoes the same sequence of transitions as all materials investigated in this paper. It was found that the transition pressures for all phase changes increased with decreasing radius of the A-site cations. - Graphical abstract: Overlay of variable pressure X-ray diffraction data of Al 2 Mo 3 O 12 collected in a diamond anvil cell. Both subtle and discontinuous phase transitions are clearly observed. - Highlights: • The high pressure behavior of A 2 Mo 3 O 12 (A=Al, Fe, (AlGa), (AlFe)) was studied. • All compounds undergo the same sequence of pressure-induced phase transitions. • The phase transition pressures correlate with the average size of the A-site cation. • All transitions were reversible with hysteresis. • Previously studied Ga 2 Mo 3 O 12 undergoes the same sequence of transitions.

  6. Sensitivity of intermittent streams to climate variations in the USA

    Science.gov (United States)

    Eng, Kenny; Wolock, David M.; Dettinger, Mike

    2015-01-01

    There is a great deal of interest in the literature on streamflow changes caused by climate change because of the potential negative effects on aquatic biota and water supplies. Most previous studies have primarily focused on perennial streams, and there have been only a few studies examining the effect of climate variability on intermittent streams. Our objectives in this study were to (1) identify regions of similar zero-flow behavior, and (2) evaluate the sensitivity of intermittent streams to historical variability in climate in the United States. This study was carried out at 265 intermittent streams by evaluating: (1) correlations among time series of flow metrics (number of zero-flow events, the average of the central 50% and largest 10% of flows) with climate (magnitudes, durations and intensity), and (2) decadal changes in the seasonality and long-term trends of these flow metrics. Results identified five distinct seasonality patterns in the zero-flow events. In addition, strong associations between the low-flow metrics and historical changes in climate were found. The decadal analysis suggested no significant seasonal shifts or decade-to-decade trends in the low-flow metrics. The lack of trends or changes in seasonality is likely due to unchanged long-term patterns in precipitation over the time period examined.

  7. Intermittent hypoxia, cardiovascular disease and obstructive sleep apnoea.

    Science.gov (United States)

    Turnbull, Chris D

    2018-01-01

    Obstructive sleep apnoea (OSA) is a common disorder and is associated with cardiovascular disease. Continuous positive airway pressure (CPAP), whilst reducing blood pressure, has not been shown to reduce cardiovascular events when used as a treatment solely for this purpose in patients with previous cardiovascular disease. Developing a better understanding of the mechanisms underlying cardiovascular disease in OSA is important to develop new treatments. Potential causative mechanisms for cardiovascular disease in OSA include arousal induced sympathetic activation, large intrathoracic pressure swings leading to shear stress on the heart and great vessels, and intermittent hypoxia (IH). This review discusses the role of IH, as a major physiological consequence of OSA, in the development of cardiovascular disease.

  8. Estudo comparativo entre a pressão positiva intermitente (Reanimador de Müller e contínua no pós-operatório de cirurgia de revascularização do miocárdio Comparative study between intermittent (Müller Reanimator and continuous positive airway pressure in the postoperative period of coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Andréa Pires Müller

    2006-03-01

    Full Text Available OBJETIVO: Comparar o efeito da aplicação da pressão positiva intermitente e contínua em pacientes no pós-operatório de cirurgia de revascularização do miocárdio. MÉTODOS: Neste estudo foram considerados quarenta pacientes, divididos em dois grupos: um submetido a pressão positiva contínua (Grupo CPAP, e outro submetido a pressão intermitente (Grupo Reanimador de Müller. Os pacientes foram avaliados nos momentos: pré-operatório, 3ª, 24ª e 48ª horas, em relação às diversas variáveis do estudo. RESULTADOS: Os grupos de pacientes eram homogêneos em relação a diversas variáveis demográficas e clínicas. Os valores gasométricos de PO2, PCO2 e SO2 estiveram dentro dos parâmetros de normalidade e não foram encontradas diferenças significantes entre os grupos. Na ventilometria os grupos apresentaram diferenças significativas no volume corrente e freqüência respiratória no pós-operatório de 48 horas. A dispnéia e a participação da musculatura acessória, nas avaliações do pós-operatório, foram encontradas com freqüência significativamente maior nos pacientes submetidos ao CPAP. Pacientes submetidos ao Reanimador de Müller apresentaram radiografia de tórax normal com maior freqüência do que pacientes submetidos ao CPAP. CONCLUSÃO: Observou-se que ambos os recursos foram capazes de manter valores de PO2, PCO2 e SO2 dentro da normalidade. Porém, quando se busca a reexpansão pulmonar, com menor carga de trabalho imposta, o Reanimador de Müller foi mais efetivo pela forma mais rápida de ação e, conseqüentemente, apresentou menores índices de dispnéia, freqüência respiratória (FR e atividade de musculatura acessória.OBJECTIVE: To compare the effect of the use of intermittent and continuous positive airway pressure in postoperative patients undergoing coronary artery bypass grafting. METHODS: This study included forty patients divided into two groups: one undergoing continuous positive airway

  9. Exposure to intermittent hypoxia and sustained hypercapnia reduces therapeutic CPAP in participants with obstructive sleep apnea.

    Science.gov (United States)

    El-Chami, Mohamad; Sudan, Sukhesh; Lin, Ho-Sheng; Mateika, Jason H

    2017-10-01

    Our purpose was to determine whether exposure to mild intermittent hypoxia leads to a reduction in the therapeutic continuous positive airway pressure required to eliminate breathing events. Ten male participants were treated with twelve 2-min episodes of hypoxia ([Formula: see text] ≈50 mmHg) separated by 2-min intervals of normoxia in the presence of [Formula: see text] that was sustained 3 mmHg above baseline. During recovery from the last episode, the positive airway pressure was reduced in a stepwise fashion until flow limitation was evident. The participants also completed a sham protocol under normocapnic conditions, which mimicked the time frame of the intermittent hypoxia protocol. After exposure to intermittent hypoxia, the therapeutic pressure was significantly reduced (i.e., 5 cmH 2 O) without evidence of flow limitation (103.4 ± 6.3% of baseline, P = 0.5) or increases in upper airway resistance (95.6 ± 15.0% of baseline, P = 0.6). In contrast, a similar decrease in pressure was accompanied by flow limitation (77.0 ± 1.8% of baseline, P = 0.001) and an increase in upper airway resistance (167.2 ± 17.5% of baseline, P = 0.01) after the sham protocol. Consistent with the initiation of long-term facilitation of upper airway muscle activity, exposure to intermittent hypoxia reduced the therapeutic pressure required to eliminate apneic events that could improve treatment compliance. This possibility, coupled with the potentially beneficial effects of intermittent hypoxia on comorbidities linked to sleep apnea, suggests that mild intermittent hypoxia may have a multipronged therapeutic effect on sleep apnea. NEW & NOTEWORTHY Our new finding is that exposure to mild intermittent hypoxia reduced the therapeutic pressure required to treat sleep apnea. These findings are consistent with previous results, which have shown that long-term facilitation of upper muscle activity can be initiated following exposure to intermittent hypoxia in humans.

  10. Sensitivity of intermittent streams to climate variations in the United States

    Science.gov (United States)

    Eng, K.

    2015-12-01

    There is growing interest in the effects of climate change on streamflows because of the potential negative effects on aquatic biota and water supplies. Previous studies of climate controls on flows have primarily focused on perennial streams, and few studies have examined the effect of climate variability on intermittent streams. Our objectives in this study were to (1) identify regions showing similar patterns of intermittency, and (2) evaluate the sensitivity of intermittent streams to historical variability in climate in the United States. This study was carried out at 265 intermittent streams by evaluating: (1) correlations among time series of flow metrics (number of zero-flow events, the average of the central 50% and largest 10% of flows) with precipitation (magnitudes, durations and intensity) and temperature, and (2) decadal changes in the seasonality and long-term trends of these flow metrics. Results identified five distinct seasonal patterns of flow intermittency: fall, fall-to-winter, non-seasonal, summer, and summer-to-winter intermittent streams. In addition, strong associations between the low-flow metrics and historical climate variability were found. However, the lack of trends in historical variations in precipitation results in no significant seasonal shifts or decade-to-decade trends in the low-flow metrics over the period of record (1950 to 2013).

  11. The Acute Effects of Intermittent Light Exposure in the Evening on Alertness and Subsequent Sleep Architecture.

    Science.gov (United States)

    Yang, Minqi; Ma, Ning; Zhu, Yingying; Su, Ying-Chu; Chen, Qingwei; Hsiao, Fan-Chi; Ji, Yanran; Yang, Chien-Ming; Zhou, Guofu

    2018-03-15

    Exposure to bright light is typically intermittent in our daily life. However, the acute effects of intermittent light on alertness and sleep have seldom been explored. To investigate this issue, we employed within-subject design and compared the effects of three light conditions: intermittent bright light (30-min pulse of blue-enriched bright light (~1000 lux, ~6000 K) alternating with 30-min dim normal light (~5 lux, ~3600 K) three times); continuous bright light; and continuous dim light on subjective and objective alertness and subsequent sleep structure. Each light exposure was conducted during the three hours before bedtime. Fifteen healthy volunteers (20 ± 3.4 years; seven males) were scheduled to stay in the sleep laboratory for four separated nights (one for adaptation and the others for the light exposures) with a period of at least one week between nights. The results showed that when compared with dim light, both intermittent light and continuous bright light significantly increased subjective alertness and decreased sleep efficiency (SE) and total sleep time (TST). Intermittent light significantly increased objective alertness than dim light did during the second half of the light-exposure period. Our results suggested that intermittent light was as effective as continuous bright light in their acute effects in enhancing subjective and objective alertness and in negatively impacting subsequent sleep.

  12. The Acute Effects of Intermittent Light Exposure in the Evening on Alertness and Subsequent Sleep Architecture

    Directory of Open Access Journals (Sweden)

    Minqi Yang

    2018-03-01

    Full Text Available Exposure to bright light is typically intermittent in our daily life. However, the acute effects of intermittent light on alertness and sleep have seldom been explored. To investigate this issue, we employed within-subject design and compared the effects of three light conditions: intermittent bright light (30-min pulse of blue-enriched bright light (~1000 lux, ~6000 K alternating with 30-min dim normal light (~5 lux, ~3600 K three times; continuous bright light; and continuous dim light on subjective and objective alertness and subsequent sleep structure. Each light exposure was conducted during the three hours before bedtime. Fifteen healthy volunteers (20 ± 3.4 years; seven males were scheduled to stay in the sleep laboratory for four separated nights (one for adaptation and the others for the light exposures with a period of at least one week between nights. The results showed that when compared with dim light, both intermittent light and continuous bright light significantly increased subjective alertness and decreased sleep efficiency (SE and total sleep time (TST. Intermittent light significantly increased objective alertness than dim light did during the second half of the light-exposure period. Our results suggested that intermittent light was as effective as continuous bright light in their acute effects in enhancing subjective and objective alertness and in negatively impacting subsequent sleep.

  13. Obstructive sleep apnea and intermittent hypoxia increase expression of dual specificity phosphatase 1.

    Science.gov (United States)

    Hoffmann, Michal S; Singh, Prachi; Wolk, Robert; Narkiewicz, Krzysztof; Somers, Virend K

    2013-12-01

    Dual specificity phosphatase 1 (DUSP1) inhibits mitogen activated protein kinase activity, and is activated by several stimuli such as sustained hypoxia, oxidative stress, and hormones. However, the effect of intermittent hypoxia is not known. The aim of this study was to evaluate the role of intermittent hypoxia on DUSP1 expression, and to validate its role in a human model of intermittent hypoxia, as seen in obstructive sleep apnea (OSA). OSA is characterized by recurrent episodes of hypoxemia/reoxygenation and is a known risk factor for cardiovascular morbidity. In-vitro studies using human coronary artery endothelial cells (HCAEC) and ex-vivo studies using white blood cells isolated from healthy and OSA subjects. Intermittent hypoxia induced DUSP1 expression in human coronary artery endothelial cells (HCAEC), and in granulocytes isolated from healthy human subjects. Functionally, DUSP1 increased the expression and activity of manganese superoxide dismutase (MnSOD) in HCAEC. Further, significant increases in DUSP1 mRNA from total blood, and in DUSP1 protein in mononuclear cells and granulocytes isolated from OSA subjects, were observed in the early morning hours after one night of intermittent hypoxemia due to untreated OSA. This early-morning OSA-induced augmentation of DUSP1 gene expression was attenuated by continuous positive airway pressure (CPAP) treatment of OSA. Intermittent hypoxia increases MnSOD activity via increased DUSP1 expression in HCAEC. Similarly, overnight intermittent hypoxemia in patients with OSA induces expression of DUSP1, which may mediate increases of MnSOD expression and activity. This may contribute significantly to neutralizing the effects of reactive oxygen species, a consequence of the intermittent hypoxemia/reperfusion elicited by OSA. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Intermittent cranial lung herniation in two dogs.

    Science.gov (United States)

    Guglielmini, Carlo; De Simone, Antonio; Valbonetti, Luca; Diana, Alessia

    2007-01-01

    Two aged dogs with chronic obstructive airway disease were evaluated because of intermittent swelling of the ventral cervical region. Radiographs made at expiration and caudal positioning of the forelimbs allowed identification of intermittent cervical lung herniation of the left and right cranial lung lobe in both dogs. Pulmonary hyperinflation, increased expiratory effort, and chronic coughing were considered responsible for the lung herniation. Cervical lung hernia should be included in the differential diagnoses of intermittent cervical swelling in dogs with chronic respiratory disorders associated with increased expiratory effort and chronic coughing.

  15. Chronic intermittent hypoxia induces cardiac inflammation and dysfunction in a rat obstructive sleep apnea model.

    Science.gov (United States)

    Wei, Qin; Bian, Yeping; Yu, Fuchao; Zhang, Qiang; Zhang, Guanghao; Li, Yang; Song, Songsong; Ren, Xiaomei; Tong, Jiayi

    2016-11-01

    Chronic intermittent hypoxia is considered to play an important role in cardiovascular pathogenesis during the development of obstructive sleep apnea (OSA). We used a well-described OSA rat model induced with simultaneous intermittent hypoxia. Male Sprague Dawley rats were individually placed into plexiglass chambers with air pressure and components were electronically controlled. The rats were exposed to intermittent hypoxia 8 hours daily for 5 weeks. The changes of cardiac structure and function were examined by ultrasound. The cardiac pathology, apoptosis, and fibrosis were analyzed by H&E staining, TUNNEL assay, and picosirius staining, respectively. The expression of inflammation and fibrosis marker genes was analyzed by quantitative real-time PCR and Western blot. Chronic intermittent hypoxia/low pressure resulted in significant increase of left ventricular internal diameters (LVIDs), end-systolic volume (ESV), end-diastolic volume (EDV), and blood lactate level and marked reduction in ejection fraction and fractional shortening. Chronic intermittent hypoxia increased TUNNEL-positive myocytes, disrupted normal arrangement of cardiac fibers, and increased Sirius stained collagen fibers. The expression levels of hypoxia induced factor (HIF)-1α, NF-kB, IL-6, and matrix metallopeptidase 2 (MMP-2) were significantly increased in the heart of rats exposed to chronic intermittent hypoxia. In conclusion, the left ventricular function was adversely affected by chronic intermittent hypoxia, which is associated with increased expression of HIF-1α and NF-kB signaling molecules and development of cardiac inflammation, apoptosis and fibrosis. © 2016 by the Journal of Biomedical Research. All rights reserved.

  16. Intermittent spatial separation of diaphragm and lower esophageal sphincter favors acidic and weakly acidic reflux

    NARCIS (Netherlands)

    Bredenoord, Albert J.; Weusten, Bas L. A. M.; Timmer, Robin; Smout, André J. P. M.

    2006-01-01

    BACKGROUND & AIMS: In small hiatal hernias, the size of the hernia is variable. Intermittent complete reduction can be observed with high-resolution manometry as a transition from a double-peak (hernia) to a single-peak (reduced) high-pressure zone. The aim of this study was to investigate whether

  17. A botanical compound, Padma 28, increases walking distance in stable intermittent claudication

    DEFF Research Database (Denmark)

    Drabaek, H; Mehlsen, J; Himmelstrup, H

    1993-01-01

    Thirty-six patients with a median age of sixty-seven years and a median duration of intermittent claudication of five years were randomized to either active treatment with Padma 28 or placebo. The effect of treatment was quantified by measurements of systemic and peripheral systolic blood pressur...

  18. Intermittent sea-level acceleration

    Science.gov (United States)

    Olivieri, M.; Spada, G.

    2013-10-01

    Using instrumental observations from the Permanent Service for Mean Sea Level (PSMSL), we provide a new assessment of the global sea-level acceleration for the last ~ 2 centuries (1820-2010). Our results, obtained by a stack of tide gauge time series, confirm the existence of a global sea-level acceleration (GSLA) and, coherently with independent assessments so far, they point to a value close to 0.01 mm/yr2. However, differently from previous studies, we discuss how change points or abrupt inflections in individual sea-level time series have contributed to the GSLA. Our analysis, based on methods borrowed from econometrics, suggests the existence of two distinct driving mechanisms for the GSLA, both involving a minority of tide gauges globally. The first effectively implies a gradual increase in the rate of sea-level rise at individual tide gauges, while the second is manifest through a sequence of catastrophic variations of the sea-level trend. These occurred intermittently since the end of the 19th century and became more frequent during the last four decades.

  19. Social Smoking among Intermittent Smokers

    Science.gov (United States)

    Shiffman, Saul; Li, Xiaoxue; Dunbar, Michael S.; Ferguson, Stuart G.; Tindle, Hilary A.; Scholl, Sarah M.

    2015-01-01

    Background “Social smoking” - smoking mostly or even only with others – may be an important pattern that implies smoking motivated extrinsically by social influences. Non-daily smokers (intermittent smokers; ITS) are often assumed to be social smokers, with some authors even assuming that all ITS are social smokers (SS+). We sought to identify and characterize social smokers in a sample of ITS. Methods 204 adult ITS (smoking 4–27 days/month) recorded the circumstances of smoking in their natural settings using Ecological Momentary Assessment, while also recording their circumstances in nonsmoking moments. SS+ were defined as ITS who were with others when they smoked most of their cigarettes, and who were ≥ 50% more likely to be with others when smoking than when not. Results Only 13% of ITS were SS+. Although defined solely on the basis of presence of others, SS+ showed a distinct pattern of smoking across multiple dimensions: Compared to other ITS (who were significantly less likely to smoke when with others), SS+ smoking was more associated with socializing, being with friends and acquaintances, drinking alcohol, weekends, evening or nighttime, being in other people’s homes, but not their own home. SS+ smoking was low in the morning and increased in the evening. SS+ smoked fewer days/week and were less dependent, but did not differ demographically. Conclusions Social smoking does constitute a highly distinct smoking pattern, but is not common among adult ITS. PMID:26205313

  20. Intermittent ileocoecal intususception in adult

    International Nuclear Information System (INIS)

    Cambal, M.; Zonca, P.; Maly, T.

    2013-01-01

    Aim: Aim of our paper is to present a case-report of chronic invagination in adult patient. Material: 28-years old woman with one year history of intermittent abdominal pain with symptoms of subileus state. She has underwent abdominal ultrasonography, abdominal X-ray, colonoscopy, irigography and abdominal CT. Appendectomy indicated for diagnosis of chronic appendicitis did not improve symptoms. Consecutively during acute problems were irigography and CT performed and diagnosis of an incomplete colon transversum obstruction of uncertain origin was established. There was stated suspicion of an intususception and patient was due to a repeated gastrointestinal passage indicated for an explorative laparotomy. During operation there was identified threefold invagination – colo-colonic, ileo-colonic and ileo-ileal. As a leading point of invagination was found in terminal ileum intraluminal polypous tumor 5 cm in diameter. Because of the secondary chronic changes of right colon wall and terminal ileum wall, after partial desinvagination right hemicolectomy was performed. Results: Patient was primary healed and now is without any subjective problems. Conclusion: Invagination is an acute abdominal event of obturative-strangulative type and it mainly occurs in infantile age. It is astonishing how long were patient´s difficulties lasting without obvious acute ileus. It is necessary in clinical practice to think on these rare reasons of gastrointestinal passage disorders. (author)

  1. White adipose tissue coloring by intermittent fasting.

    Science.gov (United States)

    Kivelä, Riikka; Alitalo, Kari

    2017-11-01

    Intermittent fasting (IF) has been shown to promote metabolic health in several organisms. Two recent papers show that IF induces white adipose tissue beiging and increases thermogenesis, which improves metabolic health in mice.

  2. On-line intermittent connector anomaly detection

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper investigates a non-traditional use of differential current sensor and current sensor to detect intermittent disconnection problems in connectors. An...

  3. Intermittent chaotic chimeras for coupled rotators

    DEFF Research Database (Denmark)

    Olmi, Simona; Martens, Erik Andreas; Thutupalli, Shashi

    2015-01-01

    Two symmetrically coupled populations of N oscillators with inertia m display chaotic solutions with broken symmetry similar to experimental observations with mechanical pendulums. In particular, we report evidence of intermittent chaotic chimeras, where one population is synchronized and the other...

  4. Feigenbaum attractor and intermittency in particle collisions

    International Nuclear Information System (INIS)

    Batunin, A.V.

    1992-01-01

    The hypothesis is proposed that the Feigenbaum attractor arising as a limit set in an infinite pichfork bifurcation sequence for unimodal one-dimensional maps underlies the intermittency phenomena in particle collisions. 23 refs.; 8 figs

  5. Counteracting negative venous line pressures to avoid arterial air bubbles: an experimental study comparing two different types of miniaturized extracorporeal perfusion systems.

    Science.gov (United States)

    Aboud, Anas; Mederos-Dahms, Hendrikje; Liebing, Kai; Zittermann, Armin; Schubert, Harald; Murray, Edward; Renner, Andre; Gummert, Jan; Börgermann, Jochen

    2015-05-29

    Because of its low rate of clinical complications, miniaturized extracorporeal perfusion systems (MEPS) are frequently used in heart centers worldwide. However, many recent studies refer to the higher probability of gaseous microemboli formation by MEPS, caused by subzero pressure values. This is the main reason why various de-airing devices were developed for today's perfusion systems. In the present study, we investigated the potential benefits of a simple one-way-valve connected to a volume replacement reservoir (OVR) for volume and pressure compensation. In an experimental study on 26 pigs, we compared MEPS (n = 13) with MEPS plus OVR (n = 13). Except OVR, perfusion equipment was identical in both groups. Primary endpoints were pressure values in the venous line and the right atrium as well as the number and volume of air bubbles. Secondary endpoints were biochemical parameters of systemic inflammatory response, ischemia, hemodilution and hemolysis. One animal was lost in the MEPS + OVR group. In the MEPS + OVR group no pressure values below -150 mmHg in the venous line and no values under -100 mmHg in right atrium were noticed. On the contrary, nearly 20% of venous pressure values in the MEPS group were below -150 and approximately 10% of right atrial pressure values were below -100 mmHg. Compared with the MEPS group, the bubble counter device showed lower numbers of arterial air bubbles in the MEPS + OVR group (mean ± SD: 13444 ± 5709 vs. 1 ± 2, respectively; p pressures and to reduce the number and volume of arterial air bubbles. This approach may lead to a lower rate of neurological complications.

  6. Structures of Bordered Pits Potentially Contributing to Isolation of a Refilled Vessel from Negative Xylem Pressure in Stems of Morus australis Poir.: Testing of the Pit Membrane Osmosis and Pit Valve Hypotheses.

    Science.gov (United States)

    Ooeda, Hiroki; Terashima, Ichiro; Taneda, Haruhiko

    2017-02-01

    Two hypotheses have been proposed to explain the mechanism preventing the refilling vessel water from being drained to the neighboring functional vessels under negative pressure. The pit membrane osmosis hypothesis proposes that the xylem parenchyma cells release polysaccharides that are impermeable to the intervessel pit membranes into the refilling vessel; this osmotically counteracts the negative pressure, thereby allowing the vessel to refill. The pit valve hypothesis proposes that gas trapped within intervessel bordered pits isolates the refilling vessel water from the surrounding functional vessels. Here, using the single-vessel method, we assessed these hypotheses in shoots of mulberry (Morus australis Poir.). First, we confirmed the occurrence of xylem refilling under negative pressure in the potted mulberry saplings. To examine the pit membrane osmosis hypothesis, we estimated the semi-permeability of pit membranes for molecules of various sizes and found that the pit membranes were not semi-permeable to polyethylene glycol of molecular mass osmosis mechanism in mulberry would be unrealistically large. © The Author 2016. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Inactivation of Gram-Negative Bacteria by Low-Pressure RF Remote Plasma Excited in N2-O2 Mixture and SF6 Gases

    Directory of Open Access Journals (Sweden)

    Ayman Al-Mariri

    2013-12-01

    Full Text Available The role of low-pressure RF plasma in the inactivation of Escherichia coli O157, Klebsiella pneumoniae, Proteus mirabilis, and Enterobacter sakazakii using N2-O2 and SF6 gases was assessed. 1×109 colony-forming units (CFUs of each bacterial isolate were placed on three polymer foils. The effects of pressure, power, distance from the source, and exposure time to plasma gases were optimized. The best conditions to inactivate the four bacteria were a 91%N2-9%O2 mixture and a 30-minute exposure time. SF6 gas was more efficient for all the tested isolates in as much as the treatment time was reduced to only three minutes. Therefore, low-pressure plasma could be used to sterilize heat and/or moisture-sensitive medical instruments.

  8. Investigation of the effect of mechanical pressure on the performance of negative lead accumulator electrodes during partial state of charge operation

    Czech Academy of Sciences Publication Activity Database

    Bača, P.; Micka, Karel; Křivík, P.; Tonar, K.; Tošer, P.

    2012-01-01

    Roč. 207, JUN 1 2012 (2012), s. 37-44 ISSN 0378-7753 Institutional research plan: CEZ:AV0Z40400503 Keywords : Lead battery electrodes * Doping with carbon or titanium dioxide * Effect of mechanical pressure Subject RIV: CG - Electrochemistry Impact factor: 4.675, year: 2012

  9. When negation is not negation

    OpenAIRE

    Milicevic, Nataša

    2008-01-01

    In this paper I will discuss the formation of different types of yes/no questions in Serbian (examples in (1)), focusing on the syntactically and semantically puzzling example (1d), which involves the negative auxiliary inversion. Although there is a negative marker on the fronted auxiliary, the construction does not involve sentential negation. This coincides with the fact that the negative quantifying NPIs cannot be licensed. The question formation and sentential negation have similar synta...

  10. Crisis induced intermittency in a fourth-order autonomous electric circuit

    International Nuclear Information System (INIS)

    Stouboulos, I.N.; Miliou, A.N.; Valaristos, A.P.; Kyprianidis, I.M.; Anagnostopoulos, A.N.

    2007-01-01

    The chaotic dynamics of a fourth-order autonomous nonlinear electric circuit has been studied. The circuit consists of two active elements, one linear negative conductance and one nonlinear resistor exhibiting a symmetrical piecewise-linear v-i characteristic and two capacitances C 1 and C 2 , which serve as the control parameters of the system. Experimental time series and the corresponding phase portraits were used to register the intermittent behaviour of the corresponding dynamical system between two interacting subattractors. The distribution of the times τ, between successive transitions from the one subattractor to the other indicates that a crisis induced intermittency occurs in the studied circuit

  11. A new low-cost negative-pressure wound therapy versus a commercially available therapy device widely used to treat complex traumatic injuries: a prospective, randomized, non-inferiority trial

    Directory of Open Access Journals (Sweden)

    Fabio Kamamoto

    Full Text Available OBJECTIVES: Negative-pressure wound therapy has been widely adopted to reduce the complexity of treating a broad range of acute and chronic wounds. However, its cost is high. The objective of this study was to evaluate the following two different methods of negative-pressure wound therapy in terms of healing time: a low-cost method of negative-pressure wound therapy (a pressure stabilizer device connected to a hospital wall-vacuum system with a gauze-sealed dressing, USP and the standard of care (vacuum-assisted closure, VAC. METHODS: This is a randomized, controlled, non-inferiority, unblinded trial. Patients admitted with complex injuries to a trauma center in a public referral hospital who were indicated for orthopedic surgery were randomized to a USP or VAC group. The primary outcome was the time required to achieve a “ready for surgery condition”, which was defined as a wound bed with healthy granulation tissue and without necrosis or purulent secretion. Wound bed area contraction, granulation tissue growth and the direct costs of the dressings were secondary outcomes. RESULTS: Variation in area and granulation tissue growth were essentially the same between the systems, and healing time was equal between the groups (p=0.379. In both systems, serial debridement increased wound area (p=0.934, and granulation tissue was also increased (p=0.408. The mean treatment cost was US$ 15.15 in the USP group and US$ 872.59 in the VAC group. CONCLUSIONS: For treating complex traumatic injuries, USP was non-inferior to and less expensive than VAC.

  12. A new low-cost negative-pressure wound therapy versus a commercially available therapy device widely used to treat complex traumatic injuries: a prospective, randomized, non-inferiority trial.

    Science.gov (United States)

    Kamamoto, Fabio; Lima, Ana Lucia Munhoz; Rezende, Marcelo Rosa de; Mattar-Junior, Rames; Leonhardt, Marcos de Camargo; Kojima, Kodi Edson; Santos, Carla Chineze Dos

    2017-12-01

    Negative-pressure wound therapy has been widely adopted to reduce the complexity of treating a broad range of acute and chronic wounds. However, its cost is high. The objective of this study was to evaluate the following two different methods of negative-pressure wound therapy in terms of healing time: a low-cost method of negative-pressure wound therapy (a pressure stabilizer device connected to a hospital wall-vacuum system with a gauze-sealed dressing, USP) and the standard of care (vacuum-assisted closure, VAC). This is a randomized, controlled, non-inferiority, unblinded trial. Patients admitted with complex injuries to a trauma center in a public referral hospital who were indicated for orthopedic surgery were randomized to a USP or VAC group. The primary outcome was the time required to achieve a "ready for surgery condition", which was defined as a wound bed with healthy granulation tissue and without necrosis or purulent secretion. Wound bed area contraction, granulation tissue growth and the direct costs of the dressings were secondary outcomes. Variation in area and granulation tissue growth were essentially the same between the systems, and healing time was equal between the groups (p=0.379). In both systems, serial debridement increased wound area (p=0.934), and granulation tissue was also increased (p=0.408). The mean treatment cost was US$ 15.15 in the USP group and US$ 872.59 in the VAC group. For treating complex traumatic injuries, USP was non-inferior to and less expensive than VAC.

  13. High negative pressure subcutaneous suction drain for managing debilitating subcutaneous emphysema secondary to tube thoracostomy for an iatrogenic post computed tomography guided transthoracic needle biopsy pneumothorax: Case report and review of literature.

    Science.gov (United States)

    Ahmed, Zeeshan; Patel, Pinakin; Singh, Suresh; Sharma, Raj Govind; Somani, Pankaj; Gouri, Abdul Rauf; Singh, Shiv

    2016-01-01

    Subcutaneous emphysema is a common complication of tube thoracostomy. Though self-limiting, it should be treated when it causes palpebral closure, dyspnea, dysphagia or undue disfigurement resulting in anxiety and distress to the patient. A 72year old man who was a known case of COPD on bronchodilators developed a large pneumothorax and respiratory distress after a CT guided transthoracic lung biopsy done for a lung opacity (approx. 3×3cm) at the right hilar region on Chest X-ray. Within 24h of an urgent tube thoracostomy, patient developed intractable subcutaneous emphysema with closure of palpebral fissure and dyspnea unresponsive to increasing suction on chest tube. A subcutaneous fenestrated drain was placed mid-way between the nipple and clavicle in the mid-clavicular line bilaterally. Continuous negative suction (-150mmHg) resulted in immediate, sustained relief and complete resolution within 5days. Extensive and debilitating SE (subcutaneous emphysema) has to be treated promptly to relieve patient discomfort, dysphagia or imminent respiratory compromise. A variety of treatment have been tried including infraclavicular blow-hole incisions, subcutaneous drains +/- negative pressure suction, fenestrated angiocatheters, Vacuum assisted dressings and increasing suction on a pre-existing chest tube. We describe a high negative pressure subcutaneous suction drain which provides immediate and sustained relief in debilitating SE. Debilitating subcutaneous emphysema which causes distress, anxiety, palpebral closure, dyspnoea or dysphagia requires intervention. High negative pressure subcutaneous suction drain provides immediate and sustained relief in extensive and debilitating SE. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Implementation of Environmental Flows for Intermittent River Systems: Adaptive Management and Stakeholder Participation Facilitate Implementation

    Science.gov (United States)

    Conallin, John; Wilson, Emma; Campbell, Josh

    2018-03-01

    Anthropogenic pressure on freshwater ecosystems is increasing, and often leading to unacceptable social-ecological outcomes. This is even more prevalent in intermittent river systems where many are already heavily modified, or human encroachment is increasing. Although adaptive management approaches have the potential to aid in providing the framework to consider the complexities of intermittent river systems and improve utility within the management of these systems, success has been variable. This paper looks at the application of an adaptive management pilot project within an environmental flows program in an intermittent stream (Tuppal Creek) in the Murray Darling Basin, Australia. The program focused on stakeholder involvement, participatory decision-making, and simple monitoring as the basis of an adaptive management approach. The approach found that by building trust and ownership through concentrating on inclusiveness and transparency, partnerships between government agencies and landholders were developed. This facilitated a willingness to accept greater risks and unintended consequences allowing implementation to occur.

  15. Intermittent ephemeral river-breaching

    Science.gov (United States)

    Reniers, A. J.; MacMahan, J. H.; Gallagher, E. L.; Shanks, A.; Morgan, S.; Jarvis, M.; Thornton, E. B.; Brown, J.; Fujimura, A.

    2012-12-01

    In the summer of 2011 we performed a field experiment in Carmel River State Beach, CA, at a time when the intermittent natural breaching of the ephemeral Carmel River occurred due to an unusually rainy period prior to the experiment associated with El Nino. At this time the river would fill the lagoon over the period of a number of days after which a breach would occur. This allowed us to document a number of breaches with unique pre- and post-breach topographic surveys, accompanying ocean and lagoon water elevations as well as extremely high flow (4m/s) velocities in the river mouth during the breaching event. The topographic surveys were obtained with a GPS-equipped backpack mounted on a walking human and show the evolution of the river breaching with a gradually widening and deepening river channel that cuts through the pre-existing beach and berm. The beach face is qualified as a steep with an average beach slope of 1:10 with significant reflection of the incident waves (MacMahan et al., 2012). The wave directions are generally shore normal as the waves refract over the deep canyon that is located offshore of the beach. The tide is mixed semi-diurnal with a range on the order of one meter. Breaching typically occurred during the low-low tide. Grain size is highly variable along the beach with layers of alternating fine and coarse material that could clearly be observed as the river exit channel was cutting through the beach. Large rocky outcroppings buried under the beach sand are also present along certain stretches of the beach controlling the depth of the breaching channel. The changes in the water level measured within the lagoon and the ocean side allows for an estimate of the volume flux associated with the breach as function of morphology, tidal elevation and wave conditions as well as an assessment of the conditions and mechanisms of breach closure, which occurred on the time scale of O(0.5 days). Exploratory model simulations will be presented at the

  16. Community response to intermittent preventive treatment of malaria in infants (IPTi in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Senn Nicolas

    2010-12-01

    Full Text Available Abstract Background Building on previous acceptability research undertaken in sub-Saharan Africa this article aims to investigate the acceptability of intermittent preventive treatment of malaria in infants (IPTi in Papua New Guinea (PNG. Methods A questionnaire was administered to mothers whose infants participated in the randomised placebo controlled trial of IPTi. Mothers whose infants participated and who refused to participate in the trial, health workers, community reporters and opinion leaders were interviewed. Men and women from the local community also participated in focus group discussions. Results Respondents viewed IPTi as acceptable in light of wider concern for infant health and the advantages of trial participation. Mothers reported complying with at-home administration of IPTi due to perceived benefits of IPTi and pressure from health workers. In spite of patchy knowledge, respondents also demonstrated a demand for infant vaccinations and considered non-vaccination to be neglect. There is little evidence that IPTi has negative impacts on attitudes to EPI, EPI adherence or existing malaria prevention practices. Conclusion The degree of similarity between findings from the acceptability studies undertaken in sub-Saharan Africa and PNG allows some generalization relating to the implementation of IPTi outside of Africa: IPTi fits well with local health cultures, appears to be accepted easily and has little impact on attitudes towards EPI or malaria prevention. The study adds to the evidence indicating that IPTi could be rolled out in a range of social and cultural contexts.

  17. Angiotensin converting enzyme 1 in the median preoptic nucleus contributes to chronic intermittent hypoxia hypertension.

    Science.gov (United States)

    Faulk, Katelynn E; Nedungadi, T Prashant; Cunningham, J Thomas

    2017-05-01

    Obstructive sleep apnea is associated with hypertension and cardiovascular disease. Chronic intermittent hypoxia is used to model the arterial hypoxemia seen in sleep apnea patients and is associated with increased sympathetic nerve activity and a sustained diurnal increase in blood pressure. The renin angiotensin system has been associated with hypertension seen in chronic intermittent hypoxia. Angiotensin converting enzyme 1, which cleaves angiotensin I to the active counterpart angiotensin II, is present within the central nervous system and has been shown to be regulated by AP-1 transcription factors, such as ΔFosB. Our previous study suggested that this transcriptional regulation in the median preoptic nucleus contributes to the sustained blood pressure seen following chronic intermittent hypoxia. Viral mediated delivery of a short hairpin RNA against angiotensin converting enzyme 1 in the median preoptic nucleus was used along with radio-telemetry measurements of blood pressure to test this hypothesis. FosB immunohistochemistry was utilized in order to assess the effects of angiotensin converting enzyme 1 knockdown on the activity of nuclei downstream from median preoptic nucleus. Angiotensin converting enzyme 1 knockdown within median preoptic nucleus significantly attenuated the sustained hypertension seen in chronic intermittent hypoxia. Angiotensin converting enzyme 1 seems to be partly responsible for regulating downstream regions involved in sympathetic and blood pressure control, such as the paraventricular nucleus and the rostral ventrolateral medulla. The data suggest that angiotensin converting enzyme 1 within median preoptic nucleus plays a critical role in the sustained hypertension seen in chronic intermittent hypoxia. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  18. Coherent Structures and Intermittency in Plasma Turbulence

    International Nuclear Information System (INIS)

    Das, Amita; Kaw, Predhiman; Sen, Abhijit

    2008-01-01

    The paper discusses some fundamental issues related to the phenomenon of intermittency in plasma turbulence with particular reference to experimental observations in fusion devices. Intermittency is typically associated with the presence of coherent structures in turbulence. Since coherent structures can play an important role in governing the transport properties of a system they have received a great deal of attention in fusion research. We review some of the experimental measurements and numerical simulation studies on the presence and formation of coherent structures in plasmas and discuss their relevance to intermittency. Intermittency, as widely discussed in the context of neutral fluid turbulence, implies multiscaling behaviour in contrast to self-similar scaling patterns observed in self organized criticality (SOC) phenomenon. The experimental evidence from plasma turbulence measurements reveal a mixed picture--while some observations support the SOC model description others indicate the presence of multiscaling behaviour. We discuss these results in the light of our present understanding of plasma turbulence and in terms of certain unique aspects of intermittency as revealed by fluid models of plasmas.

  19. Intermittency in {sup 197}Au fragmentation

    Energy Technology Data Exchange (ETDEWEB)

    Dabrowska, A; Holynski, R; Olszewski, A; Szarska, M; Wilczynska, B; Wolter, W; Wosiek, B [Institute of Nuclear Physics, Cracow (Poland); Cherry, M L; Deines-Jones, P; Jones, W V; Sengupta, K; Wefel, B [Louisiana State Univ., Baton Rouge, LA (United States). Dept. of Physics and Astronomy; Waddington, C J [Minnesota Univ., Minneapolis, MN (United States). School of Physics and Astronomy; Pozharova, E A; Skorodko, T Yu [Inst. of Theoretical and Experimental Physics, Moscow (Russian Federation); KLMM Collaboration

    1995-07-01

    The concept of factorial moments was applied to an analysis of the dynamical fluctuations in the charge distributions of the fragments emitted from gold nuclei with energies 10.6 and < 1.0 GeV/n interacting with emulsion nuclei. Clear evidence for intermittent fluctuations has been found in an analysis using all the particles released from the gold projectile, with a stronger effect observed below 1 GeV/n than at 10.6 GeV/n. For the full data sets, however, the intermittency effect was found to be very sensitive to the singly charged particles, and neglecting these particles strongly reduces the intermittency signal. When the analysis is restricted to the multiply charged fragments, an intermittency effect is revealed only for multifragmentation events, although one that is enhanced as compared to the analysis of all, singly and multiply charged, particles. The properties of the anomalous fractal dimensions suggest a sequential decay mechanism, rather than the existence of possible critical behaviour in the process of nuclear fragmentation. The likely influence of the charge conservation effects and the finite size of decaying systems on the observed intermittency signals was pointed out. (author). 37 refs, 9 figs, 5 tabs.

  20. Results of a retrospective comparative study: material cost for managing a series of large wounds in subjects with serious morbidity with a hydrokinetic fiber dressing or negative pressure wound therapy.

    Science.gov (United States)

    Hermans, Michel H E; Kwon Lee, S; Ragan, Mitzie R; Laudi, Pam

    2015-03-01

    This retrospective observational study analyzed lesions with regard to healing trends and cost of materials. The observed lesions were mostly postsurgical or stage IV pressure ulcers in patients with serious morbidity. The wounds were treated with a hydrokinetic fiber dressing (sorbion Sachet S, sorbion Gmbh & Co, a BSN medical company, Senden, Germany) (n = 26) or negative pressure wound therapy (NPWT) (n = 16). Primary healing trends (ie, reduction of wound size, change from necrosis to granulation tissue, and change from granulation tissue to epithelium) and secondary healing trends (ie, periwound conditions) were similar for wounds treated with the hydrokinetic dressing when compared to wounds treated with NPWT. Cost of materials was substantially lower for wounds treated with the hydrokinetic fiber dressing compared to the NPWT, with cost reductions of $1,640 (348%) to $2,242 (1794%) per wound, depending on the criteria used for the analysis. In this set of wounds, the hydrokinetic fiber dressing was shown to lead to similar healing results while providing substantial reductions of the cost of materials. For the types of wounds presented in this observational study, the hydrokinetic fiber dressing seems to be an effective substitution for negative pressure wound therapy.

  1. Sympathoexcitation and arterial hypertension associated with obstructive sleep apnea and cyclic intermittent hypoxia.

    Science.gov (United States)

    Weiss, J Woodrow; Tamisier, Renaud; Liu, Yuzhen

    2015-12-15

    Obstructive sleep apnea (OSA) is characterized by repetitive episodes of upper airway obstruction during sleep. These obstructive episodes are characterized by cyclic intermittent hypoxia (CIH), by sleep fragmentation, and by hemodynamic instability, and they result in sustained sympathoexcitation and elevated arterial pressure that persist during waking, after restoration of normoxia. Early studies established that 1) CIH, rather than sleep disruption, accounts for the increase in arterial pressure; 2) the increase in arterial pressure is a consequence of the sympathoactivation; and 3) arterial hypertension after CIH exposure requires an intact peripheral chemoreflex. More recently, however, evidence has accumulated that sympathoactivation and hypertension after CIH are also dependent on altered central sympathoregulation. Furthermore, although many molecular pathways are activated in both the carotid chemoreceptor and in the central nervous system by CIH exposure, two specific neuromodulators-endothelin-1 and angiotensin II-appear to play crucial roles in mediating the sympathetic and hemodynamic response to intermittent hypoxia. Copyright © 2015 the American Physiological Society.

  2. Forces and energetics of intermittent swimming

    Science.gov (United States)

    Floryan, Daniel; Van Buren, Tyler; Smits, Alexander J.

    2017-08-01

    Experiments are reported on intermittent swimming motions. Water tunnel experiments on a nominally two-dimensional pitching foil show that the mean thrust and power scale linearly with the duty cycle, from a value of 0.2 all the way up to continuous motions, indicating that individual bursts of activity in intermittent motions are independent of each other. This conclusion is corroborated by particle image velocimetry (PIV) flow visualizations, which show that the main vortical structures in the wake do not change with duty cycle. The experimental data also demonstrate that intermittent motions are generally energetically advantageous over continuous motions. When metabolic energy losses are taken into account, this conclusion is maintained for metabolic power fractions less than 1.

  3. Chaos synchronization based on intermittent state observer

    Institute of Scientific and Technical Information of China (English)

    Li Guo-Hui; Zhou Shi-Ping; Xu De-Ming

    2004-01-01

    This paper describes the method of synchronizing slave to the master trajectory using an intermittent state observer by constructing a synchronizer which drives the response system globally tracing the driving system asymptotically. It has been shown from the theory of synchronization error-analysis that a satisfactory result of chaos synchronization is expected under an appropriate intermittent period and state observer. Compared with continuous control method,the proposed intermittent method can target the desired orbit more efficiently. The application of the method is demonstrated on the hyperchaotic Rossler systems. Numerical simulations show that the length of the synchronization interval rs is of crucial importance for our scheme, and the method is robust with respect to parameter mismatch.

  4. Unsteady propulsion by an intermittent swimming gait

    Science.gov (United States)

    Akoz, Emre; Moored, Keith W.

    2018-01-01

    Inviscid computational results are presented on a self-propelled swimmer modeled as a virtual body combined with a two-dimensional hydrofoil pitching intermittently about its leading edge. Lighthill (1971) originally proposed that this burst-and-coast behavior can save fish energy during swimming by taking advantage of the viscous Bone-Lighthill boundary layer thinning mechanism. Here, an additional inviscid Garrick mechanism is discovered that allows swimmers to control the ratio of their added mass thrust-producing forces to their circulatory drag-inducing forces by decreasing their duty cycle, DC, of locomotion. This mechanism can save intermittent swimmers as much as 60% of the energy it takes to swim continuously at the same speed. The inviscid energy savings are shown to increase with increasing amplitude of motion, increase with decreasing Lighthill number, Li, and switch to an energetic cost above continuous swimming for sufficiently low DC. Intermittent swimmers are observed to shed four vortices per cycle that form into groups that are self-similar with the DC. In addition, previous thrust and power scaling laws of continuous self-propelled swimming are further generalized to include intermittent swimming. The key is that by averaging the thrust and power coefficients over only the bursting period then the intermittent problem can be transformed into a continuous one. Furthermore, the intermittent thrust and power scaling relations are extended to predict the mean speed and cost of transport of swimmers. By tuning a few coefficients with a handful of simulations these self-propelled relations can become predictive. In the current study, the mean speed and cost of transport are predicted to within 3% and 18% of their full-scale values by using these relations.

  5. Shape of power spectrum of intermittent chaos

    International Nuclear Information System (INIS)

    So, B.C.; Mori, H.

    1984-01-01

    Power spectra of intermittent chaos are calculated analytically. It is found that the power spectrum near onset point consists of a large number of Lorentzian lines with two peaks around frequencies ω = 0 and ω = ω 0 , where ω 0 is a fundamental frequency of a periodic orbit before the onset point, and furthermore the envelope of lines around ω = 0 obeys the power law 1/ + ω +2 , whereas the envelope around ω 0 obeys 1/ + ω-ω 0 +4 . The universality of these power law dependence in a certain class of intermittent chaos are clarified from a phenomenological view point. (author)

  6. Negative mass

    International Nuclear Information System (INIS)

    Hammond, Richard T

    2015-01-01

    Some physical aspects of negative mass are examined. Several unusual properties, such as the ability of negative mass to penetrate any armor, are analysed. Other surprising effects include the bizarre system of negative mass chasing positive mass, naked singularities and the violation of cosmic censorship, wormholes, and quantum mechanical results as well. In addition, a brief look into the implications for strings is given. (paper)

  7. Urban community perception towards intermittent water supply system.

    Science.gov (United States)

    Joshi, M W; Talkhande, A V; Andey, S P; Kelkar, P S

    2002-04-01

    While evaluating intermittent and continuous water supply systems, consumers opinion survey was undertaken for critical appraisal of both modes of operation. With the help of a pre-designed set of questions relating to various aspects of water supply and the opinion of consumers regarding degree of service, a house to house survey was conducted in the study area of Ghaziabad and Jaipur. The consumer opinion survey clearly indicated a satisfactory degree of service wherever adequate quantity of water was made available irrespective of the mode of water supply. Number of complaints regarding quality of water supplied, timings of supply, low pressures and breakdowns in supply were reported during intermittent water supply. Every family stored water for drinking and other uses. Most of the families discard drinking water once the fresh water supply is resumed next day. Discarded drinking water is usually used in kitchen for washing and gardening. Storage for other purposes depends on economic status and availability of other sources like open dug well in the house. While most of the respondents had no complaints on water tariff, all of them were in favour of continuous water supply.

  8. Treatment of chronic heel osteomyelitis in vasculopathic patients. Can the combined use of Integra® , skin graft and negative pressure wound therapy be considered a valid therapeutic approach after partial tangential calcanectomy?

    Science.gov (United States)

    Fraccalvieri, Marco; Pristerà, Giuseppe; Zingarelli, Enrico; Ruka, Erind; Bruschi, Stefano

    2012-04-01

    Osteomyelitis of the calcaneus is a difficult problem to manage. Patients affected by osteomyelitis of the calcaneus often have a below-the-knee amputation because of their comorbidity. In this article, we present seven cases of heel ulcerations with chronic osteomyelitis treated with Integra(®) Dermal Regeneration Template, skin graft and negative pressure wound therapy after partial tangential calcanectomy, discussing the surgical and functional results. In this casuistic of patients, all wounds healed after skin grating of the neodermis generated by Integra(®), with no patient requiring a below-knee amputation. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  9. Investigation of intermittency in simulated and experimental turbulence data by wavelet analysis

    International Nuclear Information System (INIS)

    Mahdizadeh, N.; Ramisch, M.; Stroth, U.; Lechte, C.; Scott, B.D.

    2004-01-01

    Turbulent transport in magnetized plasmas has an intermittent nature. Peaked probability density functions and a 1/frequency decay of the power spectra have been interpreted as signs of self-organized criticality generated, similar to a sand pile, by the critical gradients of ion- (ITG) or electron-temperature-gradient (ETG) driven instabilities. In order to investigate the degree of intermittency in toroidally confined plasmas in the absence of critical pressure or temperature gradients, data from the drift-Alfven-wave turbulence code DALF3 [B. Scott, Plasma Phys. Controlled Fusion 39, 1635 (1997)], running with a fixed background pressure gradient, and from a weakly driven low-temperature plasma are analyzed. The intermittency is studied on different temporal scales, which are separated by a wavelet transform. Simulated and experimental data reproduce the results on intermittent transport found in fusion plasmas. It can therefore be expected that in fusion plasmas, too, a substantial fraction of the bursty nature of turbulent transport is not related to avalanches caused by a critical gradient as generated by ITG or ETG turbulence

  10. Pressure ulcers : predicting factors, prevention and costs

    OpenAIRE

    Demarré, Liesbet

    2014-01-01

    The research outline pursued with this thesis can be divided in three parts. In the first part, studies to compare the effectiveness of several interventions for the prevention of pressure ulcers were conducted. Pressure ulcer prevention focusses on the reduction of the amount and duration of pressure and shear. An alternating device intermittently removes pressure and shear from vulnerable areas. It provides pressure relief via cyclic inflating and deflating air cells. Systematic reviews an...

  11. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: Case report

    Directory of Open Access Journals (Sweden)

    Kurtkaya-Yapicier Ozlem

    2003-06-01

    Full Text Available Abstract Background Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. Case presentation A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for Helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor Helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. Conclusions Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.

  12. Negative Leadership

    Science.gov (United States)

    2013-03-01

    Negative Leadership by Colonel David M. Oberlander United States Army United States Army War...SUBTITLE Negative Leadership 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Colonel David M...Dr. Richard C. Bullis Department of Command Leadership , and Management 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING

  13. Negative liability

    NARCIS (Netherlands)

    Dari-Mattiacci, G.

    2009-01-01

    Negative and positive externalities pose symmetrical problems to social welfare. The law internalizes negative externalities by providing general tort liability rules. According to such rules, those who cause harm to others should pay compensation. In theory, in the presence of positive

  14. Negative ... concord?

    NARCIS (Netherlands)

    Giannakidou, A

    The main claim of this paper is that a general theory of negative concord (NC) should allow for the possibility of NC involving scoping of a universal quantifier above negation. I propose that Greek NC instantiates this option. Greek n-words will be analyzed as polarity sensitive universal

  15. Fractal structures and intermittency in QCD

    International Nuclear Information System (INIS)

    Gustafson, Goesta.

    1990-04-01

    New results are presented for fractal structures and intermittency in QCD parton showers. A geometrical interpretation of the anomalous dimension in QCD is given. It is shown that model predications for factorial moments in the PEP-PETRA energy range are increased. if the properties of directly produced pions are more carefully taken into account

  16. Intermittent demand : Linking forecasting to inventory obsolescence

    NARCIS (Netherlands)

    Teunter, Ruud H.; Syntetos, Aris A.; Babai, M. Zied

    2011-01-01

    The standard method to forecast intermittent demand is that by Croston. This method is available in ERP-type solutions such as SAP and specialised forecasting software packages (e.g. Forecast Pro), and often applied in practice. It uses exponential smoothing to separately update the estimated demand

  17. Acute intermittent porphyria presenting as progressive muscular ...

    African Journals Online (AJOL)

    Acute intermittent porphyria, the most common porphyria affecting the nervous system, typically presents with neurovisceral crises followed by a motor neuropathy. We describe a 23-year-old black South African man presenting with a progressive stuttering, lower motor neuron syndrome developing over months. He had not ...

  18. Cooling tower modification for intermittent operation

    International Nuclear Information System (INIS)

    Midkiff, W.S.

    1975-03-01

    One of the cooling towers at Los Alamos Scientific Laboratory is being operated intermittently. The cooling tower has been modified to restrict air flow and to keep the tower from drying out. The modifications are relatively inexpensive, simple to operate, and have proved effective. (U.S.)

  19. Intermittent preventive treatment of malaria in pregnancy

    DEFF Research Database (Denmark)

    Mbonye, A.K.; Hansen, Kristian Schultz; Bygbjerg, Ib Christian

    2008-01-01

    The main objective of this study was to assess whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilisers could administer intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine (SP) to pregnant women. The study w...

  20. Management of patients with intermittent claudication

    NARCIS (Netherlands)

    S. Spronk (Sandra)

    2008-01-01

    textabstractIntermittent claudication is the first and mildest manifestation of peripheral arterial disease, caused by the atherosclerotic process of progressive narrowing of one or more of the arteries of the peripheral circulation.1 If the arterial system fails, it results in a progressive oxygen

  1. Intermittent resistive faults in digital cmos circuits

    NARCIS (Netherlands)

    Kerkhoff, Hans G.; Ebrahimi, Hassan

    2015-01-01

    A major threat in extremely dependable high-end process node integrated systems in e.g. Avionics are no failures found (NFF). One category of NFFs is the intermittent resistive fault, often originating from bad (e.g. Via or TSV-based) interconnections. This paper will show the impact of these faults

  2. Intermittent and global transitions in plasma turbulence

    International Nuclear Information System (INIS)

    Vlad, M.; Spineanu, F.; Itoh, K.; Itoh, S.-I.

    2003-07-01

    The dynamics of the transition processes in plasma turbulence described by the nonlinear Langevin equation (1) is studied. We show that intermittent or global transitions between metastable states can appear. The conditions for the generation of these transitions and their statistical characteristics are determined. (author)

  3. Intermittency in the particle production and in the nuclear multifragmentation

    International Nuclear Information System (INIS)

    Bozek, P.; Ploszajczak, M.

    1991-01-01

    Intermittency is a manifestation of scale invariance and randomness in physical systems. Intermittency in relativistic heavy-ion collisions and, in particular, the projectile dependence, multiplicity dependence and source-size dependence are discussed in the frame of the model of spatio-temporal intermittency. Moreover, recent theoretical results in intermittency studies of the nuclear multifragmentation are presented. (author) 35 refs., 4 figs., 1 tab

  4. Persistent negative temperature response of mesophyll conductance in red raspberry (Rubus idaeus L.) leaves under both high and low vapour pressure deficits: a role for abscisic acid?

    Science.gov (United States)

    Qiu, Changpeng; Ethier, Gilbert; Pepin, Steeve; Dubé, Pascal; Desjardins, Yves; Gosselin, André

    2017-09-01

    The temperature dependence of mesophyll conductance (g m ) was measured in well-watered red raspberry (Rubus idaeus L.) plants acclimated to leaf-to-air vapour pressure deficit (VPDL) daytime differentials of contrasting amplitude, keeping a fixed diurnal leaf temperature (T leaf ) rise from 20 to 35 °C. Contrary to the great majority of g m temperature responses published to date, we found a pronounced reduction of g m with increasing T leaf irrespective of leaf chamber O 2 level and diurnal VPDL regime. Leaf hydraulic conductance was greatly enhanced during the warmer afternoon periods under both low (0.75 to 1.5 kPa) and high (0.75 to 3.5 kPa) diurnal VPDL regimes, unlike stomatal conductance (g s ), which decreased in the afternoon. Consequently, the leaf water status remained largely isohydric throughout the day, and therefore cannot be evoked to explain the diurnal decrease of g m . However, the concerted diurnal reductions of g m and g s were well correlated with increases in leaf abscisic acid (ABA) content, thus suggesting that ABA can induce a significant depression of g m under favourable leaf water status. Our results challenge the view that the temperature dependence of g m can be explained solely from dynamic leaf anatomical adjustments and/or from the known thermodynamic properties of aqueous solutions and lipid membranes.​. © 2017 John Wiley & Sons Ltd.

  5. Intermittent Rivers and Biodiversity. Large scale analyses between hydrology and ecology in intermittent rivers

    OpenAIRE

    Blanchard, Q.

    2014-01-01

    Intermittent rivers are characterized by a temporary interruption of their flow which can manifest in a variety of ways, as much on a spatial scale as on a temporal one. This particular aspect of intermittent river hydrology gives rise to unique ecosystems, combining both aquatic and terrestrial habitats. Neglected for a long time by scientists and once considered biologically depauperate and ecologically unimportant, these fragile habitats are nowadays acknowledged for their rendered service...

  6. Towards an intermittency-friendly energy system: Comparing electric boilers and heat pumps in distributed cogeneration

    International Nuclear Information System (INIS)

    Blarke, Morten B.

    2012-01-01

    Highlights: ► We propose an “intermittency-friendly” energy system design. ► We compare intermittency-friendly concepts in distributed cogeneration. ► We investigate a new concept involving a heat pump and intermediate cold storage. ► We find significant improvements in operational intermittency-friendliness. ► Well-designed heat pump concepts are more cost-effective than electric boilers. -- Abstract: Distributed cogeneration has played a key role in the implementation of sustainable energy policies for three decades. However, increasing penetration levels of intermittent renewables is challenging that position. The paradigmatic case of West Denmark indicates that distributed operators are capitulating as wind power penetration levels are moving above 25%; some operators are retiring cogeneration units entirely, while other operators are making way for heat-only boilers. This development is jeopardizing the system-wide energy, economic, and environmental benefits that distributed cogeneration still has to offer. The solution is for distributed operators to adapt their technology and operational strategies to achieve a better co-existence between cogeneration and wind power. Four options for doing so are analysed including a new concept that integrates a high pressure compression heat pump using low-temperature heat recovered from flue gasses in combination with an intermediate cold storage, which enables the independent operation of heat pump and cogenerator. It is found that an electric boiler provides consistent improvements in the intermittency-friendliness of distributed cogeneration. However, well-designed heat pump concepts are more cost-effective than electric boilers, and in future markets where the gas/electricity price ratio is likely to increase, compression heat pumps in combination with intermediate thermal storages represent a superior potential for combining an intermittency-friendly pattern of operation with the efficient use of

  7. Effects of flow intermittency and pharmaceutical exposure on the structure and metabolism of stream biofilms.

    Science.gov (United States)

    Corcoll, Natàlia; Casellas, Maria; Huerta, Belinda; Guasch, Helena; Acuña, Vicenç; Rodríguez-Mozaz, Sara; Serra-Compte, Albert; Barceló, Damià; Sabater, Sergi

    2015-01-15

    Increasing concentrations of pharmaceutical compounds occur in many rivers, but their environmental risk remains poorly studied in stream biofilms. Flow intermittency shapes the structure and functions of ecosystems, and may enhance their sensitivity to toxicants. This study evaluates the effects of a long-term exposure of biofilm communities to a mixture of pharmaceutical compounds at environmental concentrations on biofilm bioaccumulation capacity, the structure and metabolic processes of algae and bacteria communities, and how their potential effects were enhanced or not by the occurrence of flow intermittency. To assess the interaction between those two stressors, an experiment with artificial streams was performed. Stream biofilms were exposed to a mixture of pharmaceuticals, as well as to a short period of flow intermittency. Results indicate that biofilms were negatively affected by pharmaceuticals. The algal biomass and taxa richness decreased and unicellular green algae relatively increased. The structure of the bacterial (based on denaturing gradient gel electrophoresis of amplified 16S rRNA genes) changed and showed a reduction of the operational taxonomic units (OTUs) richness. Exposed biofilms showed higher rates of metabolic processes, such as primary production and community respiration, attributed to pharmaceuticals stimulated an increase of green algae and heterotrophs, respectively. Flow intermittency modulated the effects of chemicals on natural communities. The algal community became more sensitive to short-term exposure of pharmaceuticals (lower EC50 value) when exposed to water intermittency, indicating cumulative effects between the two assessed stressors. In contrast to algae, the bacterial community became less sensitive to short-term exposure of pharmaceuticals (higher EC50) when exposed to water intermittency, indicating co-tolerance phenomena. According to the observed effects, the environmental risk of pharmaceuticals in nature is high

  8. Tratamiento mediante terapia de presión negativa VAC® de herida infectada tras artrodesis raquídea Treatment of infected wound secondary to spinal arthrodesis with negative pressure therapy VAC®

    Directory of Open Access Journals (Sweden)

    V. Yuste Benavente

    2011-12-01

    Full Text Available Las complicaciones cutáneas secundarias a artrodesis raquídea son un problema frecuente que requiere la colaboración de los Servicios de Cirugía Plástica y en cuyo tratamiento la terapia de presión negativa puede resultar útil. En este artículo presentamos el caso de un paciente afectado por metástasis vertebrales de adenocarcinoma gástrico que requirió artrodesis raquídea y desarrolló posteriormente una úlcera por presión dorsal debido al material implantado. El sistema VAC® permitió la limpieza y disminución de tamaño de la lesión, siendo posible la cobertura posterior de la misma con un colgajo miocutáneo de dorsal ancho. En este artículo discutimos la utilidad de la terapia de presión negativa en este tipo de lesiones.Cutaneous complications secondary to spinal fusion are a common problem that requires the collaboration of the Department of Plastic Surgery and in which negative pressure therapy treatment may be useful. In this paper we present the case of a patient with spinal metastases secondary to gastric adenocarcinoma that required spinal fusion and developed a dorsal pressure ulcer secondary to the implanted material. VAC® therapy system allowed cleaning the wound and decreasing the size of the injury, thus making it possible subsequently to cover it with a latissimus dorsi myocutaneous flap. In this paper we discuss the usefulness of negative pressure therapy in this type of injury.

  9. Observations of different core water cluster ions Y-(H2O)n (Y = O2, HOx, NOx, COx) and magic number in atmospheric pressure negative corona discharge mass spectrometry.

    Science.gov (United States)

    Sekimoto, Kanako; Takayama, Mitsuo

    2011-01-01

    Reliable mass spectrometry data from large water clusters Y(-)(H(2)O)(n) with various negative core ions Y(-) such as O(2)(-), HO(-), HO(2)(-), NO(2)(-), NO(3)(-), NO(3)(-)(HNO(3))(2), CO(3)(-) and HCO(4)(-) have been obtained using atmospheric pressure negative corona discharge mass spectrometry. All the core Y(-) ions observed were ionic species that play a central role in tropospheric ion chemistry. These mass spectra exhibited discontinuities in ion peak intensity at certain size clusters Y(-)(H(2)O)(m) indicating specific thermochemical stability. Thus, Y(-)(H(2)O)(m) may correspond to the magic number or first hydrated shell in the cluster series Y(-)(H(2)O)(n). The high intensity discontinuity at HO(-)(H(2)O)(3) observed was the first mass spectrometric evidence for the specific stability of HO(-)(H(2)O)(3) as the first hydrated shell which Eigen postulated in 1964. The negative ion water clusters Y(-)(H(2)O)(n) observed in the mass spectra are most likely to be formed via core ion formation in the ambient discharge area (760 torr) and the growth of water clusters by adiabatic expansion in the vacuum region of the mass spectrometers (≈1 torr). The detailed mechanism of the formation of the different core water cluster ions Y(-)(H(2)O)(n) is described. Copyright © 2010 John Wiley & Sons, Ltd.

  10. Changes in cerebral artery blood flow velocity after intermittent cerebrospinal fluid drainage.

    OpenAIRE

    Kempley, S T; Gamsu, H R

    1993-01-01

    Doppler ultrasound was used to measure blood flow velocity in the anterior cerebral artery of six premature infants with posthaemorrhagic hydrocephalus, before and after intermittent cerebrospinal fluid (CSF) drainage, on 23 occasions. There was a significant increase in mean blood flow velocity after the drainage procedures (+5.6 cm/s, 95% confidence interval +2.9 to +8.3 cm/s), which was accompanied by a decrease in velocity waveform pulsatility. CSF pressure also fell significantly. In pat...

  11. Smart intermittency-friendly cogeneration: Techno-economic performance of innovative double storage concept for integrating compression heat pumps in distributed cogeneration

    DEFF Research Database (Denmark)

    Blarke, Morten

    2011-01-01

    cogeneration plants rather than central power plants are giving way for wind power in the electricity mix. Could intermittent renewables be a threat to the system-wide energy, economic and environmental benefits that distributed cogeneration have to offer? This paper investigates how existing cogeneration...... plants may adapt their plant design and operational strategy to improve the co-existence between cogeneration and intermittent renewables. A novel intermittency-friendly and super-efficient concept in cogeneration is presented that involves integrating a high-pressure compression heat pump using heat...

  12. Intermittent control: a computational theory of human control.

    Science.gov (United States)

    Gawthrop, Peter; Loram, Ian; Lakie, Martin; Gollee, Henrik

    2011-02-01

    The paradigm of continuous control using internal models has advanced understanding of human motor control. However, this paradigm ignores some aspects of human control, including intermittent feedback, serial ballistic control, triggered responses and refractory periods. It is shown that event-driven intermittent control provides a framework to explain the behaviour of the human operator under a wider range of conditions than continuous control. Continuous control is included as a special case, but sampling, system matched hold, an intermittent predictor and an event trigger allow serial open-loop trajectories using intermittent feedback. The implementation here may be described as "continuous observation, intermittent action". Beyond explaining unimodal regulation distributions in common with continuous control, these features naturally explain refractoriness and bimodal stabilisation distributions observed in double stimulus tracking experiments and quiet standing, respectively. Moreover, given that human control systems contain significant time delays, a biological-cybernetic rationale favours intermittent over continuous control: intermittent predictive control is computationally less demanding than continuous predictive control. A standard continuous-time predictive control model of the human operator is used as the underlying design method for an event-driven intermittent controller. It is shown that when event thresholds are small and sampling is regular, the intermittent controller can masquerade as the underlying continuous-time controller and thus, under these conditions, the continuous-time and intermittent controller cannot be distinguished. This explains why the intermittent control hypothesis is consistent with the continuous control hypothesis for certain experimental conditions.

  13. CONDITIONED ANALYSIS OF HIGH-LATITUDE SOLAR WIND INTERMITTENCY

    International Nuclear Information System (INIS)

    D'Amicis, R.; Consolini, G.; Bavassano, B.; Bruno, R.

    2012-01-01

    The solar wind is a turbulent medium displaying intermittency. Its intermittent features have been widely documented and studied, showing how the intermittent character is different in fast and slow wind. In this paper, a statistical conditioned analysis of the solar wind intermittency for a period of high-latitude fast solar wind is presented. In particular, the intermittent features are investigated as a function of the Alfvénic degree of fluctuations at a given scale. The results show that the main contribution to solar wind intermittency is due to non-Alfvénic structures, while Alfvénic increments are found to be characterized by a smaller level of intermittency than the previous ones. Furthermore, the lifetime statistics of Alfvénic periods are discussed in terms of a multiscale texture of randomly oriented flux tubes.

  14. Edema pulmonar por pressão negativa após extubação traqueal: relato de caso Negative pressure pulmonary edema after tracheal extubation: case report

    Directory of Open Access Journals (Sweden)

    Fabiano Timbó Barbosa

    2007-03-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O edema pulmonar por pressão negativa após obstrução de via aérea é atualmente uma entidade bem descrita, porém pouco diagnosticada e com poucos casos relatados. O objetivo deste artigo foi relatar um caso de edema pulmonar por pressão negativa (EPPN após extubação traqueal com sucesso terapêutico, após uso de ventilação mecânica não-invasiva com pressão positiva. RELATO DO CASO: Paciente do sexo feminino, 22 anos, foi submetida à colecistectomia aberta. Os exames pré-operatórios encontravam-se sem alterações. Imediatamente após extubação a paciente apresentou dispnéia súbita e crepitações pulmonares. Foi iniciado tratamento para edema agudo de pulmão com oxigenoterapia sob máscara de Venturi, elevação do tórax e diurético. A paciente foi encaminhada a UTI devido a falha no tratamento. Ao chegar a UTI foi iniciada ventilação mecânica não-invasiva (VMNI com pressão de suporte (15 cmH2O e pressão expiratória final positiva (5 cmH2O com resolução dos sintomas. A paciente foi mantida em observação por mais 24 horas depois do evento com boas condições e recebeu alta para o quarto sem sintomas. CONCLUSÕES: O EPPN é uma entidade de difícil diagnóstico e deverá ser observada sempre que os pacientes evoluem com sinais e sintomas de insuficiência respiratória pós-extubação. Esta paciente se beneficiou de VMNI, mas caso haja falha terapêutica, a intubação traqueal e o suporte ventilatório mecânico invasivo deverão ser instituídos para melhor oxigenação dos pacientes.BACKGROUND AND OBJECTIVES: Negative pressure pulmonary edema after acute upper airway obstruction is a well-described event, thought infrequently diagnosed and reported. This report aimed at presenting a case of postextubation negative pressure pulmonary edema refractory to use of diuretics and with successful therapeutic after using positive pressure noninvasive mechanic ventilation. CASE REPORT: A

  15. Research Report: Intermittent hypobaric hypoxia and hyperbaric oxygen on GAP-43 in the rat carotid body.

    Science.gov (United States)

    Peng, Zhengwu; Fan, Juan; Liu, Ling; Kuang, Fang; Xue, Fen; Wang, Bairen

    2015-01-01

    Adaptive changes in the carotid body (CB) including the expression of the growth-associated protein-43 (GAP-43) have been studied in response to low, but not high, oxygen exposure. Expression of GAP-43 in the CB of rats under different atmospheric pressures and oxygen partial pressure (PO2) conditions was investigated. Mature male Sprague-Dawley rats were exposed to intermittent hypobaric hypoxia (IHH, 0, 1, 2 and 3 weeks), intermittent hyperbaric oxygen (IHBO2, 0, 1, 5 and 10 days, sacrificed six hours or 24 hours after the last HBO2 exposure), and intermittent hyperbaric normoxia (IHN, same treatment pattern as IHBO2). GAP-43 was highly expressed (mainly in type I cells) in the CB of normal rats. IHH u-regulated GAP-43 expression in the CB with significant differences (immunohistochemical staining [IHC]: F(3,15)=40.64, P GAP-43 expression in the CB was inhibited by IHBO2 (controls vs. IHBO2 groups, IHC: F(6,30) = 15.85, P GAP-43 expression were found for IHN. These findings indicated that different PO2 conditions, but not air pressures, played an important role in the plasticity of the CB, and that GAP-43 might be a viable factor for the plasticity of the CB.

  16. Intermittent character of interplanetary magnetic field fluctuations

    International Nuclear Information System (INIS)

    Bruno, Roberto; Carbone, Vincenzo; Chapman, Sandra; Hnat, Bogdan; Noullez, Alain; Sorriso-Valvo, Luca

    2007-01-01

    Interplanetary magnetic field magnitude fluctuations are notoriously more intermittent than velocity fluctuations in both fast and slow wind. This behavior has been interpreted in terms of the anomalous scaling observed in passive scalars in fully developed hydrodynamic turbulence. In this paper, the strong intermittent nature of the interplanetary magnetic field is briefly discussed comparing results performed during different phases of the solar cycle. The scaling properties of the interplanetary magnetic field magnitude show solar cycle variation that can be distinguished in the scaling exponents revealed by structure functions. The scaling exponents observed around the solar maximum coincide, within the errors, to those measured for passive scalars in hydrodynamic turbulence. However, it is also found that the values are not universal in the sense that the solar cycle variation may be reflected in dependence on the structure of the velocity field

  17. Intermittency exponent of the turbulent energy cascade

    International Nuclear Information System (INIS)

    Cleve, J.; Greiner, M.; Pearson, B.R.; Sreenivasan, K.R.

    2006-12-01

    We consider the turbulent energy dissipation from one-dimensional records in experiments using air and gaseous helium at cryogenic temperatures, and obtain the intermittency exponent via the two-point correlation function of the energy dissipation. The air data are obtained in a number of flows in a wind tunnel and the atmospheric boundary layer at a height of about 35 m above the ground. The helium data correspond to the centerline of a jet exhausting into a container. The air data on the intermittency exponent are consistent with each other and with a trend that increases with the Taylor microscale Reynolds number, R λ , of up to about 1000 and saturates thereafter. On the other hand, the helium data cluster around a constant value at nearly all R λ , this being about half of the asymptotic value for the air data. Some possible explanation is offered for this anomaly. (author)

  18. Effects of intermittent hypoxia on running economy.

    Science.gov (United States)

    Burtscher, M; Gatterer, H; Faulhaber, M; Gerstgrasser, W; Schenk, K

    2010-09-01

    We investigated the effects of two 5-wk periods of intermittent hypoxia on running economy (RE). 11 male and female middle-distance runners were randomly assigned to the intermittent hypoxia group (IHG) or to the control group (CG). All athletes trained for a 13-wk period starting at pre-season until the competition season. The IHG spent additionally 2 h at rest on 3 days/wk for the first and the last 5 weeks in normobaric hypoxia (15-11% FiO2). RE, haematological parameters and body composition were determined at low altitude (600 m) at baseline, after the 5 (th), the 8 (th) and the 13 (th) week of training. RE, determined by the relative oxygen consumption during submaximal running, (-2.3+/-1.2 vs. -0.3+/-0.7 ml/min/kg, Ptraining phase. Georg Thieme Verlag KG Stuttgart . New York.

  19. Optimal intermittent search strategies: smelling the prey

    International Nuclear Information System (INIS)

    Revelli, J A; Wio, H S; Rojo, F; Budde, C E

    2010-01-01

    We study the kinetics of the search of a single fixed target by a searcher/walker that performs an intermittent random walk, characterized by different states of motion. In addition, we assume that the walker has the ability to detect the scent left by the prey/target in its surroundings. Our results, in agreement with intuition, indicate that the prey's survival probability could be strongly reduced (increased) if the predator is attracted (or repelled) by the trace left by the prey. We have also found that, for a positive trace (the predator is guided towards the prey), increasing the inhomogeneity's size reduces the prey's survival probability, while the optimal value of α (the parameter that regulates intermittency) ceases to exist. The agreement between theory and numerical simulations is excellent.

  20. Optimal intermittent search strategies: smelling the prey

    Energy Technology Data Exchange (ETDEWEB)

    Revelli, J A; Wio, H S [Instituto de Fisica de Cantabria, Universidad de Cantabria and CSIC, E-39005 Santander (Spain); Rojo, F; Budde, C E [Fa.M.A.F., Universidad Nacional de Cordoba, Ciudad Universitaria, X5000HUA Cordoba (Argentina)

    2010-05-14

    We study the kinetics of the search of a single fixed target by a searcher/walker that performs an intermittent random walk, characterized by different states of motion. In addition, we assume that the walker has the ability to detect the scent left by the prey/target in its surroundings. Our results, in agreement with intuition, indicate that the prey's survival probability could be strongly reduced (increased) if the predator is attracted (or repelled) by the trace left by the prey. We have also found that, for a positive trace (the predator is guided towards the prey), increasing the inhomogeneity's size reduces the prey's survival probability, while the optimal value of {alpha} (the parameter that regulates intermittency) ceases to exist. The agreement between theory and numerical simulations is excellent.

  1. The impact of intermittent sources of energy on the market price of electricity

    International Nuclear Information System (INIS)

    Adigbli, Patrick; Mahuet, Audrey

    2013-01-01

    Parallel to liberalization of the electricity market, these past twenty years have been marked by a strong expansion of renewable energy in Europe. The increasing share of renewables in the energy mix - with a goal set by the European Commission at 20% by 2020 - has an impact on market prices. In the short run, subsidized intermittent energy may lead to lower prices or even to negative prices during certain periods of the year

  2. Experimental and analytical study of intermittency in direct contact condensation of steam in a cross-flow of water

    NARCIS (Netherlands)

    Clerx, N.; Geld, van der C.W.M.

    2009-01-01

    The topology of a condensing steam jet, at low steam mass fluxes, injected in a cross-flow of water has been investigatedexperimentally for various conditions (system pressure around 3 bar). The intermittent character of the steam pocket growthand collapse clearly appeared from the high speed

  3. AN ELDERLY WOMAN WITH INTERMITTENT CLAUDICATION

    Directory of Open Access Journals (Sweden)

    Nayyer Naveed Wazir

    2006-01-01

    Full Text Available This case report illustrates the misdiagnosis of intermittent claudication in an elderly with multiple cardiac risk factors. Careful clinical evaluation and imaging shifts the diagnosis from peripheral vascular disease to spinal stenosis. The decision whether to offer conservative therapy or proceed to spinal surgery requires an accurate assessment of the severity of the symptoms without ignoring the important role of patient preferences.

  4. Long-range forecasting of intermittent streamflow

    OpenAIRE

    F. F. van Ogtrop; R. W. Vervoort; G. Z. Heller; D. M. Stasinopoulos; R. A. Rigby

    2011-01-01

    Long-range forecasting of intermittent streamflow in semi-arid Australia poses a number of major challenges. One of the challenges relates to modelling zero, skewed, non-stationary, and non-linear data. To address this, a statistical model to forecast streamflow up to 12 months ahead is applied to five semi-arid catchments in South Western Queensland. The model uses logistic regression through Generalised Additive Models for Location, Scale and Shape (GAMLSS) to determine th...

  5. Long-range forecasting of intermittent streamflow

    OpenAIRE

    F. F. van Ogtrop; R. W. Vervoort; G. Z. Heller; D. M. Stasinopoulos; R. A. Rigby

    2011-01-01

    Long-range forecasting of intermittent streamflow in semi-arid Australia poses a number of major challenges. One of the challenges relates to modelling zero, skewed, non-stationary, and non-linear data. To address this, a probabilistic statistical model to forecast streamflow 12 months ahead is applied to five semi-arid catchments in South Western Queensland. The model uses logistic regression through Generalised Additive Models for Location, Scale and Shape (GAMLSS) to determine the probabil...

  6. Lactic acidosis and diastolic hypotension after intermittent albuterol nebulization in a pediatric patient

    Directory of Open Access Journals (Sweden)

    Tehila A. Saadia

    2015-01-01

    Full Text Available We describe a case of 13-year-old female with intermittent asthma who developed lactic acidosis and diastolic hypotension after receiving intermittent albuterol nebulizer treatment. She presented to the emergency department (ED with sudden onset of shortness of breath and chest pain. She received two albuterol nebulizer treatments at home without symptomatic relief. She was treated in the ED with intermittent albuterol nebulization for a total of 22.5 mg over the next 5 hours. A decrease in diastolic blood pressure from 60 mmHg to 40 mmHg was noted after the treatment. Blood lactate level was 5.9 mmol/L. She recovered from it and was discharged to home but she had recurrence of shortness of breath and presented to the ED two days later. She was treated with albuterol nebulization for a total of 17.5 mg over the next two and half hours and developed diastolic hypotension again, as low as 30 mm Hg. After discontinuation of albuterol nebulization, her BP normalized. Cardiopulmonary and metabolic side effects of continuous albuterol therapy have been reported in the recent medical literature. Our patient, however, developed these adverse effects on intermittent albuterol nebulizer treatment. It is important for the pediatrician to recognize the adverse effects of β2-agonist therapy to avoid carrying out extensive workup for hypotension and hyperlactatemia prolonging hospital stay.

  7. Negative CO

    NARCIS (Netherlands)

    Meysman, F.J.R.; Montserrat, F.

    2017-01-01

    Negative emission technologies (NETs) target the removal of carbon dioxide (CO2) from the atmosphere, and are being actively investigated as a strategy to limit global warming to within the 1.5–2°C targets of the 2015 UN climate agreement. Enhanced silicate weathering (ESW) proposes to

  8. Negative Certainty

    Science.gov (United States)

    Ariso, José María

    2017-01-01

    The definitions of "negative knowledge" and the studies in this regard published to date have not considered the categorial distinction Wittgenstein established between knowledge and certainty. Hence, the important role that certainty, despite its omission, should have in these definitions and studies has not yet been shown. In this…

  9. Efficient search by optimized intermittent random walks

    International Nuclear Information System (INIS)

    Oshanin, Gleb; Lindenberg, Katja; Wio, Horacio S; Burlatsky, Sergei

    2009-01-01

    We study the kinetics for the search of an immobile target by randomly moving searchers that detect it only upon encounter. The searchers perform intermittent random walks on a one-dimensional lattice. Each searcher can step on a nearest neighbor site with probability α or go off lattice with probability 1 - α to move in a random direction until it lands back on the lattice at a fixed distance L away from the departure point. Considering α and L as optimization parameters, we seek to enhance the chances of successful detection by minimizing the probability P N that the target remains undetected up to the maximal search time N. We show that even in this simple model, a number of very efficient search strategies can lead to a decrease of P N by orders of magnitude upon appropriate choices of α and L. We demonstrate that, in general, such optimal intermittent strategies are much more efficient than Brownian searches and are as efficient as search algorithms based on random walks with heavy-tailed Cauchy jump-length distributions. In addition, such intermittent strategies appear to be more advantageous than Levy-based ones in that they lead to more thorough exploration of visited regions in space and thus lend themselves to parallelization of the search processes.

  10. Negative Pressure Wound Therapy Followed by Basic Fibroblast Growth Factor Spray as a Recovery Technique in Partial Necrosis of Distally Based Sural Flap for Calcaneal Osteomyelitis: A Case Report.

    Science.gov (United States)

    Mikami, Taro; Kaida, Eriko; Yabuki, Yuichiro; Kitamura, Sho; Kokubo, Ken'ichi; Maegawa, Jiro

    2018-03-28

    The distally based sural flap is regarded as the first choice for reconstruction in the distal part of the lower leg because the flap is easy to raise, reliable in its blood supply, and prone to only a few complications. Limited data have investigated the details of treatment in cases of failure of distally based sural flaps. We report a case of calcaneal osteomyelitis in which a successful outcome was finally obtained with a partially necrosed, distally based sural flap using negative pressure wound therapy with basic fibroblast growth factor spray. The 2-year follow-up examination was uneventful. Moreover, the patient was able to walk freely with an ankle-foot orthosis in her house. This technique can be considered as a useful and effective option to recover unfavorable results of distally based sural flaps. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Losartan reduces the immediate and sustained increases in muscle sympathetic nerve activity after hyperacute intermittent hypoxia.

    Science.gov (United States)

    Jouett, Noah P; Moralez, Gilbert; Raven, Peter B; Smith, Michael L

    2017-04-01

    Obstructive sleep apnea (OSA) is characterized by intermittent hypoxemia, which produces elevations in sympathetic nerve activity (SNA) and associated hypertension in experimental models that persist beyond the initial exposure. We tested the hypotheses that angiotensin receptor blockade in humans using losartan attenuates the immediate and immediately persistent increases in 1 ) SNA discharge and 2 ) mean arterial pressure (MAP) after hyperacute intermittent hypoxia training (IHT) using a randomized, placebo-controlled, repeated-measures experimental design. We measured ECG and photoplethysmographic arterial pressure in nine healthy human subjects, while muscle SNA (MSNA) was recorded in seven subjects using microneurography. Subjects were exposed to a series of hypoxic apneas in which they inhaled two to three breaths of nitrogen, followed by a 20-s apnea and 40 s of room air breathing every minute for 20 min. Hyperacute IHT produced substantial and persistent elevations in MSNA burst frequency (baseline: 15.3 ± 1.8, IHT: 24 ± 1.5, post-IHT 20.0 ± 1.3 bursts/min, all P 0.70). This investigation confirms the role of angiotensin II type 1a receptors in the immediate and persistent sympathoexcitatory and pressor responses to IHT. NEW & NOTEWORTHY This study demonstrates for the first time in humans that losartan, an angiotensin receptor blocker (ARB), abrogates the acute and immediately persistent increases in muscle sympathetic nerve activity and arterial pressure in response to acute intermittent hypoxia. This investigation, along with others, provides important beginning translational evidence for using ARBs in treatment of the intermittent hypoxia observed in obstructive sleep apnea patients. Copyright © 2017 the American Physiological Society.

  12. Negative Pressure Pulmonary Oedema Following Adenoidectomy ...

    African Journals Online (AJOL)

    threatening complication of laryngospasm that occurs during or after general anaesthesia. It is a complication of poorly treated or unrecognized laryngospasm occurring at extubation or later in the postoperative period. Objective: To emphasize ...

  13. NEGATIVE PRESSURE WOUND THERAPY (NPWT) FOR THE ...

    African Journals Online (AJOL)

    S. O. Khainga, MBChB, MMed (Nrb), FECSA (Plastic Surgery), Consultant Plastic and ... Associate Professor, Department of Surgery, College of Health Sciences, University .... abdomen secondary to acute pancreatitis. ... wall defect and enterocutaneous fistula treatment ... and chronic wounds: a randomized controlled trial.

  14. Ecoulements intermittents de gaz et de liquide en conduite verticale Intermittent Gas and Liquid Flows in a Vertical Pipe.

    Directory of Open Access Journals (Sweden)

    Line A.

    2006-11-01

    Full Text Available Le modèle présenté ici permet la pré-détermination du gradient de pression, du taux global de gaz, et de grandeurs caractéristiques de l'intermittence, dans un écoulement à poches et bouchons en conduite verticale. L'écriture des lois de conservation en moyenne phasique conditionnelle conduit à la définition d'une cellule moyenne équivalente. La fermeture du modèle est assurée par des lois de contrainte de cisaillement film-paroi, film-poche, bouchon-paroi, par une loi d'arrachage du gaz au culot de la poche, une loi de glissement du gaz dans les bouchons et par une loi de la vitesse moyenne de propagation des fronts de poches. Le calibrage et la qualification du modèle s'appuient sur deux banques de données, dont l'une a été obtenue avec des fluides pétroliers dans des conditions proches des situations industrielles (boucle diphasique de Boussens. The model described here can be used to predetermine the pressure gradient, the overall gas rate and the characteristic intermittence magnitudes in pocket and slug flow in a vertical pipe. The way governing equations in the conditional phase average are written defines an equivalent average cell. The model is closed by film/wall, film/pocket and slug/wall shear-stress laws, by a pulloff law for the gas at the bottom of the pocket, a slippage law for the gas in the slugs, and a mean propagation velocity law for the pocket fronts. The calibration and qualification of the model are based on two data banks, one of which contains data on petroleum fluids under conditions close to industrial situations (two-phase loop at Boussens.

  15. Effects of vacusac in intermittent claudication

    DEFF Research Database (Denmark)

    Himmelstrup, H; Himmelstrup, Bodil; Mehlsen, J

    1991-01-01

    . Seventeen patients completed the study. The effect of treatment was quantified by measurements of systemic and peripheral systolic blood pressures and by measurements of the pain-free and the maximal walking distance on a treadmill. The ankle pressure index (ankle systolic pressure/arm systolic pressure...

  16. Hovering and intermittent flight in birds

    International Nuclear Information System (INIS)

    Tobalske, Bret W

    2010-01-01

    Two styles of bird locomotion, hovering and intermittent flight, have great potential to inform future development of autonomous flying vehicles. Hummingbirds are the smallest flying vertebrates, and they are the only birds that can sustain hovering. Their ability to hover is due to their small size, high wingbeat frequency, relatively large margin of mass-specific power available for flight and a suite of anatomical features that include proportionally massive major flight muscles (pectoralis and supracoracoideus) and wing anatomy that enables them to leave their wings extended yet turned over (supinated) during upstroke so that they can generate lift to support their weight. Hummingbirds generate three times more lift during downstroke compared with upstroke, with the disparity due to wing twist during upstroke. Much like insects, hummingbirds exploit unsteady mechanisms during hovering including delayed stall during wing translation that is manifest as a leading-edge vortex (LEV) on the wing and rotational circulation at the end of each half stroke. Intermittent flight is common in small- and medium-sized birds and consists of pauses during which the wings are flexed (bound) or extended (glide). Flap-bounding appears to be an energy-saving style when flying relatively fast, with the production of lift by the body and tail critical to this saving. Flap-gliding is thought to be less costly than continuous flapping during flight at most speeds. Some species are known to shift from flap-gliding at slow speeds to flap-bounding at fast speeds, but there is an upper size limit for the ability to bound (∼0.3 kg) and small birds with rounded wings do not use intermittent glides.

  17. Hovering and intermittent flight in birds

    Energy Technology Data Exchange (ETDEWEB)

    Tobalske, Bret W, E-mail: bret.tobalske@mso.umt.ed [Field Research Station at Fort Missoula, Division of Biological Sciences, University of Montana, Missoula, MT 59812 (United States)

    2010-12-15

    Two styles of bird locomotion, hovering and intermittent flight, have great potential to inform future development of autonomous flying vehicles. Hummingbirds are the smallest flying vertebrates, and they are the only birds that can sustain hovering. Their ability to hover is due to their small size, high wingbeat frequency, relatively large margin of mass-specific power available for flight and a suite of anatomical features that include proportionally massive major flight muscles (pectoralis and supracoracoideus) and wing anatomy that enables them to leave their wings extended yet turned over (supinated) during upstroke so that they can generate lift to support their weight. Hummingbirds generate three times more lift during downstroke compared with upstroke, with the disparity due to wing twist during upstroke. Much like insects, hummingbirds exploit unsteady mechanisms during hovering including delayed stall during wing translation that is manifest as a leading-edge vortex (LEV) on the wing and rotational circulation at the end of each half stroke. Intermittent flight is common in small- and medium-sized birds and consists of pauses during which the wings are flexed (bound) or extended (glide). Flap-bounding appears to be an energy-saving style when flying relatively fast, with the production of lift by the body and tail critical to this saving. Flap-gliding is thought to be less costly than continuous flapping during flight at most speeds. Some species are known to shift from flap-gliding at slow speeds to flap-bounding at fast speeds, but there is an upper size limit for the ability to bound ({approx}0.3 kg) and small birds with rounded wings do not use intermittent glides.

  18. Renewable energies: the cost of intermittency

    International Nuclear Information System (INIS)

    Crassous, Renaud; Roques, Fabien

    2013-01-01

    The authors indicate the different adaptations which will be required for the electric system to cope with the intermittency of solar and wind energy production, and propose an approximate assessment of the associated costs. Different types of adaptation are addressed: secure production in case of absence of wind or sun (electricity imports, construction of additional power stations), use of more flexible production means (gas turbines), grid extensions (connection to offshore production sites, routing of production one part of the country to the other). They think that beyond a 20 per cent share for renewable energies, these costs could rapidly increase

  19. Spatio-temporal intermittency on the sandpile

    International Nuclear Information System (INIS)

    Erzan, A.; Sinha, S.

    1990-08-01

    The self-organized critical state exhibited by a sandpile model is shown to correspond to motion on an attractor characterized by an invariant distribution of the height variable. The largest Lyapunov exponent is equal to zero. The model nonetheless displays intermittent chaos, with a multifractal distribution of local expansion coefficients in history space. Laminar spatio-temporal regions are interrupted by chaotic bursts caused by avalanches. We introduce the concept of local histories in configuration space and show that their expansion parameters also exhibit a multifractal distribution in time and space. (author). 22 refs, 5 figs

  20. A stochastic model for intermittent search strategies

    International Nuclear Information System (INIS)

    Benichou, O; Coppey, M; Moreau, M; Suet, P H; Voituriez, R

    2005-01-01

    It is often necessary, in scientific or everyday life problems, to find a randomly hidden target. What is then the optimal strategy to reach it as rapidly as possible? In this article, we develop a stochastic theory for intermittent search behaviours, which are often observed: the searcher alternates phases of intensive search and slow motion with fast displacements. The first results of this theory have already been announced recently. Here we provide a detailed presentation of the theory, as well as the full derivation of the results. Furthermore, we explicitly discuss the minimization of the time needed to find the target

  1. Intermittent oral iron supplementation during pregnancy (Review)

    Science.gov (United States)

    Peña-Rosas, Juan Pablo; De-Regil, Luz Maria; Dowswell, Therese; Viteri, Fernando E

    2014-01-01

    Background Anaemia is a frequent condition during pregnancy, particularly among women from developing countries who have insufficient iron intake to meet increased iron needs of both the mother and the fetus. Traditionally, gestational anaemia has been prevented with the provision of daily iron supplements throughout pregnancy, but adherence to this regimen due to side effects, interrupted supply of the supplements, and concerns about safety among women with an adequate iron intake, have limited the use of this intervention. Intermittent (i.e. one, two or three times a week on non-consecutive days) supplementation with iron alone or in combination with folic acid or other vitamins and minerals has recently been proposed as an alternative to daily supplementation. Objectives To assess the benefits and harms of intermittent supplementation with iron alone or in combination with folic acid or other vitamins and minerals to pregnant women on neonatal and pregnancy outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (23 March 2012). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) for ongoing studies and contacted relevant organisations for the identification of ongoing and unpublished studies (23 March 2012). Selection criteria Randomised or quasi-randomised trials. Data collection and analysis We assessed the methodological quality of trials using standard Cochrane criteria. Two review authors independently assessed trial eligibility, extracted data and conducted checks for accuracy. Main results This review includes 21 trials from 13 different countries, but only 18 trials (with 4072 women) reported on our outcomes of interest and contributed data to the review. All of these studies compared daily versus intermittent iron supplementation. Three studies provided iron alone, 12 iron+folic acid and three more iron plus multiple vitamins and minerals. Their methodological quality was mixed

  2. Intermittent fasting and cardiovascular disease: current evidence and unresolved questions.

    Science.gov (United States)

    Tinsley, Grant M; Horne, Benjamin D

    2018-01-01

    Intermittent fasting has produced a variety of beneficial health effects in animal models, although high-quality research in humans has been limited. This special report examines current evidences for intermittent fasting in humans, discusses issues that require further examination, and recommends new research that can improve the knowledge base in this emerging research area. While potentially useful for health improvement, intermittent fasting requires further study prior to widespread implementation for health purposes. Randomized, longer-term studies are needed to determine whether using intermittent fasting as a lifestyle rather than a diet is feasible and beneficial for the health of some members of the human population.

  3. Atomistic Model of Fluorescence Intermittency of Colloidal Quantum Dots

    KAUST Repository

    Voznyy, O.; Sargent, E. H.

    2014-01-01

    with foreign cations can stabilize the vacancies, inhibiting intermittency and improving quantum yield, providing an explanation of recent experimental observations. © 2014 American Physical Society.

  4. GENESIS OF INTERPLANETARY INTERMITTENT TURBULENCE: A CASE STUDY OF ROPE–ROPE MAGNETIC RECONNECTION

    Energy Technology Data Exchange (ETDEWEB)

    Chian, Abraham C.-L.; Loew, Murray H. [Department of Biomedical Engineering, George Washington University, Washington, DC 20052 (United States); Feng, Heng Q. [Institute of Space Physics, Luoyang Normal University, Luoyang (China); Hu, Qiang [Department of Space Science and CSPAR, University of Alabama in Huntsville, Huntsville, AL 35805 (United States); Miranda, Rodrigo A. [UnB-Gama Campus, and Plasma Physics Laboratory, Institute of Physics, University of Brasília (UnB), Brasília DF 70910-900 (Brazil); Muñoz, Pablo R. [Department of Physics and Astronomy, University of La Serena, Av. Juan Cisternas 1200, La Serena (Chile); Sibeck, David G. [NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States); Wu, De J., E-mail: abraham.chian@gmail.com [Purple Mountain Observatory, Chinese Academy of Sciences, Nanjing 210008 (China)

    2016-12-01

    In a recent paper, the relation between current sheet, magnetic reconnection, and turbulence at the leading edge of an interplanetary coronal mass ejection was studied. We report here the observation of magnetic reconnection at the interface region of two interplanetary magnetic flux ropes. The front and rear boundary layers of three interplanetary magnetic flux ropes are identified, and the structures of magnetic flux ropes are reconstructed by the Grad–Shafranov method. A quantitative analysis of the reconnection condition and the degree of intermittency reveals that rope–rope magnetic reconnection is the most likely site for genesis of interplanetary intermittency turbulence in this event. The dynamic pressure pulse resulting from this reconnection triggers the onset of a geomagnetic storm.

  5. Middle Ear Pressure Regulation - Complementary Action of the Mastoid and Eustachian Tube

    DEFF Research Database (Denmark)

    Gaihede, Michael; Dirckx, Joris J J; Jacobsen, Henrik

    2010-01-01

    , MEP counter-regulation presented as Eustachian tube openings with steep and fast pressure changes toward 0 Pa, whereas in others, gradual and slow pressure changes presented related to the mastoid; these changes sometimes crossed 0 Pa into opposite pressures. In many cases, combinations...... to continuous regulation of smaller pressures, whereas the tube was related to intermittent regulation of higher pressures....

  6. Connectivity analysis of suggestive brain areas involved in middle ear pressure regulation in humans

    DEFF Research Database (Denmark)

    SA, Sami; Gaihede, Michael

    2010-01-01

    , MEP counter-regulation presented as Eustachian tube openings with steep and fast pressure changes toward 0 Pa, whereas in others, gradual and slow pressure changes presented related to the mastoid; these changes sometimes crossed 0 Pa into opposite pressures. In many cases, combinations...... to continuous regulation of smaller pressures, whereas the tube was related to intermittent regulation of higher pressures....

  7. Middle Ear Pressure Regulation - Complementary Action of the Mastoid and Eustachian Tube

    DEFF Research Database (Denmark)

    Gaihede, Michael; Jacobsen, Henrik; Tveterås, Kjell

    , MEP counter-regulation presented as Eustachian tube openings with steep and fast pressure changes toward 0 Pa, whereas in others, gradual and slow pressure changes presented related to the mastoid; these changes sometimes crossed 0 Pa into opposite pressures. In many cases, combinations...... to continuous regulation of smaller pressures, whereas the tube was related to intermittent regulation of higher pressures....

  8. Intermittency study in e+e- annihilations at 29 GeV

    International Nuclear Information System (INIS)

    Sugano, K.

    1990-01-01

    The intermittency and fractal behavior in e + e - annihilations has been studied using the HRS detector at PEP (√s = 29 GeV). The factorial moments F i (i = 2 ∼ 5) in small rapidity intervals show stronger intermittency slopes than those for the πp, bar pp, and AA reactions. This direct measurement confirms our previous data derived from the k-values in the negative binomial fits to the multiplicity distributions in various central rapidity windows. The fractal moments G q have been measured for the first time in e + e - annihilations. The Legendre transform f(α) derived from the fractal moments show a self-similar behavior which is consistent with the jet cascading mechanism. 95 refs., 46 figs., 2 tabs

  9. A wavelet-based intermittency detection technique from PIV investigations in transitional boundary layers

    Science.gov (United States)

    Simoni, Daniele; Lengani, Davide; Guida, Roberto

    2016-09-01

    The transition process of the boundary layer growing over a flat plate with pressure gradient simulating the suction side of a low-pressure turbine blade and elevated free-stream turbulence intensity level has been analyzed by means of PIV and hot-wire measurements. A detailed view of the instantaneous flow field in the wall-normal plane highlights the physics characterizing the complex process leading to the formation of large-scale coherent structures during breaking down of the ordered motion of the flow, thus generating randomized oscillations (i.e., turbulent spots). This analysis gives the basis for the development of a new procedure aimed at determining the intermittency function describing (statistically) the transition process. To this end, a wavelet-based method has been employed for the identification of the large-scale structures created during the transition process. Successively, a probability density function of these events has been defined so that an intermittency function is deduced. This latter strictly corresponds to the intermittency function of the transitional flow computed trough a classic procedure based on hot-wire data. The agreement between the two procedures in the intermittency shape and spot production rate proves the capability of the method in providing the statistical representation of the transition process. The main advantages of the procedure here proposed concern with its applicability to PIV data; it does not require a threshold level to discriminate first- and/or second-order time-derivative of hot-wire time traces (that makes the method not influenced by the operator); and it provides a clear evidence of the connection between the flow physics and the statistical representation of transition based on theory of turbulent spot propagation.

  10. Chaos as an intermittently forced linear system.

    Science.gov (United States)

    Brunton, Steven L; Brunton, Bingni W; Proctor, Joshua L; Kaiser, Eurika; Kutz, J Nathan

    2017-05-30

    Understanding the interplay of order and disorder in chaos is a central challenge in modern quantitative science. Approximate linear representations of nonlinear dynamics have long been sought, driving considerable interest in Koopman theory. We present a universal, data-driven decomposition of chaos as an intermittently forced linear system. This work combines delay embedding and Koopman theory to decompose chaotic dynamics into a linear model in the leading delay coordinates with forcing by low-energy delay coordinates; this is called the Hankel alternative view of Koopman (HAVOK) analysis. This analysis is applied to the Lorenz system and real-world examples including Earth's magnetic field reversal and measles outbreaks. In each case, forcing statistics are non-Gaussian, with long tails corresponding to rare intermittent forcing that precedes switching and bursting phenomena. The forcing activity demarcates coherent phase space regions where the dynamics are approximately linear from those that are strongly nonlinear.The huge amount of data generated in fields like neuroscience or finance calls for effective strategies that mine data to reveal underlying dynamics. Here Brunton et al.develop a data-driven technique to analyze chaotic systems and predict their dynamics in terms of a forced linear model.

  11. Transient analysis of intermittent multijet sprays

    Energy Technology Data Exchange (ETDEWEB)

    Panao, Miguel R.O.; Moreira, Antonio Luis N. [Universidade Tecnica de Lisboa, IN, Center for Innovation, Technology and Policy Research, Instituto Superior Tecnico, Lisboa (Portugal); Durao, Diamantino G. [Universidade Lusiada, Lisboa (Portugal)

    2012-07-15

    This paper analyzes the transient characteristics of intermittent sprays produced by the single-point impact of multiple cylindrical jets. The aim is to perform a transient analysis of the intermittent atomization process to study the effect of varying the number of impinging jets in the hydrodynamic mechanisms of droplet formation. The results evidence that hydrodynamic mechanisms underlying the physics of ligament fragmentation in 2-impinging jets sprays also apply to sprays produced with more than 2 jets during the main period of injection. Ligaments detaching from the liquid sheet, as well as from its bounding rim, have been identified and associated with distinct droplet clusters, which become more evident as the number of impinging jets increases. Droplets produced by detached ligaments constitute the main spray, and their axial velocity becomes more uniformly distributed with 4-impinging jets because of a delayed ligament fragmentation. Multijet spray dispersion patterns are geometric depending on the number of impinging jets. Finally, an analysis on the Weber number of droplets suggests that multijet sprays are more likely to deposit on interposed surfaces, thus becoming a promising and competitive atomization solution for improving spray cooling. (orig.)

  12. Impact of intermittent fasting on glucose homeostasis.

    Science.gov (United States)

    Varady, Krista A

    2016-07-01

    This article provides an overview of the most recent human trials that have examined the impact of intermittent fasting on glucose homeostasis. Our literature search retrieved one human trial of alternate day fasting, and three trials of Ramadan fasting published in the past 12 months. Current evidence suggests that 8 weeks of alternate day fasting that produces mild weight loss (4% from baseline) has no effect on glucose homeostasis. As for Ramadan fasting, decreases in fasting glucose, insulin, and insulin resistance have been noted after 4 weeks in healthy normal weight individuals with mild weight loss (1-2% from baseline). However, Ramadan fasting may have little impact on glucoregulatory parameters in women with polycystic ovarian syndrome who failed to observe weight loss. Whether intermittent fasting is an effective means of regulating glucose homeostasis remains unclear because of the scarcity of studies in this area. Large-scale, longer-term randomized controlled trials will be required before the use of fasting can be recommended for the prevention and treatment of metabolic diseases.

  13. Intermittency Statistics in the Expanding Solar Wind

    Science.gov (United States)

    Cuesta, M. E.; Parashar, T. N.; Matthaeus, W. H.

    2017-12-01

    The solar wind is observed to be turbulent. One of the open questions in solar wind research is how the turbulence evolves as the solar wind expands to great distances. Some studies have focused on evolution of the outer scale but not much has been done to understand how intermittency evolves in the expanding wind beyond 1 AU (see [1,2]). We use magnetic field data from Voyager I spacecraft from 1 to 10AU to study the evolution of statistics of magnetic discontinuities. We perform various statistical tests on these discontinuities and make connections to the physical processes occurring in the expanding wind.[1] Tsurutani, Bruce T., and Edward J. Smith. "Interplanetary discontinuities: Temporal variations and the radial gradient from 1 to 8.5 AU." Journal of Geophysical Research: Space Physics 84.A6 (1979): 2773-2787.[2] Greco, A., et al. "Evidence for nonlinear development of magnetohydrodynamic scale intermittency in the inner heliosphere." The Astrophysical Journal 749.2 (2012): 105.

  14. Chronic intermittent hypoxia predisposes to liver injury.

    Science.gov (United States)

    Savransky, Vladimir; Nanayakkara, Ashika; Vivero, Angelica; Li, Jianguo; Bevans, Shannon; Smith, Philip L; Torbenson, Michael S; Polotsky, Vsevolod Y

    2007-04-01

    Obstructive sleep apnea (OSA) is characterized by chronic intermittent hypoxia (CIH). OSA is associated with nonalcoholic steatohepatitis (NASH) in obese subjects. The aim of this study was to investigate the effects of CIH on the liver in the absence of obesity. Lean C57BL/6J mice (n = 15) on a regular chow diet were exposed to CIH for 12 weeks and compared with pair-fed mice exposed to intermittent air (IA, n = 15). CIH caused liver injury with an increase in serum ALT (224 +/- 39 U/l versus 118 +/- 22 U/l in the IA group, P fasting serum insulin levels, and mild elevation of fasting serum total cholesterol and triglycerides (TG). Liver TG content was unchanged, whereas cholesterol content was decreased. Histology showed swelling of hepatocytes, no evidence of hepatic steatosis, and marked accumulation of glycogen in hepatocytes. CIH led to lipid peroxidation of liver tissue with a malondialdehyde (MDA)/free fatty acids (FFA) ratio of 0.54 +/- 0.07 mmol/mol versus 0.30 +/- 0.01 mmol/mol in control animals (P obesity, CIH leads to mild liver injury via oxidative stress and excessive glycogen accumulation in hepatocytes and sensitizes the liver to a second insult, whereas NASH does not develop.

  15. Intermittent preventive treatment of malaria in pregnancy

    DEFF Research Database (Denmark)

    Mbonye, A.K.; Bygbjerg, Ib Christian; Magnussen, Pascal

    2008-01-01

    OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non-randomized comm......OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non......-randomized community trial was implemented in 21 community clusters (intervention) and four clusters where health units provided routine IPTp (control). The primary outcome measures were access and adherence to IPTp, number of malaria episodes, prevalence of anaemia, and birth weight. Numbers of live births, abortions......, still births, and maternal and child deaths were secondary endpoints. FINDINGS: 1404 (67.5%) of 2081 with the new delivery system received two doses of sulfadoxine-pyrimethamine versus 281 (39.9%) of 704 with health units (P malaria episodes decreased from 906 (49...

  16. Intermittent hyperthyreosis. A heat stress syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Sulman, F G; Tal, E; Pfeifer, Y; Superstine, E [Hebrew Univ., Jerusalem (Israel). Dept. of Applied Pharmacology

    1975-09-01

    Intermittent hyperthyreosis occurs under various forms of stress, especially heat stress. The clinician may diagnose such cases as masked or apathetic hyperthyroidism or 'forme fruste' hyperthyreosis or thyroid autonomy. As most routine and standard tests may here yield inconsistent results, it is the patients' anamnesis which may provide the clue. Our Bioclimatology Unit has now seen over 100 cases in which thyroid hypersensitivity towards heat was the most prominent syndrome: 10-15% of weather-sensitive patients are affected. The patients complain before or during heat spells of such contradictory symptoms as insomnia, irritability, tension, tachycardia, palpitations, precordial pain, dyspnoe, flushes with sweating or chills, tremor, abdominal pain or diarrhea, polyuria or pollakisuria, weight loss in spite of ravenous appetite, fatigue, exhaustion, depression, adynamia, lack of concentration and confusion. Determination of urinary neurohormones allows a differential diagnosis, intermittent hyperthyreosis being characterized by three cardinal symptoms: tachycardia - every case with more than 80 pulse beats being suspect (not specific); urinary histamine - every case excreting more than 90 ..mu..g/day being suspect. Again the drawback of this test is its lack of specificity, as histamine may also be increased in cases of allergy and spondylitis; urinary thyroxine - every case excreting more than 20 ..mu..g/day T-4 being suspect. This is the only specific test. Therapy should make use of lithium carbonate and betablockers. Propyl thiouracil is rarely required.

  17. Adequacy in dialysis: intermittent versus continuous therapies.

    Science.gov (United States)

    Misra, M; Nolph, K D

    2000-01-01

    A vital conceptual difference between intermittent and continuous dialysis therapies is the difference in the relationship between Kt/V urea and dietary protein intake. For a given level of protein intake the intermittent therapies require a higher Kt/V urea due to the reasons mentioned above. The recently released adequacy guidelines by DOQI for intermittent and continuous therapies are based on these assumptions. The link between adequacy targets and patient survival is well documented for an intermittent therapy like HD. For a continuous therapy like CAPD however, the evidence linking improved peritoneal clearance to better survival is not as direct. However, present consensus allows one to extrapolate results based on HD. The concept of earlier and healthier initiation of dialysis is gaining hold and incremental dialysis forms an integral aspect of the whole concept. Tools like urea kinetic modeling give us valuable insight in making mathematical projections about the timing as well as dosing of dialysis. Daily home hemodialysis is still an underutilized modality despite offering best survival figures. Hopefully, with increasing availability of better and simpler machines its use will increase. Still several questions remain unanswered. Despite availability of data in hemodialysis patients suggesting that an increased dialysis prescription leads to a better survival, optimal dialysis dose is yet to be defined. Concerns regarding methodology of such studies and conclusions thereof has been raised. Other issues relating to design of the studies, variation in dialysis delivery, use of uncontrolled historical standards and lack of patient randomization etc also need to be considered when designing such trials. Hopefully an ongoing prospective randomized trial, namely the HEMO study, looking at two precisely defined and carefully maintained dialysis prescriptions will provide some insight into adequacy of dialysis dose and survival. In diabetic patients, the

  18. Acute Effects of Carbohydrate Supplementation on Intermittent Sports Performance.

    Science.gov (United States)

    Baker, Lindsay B; Rollo, Ian; Stein, Kimberly W; Jeukendrup, Asker E

    2015-07-14

    Intermittent sports (e.g., team sports) are diverse in their rules and regulations but similar in the pattern of play; that is, intermittent high-intensity movements and the execution of sport-specific skills over a prolonged period of time (~1-2 h). Performance during intermittent sports is dependent upon a combination of anaerobic and aerobic energy systems, both of which rely on muscle glycogen and/or blood glucose as an important substrate for energy production. The aims of this paper are to review: (1) potential biological mechanisms by which carbohydrate may impact intermittent sport performance; (2) the acute effects of carbohydrate ingestion on intermittent sport performance, including intermittent high-intensity exercise capacity, sprinting, jumping, skill, change of direction speed, and cognition; and (3) what recommendations can be derived for carbohydrate intake before/during exercise in intermittent sports based on the available evidence. The most researched intermittent sport is soccer but some sport-specific studies have also been conducted in other sports (e.g., rugby, field hockey, basketball, American football, and racquet sports). Carbohydrate ingestion before/during exercise has been shown in most studies to enhance intermittent high-intensity exercise capacity. However, studies have shown mixed results with regards to the acute effects of carbohydrate intake on sprinting, jumping, skill, change of direction speed, and cognition. In most of these studies the amount of carbohydrate consumed was ~30-60 g/h in the form of a 6%-7% carbohydrate solution comprised of sucrose, glucose, and/or maltodextrin. The magnitude of the impact that carbohydrate ingestion has on intermittent sport performance is likely dependent on the carbohydrate status of the individual; that is, carbohydrate ingestion has the greatest impact on performance under circumstances eliciting fatigue and/or hypoglycemia. Accordingly, carbohydrate ingestion before and during a game

  19. Acute Effects of Carbohydrate Supplementation on Intermittent Sports Performance

    Directory of Open Access Journals (Sweden)

    Lindsay B. Baker

    2015-07-01

    Full Text Available Intermittent sports (e.g., team sports are diverse in their rules and regulations but similar in the pattern of play; that is, intermittent high-intensity movements and the execution of sport-specific skills over a prolonged period of time (~1–2 h. Performance during intermittent sports is dependent upon a combination of anaerobic and aerobic energy systems, both of which rely on muscle glycogen and/or blood glucose as an important substrate for energy production. The aims of this paper are to review: (1 potential biological mechanisms by which carbohydrate may impact intermittent sport performance; (2 the acute effects of carbohydrate ingestion on intermittent sport performance, including intermittent high-intensity exercise capacity, sprinting, jumping, skill, change of direction speed, and cognition; and (3 what recommendations can be derived for carbohydrate intake before/during exercise in intermittent sports based on the available evidence. The most researched intermittent sport is soccer but some sport-specific studies have also been conducted in other sports (e.g., rugby, field hockey, basketball, American football, and racquet sports. Carbohydrate ingestion before/during exercise has been shown in most studies to enhance intermittent high-intensity exercise capacity. However, studies have shown mixed results with regards to the acute effects of carbohydrate intake on sprinting, jumping, skill, change of direction speed, and cognition. In most of these studies the amount of carbohydrate consumed was ~30–60 g/h in the form of a 6%–7% carbohydrate solution comprised of sucrose, glucose, and/or maltodextrin. The magnitude of the impact that carbohydrate ingestion has on intermittent sport performance is likely dependent on the carbohydrate status of the individual; that is, carbohydrate ingestion has the greatest impact on performance under circumstances eliciting fatigue and/or hypoglycemia. Accordingly, carbohydrate ingestion before

  20. Cost analysis of negative-pressure wound therapy with instillation for wound bed preparation preceding split-thickness skin grafts for massive (>100 cm(2)) chronic venous leg ulcers.

    Science.gov (United States)

    Yang, C Kevin; Alcantara, Sean; Goss, Selena; Lantis, John C

    2015-04-01

    Massive (≥100 cm(2)) venous leg ulcers (VLUs) demonstrate very low closure rates with standard compression therapy and are costly to manage. Negative-pressure wound therapy (NPWT), followed by a split-thickness skin graft (STSG), can be a cost-effective alternative to this standard care. We performed a cost analysis of these two treatments. A retrospective review was performed of 10 ulcers treated with surgical debridement, 7 days of inpatient NPWT with topical antiseptic instillation (NPWTi), and STSG, with 4 additional days of inpatient NPWT bolster over the graft. Independent medical cost estimators were used to compare the cost of this treatment protocol with standard outpatient compression therapy. The average length of time ulcers were present before patients entered the study was 38 months (range, 3-120 months). Eight of 10 patients had complete VLU closure by 6 months after NPWTi with STSG. The 6-month costs of the proposed treatment protocol and standard twice-weekly compression therapy were estimated to be $27,000 and $28,000, respectively. NPWTi with STSG treatment is more effective for closure of massive VLUs at 6 months than that reported for standard compression therapy. Further, the cost of the proposed treatment protocol is comparable with standard compression therapy. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  1. Intermittent, Non Cyclic Severe Mechanical Aortic Valve Regurgitation

    Science.gov (United States)

    Choi, Jong Hyun; Song, Seunghwan; Lee, Myung-Yong

    2013-01-01

    Mechanical aortic prosthesis dysfunction can result from thrombosis or pannus formation. We describe an unusual case of intermittent, non cyclic mechanical aortic prosthesis dysfunction due to pannus formation with thrombus in the absence of systolic restriction of disk excursion, that presented with intermittent severe aortic regurgitation. PMID:24459568

  2. Intermittent versus Continuous Physiotherapy in Children with Cerebral Palsy

    Science.gov (United States)

    Christiansen, Annette Sandahl; Lange, Christa

    2008-01-01

    The aim of this study was to compare the effect of the delivery of the same amount of intermittent versus continuous physiotherapy given to children with cerebral palsy (CP). This was organized either in an intermittent regime four times a week for 4 weeks alternating with a 6-week treatment pause, or a continuous once or twice a week regime, both…

  3. Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial.

    Science.gov (United States)

    Sundfør, T M; Svendsen, M; Tonstad, S

    2018-07-01

    Long-term adherence to conventional weight-loss diets is limited while intermittent fasting has risen in popularity. We compared the effects of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk factors in adults with abdominal obesity and ≥1 additional component of metabolic syndrome. In total 112 participants (men [50%] and women [50%]) aged 21-70 years with BMI 30-45 kg/m 2 (mean 35.2 [SD 3.7]) were randomized to intermittent or continuous energy restriction. A 6-month weight-loss phase including 10 visits with dieticians was followed by a 6-month maintenance phase without additional face-to-face counselling. The intermittent energy restriction group was advised to consume 400/600 kcal (female/male) on two non-consecutive days. Based on dietary records both groups reduced energy intake by ∼26-28%. Weight loss was similar among participants in the intermittent and continuous energy restriction groups (8.0 kg [SD 6.5] versus 9.0 kg [SD 7.1]; p = 0.6). There were favorable improvements in waist circumference, blood pressure, triglycerides and HDL-cholesterol with no difference between groups. Weight regain was minimal and similar between the intermittent and continuous energy restriction groups (1.1 kg [SD 3.8] versus 0.4 kg [SD 4.0]; p = 0.6). Intermittent restriction participants reported higher hunger scores than continuous restriction participants on a subjective numeric rating scale (4.7 [SD 2.2] vs 3.6 [SD 2.2]; p = 0.002). Both intermittent and continuous energy restriction resulted in similar weight loss, maintenance and improvements in cardiovascular risk factors after one year. However, feelings of hunger may be more pronounced during intermittent energy restriction. www.clinicaltrials.govNCT02480504. Copyright © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine

  4. Role of Carotid Body in Intermittent Hypoxia-Related Hypertension.

    Science.gov (United States)

    Iturriaga, Rodrigo; Oyarce, María Paz; Dias, Ana Carolina Rodrigues

    2017-05-01

    Obstructive sleep apnea (OSA), a common breathing disorder, is recognized as an independent risk factor for systemic hypertension. Among the alterations induced by OSA, the chronic intermittent hypoxia (CIH) is considered the main factor for the hypertension. Exposure of rodents to CIH is the gold-standard method to study the mechanisms involved in the cardiovascular alterations induced by OSA. Although it is well known that CIH produces hypertension, the underlying mechanisms are not totally elucidated. It is likely that the CIH-induced systemic oxidative stress and inflammation may elicit endothelial dysfunction and increase the arterial blood pressure. In addition, OSA patients and animals exposed to CIH show sympathetic hyperactivity and potentiated cardiorespiratory responses to acute hypoxia, suggesting that CIH enhances the peripheral hypoxic chemoreflex. Recent experimental evidences support the proposal that CIH selectively enhances carotid body (CB) chemosensory reactivity to oxygen, which in turn increases sympathetic outflow leading to neurogenic hypertension. In this review, we will discuss the supporting evidence for a critical role of the CB in the generation and maintenance of the hypertension induced by CIH, also, the contribution of oxidative stress to enhance CB chemosensory drive and the activation of sympathetic-related centers in the brain.

  5. Sympatho-adrenal activation by chronic intermittent hypoxia

    Science.gov (United States)

    Kumar, Ganesh K.; Peng, Ying-Jie

    2012-01-01

    Recurrent apnea with chronic intermittent hypoxia (CIH) is a major clinical problem in adult humans and infants born preterm. Patients with recurrent apnea exhibit heightened sympathetic activity as well as elevated plasma catecholamine levels, and these phenotypes are effectively recapitulated in rodent models of CIH. This article summarizes findings from studies addressing sympathetic activation in recurrent apnea patients and rodent models of CIH and the underlying cellular and molecular mechanisms. Available evidence suggests that augmented chemoreflex and attenuated baroreflex contribute to sympathetic activation by CIH. Studies on rodents showed that CIH augments the carotid body response to hypoxia and attenuates the carotid baroreceptor response to increased sinus pressures. Processing of afferent information from chemoreceptors at the central nervous system is also facilitated by CIH. Adult and neonatal rats exposed to CIH exhibit augmented catecholamine secretion from the adrenal medulla. Adrenal demedullation prevents the elevation of circulating catecholamines in CIH-exposed rodents. Reactive oxygen species (ROS)-mediated signaling is emerging as the major cellular mechanism triggering sympatho-adrenal activation by CIH. Molecular mechanisms underlying increased ROS generation by CIH seem to involve transcriptional dysregulation of genes encoding pro-and antioxidant enzymes by hypoxia-inducible factor-1 and -2, respectively. PMID:22723632

  6. Sympatho-adrenal activation by chronic intermittent hypoxia.

    Science.gov (United States)

    Prabhakar, Nanduri R; Kumar, Ganesh K; Peng, Ying-Jie

    2012-10-15

    Recurrent apnea with chronic intermittent hypoxia (CIH) is a major clinical problem in adult humans and infants born preterm. Patients with recurrent apnea exhibit heightened sympathetic activity as well as elevated plasma catecholamine levels, and these phenotypes are effectively recapitulated in rodent models of CIH. This article summarizes findings from studies addressing sympathetic activation in recurrent apnea patients and rodent models of CIH and the underlying cellular and molecular mechanisms. Available evidence suggests that augmented chemoreflex and attenuated baroreflex contribute to sympathetic activation by CIH. Studies on rodents showed that CIH augments the carotid body response to hypoxia and attenuates the carotid baroreceptor response to increased sinus pressures. Processing of afferent information from chemoreceptors at the central nervous system is also facilitated by CIH. Adult and neonatal rats exposed to CIH exhibit augmented catecholamine secretion from the adrenal medulla. Adrenal demedullation prevents the elevation of circulating catecholamines in CIH-exposed rodents. Reactive oxygen species (ROS)-mediated signaling is emerging as the major cellular mechanism triggering sympatho-adrenal activation by CIH. Molecular mechanisms underlying increased ROS generation by CIH seem to involve transcriptional dysregulation of genes encoding pro-and antioxidant enzymes by hypoxia-inducible factor-1 and -2, respectively.

  7. Modelling of intermittent microwave convective drying: parameter sensitivity

    Directory of Open Access Journals (Sweden)

    Zhang Zhijun

    2017-06-01

    Full Text Available The reliability of the predictions of a mathematical model is a prerequisite to its utilization. A multiphase porous media model of intermittent microwave convective drying is developed based on the literature. The model considers the liquid water, gas and solid matrix inside of food. The model is simulated by COMSOL software. Its sensitivity parameter is analysed by changing the parameter values by ±20%, with the exception of several parameters. The sensitivity analysis of the process of the microwave power level shows that each parameter: ambient temperature, effective gas diffusivity, and evaporation rate constant, has significant effects on the process. However, the surface mass, heat transfer coefficient, relative and intrinsic permeability of the gas, and capillary diffusivity of water do not have a considerable effect. The evaporation rate constant has minimal parameter sensitivity with a ±20% value change, until it is changed 10-fold. In all results, the temperature and vapour pressure curves show the same trends as the moisture content curve. However, the water saturation at the medium surface and in the centre show different results. Vapour transfer is the major mass transfer phenomenon that affects the drying process.

  8. Intermittent metabolic switching, neuroplasticity and brain health

    Science.gov (United States)

    Mattson, Mark P.; Moehl, Keelin; Ghena, Nathaniel; Schmaedick, Maggie; Cheng, Aiwu

    2018-01-01

    During evolution, individuals whose brains and bodies functioned well in a fasted state were successful in acquiring food, enabling their survival and reproduction. With fasting and extended exercise, liver glycogen stores are depleted and ketones are produced from adipose-cell-derived fatty acids. This metabolic switch in cellular fuel source is accompanied by cellular and molecular adaptations of neural networks in the brain that enhance their functionality and bolster their resistance to stress, injury and disease. Here, we consider how intermittent metabolic switching, repeating cycles of a metabolic challenge that induces ketosis (fasting and/or exercise) followed by a recovery period (eating, resting and sleeping), may optimize brain function and resilience throughout the lifespan, with a focus on the neuronal circuits involved in cognition and mood. Such metabolic switching impacts multiple signalling pathways that promote neuroplasticity and resistance of the brain to injury and disease. PMID:29321682

  9. Compensatory mechanisms activated with intermittent energy restriction

    DEFF Research Database (Denmark)

    Coutinho, Sílvia Ribeiro; Halset, Eline Holli; Gåsbakk, Sigrid

    2018-01-01

    Background & aims: Strong compensatory responses, with reduced resting metabolic rate (RMR), increased exercise efficiency (ExEff) and appetite, are activated when weight loss (WL) is achieved with continuous energy restriction (CER), which try to restore energy balance. Intermittent energy...... restriction (IER), where short spells of energy restriction are interspaced by periods of habitual energy intake, may offer some protection in minimizing those responses. We aimed to compare the effect of IER versus CER on body composition and the compensatory responses induced by WL. Methods: 35 adults (age......: 39 ± 9 y) with obesity (BMI: 36 ± 4 kg/m2) were randomized to lose a similar weight with an IER (N = 18) or a CER (N = 17) diet over a 12 week period. Macronutrient composition and overall energy restriction (33% reduction) were similar between groups. Body weight/composition, RMR, fasting...

  10. Scale Dependence of Spatiotemporal Intermittence of Rain

    Science.gov (United States)

    Kundu, Prasun K.; Siddani, Ravi K.

    2011-01-01

    It is a common experience that rainfall is intermittent in space and time. This is reflected by the fact that the statistics of area- and/or time-averaged rain rate is described by a mixed distribution with a nonzero probability of having a sharp value zero. In this paper we have explored the dependence of the probability of zero rain on the averaging space and time scales in large multiyear data sets based on radar and rain gauge observations. A stretched exponential fannula fits the observed scale dependence of the zero-rain probability. The proposed formula makes it apparent that the space-time support of the rain field is not quite a set of measure zero as is sometimes supposed. We also give an ex.planation of the observed behavior in tenus of a simple probabilistic model based on the premise that rainfall process has an intrinsic memory.

  11. [Intermittent Explosive Disorder: A Controversial Diagnosis].

    Science.gov (United States)

    Zapata, Juan Pablo; Palacio, Juan David

    2016-01-01

    Intermittent explosive disorder (IED) is aan externalizing externalising disorder characterized characterised by recurrent aggression episodes. Even though this disorder was described several decades ago, and it carries personal and social consequences, there is little in the medical scientific literature on this. bibliographic production about it is scanty. To perform a conceptualization conceptualisation of this disorder, through the review and bibliometric analysis of the available scientific articles. A search was performed in databases with the english English terms intermittent explosive disorder, impulse disorders control [MeSH], in combination with other terms. A bibliometric analysis in the GoPubMed® search engineer was also performed using all data obtained in the search. was also perfomed. IED prevalence ranges from 1.4% to 7%, it presents more frequently during middle adolescence, and with more noticeable repercussions in men males than in womenfemales. The psychopathological core of IED is the impulsive aggressive behaviour that presents in the form of «attacks» that occurs in response to a lower precipitating stimulus. Scientific publications about IED are few and relatively recent, and the vast majority is provided bycomes from the United States (56.56%), and headed by a single author. This fact highlights the need to replicate the findings described about the IED in order to demonstrate the validity and reliability of its diagnostic criteria. It is possible that doubts about the existence of a diagnosis lead have led to such a scant literature about the IED. Available studies about IED allow have allowed characterizing a group of subjects with episodes of impulsive aggression to be characterised, but this description requires replication in different latitudesneeds to be repeated in different areas. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. Managing server clusters on intermittent power

    Directory of Open Access Journals (Sweden)

    Navin Sharma

    2015-12-01

    Full Text Available Reducing the energy footprint of data centers continues to receive significant attention due to both its financial and environmental impact. There are numerous methods that limit the impact of both factors, such as expanding the use of renewable energy or participating in automated demand-response programs. To take advantage of these methods, servers and applications must gracefully handle intermittent constraints in their power supply. In this paper, we propose blinking—metered transitions between a high-power active state and a low-power inactive state—as the primary abstraction for conforming to intermittent power constraints. We design Blink, an application-independent hardware–software platform for developing and evaluating blinking applications, and define multiple types of blinking policies. We then use Blink to design both a blinking version of memcached (BlinkCache and a multimedia cache (GreenCache to demonstrate how application characteristics affect the design of blink-aware distributed applications. Our results show that for BlinkCache, a load-proportional blinking policy combines the advantages of both activation and synchronous blinking for realistic Zipf-like popularity distributions and wind/solar power signals by achieving near optimal hit rates (within 15% of an activation policy, while also providing fairer access to the cache (within 2% of a synchronous policy for equally popular objects. In contrast, for GreenCache, due to multimedia workload patterns, we find that a staggered load proportional blinking policy with replication of the first chunk of each video reduces the buffering time at all power levels, as compared to activation or load-proportional blinking policies.

  13. Intermittent Brugada Syndrome Presenting with Syncope in an Adult Female

    Directory of Open Access Journals (Sweden)

    Patricia Chavez

    2014-01-01

    Full Text Available Background. Brugada syndrome accounts for 4–12% of all sudden deaths worldwide and at least 20% of sudden deaths in patients with structurally normal hearts. Case Report. A 48-year-old female presented to the emergency department after two witnessed syncopal episodes. While awaiting discharge had a third collapse followed by cardiac arrest with shockable rhythm. Initial electrocardiogram showed wide QRS complex with left axis deviation, ST-segment elevation of 2 mm followed by a negative T wave with no isoelectric separation, suggestive of spontaneous intermittent Brugada type 1 pattern. Cardiac magnetic resonance imaging demonstrated neither structural heart disease nor abnormal myocardium. After placement of an implantable cardioverter defibrillator the patient was discharged. Why should an emergency physician be aware of this? Brugada syndrome is an infrequently encountered clinical entity which may have a fatal outcome. This syndrome primarily presents with syncope. It should be considered as a component of differential diagnosis in patients with family history of syncope and sudden cardiac death.

  14. Amygdala hyperactivation to angry faces in intermittent explosive disorder.

    Science.gov (United States)

    McCloskey, Michael S; Phan, K Luan; Angstadt, Mike; Fettich, Karla C; Keedy, Sarah; Coccaro, Emil F

    2016-08-01

    Individuals with intermittent explosive disorder (IED) were previously found to exhibit amygdala hyperactivation and relatively reduced orbital medial prefrontal cortex (OMPFC) activation to angry faces while performing an implicit emotion information processing task during functional magnetic resonance imaging (fMRI). This study examines the neural substrates associated with explicit encoding of facial emotions among individuals with IED. Twenty unmedicated IED subjects and twenty healthy, matched comparison subjects (HC) underwent fMRI while viewing blocks of angry, happy, and neutral faces and identifying the emotional valence of each face (positive, negative or neutral). We compared amygdala and OMPFC reactivity to faces between IED and HC subjects. We also examined the relationship between amygdala/OMPFC activation and aggression severity. Compared to controls, the IED group exhibited greater amygdala response to angry (vs. neutral) facial expressions. In contrast, IED and control groups did not differ in OMPFC activation to angry faces. Across subjects amygdala activation to angry faces was correlated with number of prior aggressive acts. These findings extend previous evidence of amygdala dysfunction in response to the identification of an ecologically-valid social threat signal (processing angry faces) among individuals with IED, further substantiating a link between amygdala hyperactivity to social signals of direct threat and aggression. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Enhancement of Intermittent Androgen Ablation Therapy by Finasteride Administration in Animal Models

    National Research Council Canada - National Science Library

    Wang, Zhou

    2006-01-01

    .... Intermittent androgen ablation therapy (IAAT) may slow down the development of androgen refractory tumors because intermittent recovery of androgens can induce differentiation of prostatic epithelial cells...

  16. Enhancement of Intermittent Androgen Ablation Therapy by Finasteride Administration in Animal Models

    National Research Council Canada - National Science Library

    Wang, Zhou

    2004-01-01

    .... Intermittent androgen ablation therapy may slow down the development of androgen refractory tumors because intermittent recovery of androgens can induce differentiation of prostatic epithelial cells...

  17. Enhancement of Intermittent Androgen Ablation Therapy by Finasteride Administration in Animal Models

    National Research Council Canada - National Science Library

    Wang, Zhou

    2005-01-01

    .... Intermittent androgen ablation therapy may slow down the development of androgen refractory tumors because intermittent recovery of androgens can induce differentiation of prostatic epithelial cells...

  18. Enhancement of Intermittent Androgen Ablation Therapy by Finasteride Administration in Animal Models

    National Research Council Canada - National Science Library

    Wang, Zhou

    2003-01-01

    .... Intermittent androgen ablation therapy may slow down the development of androgen refractory tumors because intermittent recovery of androgens can induce differentiation of prostatic epithelial cells...

  19. Large scale integration of intermittent renewable energy sources in the Greek power sector

    International Nuclear Information System (INIS)

    Voumvoulakis, Emmanouil; Asimakopoulou, Georgia; Danchev, Svetoslav; Maniatis, George; Tsakanikas, Aggelos

    2012-01-01

    As a member of the European Union, Greece has committed to achieve ambitious targets for the penetration of renewable energy sources (RES) in gross electricity consumption by 2020. Large scale integration of RES requires a suitable mixture of compatible generation units, in order to deal with the intermittency of wind velocity and solar irradiation. The scope of this paper is to examine the impact of large scale integration of intermittent energy sources, required to meet the 2020 RES target, on the generation expansion plan, the fuel mix and the spinning reserve requirements of the Greek electricity system. We perform hourly simulation of the intermittent RES generation to estimate residual load curves on a monthly basis, which are then inputted in a WASP-IV model of the Greek power system. We find that the decarbonisation effort, with the rapid entry of RES and the abolishment of the grandfathering of CO 2 allowances, will radically transform the Greek electricity sector over the next 10 years, which has wide-reaching policy implications. - Highlights: ► Greece needs 8.8 to 9.3 GW additional RES installations by 2020. ► RES capacity credit varies between 12.2% and 15.3%, depending on interconnections. ► Without institutional changes, the reserve requirements will be more than double. ► New CCGT installed capacity will probably exceed the cost-efficient level. ► Competitive pressures should be introduced in segments other than day-ahead market.

  20. The effect of intermittent hypobaric-hypoxia treatments on renal glutathione peroxidase activity of rats

    Science.gov (United States)

    Paramita, I. A.; Jusman, S. W. A.

    2017-08-01

    Many people living at high altitudes experiencing a condition called intermittent hypobaric hypoxia (IHH). Some people even create IHH condition as an exercise for pilots, athletes, and mountaineers. In this experiment, we aimed to determine whether the protective effect of IHH is mediated through glutathione peroxidase (GPX) enzyme. The experiment’s sample is two-month-old healthy Sprague-Dawley rat kidneys weighing 200-250 g. Intermittent hypobaric hypoxia treatment is done using a Hypobaric Chamber type I that can mimic air pressure