WorldWideScience

Sample records for mechanical circulatory assist

  1. Mechanical circulatory assist device development at the Texas Heart Institute: a personal perspective.

    Science.gov (United States)

    Frazier, O H

    2014-01-01

    In December 2013, we performed our 1000th ventricular assist device implantation at the Texas Heart Institute. In my professional career, I have been fortunate to see the development of numerous mechanical circulatory support devices for the treatment of patients with advanced heart failure. In fact, most of the cardiac pumps in wide use today were developed in the Texas Heart Institute research laboratories in cooperation with the National Heart, Lung and Blood Institute or device innovators and manufacturers and implanted clinically at our partner St. Luke's Episcopal Hospital. My early involvement in this field was guided by my mentors, Dr Michael E. DeBakey and, especially, Dr Denton A. Cooley. Also, many of the advances are directly attributable to my ongoing clinical experience. What I learned daily in my surgical practice allowed me to bring insights to the development of this technology that a laboratory researcher alone might not have had. Young academic surgeons interested in this field might be well served to be active not only in laboratory research but also in clinical practice. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Interagency registry for mechanically assisted circulatory support report on the total artificial heart.

    Science.gov (United States)

    Arabía, Francisco A; Cantor, Ryan S; Koehl, Devin A; Kasirajan, Vigneshwar; Gregoric, Igor; Moriguchi, Jaime D; Esmailian, Fardad; Ramzy, Danny; Chung, Joshua S; Czer, Lawrence S; Kobashigawa, Jon A; Smith, Richard G; Kirklin, James K

    2018-04-26

    We sought to better understand the patient population who receive a temporary total artificial heart (TAH) as bridge to transplant or as bridge to decision by evaluating data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database. We examined data related to survival, adverse events, and competing outcomes from patients who received TAHs between June 2006 and April 2017 and used hazard function analysis to explore risk factors for mortality. Data from 450 patients (87% men; mean age, 50 years) were available in the INTERMACS database. The 2 most common diagnoses were dilated cardiomyopathy (50%) and ischemic cardiomyopathy (20%). Risk factors for right heart failure were present in 82% of patients. Most patients were INTERMACS Profile 1 (43%) or 2 (37%) at implantation. There were 266 patients who eventually underwent transplantation, and 162 died. Overall 3-, 6-, and 12-month actuarial survival rates were 73%, 62%, and 53%, respectively. Risk factors for death included older age (p = 0.001), need for pre-implantation dialysis (p = 0.006), higher creatinine (p = 0.008) and lower albumin (p Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  3. Mechanical circulatory support in pediatrics.

    Science.gov (United States)

    Steffen, Robert J; Miletic, Kyle G; Schraufnagel, Dean P; Vargo, Patrick R; Fukamachi, Kiyotaka; Stewart, Robert D; Moazami, Nader

    2016-05-01

    End-stage heart failure affects thousands of children yearly and mechanical circulatory support is used at many points in their care. Extracorporeal membrane oxygenation supports both the failing heart and lungs, which has led to its use as an adjunct to cardiopulmonary resuscitation as well as in post-operative cardiogenic shock. Continuous-flow ventricular assist devices (VAD) have replaced pulsatile-flow devices in adults and early studies have shown promising results in children. The Berlin paracorporeal pulsatile VAD recently gained U.S. Food and Drug Administration approval and remains the only VAD approved in pediatrics. Failing univentricular hearts and other congenitally corrected lesions are new areas for mechanical support. Finding novel uses, improving durability, and minimizing complications are areas of growth in pediatric mechanical circulatory support.

  4. [Mechanical circulatory support saves lives -- three years' experience of the newly established assist device program at Semmelweis University, Budapest, Hungary].

    Science.gov (United States)

    Fazekas, Levente; Sax, Balázs; Hartyánszky, István; Pólos, Miklós; Horkay, Ferenc; Varga, Tamás; Rácz, Kristóf; Németh, Endre; Székely, Andrea; Paulovich, Erzsébet; Heltai, Krisztina; Zima, Endre; Szabolcs, Zoltán; Merkely, Béla

    2015-03-29

    Since the celebration of the 20th anniversary of the first heart transplantation in Hungary in 2012 the emerging need for modern heart failure management via mechanical circulatory support has evolved. In May 2012 the opening of a new heart failure and transplant unit with 9 beds together with the procurement of necessary devices at Semmelweis University accomplished this need. The aim of the authors was to report their initial experience obtained in this new cardiac assist device program. Since May, 2012, mechanical circulatory support system was applied in 89 cases in 72 patients. Indication for support were end stage heart failure refractory to medical treatment and acute left or right heart failure. Treatment was initiated for acute graft failure after heart transplantation in 27 cases, for end stage heart failure in 24 cases, for acute myocardial infarction in 21 cases, for acute postcardiotomy heart failure in 14 cases, for severe respiratory insufficiency in 2 cases and for drug intoxication in one case. Among the 30 survivor of the whole program 13 patients were successfully transplanted. The available devices can cover all modalities of current bridge therapy from short term support through medium support to heart transplantation or long term support and destination therapy. These conditions made possible the successful start of a new cardiac assist device program.

  5. Mechanical circulatory treatment of advanced heart failure

    DEFF Research Database (Denmark)

    Løgstrup, Brian B; Vase, Henrik; Gjedsted, Jakob

    2016-01-01

    Heart failure is one of the most common causes of morbidity and mortality worldwide. When patients cease to respond adequately to optimal medical therapy mechanical circulatory support has been promising. The advent of mechanical circulatory support devices has allowed significant improvements...... in patient survival and quality of life for those with advanced or end-stage heart failure. We provide a general overview of current mechanical circulatory support devices encompassing options for both short- and long-term ventricular support....

  6. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS)

    DEFF Research Database (Denmark)

    de By, Theo M M H; Mohacsi, Paul; Gummert, Jan

    2015-01-01

    other founding international members. It aims to promote scientific research to improve care of end-stage heart failure patients with ventricular assist device or a total artificial heart as long-term mechanical circulatory support. Likewise, the organization aims to provide and maintain a registry...

  7. Outcomes of pediatric patients supported with continuous-flow ventricular assist devices: A report from the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS).

    Science.gov (United States)

    Rossano, Joseph W; Lorts, Angela; VanderPluym, Christina J; Jeewa, Aamir; Guleserian, Kristine J; Bleiweis, Mark S; Reinhartz, Olaf; Blume, Elizabeth D; Rosenthal, David N; Naftel, David C; Cantor, Ryan S; Kirklin, James K

    2016-05-01

    Continuous-flow (CF) ventricular assist devices (VADs) have largely replaced pulsatile-flow VADs in adult patients. However, there are few data on CF VADs among pediatric patients. In this study we aimed to describe the overall use, patients' characteristics and outcomes of CF VADs in this population. The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a national registry for U.S. Food and Drug Adminstration (FDA)-approved VADs in patients <19 years of age. Patients undergoing placement of durable CF VADs between September 2012 and June 2015 were included and outcomes were compared with those of adults from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). CF VADs were implanted in 109 patients at 35 hospitals. The median age at implantation was 15 years (2.8 to 18.9 years) and median weight was 62 kg (range 16 to 141 kg). The underlying disease was cardiomyopathy in 89 (82%) patients. The INTERMACS level at time of implant was Level 1 in 20 (19%), Level 2 in 64 (61%) and Levels 3 to 7 in 21 (20%) patients. Most were implanted as LVADs (n = 102, 94%). Median duration of support was 2.3 months (range <1 day to 28 months). Serious adverse event rates were low, including neurologic dysfunction (early event rate 4.1 per 100 patient-months with 2 late events). Competing outcomes analysis at 6 months post-implant indicated 61% transplanted, 31% alive with device in place and 8% death before transplant. These outcomes compared favorably with the 3,894 adults supported with CF VADs as a bridge to transplant. CF VADs are commonly utilized in older children and adolescents, with excellent survival rates. Further study is needed to understand impact of patient and device characteristics on outcomes in pediatric patients. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  8. Early Right Ventricular Assist Device Use in Patients Undergoing Continuous-Flow Left Ventricular Assist Device Implantation: Incidence and Risk Factors From the Interagency Registry for Mechanically Assisted Circulatory Support.

    Science.gov (United States)

    Kiernan, Michael S; Grandin, E Wilson; Brinkley, Marshall; Kapur, Navin K; Pham, Duc Thinh; Ruthazer, Robin; Rame, J Eduardo; Atluri, Pavan; Birati, Edo Y; Oliveira, Guilherme H; Pagani, Francis D; Kirklin, James K; Naftel, David; Kormos, Robert L; Teuteberg, Jeffrey J; DeNofrio, David

    2017-10-01

    To investigate preimplant risk factors associated with early right ventricular assist device (RVAD) use in patients undergoing continuous-flow left ventricular assist device (LVAD) surgery. Patients in the Interagency Registry for Mechanically Assisted Circulatory Support who underwent primary continuous-flow-LVAD surgery were examined for concurrent or subsequent RVAD implantation within 14 days of LVAD. Risk factors for RVAD implantation and the combined end point of RVAD or death within 14 days of LVAD were assessed with stepwise logistic regression. We compared survival between patients with and without RVAD using Kaplan-Meier method and Cox proportional hazards modeling. Of 9976 patients undergoing continuous-flow-LVAD implantation, 386 patients (3.9%) required an RVAD within 14 days of LVAD surgery. Preimplant characteristics associated with RVAD use included interagency registry for mechanically assisted circulatory support patient profiles 1 and 2, the need for preoperative extracorporeal membrane oxygenation or renal replacement therapy, severe preimplant tricuspid regurgitation, history of cardiac surgery, and concomitant procedures other than tricuspid valve repair at the time of LVAD. Hemodynamic determinants included elevated right atrial pressure, reduced pulmonary artery pulse pressure, and reduced stroke volume. The final model demonstrated good performance for both RVAD implant (area under the curve, 0.78) and the combined end point of RVAD or death within 14 days (area under the curve, 0.73). Compared with patients receiving an isolated LVAD, patients requiring RVAD had decreased 1- and 6-month survival: 78.1% versus 95.8% and 63.6% versus 87.9%, respectively ( P The need for RVAD implantation after LVAD is associated with indices of global illness severity, markers of end-organ dysfunction, and profiles of hemodynamic instability. © 2017 American Heart Association, Inc.

  9. Short-term mechanical circulatory support as a bridge to durable left ventricular assist device implantation in refractory cardiogenic shock: a systematic review and meta-analysis.

    Science.gov (United States)

    den Uil, Corstiaan A; Akin, Sakir; Jewbali, Lucia S; Dos Reis Miranda, Dinis; Brugts, Jasper J; Constantinescu, Alina A; Kappetein, Arie Pieter; Caliskan, Kadir

    2017-07-01

    Short-term mechanical circulatory support (MCS) is increasingly used as a bridge to decision in patients with refractory cardiogenic shock. Subsequently, these patients might be bridged to durable MCS either as a bridge to candidacy/transplantation, or as destination therapy. The aim of this study was to review support duration and clinical outcome of short-term MCS in cardiogenic shock, and to analyse application of this technology as a bridge to long-term cardiac support (left ventricular assist device, LVAD) from 2006 till June 2016. Using Cochrane Register of Trials, Embase and Medline, a systematic review was performed on patients with cardiogenic shock from acute myocardial infarction, end-stage cardiomyopathy, or acute myocarditis, receiving short-term MCS. Studies on periprocedural, post-cardiotomy and cardiopulmonary resuscitation support were excluded. Thirty-nine studies, mainly registries of heterogeneous patient populations (n = 4151 patients), were identified. Depending on the device used (intra-aortic balloon pump, TandemHeart, Impella 2.5, Impella 5.0, CentriMag and peripheral veno-arterial extracorporeal membrane oxygenation), mean support duration was (range) 1.6-25 days and the mean proportion of short-term MCS patients discharged was (range) 45-66%. The mean proportion of bridge to durable LVAD was (range) 3-30%. Bridge to durable LVAD was most frequently performed in patients with end-stage cardiomyopathy (22 [12-35]%). We conclude that temporary MCS can be used to bridge patients with cardiogenic shock towards durable LVAD. Clinicians are encouraged to share their results in a large multicentre registry in order to investigate optimal device selection and best duration of support. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  10. Designs for mechanical circulatory support device studies.

    Science.gov (United States)

    Neaton, James D; Normand, Sharon-Lise; Gelijns, Annetine; Starling, Randall C; Mann, Douglas L; Konstam, Marvin A

    2007-02-01

    There is increased interest in mechanical circulatory support devices (MCSDs), such as implantable left ventricular assist devices (LVADs), as "destination" therapy for patients with advanced heart failure. Because patient availability to evaluate these devices is limited and randomized trials have been slow in enrolling patients, a workshop was convened to consider designs for MCSD development including alternatives to randomized trials. A workshop was jointly planned by the Heart Failure Society of America and the US Food and Drug Administration and was convened in March 2006. One of the panels was asked to review different designs for evaluating new MCSDs. Randomized trials have many advantages over studies with no controls or with nonrandomized concurrent or historical controls. These advantages include the elimination of bias in the assignment of treatments and the balancing, on average, of known and unknown baseline covariates that influence response. These advantages of randomization are particularly important for studies in which the treatments may not differ from one another by a large amount (eg, a head-to-head study of an approved LVAD with a new LVAD). However, researchers have found it difficult to recruit patients to randomized studies because the number of clinical sites that can carry out the studies is not large. Also, there is a reluctance to randomize patients when the control device is considered technologically inferior. Thus ways of improving the design of randomized trials were discussed, and the advantages and disadvantages of alternative designs were considered. The panel concluded that designs should include a randomized component. Randomized designs might be improved by allowing the control device to be chosen before randomization, by first conducting smaller vanguard studies, and by allowing crossovers in trials with optimal medical management controls. With use of data from completed trials, other databases, and registries, alternative

  11. Development of mechanical circulatory support devices in China.

    Science.gov (United States)

    Wang, Wei; Zhu, De-Ming; Ding, Wen-Xiang

    2009-11-01

    Myocardial dysfunction leading to low cardiac output syndrome is a common clinical pathophysiological state. Currently, the use of mechanical circulatory support (MCS) is an essential aspect of the treatment of patients with cardiac failure. Several groups in China are engaged in the design and development of MCS devices. These devices can be classified as pulsatile, rotary, and total artificial heart (TAH). There are two types of pulsatile pump, which are driven by air (pneumatic). One of these pumps, the Luo-Ye pump, has been used clinically for short-term support since 1998. The other is a push-plate left ventricular device, which has a variable rate mode. Various rotary devices are classified into axial and centrifugal pumps, depending on the impeller geometry. Most rotary pumps are based on the maglev principle, and some types have been used clinically. Others are still being studied in the laboratory or in animal experiments. Furthermore, certain types of total implantable pump, such as the UJS-III axial pump and the UJS-IV aortic valvo-pump, have been developed. Only one type of TAH has been developed in China. The main constituents of this artificial heart are two axial pumps, two reservoir tanks mimicking the right and left atria, flow meters, two pressure gauges, and a resistance adaptor. Although the development of mechanical assist devices in China is still in a nascent stage, a number of different types of MCS devices are currently being studied.

  12. Biological evaluation of mechanical circulatory support systems in calves

    NARCIS (Netherlands)

    Rakhorst, G; VanDerMeer, J; Kik, C; Mihaylov, D; Havlik, P; Trinkl, J; Monties, [No Value

    Data from animal experiments with mechanical circulatory support systems (MCSS) performed in Groningen and Marseille over the past years were used to obtain normal values of hematological, coagulation, rheological and blood chemistry parameters in calves. These parameters were divided between two

  13. Current Status of Mechanical Circulatory Support: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Kyriakos Spiliopoulos

    2012-01-01

    Full Text Available Heart failure is a major public health problem and its management requires a significant amount of health care resources. Even with administration of the best available medical treatment, the mortality associated with the disease remains high. As therapeutical strategies for heart failure have been refined, the number of patients suffering from the disease has expanded dramatically. Although heart transplantation still represents the gold standard therapeutical approach, the implantation of mechanical circulatory support devices (MCSDs evolved to a well-established management for this disease. The limited applicability of heart transplantation caused by a shortage of donor organs and the concurrent expand of the patient population with end-stage heart failure led to a considerable utilization of MCSDs. This paper outlines the current status of mechanical circulatory support.

  14. Bridge to recovery in two cases of dilated cardiomyopathy after long-term mechanical circulatory support

    OpenAIRE

    Pacholewicz, Jerzy; Zakliczy?ski, Micha?; Kowalik, Violetta; Nadziakiewicz, Pawe?; Kowalski, Oskar; Kalarus, Zbigniew; Zembala, Marian

    2014-01-01

    Ventricular assist devices (VADs) have become an established therapeutic option for patients with end-stage heart failure. Achieving the potential for recovery of native heart function using VADs is an established form of treatment in a selected group of patients with HF. We report two cases of VAD patients with different types of pump used for mechanical circulatory support, a continuous flow pump (Heart-Ware?) and a pulsatile pump (POLVAD MEV?), which allow regeneration of the native heart....

  15. Molecular mechanisms of circulatory dysfunction in cirrhotic portal hypertension

    Directory of Open Access Journals (Sweden)

    Hsin-Ling Ho

    2015-04-01

    Full Text Available Acute or chronic insults to the liver are usually followed by a tissue repairing process. Unfortunately, this action, in most cases, is not effective enough to restore the normal hepatic structure and function. Instead, fibrogenesis and regenerative nodules formation ensue, which are relatively nonfunctioning. The common final stage of the process is liver cirrhosis with increased intrahepatic resistance to portal venous blood flow. Throughout the entire course, the extrahepatic circulatory dysfunction, including increased splanchnic blood flow, elevated portal venous blood flow and pressure, decreased splanchnic and peripheral vascular resistance, tachycardia, and increased cardiac output, are noted and denoted as portal hypertension with hyperdynamic circulatory dysfunction. When such a condition is established, patients may suffer from fatal complications such as gastroesophageal variceal hemorrhage, hepatic encephalopathy, or hepatorenal syndrome. The cause of such a circulatory dysfunction is not fully elucidated. Nevertheless, clarification of the pathophysiology definitely contributes to the control of portal hypertension-related complications. Herein, the molecular mechanism of this intriguing disaster is reviewed and discussed.

  16. [Mechanical circulatory support in pediatrics. Experience at the Dr. Juan P. Garrahan Pediatric Hospital. Argentina].

    Science.gov (United States)

    Moreno, Guillermo E; Magliola, Ricardo; Pilán, María Luisa; Althabe, María; Balestrini, María; Lenz, Ana Miriam; Krysnki, Mariela; Rodríguez, Ricardo; Salgado, Gladys; Martin, Analía; Cardoso, Hugo; Ruffa, Pablo; Cornelis, Carlos Javier; Barreta, Jorge; García Delucis, Pablo

    2014-01-01

    Mechanical circulatory support provides oxygen to the tissues in patients with cardiac and/or respiratory reversible disease refractory to conventional treatments. The aim of this study is to show our initial results of mechanical circulatory support in children with heart disease. Retrospective cohort between March 2006 and March 2012. Demographic data (age, sex, weight, cardiac diagnosis), surgery (technique, pump, aortic cross clamping time) and mechanical circulatory support (type of assistance, indication, duration, complications and outcome) were collected. Thirty-three patients were supported (1.3% of all surgeries), extracorporeal membrane oxygenation 32 cases and one ventricular assist device. The median age 7.4 months (one day-18 years) and weight 6kg (2.3-75). The most frequent cardiac malformations supported were the transpositions of the great arteries associated with other anomalies and the corrected transpositions (ventricular inversion or double discordance). The most common reason for admission was post-cardiotomy biventricular dysfunction. Twenty-eight patients were supported in the postoperative period, 4 in the preoperative period and in one with myocarditis. Median days of support were 3 days (1-10). The most common complications were infection (21%), bleeding (21%). Elective decannulation was achieved in 94% of cases. Hospital discharge survival: 52%. The mechanical circulatory support in our institution is a safe and standard procedure. We have been using it in a small number of cases with a similar survival to that reported internationally. This complex procedure is widely justified because it allows for the recovery of more than half of the patients who otherwise would have died. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  17. Energy transmission and power sources for mechanical circulatory support devices to achieve total implantability.

    Science.gov (United States)

    Wang, Jake X; Smith, Joshua R; Bonde, Pramod

    2014-04-01

    Left ventricular assist device therapy has radically improved congestive heart failure survival with smaller rotary pumps. The driveline used to power today's left ventricular assist devices, however, continues to be a source of infection, traumatic damage, and rehospitalization. Previous attempts to wirelessly power left ventricular assist devices using transcutaneous energy transfer systems have been limited by restrictions on separation distance and alignment between the transmit and receive coils. Resonant electrical energy transfer allows power delivery at larger distances without compromising safety and efficiency. This review covers the efforts to wirelessly power mechanical circulatory assist devices and the progress made in enhancing their energy sources. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Surface Modifications of Polymeric Materials for Application in Artificial Heart and Circulatory Assist Devices

    NARCIS (Netherlands)

    Feijen, J.; Engbers, G.H.M.; Terlingen, J.G.A.; van Delden, C.J.; Poot, A.A.; Vaudaux, P.; Akutsu, Tetsuzo; Koyanagi, Hitoshi

    1996-01-01

    Several methods have been developed to modify the surfaces of materials used in artificial hearts and circulatory assist devices to suppress the host response, especially with respect to the occurrence of clotting, cellular damage, and infections. In this review, special attention is paid to

  19. Novel Method for Exchange of Impella Circulatory Assist Catheter: The "Trojan Horse" Technique.

    Science.gov (United States)

    Phillips, Colin T; Tamez, Hector; Tu, Thomas M; Yeh, Robert W; Pinto, Duane S

    2017-07-01

    Patients with an indwelling Impella may require escalation of hemodynamic support or exchange to another circulatory assistance platform. As such, preservation of vascular access is preferable in cases where anticoagulation cannot be discontinued or to facilitate exchange to an alternative catheter or closure device. Challenges exist in avoiding bleeding and loss of wire access in these situations. We describe a single-access "Trojan Horse" technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device.

  20. A microfluidic circulatory system integrated with capillary-assisted pressure sensors.

    Science.gov (United States)

    Chen, Yangfan; Chan, Ho Nam; Michael, Sean A; Shen, Yusheng; Chen, Yin; Tian, Qian; Huang, Lu; Wu, Hongkai

    2017-02-14

    The human circulatory system comprises a complex network of blood vessels interconnecting biologically relevant organs and a heart driving blood recirculation throughout this system. Recreating this system in vitro would act as a bridge between organ-on-a-chip and "body-on-a-chip" and advance the development of in vitro models. Here, we present a microfluidic circulatory system integrated with an on-chip pressure sensor to closely mimic human systemic circulation in vitro. A cardiac-like on-chip pumping system is incorporated in the device. It consists of four pumping units and passive check valves, which mimic the four heart chambers and heart valves, respectively. Each pumping unit is independently controlled with adjustable pressure and pump rate, enabling users to control the mimicked blood pressure and heartbeat rate within the device. A check valve is located downstream of each pumping unit to prevent backward leakage. Pulsatile and unidirectional flow can be generated to recirculate within the device by programming the four pumping units. We also report an on-chip capillary-assisted pressure sensor to monitor the pressure inside the device. One end of the capillary was placed in the measurement region, while the other end was sealed. Time-dependent pressure changes were measured by recording the movement of the liquid-gas interface in the capillary and calculating the pressure using the ideal gas law. The sensor covered the physiologically relevant blood pressure range found in humans (0-142.5 mmHg) and could respond to 0.2 s actuation time. With the aid of the sensor, the pressure inside the device could be adjusted to the desired range. As a proof of concept, human normal left ventricular and arterial pressure profiles were mimicked inside this device. Human umbilical vein endothelial cells (HUVECs) were cultured on chip and cells can respond to mechanical forces generated by arterial-like flow patterns.

  1. High-risk medical devices, children and the FDA: regulatory challenges facing pediatric mechanical circulatory support devices.

    Science.gov (United States)

    Almond, Christopher S D; Chen, Eric A; Berman, Michael R; Less, Joanne R; Baldwin, J Timothy; Linde-Feucht, Sarah R; Hoke, Tracey R; Pearson, Gail D; Jenkins, Kathy; Duncan, Brian W; Zuckerman, Bram D

    2007-01-01

    Pediatric mechanical circulatory support is a critical unmet need in the United States. Infant- and child-sized ventricular assist devices are currently being developed largely through federal contracts and grants through the National Heart, Lung, and Blood Institute (NHLBI). Human testing and marketing of high-risk devices for children raises epidemiologic and regulatory issues that will need to be addressed. Leaders from the US Food and Drug Administration (FDA), NHLBI, academic pediatric community, and industry convened in January 2006 for the first FDA Workshop on the Regulatory Process for Pediatric Mechanical Circulatory Support Devices. The purpose was to provide the pediatric community with an overview of the federal regulatory process for high-risk medical devices and to review the challenges specific to the development and regulation of pediatric mechanical circulatory support devices. Pediatric mechanical circulatory support present significant epidemiologic, logistic, and financial challenges to industry, federal regulators, and the pediatric community. Early interactions with the FDA, shared appreciation of challenges, and careful planning will be critical to avoid unnecessary delays in making potentially life-saving devices available for children. Collaborative efforts to address these challenges are warranted.

  2. Intracorporeal Heat Distribution from Fully Implantable Energy Sources for Mechanical Circulatory Support: A Computational Proof-of-Concept Study

    OpenAIRE

    Biasetti, Jacopo; Pustavoitau, Aliaksei; Spazzini, Pier Giorgio

    2017-01-01

    Mechanical circulatory support devices, such as total artificial hearts and left ventricular assist devices, rely on external energy sources for their continuous operation. Clinically approved power supplies rely on percutaneous cables connecting an external energy source to the implanted device with the associated risk of infections. One alternative, investigated in the 70s and 80s, employs a fully implanted nuclear power source. The heat generated by the nuclear decay can be converted into ...

  3. Long-term Mechanical Circulatory Support System reliability recommendation by the National Clinical Trial Initiative subcommittee.

    Science.gov (United States)

    Lee, James

    2009-01-01

    The Long-Term Mechanical Circulatory Support (MCS) System Reliability Recommendation was published in the American Society for Artificial Internal Organs (ASAIO) Journal and the Annals of Thoracic Surgery in 1998. At that time, it was stated that the document would be periodically reviewed to assess its timeliness and appropriateness within 5 years. Given the wealth of clinical experience in MCS systems, a new recommendation has been drafted by consensus of a group of representatives from the medical community, academia, industry, and government. The new recommendation describes a reliability test methodology and provides detailed reliability recommendations. In addition, the new recommendation provides additional information and clinical data in appendices that are intended to assist the reliability test engineer in the development of a reliability test that is expected to give improved predictions of clinical reliability compared with past test methods. The appendices are available for download at the ASAIO journal web site at www.asaiojournal.com.

  4. New Innovations in Circulatory Support With Ventricular Assist Device and Extracorporeal Membrane Oxygenation Therapy.

    Science.gov (United States)

    Sladen, Robert N

    2017-04-01

    The past decade has seen an exponential increase in the application and development of durable long-term as well as nondurable short-term mechanical circulatory support for cardiogenic shock and acute or chronic heart failure. Support has evolved from bridge-to-transplant to destination therapy, bridge to rescue, bridge to decision making, and bridge to a bridge. Notable trends include device miniaturization, minimally invasive and/or percutaneous insertion, and efforts to superimpose pulsatility on continuous flow. We can certainly anticipate that innovation will accelerate in the months and years to come. However, despite-or perhaps because of-the enhanced equipment now available, mechanical circulatory support is an expensive, complex, resource-intensive modality. It requires considerable expertise that should preferably be centralized to highly specialized centers. Formidable challenges remain: systemic inflammatory response syndromes and vasoplegia after device insertion; postoperative sepsis; optimal anticoagulation regimens to prevent device-induced thrombosis and cerebral thromboembolism; wound site, intracranial, and gastrointestinal bleeding; multisystem injury and failure; patient dissatisfaction (even when providers consider the procedure a "success"); and ethical decision making in conditions of futility.

  5. Role of long-term mechanical circulatory support in patients with advanced heart failure.

    Science.gov (United States)

    Stokes, M B; Bergin, P; McGiffin, D

    2016-05-01

    Advanced heart failure represents a small proportion of patients with heart failure that possess high-risk features associated with high hospital readmission rates, significant functional impairment and mortality. Identification of those who have progressed to, or are near a state of advanced heart failure should prompt referral to a service that offers therapies in mechanical circulatory support (MCS) and cardiac transplantation. MCS has grown as a management strategy in the care of these patients, most commonly as a bridge to cardiac transplantation. The predominant utilisation of MCS is implantation of left ventricular assist devices (LVAD), which have evolved significantly in their technology and application over the past 15-20 years. The technology has evolved to such an extent that Destination Therapy is now being utilised as a strategy in management of advanced heart failure in appropriately selected patients. Complication rates have decreased with VAD implantation, but remain a significant consideration in the decision to implant a device, and in the follow up of these patients. © 2016 Royal Australasian College of Physicians.

  6. FEATURES OF LONG-TERM MECHANICAL CIRCULATORY SUPPORT WITH CONTINUOUS-FLOW PUMP

    Directory of Open Access Journals (Sweden)

    G. P. Itkin

    2012-01-01

    Full Text Available In a review of the comparative analysis of methods and tools for long-term mechanical circulatory support with continuous flow and pulsatile flow implantable pumps. Particular attention is paid to the choice of the optimal modes of the operation of pumps based on the physical principles of the interaction between a the steady flow of blood to the pulsatile mechanics of the heart chambers. 

  7. Bridge to recovery in two cases of dilated cardiomyopathy after long-term mechanical circulatory support.

    Science.gov (United States)

    Pacholewicz, Jerzy; Zakliczyński, Michał; Kowalik, Violetta; Nadziakiewicz, Paweł; Kowalski, Oskar; Kalarus, Zbigniew; Zembala, Marian

    2014-06-01

    Ventricular assist devices (VADs) have become an established therapeutic option for patients with end-stage heart failure. Achieving the potential for recovery of native heart function using VADs is an established form of treatment in a selected group of patients with HF. We report two cases of VAD patients with different types of pump used for mechanical circulatory support, a continuous flow pump (Heart-Ware(®)) and a pulsatile pump (POLVAD MEV(®)), which allow regeneration of the native heart. Patients were qualified as INTERMACS level 3-4 for elective implantation of an LVAD. Implantations were performed without complications. The postoperative course was uncomplicated. In the HeartWare patient the follow-up was complicated by episodes of epistaxis and recurrent GIB as well as driveline infection. The follow-up of the POLVAD MEV patient was uneventful. Recurrent GIB forced us to withdraw aspirin and warfarin therapy and maintain only clopidogrel in the HeartWare patient.. In mid-February 2013 the patient was admitted due to dysfunction of the centrifugal pump with a continuous low-flow alarm and increase power consumption. Under close monitoring of the patient a decision was made to stop the pump immediately and evaluate cardiac function. The serial echocardiography studies showed significant improvement in LVEF up to 45% and no significant valvular pathology. In February 2013 LVAD explant was performed by left thoracotomy without complications. At six-month follow-up the patient was in a good clinical condition, in NYHA class I/II, and on pharmacological treatment.

  8. Dispositivo de assistência circulatória mecânica intraventricular de fluxo axial: estudo in vitro In vitro evaluation of an intraventricular axial flow pump for mechanical circulatory support

    Directory of Open Access Journals (Sweden)

    Luiz Fernando KUBRUSLY

    2000-06-01

    Full Text Available É apresentado estudo in vitro de um dispositivo de assistência circulatória totalmente implantável no ventrículo esquerdo, de fluxo axial e de tamanho pequeno (30 cc - 7 cm comprimento. Apesar dessas características foi capaz de gerar fluxos entre 5 - 8 l/min com motor, operando em 8 W, sem causar hemólise em período de até 12 horas. O custo de produção, excetuando-se o sistema de baterias, foi projetado entre 5 - 8 mil dólares, o que o torna viável para utilização clínica rotineira em nosso país.We are currently studying an intraventricular axial flow blood pump in vitro. It is designed for long term left ventricular support. The small (30 cc, 7 cm length was capable of producing flows of 5 - 8 l/min on a 8 W motor, with no device related hemolysis throughout the 12 h of the study. The cost of production, except for the batteries, has been estimated at between 5 - 8 thousand dollars, a reasonable amount for routine clinical use in Brazil.

  9. Heart Transplant and Mechanical Circulatory Support in Patients With Advanced Heart Failure.

    Science.gov (United States)

    Sánchez-Enrique, Cristina; Jorde, Ulrich P; González-Costello, José

    2017-05-01

    Patients with advanced heart failure have a poor prognosis and heart transplant is still the best treatment option. However, the scarcity of donors, long waiting times, and an increasing number of unstable patients have favored the development of mechanical circulatory support. This review summarizes the indications for heart transplant, candidate evaluation, current immunosuppression strategies, the evaluation and treatment of rejection, infectious prophylaxis, and short and long-term outcomes. Regarding mechanical circulatory support, we distinguish between short- and long-term support and the distinct strategies that can be used: bridge to decision, recovery, candidacy, transplant, and destination therapy. We then discuss indications, risk assessment, management of complications, especially with long-term support, and outcomes. Finally, we discuss future challenges and how the widespread use of long-term support for patients with advanced heart failure will only be viable if their complications and costs are reduced. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  10. Intracorporeal Heat Distribution from Fully Implantable Energy Sources for Mechanical Circulatory Support: A Computational Proof-of-Concept Study

    Directory of Open Access Journals (Sweden)

    Jacopo Biasetti

    2017-10-01

    Full Text Available Mechanical circulatory support devices, such as total artificial hearts and left ventricular assist devices, rely on external energy sources for their continuous operation. Clinically approved power supplies rely on percutaneous cables connecting an external energy source to the implanted device with the associated risk of infections. One alternative, investigated in the 70s and 80s, employs a fully implanted nuclear power source. The heat generated by the nuclear decay can be converted into electricity to power circulatory support devices. Due to the low conversion efficiencies, substantial levels of waste heat are generated and must be dissipated to avoid tissue damage, heat stroke, and death. The present work computationally evaluates the ability of the blood flow in the descending aorta to remove the locally generated waste heat for subsequent full-body distribution and dissipation, with the specific aim of investigating methods for containment of local peak temperatures within physiologically acceptable limits. To this aim, coupled fluid–solid heat transfer computational models of the blood flow in the human aorta and different heat exchanger architectures are developed. Particle tracking is used to evaluate temperature histories of cells passing through the heat exchanger region. The use of the blood flow in the descending aorta as a heat sink proves to be a viable approach for the removal of waste heat loads. With the basic heat exchanger design, blood thermal boundary layer temperatures exceed 50°C, possibly damaging blood cells and proteins. Improved designs of the heat exchanger, with the addition of fins and heat guides, allow for drastically lower blood temperatures, possibly leading to a more biocompatible implant. The ability to maintain blood temperatures at biologically compatible levels will ultimately allow for the body-wise distribution, and subsequent dissipation, of heat loads with minimum effects on the human physiology.

  11. Intracorporeal Heat Distribution from Fully Implantable Energy Sources for Mechanical Circulatory Support: A Computational Proof-of-Concept Study.

    Science.gov (United States)

    Biasetti, Jacopo; Pustavoitau, Aliaksei; Spazzini, Pier Giorgio

    2017-01-01

    Mechanical circulatory support devices, such as total artificial hearts and left ventricular assist devices, rely on external energy sources for their continuous operation. Clinically approved power supplies rely on percutaneous cables connecting an external energy source to the implanted device with the associated risk of infections. One alternative, investigated in the 70s and 80s, employs a fully implanted nuclear power source. The heat generated by the nuclear decay can be converted into electricity to power circulatory support devices. Due to the low conversion efficiencies, substantial levels of waste heat are generated and must be dissipated to avoid tissue damage, heat stroke, and death. The present work computationally evaluates the ability of the blood flow in the descending aorta to remove the locally generated waste heat for subsequent full-body distribution and dissipation, with the specific aim of investigating methods for containment of local peak temperatures within physiologically acceptable limits. To this aim, coupled fluid-solid heat transfer computational models of the blood flow in the human aorta and different heat exchanger architectures are developed. Particle tracking is used to evaluate temperature histories of cells passing through the heat exchanger region. The use of the blood flow in the descending aorta as a heat sink proves to be a viable approach for the removal of waste heat loads. With the basic heat exchanger design, blood thermal boundary layer temperatures exceed 50°C, possibly damaging blood cells and proteins. Improved designs of the heat exchanger, with the addition of fins and heat guides, allow for drastically lower blood temperatures, possibly leading to a more biocompatible implant. The ability to maintain blood temperatures at biologically compatible levels will ultimately allow for the body-wise distribution, and subsequent dissipation, of heat loads with minimum effects on the human physiology.

  12. An exploratory study of sleep quality, daytime function, and quality of life in patients with mechanical circulatory support.

    Science.gov (United States)

    Casida, Jesus M; Brewer, Robert J; Smith, Cheryl; Davis, Jean E

    2012-07-01

    To identify and describe: (1) characteristics of sleep quality, daytime sleepiness, and quality of life (QOL) pre and post implantation of a left ventricular assist device (LVAD); (2) changes in sleep quality, daytime sleepiness, and QOL at baseline and 6 months post implant; and (3) relationships among the sleep quality, daytime sleepiness, and QOL variables. We employed an exploratory research design. Fifteen patients with continuous/non-pulsatile flow LVAD consented to partake in the study. However, only 12 patients completed the baseline and 6-month post-LVAD implant data. We used the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) to measure study variables. Data were analyzed using IBM SPSS 19.0 software. Patients reported worse sleep quality accompanied by daytime sleepiness particularly at baseline, and persisting up to 6 months post LVAD implant. A significant improvement in QOL was observed at 6 months post implant, but remained at poor levels. Correlations among sleep disturbance and daytime dysfunction components of PSQI and global daytime sleepiness (ESS) with QOL were strong (Pearson's correlations r >.60; p values sleep quality, daytime sleepiness, and QOL in patients with LVADs. Our findings offer beginning evidence about the sleep-QOL connection in this population which warrants attention in clinical practice and research. Further research is required to clearly elucidate these phenomena in patients with mechanical circulatory support and other implantable artificial organs.

  13. Hemocompatibility of Axial Versus Centrifugal Pump Technology in Mechanical Circulatory Support Devices.

    Science.gov (United States)

    Schibilsky, David; Lenglinger, Matthias; Avci-Adali, Meltem; Haller, Christoph; Walker, Tobias; Wendel, Hans Peter; Schlensak, Christian

    2015-08-01

    The hemocompatible properties of rotary blood pumps commonly used in mechanical circulatory support (MCS) are widely unknown regarding specific biocompatibility profiles of different pump technologies. Therefore, we analyzed the hemocompatibility indicating markers of an axial flow and a magnetically levitated centrifugal device within an in vitro mock loop. The HeartMate II (HM II; n = 3) device and a CentriMag (CM; n = 3) adult pump were investigated in a human whole blood mock loop for 360 min using the MCS devices as a driving component. Blood samples were analyzed by enzyme-linked immunosorbent assay for markers of coagulation, complement system, and inflammatory response. There was a time-dependent activation of the coagulation (thrombin-antithrombin complexes [TAT]), complement (SC5b-9), and inflammation system (polymorphonuclear [PMN] elastase) in both groups. The mean value of TAT (CM: 4.0 μg/L vs. 29.4 μg/L, P technologies and a magnetically levitated centrifugal pump design might be superior. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals Inc.

  14. Enhancement of Arterial Pressure Pulsatility by Controlling Continuous-Flow Left Ventricular Assist Device Flow Rate in Mock Circulatory System.

    Science.gov (United States)

    Bozkurt, Selim; van de Vosse, Frans N; Rutten, Marcel C M

    Continuous-flow left ventricular assist devices (CF-LVADs) generally operate at a constant speed, which reduces pulsatility in the arteries and may lead to complications such as functional changes in the vascular system, gastrointestinal bleeding, or both. The purpose of this study is to increase the arterial pulse pressure and pulsatility by controlling the CF-LVAD flow rate. A MicroMed DeBakey pump was used as the CF-LVAD. A model simulating the flow rate through the aortic valve was used as a reference model to drive the pump. A mock circulation containing two synchronized servomotor-operated piston pumps acting as left and right ventricles was used as a circulatory system. Proportional-integral control was used as the control method. First, the CF-LVAD was operated at a constant speed. With pulsatile-speed CF-LVAD assistance, the pump was driven such that the same mean pump output was generated. Continuous and pulsatile-speed CF-LVAD assistance provided the same mean arterial pressure and flow rate, while the index of pulsatility increased significantly for both arterial pressure and pump flow rate signals under pulsatile speed pump support. This study shows the possibility of improving the pulsatility of CF-LVAD support by regulating pump speed over a cardiac cycle without reducing the overall level of support.

  15. Antithrombin III is associated with acute liver failure in patients with end-stage heart failure undergoing mechanical circulatory support.

    Science.gov (United States)

    Hoefer, Judith; Ulmer, Hanno; Kilo, Juliane; Margreiter, Raimund; Grimm, Michael; Mair, Peter; Ruttmann, Elfriede

    2017-06-01

    There are few data on the role of liver dysfunction in patients with end-stage heart failure supported by mechanical circulatory support. The aim of our study was to investigate predictors for acute liver failure in patients with end-stage heart failure undergoing mechanical circulatory support. A consecutive 164 patients with heart failure with New York Heart Association class IV undergoing mechanical circulatory support were investigated for acute liver failure using the King's College criteria. Clinical characteristics of heart failure together with hemodynamic and laboratory values were analyzed by logistic regression. A total of 45 patients (27.4%) with heart failure developed subsequent acute liver failure with a hospital mortality of 88.9%. Duration of heart failure, cause, cardiopulmonary resuscitation, use of vasopressors, central venous pressure, pulmonary capillary wedge pressure, pulmonary pulsatility index, cardiac index, and transaminases were not significantly associated with acute liver failure. Repeated decompensation, atrial fibrillation (P failure in univariate analysis only. In multivariable analysis, decreased antithrombin III was the strongest single measurement indicating acute liver failure (relative risk per %, 0.84; 95% confidence interval, 0.77-0.93; P = .001) and remained an independent predictor when adjustment for the Model for End-Stage Liver Disease score was performed (relative risk per %, 0.89; 95% confidence interval, 0.80-0.99; P = .031). Antithrombin III less than 59.5% was identified as a cutoff value to predict acute liver failure with a corresponding sensitivity of 81% and specificity of 87%. In addition to the Model for End-Stage Liver Disease score, decreased antithrombin III activity tends to be superior in predicting acute liver failure compared with traditionally thought predictors. Antithrombin III measurement may help to identify patients more precisely who are developing acute liver failure during mechanical

  16. A 20-year multicentre outcome analysis of salvage mechanical circulatory support for refractory cardiogenic shock after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Maziar Khorsandi

    2016-11-01

    Full Text Available Abstract Background Refractory post-cardiotomy cardiogenic shock (PCCS is a relatively rare phenomenon that can lead to rapid multi-organ dysfunction syndrome and is almost invariably fatal without advanced mechanical circulatory support (AMCS, namely extra-corporeal membrane oxygenation (ECMO or ventricular assist devices (VAD. In this multicentre observational study we retrospectively analyzed the outcomes of salvage venoarterial ECMO (VA ECMO and VAD for refractory PCCS in the 3 adult cardiothoracic surgery centres in Scotland over a 20-year period. Methods The data was obtained through the Edinburgh, Glasgow and Aberdeen cardiac surgery databases. Our inclusion criteria included any adult patient from April 1995 to April 2015 who had received salvage VA ECMO or VAD for PCCS refractory to intra-aortic balloon pump (IABP and maximal inotropic support following adult cardiac surgery. Results A total of 27 patients met the inclusion criteria. Age range was 34–83 years (median 51 years. There was a large male predominance (n = 23, 85 %. Overall 23 patients (85 % received VA ECMO of which 14 (61 % had central ECMO and 9 (39 % had peripheral ECMO. Four patients (15 % were treated with short-term VAD (BiVAD = 1, RVAD = 1 and LVAD = 2. The most common procedure-related complication was major haemorrhage (n = 10. Renal failure requiring renal replacement therapy (n = 7, fatal stroke (n = 5, septic shock (n = 2, and a pseudo-aneurysm at the femoral artery cannulation site (n = 1 were also observed. Overall survival to hospital discharge was 40.7 %. All survivors were NYHA class I-II at 12 months’ follow-up. Conclusion AMCS for refractory PCCS carries a survival benefit and achieves acceptable functional recovery despite a significant complication rate.

  17. Myocardial Oxidative Metabolism and Protein Synthesis during Mechanical Circulatory Support by Extracorporeal Membrane Oxygenation

    Energy Technology Data Exchange (ETDEWEB)

    Priddy, MD, Colleen M.; Kajimoto, Masaki; Ledee, Dolena; Bouchard, Bertrand; Isern, Nancy G.; Olson, Aaron; Des Rosiers, Christine; Portman, Michael A.

    2013-02-01

    Extracorporeal membrane oxygenation (ECMO) provides mechanical circulatory support essential for survival in infants and children with acute cardiac decompensation. However, ECMO also causes metabolic disturbances, which contribute to total body wasting and protein loss. Cardiac stunning can also occur which prevents ECMO weaning, and contributes to high mortality. The heart may specifically undergo metabolic impairments, which influence functional recovery. We tested the hypothesis that ECMO alters oxidative. We focused on the amino acid leucine, and integration with myocardial protein synthesis. We used a translational immature swine model in which we assessed in heart (i) the fractional contribution of leucine (FcLeucine) and pyruvate (FCpyruvate) to mitochondrial acetyl-CoA formation by nuclear magnetic resonance and (ii) global protein fractional synthesis (FSR) by gas chromatography-mass spectrometry. Immature mixed breed Yorkshire male piglets (n = 22) were divided into four groups based on loading status (8 hours of normal circulation or ECMO) and intracoronary infusion [13C6,15N]-L-leucine (3.7 mM) alone or with [2-13C]-pyruvate (7.4 mM). ECMO decreased pulse pressure and correspondingly lowered myocardial oxygen consumption (~ 40%, n = 5), indicating decreased overall mitochondrial oxidative metabolism. However, FcLeucine was maintained and myocardial protein FSR was marginally increased. Pyruvate addition decreased tissue leucine enrichment, FcLeucine, and Fc for endogenous substrates as well as protein FSR. Conclusion: The heart under ECMO shows reduced oxidative metabolism of substrates, including amino acids, while maintaining (i) metabolic flexibility indicated by ability to respond to pyruvate, and (ii) a normal or increased capacity for global protein synthesis, suggesting an improved protein balance.

  18. Mechanical circulatory support as a bridge to cardiac retransplantation: a single center experience.

    Science.gov (United States)

    Clerkin, Kevin J; Thomas, Sunu S; Haythe, Jennifer; Schulze, P Christian; Farr, Maryjane; Takayama, Hiroo; Jorde, Ulrich P; Restaino, Susan W; Naka, Yoshifumi; Mancini, Donna M

    2015-02-01

    Cardiac retransplantation is increasing in frequency. Recent data have shown that retransplantation outcomes are now comparable with primary transplantation. The use of mechanical circulatory support (MCS) as a bridge to retransplantation has similar post-retransplant outcomes to those without MCS, but the success of bridging patients to retransplant with MCS has not been well studied. From January 2000 to February 2014 at Columbia University Medical Center, 84 patients were listed for retransplantation. Of this cohort, 48 patients underwent retransplantation, 15 were bridged with MCS, 24 died, and 6 clinically improved. A retrospective analysis was performed examining waiting list time, survival to retransplantation, and survival after retransplant. The effect of the United Network of Organ Sharing (UNOS) allocation policy change in 2006 on waiting list time and MCS use was also investigated. Of 48 patients who underwent retransplantation, 11 were bridged with MCS. Overall 1-year survival to retransplantation was 81.3%. There was no significant difference in waiting list survival (p = 0.71) in those with and without MCS. Death from cardiac arrest or multiorgan failure with infection was more frequent in the medically managed group (p = 0.002). After the UNOS 2006 allocation policy change, waiting list time (599 ± 936 days in Era 1 vs 526 ± 498 days in Era 2, p = 0.65) and waiting list survival (p = 0.22) between eras were comparable, but there was a trend toward greater use of MCS (p = 0.13). Survival after retransplant was acceptable. The use of MCS as a bridge to cardiac retransplantation is a reasonable strategy. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  19. Vapor cycle energy system for implantable circulatory assist devices. Annual progress report Jul 1974--Jun 1975

    International Nuclear Information System (INIS)

    Hagen, K.G.

    1975-06-01

    The report describes the development status of a heart assist system driven by a nuclear fueled, electronically controlled vapor cycle engine termed the tidal regenerator engine (TRE). The TRE pressurization (typically from 5-160 psia) is controlled by a torque motor coupled to a displacer. The electrical power for the sensor, electronic logic and actuator is provided by a thermoelectric module interposed between the engine superheater and boiler. The TRE is direct coupled to an assist blood pump which also acts as a blood-cooled heat exchanger, pressure-volume transformer and sensor for the electronic logic. Engine efficiencies in excess of 14% have been demonstrated. Efficiency values as high as 13% have been achieved to date

  20. Vapor cycle energy system for implantable circulatory assist devices. Final summary May--Oct 1976

    International Nuclear Information System (INIS)

    Watelet, R.P.; Ruggles, A.E.; Hagen, K.G.

    1977-03-01

    The report describes the development status of a heart assist system driven by a nuclear-fueled, electronically controlled vapor cycle engine termed the tidal regenerator engine (TRE). The TRE pressurization is controlled by a torque motor coupled to a displacer. The electrical power for the sensor, electronic logic and actuator is provided by thermoelectric modules interposed between the engine superheater and boiler. The TRE is direct-coupled to an assist blood pump which also acts as a blood-cooled heat exchanger, pressure-volume trasformer and sensor for the electronic logic. Engine cycle efficiency in excess of 14% has been demonstrated routinely. Overall system efficiency on 33 watts of over 9% has been demonstrated (implied 13% engine cycle efficiency). A binary version of this engine in the annular configuration is now being tested. The preliminary tests demonstrated 10% cycle efficiency on the first buildup which ran well and started easily

  1. Dynamically Assisted Schwinger Mechanism

    International Nuclear Information System (INIS)

    Schuetzhold, Ralf; Gies, Holger; Dunne, Gerald

    2008-01-01

    We study electron-positron pair creation from the Dirac vacuum induced by a strong and slowly varying electric field (Schwinger effect) which is superimposed by a weak and rapidly changing electromagnetic field (dynamical pair creation). In the subcritical regime where both mechanisms separately are strongly suppressed, their combined impact yields a pair creation rate which is dramatically enhanced. Intuitively speaking, the strong electric field lowers the threshold for dynamical particle creation--or, alternatively, the fast electromagnetic field generates additional seeds for the Schwinger mechanism. These findings could be relevant for planned ultrahigh intensity lasers

  2. Development of mechanical brake assist; Mechanical brake assist no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, M; Shingyoji, S; Nakamura, I; Tagawa, T; Saito, Y; Ishihara, T; Kobayashi, S; Yoshida, M [Nissan Motor Co. Ltd., Tokyo (Japan)

    1997-10-01

    We have recognized that there are drivers who cannot apply strong brake pedal force , in spite of the necessity of hard braking in emergencies. We have developed a `mechanical brake assist system` which assists drivers appropriately, according to the drivers` characteristics based on studying the characteristic`s of conditions of drivers applying the brake pedal force in emergency conditions. 2 refs., 7 figs., 1 tab.

  3. Exercise physiology in chronic mechanical circulatory support patients: vascular function and beyond.

    Science.gov (United States)

    Hayward, Christopher S; Fresiello, Libera; Meyns, Bart

    2016-05-01

    The majority of patients currently implanted with left ventricular assist devices have the expectation of support for more than 2 years. As a result, survival alone is no longer a sufficient distinctive for this technology, and there have been many studies within the last few years examining functional capacity and exercise outcomes. Despite strong evidence for functional class improvements and increases in simple measures of walking distance, there remains incomplete normalization of exercise capacity, even in the presence of markedly improved resting hemodynamics. Reasons for this remain unclear. Despite current pumps being run at a fixed speed, it is widely recognized that pump outputs significantly increase with exercise. The mechanism of this increase involves the interaction between preload, afterload, and the intrinsic pump function curves. The role of the residual heart function is also important in determining total cardiac output, as well as whether the aortic valve opens with exercise. Interactions with the vasculature, with skeletal muscle blood flow and the state of the autonomic nervous system are also likely to be important contributors to exercise performance. Further studies examining optimization of pump function with active pump speed modulation and options for optimization of the overall patient condition are likely to be needed to allow left ventricular assist devices to be used with the hope of full functional physiological recovery.

  4. The vexing problem of thrombosis in long-term mechanical circulatory support.

    Science.gov (United States)

    Mehra, Mandeep R; Stewart, Garrick C; Uber, Patricia A

    2014-01-01

    Durable left ventricular assist devices (LVADs) have not only enhanced longevity but also conferred sustained improvements in quality of life, symptom control, and functional capacity in patients with medically refractory advanced heart failure. Problems with device-related infection, bleeding, neurologic events, right-sided heart failure, and device malfunction have dominated the clinical care of patients living on mechanical support. Even as adoption of durable LVADs accelerated globally, we began to encounter a growing dilemma of pump malfunction caused by thrombosis. In early 2011, clinicians began to notice a spike in the incidence of pump thrombosis with the HeartMate II (Thoratec Corp, Pleasanton, CA) LVAD. By 2012, the problem of thrombosis in LVADs began to consume most of the scientific direction as centers and collaborative groups began to dissect this nascent phenomenon. In this perspective, we describe the magnitude and implications of pump thrombosis, discuss secular and management trends in this unique population, attempt to dissect the problem at its root, offer guidance on surveillance and therapeutic principles, and outline issues that deserve our immediate and collaborative attention. © 2014 International Society for Heart and Lung Transplantation Published by International Society for the Heart and Lung Transplantation All rights reserved.

  5. Beyond the VAD: Human Factors Engineering for Mechanically Assisted Circulation in the 21st Century.

    Science.gov (United States)

    Throckmorton, Amy L; Patel-Raman, Sonna M; Fox, Carson S; Bass, Ellen J

    2016-06-01

    Thousands of ventricular assist devices (VADs) currently provide circulatory support to patients worldwide, and dozens of heart pump designs for adults and pediatric patients are under various stages of development in preparation for translation to clinical use. The successful bench-to-bedside development of a VAD involves a structured evaluation of possible system states, including human interaction with the device and auxiliary component usage in the hospital or home environment. In this study, we review the literature and present the current landscape of preclinical design and assessment, decision support tools and procedures, and patient-centered therapy. Gaps of knowledge are identified. The study findings support the need for more attention to user-centered design approaches for medical devices, such as mechanical circulatory assist systems, that specifically involve detailed qualitative and quantitative assessments of human-device interaction to mitigate risk and failure. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  6. Predictors of survival and ability to wean from short-term mechanical circulatory support device following acute myocardial infarction complicated by cardiogenic shock.

    Science.gov (United States)

    Garan, A Reshad; Eckhardt, Christina; Takeda, Koji; Topkara, Veli K; Clerkin, Kevin; Fried, Justin; Masoumi, Amirali; Demmer, Ryan T; Trinh, Pauline; Yuzefpolskaya, Melana; Naka, Yoshifumi; Burkhoff, Dan; Kirtane, Ajay; Colombo, Paolo C; Takayama, Hiroo

    2017-11-01

    Cardiogenic shock following acute myocardial infarction (AMI-CS) portends a poor prognosis. Short-term mechanical circulatory support devices (MCSDs) provide hemodynamic support for patients with cardiogenic shock but predictors of survival and the ability to wean from short-term MCSDs remain largely unknown. All patients > 18 years old treated at our institution with extra-corporeal membrane oxygenation or short-term surgical ventricular assist device for AMI-CS were studied. We collected acute myocardial infarction details with demographic and hemodynamic variables. Primary outcomes were survival to discharge and recovery from MCSD (i.e. survival without heart replacement therapy including durable ventricular assist device or heart transplant). One hundred and twenty-four patients received extra-corporeal membrane oxygenation or short-term surgical ventricular assist device following acute myocardial infarction from 2007 to 2016; 89 received extra-corporeal membrane oxygenation and 35 short-term ventricular assist device. Fifty-five (44.4%) died in the hospital and 69 (55.6%) survived to discharge. Twenty-six (37.7%) required heart replacement therapy (four transplant, 22 durable ventricular assist device) and 43 (62.3%) were discharged without heart replacement therapy. Age and cardiac index at MCSD implantation were predictors of survival to discharge; patients over 60 years with cardiac index <1.5 l/min per m 2 had a low likelihood of survival. The angiographic result after revascularization predicted recovery from MCSD (odds ratio 9.00, 95% confidence interval 2.45-32.99, p=0.001), but 50% of those optimally revascularized still required heart replacement therapy. Cardiac index predicted recovery from MCSD among this group (odds ratio 4.06, 95% confidence interval 1.45-11.55, p=0.009). Among AMI-CS patients requiring short-term MCSDs, age and cardiac index predict survival to discharge. Angiographic result and cardiac index predict ventricular recovery but 50

  7. Mechanical Circulatory Support for Advanced Heart Failure: Are We about to Witness a New "Gold Standard"?

    Science.gov (United States)

    Capoccia, Massimo

    2016-12-12

    The impact of left ventricular assist devices (LVADs) for the treatment of advanced heart failure has played a significant role as a bridge to transplant and more recently as a long-term solution for non-eligible candidates. Continuous flow left ventricular assist devices (CF-LVADs), based on axial and centrifugal design, are currently the most popular devices in view of their smaller size, increased reliability and higher durability compared to pulsatile flow left ventricular assist devices (PF-LVADs). The trend towards their use is increasing. Therefore, it has become mandatory to understand the physics and the mathematics behind their mode of operation for appropriate device selection and simulation set up. For this purpose, this review covers some of these aspects. Although very successful and technologically advanced, they have been associated with complications such as pump thrombosis, haemolysis, aortic regurgitation, gastro-intestinal bleeding and arterio-venous malformations. There is perception that the reduced arterial pulsatility may be responsible for these complications. A flow modulation control approach is currently being investigated in order to generate pulsatility in rotary blood pumps. Thrombus formation remains the most feared complication that can affect clinical outcome. The development of a preoperative strategy aimed at the reduction of complications and patient-device suitability may be appropriate. Patient-specific modelling based on 3D reconstruction from CT-scan combined with computational fluid dynamic studies is an attractive solution in order to identify potential areas of stagnation or challenging anatomy that could be addressed to achieve the desired outcome. The HeartMate II (axial) and the HeartWare HVAD (centrifugal) rotary blood pumps have been now used worldwide with proven outcome. The HeartMate III (centrifugal) is now emerging as the new promising device with encouraging preliminary results. There are now enough pumps on

  8. Getting home with artifical heart – what is the everyday life experience of people with mechanical circulatory Support. A qualitative study

    Science.gov (United States)

    Braunsdorf, Sandy

    2017-07-01

    Background: The growing number of mechanical circulatory support systems implanted with successful results in terms of quality of life and physical resilience means that more and more people are being discharged from hospital to live at home with an artificial heart. This puts high requirements on affected persons’ disease and therapy management – a subject which has attracted very little qualitative research to date. Aim: This study therefore sought to shed light on how people with mechanical circulatory support experience their everyday lives. The aim was to document the subjective associations of those affected from an insider perspective. Methods: Following the interpretative phenomenological paradigm, narrative interviews were conducted with two female and eight male participants. For qualitative analysis, a multi-step process guided by the methodology of hermeneutic philosophy was used. Results: The qualitative data analysis revealed five main topic areas. These describe patients’ state of health after implantation and the various adjustments, constraints and pressures necessitated by their illness and therapeutic requirements. On this basis, coping and management strategies are identified. Other significant aspects of patients’ everyday lives are social interaction and environment and health care with an artificial heart. Conclusions: The findings add to our knowledge of the day-to-day lives of people with mechanical circulatory support systems, giving us a better understanding of their specific situation.

  9. Cerebrovascular Accidents During Mechanical Circulatory Support: New Predictors of Ischemic and Hemorrhagic Strokes and Outcome.

    Science.gov (United States)

    Izzy, Saef; Rubin, Daniel B; Ahmed, Firas S; Akbik, Feras; Renault, Simone; Sylvester, Katelyn W; Vaitkevicius, Henrikas; Smallwood, Jennifer A; Givertz, Michael M; Feske, Steven K

    2018-05-01

    Left ventricular assist devices (LVADs) have emerged as an effective treatment for patients with advanced heart failure refractory to medical therapy. Post-LVAD strokes are an important cause of morbidity and reduced quality of life. Data on risks that distinguish between ischemic and hemorrhagic post-LVAD strokes are limited. The aim of this study was to determine the incidence of post-LVAD ischemic and hemorrhagic strokes, their association with stroke risk factors, and their effect on mortality. Data are collected prospectively on all patients with LVADs implanted at Brigham and Women's Hospital. We added retrospectively collected clinical data for these analyses. From 2007 to 2016, 183 patients (median age, 57; 80% male) underwent implantation of HeartMate II LVAD as a bridge to transplant (52%), destination therapy (39%), or bridge to transplant candidacy (8%). A total of 48 strokes occurred in 39 patients (21%): 28 acute ischemic strokes in 24 patients (13%) and 20 intracerebral hemorrhages in 19 patients (10.3%). First events occurred at a median of 238 days from implantation (interquartile range, 93-515) among those who developed post-LVAD stroke. All but 9 patients (4.9%) were on warfarin (goal international normalized ratio, 2-3.5) and all received aspirin (81-325 mg). Patients with chronic obstructive pulmonary disease were more likely to have an ischemic stroke (odds ratio, 2.96; 95% confidence interval, 1.14-7.70). Dialysis-dependent patients showed a trend toward a higher risk of hemorrhagic stroke (odds ratio, 6.31; 95% confidence interval, 0.99-40.47). Hemorrhagic stroke was associated with higher mortality (odds ratio, 3.92; 95% confidence interval, 1.34-11.45) than ischemic stroke (odds ratio, 3.17; 95% confidence interval, 1.13-8.85). Stroke is a major cause of morbidity and mortality in patients on LVAD support. Chronic obstructive pulmonary disease increases the risk of ischemic stroke, whereas dialysis may increase the risk of hemorrhagic

  10. Enhancement of arterial pressure pulsatility by controlling continuous-flow left ventricular assist device flow rate in mock circulatory system

    NARCIS (Netherlands)

    Bozkurt, S.; van de Vosse, F.N.; Rutten, M.C.M.

    Continuous-flow left ventricular assist devices (CF-LVADs) generally operate at a constant speed, which reduces pulsatility in the arteries and may lead to complications such as functional changes in the vascular system, gastrointestinal bleeding, or both. The purpose of this study is to increase

  11. Ethical dilemma: offering short-term extracorporeal membrane oxygenation support for terminally ill children who are not candidates for long-term mechanical circulatory support or heart transplantation.

    Science.gov (United States)

    Shankar, Venkat; Costello, John P; Peer, Syed M; Klugman, Darren; Nath, Dilip S

    2014-04-01

    The use of extracorporeal membrane oxygenation (ECMO) in terminally ill pediatric patients who are not candidates for long-term mechanical circulatory support or heart transplantation requires careful deliberation. We present the case of a 16-year-old female with a relapse of acute lymphoid leukemia and acute-on-chronic cardiomyopathy who received short-term ECMO therapy. In addition, we highlight several ethical considerations that were crucial to this patient's family-centered care and demonstrate that this therapy can be accomplished in a manner that respects patient autonomy and family wishes.

  12. Gas assisted Mechanical Expression of oilseeds

    NARCIS (Netherlands)

    Willems, P.

    2007-01-01

    It is the objective of this thesis to show the general applicability of the Gas Assisted Mechanical Expression (GAME) process for recovery of oil from oilseeds with high yields. In this process, the oilseeds are saturated with supercritical CO2 before mechanical pressing. The CO2 displaces part of

  13. Deep RNA sequencing reveals dynamic regulation of myocardial noncoding RNAs in failing human heart and remodeling with mechanical circulatory support.

    Science.gov (United States)

    Yang, Kai-Chien; Yamada, Kathryn A; Patel, Akshar Y; Topkara, Veli K; George, Isaac; Cheema, Faisal H; Ewald, Gregory A; Mann, Douglas L; Nerbonne, Jeanne M

    2014-03-04

    Microarrays have been used extensively to profile transcriptome remodeling in failing human heart, although the genomic coverage provided is limited and fails to provide a detailed picture of the myocardial transcriptome landscape. Here, we describe sequencing-based transcriptome profiling, providing comprehensive analysis of myocardial mRNA, microRNA (miRNA), and long noncoding RNA (lncRNA) expression in failing human heart before and after mechanical support with a left ventricular (LV) assist device (LVAD). Deep sequencing of RNA isolated from paired nonischemic (NICM; n=8) and ischemic (ICM; n=8) human failing LV samples collected before and after LVAD and from nonfailing human LV (n=8) was conducted. These analyses revealed high abundance of mRNA (37%) and lncRNA (71%) of mitochondrial origin. miRNASeq revealed 160 and 147 differentially expressed miRNAs in ICM and NICM, respectively, compared with nonfailing LV. Among these, only 2 (ICM) and 5 (NICM) miRNAs are normalized with LVAD. RNASeq detected 18 480, including 113 novel, lncRNAs in human LV. Among the 679 (ICM) and 570 (NICM) lncRNAs differentially expressed with heart failure, ≈10% are improved or normalized with LVAD. In addition, the expression signature of lncRNAs, but not miRNAs or mRNAs, distinguishes ICM from NICM. Further analysis suggests that cis-gene regulation represents a major mechanism of action of human cardiac lncRNAs. The myocardial transcriptome is dynamically regulated in advanced heart failure and after LVAD support. The expression profiles of lncRNAs, but not mRNAs or miRNAs, can discriminate failing hearts of different pathologies and are markedly altered in response to LVAD support. These results suggest an important role for lncRNAs in the pathogenesis of heart failure and in reverse remodeling observed with mechanical support.

  14. New modes of assisted mechanical ventilation.

    Science.gov (United States)

    Suarez-Sipmann, F

    2014-05-01

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

  15. Clinical trial design and rationale of the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) investigational device exemption clinical study protocol.

    Science.gov (United States)

    Heatley, Gerald; Sood, Poornima; Goldstein, Daniel; Uriel, Nir; Cleveland, Joseph; Middlebrook, Don; Mehra, Mandeep R

    2016-04-01

    The HeartMate 3 left ventricular assist system (LVAS; St. Jude Medical, Inc., formerly Thoratec Corporation, Pleasanton, CA) was recently introduced into clinical trials for durable circulatory support in patients with medically refractory advanced-stage heart failure. This centrifugal, fully magnetically levitated, continuous-flow pump is engineered with the intent to enhance hemocompatibility and reduce shear stress on blood elements, while also possessing intrinsic pulsatility. Although bridge-to-transplant (BTT) and destination therapy (DT) are established dichotomous indications for durable left ventricular assist device (LVAD) support, clinical practice has challenged the appropriateness of these designations. The introduction of novel LVAD technology allows for the development of clinical trial designs to keep pace with current practices. The prospective, randomized Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) clinical trial aims to evaluate the safety and effectiveness of the HeartMate 3 LVAS by demonstrating non-inferiority to the HeartMate II LVAS (also St. Jude Medical, Inc.). The innovative trial design includes patients enrolled under a single inclusion and exclusion criteria , regardless of the intended use of the device, with outcomes ascertained in the short term (ST, at 6 months) and long term (LT, at 2 years). This adaptive trial design includes a pre-specified safety phase (n = 30) analysis. The ST cohort includes the first 294 patients and the LT cohort includes the first 366 patients for evaluation of the composite primary end-point of survival to transplant, recovery or LVAD support free of debilitating stroke (modified Rankin score >3), or re-operation to replace the pump. As part of the adaptive design, an analysis by an independent statistician will determine whether sample size adjustment is required at pre-specified times during the study. A further 662

  16. Cardiac Rotational Mechanics As a Predictor of Myocardial Recovery in Heart Failure Patients Undergoing Chronic Mechanical Circulatory Support: A Pilot Study.

    Science.gov (United States)

    Bonios, Michael J; Koliopoulou, Antigone; Wever-Pinzon, Omar; Taleb, Iosif; Stehlik, Josef; Xu, Weining; Wever-Pinzon, James; Catino, Anna; Kfoury, Abdallah G; Horne, Benjamin D; Nativi-Nicolau, Jose; Adamopoulos, Stamatis N; Fang, James C; Selzman, Craig H; Bax, Jeroen J; Drakos, Stavros G

    2018-04-01

    Impaired qualitative and quantitative left ventricular (LV) rotational mechanics predict cardiac remodeling progression and prognosis after myocardial infarction. We investigated whether cardiac rotational mechanics can predict cardiac recovery in chronic advanced cardiomyopathy patients. Sixty-three patients with advanced and chronic dilated cardiomyopathy undergoing implantation of LV assist device (LVAD) were prospectively investigated using speckle tracking echocardiography. Acute heart failure patients were prospectively excluded. We evaluated LV rotational mechanics (apical and basal LV twist, LV torsion) and deformational mechanics (circumferential and longitudinal strain) before LVAD implantation. Cardiac recovery post-LVAD implantation was defined as (1) final resulting LV ejection fraction ≥40%, (2) relative LV ejection fraction increase ≥50%, (iii) relative LV end-systolic volume decrease ≥50% (all 3 required). Twelve patients fulfilled the criteria for cardiac recovery (Rec Group). The Rec Group had significantly less impaired pre-LVAD peak LV torsion compared with the Non-Rec Group. Notably, both groups had similarly reduced pre-LVAD LV ejection fraction. By receiver operating characteristic curve analysis, pre-LVAD peak LV torsion of 0.35 degrees/cm had a 92% sensitivity and a 73% specificity in predicting cardiac recovery. Peak LV torsion before LVAD implantation was found to be an independent predictor of cardiac recovery after LVAD implantation (odds ratio, 0.65 per 0.1 degrees/cm [0.49-0.87]; P =0.014). LV rotational mechanics seem to be useful in selecting patients prone to cardiac recovery after mechanical unloading induced by LVADs. Future studies should investigate the utility of these markers in predicting durable cardiac recovery after the explantation of the cardiac assist device. © 2018 American Heart Association, Inc.

  17. Mechanical Circulatory Support for Advanced Heart Failure: Are We about to Witness a New “Gold Standard”?

    Directory of Open Access Journals (Sweden)

    Massimo Capoccia

    2016-12-01

    Full Text Available The impact of left ventricular assist devices (LVADs for the treatment of advanced heart failure has played a significant role as a bridge to transplant and more recently as a long-term solution for non-eligible candidates. Continuous flow left ventricular assist devices (CF-LVADs, based on axial and centrifugal design, are currently the most popular devices in view of their smaller size, increased reliability and higher durability compared to pulsatile flow left ventricular assist devices (PF-LVADs. The trend towards their use is increasing. Therefore, it has become mandatory to understand the physics and the mathematics behind their mode of operation for appropriate device selection and simulation set up. For this purpose, this review covers some of these aspects. Although very successful and technologically advanced, they have been associated with complications such as pump thrombosis, haemolysis, aortic regurgitation, gastro-intestinal bleeding and arterio-venous malformations. There is perception that the reduced arterial pulsatility may be responsible for these complications. A flow modulation control approach is currently being investigated in order to generate pulsatility in rotary blood pumps. Thrombus formation remains the most feared complication that can affect clinical outcome. The development of a preoperative strategy aimed at the reduction of complications and patient-device suitability may be appropriate. Patient-specific modelling based on 3D reconstruction from CT-scan combined with computational fluid dynamic studies is an attractive solution in order to identify potential areas of stagnation or challenging anatomy that could be addressed to achieve the desired outcome. The HeartMate II (axial and the HeartWare HVAD (centrifugal rotary blood pumps have been now used worldwide with proven outcome. The HeartMate III (centrifugal is now emerging as the new promising device with encouraging preliminary results. There are now

  18. Mechanical circulatory support is associated with loss of platelet receptors glycoprotein Ibα and glycoprotein VI.

    Science.gov (United States)

    Lukito, P; Wong, A; Jing, J; Arthur, J F; Marasco, S F; Murphy, D A; Bergin, P J; Shaw, J A; Collecutt, M; Andrews, R K; Gardiner, E E; Davis, A K

    2016-11-01

    Essentials Relationship of acquired von Willebrand disease (VWD) and platelet dysfunction is explored. Patients with ventricular assist devices and on extracorporeal membrane oxygenation are investigated. Acquired VWD and platelet receptor shedding is demonstrated in the majority of patients. Loss of platelet adhesion receptors glycoprotein (GP) Ibα and GPVI may increase bleeding risk. Background Ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO) are associated with bleeding that is not fully explained by anticoagulant or antiplatelet use. Exposure of platelets to elevated shear in vitro leads to increased shedding. Objectives To investigate whether loss of platelet receptors occurs in vivo, and the relationship with acquired von Willebrand syndrome (AVWS). Methods Platelet counts, coagulation tests and von Willebrand factor (VWF) analyses were performed on samples from 21 continuous flow VAD (CF-VAD), 20 ECMO, 12 heart failure and seven aortic stenosis patients. Levels of platelet receptors were measured by flow cytometry or ELISA. Results The loss of high molecular weight VWF multimers was observed in 18 of 19 CF-VAD and 14 of 20 ECMO patients, consistent with AVWS. Platelet receptor shedding was demonstrated by elevated soluble glycoprotein (GP) VI levels in plasma and significantly reduced surface GPIbα and GPVI levels in CF-VAD and ECMO patients as compared with healthy donors. Platelet receptor levels were also significantly reduced in heart failure patients. Conclusions These data link AVWS and increased platelet receptor shedding in patients with CF-VADs or ECMO for the first time. Loss of the platelet surface receptors GPIbα and GPVI in heart failure, CF-VAD and ECMO patients may contribute to ablated platelet adhesion/activation, and limit thrombus formation under high/pathologic shear conditions. © 2016 International Society on Thrombosis and Haemostasis.

  19. Environmentally assisted cracking mechanisms in repository environments

    International Nuclear Information System (INIS)

    Mills, W.J.

    1987-02-01

    This paper assesses how environmentally assisted cracking (EAC) mechanisms in candidate container materials can be identified to enhance the accuracy of long-term projections of performance in the repository. In low and intermediate strength steels, the role of the two principal mechanisms, slip dissolution/film rupture (SD/FR) and hydrogen embrittlement (HE), is a very complex and controversial issue. No unanimity exists concerning the operative cracking mechanisms, and there is no unique or rigorous approach that would be persuasive in selecting an appropriate model. Both of the proposed mechanisms have common rate controlling processes such as surface adsorption rate, passivation rate, and oxidation rupture rate, which makes it difficult to identify the operative mechanism. Development of a quantitative model for predicting environmental effects for low-carbon steels in repository environments would provide a theoretical basis for assuring the long-term structural integrity of waste-package containment. To date, only one quantitative model has been developed. The agreement between predicted and observed behavior suggests that SD/FR processes control the environmental acceleration in crack growth rates for this class of materials. Deviations from predicted behavior due to HE effects should be uncovered experimentally. 59 refs., 4 figs., 4 tabs

  20. The mechanism of circulatory disturbances in the small intestinal wall and their role in the development of intestinal syndrome

    International Nuclear Information System (INIS)

    Kudryavtsev, V.D.; Sushkevich, L.N.

    1980-01-01

    The mechanism of vascular disorders in the wall of the small intestine, the possibility of correcting them and their significance in the development of the intestinal syndrome were analysed. The experiments in which Wistar rats were irradiated with 10 Gy yielded information on the blood flow in the small intestine, on the number of regenerating crypts, on the blood plasma volume and on arterial blood pressure. The data obtained justify to speak of an important influence of disturbances in general hemodynamics on the microcirculation in the entire organ. Reaction that fail to take place or paradoxic changes in the blood flow of tissue after injection of vasoactive substances also illustrate the significance of direct intestinal vascular damage for adversely affecting compensatory adaptation mechanisms. Markedly disturbed blood supply to the tissue and the resultant deterioration of tissue trophism at the level of an intestinal syndrome not only intensify radiogenic destructive processes in epitheliocytes, but also prevent to a certain extent the regeneration of mucous membrane of the small intestine. The possibility of achieving partial restoration of blood vessel speed in the small intestine of irradiated rats is shown if the loss of intravascular fluid is parenterally replaced with Ringer's or hemodilution solution. (author)

  1. Donations After Circulatory Death in Liver Transplant.

    Science.gov (United States)

    Eren, Emre A; Latchana, Nicholas; Beal, Eliza; Hayes, Don; Whitson, Bryan; Black, Sylvester M

    2016-10-01

    The supply of liver grafts for treatment of end-stage liver disease continues to fall short of ongoing demands. Currently, most liver transplants originate from donations after brain death. Enhanced utilization of the present resources is prudent to address the needs of the population. Donation after circulatory or cardiac death is a mechanism whereby the availability of organs can be expanded. Donations after circulatory death pose unique challenges given their exposure to warm ischemia. Technical principles of donations after circulatory death procurement and pertinent studies investigating patient outcomes, graft outcomes, and complications are highlighted in this review. We also review associated risk factors to suggest potential avenues to achieve improved outcomes and reduced complications. Future considerations and alternative techniques of organ preservation are discussed, which may suggest novel strategies to enhance preservation and donor expansion through the use of marginal donors. Ultimately, without effective measures to bolster organ supply, donations after circulatory death should remain a consideration; however, an understanding of inherent risks and limitations is necessary.

  2. Structures with Reconfigurable Circulatory Systems

    National Research Council Canada - National Science Library

    Clark, William W; Beckman, Eric J; Cho, Sung K; Weiland, Lisa M; Bielawski, Christopher W

    2008-01-01

    .... One trait that many biological system have that conventional structures do not is a circulatory system, which can be used for many purposes, one of which is the transport of structural material...

  3. Usefulness of extracorporeal membrane oxygenation using double roller pumps in a low body weight newborn: A novel strategy for mechanical circulatory support in an infant

    Directory of Open Access Journals (Sweden)

    Keisuke Nakanishi

    2016-01-01

    Full Text Available Extracorporeal membrane oxygenation (ECMO with a centrifugal pump requires a certain flow rate; therefore, its application for low body weight infants is frequently accompanied by oxygenator membrane malfunction and/or inadequate perfusion. To prevent low-flow associated complications, we report a case in which a novel system of dual roller pumps was used. A baby girl with a body mass index 0.25 m 2 , who experienced difficulty weaning from cardiopulmonary bypass after a Norwood-like operation, required an ECMO. Concerns for the tube lifespan reduction due to roller pump friction led to the use of a double roller pump circulation. The termination of ECMO during tube exchange is not needed, because circulation is maintained by another roller pump. The novel strategy of ECMO with double roller pumps will allow low perfusion rate to provide adequate circulatory support for low body weight patients.

  4. Vascular and Immunobiology of the Circulatory Sphingosine 1-Phosphate Gradient

    Science.gov (United States)

    Yanagida, Keisuke; Hla, Timothy

    2017-01-01

    Vertebrates are endowed with a closed circulatory system, the evolution of which required novel structural and regulatory changes. Furthermore, immune cell trafficking paradigms adapted to the barriers imposed by the closed circulatory system. How did such changes occur mechanistically? We propose that spatial compartmentalization of the lipid mediator sphingosine 1-phosphate (S1P) may be one such mechanism. In vertebrates, S1P is spatially compartmentalized in the blood and lymphatic circulation, thus comprising a sharp S1P gradient across the endothelial barrier. Circulatory S1P has critical roles in maturation and homeostasis of the vascular system as well as in immune cell trafficking. Physiological functions of S1P are tightly linked to shear stress, the key biophysical stimulus from blood flow. Thus, circulatory S1P confinement could be a primordial strategy of vertebrates in the development of a closed circulatory system. This review discusses the cellular and molecular basis of the S1P gradients and aims to interpret its physiological significance as a key feature of the closed circulatory system. PMID:27813829

  5. Extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation or uncontrolled donation after the circulatory determination of death following out-of-hospital refractory cardiac arrest-An ethical analysis of an unresolved clinical dilemma.

    Science.gov (United States)

    Dalle Ave, Anne L; Shaw, David M; Gardiner, Dale

    2016-11-01

    The availability of extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation (E-CPR), for use in refractory out-of hospital cardiac arrest (OHCA), is increasing. In parallel, some countries have developed uncontrolled donation after circulatory determination of death (uDCDD) programs using ECMO to preserve organs for transplantation purposes. When facing a refractory OHCA, how does the medical team choose between initiating ECMO as part of an E-CPR protocol or ECMO as part of a uDCDD protocol? To answer these questions we conducted a literature review on E-CPR compared to uDCDD protocols using ECMO and analyzed the raised ethical issues. Our analysis reveals that the inclusion criteria in E-CPR and uDCDD protocols are similar. There may be a non-negligible risk of including patients in a uDCDD protocol, when the patient might have been saved by the use of E-CPR. In order to avoid the fatal error of letting a saveable patient die, safeguards are necessary. We recommend: (1) the development of internationally accepted termination of resuscitation guidelines that would have to be satisfied prior to inclusion of patients in any uDCDD protocol, (2) the choice regarding modalities of ongoing resuscitation during transfer should be focused on the primary priority of attempting to save the life of patients, (3) only centers of excellence in life-saving resuscitation should initiate or maintain uDCDD programs, (4) E-CPR should be clinically considered first before the initiation of any uDCDD protocol, and (5) there should be no discrimination in the availability of access to E-CPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. [Neurally adjusted ventilatory assist (NAVA). A new mode of assisted mechanical ventilation].

    Science.gov (United States)

    Moerer, O; Barwing, J; Quintel, M

    2008-10-01

    The aim of mechanical ventilation is to assure gas exchange while efficiently unloading the respiratory muscles and mechanical ventilation is an integral part of the care of patients with acute respiratory failure. Modern lung protective strategies of mechanical ventilation include low-tidal-volume ventilation and the continuation of spontaneous breathing which has been shown to be beneficial in reducing atelectasis and improving oxygenation. Poor patient-ventilator interaction is a major issue during conventional assisted ventilation. Neurally adjusted ventilator assist (NAVA) is a new mode of mechanical ventilation that uses the electrical activity of the diaphragm (EAdi) to control the ventilator. First experimental studies showed an improved patient-ventilator synchrony and an efficient unloading of the respiratory muscles. Future clinical studies will have to show that NAVA is of clinical advantage when compared to conventional modes of assisted mechanical ventilation. This review characterizes NAVA according to current publications on this topic.

  7. Alcohol-assisted versus Mechanical Epithelium Removal in Photorefractive Keratectomy

    Directory of Open Access Journals (Sweden)

    Mohammad Ghoreishi,

    2010-01-01

    Full Text Available Purpose: To compare the outcomes and complications of alcohol-assisted versus mechanical corneal epithelial debridement for photorefractive keratectomy (PRK. Methods: This randomized controlled trial included 1,250 eyes of 625 patients undergoing PRK for correction of myopia and myopic astigmatism. Each patient was randomly assigned to alcohol-assisted or mechanical epithelial removal. Results: A total of 658 eyes underwent alcohol-assisted epithelial removal while the epithelium was removed mechanically in 592 eyes. Mean spherical equivalent was ‑4.37}2.3 D in the alcohol group and ‑3.8}1.3 D in the mechanical group (P = 0.78. There was no significant difference in postoperative pain between the study groups (P = 0.22. Uncorrected visual acuity ≥ 20/20 and ≥ 20/40 was achieved in 90.9% versus 93.4% (P = 0.08, and 98.9% versus 99.5% (P = 0.36 of eyes in the alcohol and mechanical groups, respectively. Final refractive error within 1D of emmetropia was achieved in 90% versus 92.2% of eyes in the alcohol and mechanical groups, respectively (P = 0.23. Alcohol-assisted debridement required less time than mechanical debridement (96±18 vs. 118±26 seconds, P=0.035. There was no significant difference between the two groups in terms of early and late postoperative complications. Conclusion: Alcohol-assisted and mechanical epithelium removal are comparable in terms of efficacy and side effects. The method of epithelial debridement in PRK may be left to the surgeon′s choice.

  8. Paraplegia following intraaortic balloon circulatory assistance

    Directory of Open Access Journals (Sweden)

    Benício Anderson

    1999-01-01

    Full Text Available Intraaortic balloon counterpulsation is frequently used in patients experiencing severe ventricular dysfunction following maximal drug therapy. However, even with the improvement of percutaneous insertion techniques, the procedure has always been followed by vascular, infectious, and neurological complications. This article describes a case of paraplegia due to intraaortic balloon counterpulsation in the postoperative period of cardiac surgery.

  9. Simulation of dilated heart failure with continuous flow circulatory support.

    Directory of Open Access Journals (Sweden)

    Yajuan Wang

    Full Text Available Lumped parameter models have been employed for decades to simulate important hemodynamic couplings between a left ventricular assist device (LVAD and the native circulation. However, these studies seldom consider the pathological descending limb of the Frank-Starling response of the overloaded ventricle. This study introduces a dilated heart failure model featuring a unimodal end systolic pressure-volume relationship (ESPVR to address this critical shortcoming. The resulting hemodynamic response to mechanical circulatory support are illustrated through numerical simulations of a rotodynamic, continuous flow ventricular assist device (cfVAD coupled to systemic and pulmonary circulations with baroreflex control. The model further incorporated septal interaction to capture the influence of left ventricular (LV unloading on right ventricular function. Four heart failure conditions were simulated (LV and bi-ventricular failure with/without pulmonary hypertension in addition to normal baseline. Several metrics of LV function, including cardiac output and stroke work, exhibited a unimodal response whereby initial unloading improved function, and further unloading depleted preload reserve thereby reducing ventricular output. The concept of extremal loading was introduced to reflect the loading condition in which the intrinsic LV stroke work is maximized. Simulation of bi-ventricular failure with pulmonary hypertension revealed inadequacy of LV support alone. These simulations motivate the implementation of an extremum tracking feedback controller to potentially optimize ventricular recovery.

  10. Vibrationally Assisted Electron Transfer Mechanism of Olfaction: Myth or Reality?

    DEFF Research Database (Denmark)

    Solov'yov, Ilia; Chang, Po-Yao; Schulten, Klaus

    2012-01-01

    to this suggestion an olfactory receptor is activated by electron transfer assisted through odorant vibrational excitation. The hundreds to thousands of different olfactory receptors in an animal recognize odorants over a discriminant landscape with surface properties and vibrational frequencies as the two major...... dimensions. In the present paper we introduce the vibrationally assisted mechanism of olfaction and demonstrate for several odorants that, indeed, a strong enhancement of an electron tunneling rate due to odorant vibrations can arise. We discuss in this regard the influence of odorant deuteration and explain...... olfactory receptors and odorants must obey for the vibrationally assisted electron transfer mechanism to function. We argue that the stated characteristics are feasible for realistic olfactory receptors, noting, though, that the receptor structure presently is still unknown, but can be studied through...

  11. Full in vitro fertilization laboratory mechanization: toward robotic assisted reproduction?

    DEFF Research Database (Denmark)

    Meseguer, Marcos; Krühne, Ulrich; Laursen, Steen

    2012-01-01

    Objective: To describe the current efforts made to standardize different steps of assisted reproductive technology processes by the introduction of new technologies for the nonsubjective sperm selection process, oocyte denudation by mechanical removal of cumulus cells, oocyte positioning, sperm...... of embryo manipulation; 5) time-lapse, proteomic, and metabolic scoring of the developing embryo, allowing multiple and optimized selection of the embryos. The technologies described in this review have not yet reported reliable clinical proofs. Conclusion(s): We already have available some...

  12. General surgical complications associated with the use of long-term mechanical circulatory support devices: are we 'under-reporting' problems?

    Science.gov (United States)

    Tchantchaleishvili, Vakhtang; Umakanthan, Ramanan; Karp, Seth; Stulak, John M; Keebler, Mary E; Maltais, Simon

    2013-05-01

    Multiple complications are associated with use of ventricular assist devices (VADs). Cardiac-related complications and infections are most frequently reported. VADs, however, can also lead to a number of general surgical complications equally significant in terms of morbidity and mortality. The authors performed a systematic literature search to review current data that specifically relate general surgical complications to patients who undergo left VAD implantation. The review provides a relatively clear understanding of the spectrum of general surgical complications and shows that they contribute significantly to morbidity and mortality in these patients.

  13. Assistive humanoid robot MARKO: development of the neck mechanism

    Directory of Open Access Journals (Sweden)

    Penčić Marko

    2017-01-01

    Full Text Available The paper presents the development of neck mechanism for humanoid robots. The research was conducted within the project which is developing a humanoid robot Marko that represents assistive apparatus in the physical therapy for children with cerebral palsy.There are two basic ways for the neck realization of the robots. The first is based on low backlash mechanisms that have high stiffness and the second one based on the viscoelastic elements having variable flexibility. We suggest low backlash differential gear mechanism that requires small actuators. Based on the kinematic-dynamic requirements a dynamic model of the robots upper body is formed. Dynamic simulation for several positions of the robot was performed and the driving torques of neck mechanism are determined.Realized neck has 2 DOFs and enables movements in the direction of flexion-extension 100°, rotation ±90° and the combination of these two movements. It consists of a differential mechanism with three spiral bevel gears of which the two are driving and are identical, and the third one which is driven gear to which the robot head is attached. Power transmission and motion from the actuators to the input links of the differential mechanism is realized with two parallel placed gear mechanisms that are identical.Neck mechanism has high carrying capacity and reliability, high efficiency, low backlash that provide high positioning accuracy and repeatability of movements, compact design and small mass and dimensions.

  14. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiología Intervencionista; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention).

    Science.gov (United States)

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

    2015-06-01

    This article provides a brief summary of the relevant recommendations and references related to percutaneous mechanical circulatory support. The goal was to provide the clinician with concise, evidence-based contemporary recommendations, and the supporting documentation to encourage their application. The full text includes disclosure of all relevant relationships with industry for each writing committee member. A fundamental aspect of all expert consensus statements is that these carefully developed, evidence-based documents can neither encompass all clinical circumstances, nor replace the judgment of individual physicians in management of each patient. The science of medicine is rooted in evidence, and the art of medicine is based on the application of this evidence to the individual patient. This expert consensus statement has adhered to these principles for optimal management of patients requiring percutaneous mechanical circulatory support. © 2015 by The Society for Cardiovascular Angiography and Interventions, The American College of Cardiology Foundation, the Heart Failure Society of America, and The Society for Thoracic Surgery.

  15. Real-Time ECG Simulation for Hybrid Mock Circulatory Loops.

    Science.gov (United States)

    Korn, Leonie; Rüschen, Daniel; Zander, Niklas; Leonhardt, Steffen; Walter, Marian

    2018-02-01

    Classically, mock circulatory loops only simulate mechanical properties of the circulation. To connect the hydraulic world with electrophysiology, we present a real-time electrical activity model of the heart and show how to integrate this model into a real-time mock loop simulation. The model incorporates a predefined conduction pathway and a simplified volume conductor to solve the bidomain equations and the forward problem of electrocardiography, resulting in a physiological simulation of the electrocardiogram (ECG) at arbitrary electrode positions. A complete physiological simulation of the heart's excitation would be too CPU intensive. Thus, in our model, complexity was reduced to allow real-time simulation of ECG-triggered medical systems in vitro; this decreases time and cost in the development process. Conversely, the presented model can still be adapted to various pathologies by locally changing the properties of the heart's conduction pathway. To simulate the ECG, the heart is divided into suitable areas, which are innervated by the hierarchically structured conduction system. To distinguish different cardiac regions, a segmentation of the heart was performed. In these regions, Prim's algorithm was applied to identify the directed minimal spanning trees for conduction orientation. Each node of the tree was assigned to a cardiac action potential generated by its hybrid automaton to represent the heart's conduction system by the spatial distribution of action potentials. To generate the ECG output, the bidomain equations were implemented and a simple model of the volume conductor of the body was used to solve the forward problem of electrocardiography. As a result, the model simulates potentials at arbitrary electrode positions in real-time. To verify the developed real-time ECG model, measurements were made within a hybrid mock circulatory loop, including a simple ECG-triggered ventricular assist device control. The model's potential value is to simulate

  16. Environment assisted degradation mechanisms in aluminum-lithium alloys

    Science.gov (United States)

    Gangloff, Richard P.; Stoner, Glenn E.; Swanson, Robert E.

    1988-01-01

    Section 1 of this report records the progress achieved on NASA-LaRC Grant NAG-1-745 (Environment Assisted Degradation Mechanisms in Al-Li Alloys), and is based on research conducted during the period April 1 to November 30, 1987. A discussion of work proposed for the project's second year is included. Section 2 provides an overview of the need for research on the mechanisms of environmental-mechanical degradation of advanced aerospace alloys based on aluminum and lithium. This research is to provide NASA with the basis necessary to permit metallurgical optimization of alloy performance and engineering design with respect to damage tolerance, long term durability and reliability. Section 3 reports on damage localization mechanisms in aqueous chloride corrosion fatigue of aluminum-lithium alloys. Section 4 reports on progress made on measurements and mechanisms of localized aqueous corrosion in aluminum-lithium alloys. Section 5 provides a detailed technical proposal for research on environmental degradation of Al-Li alloys, and the effect of hydrogen in this.

  17. CHF: circulatory homeostasis gone awry.

    Science.gov (United States)

    Weber, Karl T; Burlew, Brad S; Davis, Richard C; Newman, Kevin P; D'Cruz, Ivan A; Hawkins, Ralph G; Wall, Barry M; Parker, Robert B

    2002-01-01

    The role of the renin-angiotensin-aldosterone system (RAAS) is integral to salt and water retention, particularly by the kidneys. Over time, positive sodium balance leads first to intra- and then to extravascular volume expansion, with subsequent symptomatic heart failure. This report examines the role of the RAAS in regulating a less well recognized component essential to circulatory homeostasis--central blood volume. The regulation of central blood volume draws on integrative cardiorenal physiology and a key role played by the RAAS in its regulation. In presenting insights into the role of the RAAS in regulating central blood volume, this review also addresses other sodium-retaining states with a predisposition to edema formation, such as cirrhosis and nephrosis. (c)2002 CHF, Inc

  18. Study of the mechanisms of matrix assisted laser desorption / ionization

    International Nuclear Information System (INIS)

    Manuelli, Pascal

    1995-01-01

    This research thesis aims at a better knowledge of some aspects of a complex mechanism: the matrix-assisted laser desorption/ionization (MALDI). The author first proposes a comparative analysis of results obtained by time-of-flight (TOF) mass spectrometry and by Fourier transform mass spectrometry. He reports the study of the matrix role (notably a polymeric matrix) as a matter submitted to laser desorption. In this respect, the influence of the incident wavelength has been studied. The author also reports a comparative of ions produced by matrix laser desorption (study performed by Fourier transform mass spectrometry) and of neutral molecules (study performed by flash pyrolysis coupled with gas chromatography and with mass spectrometry). Finally, results obtained on derivatives and complexes based on beta-cyclodextrins highlight benefits as well as limitations of this technique [fr

  19. COST-EFFECTIVENESS OF CONTINUOUS-FLOW LEFT VENTRICULAR ASSIST DEVICES

    NARCIS (Netherlands)

    Neyt, Mattias; Van den Bruel, Ann; Smit, Yolba; De Jonge, Nicolaas; Erasmus, Michiel; Van Dijk, Diederik; Vlayen, Joan

    Objectives: Mechanical circulatory support through left ventricular assist devices (LVADs) improves survival and quality of life for patients with end-stage heart failure who are ineligible for cardiac transplantation. Our aim was to calculate the cost-effectiveness of continuous-flow LVADs.

  20. Mechanical circulatory treatment of advanced heart failure

    DEFF Research Database (Denmark)

    Rujic, Dragana; Sundbøll, Jens; Tofig, Bawer Jalal

    2016-01-01

    The paroxysmal supraventricular tachycardias (SVT) are commonly encountered arrhythmias and include atrioventricular nodal re-entrant tachycardia, atrioventricular reciprocating tachycardia, and focal atrial tachycardia. These tachycardias share several clinical features as well as similar manage...

  1. Thermal and thermo-mechanical simulation of laser assisted machining

    International Nuclear Information System (INIS)

    Germain, G.; Dal Santo, P.; Lebrun, J. L.; Bellett, D.; Robert, P.

    2007-01-01

    Laser Assisted Machining (LAM) improves the machinability of materials by locally heating the workpiece just prior to cutting. The heat input is provided by a high power laser focused several millimeters in front of the cutting tool. Experimental investigations have confirmed that the cutting force can be decreased, by as much as 40%, for various materials (tool steel, titanium alloys and nickel alloys). The laser heat input is essentially superficial and results in non-uniform temperature profiles within the depth of the workpiece. The temperature field in the cutting zone is therefore influenced by many parameters. In order to understand the effect of the laser on chip formation and on the temperature fields in the different deformation zones, thermo-mechanical simulation were undertaken. A thermo-mechanical model for chip formation with and without the laser was also undertaken for different cutting parameters. Experimental tests for the orthogonal cutting of 42CrMo4 steel were used to validate the simulation via the prediction of the cutting force with and without the laser. The thermo-mechanical model then allowed us to highlight the differences in the temperature fields in the cutting zone with and without the laser. In particular, it was shown that for LAM the auto-heating of the material in the primary shear zone is less important and that the friction between the tool and chip also generates less heat. The temperature fields allow us to explain the reduction in the cutting force and the resulting residual stress fields in the workpiece

  2. Application of a thermally assisted mechanical dewatering process to biomass

    Energy Technology Data Exchange (ETDEWEB)

    Mahmoud, A.; Arlabosse, P. [Universite de Toulouse, Mines Albi, CNRS, Campus Jarlard, F-81013 Albi cedex 09 (France); Ecole des Mines Albi, Centre RAPSODEE, Campus Jarlard, F-81013 Albi (France); Fernandez, A. [Universite de Toulouse, INSA, UPS, INP, LISBP, 135 Avenue de Rangueil, F-31400 Toulouse (France); INRA, UMR792 Ingenierie des Systemes Biologiques et des Procedes, CNRS, UMR5504, F-31400 Toulouse (France)

    2011-01-15

    Thermally assisted mechanical dewatering (TAMD) is a new process for energy-efficient liquid/solids separation which enhances conventional-device efficiency. The main idea of this process is to supply a flow of heat in mechanical dewatering processes to favour the reduction of the liquid content. This is not a new idea but the proposed combination, especially the chosen operating conditions (T < 100 C and P < 3000 kPa) constitutes an original approach and a significant energy saving since the liquid is kept in liquid state. Response surface methodology was used to evaluate the effects of the processing parameters of TAMD on the final dry solids content, which is a fundamental dewatering parameter and an excellent indicator of the extent of TAMD. In this study, a two-factor central composite design was used to establish the optimum conditions for the TAMD of alfalfa biomass. Experiments were carried out on a laboratory compression cell. Experiments showed that the dewatering enhancement results only from thermal effects. With a moderate heat supply (T{sub piston} = 80 C), the dry solid content of the press cake can reach 66%, compared to 36% at ambient temperature. A significant regression model, describing changes on final dry solids content with respect to independent variables, was established with determination coefficient, R{sup 2}, greater than 88%. With an energy consumption of less than 150 kWh/m{sup 3}, the use of the TAMD process before a thermal drying process leads to an energy saving of at least 30% on the overall separation chain. (author)

  3. Multiscale mechanics of TRIP-assisted multiphase steels: I. Characterization and mechanical testing

    International Nuclear Information System (INIS)

    Jacques, P.J.; Furnemont, Q.; Lani, F.; Pardoen, T.; Delannay, F.

    2007-01-01

    The mechanical behaviour of transformation-induced plasticity (TRIP)-assisted multiphase steels is addressed based on three different microstructures generated from the same steel grade. The mechanisms responsible for the work-hardening capacity and the resulting balance between strength and resistance to plastic localization are investigated at different length scales. The macroscopic mechanical response is determined by simple shear, uniaxial tension, Marciniak and equibiaxial tension supplemented by earlier tensile tests on notched and cracked specimens. It is shown that the transformation rate reaches a maximum for stress states intermediate between uniaxial tension and equibiaxial tension. At an intermediate length scale, the true in situ flow properties of the individual ferrite-bainite and retained austenite phases are determined by combining neutron diffraction and digital image correlation. This combined analysis elucidates the partitioning of stress and strain between the different constitutive phases. Based on these results, supplemented by transmission electron microscopy and electron backscattered diffraction observations, a general overview of the hardening behaviour of TRIP-assisted multiphase steels is depicted

  4. Cardiorespiratory interactions in neural circulatory control in humans.

    Science.gov (United States)

    Shamsuzzaman, A S; Somers, V K

    2001-06-01

    The reflex mechanisms and interactions described in this overview provide some explanation for the range of neural circulatory responses evident during changes in breathing. The effects described represent the integrated responses to activation of several reflex mechanisms, including peripheral and central chemoreflexes, arterial baroreflexes, pulmonary stretch receptors, and ventricular mechanoreceptors. These interactions occur on a dynamic basis and the transfer characteristics of any single interaction are, in all likelihood, also highly dynamic. Nevertheless, it is only by attempting to understand individual reflexes and their modulating influences that a more thorough understanding of the responses to complex phenomena such as hyperventilation, apnea, and obstructive sleep apnea can be better understood.

  5. The effect of heart failure and left ventricular assist device treatment on right ventricular mechanics: a computational study.

    Science.gov (United States)

    Park, Jun I K; Heikhmakhtiar, Aulia Khamas; Kim, Chang Hyun; Kim, Yoo Seok; Choi, Seong Wook; Song, Kwang Soup; Lim, Ki Moo

    2018-05-22

    Although it is important to analyze the hemodynamic factors related to the right ventricle (RV) after left ventricular assist device (LVAD) implantation, previous studies have focused only on the alteration of the ventricular shape and lack quantitative analysis of the various hemodynamic parameters. Therefore, we quantitatively analyzed various hemodynamic parameters related to the RV under normal, heart failure (HF), and HF incorporated with continuous flow LVAD therapy by using a computational model. In this study, we combined a three-dimensional finite element electromechanical model of ventricles, which is based on human ventricular morphology captured by magnetic resonance imaging (MRI) with a lumped model of the circulatory system and continuous flow LVAD function in order to construct an integrated model of an LVAD implanted-cardiovascular system. To induce systolic dysfunction, the magnitude of the calcium transient function under HF condition was reduced to 70% of the normal value, and the time constant was reduced by 30% of the normal value. Under the HF condition, the left ventricular end systolic pressure decreased, the left ventricular end diastolic pressure increased, and the pressure in the right atrium (RA), RV, and pulmonary artery (PA) increased compared with the normal condition. The LVAD therapy decreased the end-systolic pressure of the LV by 41%, RA by 29%, RV by 53%, and PA by 71%, but increased the right ventricular ejection fraction by 52% and cardiac output by 40%, while the stroke work was reduced by 67% compared with the HF condition without LVAD. The end-systolic ventricular tension and strain decreased with the LVAD treatment. LVAD enhances CO and mechanical unloading of the LV as well as those of the RV and prevents pulmonary hypertension which can be induced by HF.

  6. Full in vitro fertilization laboratory mechanization: toward robotic assisted reproduction?

    Science.gov (United States)

    Meseguer, Marcos; Kruhne, Ulrich; Laursen, Steen

    2012-06-01

    To describe the current efforts made to standardize different steps of assisted reproductive technology processes by the introduction of new technologies for the nonsubjective sperm selection process, oocyte denudation by mechanical removal of cumulus cells, oocyte positioning, sperm motility screening, fertilization, embryo culture, media replacement by microfluidics, and monitoring of embryo development by time-lapse photography, embryo secretions, and/or O(2) consumption. These technologies could be integrated in a unique and fully automated device. Pubmed database and research and development data from authors. University-affiliated private center. None. None. None. Several technologies would be useful for: 1) selection of sperm based on viability; 2) manipulation and removal of the cumulus cells' narrow channel regions combined with microfluidics; 3) advances in oocyte positioning precision through the use of joystick-controlled micromanipulators; 4) microfluidics allowing the gradual change of a culture medium, which might result in better embryo development as well as reduce the amount of embryo manipulation; 5) time-lapse, proteomic, and metabolic scoring of the developing embryo, allowing multiple and optimized selection of the embryos. The technologies described in this review have not yet reported reliable clinical proofs. We already have available some of the technologies described, but we envisage an integrated device, i.e., an IVF lab-on-a-chip, by which oocyte and sperm would be processed to achieve a perfect embryo ready to be delivered into the uterus. With such a device, sample preparation, chemical or biologic reactions, and data collection would be integrated. Copyright © 2012. Published by Elsevier Inc.

  7. The influence of process parameters on Gas Assisted Mechanical Expression (GAME) of cocoa nibs

    NARCIS (Netherlands)

    Venter, M.J.; Hink, R.; Kuipers, N.J.M.; de Haan, A.B.

    2007-01-01

    It is known that increased cocoa butter yields can be achieved with Gas Assisted Mechanical Expression (GAME) of cocoa nibs when compared to conventional expression of cocoa nibs [Venter, M.J., Willems, P., Kuipers, N.J.M. & de Haan, A.B. (2006). Gas Assisted Mechanical Expression of cocoa butter

  8. The influence of process parameters on gas assisted mechanical expression (GAME) of cocoa nibs

    NARCIS (Netherlands)

    Venter, M.J.; Hink, R.; Kuipers, N.J.M.; Haan, de A.B.

    2007-01-01

    It is known that increased cocoa butter yields can be achieved with Gas Assisted Mechanical Expression (GAME) of cocoa nibs when compared to conventional expression of cocoa nibs [Venter, M.J., Willems, P., Kuipers, N.J.M. & de Haan, A.B. (2006). Gas Assisted Mechanical Expression of cocoa butter

  9. Circulatory Arrest, Brain Arrest and Death Determination

    Directory of Open Access Journals (Sweden)

    Sam David Shemie

    2018-03-01

    Full Text Available Technological advances, particularly in the capacity to support, replace or transplant failing organs, continue to challenge and refine our understanding of human death. Given the ability to reanimate organs before and after death, both inside and outside of the body, through reinstitution of oxygenated circulation, concepts related to death of organs (e.g. cardiac death are no longer valid. This paper advances the rationale for a single conceptual determination of death related to permanent brain arrest, resulting from primary brain injury or secondary to circulatory arrest. The clinical characteristics of brain arrest are the permanent loss of capacity for consciousness and loss of all brainstem functions. In the setting of circulatory arrest, death occurs after the arrest of circulation to the brain rather than death of the heart. Correspondingly, any intervention that resumes oxygenated circulation to the brain after circulatory arrest would invalidate the determination of death.

  10. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention.

    Science.gov (United States)

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

    2015-05-19

    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines. Copyright © 2015 The Society for Cardiovascular Angiography and Interventions, The American College of Cardiology Foundation, The Heart Failure Society of America, and The Society for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  11. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie D'intervention).

    Science.gov (United States)

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

    2015-06-01

    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella®; left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines. © 2015 by The Society for Cardiovascular Angiography and Interventions, The American College of Cardiology Foundation, The Heart Failure Society of America, and The Society for Thoracic Surgery.

  12. Extracorporeal circulatory systems in the interhospital transfer of critically ill patients: experience of a single institution

    International Nuclear Information System (INIS)

    Haneya, Assad; Philipp, Alois; Foltan, Maik; Camboni, Daniele; Rupprecht, Leopold; Puehler, Thomas; Hirt, Stephan; Hilker, Michael; Kobuch, Reinhard; Schmid, Christof; Arlt, Matthias; Mueller, Thomas

    2009-01-01

    Critically ill patients with acute circulatory failure cannot be moved to other institutions unless stabilized by mechanical support systems. Extracorporeal heart and lung assist systems are increasingly used as a bridge to end-organ recovery or transplantation, and as an ultimate rescue tool in cardiopulmonary resuscitation. From July 2001 to April 2008, we had 38 requests for extracorporeal support for interhospital transfer carried out by the air medical service. Respiratory failure was present in 29 patients, who were provided with pumpless extracorporeal lung assist (PECLA) or veno-venous extracorporeal membrane oxygenation (ECMO). Cardiac failure dominated in 9 patients, who underwent implantation of extracorporeal life support (ECLS). Underlying diseases were acute respiratory distress syndrome in 15 patients, pneumonia in 7, prior lung transplant status in 4, cardiogenic shock in 7, and septic shock in 4. All assist systems were connected via peripheral vessels by the Seldinger technique. Transport was uneventful in all cases with no technical failures. On arrival at the specialized care hospital, two patients had leg ischemia and underwent relocation of the arterial cannula. After a mean (SD) support of 5.1 (3.0) days for PECLA, 3.5 (2.9) days for ECLS, and 7.3 (5.8) days for ECMO, 60%, 66%, and 66% of patients, respectively, could be successfully weaned from the systems. Discharge rates were 45% for PECLA, 44% for ECLS, and 56% for ECMO. Our experience proves that minimized extracorporeal assist devices allow safe assistance of patients with isolated or combined heart and lung failure in need of interhospital transfer. Critically ill patients get a chance to reach a center of maximum medical care. (author)

  13. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

    Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

  14. Circulatory CNP Rescues Craniofacial Hypoplasia in Achondroplasia.

    Science.gov (United States)

    Yamanaka, S; Nakao, Kazumasa; Koyama, N; Isobe, Y; Ueda, Y; Kanai, Y; Kondo, E; Fujii, T; Miura, M; Yasoda, A; Nakao, Kazuwa; Bessho, K

    2017-12-01

    Achondroplasia is the most common genetic form of human dwarfism, characterized by midfacial hypoplasia resulting in occlusal abnormality and foramen magnum stenosis, leading to serious neurologic complications and hydrocephalus. Currently, surgery is the only way to manage jaw deformity, neurologic complications, and hydrocephalus in patients with achondroplasia. We previously showed that C-type natriuretic peptide (CNP) is a potent stimulator of endochondral bone growth of long bones and vertebrae and is also a potent stimulator in the craniofacial region, which is crucial for midfacial skeletogenesis. In this study, we analyzed craniofacial morphology in a mouse model of achondroplasia, in which fibroblast growth factor receptor 3 (FGFR3) is specifically activated in cartilage ( Fgfr3 ach mice), and investigated the mechanisms of jaw deformities caused by this mutation. Furthermore, we analyzed the effect of CNP on the maxillofacial area in these animals. Fgfr3 ach mice exhibited midfacial hypoplasia, especially in the sagittal direction, caused by impaired endochondral ossification in craniofacial cartilage and by premature closure of the spheno-occipital synchondrosis, an important growth center in craniomaxillofacial skeletogenesis. We crossed Fgfr3 ach mice with transgenic mice in which CNP is expressed in the liver under the control of the human serum amyloid-P component promoter, resulting in elevated levels of circulatory CNP ( Fgfr3 ach /SAP-Nppc-Tg mice). In the progeny, midfacial hypoplasia in the sagittal direction observed in Fgfr3 ach mice was improved significantly by restoring the thickness of synchondrosis and promoting proliferation of chondrocytes in the craniofacial cartilage. In addition, the foramen magnum stenosis observed in Fgfr3 ach mice was significantly ameliorated in Fgfr3 ach /SAP-Nppc-Tg mice due to enhanced endochondral bone growth of the anterior intraoccipital synchondrosis. These results clearly demonstrate the therapeutic

  15. Study on chemical mechanical polishing of silicon wafer with megasonic vibration assisted.

    Science.gov (United States)

    Zhai, Ke; He, Qing; Li, Liang; Ren, Yi

    2017-09-01

    Chemical mechanical polishing (CMP) is the primary method to realize the global planarization of silicon wafer. In order to improve this process, a novel method which combined megasonic vibration to assist chemical mechanical polishing (MA-CMP) is developed in this paper. A matching layer structure of polishing head was calculated and designed. Silicon wafers are polished by megasonic assisted chemical mechanical polishing and traditional chemical mechanical polishing respectively, both coarse polishing and precision polishing experiments were carried out. With the use of megasonic vibration, the surface roughness values Ra reduced from 22.260nm to 17.835nm in coarse polishing, and the material removal rate increased by approximately 15-25% for megasonic assisted chemical mechanical polishing relative to traditional chemical mechanical polishing. Average Surface roughness values Ra reduced from 0.509nm to 0.387nm in precision polishing. The results show that megasonic assisted chemical mechanical polishing is a feasible method to improve polishing efficiency and surface quality. The material removal and finishing mechanisms of megasonic vibration assisted polishing are investigated too. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Orthodontic intrusion : Conventional and mini-implant assisted intrusion mechanics

    Directory of Open Access Journals (Sweden)

    Anup Belludi

    2012-01-01

    intrusion has revolutionized orthodontic anchorage and biomechanics by making anchorage perfectly stable. This article addresses various conventional clinical intrusion mechanics and especially intrusion using mini-implants that have proven effective over the years for intrusion of maxillary anteriors.

  17. Animal Assisted Interactions to Alleviate Psychological Symptoms in Patients on Mechanical Ventilation.

    Science.gov (United States)

    Hetland, Breanna; Bailey, Tanya; Prince-Paul, Maryjo

    2017-12-01

    Mechanical ventilation is a common life support intervention for critically ill patients that can cause stressful psychological symptoms. Animal assisted interactions have been used in variety of inpatient settings to reduce symptom burden and promote overall well-being. Due to the severity of illness associated with critical care, use of highly technological equipment, and heightened concern for infection control and patient safety, animal-assisted interaction has not been widely adopted in the intensive care unit. This case study of the therapeutic interaction between a canine and a mechanically ventilated patient provides support for the promotion of animal-assisted interactions as an innovative symptom management strategy in the intensive care unit.

  18. Mechanically assisted liquid lens zoom system for mobile phone cameras

    Science.gov (United States)

    Wippermann, F. C.; Schreiber, P.; Bräuer, A.; Berge, B.

    2006-08-01

    Camera systems with small form factor are an integral part of today's mobile phones which recently feature auto focus functionality. Ready to market solutions without moving parts have been developed by using the electrowetting technology. Besides virtually no deterioration, easy control electronics and simple and therefore cost-effective fabrication, this type of liquid lenses enables extremely fast settling times compared to mechanical approaches. As a next evolutionary step mobile phone cameras will be equipped with zoom functionality. We present first order considerations for the optical design of a miniaturized zoom system based on liquid-lenses and compare it to its mechanical counterpart. We propose a design of a zoom lens with a zoom factor of 2.5 considering state-of-the-art commercially available liquid lens products. The lens possesses auto focus capability and is based on liquid lenses and one additional mechanical actuator. The combination of liquid lenses and a single mechanical actuator enables extremely short settling times of about 20ms for the auto focus and a simplified mechanical system design leading to lower production cost and longer life time. The camera system has a mechanical outline of 24mm in length and 8mm in diameter. The lens with f/# 3.5 provides market relevant optical performance and is designed for an image circle of 6.25mm (1/2.8" format sensor).

  19. Circulatory mitochondrial DNA is a pro-inflammatory agent in maintenance hemodialysis patients.

    Directory of Open Access Journals (Sweden)

    Hongdi Cao

    Full Text Available Chronic inflammation is highly prevalent in maintenance hemodialysis (MHD patients, and it has been shown to be a strong predictor of morbidity and mortality. Mitochondrial DNA (mtDNA released into circulation after cell damage can promote inflammation in patients and animal models. However, the role and mechanisms of circulatory mtDNA in chronic inflammation in MHD patients remain unknown. Sixty MHD patients and 20 health controls were enrolled in this study. The circulatory mtDNA was detected by quantitative real-time PCR assay. Plasma interleukin 6 (IL-6 and tumor necrosis factor α (TNF-α were quantitated by ELISA assay. Dialysis systems in MHD patients and in vitro were used to evaluate the effect of different dialysis patterns on circulatory mtDNA. Circulatory mtDNA was elevated in MHD patients comparing to that of health control. Regression analysis demonstrated that plasma mtDNA was positively associated with TNF-α and the product of serum calcium and phosphorus, while negatively associated with hemoglobin and serum albumin in MHD patients. MtDNA induced the secretion of IL-6 and TNF-α in the THP-1 cells. Single high-flux hemodialysis (HF-HD and on line hemodiafiltration (OL-HDF but not low-flux hemodialysis (LF-HD could partially reduce plasma mtDNA in MHD patients. In vitro, both HD and hemofiltration (HF could fractional remove mtDNA. Collectively, circulatory mtDNA is elevated and its level is closely correlated with chronic inflammation in MHD patients. HF-HD and HDF can partially reduce circulatory mtDNA in MHD patients.

  20. CIRCULATORY FAILURE DURING NON-INHALED FORMS OF CYANIDE INTOXICATION

    Science.gov (United States)

    Haouzi, Philippe; Tubbs, Nicole; Rannals, Matthew D.; Judenherc-Haouzi, Annick; Cabell, Larry A.; McDonough, Joe A.; Sonobe, Takashi

    2016-01-01

    Our objective was to determine how circulatory failure develops following systemic administration of potassium cyanide (KCN). We used a non-inhaled modality of intoxication, wherein the change in breathing pattern would not influence the diffusion of CN into the blood, akin to the effects of ingesting toxic levels of CN. In a group of 300–400 g rats, CN-induced coma (CN IP, 7 mg/kg) produced a central apnea within 2–3 minutes along with a potent and prolonged gasping pattern leading to auto-resuscitation in 38% of the animals. Motor deficits and neuronal necrosis were nevertheless observed in the surviving animals. To clarify the mechanisms leading to potential auto-resuscitation versus asystole, 12 urethane-anesthetized rats were then exposed to the lowest possible levels of CN exposure that would lead to breathing depression within 7–8 minutes; this dose averaged 0.375 mg/kg/min iv. At this level of intoxication, a cardiac depression developed several minutes only after the onset of the apnea, leading to cardiac asystole as PaO2 reached value around 15 Torr, unless breathing was maintained by mechanical ventilation or through spontaneous gasping. Higher levels of KCN exposure in 10 animals provoked a primary cardiac depression, which led to a rapid cardiac arrest by pulseless electrical activity despite the maintenance of PaO2 by mechanical ventilation. These effects were totally unrelated to the potassium contained in KCN. It is concluded that circulatory failure can develop as a direct consequence of CN induced apnea but in a narrow range of exposure. In this “low” range, maintaining pulmonary gas exchange after exposure, through mechanical ventilation (or spontaneous gasping) can reverse cardiac depression and restore spontaneous breathing. At higher level of intoxication, cardiac depression is to be treated as a specific and spontaneously irreversible consequence of CN exposure, leading to a pulseless electrical activity. PMID:27513083

  1. Pediatric Donation After Circulatory Determination of Death: A Scoping Review.

    Science.gov (United States)

    Weiss, Matthew J; Hornby, Laura; Witteman, William; Shemie, Sam D

    2016-03-01

    Although pediatric donation after circulatory determination of death is increasing in frequency, there are no national or international donation after circulatory determination of death guidelines specific to pediatrics. This scoping review was performed to map the pediatric donation after circulatory determination of death literature, identify pediatric donation after circulatory determination of death knowledge gaps, and inform the development of national or regional pediatric donation after circulatory determination of death guidelines. Terms related to pediatric donation after circulatory determination of death were searched in Embase and MEDLINE, as well as the non-MEDLINE sources in PubMed from 1980 to May 2014. Seven thousand five hundred ninety-seven references were discovered and 85 retained for analysis. All references addressing pediatric donation after circulatory determination of death were considered. Exclusion criteria were articles that did not address pediatric patients, animal or laboratory studies, surgical techniques, and local pediatric donation after circulatory determination of death protocols. Narrative reviews and opinion articles were the most frequently discovered reference (25/85) and the few discovered studies were observational or qualitative and almost exclusively retrospective. Retained references were divided into themes and analyzed using qualitative methodology. The main discovered themes were 1) studies estimating the number of potential pediatric donation after circulatory determination of death donors and their impact on donation; 2) ethical issues in pediatric donation after circulatory determination of death; 3) physiology of the dying process after withdrawal of life-sustaining therapy; 4) cardiac pediatric donation after circulatory determination of death; and 5) neonatal pediatric donation after circulatory determination of death. Donor estimates suggest that pediatric donation after circulatory determination of death will

  2. Circulatory Responses to Operative Stress in Females with Gestosis

    Directory of Open Access Journals (Sweden)

    I. V. Mikhno

    2007-01-01

    Full Text Available Objective: to study the specific features of hemodynamic responses in females with gestosis in the perioperative period; to evaluate the impact of intensive care on the basis of co-administration of dalargin, dexamethasone, pen-toxifylline, and reamberin.Materials and methods. A Diamant KM-AP-01 rheograph (Saint Petersburg was used to study hemodynamic parameters in 142 patients in whom surgical delivery was made under spinal anesthesia. A control group comprised 30 patients with uncomplicated pregnancy; Group 1 included 26 females with moderate gestosis; Group 2 consisted of 27 females with moderate gestosis who received the developed intensive care regimen; Group 3 comprised 29 females with severe gestosis; Group 4 included 30 females to whom the developed intensive care regimen was applied on the basis of the concurrent use of dalargin, dexamethasone, pentoxifylline, and reamberin.Results: A neurogenic mechanism prevails in females with moderate gestosis. The decreased baseline cardiac index is mostly due to a high postload. Surgical stress does not deteriorate postoperative circulatory parameters, which suggests that females with moderate gestosis have adequate capacities for self-regulation. As gestosis progresses to a severe degree, a role of humoral mechanisms increases in the maintenance of arteriolar spasm. Arteriolar spasm and hypokinetic hemodynamics are retained within 5 postoperative days, which is indicative of the inadequacy of self-regulation and compensatory mechanisms in overcoming two stressors: severe gestosis and surgical aggression.Conclusion: the intensive care regimen developed on the basis of combined use of dalargin, dexamethasone, pentoxifylline, and reamberin favors a more intensive (the promptest normalization of circulatory parameters after surgical delivery in females with moderate and severe gestosis. 

  3. Mechanical Design Technology--Modified. (Computer Assisted Drafting, Computer Aided Design). Curriculum Grant 84/85.

    Science.gov (United States)

    Schoolcraft Coll., Livonia, MI.

    This document is a curriculum guide for a program in mechanical design technology (computer-assisted drafting and design developed at Schoolcraft College, Livonia, Michigan). The program helps students to acquire the skills of drafters and to interact with electronic equipment, with the option of becoming efficient in the computer-aided…

  4. A novel vibration assisted polishing device based on the flexural mechanism driven by the piezoelectric actuators

    Directory of Open Access Journals (Sweden)

    Guilian Wang

    2018-01-01

    Full Text Available The vibration assisted polishing has widely application fields because of higher machining frequency and better polishing quality, especially the polishing with the non-resonant mode that is regarded as a kind of promising polishing method. This paper reports a novel vibration assisted polishing device, consisting of the flexible hinge mechanism driven by the piezoelectric actuators, which is suitable for polishing planes or curve surfaces with slow curvature. Firstly, the generation methods of vibration trajectory are investigated for the same frequency and different frequency signals’ inputs, respectively, and then the types of elliptic and Lissajous’s vibration trajectories are generated respectively. Secondly, a flexural mechanism consisting of the right circular flexible hinges and the leaf springs is developed to produce two-dimensional vibration trajectory. Statics and dynamics investigating of this flexible mechanism are finished in detail. The analytical models about input and output compliances of the flexural mechanism are established according to the matrix-based compliance modeling, and the dynamic model of the flexural mechanism based on the Euler-Lagrange equation is also presented. The finite element model of the flexural mechanism was established to carry out the numerical simulation in order to testify the rationality of device design. Finally, the polishing experiment is carried out to prove the effectiveness of the vibration device. The experimental results show that this novel vibration assisted polishing device developed in this study can remove more effectively the cutting marks left by last process and obviously reduce the workpiece surface roughness.

  5. A Glider-Assisted Link Disruption Restoration Mechanism in Underwater Acoustic Sensor Networks.

    Science.gov (United States)

    Jin, Zhigang; Wang, Ning; Su, Yishan; Yang, Qiuling

    2018-02-07

    Underwater acoustic sensor networks (UASNs) have become a hot research topic. In UASNs, nodes can be affected by ocean currents and external forces, which could result in sudden link disruption. Therefore, designing a flexible and efficient link disruption restoration mechanism to ensure the network connectivity is a challenge. In the paper, we propose a glider-assisted restoration mechanism which includes link disruption recognition and related link restoring mechanism. In the link disruption recognition mechanism, the cluster heads collect the link disruption information and then schedule gliders acting as relay nodes to restore the disrupted link. Considering the glider's sawtooth motion, we design a relay location optimization algorithm with a consideration of both the glider's trajectory and acoustic channel attenuation model. The utility function is established by minimizing the channel attenuation and the optimal location of glider is solved by a multiplier method. The glider-assisted restoration mechanism can greatly improve the packet delivery rate and reduce the communication energy consumption and it is more general for the restoration of different link disruption scenarios. The simulation results show that glider-assisted restoration mechanism can improve the delivery rate of data packets by 15-33% compared with cooperative opportunistic routing (OVAR), the hop-by-hop vector-based forwarding (HH-VBF) and the vector based forward (VBF) methods, and reduce communication energy consumption by 20-58% for a typical network's setting.

  6. A Glider-Assisted Link Disruption Restoration Mechanism in Underwater Acoustic Sensor Networks

    Directory of Open Access Journals (Sweden)

    Zhigang Jin

    2018-02-01

    Full Text Available Underwater acoustic sensor networks (UASNs have become a hot research topic. In UASNs, nodes can be affected by ocean currents and external forces, which could result in sudden link disruption. Therefore, designing a flexible and efficient link disruption restoration mechanism to ensure the network connectivity is a challenge. In the paper, we propose a glider-assisted restoration mechanism which includes link disruption recognition and related link restoring mechanism. In the link disruption recognition mechanism, the cluster heads collect the link disruption information and then schedule gliders acting as relay nodes to restore the disrupted link. Considering the glider’s sawtooth motion, we design a relay location optimization algorithm with a consideration of both the glider’s trajectory and acoustic channel attenuation model. The utility function is established by minimizing the channel attenuation and the optimal location of glider is solved by a multiplier method. The glider-assisted restoration mechanism can greatly improve the packet delivery rate and reduce the communication energy consumption and it is more general for the restoration of different link disruption scenarios. The simulation results show that glider-assisted restoration mechanism can improve the delivery rate of data packets by 15–33% compared with cooperative opportunistic routing (OVAR, the hop-by-hop vector-based forwarding (HH-VBF and the vector based forward (VBF methods, and reduce communication energy consumption by 20–58% for a typical network’s setting.

  7. Ventricular assist device implantation in a young patient with non-compaction cardiomyopathy and hereditary spherocytosis.

    Science.gov (United States)

    Huenges, Katharina; Panholzer, Bernd; Cremer, Jochen; Haneya, Assad

    2018-04-01

    A case of a 15-year-old female patient with acute heart failure due to non-compaction cardiomyopathy and hereditary anaemia (hereditary spherocytic elliptocytosis) requiring ventricular assist device implantation as a bridge to transplantation is presented. The possible effects of mechanical stress on erythrocytes potentially induced by mechanical circulatory support remains unclear, but it may lead to haemolytic crisis in patients suffering from hereditary anaemia. In our case, ventricular assist device therapy was feasible, and haematological complications did not occur within 6 weeks of bridging our patient to heart transplantation.

  8. Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy.

    Science.gov (United States)

    Wagner, Mark T; Mithoefer, Michael C; Mithoefer, Ann T; MacAulay, Rebecca K; Jerome, Lisa; Yazar-Klosinski, Berra; Doblin, Rick

    2017-08-01

    A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. There is evidence that lasting changes in the personality feature of "openness" occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of change. The present study investigated whether heightened Openness and decreased Neuroticism served as a mechanism of change within a randomized trial of MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD. The Clinician-Administered PTSD Scale (CAPS) Global Scores and NEO PI-R Personality Inventory (NEO) Openness and Neuroticism Scales served as outcome measures. Results indicated that changes in Openness but not Neuroticism played a moderating role in the relationship between reduced PTSD symptoms and MDMA treatment. Following MDMA-assisted psychotherapy, increased Openness and decreased Neuroticism when comparing baseline personality traits with long-term follow-up traits also were found. These preliminary findings suggest that the effect of MDMA-assisted psychotherapy extends beyond specific PTSD symptomatology and fundamentally alters personality structure, resulting in long-term persisting personality change. Results are discussed in terms of possible mechanisms of psychotherapeutic change.

  9. Comparison of Three Epithelial Removal Techniques in PRK: Mechanical, Alcohol-assisted, and Transepithelial Laser.

    Science.gov (United States)

    Shapira, Yinon; Mimouni, Michael; Levartovsky, Shmuel; Varssano, David; Sela, Tzahi; Munzer, Gur; Kaiserman, Igor

    2015-11-01

    To compare the visual and refractive results obtained after photorefractive keratectomy (PRK) in patients who underwent one of three different epithelial removal techniques. The authors reviewed the medical files of consecutive eyes with myopia and myopic astigmatism that were treated during a 10-year period by mechanical PRK, alcohol-assisted PRK, or transepithelial PRK (in the phototherapeutic keratectomy mode), and observed for more than 1 year. A total of 3,417 patients (3,417 eyes) were included in this study. At 3 and 6 months postoperatively, the outcome of alcohol-assisted PRK was superior both in efficacy (P PRK and transepithelial PRK, which were similar. At more than 1 year postoperatively, the mean efficacy index was still high for alcohol-assisted PRK, but low for the transepithelial PRK, corresponding to a mean uncorrected visual acuity of more than one Snellen line lower than those of the other two techniques (P PRK (P PRK. Copyright 2015, SLACK Incorporated.

  10. Plasma-assisted ignition and combustion: nanosecond discharges and development of kinetic mechanisms

    Science.gov (United States)

    Starikovskaia, S. M.

    2014-09-01

    This review covers the results obtained in the period 2006-2014 in the field of plasma-assisted combustion, and in particular the results on ignition and combustion triggered or sustained by pulsed nanosecond discharges in different geometries. Some benefits of pulsed high voltage discharges for kinetic study and for applications are demonstrated. The necessity of and the possibility of building a particular kinetic mechanism of plasma-assisted ignition and combustion are discussed. The most sensitive regions of parameters for plasma-combustion kinetic mechanisms are selected. A map of the pressure and temperature parameters (P-T diagram) is suggested, to unify the available data on ignition delay times, ignition lengths and densities of intermediate species reported by different authors.

  11. Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy

    OpenAIRE

    Wagner, Mark T; Mithoefer, Michael C; Mithoefer, Ann T; MacAulay, Rebecca K; Jerome, Lisa; Yazar-Klosinski, Berra; Doblin, Rick

    2017-01-01

    A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. There is evidence that lasting changes in the personality feature of ?openness? occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of c...

  12. Muscle-tendon mechanics explain unexpected effects of exoskeleton assistance on metabolic rate during walking.

    Science.gov (United States)

    Jackson, Rachel W; Dembia, Christopher L; Delp, Scott L; Collins, Steven H

    2017-06-01

    The goal of this study was to gain insight into how ankle exoskeletons affect the behavior of the plantarflexor muscles during walking. Using data from previous experiments, we performed electromyography-driven simulations of musculoskeletal dynamics to explore how changes in exoskeleton assistance affected plantarflexor muscle-tendon mechanics, particularly for the soleus. We used a model of muscle energy consumption to estimate individual muscle metabolic rate. As average exoskeleton torque was increased, while no net exoskeleton work was provided, a reduction in tendon recoil led to an increase in positive mechanical work performed by the soleus muscle fibers. As net exoskeleton work was increased, both soleus muscle fiber force and positive mechanical work decreased. Trends in the sum of the metabolic rates of the simulated muscles correlated well with trends in experimentally observed whole-body metabolic rate ( R 2 =0.9), providing confidence in our model estimates. Our simulation results suggest that different exoskeleton behaviors can alter the functioning of the muscles and tendons acting at the assisted joint. Furthermore, our results support the idea that the series tendon helps reduce positive work done by the muscle fibers by storing and returning energy elastically. We expect the results from this study to promote the use of electromyography-driven simulations to gain insight into the operation of muscle-tendon units and to guide the design and control of assistive devices. © 2017. Published by The Company of Biologists Ltd.

  13. Stent-assisted mechanical recanalization for the treatment of acute ischemic stroke

    International Nuclear Information System (INIS)

    Xu Haowen; Song Bo; Guo Xinbin; Guan Sheng

    2011-01-01

    Objective: to evaluate the safety and efficacy of stent-assisted mechanical recanalization technique in treating acute ischemic stroke. Methods: Stent-assisted mechanical recanalization procedure was carried out in 12 patients with acute ischemic stroke. The lesions were located at the anterior circulation in 10 cases and at posterior circulation in 2 cases. The clinical data were retrospectively analyzed. The technical success rate, the vascular recanalization, the occurrence of symptomatic intracranial hemorrhage, the clinical improvement and mortality were observed and evaluated. Results: The stent was successfully deployed in 11 patients (92%). After the treatment, different degrees of vascular recanalization were obtained in all patients. The complete (TIMI 3), partial (TIMI 2) and minor (TIMI 1) recanalization rate was 58.3% (7/12), 25% (3/12) and 8.3% (1/12), respectively. Postoperative symptomatic intracranial hemorrhage occurred in one patient (8.3%). Stroke-related death occurred in one patient (8.3%) and eight patients had their modified Rankin Score ≤ 2. Conclusion: For the treatment of acute ischemic stroke, stent-assisted mechanical recanalization technique is clinically feasible and safe with high vascular recanalization rate although further studies with larger sample to clarify its clinical usefulness are still needed. (authors)

  14. Development of ventricular assist devices in China: present status, opportunities and challenges.

    Science.gov (United States)

    Gu, Kaiyun; Chang, Yu; Gao, Bin; Wan, Feng; Loisance, Daniel; Zeng, Yi

    2014-08-01

    The growing number of heart failure patients and the scarcity of organ donors account for the huge need for the development of mechanical circulatory systems, including ventricular assist devices (VADs) and artificial hearts, in China. Several research programmes on blood pumps have been under way for the last three decades. However, unlike in other countries, the development of VADs has been extremely slow, and no system is currently approved and available for clinical application. There are many reasons for this situation. This article provides an overview of the present development of experimental and clinical research on VADs in China. In addition, the challenges for the clinical development of mechanical circulatory support in China are discussed. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. EVAHEART: an implantable centrifugal blood pump for long-term circulatory support.

    Science.gov (United States)

    Yamazaki, Kenji; Kihara, Shinichiro; Akimoto, Takehide; Tagusari, Osamu; Kawai, Akihiko; Umezu, Mitsuo; Tomioka, Jun; Kormos, Robert L; Griffith, Bartley P; Kurosawa, Hiromi

    2002-11-01

    We developed "EVAHEART": a compact centrifugal blood pump system as an implantable left ventricular assist device for long-term circulatory support. The 55 x 64 mm pump is made from pure titanium, and weighs 370 g. The entire blood-contacting surface is covered with an anti-thrombogenic coating of diamond like carbon (DLC) or 2-methacryloyloxyethyl phosphorylcholine (MPC) to improve blood compatibility. Flows exceeding 12 L/min against 100 mmHg pressure at 2600 rpm was measured. A low-temperature mechanical seal with recirculating cooling system is used to seal the shaft. EVAHEART demonstrated an acceptably low hemolysis rate with normalized index of hemolysis of 0.005 +/- 0.002 g/100L. We evaluated the pump in long-term in-vivo experiments with seven calves. Via left thoracotomy, we conducted left ventricular apex-descending aorta bypass, placing the pump in the left thoracic cavity. Pump flow rates was maintained at 5-9 L/min, pump power consumption remained stable at 9-10 W in all cases, plasma free Hb levels were less than 15 mg/dl, and the seal system showed good seal capability throughout the experiments. The calves were sacrificed on schedule on postoperative day 200, 222, 142, 90, 151, 155, and 133. No thrombi formed on the blood contacting surface with either the DLC or MPC coating, and no major organ thromboembolisms occurred except for a few small renal infarcts. EVAHEART centrifugal blood pump demonstrated excellent performance in long-term in-vivo experiments.

  16. Development of an assistive motorized hip orthosis: kinematics analysis and mechanical design.

    Science.gov (United States)

    Olivier, Jeremy; Bouri, Mohamed; Ortlieb, Amalric; Bleuler, Hannes; Clavel, Reymond

    2013-06-01

    With the increase of life expectancy, a higher number of elderly need assistance to maintain their mobility and their independance. The hip joint is crucial for walking and is problematic for a large number of aged people. In this paper we present a novel design of a motorized hip orthosis to assist elderly people while walking, stair climbing and during the sit-to-stand transistions. The kinematics was developed based on biomechanics considerations. To be able to achieve a large assistance rate, velocity and torques of the hip joint were studied from the literature. In order to fit with these requirements, an amplification mechanism inspired by excavators was developed and implemented. Comfort considerations were also taken into account and a custom interface was designed with the collaboration of a professional orthopaedic technician. First tests with the prototype showed that the workspace is sufficient for walking, for stair climbing as well as for sit-to-stand transitions. The assistance rate can go up to 30% for a 70 kg subject during walking at a cadence of 100 steps/min. The comfort is guaranteed despite the important weight (4.3 kg) of this first prototype.

  17. Use of Short-term Circulatory Support as a Bridge in Pediatric Heart Transplantation

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Canêo

    2015-01-01

    Full Text Available Background: Heart transplantation is considered the gold standard therapy for the advanced heart failure, but donor shortage, especially in pediatric patients, is the main limitation for this procedure, so most sick patients die while waiting for the procedure. Objective: To evaluate the use of short-term circulatory support as a bridge to transplantation in end-stage cardiomyopathy. Methods: Retrospective clinical study. Between January 2011 and December 2013, 40 patients with cardiomyopathy were admitted in our Pediatric Intensive Care Unit, with a mean age of 4.5 years. Twenty patients evolved during hospitalization with clinical deterioration and were classified as Intermacs 1 and 2. One patient died within 24 hours and 19 could be stabilized and were listed. They were divided into 2 groups: A, clinical support alone and B, implantation of short-term circulatory support as bridge to transplantation additionally to clinical therapy. Results: We used short-term mechanical circulatory support as a bridge to transplantation in 9. In group A (n=10, eight died waiting and 2 patients (20% were transplanted, but none was discharged. In group B (n=9, 6 patients (66.7% were transplanted and three were discharged.The mean support time was 21,8 days (6 to 984h. The mean transplant waiting list time was 33,8 days. Renal failure and sepsis were the main complication and causeof death in group A while neurologic complications were more prevalent en group B. Conclusion: Mechanical circulatory support increases survival on the pediatric heart transplantation waiting list in patients classified as Intermacs 1 and 2.

  18. CT screening of vertebrarterial circulatory disorder

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Shigeru; Toyoda, Keiko; Moriyama, Hiroshi [Jikei Univ., Tokyo (Japan). School of Medicine

    2001-09-01

    The frequency of MR angiography (MRA) used to diagnose vertebrobasiliar insufficiency appears high. Findings of abnormality by MRA show cases with maldescription of hemivertebral artery. In such cases, it is unclear whether these are due to anaplasia of the vertebral artery or to the existence of morbid constriction, thus requiring confirmation by a vertebral arteriography (VAG). We observe the vascular morphology of vertebral artery by Computed tomography (CT) scanning for screening circulatory disorders. In photography and CT scan reading, the region was severally photographed between foramen magnum and aortic arch by plain CT and contrast CT at a slice of 5 mm. The constrictive region of the vertebral artery was estimated by comparing plain and contrast CT. Subjects were 34 clinical cases of vascular maldescription in the vertebrobasilar artery, nearly no blood vessel description, or blood vessel winding or inclination. We determined the constrictive morbid state of the vertebral or subclavian artery and cervical vertebra deformity. In findings of maldescription by MRA, it was suggested that discrimination is feasible to a certain degree, whether the vertebral artery has a morbid constrictive region or due to anaplasia. Our results suggest that screening by CT scanning may be more efficient than that by MRA. (author)

  19. CT screening of vertebrarterial circulatory disorder

    International Nuclear Information System (INIS)

    Yoshida, Shigeru; Toyoda, Keiko; Moriyama, Hiroshi

    2001-01-01

    The frequency of MR angiography (MRA) used to diagnose vertebrobasiliar insufficiency appears high. Findings of abnormality by MRA show cases with maldescription of hemivertebral artery. In such cases, it is unclear whether these are due to anaplasia of the vertebral artery or to the existence of morbid constriction, thus requiring confirmation by a vertebral arteriography (VAG). We observe the vascular morphology of vertebral artery by Computed tomography (CT) scanning for screening circulatory disorders. In photography and CT scan reading, the region was severally photographed between foramen magnum and aortic arch by plain CT and contrast CT at a slice of 5 mm. The constrictive region of the vertebral artery was estimated by comparing plain and contrast CT. Subjects were 34 clinical cases of vascular maldescription in the vertebrobasilar artery, nearly no blood vessel description, or blood vessel winding or inclination. We determined the constrictive morbid state of the vertebral or subclavian artery and cervical vertebra deformity. In findings of maldescription by MRA, it was suggested that discrimination is feasible to a certain degree, whether the vertebral artery has a morbid constrictive region or due to anaplasia. Our results suggest that screening by CT scanning may be more efficient than that by MRA. (author)

  20. Transplantation of Hearts Donated after Circulatory Death

    Directory of Open Access Journals (Sweden)

    Christopher W. White

    2018-02-01

    Full Text Available Cardiac transplantation has become limited by a critical shortage of suitable organs from brain-dead donors. Reports describing the successful clinical transplantation of hearts donated after circulatory death (DCD have recently emerged. Hearts from DCD donors suffer significant ischemic injury prior to organ procurement; therefore, the traditional approach to the transplantation of hearts from brain-dead donors is not applicable to the DCD context. Advances in our understanding of ischemic post-conditioning have facilitated the development of DCD heart resuscitation strategies that can be used to minimize ischemia-reperfusion injury at the time of organ procurement. The availability of a clinically approved ex situ heart perfusion device now allows DCD heart preservation in a normothermic beating state and minimizes exposure to incremental cold ischemia. This technology also facilitates assessments of organ viability to be undertaken prior to transplantation, thereby minimizing the risk of primary graft dysfunction. The application of a tailored approach to DCD heart transplantation that focuses on organ resuscitation at the time of procurement, ex situ preservation, and pre-transplant assessments of organ viability has facilitated the successful clinical application of DCD heart transplantation. The transplantation of hearts from DCD donors is now a clinical reality. Investigating ways to optimize the resuscitation, preservation, evaluation, and long-term outcomes is vital to ensure a broader application of DCD heart transplantation in the future.

  1. Management issues during HeartWare left ventricular assist device implantation and the role of transesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Sanjay Orathi Patangi

    2013-01-01

    Full Text Available Left ventricular assist devices (LVAD are increasingly used for mechanical circulatory support of patients with severe heart failure, primarily as a bridge to heart transplantation. Transesophageal echocardiography (TEE plays a major role in the clinical decision making during insertion of the devices and in the post-operative management of these patients. The detection of structural and device-related mechanical abnormalities is critical for optimal functioning of assist device. In this review article, we describe the usefulness of TEE for optimal perioperative management of patients presenting for HeartWare LVAD insertion.

  2. TRENDS IN OFFICIAL DEVELOPMENT ASSISTANCE TO DEVELOPING COUNTRIES AND POSSIBILITIES OF ALTERNATIVE FINANCING MECHANISMS

    Directory of Open Access Journals (Sweden)

    Talknice Saungweme

    2013-09-01

    Full Text Available The study analyses trends in Official Development Assistance (ODA to developing countries, mainly Africa, and possibilities of new financing instruments. Economies of most developing countries, especially those in Sub-Saharan Africa, are characterised by low investment flows, huge import bills and lower exports. Subsequently, development assistance is the major source of external finance and has taken the form of budget support, humanitarian and development finance. However, the noted fall in ODA in 2005, 2009 and 2012 might adversely impact directly on the attainment of millennium development goals in 2015. This negative trend in ODA is a result of a combination of factors such as economic constraints in the donor countries (for example, the debt crisis and/or a new shift in financing mechanisms to developing countries.

  3. Life time estimation for irradiation assisted mechanical cracking of PWR RCCA rodlets

    Energy Technology Data Exchange (ETDEWEB)

    Matsuoka, Takanori; Yamaguchi, Youichirou [Nuclear Development Corp., Tokai, Ibaraki (Japan)

    1999-09-01

    Intergranular cracks of cladding tubes had been observed at the tips of the rodlets of PWR rod cluster control assemblies (RCCAs). Because RCCAs were important core components, an investigation was carried out to estimate their service lifetime. The reviews on their mechanism and the life time estimation are shown in this paper. The summaries are as follows. (1) The mechanism of the intergranular crack of the cladding tube was not IASCC but irradiation assisted mechanical cracking (IAMC) caused by an increase in hoop strain due to the swelling of the absorber and a decrease in elongation due to neutron irradiation. (2) The crack initiation limit of cylindrical shells made of low ductile material and subjected to internal pressure was determined in relation to the uniform strain of the material and was in accordance with that of the RCCA rodlets in an actual plant. (3) From the above investigation, the method of estimating the lifetime and countermeasures for its extension were obtained. (author)

  4. Ion transport in circulatory and/or septic shock

    International Nuclear Information System (INIS)

    Sayeed, M.M.

    1987-01-01

    This review surveys investigations of membrane ion transport in animals in hemorrhagic, endotoxic, or bacteremic shock. The focus of the review is on ion transport studies in the skeletal muscle and liver. Skeletal muscle Na + -K + transport alterations have been shown during the induction of shock via hemorrhage, endotoxin, or live Gram-negative bacteria in the rodent, canine, and primate species. These alterations include impairment of active cellular K + accumulation, increased permeability to 24 Na + and Cl - , and membrane depolarization. The ion transport alterations in the skeletal muscle are compatible with movement of extracellular fluid into the intracellular compartment. Such fluid movements can potentially lead to decreases in circulating plasma volume and thus to circulatory deficits in shock. Studies in the liver of rats subjected to hemorrhagic or endotoxic shock indicated the failure of electrogenic Na + pump. Although the hepatic cellular membrane permeability to Na + relative to permeability to K + appeared unaltered in hemorrhagic shock, endotoxic shock caused an increase in permeability to Na + . Hepatic cellular 45 Ca + regulation also appeared to be adversely affected during endotoxic shock. Alterations in hepatic Na + -K + transport and Ca + regulation could contribute to impairment in hepatic glucose production during shock. Although mechanisms of altered membrane ion transport during shock states remain unknown, such changes could occur prior to any substantial loss of cellular metabolic energy

  5. Circulatory and Renal Consequences of Pregnancy in Diabetic NOD Mice

    Science.gov (United States)

    Burke, S.D.; Barrette, V.F.; David, S.; Khankin, E. V.; Adams, M.A.; Croy, B.A.

    2011-01-01

    Objectives Women with diabetes have elevated gestational risks for severe hemodynamic complications, including preeclampsia in mid- to late pregnancy. This study employed continuous, chronic radiotelemetry to compare the hemodynamic patterns in non-obese diabetic (NOD) mice who were overtly diabetic or normoglycemic throughout gestation. We hypothesized that overtly diabetic, pregnant NOD mice would develop gestational hypertension and provide understanding of mechanisms in progression of this pathology. Study Design Telemeter-implanted, age-matched NOD females with and without diabetes were assessed for six hemodynamic parameters (mean, systolic, diastolic, pulse pressures, heart rate and activity) prior to mating, over pregnancy and over a 72 hr post-partum interval. Urinalysis, serum biochemistry and renal histopathology were also conducted. Results Pregnant, normoglycemic NOD mice had a hemodynamic profile similar to other inbred strains, despite insulitis. This pattern was characterized by an interval of pre-implantation stability, post implantation decline in arterial pressure to mid gestation, and then a rebound to pre-pregnancy baseline during later gestation. Overtly diabetic NOD mice had a blood pressure profile that was normal until mid-gestation then become mildly hypotensive (−7mmHg, Ppost-partum (−10% pre-pregnancy pressure and HR, P<0.05). Conclusions Pregnancy accelerates circulatory and renal pathologies in overtly diabetic NOD mice and is characterized by depressed arterial pressure from mid-gestation and birth of growth 45 restricted offspring. PMID:22014504

  6. [Pressure support ventilation and proportional assist ventilation during weaning from mechanical ventilation].

    Science.gov (United States)

    Aguirre-Bermeo, H; Bottiroli, M; Italiano, S; Roche-Campo, F; Santos, J A; Alonso, M; Mancebo, J

    2014-01-01

    To compare tolerance, duration of mechanical ventilation (MV) and clinical outcomes during weaning from MV in patients subjected to either pressure support ventilation (PSV) or proportional assist ventilation (PAV). A prospective, observational study was carried out. Intensive Care Unit. A total of 40 consecutive subjects were allocated to either the PSV or the PAV group until each group contained 20 patients. Patients were included in the study when they met the criteria to begin weaning and the attending physician decided to initiate the weaning process. The physician selected the modality and set the ventilatory parameters. None. Demographic data, respiratory mechanics, ventilatory parameters, duration of MV, and clinical outcomes (reintubation, tracheostomy, mortality). Baseline characteristics were similar in both groups. No significant differences were observed between the PSV and PAV groups in terms of the total duration of MV (10 [5-18] vs. 9 [7-19] days; P=.85), reintubation (5 [31%] vs. 3 [19%]; P=.69), or mortality (4 [20%] vs. 5 [25%] deaths; P=1). Eight patients (40%) in the PSV group and 6 patients (30%) in the PAV group (P=.74) required a return to volume assist-control ventilation due to clinical deterioration. Tolerance, duration of MV and clinical outcomes during weaning from mechanical ventilation were similar in PSV and PAV. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  7. Ultrasound assisted extraction of food and natural products. Mechanisms, techniques, combinations, protocols and applications. A review.

    Science.gov (United States)

    Chemat, Farid; Rombaut, Natacha; Sicaire, Anne-Gaëlle; Meullemiestre, Alice; Fabiano-Tixier, Anne-Sylvie; Abert-Vian, Maryline

    2017-01-01

    This review presents a complete picture of current knowledge on ultrasound-assisted extraction (UAE) in food ingredients and products, nutraceutics, cosmetic, pharmaceutical and bioenergy applications. It provides the necessary theoretical background and some details about extraction by ultrasound, the techniques and their combinations, the mechanisms (fragmentation, erosion, capillarity, detexturation, and sonoporation), applications from laboratory to industry, security, and environmental impacts. In addition, the ultrasound extraction procedures and the important parameters influencing its performance are also included, together with the advantages and the drawbacks of each UAE techniques. Ultrasound-assisted extraction is a research topic, which affects several fields of modern plant-based chemistry. All the reported applications have shown that ultrasound-assisted extraction is a green and economically viable alternative to conventional techniques for food and natural products. The main benefits are decrease of extraction and processing time, the amount of energy and solvents used, unit operations, and CO 2 emissions. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Mechanical properties of silicon oxynitride thin films prepared by low energy ion beam assisted deposition

    International Nuclear Information System (INIS)

    Shima, Yukari; Hasuyama, Hiroki; Kondoh, Toshiharu; Imaoka, Yasuo; Watari, Takanori; Baba, Koumei; Hatada, Ruriko

    1999-01-01

    Silicon oxynitride (SiO x N y ) films (0.1-0.7 μm) were produced on Si (1 0 0), glass and 316L stainless steel substrates by ion beam assisted deposition (IBAD) using Si evaporation and the concurrent bombardment with a mixture of 200 eV N 2 and Ar, or O 2 and Ar ions. Adhesion was evaluated by pull-off tests. Film hardness was measured by a nanoindentation system with AFM. The measurement of internal stress in the films was carried out by the Stoney method. The film structure was examined by GXRD. XPS was employed to measure the composition of films and to analyze the chemical bonds. The dependence of mechanical properties on the film thickness and the processing temperature during deposition was studied. Finally, the relations between the mechanical properties of the films and the correlation with corrosion-protection ability of films are discussed and summarized

  9. Prototype of a mechanical assistance device for the wrists' flexion-extension movement

    International Nuclear Information System (INIS)

    Politti, Julio C; Puglisi, Lisandro J; Farfan, Fernando D

    2007-01-01

    Using CMU actuators, a Prototype of Mechanical Assistance Device for the Wrist's Flexion Movement (PMA) was developed and probed in a mechanical model, in order to be implemented in a future as a dynamic powered orthosis or as a rehabilitation assistant instrument. Two Mayor Actuators conformed by three CMU actuators arranged in a series configuration, allows to an artificial hand to be placed in four predefined positions: 0 0 , 20 0 , 40 0 and 60 0 . The synchronism and control of the actuators is achieved with the Programmable Control Module (PCM). It is capable to drive up to six CMU actuators, and possess two different modes of execution: a Manual mode and an Exercise mode. In the Manual Mode, the position of the hand responds directly to the commands of the keyboard of the front panel, and in the Exercise mode, the hand realizes a repetitive and programmed movement. The prototype was tested in 100 positions in the Manual Mode and for 225 works cycles in the Exercise Mode. The relative repetition error was less than 5% for both test. This prototype only consumes 4,15W, which makes it possible to be powered by small rechargeable batteries, allowing its use as a portable device

  10. Trigger performance of mid-level ICU mechanical ventilators during assisted ventilation: a bench study.

    Science.gov (United States)

    Ferreira, Juliana C; Chipman, Daniel W; Kacmarek, Robert M

    2008-09-01

    To compare the triggering performance of mid-level ICU mechanical ventilators with a standard ICU mechanical ventilator. Experimental bench study. The respiratory care laboratory of a university-affiliated teaching hospital. A computerized mechanical lung model, the IngMar ASL5000. Ten mid-level ICU ventilators were compared to an ICU ventilator at two levels of lung model effort, three combinations of respiratory mechanics (normal, COPD and ARDS) and two modes of ventilation, volume and pressure assist/control. A total of 12 conditions were compared. Performance varied widely among ventilators. Mean inspiratory trigger time was ventilators. The mean inspiratory delay time (time from initiation of the breath to return of airway pressure to baseline) was longer than that for the ICU ventilator for all tested ventilators except one. The pressure drop during triggering (Ptrig) was comparable with that of the ICU ventilator for only two ventilators. Expiratory Settling Time (time for pressure to return to baseline) had the greatest variability among ventilators. Triggering differences among these mid-level ICU ventilators and with the ICU ventilator were identified. Some of these ventilators had a much poorer triggering response with high inspiratory effort than the ICU ventilator. These ventilators do not perform as well as ICU ventilators in patients with high ventilatory demand.

  11. A simplified approach to the regulation of mechanical circulatory support

    Czech Academy of Sciences Publication Activity Database

    Pražák, Josef; Leitermann, D.; Musil, Jan

    2000-01-01

    Roč. 23, č. 8 (2000), s. 569 ISSN 0391-3988. [ESAO congress in co-operation with the ESEM Lausanne /23./. Lausanne, 31.08.2000-02.09.2000] R&D Projects: GA ČR GA106/98/1373; GA AV ČR KSK1076602 Subject RIV: BO - Biophysics Impact factor: 0.931, year: 2000

  12. An Integrated Simulation Tool for Modeling the Human Circulatory System

    Science.gov (United States)

    Asami, Ken'ichi; Kitamura, Tadashi

    This paper presents an integrated simulation of the circulatory system in physiological movement. The large circulatory system model includes principal organs and functional units in modules in which comprehensive physiological changes such as nerve reflexes, temperature regulation, acid/base balance, O2/CO2 balance, and exercise are simulated. A beat-by-beat heart model, in which the corresponding electrical circuit problems are solved by a numerical analytic method, enables calculation of pulsatile blood flow to the major organs. The integration of different perspectives on physiological changes makes this simulation model applicable for the microscopic evaluation of blood flow under various conditions in the human body.

  13. Comparison of the external physical damages between laser-assisted and mechanical immobilized human sperm using scanning electronic microscopy.

    Directory of Open Access Journals (Sweden)

    David Y L Chan

    Full Text Available We aim to visualize the external physical damages and distinct external phenotypic effects between mechanical and laser-assisted immobilized human spermatozoa using scanning electronic microscopy (SEM. Human spermatozoa were immobilized mechanically or with laser assistance for SEM examination and the membrane integrities were checked on both types of immobilized spermatozoa. We found evidence of external damages at SEM level on mechanically kinked sperm, but not on laser-assisted immobilized sperm. Although no external damage was found on laser-assist immobilized sperm, there were two distinct types of morphological changes when spermatozoa were stricken by infra-red laser. Coiled tails were immediately formed when Laser pulse was applied to the sperm end piece area, whereas laser applied to the sperm principal piece area resulted in a sharp bend of sperm tails. Sperm immobilized by laser did not exhibit any morphological change if the laser did not hit within the on-screen central target zone or if the laser hit the sperm mid piece or head. Our modified membrane integrity assay revealed that the external membrane of more than half of the laser-assisted immobilized sperm remained intact. In conclusion, mechanical immobilization produced membrane damages whilst laser-assisted immobilization did not result in any external membrane damages besides morphological changes at SEM level.

  14. MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms?

    Science.gov (United States)

    Feduccia, Allison A; Mithoefer, Michael C

    2018-06-08

    MDMA-assisted psychotherapy for treatment of PTSD has recently progressed to Phase 3 clinical trials and received Breakthrough Therapy designation by the FDA. MDMA used as an adjunct during psychotherapy sessions has demonstrated effectiveness and acceptable safety in reducing PTSD symptoms in Phase 2 trials, with durable remission of PTSD diagnosis in 68% of participants. The underlying psychological and neurological mechanisms for the robust effects in mitigating PTSD are being investigated in animal models and in studies of healthy volunteers. This review explores the potential role of memory reconsolidation and fear extinction during MDMA-assisted psychotherapy. MDMA enhances release of monoamines (serotonin, norepinephrine, dopamine), hormones (oxytocin, cortisol), and other downstream signaling molecules (BDNF) to dynamically modulate emotional memory circuits. By reducing activation in brain regions implicated in the expression of fear- and anxiety-related behaviors, namely the amygdala and insula, and increasing connectivity between the amygdala and hippocampus, MDMA may allow for reprocessing of traumatic memories and emotional engagement with therapeutic processes. Based on the pharmacology of MDMA and the available translational literature of memory reconsolidation, fear learning, and PTSD, this review suggests a neurobiological rationale to explain, at least in part, the large effect sizes demonstrated for MDMA in treating PTSD. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Stress-assisted grain growth in nanocrystalline metals: Grain boundary mediated mechanisms and stabilization through alloying

    International Nuclear Information System (INIS)

    Zhang, Yang; Tucker, Garritt J.; Trelewicz, Jason R.

    2017-01-01

    The mechanisms of stress-assisted grain growth are explored using molecular dynamics simulations of nanoindentation in nanocrystalline Ni and Ni-1 at.% P as a function of grain size and deformation temperature. Grain coalescence is primarily confined to the high stress region beneath the simulated indentation zone in nanocrystalline Ni with a grain size of 3 nm. Grain orientation and atomic displacement vector mapping demonstrates that coalescence transpires through grain rotation and grain boundary migration, which are manifested in the grain interior and grain boundary components of the average microrotation. A doubling of the grain size to 6 nm and addition of 1 at.% P eliminates stress-assisted grain growth in Ni. In the absence of grain coalescence, deformation is accommodated by grain boundary-mediated dislocation plasticity and thermally activated in pure nanocrystalline Ni. By adding solute to the grain boundaries, the temperature-dependent deformation behavior observed in both the lattice and grain boundaries inverts, indicating that the individual processes of dislocation and grain boundary plasticity will exhibit different activity based on boundary chemistry and deformation temperature.

  16. Report on assessment of the mechanism of bacterially assisted oxidation of pyritic uranium tailings

    International Nuclear Information System (INIS)

    Halbert, B.B.; Scharer, J.M.; Knapp, R.A.

    1984-07-01

    The oxidation of pyritic minerals has been shown to be catalyzed by the presence of iron- and sulphur-oxidizing bacteria. Thiobacillus ferroxidans plays the most significant role in the formation and propagation of acidic conditions. Optimum growth conditions for the T. ferroxidans occurs at a temperature of 35 degrees C and pH of 2 to 3. Bacterially assisted oxidation of pyrite involves both direct and indirect contact mechanisms. The direct contact mechanism entails enzymatic oxidation of the insoluble sulphide moiety. The indirect mechanism involves bacterial oxidation of the dissolved ferrous component to the ferric state. The ferric iron, in turn, acts as the prime oxidant of pyrite and is reduced to ferrous iron. The re-oxidation of the dissolved ferrous component which is catalyzed by bacterial activity, completes the cyclic process. The rate of bacterial oxidation is affected by: the geochemistry and reactivity of the pyritic material; the amount of pyrite present in the waste material and the exposed surface area of the pyritic component; the availability of oxygen and carbon dioxide; the pH and temperature of the leach solution; and the presence (or absence) of organic inhibitors. Of the above factors, oxygen has been frequently identified as the rate limiting reactant in tailings

  17. Mechanisms of irradiation assisted stress corrosion cracking in austenitic stainless steels

    International Nuclear Information System (INIS)

    Was, G.S.; Busby, G.T.

    2004-01-01

    Full text of publication follows: Service and laboratory experience have shown that irradiation enhances the stress corrosion cracking of austenitic alloys in high temperature water. The degree of irradiation assisted stress corrosion cracking (IASCC) increases with dose as the microstructure undergoes significant changes, including dislocation loop formation, grain boundary segregation and hardening. These changes occur simultaneously and at comparable rates, complicating the attribution of IASCC to specific components of the microstructure. Each of the principal effects of irradiation have been considered as potential causes of IASCC, but the multivariable nature of the problem obscures a definitive determination of the mechanism. Rather, the mechanism of IASCC is more likely due to a combination of factors, some which have not yet been considered. Among these effects is the heterogeneity of deformation caused by the irradiated microstructure, and the interaction of localized deformation bands with grain boundaries. Current understanding and proposed mechanisms of IASCC will be reviewed, and recent progress on the role of heterogeneous deformation on IASCC will be presented. (authors)

  18. Preparation of sago starch-based biocomposite reinforced microfibrillated cellulose of bamboo assisted by mechanical treatment

    Science.gov (United States)

    Silviana, S.; Hadiyanto, H.

    2017-06-01

    The utilization of green composites by using natural fibres is developed due to their availability, ecological benefits, and good properties in mechanical and thermal. One of the potential sources is bamboo that has relative high cellulose content. This paper was focused on the preparation of sago starch-based reinforced microfribrillated cellulose of bamboo that was assisted by mechanical treatment. Microfibrillated cellulose of bamboo was prepared by isolation of cellulose with chemical treatment. Preparation of bamboo microfibrillated cellulose was conducted by homogenizers for dispersing bamboo cellulose, i.e. high pressure homogenizer and ultrasonic homogenizer. Experiments were elaborated on several variables such as the concentration of bamboo microfibrillated cellulose dispersed in water (1-3 %w) and the volume of microfibrillated cellulose (37.5-75%v). Four %w of sago starch solution was mixed with bamboo microfibrillated cellulose and glycerol with plasticizer and citric acid as cross linker. This paper provided the analysis of tensile strength as well as SEM for mechanical and morphology properties of the biocomposite. The results showed that the preparation of sago starch-based biocomposite reinforced bamboo microfibrillated cellulose by using ultrasonic homogenizer yielded the highest tensile strength and well dispersed in the biocomposite.

  19. Growth mechanism of silver nanowires synthesized by polyvinylpyrrolidone-assisted polyol reduction

    International Nuclear Information System (INIS)

    Gao Yan; Jiang Peng; Song Li; Liu Lifeng; Yan Xiaoqin; Zhou Zhenping; Liu Dongfang; Wang Jianxiong; Yuan Huajun; Zhang Zengxing; Zhao Xiaowei; Dou Xinyuan; Zhou Weiya; Wang Gang; Xie Sishen

    2005-01-01

    Silver (Ag) nanowires with a pentagonal cross section have been synthesized by polyvinylpyrrolidone (PVP)-assisted polyol reduction in the presence of Pt nanoparticle seeds. The UV-visible absorption spectra and scanning electron microscopy have been used to trace the growth process of the Ag nanowires. X-ray photoelectron spectroscopy investigation further shows that the PVP molecules are adsorbed on the surface of the Ag nanowires through Ag : O coordination. Comparing with the growth process of Ag nanoparticles, a possible growth mechanism of the Ag nanowires has been proposed. It is implied that the PVP molecules are used as both a protecting agent and a structure-directing agent for the growth of Ag nanowires. It is concluded that the five-fold twinning Ag nanoparticles are formed through heterogenous nucleation after the introduction of Pt nanoparticle seeds and then grow anisotropically along the (110) direction, while the growth along (100) is relatively depressed

  20. Wind- and stack-assisted mechanical ventilation with heat recovery and night cooling

    DEFF Research Database (Denmark)

    Hviid, Christian Anker; Svendsen, Svend

    presented the outline of a heat recovery concept suitable for stack and wind-assisted mechanical ventilation systems with total system pressure losses of 74Pa. The heat recovery concept is based on two air-to-water exchangers connected by a liquid loop powered by a pump. The core element of the concept......, a prototype of a heat exchanger, was developed based on design criteria about pressure drop, eciency and production concerns. The exchanger is based on banks of plastic tubing cris-crossing the air flow, thus creating approximate counter flow between air and water. Round PE plastic tubing is used. The tubing...... is commonly used for water-based floor-heating systems. Oval or even wing shaped tubes may have better heat transfer and lower drag coecient, but round tubes require less meticulous production procedures. The tubing used here is mass-produced, cheap, and flexible but the current design does require many...

  1. Preparing high-density polymer brushes by mechanically assisted polymer assembly (MAPA)

    Science.gov (United States)

    Wu, Tao; Efimenko, Kirill; Genzer, Jan

    2001-03-01

    We introduce a novel method of modifying the surface properties of materials. This technique, called MAPA (="mechanically assisted polymer assembly"), is based on: 1) chemically attaching polymerization initiators to the surface of an elastomeric network that has been previously stretched by a certain length, Δx, and 2) growing end-anchored macromolecules using surface initiated ("grafting from") atom transfer living radical polymerization. After the polymerization, the strain is removed from the substrate, which returns to its original size causing the grafted macromolecules to stretch away from the substrate and form a dense polymer brush. We demonstrate the feasibility of the MAPA method by preparing high-density polymer brushes of poly(acryl amide), PAAm. We show that, as expected, the grafting density of the PAAm brushes can be increased by increasing Δx. We demonstrate that polymer brushes with extremely high grafting densities can be successfully prepared by MAPA.

  2. Current Trends in Implantable Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Jens Garbade

    2011-01-01

    Full Text Available The shortage of appropriate donor organs and the expanding pool of patients waiting for heart transplantation have led to growing interest in alternative strategies, particularly in mechanical circulatory support. Improved results and the increased applicability and durability with left ventricular assist devices (LVADs have enhanced this treatment option available for end-stage heart failure patients. Moreover, outcome with newer pumps have evolved to destination therapy for such patients. Currently, results using nonpulsatile continuous flow pumps document the evolution in outcomes following destination therapy achieved subsequent to the landmark Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure Trial (REMATCH, as well as the outcome of pulsatile designed second-generation LVADs. This review describes the currently available types of LVADs, their clinical use and outcomes, and focuses on the patient selection process.

  3. Implantable nuclear-fueled circulatory support system. V. Acute physiologic analyses

    Energy Technology Data Exchange (ETDEWEB)

    Huffman, F N; Migliore, J J; Hagen, K G; Daly, B D.T.; Robinson, W J; Ruggles, A E; Norman, J C

    1973-01-01

    Nuclear-Fueled circulatory assist systems have reached the stage of in vivo evaluation. Physiologic studies of the effects of intracorporeal heat and radiation as well as blood pumps indicate that these factors should not preclude clinical application of nuclear artificial hearts. In the circulatory system under consideration, a fraction of the heat from a 50 watt Plutonium-238 fuel capsule is converted into hydraulic power for driving a left ventricular assist pump via a miniature, electronically controlled steam (tidal regenerator) engine. The engine is pressurized (8-140 PSIA) by the displacement of a single drop of water between the condenser (150/sup 0/F) and the boiler (360/sup 0/F). The electrical power for sensing, logic and displacement is provided by a thermoelectric module interposed between the superheater (900/sup 0/F) and boiler. The pusher plate pump also functions as a blood-cooled heat exchanger and sensor for the control logic. The assist pump is connected between the apex of the left ventricle and the descending thoracic aorta. The power source module is suspended in the left retroperitoneal cavity from the psoas tendon. The blood interface of the pump is flocked with polyester fibers. A stable biologic lining develops in the pump using Dextran as the only anticoagulant. The longest in vivo testing period has been 4/sup 1///sub 2/ days. Plasma hemoglobinshave remained below 10 mg/sup 0///sub 0/. Although rectal temperatures have not increased, elevated respiratory rates have been noted. Reduction of left ventricular pressure and dp/dt have been demonstrated with maintenance of arterial pressure.

  4. Intacs for keratoconus and post-LASIK ectasia: mechanical versus femtosecond laser-assisted channel creation.

    Science.gov (United States)

    Carrasquillo, Karen G; Rand, Janet; Talamo, Jonathan H

    2007-09-01

    To evaluate the efficacy of intracorneal ring segments to treat keratoconus and post-laser in situ keratomileusis (LASIK) keratectasia implanted by using either mechanical dissection or a femtosecond laser. Thirty-three eyes of 29 patients had intracorneal ring segments implanted by using mechanical dissection (17 eyes) or a femtosecond laser (16 eyes). Mean follow-up was 10.3 months. Parameters assessed before and after surgery included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refractive spherical equivalent (MRSE), refractive cylinder (RC), best contact lens-corrected visual acuity (BCLVA), and contact lens tolerance. Statistically significant changes occurred for all parameters when we analyzed all 33 eyes as 1 group. Mean UCVA LogMar values improved from 1.0 +/- 0.3 (20/200) to 0.6 +/- 0.4 (20/80) (P < 0.0005). Mean BSCVA changed from 0.3 +/- 0.2 (20/40) to 0.2 +/- 0.2 (20/30) (10%; P < 0.05), and MRSE from -9 +/- 4 to -7 +/- 4 D (P < 0.05; 20%). There was a decrease of 0.5 D or more of RC in 62% of eyes. BCLVA improved from 0.2 +/- 0.2 (20/30) to 0.1 +/- 0.1 (20/25) after surgery (P < 0.02). Contact lens tolerance improved in 81% of eyes. There was no statistically significant difference in outcomes between mechanical dissection and femtosecond laser-assisted techniques. However, although statistical power was adequate to detect changes in clinical parameters as a result of surgery, it was not sufficient to conclusively show such differences between surgical techniques. For mild to moderate cases of keratoconus and post-LASIK keratectasia, the use of a femtosecond laser for Intacs channel creation seems as effective as mechanical dissection. Future studies are warranted to further evaluate channel creation by a femtosecond laser.

  5. Circulatory Markings at Double-Lane Traffic Roundabout.

    NARCIS (Netherlands)

    Bie, Jing; Lo, Hong K.; Wong, S.C.

    2008-01-01

    This paper compares two types of circulatory markings at a double-lane traffic roundabout: the concentric marking scheme and the Alberta marking scheme. The effects of these two marking schemes on drivers' lane choice behavior, delay, and safety, are compared based on data collected from before and

  6. Early Identification of Circulatory Shock in Critical Care Transport

    Science.gov (United States)

    2008-09-30

    disclosure and community consultation. Early Identification of Circulatory Shock in Critical Care Transport 2 Community consultation for this...in two aircraft types (Eurocopter EC 135 and EC 145), in IFR weather conditions, and during both day and night operations. We calculated the

  7. Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study

    International Nuclear Information System (INIS)

    Little, Mark P.; Zablotska, Lydia B.; Brenner, Alina V.; Lipshultz, Steven E.

    2016-01-01

    High-dose ionizing radiation is associated with circulatory disease. Risks from lower-dose fractionated exposures, such as from diagnostic radiation procedures, remain unclear. In this study we aimed to ascertain the relationship between fractionated low-to-medium dose radiation exposure and circulatory disease mortality in a cohort of 13,568 tuberculosis patients in Massachusetts, some with fluoroscopy screenings, between 1916 and 1961 and follow-up until the end of 2002. Analysis of mortality was in relation to cumulative thyroid (cerebrovascular) or lung (all other circulatory disease) radiation dose via Poisson regression. Over the full dose range, there was no overall radiation-related excess risk of death from circulatory disease (n = 3221; excess relative risk/Gy −0.023; 95 % CI −0.067, 0.028; p = 0.3574). Risk was somewhat elevated in hypertensive heart disease (n = 89; excess relative risk/Gy 0.357; 95 % CI −0.043, 1.030, p = 0.0907) and slightly decreased in ischemic heart disease (n = 1950; excess relative risk/Gy −0.077; 95 % CI −0.130, −0.012; p = 0.0211). However, under 0.5 Gy, there was a borderline significant increasing trend for all circulatory disease (excess relative risk/Gy 0.345; 95 % CI −0.032, 0.764; p = 0.0743) and for ischemic heart disease (excess relative risk/Gy 0.465; 95 % CI, −0.032, 1.034, p = 0.0682). Pneumolobectomy increased radiation–associated risk (excess relative risk/Gy 0.252; 95 % CI 0.024, 0.579). Fractionation of dose did not modify excess risk. In summary, we found no evidence of radiation-associated excess circulatory death risk overall, but there are indications of excess circulatory death risk at lower doses (<0.5 Gy). Although consistent with other radiation-exposed groups, the indications of higher risk at lower doses are unusual and should be confirmed against other data.

  8. Safety mechanism assisted by the repressor of tetracycline (SMART) vaccinia virus vectors for vaccines and therapeutics.

    Science.gov (United States)

    Grigg, Patricia; Titong, Allison; Jones, Leslie A; Yilma, Tilahun D; Verardi, Paulo H

    2013-09-17

    Replication-competent viruses, such as Vaccinia virus (VACV), are powerful tools for the development of oncolytic viral therapies and elicit superior immune responses when used as vaccine and immunotherapeutic vectors. However, severe complications from uncontrolled viral replication can occur, particularly in immunocompromised individuals or in those with other predisposing conditions. VACVs constitutively expressing interferon-γ (IFN-γ) replicate in cell culture indistinguishably from control viruses; however, they replicate in vivo to low or undetectable levels, and are rapidly cleared even in immunodeficient animals. In an effort to develop safe and highly effective replication-competent VACV vectors, we established a system to inducibly express IFN-γ. Our SMART (safety mechanism assisted by the repressor of tetracycline) vectors are designed to express the tetracycline repressor under a constitutive VACV promoter and IFN-γ under engineered tetracycline-inducible promoters. Immunodeficient SCID mice inoculated with VACVs not expressing IFN-γ demonstrated severe weight loss, whereas those given VACVs expressing IFN-γ under constitutive VACV promoters showed no signs of infection. Most importantly, mice inoculated with a VACV expressing the IFN-γ gene under an inducible promoter remained healthy in the presence of doxycycline, but exhibited severe weight loss in the absence of doxycycline. In this study, we developed a safety mechanism for VACV based on the conditional expression of IFN-γ under a tightly controlled tetracycline-inducible VACV promoter for use in vaccines and oncolytic cancer therapies.

  9. Nuclear-fueled circulatory support systems

    Energy Technology Data Exchange (ETDEWEB)

    Norman, J C [Texas Heart Inst. (USA)

    1975-08-01

    Experiments on calves using two types of systems for nuclear left ventricular assist pumps are described. These two systems use a nuclear heat source containing 120 g, 1600 Ci Pu-238 in the form of plutonium oxide. The heat source for the first system is the tidal regenerator engine with no valve or seal and is controlled using a hall effect displacement sensor. The second left ventricular assist system uses heat generated by nuclear decay for producing high gas pressure which is converted into a high hydraulic pressure for pumping. The engine efficiency amounts to 7 to 16%, and the measurement value of the pump efficiency obtained is 85%. How these two systems are synchronized with the left ventricle of vital body is described. IN a transplant experiment for a short period (175 hours) in the initial stage, the possibility of the present method was demonstrated. A long-term performance experiment and improvement of the systems are anticipated. However, there still remain many problems, such as improvement of efficiency, reliability, and performance and diminution of the size.

  10. THE DETONATION MECHANISM OF THE PULSATIONALLY ASSISTED GRAVITATIONALLY CONFINED DETONATION MODEL OF Type Ia SUPERNOVAE

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, G. C. IV; Graziani, C.; Weide, K.; Norris, J.; Hudson, R.; Lamb, D. Q. [Flash Center for Computational Science, University of Chicago, Chicago, IL 60637 (United States); Fisher, R. T. [Department of Physics, University of Massachusetts Dartmouth, 285 Old Westport Road, North Dartmouth, MA 02740 (United States); Townsley, D. M. [Department of Physics and Astronomy, University of Alabama, Tuscaloosa, AL 35487 (United States); Meakin, C. [Steward Observatory, University of Arizona, Tucson, AZ 85721 (United States); Reid, L. B. [NTEC Environmental Technology, Subiaco WA 6008 (Australia)

    2012-11-01

    We describe the detonation mechanism composing the 'pulsationally assisted' gravitationally confined detonation (GCD) model of Type Ia supernovae. This model is analogous to the previous GCD model reported in Jordan et al.; however, the chosen initial conditions produce a substantively different detonation mechanism, resulting from a larger energy release during the deflagration phase. The resulting final kinetic energy and {sup 56}Ni yields conform better to observational values than is the case for the 'classical' GCD models. In the present class of models, the ignition of a deflagration phase leads to a rising, burning plume of ash. The ash breaks out of the surface of the white dwarf, flows laterally around the star, and converges on the collision region at the antipodal point from where it broke out. The amount of energy released during the deflagration phase is enough to cause the star to rapidly expand, so that when the ash reaches the antipodal point, the surface density is too low to initiate a detonation. Instead, as the ash flows into the collision region (while mixing with surface fuel), the star reaches its maximally expanded state and then contracts. The stellar contraction acts to increase the density of the star, including the density in the collision region. This both raises the temperature and density of the fuel-ash mixture in the collision region and ultimately leads to thermodynamic conditions that are necessary for the Zel'dovich gradient mechanism to produce a detonation. We demonstrate feasibility of this scenario with three three-dimensional (3D), full star simulations of this model using the FLASH code. We characterized the simulations by the energy released during the deflagration phase, which ranged from 38% to 78% of the white dwarf's binding energy. We show that the necessary conditions for detonation are achieved in all three of the models.

  11. Effects of assisted and variable mechanical ventilation on cardiorespiratory interactions in anesthetized pigs.

    Science.gov (United States)

    Beda, Alessandro; Güldner, Andreas; Simpson, David M; Carvalho, Nadja C; Franke, Susanne; Uhlig, Christopher; Koch, Thea; Pelosi, Paolo; de Abreu, Marcelo Gama

    2012-03-01

    The physiological importance of respiratory sinus arrhythmia (RSA) and cardioventilatory coupling (CVC) has not yet been fully elucidated, but these phenomena might contribute to improve ventilation/perfusion matching, with beneficial effects on gas exchange. Furthermore, decreased RSA amplitude has been suggested as an indicator of impaired autonomic control and poor clinical outcome, also during positive-pressure mechanical ventilation (MV). However, it is currently unknown how different modes of MV, including variable tidal volumes (V(T)), affect RSA and CVC during anesthesia. We compared the effects of pressure controlled (PCV) versus pressure assisted (PSV) ventilation, and of random variable versus constant V(T), on RSA and CVC in eight anesthetized pigs. At comparable depth of anesthesia, global hemodynamics, and ventilation, RSA amplitude increased from 20 ms in PCV to 50 ms in PSV (p < 0.05). CVC was detected (using proportional Shannon entropy of the interval between each inspiration onset and the previous R-peak in ECG) in two animals in PCV and seven animals in PSV. Variable V(T) did not significantly influence these phenomena. Furthermore, heart period and systolic arterial pressure oscillations were in phase during PCV but in counter-phase during PSV. At the same depth of anesthesia in pigs, PSV increases RSA amplitude and CVC compared to PCV. Our data suggest that the central respiratory drive, but not the baroreflex or the mechano-electric feedback in the heart, is the main mechanism behind the RSA increase. Hence, differences in RSA and CVC between mechanically ventilated patients might reflect the difference in ventilation mode rather than autonomic impairment. Also, since gas exchange did not increase from PCV to PSV, it is questionable whether RSA has any significance in improving ventilation/perfusion matching during MV.

  12. Effects of assisted and variable mechanical ventilation on cardiorespiratory interactions in anesthetized pigs

    International Nuclear Information System (INIS)

    Beda, Alessandro; Güldner, Andreas; Carvalho, Nadja C; Franke, Susanne; Uhlig, Christopher; Koch, Thea; De Abreu, Marcelo Gama; Simpson, David M; Pelosi, Paolo

    2012-01-01

    The physiological importance of respiratory sinus arrhythmia (RSA) and cardioventilatory coupling (CVC) has not yet been fully elucidated, but these phenomena might contribute to improve ventilation/perfusion matching, with beneficial effects on gas exchange. Furthermore, decreased RSA amplitude has been suggested as an indicator of impaired autonomic control and poor clinical outcome, also during positive-pressure mechanical ventilation (MV). However, it is currently unknown how different modes of MV, including variable tidal volumes (V T ), affect RSA and CVC during anesthesia. We compared the effects of pressure controlled (PCV) versus pressure assisted (PSV) ventilation, and of random variable versus constant V T , on RSA and CVC in eight anesthetized pigs. At comparable depth of anesthesia, global hemodynamics, and ventilation, RSA amplitude increased from 20 ms in PCV to 50 ms in PSV (p < 0.05). CVC was detected (using proportional Shannon entropy of the interval between each inspiration onset and the previous R-peak in ECG) in two animals in PCV and seven animals in PSV. Variable V T did not significantly influence these phenomena. Furthermore, heart period and systolic arterial pressure oscillations were in phase during PCV but in counter-phase during PSV. At the same depth of anesthesia in pigs, PSV increases RSA amplitude and CVC compared to PCV. Our data suggest that the central respiratory drive, but not the baroreflex or the mechano-electric feedback in the heart, is the main mechanism behind the RSA increase. Hence, differences in RSA and CVC between mechanically ventilated patients might reflect the difference in ventilation mode rather than autonomic impairment. Also, since gas exchange did not increase from PCV to PSV, it is questionable whether RSA has any significance in improving ventilation/perfusion matching during MV. (paper)

  13. Role of material properties and mechanical constraint on stress-assisted diffusion in plate electrodes of lithium ion batteries

    International Nuclear Information System (INIS)

    Song Yicheng; Zhang Junqian; Shao Xianjun; Guo Zhansheng

    2013-01-01

    This work investigates the stress-assisted diffusion of lithium ions in layered electrodes of Li-ion batteries. Decoupled diffusion governing equations are obtained. Material properties, which are characterized by a single dimensionless parameter, and mechanical constraint between a current collector and an active layer, which is characterized by the elastic modulus ratio and thickness ratio between the layers, are identified as key factors that govern the stress-assisted diffusion. For a symmetric plate electrode, stress is induced by the Li-ion concentration gradient, and stress-assisted diffusion therefore depends only on the material properties. For an asymmetric bilayer electrode, mechanical constraint plays a very important role in the diffusion via generation of bending stress. Diffusion may be facilitated, or inversely impeded, according to the constraint. By summarizing the coupling factors of common active materials and investigating the concentration variation induced by stress-assisted diffusion in various electrodes, this work provides insights on stress-assisted diffusion in a layered electrode, as well as suggestions for relevant modelling works on whether the stress-assisted diffusion should be taken into account according to the selection of material and structure. (paper)

  14. Amorphization of Fe-based alloy via wet mechanical alloying assisted by PCA decomposition

    Energy Technology Data Exchange (ETDEWEB)

    Neamţu, B.V., E-mail: Bogdan.Neamtu@stm.utcluj.ro [Materials Science and Engineering Department, Technical University of Cluj-Napoca, 103-105, Muncii Avenue, 400641, Cluj-Napoca (Romania); Chicinaş, H.F.; Marinca, T.F. [Materials Science and Engineering Department, Technical University of Cluj-Napoca, 103-105, Muncii Avenue, 400641, Cluj-Napoca (Romania); Isnard, O. [Université Grenoble Alpes, Institut NEEL, F-38042, Grenoble (France); CNRS, Institut NEEL, 25 rue des martyrs, BP166, F-38042, Grenoble (France); Pană, O. [National Institute for Research and Development of Isotopic and Molecular Technologies, 65-103 Donath Street, 400293, Cluj-Napoca (Romania); Chicinaş, I. [Materials Science and Engineering Department, Technical University of Cluj-Napoca, 103-105, Muncii Avenue, 400641, Cluj-Napoca (Romania)

    2016-11-01

    used as microalloying elements which could provide the required extra amount of metalloids. - Highlights: • Amorphization of Fe{sub 75}Si{sub 20}B{sub 5} alloy via wet mechanical alloying is assisted by PCA decomposition. • Powder amorphization was not achieved even after 140 de hours of dry MA. • Wet MA using different PCA leads to powder amorphization at different MA duration. • Regardless of PCA type, contamination with 2.3 wt% C is needed for amorphization.

  15. Functional stability of cerebral circulatory system

    Science.gov (United States)

    Moskalenko, Y. Y.

    1980-01-01

    The functional stability of the cerebral circulation system seems to be based on the active mechanisms and on those stemming from specific of the biophysical structure of the system under study. This latter parameter has some relevant criteria for its quantitative estimation. The data obtained suggest that the essential part of the mechanism for active responses of cerebral vessels which maintains the functional stability of this portion of the vascular system, consists of a neurogenic component involving central nervous structures localized, for instance, in the medulla oblongata.

  16. Mechanisms of defect complex formation and environmental-assisted fracture behavior of iron aluminides

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, B.R.; Muratov, L.S.; Kang, B.S.J.; Li, K.Z. [West Virginia Univ., Morgantown, WV (United States)

    1997-12-01

    Iron aluminide has excellent corrosion resistance in high-temperature oxidizing-sulfidizing environments; however, there are problems at room and medium temperature with hydrogen embrittlement as related to exposure to moisture. In this research, a coordinated computational modeling/experimental study of mechanisms related to environmental-assisted fracture behavior of selected iron aluminides is being undertaken. The modeling and the experimental work will connect at the level of coordinated understanding of the mechanisms for hydrogen penetration and for loss of strength and susceptibility to fracture. The focus of the modeling component at this point is on the challenging question of accurately predicting the iron vacancy formation energy in Fe{sub 3}A{ell} and the subsequent tendency, if present, for vacancy clustering. The authors have successfully performed, on an ab initio basis, the first calculation of the vacancy formation energy in Fe{sub 3}A{ell}. These calculations include lattice relaxation effects which are quite large. This has significant implications for vacancy clustering effects with consequences to be explored for hydrogen diffusion. The experimental work at this stage has focused on the relationship of the choice and concentration of additives to the improvement of resistance to hydrogen embrittlement and hence to the fracture behavior. For this reason, comparative crack growth tests of FA-186, FA-187, and FA-189 iron aluminides (all with basic composition of Fe-28A{ell}-5Cr, at % with micro-alloying additives of Zr, C or B) under, air, oxygen, or water environment have been performed. These tests showed that the alloys are susceptible to room temperature hydrogen embrittlement in both B2 and DO{sub 3} conditions. Test results indicated that FA-187, and FA-189 are intrinsically more brittle than FA-186.

  17. Surfactant-assisted dispersion of carbon nanotubes: mechanism of stabilization and biocompatibility of the surfactant

    International Nuclear Information System (INIS)

    Singh, Raman Preet; Jain, Sanyog; Ramarao, Poduri

    2013-01-01

    Nanoparticles (NPs) are thermodynamically unstable system and tend to aggregate to reduce free energy. The aggregation property of NPs results in inhomogeneous exposure of cells to NPs resulting in variable cellular responses. Several types of surfactants are used to stabilize NP dispersions and obtain homogenous dispersions. However, the effects of these surfactants, per se, on cellular responses are not completely known. The present study investigated the application of Pluronic F68 (PF68) for obtaining stable dispersion of NPs using carbon nanotubes as model NPs. PF68-stabilized NP suspensions are stable for long durations and do not show signs of aggregation or settling during storage or after autoclaving. The polyethylene oxide blocks in PF68 provide steric hindrance between adjacent NPs leading to stable NP dispersions. Further, PF68 is biocompatible in nature and does not affect integrity of mitochondria, lysosomes, DNA, and nuclei. Also, PF68 neither induce free radical or cytokine production nor does it interfere with cellular uptake mechanisms. The results of the present study suggest that PF68-assisted dispersion of NPs produced suspensions, which are stable after autoclaving. Further, PF68 does not interfere with normal physiological functions suggesting its application in nanomedicine and nanotoxicity evaluation

  18. Mechanisms and clinical applications of the vacuum-assisted closure (VAC) Device: a review.

    Science.gov (United States)

    Venturi, Mark L; Attinger, Christopher E; Mesbahi, Ali N; Hess, Christopher L; Graw, Katherine S

    2005-01-01

    The use of sub-atmospheric pressure dressings, available commercially as the vacuum-assisted closure (VAC) device, has been shown to be an effective way to accelerate healing of various wounds. The optimal sub-atmospheric pressure for wound healing appears to be approximately 125 mm Hg utilizing an alternating pressure cycle of 5 minutes of suction followed by 2 minutes off suction. Animal studies have demonstrated that this technique optimizes blood flow, decreases local tissue edema, and removes excessive fluid from the wound bed. These physiologic changes facilitate the removal of bacteria from the wound. Additionally, the cyclical application of sub-atmospheric pressure alters the cytoskeleton of the cells in the wound bed, triggering a cascade of intracellular signals that increases the rate of cell division and subsequent formation of granulation tissue. The combination of these mechanisms makes the VAC device an extremely versatile tool in the armamentarium of wound healing. This is evident in the VAC device's wide range of clinical applications, including treatment of infected surgical wounds, traumatic wounds, pressure ulcers, wounds with exposed bone and hardware, diabetic foot ulcers, and venous stasis ulcers. VAC has also proven useful in reconstruction of wounds by allowing elective planning of the definitive reconstructive surgery without jeopardizing the wound or outcome. Furthermore, VAC has significantly increased the skin graft success rate when used as a bolster over the freshly skin-grafted wound. VAC is generally well tolerated and, with few contraindications or complications, is fast becoming a mainstay of current wound care.

  19. Surfactant-assisted dispersion of carbon nanotubes: mechanism of stabilization and biocompatibility of the surfactant

    Science.gov (United States)

    Singh, Raman Preet; Jain, Sanyog; Ramarao, Poduri

    2013-10-01

    Nanoparticles (NPs) are thermodynamically unstable system and tend to aggregate to reduce free energy. The aggregation property of NPs results in inhomogeneous exposure of cells to NPs resulting in variable cellular responses. Several types of surfactants are used to stabilize NP dispersions and obtain homogenous dispersions. However, the effects of these surfactants, per se, on cellular responses are not completely known. The present study investigated the application of Pluronic F68 (PF68) for obtaining stable dispersion of NPs using carbon nanotubes as model NPs. PF68-stabilized NP suspensions are stable for long durations and do not show signs of aggregation or settling during storage or after autoclaving. The polyethylene oxide blocks in PF68 provide steric hindrance between adjacent NPs leading to stable NP dispersions. Further, PF68 is biocompatible in nature and does not affect integrity of mitochondria, lysosomes, DNA, and nuclei. Also, PF68 neither induce free radical or cytokine production nor does it interfere with cellular uptake mechanisms. The results of the present study suggest that PF68-assisted dispersion of NPs produced suspensions, which are stable after autoclaving. Further, PF68 does not interfere with normal physiological functions suggesting its application in nanomedicine and nanotoxicity evaluation.

  20. A durability study of a paracorporeal pulsatile electro-mechanical pneumatic biventricular assist device.

    Science.gov (United States)

    Choi, Hyuk; Lee, Heung-Man; Nam, Kyoung Won; Choi, Jaesoon; Lee, Jung-Joo; Kim, Ho Chul; Song, Seung Joon; Ahn, Chi Bum; Son, Ho Sung; Lim, Choon Hak; Son, Kuk Hui; Park, Yong Doo; Jeong, Gi Seok; Sun, Kyung

    2011-06-01

    In 2002, the paracorporeal pulsatile electro-mechanical pneumatic ventricular assist device (VAD) began to be developed by the Korea Artificial Organ Center at Korea University under a Health & Medical Technology Research and Development program which finished in 2008. In vitro durability testing was conducted on the paracorporeal pulsatile pneumatic VAD to determine device durability and to evaluate device failures. The 1- and 2-year reliability of the paracorporeal pulsatile pneumatic VAD was shown to be 91.2% and 54.9%, respectively, with an 80% confidence level. Failure modes were analyzed using fault tree analysis, with customized software continuously acquiring data during the test period. After this period, 21 in vivo animal tests were done, with 14 cases of left atrium to left ventricle (LV) inflow cannulation (36Fr)/outflow grafting to descending aorta, and seven cases of apex cannulation of LV to descending aorta (12 mm). The longest postoperative day (182 days) in Korea was recently recorded in in vivo animal testing (bovine, 90 kg, male, 3.5-4.0 L/min flow rate, and 55 bpm). © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  1. [Risk factors for presence of complications of the mechanical ventilatory assistance in the newborn].

    Science.gov (United States)

    Tapia-Rombo, Carlos Antonio; Domínguez-Martínez, Rosalba; Saucedo-Zavala, Victor Joel; Cuevas-Urióstegui, Maria Luisa

    2004-01-01

    The mechanical ventilatory assistance (MVA) is a procedure that is used very often in the neonatal intensive care units but its use its linked to a lot of complications. The objective of this study was to determine the risk factors for the presence of complications of the MVA in the newborns infants. One hundred thirty five medical records from January 98 to June 2000 of newborns that had been discharged by amelioration or death were reviewed retrospectively. All of them had been received MVA; twenty medical record were excluded. They were divided in two groups: group A, neonates that had presented complications during MVA, composed of 40 patients (cases) and B, neonates with MVA, but that had not presented complications due to the procedure of 75 patients (controls). In group A there were 39 preterm neonates and in B, 58 preterm neonates, the rest were term neonates. It was used descriptive and inferential statistics. Odds ratio (OR) and multivariate analysis were used to study risk factors with confidence interval (CI) of 95%. Statistical significance was considered at p newborn patients critically ill, with low birth weight, low gestational age, with RDS, who need more ventilatory support will be more liable to have complications and, as consequence, the mortality will be increased. For this reason it is essential a close monitoring of this group of patients for not over supporting them in IOF, PIP and cycles, thus avoiding as far as possible, the complications of the MVA.

  2. Surfactant-assisted dispersion of carbon nanotubes: mechanism of stabilization and biocompatibility of the surfactant

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Raman Preet, E-mail: ramanpreetsingh@hotmail.com [Evalueserve SEZ (Gurgaon) Pvt. Ltd. (India); Jain, Sanyog [National Institute of Pharmaceutical Education and Research, Centre for Pharmaceutical Nanotechnology, Department of Pharmaceutics (India); Ramarao, Poduri, E-mail: ramaraop@yahoo.com [Central University of Punjab, School of Basic and Applied Sciences (India)

    2013-10-15

    Nanoparticles (NPs) are thermodynamically unstable system and tend to aggregate to reduce free energy. The aggregation property of NPs results in inhomogeneous exposure of cells to NPs resulting in variable cellular responses. Several types of surfactants are used to stabilize NP dispersions and obtain homogenous dispersions. However, the effects of these surfactants, per se, on cellular responses are not completely known. The present study investigated the application of Pluronic F68 (PF68) for obtaining stable dispersion of NPs using carbon nanotubes as model NPs. PF68-stabilized NP suspensions are stable for long durations and do not show signs of aggregation or settling during storage or after autoclaving. The polyethylene oxide blocks in PF68 provide steric hindrance between adjacent NPs leading to stable NP dispersions. Further, PF68 is biocompatible in nature and does not affect integrity of mitochondria, lysosomes, DNA, and nuclei. Also, PF68 neither induce free radical or cytokine production nor does it interfere with cellular uptake mechanisms. The results of the present study suggest that PF68-assisted dispersion of NPs produced suspensions, which are stable after autoclaving. Further, PF68 does not interfere with normal physiological functions suggesting its application in nanomedicine and nanotoxicity evaluation.

  3. Anchoring in Destination-Therapy Left Ventricular Assist Device Decision Making: A Mechanical Turk Survey.

    Science.gov (United States)

    Paine, Arcadia M; Allen, Larry A; Thompson, Jocelyn S; McIlvennan, Colleen K; Jenkins, Amy; Hammes, Andrew; Kroehl, Miranda; Matlock, Daniel D

    2016-11-01

    People with end-stage heart failure may have to decide about destination-therapy left ventricular assist device (DT-LVAD). Individuals facing difficult decisions often rely on heuristics, such as anchoring, which predictably bias decision outcomes. We aimed to investigate whether showing a larger historical Heartmate XVE creates an anchoring effect, making the smaller Heartmate II (HMII) appear more favorable. With the use of Amazon Mechanical Turk, participants watched videos asking them to imagine themselves dying of end-stage heart failure, then were presented the option of LVAD as potentially life-prolonging therapy. Participants were randomized to a control group who were only shown the HMII device, and the intervention group who saw the XVE device before the HMII. Participants then completed surveys. A total of 487 participants completed the survey (control = 252; intervention = 235); 79% were affect likelihood of accepting the LVAD, it did affect device perception. This article highlights an important point with clinical implications: factors such as anchoring have the potential to inappropriately influence perceptions and decisions and should be carefully considered in research and practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Risk assessment and comparative effectiveness of left ventricular assist device and medical management in ambulatory heart failure patients: design and rationale of the ROADMAP clinical trial.

    Science.gov (United States)

    Rogers, Joseph G; Boyle, Andrew J; O'Connell, John B; Horstmanshof, Douglas A; Haas, Donald C; Slaughter, Mark S; Park, Soon J; Farrar, David J; Starling, Randall C

    2015-02-01

    Mechanical circulatory support is now a proven therapy for the treatment of patients with advanced heart failure and cardiogenic shock. The role for this therapy in patients with less severe heart failure is unknown. The objective of this study is to examine the impact of mechanically assisted circulation using the HeartMate II left ventricular assist device in patients who meet current US Food and Drug Administration-defined criteria for treatment but are not yet receiving intravenous inotropic therapy. This is a prospective, nonrandomized clinical trial of 200 patients treated with either optimal medical management or a mechanical circulatory support device. This trial will be the first prospective clinical evaluation comparing outcomes of patients with advanced ambulatory heart failure treated with either ongoing medical therapy or a left ventricular assist device. It is anticipated to provide novel insights regarding relative outcomes with each treatment and an understanding of patient and provider acceptance of the ventricular assist device therapy. This trial will also provide information regarding the risk of events in "stable" patients with advanced heart failure and guidance for the optimal timing of left ventricular assist device therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Left Ventricular Assist Devices: The Adolescence of a Disruptive Technology.

    Science.gov (United States)

    Pinney, Sean P

    2015-10-01

    Clinical outcomes for patients with advanced heart failure receiving left ventricular assist devices are driven by appropriate patient selection, refined surgical technique, and coordinated medical care. Perhaps even more important is innovative pump design. The introduction and widespread adoption of continuous-flow ventricular assist devices has led to a paradigm shift within the field of mechanical circulatory support, making the promise of lifetime device therapy closer to reality. The disruption caused by this new technology, on the one hand, produced meaningful improvements in patient survival and quality of life, but also introduced new clinical challenges, such as bleeding, pump thrombosis, and acquired valvular heart disease. Further evolution within this field will require financial investment to sustain innovation leading to a fully implantable, durable, and cost-effective pump for a larger segment of patients with advanced heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. The coercivity mechanism of Pr–Fe–B nanoflakes prepared by surfactant-assisted ball milling

    Energy Technology Data Exchange (ETDEWEB)

    Zuo, Wen-Liang, E-mail: wlzuo@iphy.ac.cn; Zhang, Ming; Niu, E.; Shao, Xiao-Ping; Hu, Feng-Xia; Sun, Ji-Rong; Shen, Bao-Gen, E-mail: shenbg@aphy.iphy.ac.cn

    2015-09-15

    The strong (00l) textured Pr{sub 12+x}Fe{sub 82−x}B{sub 6} (x=0, 1, 2, 3, 4) nanoflakes with high coercivity were prepared by surfactant-assisted ball milling (SABM). The thickness and length of the flakes are mainly in the range of 50−200 nm and 0.5−2 μm, respectively. A coercivity of 4.16 kOe for Pr{sub 15}Fe{sub 79}B{sub 6} nanoflakes was obtained, which is the maximum coercivity of R{sub 2}Fe{sub 14}B (R=Pr, Nd) nanoflakes or nanoparticles reported up to now. The results of XRD and SEM for the aligned Pr{sub 15}Fe{sub 79}B{sub 6} nanoflakes indicate that a strong (00l) texture is obtained and the easy magnetization direction is parallel to the surface of the flakes. The angular dependence of coercivity for aligned sample indicates that the coercivity mechanism of the as-milled nanoflakes is mainly dominated by domain wall pinning. Meanwhile, the field dependence of coercivity, isothermal (IRM) and dc demagnetizing (DCD) remanence curves also indicate that the coercivity is mainly determined by domain wall pinning, and nucleation also has an important effect. In addition, the mainly interaction of flakes is dipolar coupling. The research of coercivity mechanism for Pr{sub 15}Fe{sub 79}B{sub 6} nanoflakes is important for guidance the further increase its value, and is useful for the future development of the high performance nanocomposite magnets and soft/hard exchange spring magnets. - Highlights: • A coercivity of 4.16 kOe for Pr{sub 15}Fe{sub 79}B{sub 6} nanoflakes was obtained. • The strong (00l) textured is obtained for Pr{sub 15}Fe{sub 79}B{sub 6} nanoflakes. • The interaction of nanoflakes is mainly dipolar coupling. • Domain wall pinning is the mainly coercivity mechanism.

  7. Mass Transport: Circulatory System with Emphasis on Nonendothermic Species.

    Science.gov (United States)

    Crossley, Dane A; Burggren, Warren W; Reiber, Carl L; Altimiras, Jordi; Rodnick, Kenneth J

    2016-12-06

    Mass transport can be generally defined as movement of material matter. The circulatory system then is a biological example given its role in the movement in transporting gases, nutrients, wastes, and chemical signals. Comparative physiology has a long history of providing new insights and advancing our understanding of circulatory mass transport across a wide array of circulatory systems. Here we focus on circulatory function of nonmodel species. Invertebrates possess diverse convection systems; that at the most complex generate pressures and perform at a level comparable to vertebrates. Many invertebrates actively modulate cardiovascular function using neuronal, neurohormonal, and skeletal muscle activity. In vertebrates, our understanding of cardiac morphology, cardiomyocyte function, and contractile protein regulation by Ca2+ highlights a high degree of conservation, but differences between species exist and are coupled to variable environments and body temperatures. Key regulators of vertebrate cardiac function and systemic blood pressure include the autonomic nervous system, hormones, and ventricular filling. Further chemical factors regulating cardiovascular function include adenosine, natriuretic peptides, arginine vasotocin, endothelin 1, bradykinin, histamine, nitric oxide, and hydrogen sulfide, to name but a few. Diverse vascular morphologies and the regulation of blood flow in the coronary and cerebral circulations are also apparent in nonmammalian species. Dynamic adjustments of cardiovascular function are associated with exercise on land, flying at high altitude, prolonged dives by marine mammals, and unique morphology, such as the giraffe. Future studies should address limits of gas exchange and convective transport, the evolution of high arterial pressure across diverse taxa, and the importance of the cardiovascular system adaptations to extreme environments. © 2017 American Physiological Society. Compr Physiol 7:17-66, 2017. Copyright © 2017 John

  8. Circulatory Arrest: A Surgical Option for Adult Window Ductus Closure

    Directory of Open Access Journals (Sweden)

    Vithalkumar Malleshi Betigeri

    2012-03-01

    Full Text Available The window ductus , an atypical type of patent ductus arteriosus(PDA is a characteristically large in size(>2cm with no recognizable length, characteristic continuation of main pulmonary artery with aortic arch and absence of internal ductal tissue. Surgical safety and effectiveness of its closure can be increased by using cardiopulmonary bypass (CPB and hypothermic total circulatory arrest (HTCA via median sternotomy.

  9. Modeling the heart and the circulatory system

    CERN Document Server

    2015-01-01

    The book comprises contributions by some of the most respected scientists in the field of mathematical modeling and numerical simulation of the human cardiocirculatory system. The contributions cover a wide range of topics, from the preprocessing of clinical data to the development of mathematical equations, their numerical solution, and both in-vivo and in-vitro validation. They discuss the flow in the systemic arterial tree and the complex electro-fluid-mechanical coupling in the human heart. Many examples of patient-specific simulations are presented. This book is addressed to all scientists interested in the mathematical modeling and numerical simulation of the human cardiocirculatory system.

  10. Multidisciplinary approach to radiation late effects in the brain circulatory system: First results

    International Nuclear Information System (INIS)

    Keyeux, A.J.M.; Reinhold, H.S.; Gerber, G.B.; Maisin, J.R.; Reyners, H.; Gianfelici de Reyners, E.; Calvo, W.

    1976-01-01

    Although acute vascular damage and the early functional impairment of the central nervous system has been studied relatively frequently, the pathophysiological mechanisms of late radiation effects and their relevance to vascular damage, are less well investigated and are poorly understood. As the possibility of later radiation damage is a factor which limits the therapist in the radiation dose, he can give to effect a local tumour cure, it is essential that the mechanisms and importance of vascular irradiation damage be determined before late effects can either be treated or avoided. In view of the inconclusive results obtained by previous authors, it was felt that a multidisciplinary approach might better be suited to solve this problem. Thus, in 1973 a research project was initiated by EULEP to investigate the origins and consequences of radiation induced vascular changes after local irradiation of the brain. In this preliminary report, data on morphological, circulatory and biochemical parameters are presented and discussed. (GC)

  11. U arm type x-ray radiograph system for circulatory system

    International Nuclear Information System (INIS)

    Kiuchi, Shigeo; Kaga, Yuji; Sato, Masami; Komatsuda, Yasushi; Nishio, Kosaku.

    1979-01-01

    This report is concerned with the function and usefulness of U arm type X-ray radiograph system for circulatory system jointly developed by Yamagata University and Toshiba Medical Co., Ltd. The system was used 560 times in 2 years mostly for cinephotography. It has such features as follows: (1) The compound oblique position radiography mechanism of U arm is useful for the separative radiography around coronary artery. (2) The mechanism of U arm is very quick in photographing with fluoroscopy. (3) Very sharp II indirect biplane photographs without obscurity due to enlarging can be taken. (4) An operator can position objects readily by operating a sterilizing switch. (5) Both short time photographing of 1 m sec and high speed repeated photographing of 12 times/sec can be made with the photo timer. (6) The fog due to mutual scattering in RSC biplane photographing can be removed by II blanking method. (Kobatake, H.)

  12. High speed phototimer and biplane II blanking method in 105 mm RSC photographing of circulatory system

    International Nuclear Information System (INIS)

    Kaga, Yuji; Kiuchi, Shigeo; Sato, Masami; Komatsuda, Yasushi; Nishio, Kosaku.

    1979-01-01

    A high speed phototimer as an autoexposure mechanism was developed for 105 mm II indirect continuous photographing of circulatory system. The phototimer can give repeated response of 12 times/sec and the shortest X-ray shut out of 1 m sec. The proper lighting field for the phototimer is 7 mm diameter (12%) of the II input area, equivalent to 80 mm in diameter), and the tube voltage, object property and the focus-II distance characteristics are all well corrected to give good photographs of optimal density. The mutual fog in biplane photographing can be removed by adopting II blanking method. As blanking can respond quite rapidly, photographing time plus 2 m sec is enough for blanking time. That means the positive phase can be brought close to 3 m sec. This mechanism can be applied for biplane cine-photographing. (Kobatake, H.)

  13. Circulatory nucleosome levels are significantly increased in early and late-onset preeclampsia.

    Science.gov (United States)

    Zhong, Xiao Yan; Gebhardt, Stefan; Hillermann, Renate; Tofa, Kashefa Carelse; Holzgreve, Wolfgang; Hahn, Sinuhe

    2005-08-01

    Elevations in circulatory DNA, as measured by real-time PCR, have been observed in pregnancies with manifest preeclampsia. Recent reports have indicated that circulatory nucleosome levels are elevated in the periphery of cancer patients. We have now examined whether circulatory nucleosome levels are similarly elevated in cases with preeclampsia. Maternal plasma samples were prepared from 17 cases with early onset preeclampsia (34 weeks gestation) with 10 matched normotensive controls. Levels of circulatory nucleosomes were quantified by commercial ELISA (enzyme-linked immunosorbant assay). The level of circulatory nucleosomes was significantly elevated in both study preeclampsia groups, compared to the matched normotensive control group (p = 0.000 and p = 0.001, respectively). Our data suggests that preeclampsia is associated with the elevated presence of circulatory nucleosomes, and that this phenomenon occurs in both early- and late-onset forms of the disorder. Copyright 2005 John Wiley & Sons, Ltd.

  14. Factors influencing the outcome of paediatric cardiac surgical patients during extracorporeal circulatory support

    Directory of Open Access Journals (Sweden)

    Peek Giles J

    2007-01-01

    Full Text Available Abstract Background Veno-arterial extracorporeal membrane oxygenation (ECMO is a common modality of circulatory assist device used in children. We assessed the outcome of children who had ECMO following repair of congenital cardiac defects (CCD and identified the risk factors associated with hospital mortality. Methods From April 1990 to December 2003, 53 patients required ECMO following surgical correction of CCD. Retrospectively collected data was analyzed with univariate and multivariate logistic regression analysis. Results Median age and weight of the patients were 150 days and 5.4 kgs respectively. The indications for ECMO were low cardiac output in 16, failure to wean cardiopulmonary bypass in 13, cardiac arrest in 10 and cardio-respiratory failure in 14 patients. The mean duration of ECMO was 143 hours. Weaning off from ECMO was successful in 66% and of these 83% were survival to hospital-discharge. 37.7% of patients were alive for the mean follow-up period of 75 months. On univariate analysis, arrhythmias, ECMO duration >168 hours, bleeding complications, renal replacement therapy on ECMO, arrhythmias and cardiac arrest after ECMO were associated with hospital mortality. On multivariate analysis, abnormal neurology, bleeding complications and arrhythmias after ECMO were associated with hospital mortality. Extra and intra-thoracic cannulations were used in 79% and 21% of patients respectively and extra-thoracic cannulation had significantly less bleeding complications (p = 0.031. Conclusion ECMO provides an effective circulatory support following surgical repair of CCD in children. Extra-thoracic cannulation is associated with less bleeding complications. Abnormal neurology, bleeding complications on ECMO and arrhythmias after ECMO are poor prognostic indicators for hospital survival.

  15. Reversal mechanisms and interactions in magnetic systems: coercivity versus switching field and thermally assisted demagnetization

    Directory of Open Access Journals (Sweden)

    Cebollada, F.

    2005-06-01

    Full Text Available In this paper we present a comparative analysis of the magnetic interactions and reversal mechanisms of two different systems: NdFeB-type alloys with grain sizes in the single domain range and Fe-SiO2 nanocomposites with Fe concentrations above and below the percolation threshold. We evidence that the use of the coercivity as the main parameter to analyse them might be misleading due to the convolution of both reversible and irreversible magnetization variations. We show that the switching field and thermally assisted demagnetization allow a better understanding of these mechanisms since they involve just irreversible magnetization changes. Specifically, the experimental analysis of the coercivity adquisition process for the NdFeB-type system suggests that the magnetization reversal is nucleated at the spin misalignments present due to intergranular exchange interactions. On the other hand, the study of the magnetic viscosity and of the isothermal remanent magnetization (IRM and direct field demagnetization (DCD remanence curves indicates that the dipolar interactions are responsible for the propagation of the switching started at individual particles.

    En este artículo presentamos un análisis comparativo de la influencia de la microestructura a través de las interacciones magnéticas en los mecanismos de inversión de la magnetización en dos sistemas diferentes: aleaciones tipo NdFeB con tamaños de grano en el rango de monodominio y nanocompuestos de Fe-SiO2 con concentraciones de Fe tanto por encima como por debajo del umbral de percolación. Ponemos de manifiesto que el uso del campo coercitivo como parámetro de análisis puede llevar a equívocos debido a la coexistencia de variaciones reversibles e irreversibles de la magnetización. También mostramos que el campo de conmutación y la desimanación térmicamente asistida permiten una mejor comprensión de dichos mecanismos ya que reflejan exclusivamente cambios irreversibles de

  16. [Cerebral oximetry in pulmonary thromboendarterectomy with circulatory arrest].

    Science.gov (United States)

    Catalán Escudero, P; González Román, A; Serra Ruiz, C N; Barbero Mielgo, M; García Fernández, J

    2014-02-01

    Pulmonary thromboendarterectomy is an uncommon procedure and should be performed with circulatory arrest. One of the major concerns is the postoperative central neurological injuries. Perioperative brain oxygen monitoring is advisable in this surgical procedure for the early detection of brain hypoperfusion episodes and their intensity as well as any other postoperative episodes that can deteriorate the neurological outcome. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  17. Influences of Duration of Inspiratory Effort, Respiratory Mechanics, and Ventilator Type on Asynchrony With Pressure Support and Proportional Assist Ventilation.

    Science.gov (United States)

    Vasconcelos, Renata S; Sales, Raquel P; Melo, Luíz H de P; Marinho, Liégina S; Bastos, Vasco Pd; Nogueira, Andréa da Nc; Ferreira, Juliana C; Holanda, Marcelo A

    2017-05-01

    Pressure support ventilation (PSV) is often associated with patient-ventilator asynchrony. Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. The objective of this study was to evaluate the influence of respiratory mechanics and patient effort on patient-ventilator asynchrony during PSV and PAV plus (PAV+). We used a mechanical lung simulator and studied 3 respiratory mechanics profiles (normal, obstructive, and restrictive), with variations in the duration of inspiratory effort: 0.5, 1.0, 1.5, and 2.0 s. The Auto-Trak system was studied in ventilators when available. Outcome measures included inspiratory trigger delay, expiratory trigger asynchrony, and tidal volume (V T ). Inspiratory trigger delay was greater in the obstructive respiratory mechanics profile and greatest with a effort of 2.0 s (160 ms); cycling asynchrony, particularly delayed cycling, was common in the obstructive profile, whereas the restrictive profile was associated with premature cycling. In comparison with PSV, PAV+ improved patient-ventilator synchrony, with a shorter triggering delay (28 ms vs 116 ms) and no cycling asynchrony in the restrictive profile. V T was lower with PAV+ than with PSV (630 mL vs 837 mL), as it was with the single-limb circuit ventilator (570 mL vs 837 mL). PAV+ mode was associated with longer cycling delays than were the other ventilation modes, especially for the obstructive profile and higher effort values. Auto-Trak eliminated automatic triggering. Mechanical ventilation asynchrony was influenced by effort, respiratory mechanics, ventilator type, and ventilation mode. In PSV mode, delayed cycling was associated with shorter effort in obstructive respiratory mechanics profiles, whereas premature cycling was more common with longer effort and a restrictive profile. PAV+ prevented premature cycling but not delayed cycling, especially in obstructive respiratory mechanics

  18. A cholinergic contribution to the circulatory responses evoked at the onset of handgrip exercise in humans

    DEFF Research Database (Denmark)

    Vianna, Lauro C; Fadel, Paul J; Secher, Niels H

    2015-01-01

    A cholinergic (muscarinic) contribution to the initial circulatory response to exercise in humans remains controversial. Herein, we posit that this may be due to exercise mode with a cholinergic contribution being important during isometric handgrip exercise, where the hyperemic response......-induced fall in SVR and, thereby, augmented the pressor response (+13 ± 3 mmHg at 10 s; P exercise. These findings suggest that a cholinergic mechanism is important for the BP...... resistance (SVR) in young healthy males, while performing either 20 s of isometric handgrip contraction at 40% maximum voluntary contraction (protocol 1; n = 9) or 20 s of low-intensity leg cycling exercise (protocol 2; n = 8, 42 ± 8 W). Exercise trials were conducted under control (no drug) conditions...

  19. Contrasting Grading Approaches in Introductory Physics and Quantum Mechanics: The Case of Graduate Teaching Assistants

    Science.gov (United States)

    Marshman, Emily; Sayer, Ryan; Henderson, Charles; Singh, Chandralekha

    2017-01-01

    At large research universities, physics graduate teaching assistants (TAs) are often responsible for grading in courses at all levels. However, few studies have focused on TAs' grading practices in introductory and advanced physics courses. This study was designed to investigate whether physics graduate TAs grade students in introductory physics…

  20. Angiographic examinations of the circulatory development of living chick embryos

    International Nuclear Information System (INIS)

    Stoeter, P.; Buchhoecker, M.; Bruzek, W.; Drews, U.; Schulze, K.; Tuebingen Univ.; Tuebingen Univ.

    1980-01-01

    In chick embryos of an age of incubation of 5-14 days, the physiological development of the circulation and the morphological differentation of the arterical system were studied by intravital and postmortal angiography. For the examinations of the living embryos, a special radiographic and injection technique had to be developed. The contrast medium was injected into the umbilical veins and transported by the actions of the embryonic heart. Continuous ECG recordings showed no marked interference of the injections with the cardiac activity. According to the angiographic findings, the circulation is relatively fast within the main arteries, but the capillary perfusion is prolonged and lasts up to several minutes. The average circulatory velocity of the blood stream within the carotid artery increases parallel to the arterial enlargement, whereas the circulatory time decreases and the number of heart beats during the period of carotid opacification does not change to a great extent. By this, a steady transport of gas and nutritional material may be achieved in the growing arterial system. (orig.) [de

  1. The Achilles' heel of left ventricular assist device therapy: right ventricle.

    Science.gov (United States)

    Ranganath, Neel K; Smith, Deane E; Moazami, Nader

    2018-06-01

    Many patients suffer from either persistent right ventricular failure (RVF) at the time of left ventricular assist device (LVAD) or have ongoing symptoms consistent with RVF during chronic mechanical circulatory support. The lack of long-term right ventricular assist devices (RVADs) has limited the impact that mechanical circulatory support can provide to patients with biventricular failure. We aim to review the entire spectrum of RVF in patients receiving LVADs and reflect on why this entity remains the Achilles' heel of LVAD therapy. In the early postoperative period, LVAD implantation reduces right ventricle (RV) afterload, but RV dysfunction may be exacerbated secondary to increased venous return. With prolonged therapy, the decreased RV afterload leads to improved RV contractile function. Bayesian statistical models outperform previously published preoperative risk scores by considering inter-relationships and conditional probabilities amongst independent variables. Various echocardiographic parameters and the pulmonary artery pulsatility index have shown promise in predicting post-LVAD RVF. Recent publications have delineated the emergence of 'delayed' RVF. Several devices are currently being investigated for use as RVADs. Post-LVAD RVF depends on the RV's ability to adapt to acute hemodynamic changes imposed by the LVAD. Management options are limited due to the lack of an easily implantable, chronic-use RVAD.

  2. Plasma Assisted Ignition and Combustion at Low Initial Gas Temperatures: Development of Kinetic Mechanism

    Science.gov (United States)

    2016-10-05

    R and Pouvesle J M 2009 Experimental study of a compact nanosecond plasma gun Plasma Processes and Polymers 6 795—802 [11] Heinlin J, Morfill G...radially symmetrical geometry. The thickness of the plasma layer in the direction perpendicular to the dielectric plane is about 1 mm. The central coaxial ...Positive and negative polarity discharge at elevated pres- sures Discharge in coaxial geometry has been developed for plasma assisted ignition at high

  3. Employee assistance programmes as mechanism for enhancing performance at Emfuleni Local Municipality / Stilalla Paulus Mosia

    OpenAIRE

    Mosia, Stilalla Paulus

    2007-01-01

    The role of local government is to ensure that all citizens have access to the basic services. Thus, the Emfuleni Local Municipality has the Constitutional obligation to provide an effective and efficient people-centered administration that will ensure quality and sustainable service delivery. The Emfuleni Local Municipality (ELM) tends to have a culture of non-performance or low service delivery which is prevalent amongst employees or personnel. Employee Assistance Programme (EAP) is the ...

  4. Sizable variations in circulatory disease mortality by region and country of birth in six European countries

    DEFF Research Database (Denmark)

    Rafnsson, Snorri B; Bhopal, Raj S; Agyemang, Charles

    2013-01-01

    BACKGROUND: Circulatory disease mortality inequalities by country of birth (COB) have been demonstrated for some EU countries but pan-European analyses are lacking. We examine inequalities in circulatory mortality by geographical region/COB for six EU countries. METHODS: We obtained national deat...

  5. External validation of prediction models for time to death in potential donors after circulatory death

    NARCIS (Netherlands)

    Kotsopoulos, A.M.M.; Böing-Messing, F.; Jansen, N.E.; Vos, P.; Abdo, W.F.

    2018-01-01

    Predicting time to death in controlled donation after circulatory death (cDCD) donors following withdrawal of life‐sustaining treatment (WLST) is important but poses a major challenge. The aim of this study is to determine factors predicting time to circulatory death within 60 minutes after WSLT and

  6. Application of a user-friendly comprehensive circulatory model for estimation of hemodynamic and ventricular variables

    NARCIS (Netherlands)

    Ferrari, G.; Kozarski, M.; Gu, Y. J.; De Lazzari, C.; Di Molfetta, A.; Palko, K. J.; Zielinski, K.; Gorczynska, K.; Darowski, M.; Rakhorst, G.

    2008-01-01

    Purpose: Application of a comprehensive, user-friendly, digital computer circulatory model to estimate hemodynamic and ventricular variables. Methods: The closed-loop lumped parameter circulatory model represents the circulation at the level of large vessels. A variable elastance model reproduces

  7. Ghost peaks observed after atmospheric pressure matrix-assisted laser desorption/ionization experiments may disclose new ionization mechanism of matrix-assisted hypersonic velocity impact ionization.

    Science.gov (United States)

    Moskovets, Eugene

    2015-08-30

    Understanding the mechanisms of matrix-assisted laser desorption/ionization (MALDI) promises improvements in the sensitivity and specificity of many established applications in the field of mass spectrometry. This paper reports a serendipitous observation of a significant ion yield in a post-ionization experiment conducted after the sample had been removed from a standard atmospheric pressure (AP)-MALDI source. This post-ionization is interpreted in terms of collisions of microparticles moving with a hypersonic velocity into a solid surface. Calculations show that the thermal energy released during such collisions is close to that absorbed by the top matrix layer in traditional MALDI. The microparticles, containing both the matrix and analytes, could be detached from a film produced inside the inlet capillary during the sample ablation and accelerated by the flow rushing through the capillary. These observations contribute some new perspective to ion formation in both laser and laser-less matrix-assisted ionization. An AP-MALDI ion source hyphenated with a three-stage high-pressure ion funnel system was utilized for peptide mass analysis. After the laser had been turned off and the MALDI sample removed, ions were detected during a gradual reduction of the background pressure in the first funnel. The constant-rate pressure reduction led to the reproducible appearance of different singly and doubly charged peptide peaks in mass spectra taken a few seconds after the end of the MALDI analysis of a dried-droplet spot. The ion yield as well as the mass range of ions observed with a significant delay after a completion of the primary MALDI analysis depended primarily on the background pressure inside the first funnel. The production of ions in this post-ionization step was exclusively observed during the pressure drop. A lower matrix background and significant increase in relative yield of double-protonated ions are reported. The observations were partially consistent

  8. Numerical Models of Human Circulatory System under Altered Gravity: Brain Circulation

    Science.gov (United States)

    Kim, Chang Sung; Kiris, Cetin; Kwak, Dochan; David, Tim

    2003-01-01

    A computational fluid dynamics (CFD) approach is presented to model the blood flow through the human circulatory system under altered gravity conditions. Models required for CFD simulation relevant to major hemodynamic issues are introduced such as non-Newtonian flow models governed by red blood cells, a model for arterial wall motion due to fluid-wall interactions, a vascular bed model for outflow boundary conditions, and a model for auto-regulation mechanism. The three-dimensional unsteady incompressible Navier-Stokes equations coupled with these models are solved iteratively using the pseudocompressibility method and dual time stepping. Moving wall boundary conditions from the first-order fluid-wall interaction model are used to study the influence of arterial wall distensibility on flow patterns and wall shear stresses during the heart pulse. A vascular bed modeling utilizing the analogy with electric circuits is coupled with an auto-regulation algorithm for multiple outflow boundaries. For the treatment of complex geometry, a chimera overset grid technique is adopted to obtain connectivity between arterial branches. For code validation, computed results are compared with experimental data for steady and unsteady non-Newtonian flows. Good agreement is obtained for both cases. In sin-type Gravity Benchmark Problems, gravity source terms are added to the Navier-Stokes equations to study the effect of gravitational variation on the human circulatory system. This computational approach is then applied to localized blood flows through a realistic carotid bifurcation and two Circle of Willis models, one using an idealized geometry and the other model using an anatomical data set. A three- dimensional anatomical Circle of Willis configuration is reconstructed from human-specific magnetic resonance images using an image segmentation method. The blood flow through these Circle of Willis models is simulated to provide means for studying gravitational effects on the brain

  9. The phonon-assisted tunneling mechanism of conduction in ZnO nanowires and films

    International Nuclear Information System (INIS)

    Pipinys, Povilas; Ohlckers, Per

    2010-01-01

    The phonon-assisted tunneling (PhAT) model is applied for an explanation of the conductivity dependence on temperature and temperature-dependent I-V characteristics measured by other investigators for zinc oxide (ZnO) nanowires and films. Our proposed model describes well not only conductivity dependence on temperature measured in a wide temperature range, but also temperature-dependent I-V data using the same set of parameters characterizing the material under investigation. The values of active phonons energy are estimated from a fit of the conductivity dependence to temperature data with the PhAT theory.

  10. Spectral line intensity irreversibility in circulatory plasma magnetization processes

    Science.gov (United States)

    Qu, Z. Q.; Dun, G. T.

    2012-01-01

    Spectral line intensity variation is found to be irreversible in circulatory plasma magnetization process by experiments described in this paper, i.e., the curves illustrating spectral line photon fluxes irradiated from a light source immerged in a magnetic field by increasing the magnetic induction cannot be reproduced by decreasing the magnetic induction within the errors. There are two plasma magnetization patterns found. One shows that the intensities are greater at the same magnetic inductions during the magnetic induction decreasing process after the increasing, and the other gives the opposite effect. This reveals that the magneto-induced excitation and de-excitation process is irreversible like ferromagnetic magnetization. But the two irreversible processes are very different in many aspects stated in the text.

  11. Pathophysiology of cerebral circulatory disorders in idiopathic normal pressure hydrocephalus

    International Nuclear Information System (INIS)

    Takeuchi, Totaro; Goto, Hiromi; Izaki, Kenji

    2007-01-01

    This study was conducted to elucidate the pathologic conditions of cerebral circulatory disorders in idiopathic normal pressure hydrocephalus (iNPH). Among 44 possible iNPH patients, 40 patients underwent shunt surgery based on diagnostic flow charts plotted by the Southern Tohoku method and were evaluated to be shunt-effective at the end of the first post-surgical month. The cerebral blood flow (CBF) was measured by N-isopropyl-( 123 I)-P-iodo-amphetamine single photon emission computed tomography (mean, mCBF; cortical region, cCBF; thalamus-basal ganglia region, tbCBF on autoradiography [ARG] method) and the perfusion patterns of the cerebral cortex were measured based on three-dimensional stereotactic surface projection (3D-SSP) Z-score images, before and 1 month after the surgery in all 40 subjects. The mCBF rose significantly from 32.1±2.74 ml/100 g/min before surgery to 39.8±3.02 ml/100 g/min after surgery (p<0.03). Investigation of the change of CBF revealed reductions in the cCBF (3 cases), tbCBF (9 cases), and cCBF+tbCBF (28 cases), with the reduced-cCBF group totaling 31 cases and the reduced-tbCBF group totaling 37 cases. Investigation of cerebral cortex hypoperfusion by 3D-SSP Z-score revealed 31 cases with hypoperfusion (frontal lobe type [19 cases], occipitotemporal lobe type [5 cases], mixed type [7 cases]) and nine cases with cortical normoperfusion (N). The pattern of reduction of the cortical blood flow on ARG method was favorably correlated with the pattern of hypoperfusion of the cerebral cortex on 3D-SSP Z-score images before surgery. A reduction of blood flow was found in the thalamus-basal ganglia region of all N type cases. The blood flow improved in 19 of 31 (61.3%) cases of the reduced-cCBF group and in 32 of 37 (86.5%) cases of the reduced-tbCBF group. All of the cases without detectable improvement exhibited increased blood flow in non-reduction areas. Investigation of the hypoperfusion patterns of the cerebral cortex on 3D-SSP Z

  12. Peripheral Circulatory Features during High-Frequency Jet Ventilation

    Directory of Open Access Journals (Sweden)

    M. B. Kontorovich

    2010-01-01

    Full Text Available The paper gives the results of a study of peripheral circulatory features during high-frequency jet ventilation (HFJV. The main specific features of peripheral circulation and oxygen transport during HFJV are formulated on the basis of a study of cardiac output (impedance cardiography, peripheral vascular resistance, peripheral vascular blood filling (photoplethysmogram analysis, adaptive peripheral blood flow reactions (spectral analysis of peripheral vascular pulsation. HFJV gives rise to the peculiar pattern of peripheral hemodynamics and tissue gas exchange, which is characterized by higher oxygen uptake without a decrease in mixed venous blood saturation, with normal extraction coefficient and preserved low peripheral vascular resistance. During HFJV, unlike traditional ventilation, the main peripheral hemodynamic feature is the increased capillary bed blood volume caused by the blood flow involvement of reserve capillaries under control of volume (parasympathetic regulation of adaptive peripheral hemodynamic reactions. Key words: high-frequency jet ventilation, oxygen transport, peripheral hemodynamics.

  13. Intraoperative care for aortic surgery using circulatory arrest.

    Science.gov (United States)

    Fernández Suárez, Félix Ezequiel; Fernández Del Valle, David; González Alvarez, Adrián; Pérez-Lozano, Blanca

    2017-05-01

    The total circulatory arrest (CA) is necessary to achieve optimal surgical conditions in certain aortic pathologies, especially in those affecting the ascending aorta and aortic arch. During this procedure it is necessary to protect all the organs of ischemia, especially those of the central nervous system and for this purpose several strategies have been developed. The first and most important protective method is systemic hypothermia. The degree of hypothermia and the route of application have been evolving and currently tend to use moderate hypothermia (MH) (20.1-28 °C) associated with unilateral or bilateral selective cerebral perfusion methods. In this way the neurological results are better, the interval of security is greater and the times of extracorporeal circulation are smaller. Even so, it is necessary to take into account that there is the possibility of ischemia in the lower part of the body, especially of the abdominal viscera and the spinal cord, therefore the time of circulatory stop should be limited and not to exceed 80 minutes. Evidence of possible neurological drug protection is very weak and only mannitol, magnesium, and statins can produce some benefit. Inhalational anesthetics and some intravenous seem to have advantages, but more studies would be needed to test their long-term benefit. Other important parameters to be monitored during these procedures are blood glucose, anemia and coagulation disorders and acid-base balance. The recommended monitoring is common in complex cardiovascular procedures and it is of special importance the neurological monitoring that can be performed with several techniques, although currently the most used are Bispectral Index (BIS) and Near-Infrared Spectroscopy (NIRS). It is also essential to monitor the temperature routinely at the nasopharyngeal and bladder level and it is important to control coagulation with rotational thromboelastometry (ROTEM).

  14. A benchtop biorobotic platform for in vitro observation of muscle-tendon dynamics with parallel mechanical assistance from an elastic exoskeleton.

    Science.gov (United States)

    Robertson, Benjamin D; Vadakkeveedu, Siddarth; Sawicki, Gregory S

    2017-05-24

    We present a novel biorobotic framework comprised of a biological muscle-tendon unit (MTU) mechanically coupled to a feedback controlled robotic environment simulation that mimics in vivo inertial/gravitational loading and mechanical assistance from a parallel elastic exoskeleton. Using this system, we applied select combinations of biological muscle activation (modulated with rate-coded direct neural stimulation) and parallel elastic assistance (applied via closed-loop mechanical environment simulation) hypothesized to mimic human behavior based on previously published modeling studies. These conditions resulted in constant system-level force-length dynamics (i.e., stiffness), reduced biological loads, increased muscle excursion, and constant muscle average positive power output-all consistent with laboratory experiments on intact humans during exoskeleton assisted hopping. Mechanical assistance led to reduced estimated metabolic cost and MTU apparent efficiency, but increased apparent efficiency for the MTU+Exo system as a whole. Findings from this study suggest that the increased natural resonant frequency of the artificially stiffened MTU+Exo system, along with invariant movement frequencies, may underlie observed limits on the benefits of exoskeleton assistance. Our novel approach demonstrates that it is possible to capture the salient features of human locomotion with exoskeleton assistance in an isolated muscle-tendon preparation, and introduces a powerful new tool for detailed, direct examination of how assistive devices affect muscle-level neuromechanics and energetics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Ethical challenges with the left ventricular assist device as a destination therapy

    Directory of Open Access Journals (Sweden)

    Rady Mohamed Y

    2008-08-01

    Full Text Available Abstract The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1 direct participation of a multidisciplinary care team, including palliative care specialists, (2 a concise plan of care for anticipated device-related complications, (3 careful surveillance and counseling for caregiver burden, (4 advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5 a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e

  16. Structural and mechanical properties of hydroxyapatite coatings formed by ion-beam assisted deposition

    Science.gov (United States)

    Zykova, A.; Safonov, V.; Dudin, S.; Yakovin, S.; Donkov, N.; Ghaemi, M. H.; Szkodo, M.; Antoszkiewicz, M.; Szyfelbain, M.; Czaban, A.

    2018-03-01

    The ion-beam assisted deposition (IBAD) is an advanced method capable of producing crystalline coatings at low temperatures. We determined the characteristics of hydroxyapatite Ca10(PO4)6(OH)2 target and coatings formed by IBAD using X-ray photoemission spectroscopy (XPS), X-ray diffraction (XRD), scanning electron microscopy (SEM), atomic force microscopy (AFM) and energy dispersive X-ray (EDX). The composition of the coatings’ cross-section and surface was close to those of the target. The XPS spectra showed that the binding energy values of Ca (2p1/2, 2p3/2), P (2p3/2), and O 1s levels are related to the hydroxyapatite phase. The coatings demonstrate an optimal H/E ratio, and a good resistance to scratch tests.

  17. Evaporation mechanisms of MgO in laser assisted atom probe tomography

    KAUST Repository

    Mazumder, Baishakhi

    2011-05-01

    In this paper the field evaporation properties of bulk MgO and sandwiched MgO layers in Fe are compared using laser assisted Atom Probe Tomography. The comparison of flight time spectra gives an estimate of the evaporation times as a function of the wavelength and the laser energy. It is shown that the evaporation takes place in two steps on two different time scales in MgO. It is also shown that as long as the MgO layer is buried in Fe, the evaporation is dominated by the photon absorption in Fe layer at the tip apex. Eventually the evaporation process of MgO is discussed based on the difference between the bulk materials and the multilayer samples. © 2010 Elsevier B.V.

  18. Evaporation mechanisms of MgO in laser assisted atom probe tomography

    KAUST Repository

    Mazumder, Baishakhi; Vella, Angela; Dé conihout, Bernard; Al-Kassab, Talaat

    2011-01-01

    In this paper the field evaporation properties of bulk MgO and sandwiched MgO layers in Fe are compared using laser assisted Atom Probe Tomography. The comparison of flight time spectra gives an estimate of the evaporation times as a function of the wavelength and the laser energy. It is shown that the evaporation takes place in two steps on two different time scales in MgO. It is also shown that as long as the MgO layer is buried in Fe, the evaporation is dominated by the photon absorption in Fe layer at the tip apex. Eventually the evaporation process of MgO is discussed based on the difference between the bulk materials and the multilayer samples. © 2010 Elsevier B.V.

  19. A novel mechanical lung model of pulmonary diseases to assist with teaching and training

    Directory of Open Access Journals (Sweden)

    Shaw Geoffrey M

    2006-08-01

    Full Text Available Abstract Background A design concept of low-cost, simple, fully mechanical model of a mechanically ventilated, passively breathing lung is developed. An example model is built to simulate a patient under mechanical ventilation with accurate volumes and compliances, while connected directly to a ventilator. Methods The lung is modelled with multiple units, represented by rubber bellows, with adjustable weights placed on bellows to simulate compartments of different superimposed pressure and compliance, as well as different levels of lung disease, such as Acute Respiratory Distress Syndrome (ARDS. The model was directly connected to a ventilator and the resulting pressure volume curves recorded. Results The model effectively captures the fundamental lung dynamics for a variety of conditions, and showed the effects of different ventilator settings. It was particularly effective at showing the impact of Positive End Expiratory Pressure (PEEP therapy on lung recruitment to improve oxygenation, a particulary difficult dynamic to capture. Conclusion Application of PEEP therapy is difficult to teach and demonstrate clearly. Therefore, the model provide opportunity to train, teach, and aid further understanding of lung mechanics and the treatment of lung diseases in critical care, such as ARDS and asthma. Finally, the model's pure mechanical nature and accurate lung volumes mean that all results are both clearly visible and thus intuitively simple to grasp.

  20. Relation between awareness of circulatory disorders and smoking in a general population health examination

    Directory of Open Access Journals (Sweden)

    Völzke Henry

    2006-02-01

    Full Text Available Abstract Background Little is known about proportions of smokers who maintain smoking after they are aware of a circulatory disorder. The goal was to analyze the extent to which the number of circulatory disorders may be related to being a current smoker. Methods Cross-sectional survey study with a probability sample of residents in Germany investigated in health examination centers. Questionnaire data of 3,778 ever smoking participants aged 18 – 79 were used, questions included whether the respondent had ever had hypertension, myocardial infarction, other coronary artery disease, heart failure, stroke, other cerebrovascular disease, peripheral vascular disease, and venous thrombosis. Logistic regression was calculated for circulatory disorders and their number with current smoking as the dependent variable, and odds ratios (OR are presented adjusted for physician contact, inpatient treatment, smoking cessation counseling, heavy smoking, exercise, overweight and obesity, school education, sex and age. Results Among ever smokers who had 1 circulatory disorder, 52.1 % were current smokers and among those who reported that they had 3 or more circulatory disorders 28.0 % were current smokers at the time of the interview. The adjusted odds of being a current smoker were lower for individuals who had ever smoked in life and had 2 or more central circulatory disorders, such as myocardial infarction, heart failure or stroke, than for ever smokers without central circulatory disorder (2 or more disorders: adjusted OR 0.6, 95 % confidence interval, CI, 0.4 to 0.8. Conclusion Among those with central circulatory disorders, there is a substantial portion of individuals who smoke despite their disease. The data suggest that only a portion of smokers among the general population seems to be discouraged from smoking by circulatory disorders or its accompanying cognitive or emotional processes.

  1. Study of the Stereochemistry and Oxidation Mechanism of Plant Polyphenols, Assisted by Computational Chemistry.

    Science.gov (United States)

    Matsuo, Yosuke

    2017-01-01

    In recent years, plant polyphenols have attracted great attention due to their wide range of biological activities. Certain kinds of polyphenols have complex structures; therefore, it is difficult to elucidate their total structure, including stereochemistry. In this study, we reinvestigated the stereostructures of two major C-glycosidic ellagitannins contained in Quercus plants, vescalagin and castalagin, and revised their stereostructures based on theoretical calculations of spectroscopic data. We also determined the structures of quercusnins A and B, isolated from the sapwood of Quercus crispula, based on theoretical calculations of NMR data. The oxidation mechanism of polyphenols has not been entirely elucidated. Therefore, we have also studied the oxidation mechanism of tea catechins during black tea production. Our investigation of the oxidation mechanism of black tea pigment theaflavins revealed that the difference in the position of the galloyl ester affords different oxidation products of theaflavins. In addition, oxidation products of pyrogallol-type catechins could be classified into three types-dehydrotheasinensins, theacitrins, and proepitheaflagallins; their detailed production and degradation mechanisms were also examined.

  2. Gas assisted mechanical expression of cocoa butter from cocoa nibs and edible oils from oilseeds

    NARCIS (Netherlands)

    Venter, M.J.; Willems, P.; Kuipers, N.J.M.; Haan, de A.B.

    2006-01-01

    The current methods used to recover high quality oil from oilseeds have low yields (mechanical expression, aqueous extraction), require the use of toxic chemicals and rigorous purification processes that can reduce the quality of the oil (solvent extraction with hexane) or are unsuitable for the

  3. Optical-response properties in an atom-assisted optomechanical system with a mechanical pump

    Science.gov (United States)

    Sun, Xue-Jian; Chen, Hao; Liu, Wen-Xiao; Li, Hong-Rong

    2017-05-01

    We investigate the optical-response properties of a coherent-mechanical pumped optomechanical system (OMS) coupled to a Λ-type three-level atomic ensemble. Due to the optomechanical and the cavity-atom couplings, the optomechanically induced transparency (OMIT) and electromagnetically induced transparency (EIT) phenomena could both be observed from our proposal. In the presence of a coherent mechanical pump, we show that the OMIT behavior of the probe field exhibits a phase-dependent effect, leading to the switch from OMIT to optomechanically induced absorption or amplification, while the feature of EIT remains unchanged. The distinctly different effects of the mechanical pump on OMIT and EIT behavior assure us that the absorption (amplification) and transparency of the output probe field can be simultaneously observed. Moreover, a tunable switch from slow to fast light can also be realized by tuning the phase and amplitude of the mechanical pump. In particular, the presence of the atomic ensemble can further adjust the group delay, providing additional flexibility for achieving the tunable switch.

  4. Laryngeal response patterns influence the efficacy of mechanical assisted cough in amyotrophic lateral sclerosis.

    OpenAIRE

    Andersen, Tiina Maarit; Sandnes, Astrid; Brekka, Anne Kristine; Hilland, Magnus; Clemm, Hege; Fondenes, Ove; Tysnes, Ole Bjørn; Heimdal, John-Helge; Halvorsen, Thomas; Vollsæter, Maria; Røksund, Ola Drange

    2016-01-01

    Background: Most patients with amyotrophic lateral sclerosis (ALS) are treated with mechanical insufflation–exsufflation (MI-E) in order to improve cough. This method often fails in ALS with bulbar involvement, allegedly due to upper-airway malfunction. We have studied this phenomenon in detail with laryngoscopy to unravel information that could lead to better treatment. Methods: We conducted a cross-sectional study of 20 patients with ALS and 20 healthy age-matched and sex-matched v...

  5. Mechanism of Particle Formation in Silver/Epoxy Nanocomposites Obtained through a Visible-Light-Assisted in Situ Synthesis.

    Science.gov (United States)

    dell'Erba, Ignacio E; Martínez, Francisco D; Hoppe, Cristina E; Eliçabe, Guillermo E; Ceolín, Marcelo; Zucchi, Ileana A; Schroeder, Walter F

    2017-10-03

    A detailed understanding of the processes taking place during the in situ synthesis of metal/polymer nanocomposites is crucial to manipulate the shape and size of nanoparticles (NPs) with a high level of control. In this paper, we report an in-depth time-resolved analysis of the particle formation process in silver/epoxy nanocomposites obtained through a visible-light-assisted in situ synthesis. The selected epoxy monomer was based on diglycidyl ether of bisphenol A, which undergoes relatively slow cationic ring-opening polymerization. This feature allowed us to access a full description of the formation process of silver NPs before this was arrested by the curing of the epoxy matrix. In situ time-resolved small-angle X-ray scattering investigation was carried out to follow the evolution of the number and size of the silver NPs as a function of irradiation time, whereas rheological experiments combined with near-infrared and ultraviolet-visible spectroscopies were performed to interpret how changes in the rheological properties of the matrix affect the nucleation and growth of particles. The analysis of the obtained results allowed us to propose consistent mechanisms for the formation of metal/polymer nanocomposites obtained by light-assisted one-pot synthesis. Finally, the effect of a thermal postcuring treatment of the epoxy matrix on the particle size in the nanocomposite was investigated.

  6. Mechanical Characterization of Polydopamine-Assisted Silver Deposition on Polymer Substrates

    Science.gov (United States)

    Cordes, Amanda Laurence

    Inspired by the adhesive proteins in marine mussels, polydopamine has become a popular adhesive ad-layer for surface functionalization of a variety of substrates. Based on the chemistry of the dopamine monomer, amine and thiol functional groups are hypothesized to increase adhesion between polymer substrates and polydopamine thin films. This hypothesis was the central motivation for development of a tailorable thiol-ene system in order to study the effects of substrate chemistry on polydopamine adhesion. While polydopamine-adhered silver has been studied on a variety of substrates, no in depth mechanical characterization has been performed and to date, no research has been published on thiol-enes coated in polydopamine-adhered silver. The purpose of this study was to characterize the mechanical durability and adhesion properties of a polydopamine-adhered silver film on commercial substrates and a tailorable thiol-ene system. Polydopamine and silver coatings were deposited on a variety of polymer substrates through a simple dip-coat process. The polydopamine forms a thin uniform adhesive layer and the silver deposits in a discontinuous manner with a nanoparticle sized base layer covering the full surface and micron-sized clusters adhered sporadically on top. Mechanical tensile testing was performed to characterize the durability of the silver coating on commercial polymers. Coated nylon and HDPE showed no signs of degradation or delamination of the polydopamine-adhered silver coating up to 30% strain although both substrates showed large plastic deformation. Peel tests were performed on both commercial polymers as well as a tailorable thiol-ene system. Results support the hypothesis that polydopamine adhesion is increased with the presence of functional groups. Parts of the HDPE sample were cleanly peeled, but silver patches were left sporadically across the surface pointing to weaker adhesion between polyethylene and polydopamine. A high adhesive strength tape was

  7. Ga-assisted catalyst-free growth mechanism of GaAs nanowires by molecular beam epitaxy

    International Nuclear Information System (INIS)

    Colombo, C.; Spirkoska, D.; Frimmer, M.; Abstreiter, G.; Fontcuberta i Morral, A.

    2008-01-01

    The mechanisms of Ga-assisted GaAs nanowires grown by molecular beam epitaxy are addressed. The axial and radial growth rates as a function of the Ga rate and As pressure indicate that on the opposite of what is observed in thin film epitaxy, the growth rate of the nanowires is arsenic limited. As a consequence, the axial growth rate of the wires can be controlled by the As 4 pressure. Additionally, due to the small As 4 pressure leading to nanowire growth, the deposition on the facets is very slow, leading to a much lower radial growth rate. Finally, we present a model that is able to accurately describe the presented observations and predicts a maximum length of nontapered nanowires of 40 μm

  8. Microstructure and mechanical properties of friction stir lap welded Mg/Al joint assisted by stationary shoulder

    Science.gov (United States)

    Ji, Shude; Li, Zhengwei

    2017-11-01

    Using magnesium alloy as upper sheet, 3 mm-thick AZ31 magnesium alloy and 6061 aluminum alloy were joined using friction stir lap welding assisted by stationary shoulder. The effects of tool rotating speed on cross-sections, microstructure and mechanical properties of Mg/Al lap joints were mainly discussed. Results showed that stationary shoulder contributed to joint formation, by which stir zones (SZ) were characterized by big onion rings after welding. Because of the big forging force exerted by stationary shoulder, the upper region of hook was well bonded. SZ showed much higher hardness because of intermetallic compounds (IMCs). The bonding conditions at the base material (BM)/SZ interface at advancing side and the hook region played important roles on joint lap shear properties. The X-ray diffraction pattern analysis revealed that the main IMCs were Al3Mg2 and Al12Mg17.

  9. Ultrasonic assisted production of starch nanoparticles: Structural characterization and mechanism of disintegration.

    Science.gov (United States)

    Boufi, Sami; Bel Haaj, Sihem; Magnin, Albert; Pignon, Frédéric; Impéror-Clerc, Marianne; Mortha, Gérard

    2018-03-01

    In this paper, the disintegration of starch (waxy and standard starch) granules into nanosized particles under the sole effect of high power ultrasonication treatment in water/isopropanol is investigated, by using wide methods of analysis. The present work aims at a fully characterization of the starch nanoparticles produced by ultrasonication, in terms of size, morphology and structural properties, and the proposition of a possible mechanism explaining the top-down generation of starch nanoparticles (SNPs) via high intensity ultrasonication. Dynamic light scattering measurements have indicated a leveling of the particle size to about 40nm after 75min of ultrasonication. The WAXD, DSC and Raman have revealed the amorphous character of the SNPs. FE-SEM. AFM observations have confirmed the size measured by DLS and suggested that SNPs exhibited 2D morphology of platelet-like shapes. This morphology is further supported by SAXS. On the basis of data collected from the different characterization techniques, a possible mechanism explaining the disintegration process of starch granules into NPs is proposed. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Optoelectronic enhancement of monocrystalline silicon solar cells by porous silicon-assisted mechanical grooving

    Energy Technology Data Exchange (ETDEWEB)

    Ben Rabha, Mohamed; Mohamed, Seifeddine Belhadj; Dimassi, Wissem; Gaidi, Mounir; Ezzaouia, Hatem; Bessais, Brahim [Laboratoire de Photovoltaique, Centre de Recherches et des Technologies de l' Energie, Technopole de Borj-Cedria, BP 95, 2050 Hammam-Lif (Tunisia)

    2011-03-15

    One of the most important factors influencing silicon solar cells performances is the front side reflectivity. Consequently, new methods for efficient reduction of this reflectivity are searched. This has always been done by creating a rough surface that enables incident light of being absorbed within the solar cell. Combination of texturization-porous silicon surface treatment was found to be an attractive technical solution for lowering the reflectivity of monocrystalline silicon (c-Si). The texturization of the monocrystalline silicon wafer was carried out by means of mechanical grooving. A specific etching procedure was then applied to form a thin porous silicon layer enabling to remove mechanical damages. This simple and low cost method reduces the total reflectivity from 29% to 7% in the 300 - 950 nm wavelength range and enhances the diffusion length of the minority carriers from 100 {mu}m to 790 {mu}m (copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  11. Computational studies on non-succinimide-mediated stereoinversion mechanism of aspartic acid residues assisted by phosphate

    Science.gov (United States)

    Nakayoshi, Tomoki; Fukuyoshi, Shuichi; Takahashi, Ohgi; Oda, Akifumi

    2018-03-01

    Although nearly all of the amino acids that constitute proteins are l-amino acids, d-amino acid residues in human proteins have been recently reported. d-amino acid residues cause a change in the three-dimensional structure of proteins, and d-aspartic acid (Asp) residues are considered to be one of the causes of age-related diseases. The stereoinversion of Asp residues in peptides and proteins is thought to proceed via a succinimide intermediate; however, it has been reported that stereoinversion can occur even under conditions where a succinimide intermediate cannot be formed. In order to elucidate the non-succinimide-mediated stereoinversion pathway, we investigated the stereoinversion of l-Asp to d-Asp catalysed by phosphate and estimated the activation barrier using B3LYP/6-31+G(d,p) density functional theory (DFT) calculations. For the DFT calculations, a model compound in which the Asp residue is capped with acetyl and methyl-amino groups on the N- and C-termini, respectively, was used. The calculated activation barrier was not excessively high for the stereoinversion to occur in vivo. Therefore, this stereoinversion mechanism may compete with the succinimide-mediated mechanism.

  12. Generation of OH Radical by Ultrasonic Irradiation in Batch and Circulatory Reactor

    Science.gov (United States)

    Fang, Yu; Shimizu, Sayaka; Yamamoto, Takuya; Komarov, Sergey

    2018-03-01

    Ultrasonic technology has been widely investigated in the past as one of the advance oxidation processes to treat wastewater, in this process acoustic cavitation causes generation of OH radical, which play a vital role in improving the treatment efficiency. In this study, OH radical formation rate was measured in batch and circulatory reactor by using Weissler reaction at various ultrasound output power. It is found that the generation rate in batch reactor is higher than that in circulatory reactor at the same output power. The generation rate tended to be slower when output power exceeds 137W. The optimum condition for circulatory reactor was found to be 137W output and 4L/min flow rate. Results of aluminum foil erosion test revealed a strong dependence of cavitation zone length on the ultrasound output power. This is assumed to be one of the reasons why the generation rate of HO radicals becomes slower at higher output power in circulatory reactor.

  13. The Implications of the Shift Toward Donation After Circulatory Death in Australia

    Directory of Open Access Journals (Sweden)

    Janske Reiling, MD, PhD

    2017-12-01

    Discussion. This study shows that livers donated after circulatory death are an underused resource in Australia. Better use of these currently available organs would be a highly cost-effective way of reducing waiting list mortality in liver transplantation.

  14. Nitroglycerin reverts clinical manifestations of poor peripheral perfusion in patients with circulatory shock

    NARCIS (Netherlands)

    A.A.P. Lima (Alexandre ); M.E. van Genderen (Michel); J. van Bommel (Jasper); E. Klijn (Elko); T. Jansem (Tim); J. Bakker (Jan)

    2014-01-01

    textabstractIntroduction: Recent clinical studies have shown a relationship between abnormalities in peripheral perfusion and unfavorable outcome in patients with circulatory shock. Nitroglycerin is effective in restoring alterations in microcirculatory blood flow. The aim of this study was to

  15. Multiscale mechanics of TRIP-assisted multiphase steels: II. Micromechanical modelling

    International Nuclear Information System (INIS)

    Lani, F.; Furnemont, Q.; Van Rompaey, T.; Delannay, F.; Jacques, P.J.; Pardoen, T.

    2007-01-01

    The stress and strain partitioning between the different phases of transformation-induced plasticity (TRIP)-aided multiphase steels is evaluated using a mean field homogenization approach. The change of the austenite volume fraction under straining is predicted using a micromechanics-based criterion for the martensitic transformation adapted to the case of small, isolated, transforming austenite grains. The parameters of the model are identified from the mechanical response and transformation kinetics measured under uniaxial tension for two steels differing essentially by the austenite stability. The model is validated by comparing the predictions with tests performed under different loading conditions: pure shear, intermediate biaxial and equibiaxial. An analysis of the effect of the austenite stability on strength and ductility provides guidelines for optimizing properties according to the stress state

  16. Harms of unsuccessful donation after circulatory death: An exploratory study.

    Science.gov (United States)

    Taylor, Lauren J; Buffington, Anne; Scalea, Joseph R; Fost, Norman; Croes, Kenneth D; Mezrich, Joshua D; Schwarze, Margaret L

    2018-02-01

    While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face-to-face interviews with family members (N = 15) who had direct experience with unsuccessful DCD and 5 focus groups with professionals involved in the donation process. We used qualitative content analysis to characterize the harms of nondonation as perceived by participants. Participants reported a broad spectrum of harms affecting organ recipients, donors, and donor families. Harms included waste of precious life-giving organs and hospital resources, inability to honor the donor's memory and character, and impaired ability for families to make sense of tragedy and cope with loss. Donor families empathized with the initial hope and ultimate despair of potential recipients who must continue their wait on the transplant list. Focus group members reinforced these findings and highlighted the struggle of families to navigate the uncertainty regarding the timing of death during the donation process. While families reported significant harm, many appreciated the donation attempt. These findings highlight the importance of organ donation to donor families and the difficult experiences associated with current processes that could inform development of alternative donation strategies. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  17. Annular tidal regenerator engine for nuclear circulatory support systems

    International Nuclear Information System (INIS)

    Hagen, K.G.; Ruggles, A.E.; Fam, S.S.; Torti, V.A.

    1975-01-01

    In order to simplify the configuration of the tidal regenerator engine nuclear-powered circulatory support system, thereby drastically reducing its size and improving the intrinsic reliability, the engine has been redesigned. This redesign focuses on allowing power to be extracted at the low temperature end of the engine utilizing a piston-cylinder arrangement wherein all of the necessary heat transfer processes occur in the annular gap between the piston and cylinder. In all other respects the engine retains its basic characteristics as a hybrid between a Stirling engine and a Rankine engine. A significant advantage of the new arrangement is the ability to raise the superheat temperature limit from 650 0 F to over 900 0 F. This has yielded an increase in engine efficiency from 10 percent to 14 percent, and further increases are anticipated by utilizing an expansion and/or a binary version of the engine. The implantable system volume has been reduced by a factor of three and orientation insensitivity with respect to gravity has been demonstrated. Many system components have already demonstrated endurances of several thousand hours

  18. Effect of Withania Somnifera Root Powder on the Levels of Circulatory Lipid Peroxidation and Liver Marker Enzymes in Chronic Hyperammonemia

    Directory of Open Access Journals (Sweden)

    B. Harikrishnan

    2008-01-01

    Full Text Available Withania somnifera (L Dunal (Solanaceae, commonly called Ashwagandha (Sanskrit is an Ayurvedic Indian medicinal plant, which has been widely used as a home remedy for several ailments. We have investigated the influence of W.somnifera root powder on the levels of circulatory ammonia, urea, lipid peroxidation products such as TBARS (thiobarbituric acid and reactive substances, HP (hydroperoxides and liver marker enzymes such as AST (aspartate transaminase, ALT (alanine transaminase and ALP (alkaline phosphatase, for its hepatoprotective effect in ammonium chloride induced hyperammonemia. Ammonium chloride treated rats showed a significant increase in the levels of circulatory ammonia, urea, AST, ALT, ALP, TBARS and HP. These changes were significantly decreased in rats treated with W.somnifera root powder and ammonium chloride. Our results indicate that W.somnifera offers hepatoprotection by influencing the levels of lipid peroxidation products and liver markers in experimental hyperammonemia and this could be due to (i the presence of alkaloids, withanolids and flavonoids, (ii normalizing the levels of urea and urea related compounds, (iii its free radical scavenging property and (iv its antioxidant property. The exact underlying mechanism is still unclear and further research needed.

  19. [Risk factors associated to complications of the mechanical ventilatory assistance in the premature newborn].

    Science.gov (United States)

    Tapia-Rombo, Carlos Antonio; Rodríguez-Jiménez, Gustavo; Ballesteros-del Olmo, Julio César; Cuevas-Urióstegui, María Luisa

    2009-01-01

    To determine risk factors associated with the presence of complications with mechanical ventilatory support (MVS) in the preterm infants (PI). One hundred thirty medical records of PI that had been discharged by amelioration or death were reviewed retrospectively. They were divided in two groups: group A, PI that had presented complications during MVS (cases) and B, PI with MVS, but that had not presented complications due to the procedure (controls). Statistical significance was considered at p < 0.05. The significative risk factors in the multivariate analysis reached significance for the associated of complications: gestational age (32 weeks or less), orotracheal reintubations three o more times, cycles of 60 per minute or more at the third day of being had initiate the MVS, and the symptomatic patent ductus arteriosus (PDA), all with p < 0.05. It will be necessary to impact more on the cycles level to diminish him below 60 per minute to the third day when it is feasible, to make the smallest reintubations number, to correct quickly the PDA when it is symptomatic, to avoid this way as much as possible, the complications of the MVS.

  20. Multiplicity and contiguity of ablation mechanisms in laser-assisted analytical micro-sampling

    International Nuclear Information System (INIS)

    Bleiner, Davide; Bogaerts, Annemie

    2006-01-01

    Laser ablation is implemented in several scientific and technological fields, as well as a rapid sample introduction technique in elemental and trace analysis. At high laser fluence, the ejection of micro-sized droplets causes the enhancement of the surface recession speed and depth resolution degradation as well as the alteration of the sampling stoichiometry. The origin of such large particles seems to be due to at least two different processes, phase explosion and melt splashing. Experimental evidence for both was found in metallic matrices, whereas non-metallic samples showed more complex phenomena like cracking. The spatial distribution of the beam energy profile is responsible for significant differences in the ablation mechanism across the irradiated region and for heterogeneous sampling. Under Gaussian irradiance distribution, the center of the crater, where the irradiance is the highest, experienced a fast heating with rapid ejection of a mixture of particles and vapor (spinodal breakdown). The crater periphery was subjected to more modest irradiation, with melt mobilization and walls formation. The overall resulting particle size distribution was composed of an abundant nano-sized fraction, produced by vapor condensation, and a micro-sized fraction during melt expulsion

  1. Laryngeal response patterns influence the efficacy of mechanical assisted cough in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Andersen, Tiina; Sandnes, Astrid; Brekka, Anne Kristine; Hilland, Magnus; Clemm, Hege; Fondenes, Ove; Tysnes, Ole-Bjørn; Heimdal, John-Helge; Halvorsen, Thomas; Vollsæter, Maria; Røksund, Ola Drange

    2017-03-01

    Most patients with amyotrophic lateral sclerosis (ALS) are treated with mechanical insufflation-exsufflation (MI-E) in order to improve cough. This method often fails in ALS with bulbar involvement, allegedly due to upper-airway malfunction. We have studied this phenomenon in detail with laryngoscopy to unravel information that could lead to better treatment. We conducted a cross-sectional study of 20 patients with ALS and 20 healthy age-matched and sex-matched volunteers. We used video-recorded flexible transnasal fibre-optic laryngoscopy during MI-E undertaken according to a standardised protocol, applying pressures of ±20 to ±50 cm H 2 O. Laryngeal movements were assessed from video files. ALS type and characteristics of upper and lower motor neuron symptoms were determined. At the supraglottic level, all patients with ALS and bulbar symptoms (n=14) adducted their laryngeal structures during insufflation. At the glottic level, initial abduction followed by subsequent adduction was observed in all patients with ALS during insufflation and exsufflation. Hypopharyngeal constriction during exsufflation was observed in all subjects, most prominently in patients with ALS and bulbar symptoms. Healthy subjects and patients with ALS and no bulbar symptoms (n=6) coordinated their cough well during MI-E. Laryngoscopy during ongoing MI-E in patients with ALS and bulbar symptoms revealed laryngeal adduction especially during insufflation but also during exsufflation, thereby severely compromising the size of the laryngeal inlet in some patients. Individually customised settings can prevent this and thereby improve and extend the use of non-invasive MI-E. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Investigations in physical mechanism of the oxidative desulfurization process assisted simultaneously by phase transfer agent and ultrasound.

    Science.gov (United States)

    Bhasarkar, Jaykumar B; Chakma, Sankar; Moholkar, Vijayanand S

    2015-05-01

    This paper attempts to discern the physical mechanism of the oxidative desulfurization process simultaneously assisted by ultrasound and phase transfer agent (PTA). With different experimental protocols, an attempt is made to deduce individual beneficial effects of PTA and ultrasound on the oxidative desulfurization system, and also the synergy between the effects of PTA and ultrasound. Effect of PTA is more marked for mechanically stirred system due to mass transfer limitations, while intense emulsification due to ultrasound helps overcome the mass transfer limitations and reduces the extent of enhancement of oxidation by PTA. Despite application of PTA and ultrasound, the intrinsic factors and properties of the reactants such as polarity (and hence partition coefficient) and diffusivity have a crucial effect on the extent of oxidation. The intrinsic reactivity of the oxidant also plays a vital role, as seen from the extent of oxidation achieved with performic acid and peracetic acid. The interfacial transport of oxidant in the form of oxidant-PTA complex reduces the undesired consumption of oxidant by the reducing species formed during transient cavitation in organic medium, which helps effective utilization of oxidant towards desulfurization. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Increased multiaxial lumbar motion responses during multiple-impulse mechanical force manually assisted spinal manipulation

    Directory of Open Access Journals (Sweden)

    Gunzburg Robert

    2006-04-01

    Full Text Available Abstract Background Spinal manipulation has been found to create demonstrable segmental and intersegmental spinal motions thought to be biomechanically related to its mechanisms. In the case of impulsive-type instrument device comparisons, significant differences in the force-time characteristics and concomitant motion responses of spinal manipulative instruments have been reported, but studies investigating the response to multiple thrusts (multiple impulse trains have not been conducted. The purpose of this study was to determine multi-axial segmental and intersegmental motion responses of ovine lumbar vertebrae to single impulse and multiple impulse spinal manipulative thrusts (SMTs. Methods Fifteen adolescent Merino sheep were examined. Tri-axial accelerometers were attached to intraosseous pins rigidly fixed to the L1 and L2 lumbar spinous processes under fluoroscopic guidance while the animals were anesthetized. A hand-held electromechanical chiropractic adjusting instrument (Impulse was used to apply single and repeated force impulses (13 total over a 2.5 second time interval at three different force settings (low, medium, and high along the posteroanterior axis of the T12 spinous process. Axial (AX, posteroanterior (PA, and medial-lateral (ML acceleration responses in adjacent segments (L1, L2 were recorded at a rate of 5000 samples per second. Peak-peak segmental accelerations (L1, L2 and intersegmental acceleration transfer (L1–L2 for each axis and each force setting were computed from the acceleration-time recordings. The initial acceleration response for a single thrust and the maximum acceleration response observed during the 12 multiple impulse trains were compared using a paired observations t-test (POTT, alpha = .05. Results Segmental and intersegmental acceleration responses mirrored the peak force magnitude produced by the Impulse Adjusting Instrument. Accelerations were greatest for AX and PA measurement axes. Compared to

  4. Quantitative Circulatory Physiology: an integrative mathematical model of human physiology for medical education.

    Science.gov (United States)

    Abram, Sean R; Hodnett, Benjamin L; Summers, Richard L; Coleman, Thomas G; Hester, Robert L

    2007-06-01

    We have developed Quantitative Circulatory Physiology (QCP), a mathematical model of integrative human physiology containing over 4,000 variables of biological interactions. This model provides a teaching environment that mimics clinical problems encountered in the practice of medicine. The model structure is based on documented physiological responses within peer-reviewed literature and serves as a dynamic compendium of physiological knowledge. The model is solved using a desktop, Windows-based program, allowing students to calculate time-dependent solutions and interactively alter over 750 parameters that modify physiological function. The model can be used to understand proposed mechanisms of physiological function and the interactions among physiological variables that may not be otherwise intuitively evident. In addition to open-ended or unstructured simulations, we have developed 30 physiological simulations, including heart failure, anemia, diabetes, and hemorrhage. Additional stimulations include 29 patients in which students are challenged to diagnose the pathophysiology based on their understanding of integrative physiology. In summary, QCP allows students to examine, integrate, and understand a host of physiological factors without causing harm to patients. This model is available as a free download for Windows computers at http://physiology.umc.edu/themodelingworkshop.

  5. An implantable centrifugal blood pump for long term circulatory support.

    Science.gov (United States)

    Yamazaki, K; Litwak, P; Kormos, R L; Mori, T; Tagusari, O; Antaki, J F; Kameneva, M; Watach, M; Gordon, L; Umezu, M; Tomioka, J; Koyanagi, H; Griffith, B P

    1997-01-01

    A compact centrifugal blood pump was developed as an implantable left ventricular assist system. The impeller diameter is 40 mm and the pump dimensions are 55 x 64 mm. This first prototype was fabricated from titanium alloy, resulting in a pump weight of 400 g including a brushless DC motor. Weight of the second prototype pump was reduced to 280 g. The entire blood contacting surface is coated with diamond like carbon to improve blood compatibility. Flow rates of over 7 L/min against 100 mmHg pressure at 2,500 rpm with 9 W total power consumption have been measured. A newly designed mechanical seal with a recirculating purge system ("Cool-Seal") is used as a shaft seal. In this seal system, seal temperature is kept under 40 degrees C to prevent heat denaturation of blood proteins. Purge fluid also cools the pump motor coil and journal bearing. The purge fluid is continuously purified and sterilized by an ultrafiltration filter incorporated into the paracorporeal drive console. In vitro experiments with bovine blood demonstrated an acceptably low hemolysis rate (normalized index of hemolysis = 0.005 +/- 0.002 g/100 L). In vivo experiments are currently ongoing using calves. Via left thoracotomy, left ventricular apex-descending aorta bypass was performed utilizing a PTFE (Polytetrafluoroethylene) vascular graft, with the pump placed in the left thoracic cavity. In two in vivo experiments, pump flow rate was maintained at 5-8 L/min, and pump power consumption remained stable at 9-10 W. All plasma free hemoglobin levels were measured at < 15 mg/dl. The seal system has demonstrated good seal capability with negligible purge fluid consumption (< 0.5 ml/ day). Both animals remain under observation after 162 and 91 days of continuous pump function.

  6. The effect of helium-oxygen-assisted mechanical ventilation on chronic obstructive pulmonary disease exacerbation: A systemic review and meta-analysis.

    Science.gov (United States)

    Wu, Xu; Shao, Chuan; Zhang, Liang; Tu, Jinjing; Xu, Hui; Lin, Zhihui; Xu, Shuguang; Yu, Biyun; Tang, Yaodong; Li, Shanqun

    2018-03-01

    Chronic obstructive pulmonary disease (COPD) is often accompanied by acute exacerbations. Patients of COPD exacerbation suffering from respiratory failure often need the support of mechanical ventilation. Helium-oxygen can be used to reduce airway resistance during mechanical ventilation. The aim of this study is to evaluate the effect of helium-oxygen-assisted mechanical ventilation on COPD exacerbation through a meta-analysis. A comprehensive literature search through databases of Pub Med (1966∼2016), Ovid MEDLINE (1965∼2016), Cochrane EBM (1991∼2016), EMBASE (1974∼2016) and Ovid MEDLINE was performed to identify associated studies. Randomized clinical trials met our inclusion criteria that focus on helium-oxygen-assisted mechanical ventilation on COPD exacerbation were included. The quality of the papers was evaluated after inclusion and information was extracted for meta-analysis. Six articles and 392 patients were included in total. Meta-analysis revealed that helium-oxygen-assisted mechanical ventilation reduced Borg dyspnea scale and increased arterial PH compared with air-oxygen. No statistically significant difference was observed between helium-oxygen and air-oxygen as regards to WOB, PaCO 2 , OI, tracheal intubation rates and mortality within hospital. Our study suggests helium-oxygen-assisted mechanical ventilation can help to reduce Borg dyspnea scale. In terms of the tiny change of PH, its clinical benefit is negligible. There is no conclusive evidence indicating the beneficial effect of helium-oxygen-assisted mechanical ventilation on clinical outcomes or prognosis of COPD exacerbation. © 2017 John Wiley & Sons Ltd.

  7. Optimization of a miniature Maglev ventricular assist device for pediatric circulatory support.

    Science.gov (United States)

    Zhang, Juntao; Koert, Andrew; Gellman, Barry; Gempp, Thomas M; Dasse, Kurt A; Gilbert, Richard J; Griffith, Bartley P; Wu, Zhongjun J

    2007-01-01

    A miniature Maglev blood pump based on magnetically levitated bearingless technology is being developed and optimized for pediatric patients. We performed impeller optimization by characterizing the hemodynamic and hemocompatibility performances using a combined computational and experimental approach. Both three-dimensional flow features and hemolytic characteristics were analyzed using computational fluid dynamics (CFD) modeling. Hydraulic pump performances and hemolysis levels of three different impeller designs were quantified and compared numerically. Two pump prototypes were constructed from the two impeller designs and experimentally tested. Comparison of CFD predictions with experimental results showed good agreement. The optimized impeller remarkably increased overall pump hydraulic output by more than 50% over the initial design. The CFD simulation demonstrated a clean and streamlined flow field in the main flow path. The numerical results by hemolysis model indicated no significant high shear stress regions. Through the use of CFD analysis and bench-top testing, the small pediatric pump was optimized to achieve a low level of blood damage and improved hydraulic performance and efficiency. The Maglev pediatric blood pump is innovative due to its small size, very low priming volume, excellent hemodynamic and hematologic performance, and elimination of seal-related and bearing-related failures due to adoption of magnetically levitated bearingless motor technology, making it ideal for pediatric applications.

  8. Impact and Effectiveness of Dual Aspiration Technique in Stent-Assisted Mechanical Thrombectomy: Recent Improvements in Acute Stroke Management

    Energy Technology Data Exchange (ETDEWEB)

    Hopf-Jensen, S., E-mail: hopfsi@diako.de; Preiß, M.; Marques, L.; Lehrke, S. [Diakonissenhospital Flensburg, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany); Schattschneider, J.; Stolze, H. [Diakonissenhospital Flensburg, Department of Neurology (Germany); Müller-Hülsbeck, S. [Diakonissenhospital Flensburg, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany)

    2016-11-15

    Background and PurposeTo evaluate feasibility and impact of dual aspiration technique (DAT) within stent-assisted mechanical thrombectomy on procedural parameters and clinical outcome.Materials and MethodsWithin 16 months, 76 consecutive patients (mean age 70.7 year; range 33–89) underwent stent-assisted mechanical thrombectomy. Of 52 enrolled patients (68.4 %) with occlusion of the anterior circulation, 22 patients (42.3 %) underwent DAT; 30 patients (57.7 %) were treated in conventional monoaspiration technique (MAT). Epidemiological data, clinical and imaging characteristics (mRS, NIHSS, ASPECTS) as well as procedural details were analyzed (TICI, number of retrieval, procedure time). Clinical outcome was determined with mRS at discharge and after 90 days.ResultsIn the context of DAT additional carotid artery stenting was required in 45.5 % (10/22) in underlying tandem lesion (vs. 0/30 MAT). No differences were found in NIHSS at admission (MAT: 20.5, range 15–29; DAT: 18.6; range 11–25), mRS at admission (MAT: 4.6 vs. DAT: 4.57) or ASPECT score (MAT: 8.3, ±1.5; DAT: 8.4, ±1.5; P > 0.05). TICI ≥ 2b/3 was conducted in 90 % (MAT) and 100 % (DAT), respectively. The procedure time was longer in the MAT group (65 min, ±25.9, range 18–126) compared to the DAT group (49.7 min, ±15, range 32–101; P = 0.016). The clinical outcome increased from admission to discharge and in follow-up after 90 days (mRS ≥ 2: MAT: 53.3 %, DAT: 54.5 %; P > 0.05).ConclusionsThe dual aspiration technique with an additional intermediate guide catheter placed closed to the stent retriever leads to decreased procedure time in the anterior circulation. Even in cases with higher thrombus load and treated in DAT, clinical outcome improved.

  9. Aortic arch reconstruction: deep and moderate hypothermic circulatory arrest with selective antegrade cerebral perfusion.

    Science.gov (United States)

    Wu, YanWen; Xiao, LiQiong; Yang, Ting; Wang, Lei; Chen, Xin

    2017-07-01

    To compare the effects of moderate and deep hypothermic circulatory arrest (DHCA) with selective antegrade cerebral perfusion (SACP) during aortic arch surgery in adult patients and to offer the evidence for the detection of the temperature which provides best brain protection in the subjects who accept aortic arch reconstruction surgery. A total of 109 patients undergoing surgery of the aortic arch were divided into the moderate hypothermic circulatory arrest group (Group I) and the deep hypothermic circulatory arrest group (Group II). We recorded the data of the patients and their cardiopulmonary bypass (CPB) time, aortic clamping time, SACP time and postoperative anesthetized recovery time, tracheal intubation time, time in the intensive care unit (ICU) and postoperative neurologic dysfunction. Patient characteristics were similar in the two groups. There were four patients who died in Group II and 1 patient in Group I. There were no significant differences in aortic clamping time of each group (111.4±58.4 vs. 115.9±16.2) min; SACP time (27.4±5.9 vs. 23.5±6.1) min of the moderate hypothermic circulatory arrest group and the deep hypothermic circulatory arrest group; there were significant differences in cardiopulmonary bypass time (207.4±20.9 vs. 263.8±22.6) min, postoperative anesthetized recovery time (19.0±11.1 vs. 36.8±25.3) hours, extubation time (46.4±15.1 vs. 64.4±6.0) hours; length of stay in the intensive care unit (ICU) (4.7±1.7 vs. 8±2.3) days and postoperative neurologic dysfunction in the two groups. Compared to deep hypothermic circulatory arrest, moderate hypothermic circulatory arrest can provide better brain protection and achieve good clinical results.

  10. On-the-job training makes the difference: healthcare assistants' perceived competence and responsibility in the care of patients with home mechanical ventilation.

    Science.gov (United States)

    Swedberg, Lena; Michélsen, Hans; Chiriac, Eva Hammar; Hylander, Ingrid

    2015-06-01

    To describe and analyse perceived competence and perceived responsibility among healthcare assistants (HC assistants), caring for patients with home mechanical ventilation (HMV) and other advanced caring needs, adjusted for socio-demographic and workplace background factors. A cross-sectional study was conducted including 128 HC assistants employed in Stockholm County, Sweden. The HC assistants responded to a study-specific questionnaire on perceived competence and perceived responsibility, provided socio-demographic and workplace background data, as well as information on the patient characteristics for the understanding of their work situations. Descriptive statistics and logistic regression analyses were performed. Eighty per cent of the HC assistants rated their perceived competence as high, and fifty-nine per cent rated their perceived responsibility as high. Fifty-five per cent lacked formal healthcare training, and only one in five of the HC assistants had a formal training equivalent with a licensed practical nurse (LPN) examination. Males lacked formal training to a greater extent than females and rated their competence accordingly. On-the-job training was significantly associated with high ratings on both perceived competence and perceived responsibility, and clinical supervision was associated with high rating on perceived responsibility. HC assistants with limited formal training self-reported their competence as high, and on-the-job training was found to be important. Also, clinical supervision was found important for their perception of high responsibility. In Sweden, HC assistants have a 24-hour responsibility for the care and safety of their patient with HMV and other advanced caring needs. The study results point out important issues for further research regarding formal training requirements as well as the needs for standardised workplace training and supervision of HC assistants. The consequences of transfer of responsibility by delegation from

  11. The ionization mechanisms in direct and dopant-assisted atmospheric pressure photoionization and atmospheric pressure laser ionization.

    Science.gov (United States)

    Kauppila, Tiina J; Kersten, Hendrik; Benter, Thorsten

    2014-11-01

    A novel, gas-tight API interface for gas chromatography-mass spectrometry was used to study the ionization mechanism in direct and dopant-assisted atmospheric pressure photoionization (APPI) and atmospheric pressure laser ionization (APLI). Eight analytes (ethylbenzene, bromobenzene, naphthalene, anthracene, benzaldehyde, pyridine, quinolone, and acridine) with varying ionization energies (IEs) and proton affinities (PAs), and four common APPI dopants (toluene, acetone, anisole, and chlorobenzene) were chosen. All the studied compounds were ionized by direct APPI, forming mainly molecular ions. Addition of dopants suppressed the signal of the analytes with IEs above the IE of the dopant. For compounds with suitable IEs or Pas, the dopants increased the ionization efficiency as the analytes could be ionized through dopant-mediated gas-phase reactions, such as charge exchange, proton transfer, and other rather unexpected reactions, such as formation of [M + 77](+) in the presence of chlorobenzene. Experiments with deuterated toluene as the dopant verified that in case of proton transfer, the proton originated from the dopant instead of proton-bound solvent clusters, as in conventional open or non-tight APPI sources. In direct APLI using a 266 nm laser, a narrower range of compounds was ionized than in direct APPI, because of exceedingly high IEs or unfavorable two-photon absorption cross-sections. Introduction of dopants in the APLI system changed the ionization mechanism to similar dopant-mediated gas-phase reactions with the dopant as in APPI, which produced mainly ions of the same form as in APPI, and ionized a wider range of analytes than direct APLI.

  12. Transitions to Home Mechanical Ventilation: The Experiences of Canadian Ventilator-Assisted Adults and Their Family Caregivers.

    Science.gov (United States)

    Dale, Craig M; King, Judy; Nonoyama, Mika; Carbone, Sarah; McKim, Douglas; Road, Jeremy; Rose, Louise

    2017-12-28

    Several studies have explored the experience of ventilator-assisted individual (VAIs) living at home with family caregivers. However, few explore the experiences of these individuals as they transition from a hospital setting to living at home with a view to identifying modifiable processes that could optimize transition. This descriptive, qualitative study sought to elucidate barriers to, and facilitators of, transition to home mechanical ventilation (HMV) from the perspective of Canadian VAIs and their family caregivers. Participant recruitment occurred through hospital and community respiratory clinicians based in the four Canadian provinces of Alberta, British Columbia, Ontario, and Saskatchewan. Semi-structured telephone or face-to-face interviews at home were undertaken with 33 individuals including 19 VAIs and 14 family caregivers between 3 to 24 months of transitioning to HMV. Interview data was analyzed using content analysis. Formal teaching of knowledge and skills relevant to HMV within the hospital setting prior to transition was perceived as having an immediate and enduring positive impact on transition. However, family-clinician conflict, information gaps, and persistent lack of trained personal support workers (PSWs) to provide care in the home contributed to maladjustment relating to transition. Participants strongly recommended improved transitional care in the form of respiratory health professional telephone support, home outreach, in addition to training of PSWs. Transition to HMV is a complex and demanding process. Extended HMV training and support may be helpful in mediating adjustment challenges thus reducing stress, caregiver burden and improving health related quality of life for VAIs and family caregivers.

  13. Plasma-assisted partial oxidation of methane at low temperatures: numerical analysis of gas-phase chemical mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Goujard, Valentin; Nozaki, Tomohiro; Yuzawa, Shuhei; Okazaki, Ken [Department of Mechanical and Control Engineering, Tokyo Institute of Technology, 2-12-1 O-okayama, Meguro, 1528552, Tokyo (Japan); Agiral, Anil, E-mail: tnozaki@mech.titech.ac.jp [Mesoscale Chemical Systems, MESA Institute for Nanotechnology, Faculty of Science and Technology, University of Twente, PO Box 217, 7500 AE, Enschede (Netherlands)

    2011-07-13

    Methane partial oxidation was investigated using a plasma microreactor. The experiments were performed at 5 and 300 deg. C. Microreactor configuration allows an efficient evacuation of the heat generated by methane partial oxidation and dielectric barrier discharges, allowing at the same time a better temperature control. At 5 deg. C, liquid condensation of low vapour pressure compounds, such as formaldehyde and methanol, occurs. {sup 1}H-NMR analysis allowed us to demonstrate significant CH{sub 3}OOH formation during plasma-assisted partial oxidation of methane. Conversion and product selectivity were discussed for both temperatures. In the second part of this work, a numerical simulation was performed and a gas-phase chemical mechanism was proposed and discussed. From the comparison between the experimental results and the simulation it was found that CH{sub 3}OO{center_dot} formation has a determinant role in oxygenated compound production, since its fast formation disfavoured radical recombination. At 5 deg. C the oxidation leads mainly towards oxygenated compound formation, and plasma dissociation was the major phenomenon responsible for CH{sub 4} conversion. At 300 deg. C, higher CH{sub 4} conversion resulted from oxidative reactions induced by {center_dot}OH radicals with a chemistry predominantly oxidative, producing CO, H{sub 2}, CO{sub 2} and H{sub 2}O.

  14. Electrochemically assisted mechanically controllable break junction studies on the stacking configurations of oligo(phenylene ethynylene)s molecular junctions

    International Nuclear Information System (INIS)

    Zheng, Jue-Ting; Yan, Run-Wen; Tian, Jing-Hua; Liu, Jun-Yang; Pei, Lin-Qi; Wu, De-Yin; Dai, Ke; Yang, Yang; Jin, Shan

    2016-01-01

    Highlights: • I-V characteristics of a series of oligo(phenylene ethynylene)s molecular junctions were measured. • Conductance values were found to be dependent on molecular length and substituent group. • The measured low conductance values were explained by theoretical calculations. • EC-MCBJ is feasible to fabricate and characterize molecular junctions. - Abstract: We demonstrate an electrochemically assisted mechanically controllable break junction (EC-MCBJ) approach for current-voltage characteristic (I-V curve) measurements of metal/molecule/metal junctions. A series of oligo(phenylene ethynylene)s compounds (OPEs), including those involving electron withdrawing substituent group and different backbone lengths, had been successfully designed, synthesized, and placed onto the fabricated nanogap to form molecular junctions. The observed evolution in the measured conductances of OPEs indicates that there is a dependence of conductance on molecular length and substituent group. Compared with those extracted from conductance histogram construction, the conductances of OPEs measured from I-V curves are considerably lower. Based on the transmission spectra of OPEs that calculated by density functional theory (DFT) combined with non-equilibrium Green’s function (NEGF) method, this difference was attributed to our distinct experimental operation, which may give rise to a stacking configuration of two OPE molecules.

  15. Room and ultrahigh temperature structure-mechanical property relationships of tungsten alloys formed by field assisted sintering technique (FAST)

    Energy Technology Data Exchange (ETDEWEB)

    Browning, Paul N.; Alagic, Sven [Pennsylvania State University, Department of Materials Science and Engineering, State College, PA-16801 (United States); Pennsylvania State University, Applied Research Laboratory, State College, PA-16801 (United States); Kulkarni, Anil [Pennsylvania State University, Department of Nuclear and Mechanical Engineering, State College, PA-16801 (United States); Matson, Lawrence [Materials and Manufacturing Directorate, Wright Patterson Air Force Base, Dayton, OH (United States); Singh, Jogender, E-mail: jxs46@arl.psu.edu [Pennsylvania State University, Department of Materials Science and Engineering, State College, PA-16801 (United States); Pennsylvania State University, Applied Research Laboratory, State College, PA-16801 (United States)

    2016-09-30

    Tungsten based alloys have become of critical importance in a number of applications including plasma-facing materials in nuclear fusion reactors, rocket nozzles for aerospace applications, and in kinetic energy penetrators in the defense industry. Formation of components for these uses by powder metallurgical techniques has proven challenging, due to tungsten's relatively poor sinterability. Here we report the use of field assisted sintering technique (FAST) to produce high density, fine grain alloys with mechanical properties comparable or superior to that of components produced by conventional techniques. Alloys of pure tungsten, W-3 vol%TiC, W-5 vol%TiC, and W-10 vol%Ta were synthesized at 2100 °C, 35 MPa for 25 min using FAST. Microstructural characterization revealed effective reduction of grain size with TiC addition and preferential diffusion of oxygen into the center of tantalum particles in tantalum containing alloys. Tensile testing of alloys revealed TiC addition to W resulted in substantially improved ultimate tensile strength at the cost of ductility in comparison at temperatures up to 1926 °C (3500 °F) however this strengthening effect was lost at 2204 °C (4000 °F). Addition of 10 vol%Ta to W resulted in reduced hardness at room temperature, but substantially increased yield strength at the cost of slightly reduced ductility at 1926 °C and 2204 °C.

  16. Synthesis of nanoparticles from malleable and ductile metals using powder-free, reactant-assisted mechanical attrition.

    Science.gov (United States)

    McMahon, Brandon W; Perez, Jesus Paulo L; Yu, Jiang; Boatz, Jerry A; Anderson, Scott L

    2014-11-26

    A reactant-assisted mechanochemical method was used to produce copious nanoparticles from malleable/ductile metals, demonstrated here for aluminum, iron, and copper. The milling media is intentionally degraded via a reactant-accelerated wear process, where the reactant aids particle production by binding to the metal surfaces, enhancing particle production, and reducing the tendency toward mechanochemical (cold) welding. The mechanism is explored by comparing the effects of different types of solvents and solvent mixtures on the amount and type of particles produced. Particles were functionalized with oleic acid to aid in particle size separation, enhance dispersion in hydrocarbon solvents, and protect the particles from oxidation. For aluminum and iron, the result is air-stable particles, but for copper, the suspended particles are found to dissolve when exposed to air. Characterization was performed using electron microscopy, dynamic light scattering, Fourier transform infrared spectroscopy, solid state nuclear magnetic resonance, and X-ray photoelectron spectroscopy. Density functional theory was used to examine the nature of carboxylic acid binding to the aluminum surface, confirming the dominance of bridging bidentate binding.

  17. Reinforced carbon fiber laminates with oriented carbon nanotube epoxy nanocomposites: Magnetic field assisted alignment and cryogenic temperature mechanical properties.

    Science.gov (United States)

    He, Yuxin; Yang, Song; Liu, Hu; Shao, Qian; Chen, Qiuyu; Lu, Chang; Jiang, Yuanli; Liu, Chuntai; Guo, Zhanhu

    2018-05-01

    The epoxy nanocomposites with ordered multi-walled carbon nanotubes (MWCNTs) were used to influence the micro-cracks resistance of carbon fiber reinforced epoxy (CF/EP) laminate at 77 K, Oxidized MWCNTs functionalized with Fe 3 O 4 (Fe 3 O 4 /O-MWCNTs) with good magnetic properties were prepared by co-precipitation method and used to modify epoxy (EP) for cryogenic applications. Fe 3 O 4 /O-MWCNTs reinforced carbon fiber epoxy composites were also prepared through vacuum-assisted resin transfer molding (VARTM). The ordered Fe 3 O 4 /O-MWCNTs were observed to have effectively improved the mechanical properties of epoxy (EP) matrix at 77 K and reduce the coefficient of thermal expansion (CTE) of EP matrix. The ordered Fe 3 O 4 /O-MWCNTs also obviously improved the micro-cracks resistance of CF/EP composites at 77 K. Compared to neat EP, the CTE of ordered Fe 3 O 4 /O-MWCNTs modified CF/EP composites was decreased 37.6%. Compared to CF/EP composites, the micro-cracks density of ordered Fe 3 O 4 /O-MWCNTs modified CF/EP composites at 77 K was decreased 37.2%. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Ghost peaks observed after AP-MALDI experiment may disclose new ionization mechanism of matrix assisted hypersonic velocity impact ionization

    Science.gov (United States)

    Moskovets, Eugene

    2015-01-01

    RATIONALE Understanding the mechanisms of MALDI promises improvements in the sensitivity and specificity of many established applications in the field of mass spectrometry. This paper reports a serendipitous observation of a significant ion yield in a post-ionization experiment conducted after the sample has been removed from a standard atmospheric pressure (AP)-MALDI source. This post-ionization is interpreted in terms of collisions of microparticles moving with a hypersonic velocity into a solid surface. Calculations show that the thermal energy released during such collisions is close to that absorbed by the top matrix layer in traditional MALDI. The microparticles, containing both the matrix and analytes, could be detached from a film produced inside the inlet capillary during the sample ablation and accelerated by the flow rushing through the capillary. These observations contribute some new perspective to ion formation in both laser and laserless matrix-assisted ionization. METHODS An AP-MALDI ion source hyphenated with a three-stage high-pressure ion funnel system was utilized for peptide mass analysis. After the laser was turned off and MALDI sample was removed, ions were detected during a gradual reduction of the background pressure in the first funnel. The constant-rate pressure reduction led to the reproducible appearance of different singly- and doubly-charged peptide peaks in mass spectra taken a few seconds after the end of the MALDI analysis of a dried-droplet spot. RESULTS The ion yield as well as the mass range of ions observed with a significant delay after a completion of the primary MALDI analysis depended primarily on the background pressure inside the first funnel. The production of ions in this post-ionization step was exclusively observed during the pressure drop. A lower matrix background and significant increase in relative yield of double-protonated ions are reported. CONCLUSIONS The observations were partially consistent with a model of

  19. Validation of a mechanism to balance exercise difficulty in robot-assisted upper-extremity rehabilitation after stroke

    Directory of Open Access Journals (Sweden)

    Zimmerli Lukas

    2012-02-01

    Full Text Available Abstract Background The motivation of patients during robot-assisted rehabilitation after neurological disorders that lead to impairments of motor functions is of great importance. Due to the increasing number of patients, increasing medical costs and limited therapeutic resources, clinicians in the future may want patients to practice their movements at home or with reduced supervision during their stay in the clinic. Since people only engage in an activity and are motivated to practice if the outcome matches the effort at which they perform, an augmented feedback application for rehabilitation should take the cognitive and physical deficits of patients into account and incorporate a mechanism that is capable of balancing i.e. adjusting the difficulty of an exercise in an augmented feedback application to the patient's capabilities. Methods We propose a computational mechanism based on Fitts' Law that balances i.e. adjusts the difficulty of an exercise for upper-extremity rehabilitation. The proposed mechanism was implemented into an augmented feedback application consisting of three difficulty conditions (easy, balanced, hard. The task of the exercise was to reach random targets on the screen from a starting point within a specified time window. The available time was decreased with increasing condition difficulty. Ten subacute stroke patients were recruited to validate the mechanism through a study. Cognitive and motor functions of patients were assessed using the upper extremity section of the Fugl-Meyer Assessment, the modified Ashworth scale as well as the Addenbrookes cognitive examination-revised. Handedness of patients was obtained using the Edinburgh handedness inventory. Patients' performance during the execution of the exercises was measured twice, once for the paretic and once for the non-paretic arm. Results were compared using a two-way ANOVA. Post hoc analysis was performed using a Tukey HSD with a significance level of p Results

  20. Review of the models and mechanisms for environmentally-assisted crack growth of pressure vessel and piping steels in PWR environments

    International Nuclear Information System (INIS)

    Cullen, W.; Gabetta, G.; Hanninen, H.

    1985-12-01

    The crack-tip micromechanisms and the computational models for environmentally-assisted cracking in pressure vessel and piping steels in high-temperature, low-oxygen (PWR), reactor-grade water are described and evaluated in this report. The report begins with a brief description of the critical variables which are known to affect environmentally-assisted subcritical cracking in these metal/environment systems. The micromechanistic models are discussed in some detail, with anodic dissolution and hydrogen assistance being the prime candidates for the successful explanation of the observed phenomena. The anodic dissolution model offers far better quantification of the environmentally-assisted crack growth rates, but tends to overpredict the rates for a large number of conditions. The hydrogen assistance models qualitatively could account for a wider range of effects, but quantification of the model is virtually nonexistent. A variety of calculational models are in various stages of development; all of them are far from use as a predictive tool. Crack-tip strain rate models have received the most attention, and the approach to their use has been to partition the environmentally-assisted growth rates into a mechanically-driven component, with the environmental enhancement superposed. The environment component is then correlated with a calculated crack-tip strain rate. 141 refs., 59 figs

  1. Needle-tissue interactive mechanism and steering control in image-guided robot-assisted minimally invasive surgery: a review.

    Science.gov (United States)

    Li, Pan; Yang, Zhiyong; Jiang, Shan

    2018-06-01

    Image-guided robot-assisted minimally invasive surgery is an important medicine procedure used for biopsy or local target therapy. In order to reach the target region not accessible using traditional techniques, long and thin flexible needles are inserted into the soft tissue which has large deformation and nonlinear characteristics. However, the detection results and therapeutic effect are directly influenced by the targeting accuracy of needle steering. For this reason, the needle-tissue interactive mechanism, path planning, and steering control are investigated in this review by searching literatures in the last 10 years, which results in a comprehensive overview of the existing techniques with the main accomplishments, limitations, and recommendations. Through comprehensive analyses, surgical simulation for insertion into multi-layer inhomogeneous tissue is verified as a primary and propositional aspect to be explored, which accurately predicts the nonlinear needle deflection and tissue deformation. Investigation of the path planning of flexible needles is recommended to an anatomical or a deformable environment which has characteristics of the tissue deformation. Nonholonomic modeling combined with duty-cycled spinning for needle steering, which tracks the tip position in real time and compensates for the deviation error, is recommended as a future research focus in the steering control in anatomical and deformable environments. Graphical abstract a Insertion force when the needle is inserted into soft tissue. b Needle deflection model when the needle is inserted into soft tissue [68]. c Path planning in anatomical environments [92]. d Duty-cycled spinning incorporated in nonholonomic needle steering [64].

  2. Novel circulatory connection from the acupoint Zhong Wan(CV12 to pancreas

    Directory of Open Access Journals (Sweden)

    Minsoo Kim

    2008-03-01

    Full Text Available Objectives : Demonstrating a novel circulatory path from the acupoint(CV12 to the pancreas. Method : Alcian blue(1% solution, 20μl, pH 7.4 was injected into the acupoint(CV12. Two hours later the surfaces of internal organs were observed by using a stereomicroscope. Results : Alcian blue arrived and colored the omental fat band(OFB on the pancreas. The OFB connected the head and tail of the pancreas, the pancreas and the spleen, and the pancreas and the stomach. Conclusion : The existence of a novel circulatory path from the acupoint CV12 to the pancreas and its OFB was demonstrated.

  3. Theological reflections on donation after circulatory death: the wisdom of Paul Ramsey and Moshe Feinstein.

    Science.gov (United States)

    Jotkowitz, A

    2008-10-01

    Due to the worldwide shortage of organs for transplantation, there has been an increased use of organs obtained after circulatory death alone. A protocol for this procedure has recently been approved by a major transplant consortium. This development raises serious moral and ethical concerns. Two renowned theologians of the previous generation, Paul Ramsey and Moshe Feinstein, wrote extensively on the ethical issues relating to transplantation, and their work has much relevance to current moral dilemmas. Their writings relating to definition of death, organ transplantation and the care of the terminally ill are briefly presented, and their potential application to the moral problem of organ donation after circulatory death is discussed.

  4. Fe-N{sub x}/C assisted chemical–mechanical polishing for improving the removal rate of sapphire

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Li, E-mail: xl0522@126.com [State Key Laboratory of Tribology, Tsinghua University, Beijing 100084 (China); Shenzhen Key Laboratory of Micro/Nano Manufacturing, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057 (China); Zou, Chunli; Shi, Xiaolei [State Key Laboratory of Tribology, Tsinghua University, Beijing 100084 (China); Shenzhen Key Laboratory of Micro/Nano Manufacturing, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057 (China); Pan, Guoshun, E-mail: pangs@tsinghua.edu.cn [State Key Laboratory of Tribology, Tsinghua University, Beijing 100084 (China); Shenzhen Key Laboratory of Micro/Nano Manufacturing, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057 (China); Luo, Guihai; Zhou, Yan [State Key Laboratory of Tribology, Tsinghua University, Beijing 100084 (China); Shenzhen Key Laboratory of Micro/Nano Manufacturing, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057 (China)

    2015-07-15

    Highlights: • A novel non-noble metal catalyst (Fe-N{sub x}/C) was prepared. • Fe-N{sub x}/C shows remarkable catalytic activity for improving the removal rate of sapphire in alkaline solution. • The optimum CMP removal by Fe-N{sub x}/C yielded a superior surface finish of 0.078 nm the average roughness. • Fe{sub 2}O{sub 3}, Fe{sub 3}O{sub 4}, pyridinic N as well as pyrrolic N group possibly serving as the catalytic sites. • A soft hydration layer (boehmite, AlO(OH)) was generated on the surface of sapphire during CMP process. - Abstract: In this paper, a novel non-noble metal catalyst (Fe-N{sub x}/C) is used to improve the removal mass of sapphire as well as obtain atomically smooth sapphire wafer surfaces. The results indicate that Fe-N{sub x}/C shows good catalytic activity towards sapphire removal rate. And the material removal rates (MRRs) are found to vary with the catalyst content in the polishing fluid. Especially that when the polishing slurry mixes with 16 ppm Fe-N{sub x}/C shows the maximum MRR and its removal mass of sapphire is 38.43 nm/min, more than 15.44% larger than traditional CMP using the colloidal silicon dioxide (SiO{sub 2}) without Fe-N{sub x}/C. Catalyst-assisted chemical–mechanical polishing of sapphire is studied with X-ray photoelectron spectroscopy (XPS). It is found that the formation of a soft hydration layer (boehmite, γ-AlOOH or γ-AlO(OH)) on sapphire surface facilitates the material removal and achieving fine surface finish on basal plane. Abrasives (colloid silica together with magnetite, ingredient of Fe-N{sub x}/C) with a hardness between boehmite and sapphire polish the c-plane of sapphire with good surface finish and efficient removal. Fe{sub 2}O{sub 3}, Fe{sub 3}O{sub 4}, pyridinic N as well as pyrrolic N group would be the catalytical active sites and accelerate this process. Surface quality is characterized with atomic force microscopy (AFM). The optimum CMP removal by Fe-N{sub x}/C also yields a superior

  5. From Head to Toe: Respiratory, Circulatory, and Skeletal Systems. Book 3.

    Science.gov (United States)

    Wiebe, Arthur, Ed.; And Others

    Designed to supplement curricular programs dealing with the human body, this booklet offers an activity-based, student-oriented approach for middle school teachers and students. Twelve activities focus on principles and skills related to the respiratory, circulatory, and skeletal systems. Each activity consists of student sheets and a teacher's…

  6. Evaluation of exercise-respiratory system modifications and preliminary respiratory-circulatory system integration scheme

    Science.gov (United States)

    Gallagher, R. R.

    1974-01-01

    The respiratory control system, functioning as an independent system, is presented with modifications of the exercise subroutine. These modifications illustrate an improved control of ventilation rates and arterial and compartmental gas tensions. A very elementary approach to describing the interactions of the respiratory and circulatory system is presented.

  7. Hypothermic Oxygenated Machine Perfusion in Porcine Donation After Circulatory Determination of Death Liver Transplant

    NARCIS (Netherlands)

    Fondevila, Constantino; Hessheimer, Amelia J.; Maathuis, Mark-Hugo J.; Munoz, Javier; Taura, Pilar; Calatayud, David; Leuvenink, Henri; Rimola, Antoni; Garcia-Valdecasas, Juan C.; Ploeg, Rutger J.

    2012-01-01

    Background. Livers from donation after circulatory determination-of-death (DCD) donors suffer ischemic injury during a preextraction period of cardiac arrest and are infrequently used for transplantation; they have the potential, however, to considerably expand the donor pool. We aimed to determine

  8. Surgical thromboendarterectomy for chronic thromboembolic pulmonary hypertension using circulatory arrest with selective antegrade cerebral perfusion

    NARCIS (Netherlands)

    Zeebregts, CJAM; Dossche, KM; Morshuis, WJ; Knaepen, PJ; Schepens, MAAM

    The use of circulatory arrest with selective antegrade cerebral perfusion is described in a 59-year-old man who underwent thrombendarterectomy for chronic thromboembolic pulmonary hypertension. The postoperative course was uneventful. The described surgical technique may prevent the patient from

  9. Outcome of pancreas transplantation from donation after circulatory death compared to donation after brain death

    NARCIS (Netherlands)

    van Loo, Ellen S.; Krikke, Christina; Hofker, Hendrik S.; Berger, Stefan P.; Leuvenink, Henri G. D.; Pol, Robert A.

    Introduction: To overcome the gap of organ shortage grafts from donation after circulatory death (DCD) can be used. This review evaluates the outcomes after DCD pancreas donation compared to donation after brain death (DBD). Materials and methods: A literature search was performed using Medline,

  10. Pancreas transplantation with grafts from donors deceased after circulatory death (DCD) : 5 years single center experience

    NARCIS (Netherlands)

    Kopp, Wouter H; Lam, Hwai-Ding; Schaapherder, Alexander F M; Huurman, Volkert A L; van der Boog, Paul; de Koning, Eelco; de Fijter, Johan W; Baranski, Andrzej; Braat, Andries E

    2017-01-01

    INTRODUCTION: Donation after circulatory death (DCD) pancreas transplantation has been shown to be an additional way to deal with donor organ shortages. The results of 5-year DCD pancreas transplantation are presented. METHODS: A retrospective, single center analysis (2011 - 2015) was performed to

  11. Fast self-diffusion of ions in CH 3 NH 3 PbI 3 : the interstiticaly mechanism versus vacancy-assisted mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ji-Hui; Yin, Wan-Jian; Park, Ji-Sang; Wei, Su-Huai

    2016-01-01

    The stability of organic-inorganic halide perovskites is a major challenge for their applications and has been extensively studied. Among the possible underlying reasons, ion self-diffusion has been inferred to play important roles. While theoretical studies congruously support that iodine is more mobile, experimental studies only observe the direct diffusion of the MA ion and possible diffusion of iodine. The discrepancy may result from the incomplete understanding of ion diffusion mechanisms. With the help of first-principles calculations, we studied ion diffusion in CH3NH3PbI3 (MAPbI3) through not only the vacancy-assisted mechanisms presumed in previous theoretical studies, but also the neglected interstiticaly mechanisms. We found that compared to the diffusion through the vacancy-assisted mechanism, MA ion diffusion through the interstiticaly mechanism has a much smaller barrier which could explain experimental observations. For iodine diffusion, both mechanisms can yield relatively small barriers. Depending on the growth conditions, defect densities of vacancies and interstitials can vary and so do the diffusion species as well as diffusion mechanisms. Our work thus supports that both MA and iodine ion diffusion could contribute to the performance instability of MAPbI3. While being congruous with experimental results, our work fills the research gap by providing a full understanding of ion diffusion in halide perovskites.

  12. Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death—Summary Report*

    Science.gov (United States)

    Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, ; Sonny; Sivarajan, V. Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A.; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D.

    2017-01-01

    Objectives: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. Methods: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. Results: We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation

  13. Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death-Summary Report.

    Science.gov (United States)

    Weiss, Matthew J; Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, Sonny; Sivarajan, V Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D

    2017-11-01

    Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory

  14. Analysis of Dose Response for Circulatory Disease After Radiotherapy for Benign Disease

    Energy Technology Data Exchange (ETDEWEB)

    Little, Mark P., E-mail: mark.little@nih.gov [Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Rockville, Maryland (United States); Kleinerman, Ruth A. [Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Rockville, Maryland (United States); Stovall, Marilyn; Smith, Susan A. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mabuchi, Kiyohiko [Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Rockville, Maryland (United States)

    2012-12-01

    Purpose: To assess the shape of the dose-response for various circulatory disease endpoints, and modifiers by age and time since exposure. Methods and Materials: This was an analysis of the US peptic ulcer data testing for heterogeneity of radiogenic risk by circulatory disease endpoint (ischemic heart, cerebrovascular, other circulatory disease). Results: There were significant excess risks for all circulatory disease, with an excess relative risk Gy{sup -1} of 0.082 (95% CI 0.031-0.140), and ischemic heart disease, with an excess relative risk Gy{sup -1} of 0.102 (95% CI 0.039-0.174) (both p = 0.01), and indications of excess risk for stroke. There were no statistically significant (p > 0.2) differences between risks by endpoint, and few indications of curvature in the dose-response. There were significant (p < 0.001) modifications of relative risk by time since exposure, the magnitude of which did not vary between endpoints (p > 0.2). Risk modifications were similar if analysis was restricted to patients receiving radiation, although the relative risks were slightly larger and the risk of stroke failed to be significant. The slopes of the dose-response were generally consistent with those observed in the Japanese atomic bomb survivors and in occupationally and medically exposed groups. Conclusions: There were excess risks for a variety of circulatory diseases in this dataset, with significant modification of risk by time since exposure. The consistency of the dose-response slopes with those observed in radiotherapeutically treated groups at much higher dose, as well as in lower dose-exposed cohorts such as the Japanese atomic bomb survivors and nuclear workers, implies that there may be little sparing effect of fractionation of dose or low-dose-rate exposure.

  15. Diseases of the circulatory system and the likelihood of their development in the workforce at the Chernobyl nuclear power plant

    International Nuclear Information System (INIS)

    Khomazyuk, N.N.; Goncharenko, L.I.; Kovalev, A.C.; Nastina, E.M.; Chebanyuk, C.V.

    1995-01-01

    Large doses of general or localized radiation can provoke changes in the circulatory system, can affect all layers of the heart and cause selective damage to vascular endothelium. A study of the condition of the circulatory system in the victims of the Chernobyl disaster was carried out by the authors in 1986. This paper presents the results of an investigation into the condition of the circulatory system of Chernobyl employees working for long periods with sources of ionizing radiation. (O.L.). 11 refs., 3 figs

  16. Scandinavian SSAI clinical practice guideline on choice of first-line vasopressor for patients with acute circulatory failure

    DEFF Research Database (Denmark)

    Møller, M H; Claudius, C; Junttila, E

    2016-01-01

    BACKGROUND: Adult critically ill patients often suffer from acute circulatory failure, necessitating use of vasopressor therapy. The aim of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force for Acute Circulatory Failure was to present clinically relevant...... to recommendations. We assessed the following subpopulations of patients with acute circulatory failure: 1) shock in general, 2) septic shock, 3) cardiogenic shock, 4) hypovolemic shock and 5) other types of shock, including vasodilatory shock. We assessed patient-important outcome measures, including mortality...

  17. Review: Circulatory disorders induced by ochratoxin A | Hussein ...

    African Journals Online (AJOL)

    The cardiotoxic mechanism of OA has been established by both in vivo and in vitro study on the rat and frog hearts. Sympathetic ... Ochratoxin A seriously affects the circulating blood and the circulating body fluid which are currently defined as the internal environment that facilitate the metabolic processes and homeostasis.

  18. Comparison of outcomes of kidney transplantation from donation after brain death, donation after circulatory death, and donation after brain death followed by circulatory death donors.

    Science.gov (United States)

    Chen, Guodong; Wang, Chang; Ko, Dicken Shiu-Chung; Qiu, Jiang; Yuan, Xiaopeng; Han, Ming; Wang, Changxi; He, Xiaoshun; Chen, Lizhong

    2017-11-01

    There are three categories of deceased donors of kidney transplantation in China, donation after brain death (DBD), donation after circulatory death (DCD), and donation after brain death followed by circulatory death (DBCD) donors. The aim of this study was to compare the outcomes of kidney transplantation from these three categories of deceased donors. We retrospectively reviewed 469 recipients who received deceased kidney transplantation in our hospital from February 2007 to June 2015. The recipients were divided into three groups according to the source of their donor kidneys: DBD, DCD, or DBCD. The primary endpoints were delayed graft function (DGF), graft loss, and patient death. The warm ischemia time was much longer in DCD group compared to DBCD group (18.4 minutes vs 12.9 minutes, P < .001). DGF rate was higher in DCD group than in DBD and DBCD groups (22.5% vs 10.2% and 13.8%, respectively, P = .021). Urinary leakage was much higher in DCD group (P = .049). Kaplan-Meier analysis showed that 1-, 2-, and 3-year patient survivals were all comparable among the three groups. DBCD kidney transplantation has lower incidences of DGF and urinary leakage than DCD kidney transplant. However, the overall patient and graft survival were comparable among DBD, DCD, and DBCD kidney transplantation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Contribution of Circulatory Disturbances in Subchondral Bone to the Pathophysiology of Osteoarthritis.

    Science.gov (United States)

    Aaron, Roy K; Racine, Jennifer; Dyke, Jonathan P

    2017-08-01

    This review describes the contributions of abnormal bone circulation to the pathophysiology of osteoarthritis. Combining dynamic imaging with MRI and PET with previous observations reveals that venous stasis and a venous outlet syndrome is most likely the key circulatory pathology associated with the initiation or progression of osteoarthritis. MRI and PET have revealed that venous outflow obstruction results in physicochemical changes in subchondral bone to which osteoblasts are responsive. The osteoblasts express an altered pattern of cytokines, many of which can serve as structural or signaling molecules contributing to both bone remodeling and cartilage degeneration. The patterns of circulatory changes are associated with alterations in the physicochemical environment of subchondral bone, including hypoxia. Osteoblast cytokines can transit the subchondral bone plate and calcified cartilage and communicate with chondrocytes.

  20. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy.

    LENUS (Irish Health Repository)

    O' Sullivan, Katie E

    2013-12-01

    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent operative intervention.

  1. OUTCOMES OF LIVER TRANSPLANTATION USING DONATIONS AFTER CIRCULATORY DEATH : A SINGLE-CENTER EXPERIENCE

    OpenAIRE

    MEURISSE, Nicolas; VANDEN BUSSCHE, S; JOCHMANS, I; FRANCOIS, J; DESSCHANS, B; LALEMAN, W; VAN DER MERWE, S; VAN STEENBERGEN, W; CASSIMAN, D; VERSLYPE, C; AERTS, R; NEVENS, F; PIRENNE, J; MONBALIU, D

    2012-01-01

    Introduction Orthotopic liver transplantation (OLT) (LTx) using donation after circulatory death (DCD) donors is increasingly performed, but still considered to risk of poorer outcomes compared with standard donations after brain death (DBD)-OLT. Therefore we reviewed our results of DCD-OLT. Patients and Methods Between 2003 and 2010, we performed 30 DCD-OLT (6% of all OLT). We retrospectively reviewed medical records of donors and recipients after DCD versus DBD-OLT to analyze bil...

  2. The Impact of Ionospheric and Geomagnetic Changes on Mortality from Diseases of the Circulatory System

    Czech Academy of Sciences Publication Activity Database

    Podolská, Kateřina

    2018-01-01

    Roč. 27, č. 2 (2018), s. 404-417 ISSN 1052-3057 Institutional support: RVO:68378289 Keywords : mortality * circulatory system diseases * solar indices * cluster analysis using time Subject RIV: DN - Health Impact of the Environment Quality OBOR OECD: Public and environmental health Impact factor: 1.517, year: 2016 http://www.strokejournal.org/article/S1052-3057(17)30488-3/fulltext

  3. Favorable circulatory system outcomes as adjuvant traditional Chinese medicine (TCM treatment for cerebrovascular diseases in Taiwan.

    Directory of Open Access Journals (Sweden)

    Hsienhsueh Elley Chiu

    Full Text Available This study searches the National Health Insurance Research Database (NHIRD used in a previous project, aiming for reconstructing possible cerebrovascular disease-related groups (DRG,and estimating the costs between cerebrovascular disease and related diseases.We conducted a nationwide retrospective cohort study in stroke inpatients, we examined the overall costs in 3 municipalities in Taiwan, by evaluating the possible costs of the expecting diagnosis related group (DRG by using the international classification of diseases version-9 (ICD-9 system, and the overall analysis of the re-admission population that received traditional Chinese medicine (TCM treatment and those who did not.The trend demonstrated that the non-participant costs were consistent with the ICD-9 categories (430 to 437 because similarities existed between years 2006 to 2007. Among the TCM patients, a wide variation and additional costs were found compared to non-TCM patients during these 2 years. The average re-admission duration was significantly shorter for TCM patients, especially those initially diagnosed with ICD 434 during the first admission. In addition, TCM patients demonstrated more severe general symptoms, which incurred high conventional treatment costs, and could result in re-admission for numerous reasons. However, in Disease 7 of ICD-9 category, representing the circulatory system was most prevalent in non-TCM inpatients, which was the leading cause of re-admission.We concluded that favorable circulatory system outcomes were in adjuvant TCM treatment inpatients, there were less re-admission for circulatory system events and a two-third reduction of re-admission within ICD-9 code 430 to 437, compared to non-TCM ones. However, there were shorter re-admission duration other than circulatory system events by means of unfavorable baseline condition.

  4. A cause of circulatory collapse that should be considered following trauma

    Directory of Open Access Journals (Sweden)

    Omar Hesham R

    2010-08-01

    Full Text Available Abstract Management of poly-trauma patients presenting to the emergency room is usually a challenging and formidable task. Two of the common problems seen in those patients are shock and neurological dysfunction. A huge differential for post-traumatic circulatory collapse exist and timely identification of the etiology is of utmost importance to avoid complications. In this report we are describing 2 cases presenting with circulatory collapse following trauma. The first case was a 29 year old female who presented after a motor vehicle accident fully conscious with severe hypotension and bradycardia. The second case presented with severe hemodynamic instability after falling at home. Physical examination of both patients revealed weakness in all 4 limbs and CT cervical spine revealed complete anterior sublaxation of C5 over C6 cervical vertebrae in the first case and partial sublaxation of C5 over C6 cervical vertebrae in the second case confirming that spinal cord injury is the likely cause for these hemodynamic alterations. A high index of suspicion for spinal cord injuries is therefore mandatory when managing a trauma patient presenting with quadriparesis and hemodynamic instability that is otherwise unexplained especially when the ensuing hypotension is associated with bradycardia instead of reflex tachycardia. Awareness of this cause of circulatory collapse is particularly important in the unconscious patient where eliciting sensory and motor deficits looking for spinal cord injury is not always feasible. Both patients were transferred to the intensive care unit and were maintained on epinephrine till becoming hemodynamically stable. The report aims to sensitize readers to this cause of post-traumatic circulatory collapse.

  5. Low-frequency dynamics of autonomic regulation of circulatory system in healthy subjects

    Science.gov (United States)

    Skazkina, V. V.; Borovkova, E. I.; Galushko, T. A.; Khorev, V. S.; Kiselev, A. R.

    2018-04-01

    The paper is devoted to the analysis of dynamic of interactions between signals of autonomic circulatory regulation. We investigated two-hour experimental records of 30 healthy people. Phase synchronization was studied using the signals of the electrocardiogram and the photoplethysmogram of vessels. We found the presence of long synchronous intervals in some subjects. For analysis of the dynamic we calculated autocorrelation functions. The analysis made it possible to reveal indirect signs of the influence of the humoral regulation system.

  6. Mechanism of coercivity enhancement by Ag addition in FePt-C granular films for heat assisted magnetic recording media

    Energy Technology Data Exchange (ETDEWEB)

    Varaprasad, B. S. D. Ch. S.; Takahashi, Y. K., E-mail: takahashi.yukiko@nims.go.jp; Wang, J.; Hono, K. [National Institute for Materials Science (NIMS), 1-2-1 Sengen, Tsukuba 305-0047 (Japan); Ina, T.; Nakamura, T.; Ueno, W.; Nitta, K.; Uruga, T. [Japan Synchrotron Radiation Research Institute (JASRI/SPring-8), 1-1-1 Kouto, Sayo, Hyogo 679-5198 (Japan)

    2014-06-02

    We investigated the Ag distribution in a FePtAg-C granular film that is under consideration for a heat assisted magnetic recording medium by aberration-corrected scanning transmission electron microscope-energy dispersive X-ray spectroscopy and X-ray absorption fine structure. Ag is rejected from the core of FePt grains during the deposition, forming Ag-enriched shell surrounding L1{sub 0}-ordered FePt grains. Since Ag has no solubility in both Fe and Pt, the rejection of Ag induces atomic diffusions thereby enhancing the kinetics of the L1{sub 0}-order in the FePt grains.

  7. Acquisition of Mechanically Assisted Spark Plasma Sintering System for Advanced Research and Education on Functionally Graded Hybrid Materials

    Science.gov (United States)

    2012-03-14

    Institute. The proposed effort offers a multidisciplinary research program to achieve the topic goals by coupling thermal- acoustic - mechanical flight...optional optical pyrometer .  Single port for standard (mechanical vacuum pump) and high vacuum system. POWER SUPPLY  10,000 amp, 10 VDC pulsed...Amperage TEMPERATURE CONTROL SYSTEM  Ten (10) Type K and five (5) Type C thermocouples with protective flexible sheaths.  Optical Pyrometer

  8. Peer-Assisted Learning Programme: Supporting Students in High-Risk Subjects at the Mechanical Engineering Department at Walter Sisulu University

    Directory of Open Access Journals (Sweden)

    Makala Qonda

    2017-12-01

    Full Text Available The majority of the students who enroll at the Walter Sisulu University (WSU in South Africa are not equipped with the necessary academic/learning skills to cope with the university environment, especially in Mechanical Engineering. The Department of Higher Education and Training (2013, p. 17, further states that “students’ support is crucial to ensure that students adapt to the demands of college life and that they can meet the demands of college programmes”. Particularly in South Africa, the school environment might also contribute to poor student performance as a result of insufficient student support, and a lack of facilities and resources. In order to address this gap, a Peer-Assisted Learning (PAL programme was implemented to provide support targeting high-risk subjects for at-risk students in Mechanical Engineering at WSU. The programme therefore is pro-active and student-driven in that senior students assist junior students with their academic work and learning processes. The programme is designed to encourage collaborative and cooperative learning approaches during group sessions and active student engagement to support student learning (Laal & Laal, 2012. The programme requires substantial resources and time commitments. It is important from an operational, learning, and student perspective to understand in what ways the PAL programme assists students (if at all. Eliciting the experiences of students also helps the department to design interventions from a student-centred perspective using the lens of learning theories.  This qualitative case study explores the student experience of the Peer-Assisted Learning (PAL programme. Open-ended questionnaires/survey from 20 first-year students elicited their perceptions and experiences of the PAL programme. Responses were analysed thematically. Findings indicated that the students had useful insights that may contribute to revising the programme. Aspects mentioned were improved study

  9. Control of Cell Fate in the Circulatory and Ventilatory Systems

    CERN Document Server

    Thiriet, Marc

    2012-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanisms. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning. Volumes 1 and 2 are devoted to cell organization and fate, as well as activities that are autoregulated and/or controlled by the cell environment. Volume 1 examined cellular features that allow adaptation to env...

  10. Intracellular Signaling Mediators in the Circulatory and Ventilatory Systems

    CERN Document Server

    Thiriet, Marc

    2013-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to phenomenological models of nano- and microscopic events in a corrector scheme of regulated mechanisms when the vessel lumen caliber varies markedly. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning. Volume 4 is devoted to major sets of intracellular mediators that transmit signals upon stimulation of cell-surface receptors.  Activation of...

  11. An elastic-plastic fracture mechanics based methodology to characterize cracking behavior and its application to environmental assisted processes

    International Nuclear Information System (INIS)

    Alvarez, J.A.; Gutierrez-Solana, F.

    1999-01-01

    Cracking processes suffered by new structural and piping steels when used in petroleum or other energy installations have demonstrated the need for a cracking resistance characterization methodology. This methodology, valid for both elastic and elastoplastic regimes, should be able to define crack propagation kinetics as a function of their controlling local parameters. This work summarizes an experimental and analytical methodology that has been shown to be suitable for characterizing cracking processes using compact tensile specimens, especially subcritical environmentally assisted ones, such as those induced by hydrogen in microalloyed steels. The applied and validated methodology has been shown to offer quantitative results of cracking behavior and to correlate these with the existing fracture micromechanisms. (orig.)

  12. Radar-Assisted Mapping of Massive Ice in Western Utopia Planitia, Mars: Degradational Mechanisms and Implications for Surface Evolution

    Science.gov (United States)

    Stuurman, C. M.; Levy, J. S.; Holt, J. W.; Harrison, T. N.; Osinski, G. R.

    2015-12-01

    Western Utopia Planitia remains an enigmatic region of Mars. Radar and morphological analyses have framed the area as rich in ground ice, however there exist multiple theories regarding how the ice was emplaced. Here, we combine radar and morphological analyses to characterize the recent history of water ice in western Utopia Planitia. A radar reflective interface found in SHAllow RADar (SHARAD) data in Utopia Planitia is found to correlate with layered mesas 80-110 m thick. Discontinuities in the radar reflective interface relate to degradation of the layered mesas. This work uses the extent of the reflective interface to map the previous extent of the layered mesas, which we believe constitutes the remnants of a large ice sheet formed in the Late Amazonian. The past volume of the ice sheet is to be determined by the SHARAD-assisted mapping. This volume will be related to the recent climate history of western Utopia Planitia.

  13. Carrot juice ingestion attenuates high fructose-induced circulatory pro-inflammatory mediators in weanling Wistar rats.

    Science.gov (United States)

    Mahesh, Malleswarapu; Bharathi, Munugala; Raja Gopal Reddy, Mooli; Pappu, Pranati; Putcha, Uday Kumar; Vajreswari, Ayyalasomayajula; Jeyakumar, Shanmugam M

    2017-03-01

    Adipose tissue, an endocrine organ, plays a vital role not only in energy homeostasis, but also in the development and/or progression of various metabolic diseases, such as insulin resistance, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD), via several factors and mechanisms, including inflammation. This study tested, whether carrot juice administration affected the adipose tissue development and its inflammatory status in a high fructose diet-induced rat model. For this purpose, male weanling Wistar rats were divided into four groups and fed either control or high fructose diet of AIN-93G composition with or without carrot juice ingestion for an 8 week period. Administration of carrot juice did not affect the adiposity and cell size of visceral fat depot; retroperitoneal white adipose tissue (RPWAT), which was corroborated with unaltered expression of genes involved in adipogenic and lipogenic pathways. However, it significantly reduced the high fructose diet-induced elevation of plasma free fatty acid (FFA) (P ≤ 0.05), macrophage chemoattractant protein 1 (MCP1) (P ≤ 0.01) and high sensitive C-reactive protein (hsCRP) (P ≤ 0.05) levels. Carrot juice administration attenuated the high fructose diet-induced elevation of levels of circulatory FFA and pro-inflammatory mediators; MCP1 and hsCRP without affecting the adiposity and cell size of visceral fat depot; RPWAT. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  14. Mechanical and Thermal Properties of Dental Composites Cured with CAD/CAM Assisted Solid-State Laser

    Directory of Open Access Journals (Sweden)

    Roberto De Santis

    2018-03-01

    Full Text Available Over the last three decades, it has been frequently reported that the properties of dental restorative composites cured with argon laser are similar or superior to those achieved with conventional halogen and light emitting diode (LED curing units. Whereas laser curing is not dependent on the distance between the curing unit and the material, such distance represents a drawback for conventional curing units. However, a widespread clinical application of this kind of laser remains difficult due to cost, heavy weight, and bulky size. Recently, with regard to the radiation in the blue region of the spectrum, powerful solid-state lasers have been commercialized. In the current research, CAD (computer-aided design/CAM (computer-aided manufacturing assisted solid-state lasers were employed for curing of different dental restorative composites consisting of micro- and nanoparticle-reinforced materials based on acrylic resins. Commercial LED curing units were used as a control. Temperature rise during the photopolymerisation process and bending properties were measured. By providing similar light energy dose, no significant difference in temperature rise was observed when the two light sources provided similar intensity. In addition, after 7 days since curing, bending properties of composites cured with laser and LED were similar. The results suggested that this kind of laser would be suitable for curing dental composites, and the curing process does not suffer from the tip-to-tooth distance.

  15. Phase evolution and mechanical behavior of 0.36 wt% C high strength TRIP-assisted steel

    Energy Technology Data Exchange (ETDEWEB)

    Ghosh, Swarup Kumar; Chattopadhyay, Partha Protim [Department of Metallurgy and Materials Engineering, Bengal Engineering and Science University, Shibpur, Howrah 711 103 (India)

    2012-12-15

    Phase evolution in a 0.36 wt% C steel has been studied by thermodynamic calculation and dilatometric analysis with an aim to achieve high strength TRIP-assisted steel with bainitic microstructure. The equilibrium phase fraction calculated as the function of temperature indicated the formation of {delta}-ferrite ({approx}98%) at 1417 C. In contrast, similar calculation under para-equilibrium condition exhibited transformation of {delta}-ferrite to austenite at the temperature below 1300 C. During further cooling two-phase ({alpha}+{gamma}) microstructure has been found to be stable at the intercritical temperature range. The experimentally determined CCT diagram has revealed that adequate hardenability is achievable in the steel under continuous cooling condition at cooling rate >5 C s{sup -1}. In view of the aforesaid results, the steel has been hot rolled and subjected to different process schedule conducive to the evolution of bainitic microstructure. The hot rolled steel has exhibited reasonably good tensile properties. However, cold deformation of the hot rolled sample followed by intercritical annealing and subsequent isothermal bainitic transformation has resulted in high strength (>1000 MPa) with attractive elongation due to the favorable work hardening condition during plastic deformation offered by the multiphase microstructure. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  16. Mechanical and Thermal Properties of Dental Composites Cured with CAD/CAM Assisted Solid-State Laser

    Science.gov (United States)

    De Santis, Roberto; Gloria, Antonio; Maietta, Saverio; Martorelli, Massimo; De Luca, Alessandro; Spagnuolo, Gianrico; Riccitiello, Francesco; Rengo, Sandro

    2018-01-01

    Over the last three decades, it has been frequently reported that the properties of dental restorative composites cured with argon laser are similar or superior to those achieved with conventional halogen and light emitting diode (LED) curing units. Whereas laser curing is not dependent on the distance between the curing unit and the material, such distance represents a drawback for conventional curing units. However, a widespread clinical application of this kind of laser remains difficult due to cost, heavy weight, and bulky size. Recently, with regard to the radiation in the blue region of the spectrum, powerful solid-state lasers have been commercialized. In the current research, CAD (computer-aided design)/CAM (computer-aided manufacturing) assisted solid-state lasers were employed for curing of different dental restorative composites consisting of micro- and nanoparticle-reinforced materials based on acrylic resins. Commercial LED curing units were used as a control. Temperature rise during the photopolymerisation process and bending properties were measured. By providing similar light energy dose, no significant difference in temperature rise was observed when the two light sources provided similar intensity. In addition, after 7 days since curing, bending properties of composites cured with laser and LED were similar. The results suggested that this kind of laser would be suitable for curing dental composites, and the curing process does not suffer from the tip-to-tooth distance. PMID:29584683

  17. Investigate the ultrasound energy assisted adsorption mechanism of nickel(II) ions onto modified magnetic cobalt ferrite nanoparticles: Multivariate optimization.

    Science.gov (United States)

    Mehrabi, Fatemeh; Alipanahpour Dil, Ebrahim

    2017-07-01

    In present study, magnetic cobalt ferrite nanoparticles modified with (E)-N-(2-nitrobenzylidene)-2-(2-(2-nitrophenyl)imidazolidine-1-yl) ethaneamine (CoFe 2 O 4 -NPs-NBNPIEA) was synthesized and applied as novel adsorbent for ultrasound energy assisted adsorption of nickel(II) ions (Ni 2+ ) from aqueous solution. The prepared adsorbent characterized by Fourier transforms infrared spectroscopy (FT-IR), transmission electron microscope (TEM), vibrating sample magnetometer (VSM) and X-ray diffraction (XRD). The dependency of adsorption percentage to variables such as pH, initial Ni 2+ ions concentration, adsorbent mass and ultrasound time were studied with response surface methodology (RSM) by considering the desirable functions. The quadratic model between the dependent and independent variables was built. The proposed method showed good agreement between the experimental data and predictive value, and it has been successfully employed to adsorption of Ni 2+ ions from aqueous solution. Subsequently, the experimental equilibrium data at different concentration of Ni 2+ ions and 10mg amount of adsorbent mass was fitted to conventional isotherm models like Langmuir, Freundlich, Tempkin, Dubinin-Radushkevich and it was revealed that the Langmuir is best model for explanation of behavior of experimental data. In addition, conventional kinetic models such as pseudo-first and second-order, Elovich and intraparticle diffusion were applied and it was seen that pseudo-second-order equation is suitable to fit the experimental data. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Flow visualization of a monoleaflet and bileaflet mechanical heart valve in a pneumatic ventricular assist device using a PIV system.

    Science.gov (United States)

    Lee, Hwansung; Tatsumi, Eisuke; Taenaka, Yoshiyuki

    2010-01-01

    Our group is developing a new type of pulsatile pneumatic ventricular assist device (PVAD) that uses the Medtronic Hall tilting disc valve (M-H valve). Although tilting disc valves have good washout effect inside the blood pump, they are no longer in common clinical use and may be difficult to obtain in the future. To investigate the stability of the Sorin Bicarbon valve (S-B valve) in our PVAD, we constructed a model pump made of an acrylic resin with the same configuration as our PVAD and attempted to compare the flow visualization upstream and downstream of the outlet position valve between the M-H valve and the S-B valve using a particle image velocimetry (PIV) method. The outlet S-B valve had faster closure than the M-H valve. The maximum flow velocity was greater than with the M-H valve. The maximum Reynolds shear stress (RSS) of the M-H valve reached 150 N/m(2) and that of the S-B valve reached 300 N/m(2) upstream during the end-systolic and early-diastolic phases. In both valves, the maximum RSS upstream of the valve was higher than downstream of the valve because of the regurgitation flow during valve closure. In addition, the maximum viscous shear stress reached above 2 N/m(2), which occupied only about 1%-1.5% of the maximum RSS.

  19. Comparative analysis of von Willebrand factor profiles after implantation of left ventricular assist device and total artificial heart.

    Science.gov (United States)

    Reich, H J; Morgan, J; Arabia, F; Czer, L; Moriguchi, J; Ramzy, D; Esmailian, F; Lam, L; Dunhill, J; Volod, O

    2017-08-01

    Essentials Bleeding is a major source of morbidity during mechanical circulatory support. von Willebrand factor (VWF) multimer loss may contribute to bleeding. Different patterns of VWF multimer loss were seen with the two device types. This is the first report of total artificial heart associated VWF multimer loss. Background Bleeding remains a challenge during mechanical circulatory support and underlying mechanisms are incompletely understood. Functional von Willebrand factor (VWF) impairment because of loss of high-molecular-weight multimers (MWMs) produces acquired von Willebrand disease (VWD) after left ventricular assist device (LVAD). Little is known about VWF multimers with total artificial hearts (TAHs). Here, VWF profiles with LVADs and TAHs are compared using a VWD panel. Methods VWD evaluations for patients with LVAD or TAH (2013-14) were retrospectively analyzed and included: VWF activity (ristocetin cofactor, VWF:RCo), VWF antigen (VWF:Ag), ratio of VWF:RCo to VWF:Ag, and quantitative VWF multimeric analysis. Results Twelve patients with LVADs and 12 with TAHs underwent VWD evaluation. All had either normal (47.8%) or elevated (52.2%) VWF:RCo, normal (26.1%) or elevated (73.9%) VWF:Ag and 50.0% were disproportional (ratio ≤ 0.7). Multimeric analysis showed abnormal patterns in all patients with LVADs: seven with high MWM loss; five with highest MWM loss. With TAH, 10/12 patients had abnormal patterns: all with highest MWM loss. High MWM loss correlated with presence of LVAD and highest MWM loss with TAH. Increased low MWMs were detected in 22/24. Conclusion Using VWF multimeric analysis, abnormalities after LVAD or TAH were detected that would be missed with measurements of VWF level alone: loss of high MWM predominantly in LVAD, loss of highest MWM in TAH, and elevated levels of low MWM in both. This is the first study to describe TAH-associated highest MWM loss, which may contribute to bleeding. © 2017 International Society on Thrombosis and

  20. Evidence for hydrogen-assisted recovery of cold-worked palladium: hydrogen solubility and mechanical properties studies

    Directory of Open Access Journals (Sweden)

    Maria Ferrer

    2017-07-01

    Full Text Available The influence of hydrogen as an agent to accelerate the thermal recovery of cold-worked palladium has been investigated. The techniques used to characterize the effects of hydrogen on the thermal recovery of palladium were hydrogen solubility and mechanical property measurements. Results show that the presence of modest amounts of hydrogen during annealing of cold-worked palladium does enhance the degree of thermal recovery, with a direct correlation between the amount of hydrogen during annealing and the degree of recovery. The results indicate that the damage resulting from cold-working palladium can be more effectively and efficiently reversed by suitable heat treatments in the presence of appropriate amounts of hydrogen, as compared to heat treatment in vacuum. The somewhat novel technique of using changes in the hydrogen solubility of palladium as an indicator of thermal recovery has been validated and complements the more traditional technique of mechanical property measurements.

  1. Advances in mechanical ventilation and pulmonary research for the enhancement of preterm and premature infant respiratory assistance

    OpenAIRE

    Silverii, Adam Phillip

    2017-01-01

    Chronic lung disease in premature and preterm infancy occurs due to the physiology of the underdeveloped pulmonary system. Therefore it is generally accepted that preterm and premature infants need significant respiratory support and a lung-protective strategy, starting from the delivery room where an inadequate respiratory approach may result in a poor outcome. However, there has been evidence to show that mechanical ventilation may aggravate or even cause lung disease if it is not expert...

  2. The mechanism underlying calcium phosphate precipitation on titanium via ultraviolet, visible, and near infrared laser-assisted biomimetic process

    International Nuclear Information System (INIS)

    Mahanti, Moumita; Nakamura, Maki; Pyatenko, Alexander; Sakamaki, Ikuko; Koga, Kenji; Oyane, Ayako

    2016-01-01

    We recently developed a rapid single-step calcium phosphate (CaP) precipitation technique on several substrates using a laser-assisted biomimetic process (LAB process). In this process, ultraviolet (UV, λ   =  355 nm) pulsed laser irradiation has been applied to a substrate that is immersed in a supersaturated CaP solution. In the present study, the LAB process for CaP precipitation on a titanium substrate was successfully expanded to include not only UV but also visible (VIS, λ   =  532 nm) and near infrared (NIR, λ   =  1064 nm) lasers. Surface heating and plasma-mediated surface reactions (micro-deformation, oxidization, photoexcitation, and wetting) generated by UV, VIS, or NIR lasers are considered to be involved in the CaP precipitation on the titanium surface in the LAB process. The kinetics of these reactions and consequently of CaP precipitation were dependent on the laser wavelength and fluence. The higher laser fluence did not always accelerate CaP precipitation on the substrate; rather, it was found that an optimal range of fluence exists for each laser wavelength. These results suggest that for efficient CaP precipitation, a suitable laser wavelength should be selected according to the optical absorption properties of the substrate material and the laser fluence should also be adjusted to induce surface heating and plasma-mediated surface reactions that are favorable for CaP precipitation. (paper)

  3. A simple and rapid infrared-assisted self enzymolysis extraction method for total flavonoid aglycones extraction from Scutellariae Radix and mechanism exploration.

    Science.gov (United States)

    Wang, Liping; Duan, Haotian; Jiang, Jiebing; Long, Jiakun; Yu, Yingjia; Chen, Guiliang; Duan, Gengli

    2017-09-01

    A new, simple, and fast infrared-assisted self enzymolysis extraction (IRASEE) approach for the extraction of total flavonoid aglycones (TFA) mainly including baicalein, wogonin, and oroxylin A from Scutellariae Radix is presented to enhance extraction yield. Extraction enzymolysis temperature, enzymolysis liquid-to-solid ratio, enzymolysis pH, enzymolysis time and infrared power, the factors affecting IRASEE procedure, were investigated in a newly designed, temperature-controlled infrared-assisted extraction (TC-IRAE) system to acquire the optimum analysis conditions. The results illustrated that IRASEE possessed great advantages in terms of efficiency and time compared with other conventional extraction techniques. Furthermore, the mechanism of IRASEE was preliminarily explored by observing the microscopic change of the samples surface structures, studying the main chemical compositions change of the samples before and after extraction and investigating the kinetics and thermodynamics at three temperature levels during the IRASEE process. These findings revealed that IRASEE can destroy the surface microstructures to accelerate the mass transfer and reduce the activation energy to intensify the chemical process. This integrative study presents a simple, rapid, efficient, and environmental IRASEE method for TFA extraction which has promising prospects for other similar herbal medicines. Graphical Abstract ᅟ.

  4. Plastic deformation to enhance plasma-assisted nitriding: On surface contamination induced by Surface Mechanical Attrition Treatment

    International Nuclear Information System (INIS)

    Samih, Youssef; Novelli, Marc; Bolle, Bernard; Allain, Nathalie; Fundenberger, Jean-Jacques; Marcos, Grégory; Czerwiec, Thierry; Grosdidier, Thierry; Thiriet, Tony

    2014-01-01

    The Surface Mechanical Attrition Treatment is a recent technique leading to the formation of nanostructured layers by the repeated action of impacting balls. While several communications have revealed possible contamination of the SMATed surfaces, the nature of this surface contamination was analyzed in the present contribution for the treatment of an AISI 316L stainless steel. It is shown, by a combination of Transmission Electron Microscopy and Glow Discharge – Optical Emission Spectrometry, that the surface was alloyed with Ti, Al and V coming from the sonotrode that is used to move the balls as well as Zr coming from the zirshot® balls themselves

  5. Plastic deformation to enhance plasma-assisted nitriding: On surface contamination induced by Surface Mechanical Attrition Treatment

    Science.gov (United States)

    Samih, Youssef; Novelli, Marc; Thiriet, Tony; Bolle, Bernard; Allain, Nathalie; Fundenberger, Jean-Jacques; Marcos, Grégory; Czerwiec, Thierry; Grosdidier, Thierry

    2014-08-01

    The Surface Mechanical Attrition Treatment is a recent technique leading to the formation of nanostructured layers by the repeated action of impacting balls. While several communications have revealed possible contamination of the SMATed surfaces, the nature of this surface contamination was analyzed in the present contribution for the treatment of an AISI 316L stainless steel. It is shown, by a combination of Transmission Electron Microscopy and Glow Discharge - Optical Emission Spectrometry, that the surface was alloyed with Ti, Al and V coming from the sonotrode that is used to move the balls as well as Zr coming from the zirshot® balls themselves.

  6. Generalized derivation of the added-mass and circulatory forces for viscous flows

    Science.gov (United States)

    Limacher, Eric; Morton, Chris; Wood, David

    2018-01-01

    The concept of added mass arises from potential flow analysis and is associated with the acceleration of a body in an inviscid irrotational fluid. When shed vorticity is modeled as vortex singularities embedded in this irrotational flow, the associated force can be superimposed onto the added-mass force due to the linearity of the governing Laplace equation. This decomposition of force into added-mass and circulatory components remains common in modern aerodynamic models, but its applicability to viscous separated flows remains unclear. The present work addresses this knowledge gap by presenting a generalized derivation of the added-mass and circulatory force decomposition which is valid for a body of arbitrary shape in an unbounded, incompressible fluid domain, in both two and three dimensions, undergoing arbitrary motions amid continuous distributions of vorticity. From the general expression, the classical added-mass force is rederived for well-known canonical cases and is seen to be additive to the circulatory force for any flow. The formulation is shown to be equivalent to existing theoretical work under the specific conditions and assumptions of previous studies. It is also validated using a numerical simulation of a pitching plate in a steady freestream flow, conducted by Wang and Eldredge [Theor. Comput. Fluid Dyn. 27, 577 (2013), 10.1007/s00162-012-0279-5]. In response to persistent confusion in the literature, a discussion of the most appropriate physical interpretation of added mass is included, informed by inspection of the derived equations. The added-mass force is seen to account for the dynamic effect of near-body vorticity and is not (as is commonly claimed) associated with the acceleration of near-body fluid which "must" somehow move with the body. Various other consequences of the derivation are discussed, including a concept which has been labeled the conservation of image-vorticity impulse.

  7. Noninvasive optoacoustic system for rapid diagnosis and management of circulatory shock

    Science.gov (United States)

    Petrov, Irene Y.; Kinsky, Michael; Petrov, Yuriy; Petrov, Andrey; Henkel, S. N.; Seeton, Roger; Esenaliev, Rinat O.; Prough, Donald S.

    2013-03-01

    Circulatory shock can lead to death or severe complications, if not promptly diagnosed and effectively treated. Typically, diagnosis and management of circulatory shock are guided by blood pressure and heart rate. However, these variables have poor specificity, sensitivity, and predictive value. Early goal-directed therapy in septic shock patients, using central venous catheterization (CVC), reduced mortality from 46.5% to 30%. However, CVC is invasive and complication-prone. We proposed to use an optoacoustic technique for noninvasive, rapid assessment of peripheral and central venous oxygenation. In this work we used a medical grade optoacoustic system for noninvasive, ultrasound image-guided measurement of central and peripheral venous oxygenation. Venous oxygenation during shock declines more rapidly in the periphery than centrally. Ultrasound imaging of the axillary [peripheral] and internal jugular vein [central] was performed using the Vivid e (GE Healthcare). We built an optoacoustic interface incorporating an optoacoustic transducer and a standard ultrasound imaging probe. Central and peripheral venous oxygenations were measured continuously in healthy volunteers. To simulate shock-induced changes in central and peripheral oxygenation, we induced peripheral vasoconstriction in the upper extremity by using a cooling blanket. Central and peripheral venous oxygenations were measured before (baseline) and after cooling and after rewarming. During the entire experiment, central venous oxygenation was relatively stable, while peripheral venous oxygenation decreased by 5-10% due to cooling and recovered after rewarming. The obtained data indicate that noninvasive, optoacoustic measurements of central and peripheral venous oxygenation may be used for diagnosis and management of circulatory shock with high sensitivity and specificity.

  8. Delayed Referral Results in Missed Opportunities for Organ Donation After Circulatory Death.

    Science.gov (United States)

    Krmpotic, Kristina; Payne, Clare; Isenor, Cynthia; Dhanani, Sonny

    2017-06-01

    Rates of organ donation and transplantation have steadily increased in the United States and Canada over the past decade, largely attributable to a notable increase in donation after circulatory death. However, the number of patients awaiting solid organ transplantation continues to remain much higher than the number of organs transplanted each year. The objective of this study was to determine the potential to increase donation rates further by identifying gaps in the well-established donation after circulatory death process in Ontario. Retrospective cohort study. Provincial organ procurement organization. Patients who died in designated donation hospitals within the province of Ontario, Canada between April 1, 2013, and March 31, 2015. None. Of 1,407 patient deaths following planned withdrawal of life-sustaining therapy, 54.0% (n = 760) were medically suitable for donation after circulatory death. In 438 cases where next of kin was approached, consent rates reached 47.5%. A total of 119 patients became actual organ donors. Only 66.2% (n = 503) of suitable patients were appropriately referred, resulting in 251 missed potential donors whose next of kin could not be approached regarding organ donation because referral occurred after initiation of withdrawal of life-sustaining therapy or not at all. The number of medically suitable patients who die within 2 hours of planned withdrawal of life-sustaining therapy is nearly six times higher than the number of actual organ donors, with the greatest loss of potential due to delayed referral until at the time of or after planned withdrawal of life-sustaining therapy. Intensive care teams are not meeting their ethical responsibility to recognize impending death and appropriately refer potential organ donors to the local organ procurement organization. In cases where patients had previously registered their consent decision, they were denied a healthcare right.

  9. A possible general mechanism for ultrasound-assisted extraction (UAE) suggested from the results of UAE of chlorogenic acid from Cynara scolymus L. (artichoke) leaves.

    Science.gov (United States)

    Saleh, I A; Vinatoru, M; Mason, T J; Abdel-Azim, N S; Aboutabl, E A; Hammouda, F M

    2016-07-01

    The use of ultrasound-assisted extraction (UAE) for the extraction of chlorogenic acid (CA) from Cynara scolymus L., (artichoke) leaves using 80% methanol at room temperature over 15 min gave a significant increase in yield (up to a 50%) compared with maceration at room temperature and close to that obtained by boiling over the same time period. A note of caution is introduced when comparing UAE with Soxhlet extraction because, in the latter case, the liquid entering the Soxhlet extractor is more concentrated in methanol (nearly 100%) that the solvent in the reservoir (80% methanol) due to fractionation during distillation. The mechanism of UAE is discussed in terms of the effects of cavitation on the swelling index, solvent diffusion and the removal of a stagnant layer of solvent surrounding the plant material. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Development of Duplex Stainless Steels by Field-Assisted Hot Pressing: Influence of the Particle Size and Morphology of the Powders on the Final Mechanical Properties

    Science.gov (United States)

    García-Junceda, A.; Rincón, M.; Torralba, J. M.

    2018-01-01

    The feasibility of processing duplex stainless steels with promising properties using a powder metallurgical route, including the consolidation by field-assisted hot pressing, is assessed in this investigation. The influence of the particle size and morphology of the raw austenitic and ferritic powders on the final microstructure and properties is also evaluated for an austenitic content of 60 wt pct. In addition, the properties of a new microconstituent generated between the initial constituents are analyzed. The maximum sintered density (98.9 pct) and the best mechanical behavior, in terms of elastic modulus, nanohardness, yield strength, ultimate tensile strength, and ductility, are reached by the duplex stainless steel processed with austenitic and ferritic gas atomized stainless steel powders.

  11. [Temperature that modifies the effect of air pollution on emergency room visits for circulatory and respiratory diseases in Beijing, China].

    Science.gov (United States)

    Wang, L L; Zhang, Q; Bai, R H; Mi, B B; Yan, H

    2017-08-10

    Objective: To analyze the temperature modification effect on emergency room visits for circulatory and respiratory diseases caused by air pollution, in Beijing. Methods: Data on both circulatory and respiratory diseases in 2010 and 2011 were collected, Both meteorological and air pollutants related data were obtained from the National Scientific Data Sharing Platform for Population and Health. By using the stratified time-series models, we analyzed the effects of air pollution on emergency room visits for circulatory and respiratory diseases under different temperature zones, from 2010 to 2011, in Beijing. Results: Low temperature (daily average temperatureeffect of air pollution index (API) on emergency room visits for circulatory diseases, Under 10 units of API, the relative risks and confidence interval appeared as 1.067 (1.054-1.080). However, high (daily average temperature between 24.4 ℃ and 28.5 ℃) and extra-high temperature (daily average temperature >28.5 ℃) could enhance the effect of API on emergency room visits for respiratory diseases, Under 10 units of API, the relative risks and confidence interval were 1.021 (1.015-1.028) and 1.006 (1.003-1.008), respectively. Conclusion: Temperature seemed to have modified the association between air pollution and both circulatory and respiratory diseases.

  12. Diseases of the circulatory system among adult people diagnosed with infantile autism as children

    DEFF Research Database (Denmark)

    Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

    2016-01-01

    BACKGROUND: Research dealing with adult people with autism spectrum disorders (ASD) noticeably lags behind studies of children and young individuals with ASD. AIMS: The objective of this study was to compare the prevalence and types of diseases of the circulatory system in a clinical sample of 118...... adult people diagnosed with infantile autism (IA) as children with 336 sex and age matched controls from the general population. METHODS AND PROCEDURES: All participants were screened through the nationwide Danish National Hospital Register. The average observation time of both groups was 37.2 years...

  13. Burden of Circulatory System Diseases and Ignored Barriers ofKnowledge Translation

    Directory of Open Access Journals (Sweden)

    Hamed-Basir Ghafouri

    2012-10-01

    Full Text Available Circulatory system disease raise third highest disability-adjusted life years among Iranians and ischemic cardiac diseases are main causes for such burden. Despite available evidences on risk factors of the disease, no effective intervention was implemented to control and prevent the disease. This paper non-systematically reviews available literature on the problem, solutions, and barriers of implementation of knowledge translation in Iran. It seems that there are ignored factors such as cultural and motivational issues in knowledge translation interventions but there are hopes for implementation of started projects and preparation of students as next generation of knowledge transferors.

  14. The Effects of Ion-Assisted Deposition on the Mechanical, Physical, Chemical and Optical Properties of Magnesium Fluoride Thin Films.

    Science.gov (United States)

    Kennemore, Charles Milton, III

    1992-01-01

    This dissertation investigates the results of ion assisted deposition (IAD) on various properties of magnesium fluoride thin films deposited on room temperature substrates. MgF_2 films deposited in this manner have increased abrasion resistance and increased adhesion comparable to that found in films deposited at the usual substrate temperature of approximately 300 ^circC. IAD tends to drive the normal high tensile stress of non-IAD films to a more compressive state thereby reducing the overall stress. The IAD MgF _2 films have a higher index of refraction than non-IAD films, as high as 1.41, and the ultraviolet absorption edge in shifted to longer wavelengths beginning about 350 nm but no detectable absorption at visible wavelengths is seen in the films deposited with less than 250 eV bombardment energies. However, at higher IAD energies beginning at approximately 600 eV an absorption band is present in the red end of the visible spectrum making low energy bombardment the parameter of choice. Transmission electron microscopy and X-ray diffraction studies show that the IAD films have a more amorphous-like structure with fewer and smaller crystallites than non-IAD films deposited on either heated or unheated substrates. Rutherford backscattering spectroscopy (RBS) shows the bombarded films have fluorine depletion that roughly scales with the energy of bombardment with F:Mg ratios as low as 1.69 being found. Bombardment by fluorinated compounds, specifically C_2 F_6 and SF_6 , limit this depletion and in some instances super fluorinate the resulting compound. Additionally, RBS shows that IAD introduces a significant amount of oxygen throughout the film that is unaccountable as water take-up. X-ray photoelectron spectroscopy (XPS) indicates the presence of two compounds of oxygen that are attributed to MgO and Mg(OH)_2 or some oxy-fluoride complex similar to them and it is the introduction of these compounds which provide for the changes in the properties of IAD MgF_2

  15. Help seeking in aggressive and nonaggressive boys as a function of social or mechanical mediation of assistance.

    Science.gov (United States)

    Shea, B J; Routh, D K; Cottrell, N B; Brecht, J M

    1973-04-01

    The behavior of preadolescent and adolescent boys, rated as aggressive and nonaggressive, was examined to test predictions from Bandura and Walters' social-learning theory and from Weiss and Miller's punishment model of audience-observation effects. The subjects were given a bogus motor task, actually insoluble, with help available on each trial. For half the subjects, help was given through the mediation of a social agent; for the rest, help was on a nonsocial, mechanically mediated basis. The groups for whom help was socially mediated made fewer help-seeking responses and decreased the number of such responses over successive trial blocks. The predictions from Bandura and Walters' theory were not supported, since neither age nor degree of aggressiveness had an effect on help-seeking responses. The results were, however, consistent with the punishment model of audience effects.

  16. NASA Models of Space Radiation Induced Cancer, Circulatory Disease, and Central Nervous System Effects

    Science.gov (United States)

    Cucinotta, Francis A.; Chappell, Lori J.; Kim, Myung-Hee Y.

    2013-01-01

    The risks of late effects from galactic cosmic rays (GCR) and solar particle events (SPE) are potentially a limitation to long-term space travel. The late effects of highest concern have significant lethality including cancer, effects to the central nervous system (CNS), and circulatory diseases (CD). For cancer and CD the use of age and gender specific models with uncertainty assessments based on human epidemiology data for low LET radiation combined with relative biological effectiveness factors (RBEs) and dose- and dose-rate reduction effectiveness factors (DDREF) to extrapolate these results to space radiation exposures is considered the current "state-of-the-art". The revised NASA Space Risk Model (NSRM-2014) is based on recent radio-epidemiology data for cancer and CD, however a key feature of the NSRM-2014 is the formulation of particle fluence and track structure based radiation quality factors for solid cancer and leukemia risk estimates, which are distinct from the ICRP quality factors, and shown to lead to smaller uncertainties in risk estimates. Many persons exposed to radiation on earth as well as astronauts are life-time never-smokers, which is estimated to significantly modify radiation cancer and CD risk estimates. A key feature of the NASA radiation protection model is the classification of radiation workers by smoking history in setting dose limits. Possible qualitative differences between GCR and low LET radiation increase uncertainties and are not included in previous risk estimates. Two important qualitative differences are emerging from research studies. The first is the increased lethality of tumors observed in animal models compared to low LET radiation or background tumors. The second are Non- Targeted Effects (NTE), which include bystander effects and genomic instability, which has been observed in cell and animal models of cancer risks. NTE's could lead to significant changes in RBE and DDREF estimates for GCR particles, and the potential

  17. Assistência circulatória com oxigenação por membrana extracorpórea (ECMO no adulto: um conceito falido ou esquecido? Adult extracorporeal life support: a failed or forgotten concept?

    Directory of Open Access Journals (Sweden)

    Alexandre Siciliano Colafranceschi

    2008-07-01

    oxygenation for temporary mechanical circulatory support of adults that present with acute refractory cardiogenic shock in our institution. There is no other published experience of the use of this system in this scenario in Brazil. OBJECTIVE: To describe our experience with the use of the extracorporeal membrane oxygenation for circulatory support in adults. METHODS: Retrospective analysis of the medical files of patients submitted to the implant of extracorporeal membrane oxygenation system for circulatory assistance in acute and refractory cardiogenic shock. RESULTS: Eleven patients (63,5yo; 45,5%male were considered for analysis from 2005 to 2007. Median support time was 77 hours (10-240h and 5 patients have survived 30 days (45,5%. Two patients were subsequently submitted to prolonged paracorporeal circulatory assistance. Mortality on ECMO (6 patients was due to multiple organ failure (66,6% and refractory bleeding (33,4%. CONCLUSION: ECMO system is an option to be used in acute refractory cardiogenic shock as a bridge to recovery or selecting patients that might benefit from prolonged paracorporeal assist devices (bridge to bridge.

  18. Yeast-assisted synthesis of polypyrrole: Quantification and influence on the mechanical properties of the cell wall.

    Science.gov (United States)

    Andriukonis, Eivydas; Stirke, Arunas; Garbaras, Andrius; Mikoliunaite, Lina; Ramanaviciene, Almira; Remeikis, Vidmantas; Thornton, Barry; Ramanavicius, Arunas

    2018-04-01

    In this study, the metabolism of yeast cells (Saccharomyces cerevisiae) was utilized for the synthesis of the conducting polymer - polypyrrole (Ppy).Yeast cells were modified in situ by synthesized Ppy. The Ppy was formed in the cell wall by redox-cycling of [Fe(CN) 6 ] 3-/4- , performed by the yeast cells. Fluorescence microscopy, enzymatic digestions, atomic force microscopy and isotope ratio mass spectroscopy were applied to determine both the polymerization reaction itself and the polymer location in yeast cells. Ppy formation resulted in enhanced resistance to lytic enzymes, significant increase of elasticity and alteration of other mechanical cell wall properties evaluated by atomic force microscopy (AFM). The suggested method of polymer synthesis allows the introduction of polypyrrole structures within the cell wall, which is build up from polymers consisting of carbohydrates. This cell wall modification strategy could increase the usefulness of yeast as an alternative energy source in biofuel cells, and in cell based biosensors. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Mechanism of Microwave-Assisted Pyrolysis of Glucose to Furfural Revealed by Isotopic Tracer and Quantum Chemical Calculations.

    Science.gov (United States)

    Bao, Liwei; Shi, Lei; Luo, Hu; Kong, Lingzhao; Li, Shenggang; Wei, Wei; Sun, Yuhan

    2017-08-10

    Glucose labeled with 13 C or 18 O was used to investigate the mechanism of its conversion into furfural by microwaveassisted pyrolysis. The isotopic content and location in furfural were determined from GC-MS and 13 C NMR spectroscopic measurements and data analysis. The results suggest that the carbon skeleton in furfural is mainly derived from C1 to C5 of glucose, whereas the C of the aldehyde group and the O of the furan ring in furfural primarily originate from C1 and O5 of glucose, respectively. For the first time, the source of O in the furan ring of furfural was elucidated directly by experiment, providing results that are consistent with predictions from recent quantum chemical calculations. Moreover, further theoretical calculations indicate substantially lower energy barriers than previous predictions by considering the potential catalytic effect of formic acid, which is one of the pyrolysis products. The catalytic role of formic acid is further confirmed by experimental evidence. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Hydraulic testing of intravascular axial flow blood pump designs with a protective cage of filaments for mechanical cavopulmonary assist.

    Science.gov (United States)

    Kapadia, Jugal Y; Pierce, Kathryn C; Poupore, Amy K; Throckmorton, Amy L

    2010-01-01

    To provide hemodynamic support to patients with a failing single ventricle, we are developing a percutaneously inserted, magnetically levitated axial flow blood pump designed to augment pressure in the cavopulmonary circulation. The device is designed to serve as a bridge-to-transplant, bridge-to-recovery, bridge-to-hemodynamic stability, or bridge-to-surgical reconstruction. This study evaluated the hydraulic performance of three blood pump prototypes (a four-bladed impeller, a three-bladed impeller, and a three-bladed impeller with a four-bladed diffuser) whose designs evolved from previous design optimization phases. Each prototype included the same geometric protective cage of filaments, which stabilize the rotor within the housing and protect the housing wall from the rotating blades. All prototypes delivered pressure rises over a range of flow rates and rotational speeds that would be sufficient to augment hemodynamic conditions in the cavopulmonary circulation. The four-bladed impeller outperformed the two remaining prototypes by >40%; this design was able to generate a pressure rise of 4-28 mm Hg for flow rates of 0.5-10 L/min at rotational speeds of 4,000-7,000 RPM. Successful development of this blood pump will provide clinicians with a feasible therapeutic option for mechanically supporting the failing Fontan.

  1. Relevances between cerebral circulatory disorder and symptom in idiopathic normal pressure hydrocephalus

    International Nuclear Information System (INIS)

    Takeuchi, Totaro; Shimizu, Tsuneo; Watanabe, Kazuo

    2010-01-01

    The subjects were shunt-effective idiopathic normal pressure hydrocephalus (iNPH) 40 patients. Before and one year after surgery, measurements of the cerebral circulatory dynamics (the cerebral blood flow pattern by region of interest (ROI) setting using 123 I-iofetamine (IMP) single photon emission computed tomography (SPECT)), and an evaluation of symptoms (gait disturbance: G, dementia: D, urinary incontinence: U) by grading scale (JNPHGS-R). Preoperative cerebral circulation and symptoms: As for the each symptoms and blood flow patterns, the seventies of G (p=0.017) in whole cortex non-reduction group (thalamus-basal ganglia reduction group) and D (p=0.021) in whole cortex reduction group were obviously high compared with other symptoms particularly. Circulation and symptoms one year after surgery: As the circulatory dynamics at different improvement sites and each symptoms, it was obviously mild for G (p=0.003) in the group with an increased only thalamus-basal ganglia blood flow and increased both whole cortex and thalamus-basal ganglia blood flow and tend to mild for D (p=0.091) in the group with an increased only whole cortex blood flow and increased both whole cortex and thalamus-basal ganglia blood flow compared with other symptoms. (author)

  2. Pulmonary circulatory effects of norepinephrine in newborn infants with persistent pulmonary hypertension.

    Science.gov (United States)

    Tourneux, Pierre; Rakza, Thameur; Bouissou, Antoine; Krim, Gérard; Storme, Laurent

    2008-09-01

    To evaluate the respiratory and the pulmonary circulatory effects of norepinephrine in newborn infants with persistent pulmonary hypertension (PPHN)-induced cardiac dysfunction. Inclusion criteria were: 1) Newborn infants >35 weeks gestational age; 2) PPHN treated with inhaled nitric oxide; and 3) symptoms of circulatory failure despite adequate fluid resuscitation. Lung function and pulmonary hemodynamic variables assessed with Doppler echocardiography were recorded prospectively before and after starting norepinephrine. Eighteen newborns were included (gestational age: 37 +/- 3 weeks; birth weight: 2800 +/- 700 g). After starting norepinephrine, systemic pressure and left ventricular output increased respectively from 33 +/- 4 mm Hg to 49 +/- 4 mm Hg and from 172 +/- 79 mL/kg/min to 209+/-90 mL/kg/min (P ventilatory variables have not been changed, the post-ductal transcutaneous arterial oxygen saturation increased from 89% +/- 1% to 95% +/- 4%, whereas the oxygen need decreased from 51% +/- 24% to 41% +/- 20% (P newborn infants with PPHN through a decrease in pulmonary/systemic artery pressure ratio and improved cardiac performance.

  3. Circulatory shear flow alters the viability and proliferation of circulating colon cancer cells

    Science.gov (United States)

    Fan, Rong; Emery, Travis; Zhang, Yongguo; Xia, Yuxuan; Sun, Jun; Wan, Jiandi

    2016-06-01

    During cancer metastasis, circulating tumor cells constantly experience hemodynamic shear stress in the circulation. Cellular responses to shear stress including cell viability and proliferation thus play critical roles in cancer metastasis. Here, we developed a microfluidic approach to establish a circulatory microenvironment and studied circulating human colon cancer HCT116 cells in response to a variety of magnitude of shear stress and circulating time. Our results showed that cell viability decreased with the increase of circulating time, but increased with the magnitude of wall shear stress. Proliferation of cells survived from circulation could be maintained when physiologically relevant wall shear stresses were applied. High wall shear stress (60.5 dyne/cm2), however, led to decreased cell proliferation at long circulating time (1 h). We further showed that the expression levels of β-catenin and c-myc, proliferation regulators, were significantly enhanced by increasing wall shear stress. The presented study provides a new insight to the roles of circulatory shear stress in cellular responses of circulating tumor cells in a physiologically relevant model, and thus will be of interest for the study of cancer cell mechanosensing and cancer metastasis.

  4. The risk mortality of the population of azerbaijan from circulatory diseases, depending on the season

    Directory of Open Access Journals (Sweden)

    A. J. Rzayeva

    2015-06-01

    Azerbaijan State Advanced Training Institute for doctors named after A. Aliyev, Baku   ABSTRACT The Objective.  To obtain evidence-based data about the role of seasons of the year in the formation of the population mortality risk from the circulatory system diseases  (CSD in Azerbaijan and its regions with specific climate. Materials of the study. A case of mortality was a unit of statistical observation. The fatalities from all reasons, including CSD have been distributed by the days of every month in the year. Daily average amount of fatalities by months and seasons ( from 20 December to 19 March – winter; from 20 March to 19 June- spring; from 20 June to 16 September; from 20 September to 19 December - autumn have been determined. Results.  In Azerbaijan the risk of general mortality and mortality from CSD is the highest in winter, it decreases in spring but nonuniformly (the general mortality rate is less than that from CSD. That is why the share of CSD increases among mortality reasons. Conclusions. Seasonal change of mortality risks from CSD is multivariant. Winter-spring increase of risk predominates in Azerbaijan. In some regions of Azerbaijan the mortality risk from CSD increases only once either in spring or in summer or winter. Key words: seasonal dynamics, risk of mortality, circulatory system diseases.

  5. Developing Seventh Grade Students’ Systems Thinking Skills in the Context of the Human Circulatory System

    Science.gov (United States)

    Raved, Lena; Yarden, Anat

    2014-01-01

    Developing systems thinking skills in school can provide useful tools to deal with a vast amount of medical and health information that may help learners in decision making in their future lives as citizen. Thus, there is a need to develop effective tools that will allow learners to analyze biological systems and organize their knowledge. Here, we examine junior high school students’ systems thinking skills in the context of the human circulatory system. A model was formulated for developing teaching and learning materials and for characterizing students’ systems thinking skills. Specifically, we asked whether seventh grade students, who studied about the human circulatory system, acquired systems thinking skills, and what are the characteristics of those skills? Concept maps were used to characterize students’ systems thinking components and examine possible changes in the students’ knowledge structure. These maps were composed by the students before and following the learning process. The study findings indicate a significant improvement in the students’ ability to recognize the system components and the processes that occur within the system, as well as the relationships between different levels of organization of the system, following the learning process. Thus, following learning students were able to organize the systems’ components and its processes within a framework of relationships, namely the students’ systems thinking skills were improved in the course of learning using the teaching and learning materials. PMID:25520948

  6. Developing seventh grade students' systems thinking skills in the context of the human circulatory system.

    Science.gov (United States)

    Raved, Lena; Yarden, Anat

    2014-01-01

    Developing systems thinking skills in school can provide useful tools to deal with a vast amount of medical and health information that may help learners in decision making in their future lives as citizen. Thus, there is a need to develop effective tools that will allow learners to analyze biological systems and organize their knowledge. Here, we examine junior high school students' systems thinking skills in the context of the human circulatory system. A model was formulated for developing teaching and learning materials and for characterizing students' systems thinking skills. Specifically, we asked whether seventh grade students, who studied about the human circulatory system, acquired systems thinking skills, and what are the characteristics of those skills? Concept maps were used to characterize students' systems thinking components and examine possible changes in the students' knowledge structure. These maps were composed by the students before and following the learning process. The study findings indicate a significant improvement in the students' ability to recognize the system components and the processes that occur within the system, as well as the relationships between different levels of organization of the system, following the learning process. Thus, following learning students were able to organize the systems' components and its processes within a framework of relationships, namely the students' systems thinking skills were improved in the course of learning using the teaching and learning materials.

  7. Colloids Versus Albumin in Large Volume Paracentesis to Prevent Circulatory Dysfunction: Evidence-based Case Report.

    Science.gov (United States)

    Widjaja, Felix F; Khairan, Paramita; Kamelia, Telly; Hasan, Irsan

    2016-04-01

    Large volume paracentesis may cause paracentesis induced circulatory dysfunction (PICD). Albumin is recommended to prevent this abnormality. Meanwhile, the price of albumin is too expensive and there should be another alternative that may prevent PICD. This report aimed to compare albumin to colloids in preventing PICD. Search strategy was done using PubMed, Scopus, Proquest, dan Academic Health Complete from EBSCO with keywords of "ascites", "albumin", "colloid", "dextran", "hydroxyethyl starch", "gelatin", and "paracentesis induced circulatory dysfunction". Articles was limited to randomized clinical trial and meta-analysis with clinical question of "In hepatic cirrhotic patient undergone large volume paracentesis, whether colloids were similar to albumin to prevent PICD". We found one meta-analysis and four randomized clinical trials (RCT). A meta analysis showed that albumin was still superior of which odds ratio 0.34 (0.23-0.51). Three RCTs showed the same results and one RCT showed albumin was not superior than colloids. We conclude that colloids could not constitute albumin to prevent PICD, but colloids still have a role in patient who undergone paracentesis less than five liters.

  8. Performance of Noninvasive Assessment in the Diagnosis of Right Heart Failure After Left Ventricular Assist Device.

    Science.gov (United States)

    Joly, Joanna M; El-Dabh, Ashraf; Marshell, Ramey; Chatterjee, Arka; Smith, Michelle G; Tresler, Margaret; Kirklin, James K; Acharya, Deepak; Rajapreyar, Indranee N; Tallaj, José A; Pamboukian, Salpy V

    2018-06-01

    Right heart failure (RHF) after left ventricular assist device (LVAD) is associated with poor outcomes. Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) defines RHF as elevated right atrial pressure (RAP) plus venous congestion. The purpose of this study was to examine the diagnostic performance of the noninvasive INTERMACS criteria using RAP as the gold standard. We analyzed 108 patients with LVAD who underwent 341 right heart catheterizations (RHC) between January 1, 2006, and December 31, 2013. Physical exam, echocardiography, and laboratory data at the time of RHC were collected. Conventional two-by-two tables were used and missing data were excluded. The noninvasive INTERMACS definition of RHF is 32% sensitive (95% CI, 0.21-0.44) and 97% specific (95% CI, 0.95-0.99) for identifying elevated RAP. Clinical assessment failed to identify two-thirds of LVAD patients with RAP > 16 mm Hg. More than half of patients with elevated RAP did not have venous congestion, which may represent a physiologic opportunity to mitigate the progression of disease before end-organ damage occurs. One-quarter of patients who met the noninvasive definition of RHF did not actually have elevated RAP, potentially exposing patients to unnecessary therapies. In practice, if any component of the INTERMACS definition is present or equivocal, our data suggest RHC is warranted to establish the diagnosis.

  9. The pharmacotherapy implications of ventricular assist device in the patient with end-stage heart failure.

    Science.gov (United States)

    Von Ruden, Serena A S; Murray, Margaret A; Grice, Jennifer L; Proebstle, Amy K; Kopacek, Karen J

    2012-04-01

    Advances in mechanical circulatory support, such as the use of ventricular assist devices (VADs), have become a means for prolonging survival in end-stage heart failure (HF). VADs decrease the symptoms of HF and improve quality of life by replacing some of the work of a failing heart. They unload the ventricle to provide improved cardiac output and end-organ perfusion, resulting in improvement in cardiorenal syndromes and New York Heart Association functional class rating. VADs are currently used asa bridge to heart transplantation, a bridge to recovery of cardiac function, or as destination therapy. Complications of VAD include bleeding, infections, arrhythmias, multiple organ failure, right ventricular failure, and neurological dysfunction. Patients with VAD have unique pharmacotherapeutic requirements in terms of anticoagulation, appropriate antibiotic selection, and continuation of HF medications. Pharmacists in acute care and community settings are well prepared to care for the patient with VAD. These patients require thorough counseling and follow-up with regard to prevention and treatment of infections, appropriate levels of anticoagulation, and maintenance of fluid balance. A basic understanding of this unique therapy can assist pharmacists in attending to the needs of patients with VAD.

  10. Mechanics

    CERN Document Server

    Hartog, J P Den

    1961-01-01

    First published over 40 years ago, this work has achieved the status of a classic among introductory texts on mechanics. Den Hartog is known for his lively, discursive and often witty presentations of all the fundamental material of both statics and dynamics (and considerable more advanced material) in new, original ways that provide students with insights into mechanical relationships that other books do not always succeed in conveying. On the other hand, the work is so replete with engineering applications and actual design problems that it is as valuable as a reference to the practicing e

  11. The medical physics of ventricular assist devices

    International Nuclear Information System (INIS)

    Wood, Houston G; Throckmorton, Amy L; Untaroiu, Alexandrina; Song Xinwei

    2005-01-01

    Millions of patients, from infants to adults, are diagnosed with congestive heart failure each year all over the world. A limited number of donor hearts available for these patients results in a tremendous demand for alternative, supplemental circulatory support in the form of artificial heart pumps or ventricular assist devices (VADs). The development procedure for such a device requires careful consideration of biophysical factors, such as biocompatibility, haemolysis, thrombosis, implantability, physiologic control feasibility and pump performance. Conventional pump design equations based on Newton's law and computational fluid dynamics (CFD) are readily used for the initial design of VADs. In particular, CFD can be employed to predict the pressure-flow performance, hydraulic efficiencies, flow profile through the pump, stress levels and biophysical factors, such as possible blood cell damage. These computational flow simulations may involve comprehensive steady and transient flow analyses. The transient simulations involve time-varying boundary conditions and virtual modelling of the impeller rotation in the blood pumps. After prototype manufacture, laser flow measurements with sophisticated optics and mock circulatory flow loop testing assist with validation of pump design and identification of irregular flow patterns for optimization. Additionally, acute and chronic animal implants illustrate the blood pump's ability to support life physiologically. These extensive design techniques, coupled with fundamental principles of physics, ensure a reliable and effective VAD for thousands of heart failure patients each year

  12. Effect of Electropulsing-Assisted Ultrasonic Nanocrystalline Surface Modification on the Surface Mechanical Properties and Microstructure of Ti-6Al-4V Alloy

    Science.gov (United States)

    Ye, Yongda; Wang, Haibo; Tang, Guoyi; Song, Guolin

    2018-05-01

    The effect of electropulsing-assisted ultrasonic nanocrystalline surface modification (EP-UNSM) on surface mechanical properties and microstructure of Ti-6Al-4V alloy is investigated. Compared to conventional ultrasonic nanocrystalline surface modification (UNSM), EP-UNSM can effectively facilitate surface roughness and morphology, leading to excellent surface roughness (reduced from Ra 0.918 to Ra 0.028 μm by UNSM and Ra 0.019 μm by EP-UNSM) and smoother morphology with less cracks and defects. Surface friction coefficients are enhanced, resulting in lower and smoother friction coefficients. In addition, the surface-strengthened layer and ultra-refined grains are significantly enhanced with more severe plastic deformation and a greater surface hardness (a maximum hardness value of 407 HV and an effective depth of 550 μm, in comparison with the maximum hardness value of 364 HV and effective depth of 300 μm obtained by conventional UNSM). Remarkable enhancement of surface mechanical properties can be attributed to the refined gradient microstructure and the enhanced severe plastic deformation layer induced by coupling the effects of UNSM and electropulsing. The accelerated dislocation mobility and atom diffusion caused by the thermal and athermal effects of electropulsing treatment may be the primary intrinsic reasons for these improvements.

  13. Revealing the Formation Mechanism of CsPbBr3 Perovskite Nanocrystals Produced via a Slowed-Down Microwave-Assisted Synthesis.

    Science.gov (United States)

    Li, Yanxiu; Huang, He; Xiong, Yuan; Kershaw, Stephen V; Rogach, Andrey L

    2018-03-24

    We developed a microwave-assisted slowed-down synthesis of CsPbBr 3 perovskite nanocrystals, which retards the reaction and allows us to gather useful insights into the formation mechanism of these nanoparticles, by examining the intermediate stages of their growth. The trends in the decay of the emission intensity of CsPbBr 3 nanocrystals under light exposure are well correlated with their stability against decomposition in TEM under electron beam. The results show the change of the crystal structure of CsPbBr 3 nanocrystals from a deficient and easier to be destroyed lattice to a well crystallized one. Conversely the shift in the ease of degradation sheds light on the formation mechanism, indicating first the formation of a bromoplumbate ionic scaffold, with Cs-ion infilling lagging a little behind. Increasing the cation to halide ratio towards the stoichiometric level may account for the improved radiative recombination rates observed in the longer reaction time materials. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Diseases of the circulatory system: health status and perspectives for changes

    Directory of Open Access Journals (Sweden)

    V. I. Klimenko

    2014-02-01

    Full Text Available During last 20 years rates of incidence and prevalence of diseases of the circulatory system in Ukraine have been growing from year to year and became problems of current interest. According to the program of WHO, realization of diseases prevention is provided by using of scientific justification and monitoring of health indexes, including diseases of the circulatory system. Goal of our research was to analyze health status of population of Zaporozhye region concerning cardiovascular diseases. Data since 1995 to 2012 y. were taken in the Center of medical statistics of Zaporozhye region. Comparative analysis of obtained data was conducted in dynamics and with definition of specific weight of able to work population in structure of indexes and gender differences. In article we showed, that on the background of depopulation of Ukraine during last 20 years, prevalence of diseases of the circulatory system increased by 2 times, and level of mortality from them increased for 45%. Specific weight of mortality from diseases of the circulatory system among adult population (state for 01.2013 y. in Ukraine was 65,7%, in Zaporozhye region – 63,6%, among able to work population – 30,5%, in Zaporozhye region – 33,4%, but mortality among able to work men in Zaporozhye region was in 5,5 times higher than in women. Specific weight of the diseases of the circulatory system in structure of general morbidity in total population in Ukraine was 31,5%, among able to work population – 24,1%; among total population of Zaporozhye region – 36,6% (in town – 35,0%; in country region – 39,8%, among able to work population of Zaporozhye region – 24,6% (in town – 22,8%; in country region – 27,6%. Structure of general morbidity of the cardiovascular diseases during last 10 years in Ukraine and in Zaporozhye region is stable. Leading place belongs to arterial hypertension: 56,1%- in Ukraine, 57,7 % - in Zaporozhye region. Comparing to Ukraine, before 2005 y

  15. Enhancement of thermal and mechanical properties of poly(MMA-co-BA)/Cloisite 30B nanocomposites by ultrasound-assisted in-situ emulsion polymerization.

    Science.gov (United States)

    Sharma, Sachin; Kumar Poddar, Maneesh; Moholkar, Vijayanand S

    2017-05-01

    This study reports synthesis and characterization of poly(MMA-co-BA)/Cloisite 30B (organo-modified montmorillonite clay) nanocomposites by ultrasound-assisted in-situ emulsion polymerization. Copolymers have been synthesized with MMA:BA monomer ratio of 4:1, and varying clay loading (1-5wt% monomer). The poly(MMA-co-BA)/Cloisite 30B nanocomposites have been characterized for their thermal and mechanical properties. Ultrasonically synthesized nanocomposites have been revealed to possess higher thermal degradation resistance and mechanical strength than the nanocomposites synthesized using conventional techniques. These properties, however, show an optimum (or maxima) with clay loading. The maximum values of thermal and mechanical properties of the nanocomposites with optimum clay loading are as follows. Thermal degradation temperatures: T 10% =320°C (4wt%), T 50 =373°C (4wt%), maximum degradation temperature=384°C (4wt%); glass transition temperature=64.8°C (4wt%); tensile strength=20MPa (2wt%), Young's modulus=1.31GPa (2wt%), Percentage elongation=17.5% (1wt%). Enhanced properties of poly(MMA-co-BA)/Cloisite 30B nanocomposites are attributed to effective exfoliation and dispersion of clay nanoparticles in copolymer matrix due to intense micro-convection induced by ultrasound and cavitation. Clay platelets help in effective heat absorption with maximum surface interaction/adhesion that results in increased thermal resistivity of nanocomposites. Hindered motion of the copolymer chains due to clay platelets results in enhancement of tensile strength and Young's modulus of nanocomposite. Rheological (liquid) study of the nanocomposites reveals that nanocomposites have higher yield stress and infinite shear viscosity than neat copolymer. Nonetheless, nanocomposites still display shear thinning behavior - which is typical of the neat copolymer. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. First pediatric transatlantic air ambulance transportation on a Berlin Heart EXCOR left ventricular assist device as a bridge to transplantation.

    Science.gov (United States)

    Tissot, Cecile; Buchholz, Holger; Mitchell, Max B; da Cruz, Eduardo; Miyamoto, Shelley D; Pietra, Bill A; Charpentier, Arnaud; Ghez, Olivier

    2010-03-01

    Mechanical circulatory devices are indicated in patients with refractory cardiac failure as a bridge to recovery or to transplantation. Whenever required, transportation while on mechanical support is a challenge and still limited by technical restrictions or distance. We report the first pediatric case of transatlantic air transportation on a Berlin Heart EXCOR ventricular assist device (Berlin Heart, Berlin, Germany) of a 13-yr-old American female who presented in cardiogenic shock with severe systolic dysfunction while vacationing in France. Rapid hemodynamic deterioration occurred despite maximal medical treatment, and she was supported initially with extracorporeal membrane oxygenation converted to a Berlin Heart EXCOR left ventricular assist device. Long-distance air transportation of the patient was accomplished 3 wks after implantation from Marseille, France, to Denver, Colorado. No adverse hemodynamic effects were encountered during the 13.5-hr flight (8770 km). The patient did not recover sufficient cardiac function and underwent successful orthotopic heart transplantation 3 months after the initial event. Our experience suggests that long-distance air transportation of pediatric patients using the Berlin Heart EXCOR mobile unit as a bridge to recovery or transplantation is feasible and appears safe.

  17. Stroke volume variation compared with pulse pressure variation and cardiac index changes for prediction of fluid responsiveness in mechanically ventilated patients

    Directory of Open Access Journals (Sweden)

    Randa Aly Soliman

    2015-04-01

    Conclusions: Baseline stroke volume variation ⩾8.15% predicted fluid responsiveness in mechanically ventilated patients with acute circulatory failure. The study also confirmed the ability of pulse pressure variation to predict fluid responsiveness.

  18. Fetal rat metabonome alteration by prenatal caffeine ingestion probably due to the increased circulatory glucocorticoid level and altered peripheral glucose and lipid metabolic pathways

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yansong [Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan University, Wuhan, 430071 (China); Xu, Dan [Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan University, Wuhan, 430071 (China); Research Center of Food and Drug Evaluation, Wuhan University, Wuhan, 430071 (China); Feng, Jianghua, E-mail: jianghua.feng@xmu.edu.cn [Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, 430071 (China); Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Xiamen, 361005 (China); Kou, Hao; Liang, Gai [Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan University, Wuhan, 430071 (China); Yu, Hong; He, Xiaohua; Zhang, Baifang; Chen, Liaobin [Research Center of Food and Drug Evaluation, Wuhan University, Wuhan, 430071 (China); Magdalou, Jacques [UMR 7561 CNRS-Nancy Université, Faculté de Médicine, Vandoeuvre-lès-Nancy (France); Wang, Hui, E-mail: wanghui19@whu.edu.cn [Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan University, Wuhan, 430071 (China); Research Center of Food and Drug Evaluation, Wuhan University, Wuhan, 430071 (China)

    2012-07-15

    The aims of this study were to clarify the metabonome alteration in fetal rats after prenatal caffeine ingestion and to explore the underlying mechanism pertaining to the increased fetal circulatory glucocorticoid (GC). Pregnant Wistar rats were daily intragastrically administered with different doses of caffeine (0, 20, 60 and 180 mg/kg) from gestational days (GD) 11 to 20. Metabonome of fetal plasma and amniotic fluid on GD20 were analyzed by {sup 1}H nuclear magnetic resonance-based metabonomics. Gene and protein expressions involved in the GC metabolism, glucose and lipid metabolic pathways in fetal liver and gastrocnemius were measured by real-time RT-PCR and immunohistochemistry. Fetal plasma metabonome were significantly altered by caffeine, which presents as the elevated α- and β‐glucose, reduced multiple lipid contents, varied apolipoprotein contents and increased levels of a number of amino acids. The metabonome of amniotic fluids showed a similar change as that in fetal plasma. Furthermore, the expressions of 11β-hydroxysteroid dehydrogenase 2 (11β-HSD-2) were decreased, while the level of blood GC and the expressions of 11β-HSD-1 and glucocorticoid receptor (GR) were increased in fetal liver and gastrocnemius. Meanwhile, the expressions of insulin-like growth factor 1 (IGF-1), IGF-1 receptor and insulin receptor were decreased, while the expressions of adiponectin receptor 2, leptin receptors and AMP-activated protein kinase α2 were increased after caffeine treatment. Prenatal caffeine ingestion characteristically change the fetal metabonome, which is probably attributed to the alterations of glucose and lipid metabolic pathways induced by increased circulatory GC, activated GC metabolism and enhanced GR expression in peripheral metabolic tissues. -- Highlights: ► Prenatal caffeine ingestion altered the metabonome of IUGR fetal rats. ► Caffeine altered the glucose and lipid metabolic pathways of IUGR fetal rats. ► Prenatal caffeine

  19. Fetal rat metabonome alteration by prenatal caffeine ingestion probably due to the increased circulatory glucocorticoid level and altered peripheral glucose and lipid metabolic pathways

    International Nuclear Information System (INIS)

    Liu, Yansong; Xu, Dan; Feng, Jianghua; Kou, Hao; Liang, Gai; Yu, Hong; He, Xiaohua; Zhang, Baifang; Chen, Liaobin; Magdalou, Jacques; Wang, Hui

    2012-01-01

    The aims of this study were to clarify the metabonome alteration in fetal rats after prenatal caffeine ingestion and to explore the underlying mechanism pertaining to the increased fetal circulatory glucocorticoid (GC). Pregnant Wistar rats were daily intragastrically administered with different doses of caffeine (0, 20, 60 and 180 mg/kg) from gestational days (GD) 11 to 20. Metabonome of fetal plasma and amniotic fluid on GD20 were analyzed by 1 H nuclear magnetic resonance-based metabonomics. Gene and protein expressions involved in the GC metabolism, glucose and lipid metabolic pathways in fetal liver and gastrocnemius were measured by real-time RT-PCR and immunohistochemistry. Fetal plasma metabonome were significantly altered by caffeine, which presents as the elevated α- and β‐glucose, reduced multiple lipid contents, varied apolipoprotein contents and increased levels of a number of amino acids. The metabonome of amniotic fluids showed a similar change as that in fetal plasma. Furthermore, the expressions of 11β-hydroxysteroid dehydrogenase 2 (11β-HSD-2) were decreased, while the level of blood GC and the expressions of 11β-HSD-1 and glucocorticoid receptor (GR) were increased in fetal liver and gastrocnemius. Meanwhile, the expressions of insulin-like growth factor 1 (IGF-1), IGF-1 receptor and insulin receptor were decreased, while the expressions of adiponectin receptor 2, leptin receptors and AMP-activated protein kinase α2 were increased after caffeine treatment. Prenatal caffeine ingestion characteristically change the fetal metabonome, which is probably attributed to the alterations of glucose and lipid metabolic pathways induced by increased circulatory GC, activated GC metabolism and enhanced GR expression in peripheral metabolic tissues. -- Highlights: ► Prenatal caffeine ingestion altered the metabonome of IUGR fetal rats. ► Caffeine altered the glucose and lipid metabolic pathways of IUGR fetal rats. ► Prenatal caffeine ingestion

  20. Insight into the mechanism of methanol assistance with syngas conversion over partially hydroxylated γ-Al2O3(110D) surface in slurry bed.

    Science.gov (United States)

    Bai, Bing; Bai, Hui; Cao, Hao-Jie; Gao, Zhi-Hua; Zuo, Zhi-Jun; Huang, Wei

    2018-04-27

    Despite numerous studies devoted to the various properties of γ-Al2O3, the explorations of its catalytic activity remain scarce. In this study, density functional theory calculations are performed to study the elementary adsorption and reaction mechanisms for syngas conversion on partially hydroxylated γ-Al2O3(110D) surface in liquid paraffin. It is found that the partially hydroxylated γ-Al2O3(110D) surface with the hydroxyl coverage of 8.9 OH nm-2 is formed by two dissociative adsorptions of H2O on the dry γ-Al2O3(110D) surface. The hydroxyl coverage conditions play a key role in determining the dominant reaction mechanism on account of the existence of strong hydrogen bonds. The preferential pathway for syngas conversion with assistance of methanol over the partially hydroxylated γ-Al2O3(110D) surface in liquid paraffin has been proven to be CH3OH → CH3O + H → CH3 + OH, CH3 + CO → CH3CO. C2H5OH is then formed by successive hydrogenation via the pathway CH3CO + 3H → CH3CHO + 2H → CH3CH2O + H → C2H5OH. Here, CH3CHO formation by CH3CO hydrogenation is not inhibited. Actually, with the assistance of partially hydroxylated γ-Al2O3, CH3CHO has been synthesized with high selectivity in our previous experiment by the reaction of methanol and syngas, which provides favorable evidence for our results. The rate-limiting step is the formation of CH3O from CH3OH dehydrogenation with an activation barrier of 122.2 kJ mol-1. Moreover, the reaction barrier of CO insertion into the adsorbed CH3 group is at least 89.4 kJ mol-1, lower than those of CH4, C2H6, and CH3OCH3 formations. ADCH charge and ESP analyses indicate that the typical (Al, O) Lewis acid-base pair may have a significant effect upon the initial C-C chain formation. Thus, the present study provides a new approach for the rational tailoring and designing of new catalysts with superior reactivity involved in syngas conversion.

  1. Effect of 5E Instructional Model in Student Success in Primary School 6th Year Circulatory System Topic

    Science.gov (United States)

    Cardak, Osman; Dikmenli, Musa; Saritas, Ozge

    2008-01-01

    The aim of this study is to research the effect of the 5E instructional model on primary (sixth grade) student success during the circulatory system unit. This study was conducted with 38 students in two different classes by the same researcher in 2006-2007. One of the classes was assigned as the control group and the other as the experimental…

  2. Ultrasound-assisted green economic synthesis of hydroxyapatite nanoparticles using eggshell biowaste and study of mechanical and biological properties for orthopedic applications.

    Science.gov (United States)

    Ingole, Vijay H; Hany Hussein, Kamal; Kashale, Anil A; Ghule, Kalyani; Vuherer, Tomaž; Kokol, Vanja; Chang, Jia-Yaw; Ling, Yong-Chien; Vinchurkar, Aruna; Dhakal, Hom N; Ghule, Anil V

    2017-11-01

    Nanostructured hydroxyapatite (HAp) is the most favorable candidate biomaterial for bone tissue engineering because of its bioactive and osteoconductive properties. Herein, we report for the first time ultrasound-assisted facile and economic approach for the synthesis of nanocrystalline hydroxyapatite (Ca 10 (PO 4 ) 6 (OH) 2 ) using recycled eggshell biowaste referred as EHAp. The process involves the reaction of eggshell biowaste as a source of calcium and ammonium dihydrogen orthophosphate as a phosphate source. Ultrasound-mediated chemical synthesis of hydroxyapatite (HAp) is also carried out using similar approach wherein commercially available calcium hydroxide and ammonium dihydrogen orthophosphate were used as calcium and phosphate precursors, respectively and referred as CHAp for better comparison. The prepared materials were characterized by X-ray diffraction, field emission scanning electron microscopy, Fourier transform infrared spectroscopy, and Raman spectroscopy to determine crystal structure, particle morphology, and the presence of chemical functional groups. The nanocrystalline EHAp and CHAp were observed to have spherical morphology with uniform size distribution. Furthermore, mechanical properties such as Vickers hardness, fracture toughness, and compression tests have been studied of the EHAp and CHAp samples showing promising results. Mechanical properties show the influence of calcination at 600°C EHAp and CHAp material. After calcination, in the case of EHAp material an average hardness, mechanical strength, elastic modulus, and fracture toughness were found 552 MPa, 46.6 MPa, 2824 MPa, and 3.85 MPa m 1/2 , respectively, while in the case of CHAp 618 MPa, 47.5 MPa, 2071 MPa, and 3.13 MPa m 1/2 . In vitro cell studies revealed that the EHAp and CHAp nanoparticles significantly increased the attachment and proliferation of the hFOB cells. Here, we showed that EHAp and CHAp provide promising biocompatible materials that do not affect the cell

  3. Rapid microwave-assisted nonaqueous synthesis and growth mechanism of AgCl/Ag, and its daylight-driven plasmonic photocatalysis.

    Science.gov (United States)

    Jiang, Jing; Zhang, Lizhi

    2011-03-21

    We report on a rapid microwave-assisted nonaqueous synthesis and the growth mechanism of AgCl/Ag with controlled size and shape. By rationally varying the reaction temperature and the microwave irradiation time, we achieved the transformation of nanocubes to rounded triangular pyramids by a combined process of "oriented attachment" and Ostwald ripening. The surface plasmon resonance (SPR) properties of the as-prepared AgCl/Ag have been found to be somewhat dependent on the size, morphology, and composition. The as-prepared AgCl/Ag exhibits high photocatalytic activity and good reusability for decomposing organic pollutants (such as methyl orange (MO), rhodamine B (RhB), and pentachlorophenol (PCP)) under indoor artificial daylight illumination (ca. 1 mW cm(-2)). The AgCl/Ag has also been found to display a superior ability to harvest diffuse indoor daylight (ca. 5 mW cm(-2)), and could complete the degradation of 10 mg  L(-1) MO within 15 min. Experiments involving the trapping of active species have shown that the photocatalytic degradation of organic pollutants in the AgCl/Ag system may proceed through direct hole transfer. This study has revealed that plasmonic daylight photocatalysis may open a new frontier for indoor pollutant control around the clock under fluorescent lamp illumination. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Ultrasound assisted production of fatty acid methyl esters from transesterification of triglycerides with methanol in the presence of KOH catalyst: optimization, mechanism and kinetics.

    Science.gov (United States)

    Thanh, Le Tu; Okitsu, Kenji; Maeda, Yasuaki; Bandow, Hiroshi

    2014-03-01

    Ultrasound assisted transesterification of triglycerides (TG) with methanol in the presence of KOH catalyst was investigated, where the changes in the reactants and products (diglycerides (DG), monoglycerides (MG), fatty acid methyl esters (FAME) and glycerin (GL)) concentrations were discussed to understand the reaction mechanism and kinetics under ultrasound irradiation. The optimum reaction condition for the FAME production was the concentration of KOH 1.0 wt.%, molar ratio of TG to methanol of 1:6, and irradiation time of 25 min. The rate constants during the TG transesterification with methanol into GL and FAME were estimated by a curve fitting method with simulated curves to the obtained experimental results. The rate constants of [Formula: see text] were estimated to be 0.21, 0.008, 0.23, 0.005, 0.14 and 0.001 L mol(-1)min(-1), respectively. The rate determining step for the TG transesterification with methanol into GL and FAME was the reaction of MG with methanol into GL and FAME. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Interracial Structure and Formation Mechanism of Ultrasonic-assisted Brazed Joint of SiC Ceramics with Al-12Si Filler Metals in Air

    Institute of Scientific and Technical Information of China (English)

    Xiaoguang Chen; Ruishan Xie; Zhiwei Lai; Lei Liu; Jiuchun Yan; Guisheng Zou

    2017-01-01

    Ultrasonic-assisted brazing of SiC ceramics was performed by filling with an Al--12Si alloy at a low temperature of 620 ℃ in air.The interfacial characteristics and formation mechanism were investigated.The joint shear strength reached 84-94 MPa using the ultrasonic time of 2-16 s.The fracture morphology showed that the fracture path initiated and propagated in the joint alloy.The thin film of amorphous SiO2 that formed on the SiC surface was non-uniformly decomposed and diffused into the liquid Al-12Si alloy under the cavitation erosion effect of ultrasound.Abnormal isolated blocks of Al2SiO5 compounds formed at the interface between Al--12Si and a thicker SiO2 layer formed during the thermal oxidation treatment of the SiC ceramic.The SiO2 layer on the SiC ceramic did not hinder or impair the wetting and bonding process,and a stronger bond could form between Al-12Si and SiO2 or SiC in ultrasonicassisted brazing.

  6. Materials and Mechanisms of Photo-Assisted Chemical Reactions under Light and Dark Conditions: Can Day-Night Photocatalysis Be Achieved?

    Science.gov (United States)

    Sakar, M; Nguyen, Chinh-Chien; Vu, Manh-Hiep; Do, Trong-On

    2018-03-09

    The photoassisted catalytic reaction, conventionally known as photocatalysis, is expanding into the field of energy and environmental applications. It is widely known that the discovery of TiO 2 -assisted photochemical reactions has led to several unique applications, such as degradation of pollutants in water and air, hydrogen production through water splitting, fuel conversion, cancer treatment, antibacterial activity, self-cleaning glasses, and concrete. These multifaceted applications of this phenomenon can be enriched and expanded further if this process is equipped with more tools and functions. The term "photoassisted" catalytic reactions clearly emphasizes that photons are required to activate the catalyst; this can be transcended even into the dark if electrons are stored in the material for the later use to continue the catalytic reactions in the absence of light. This can be achieved by equipping the photocatalyst with an electron-storage material to overcome current limitations in photoassisted catalytic reactions. In this context, this article sheds lights on the materials and mechanisms of photocatalytic reactions under light and dark conditions. The manifestation of such systems could be an unparalleled technology in the near future that could influence all spheres of the catalytic sciences. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. The circulatory system: blood procurement, AIDS, and the social body in China.

    Science.gov (United States)

    Erwin, Kathleen

    2006-06-01

    The market for blood thrived in China for more than a decade, preying on rural villagers desperate for cash. Profit motives and unhygienic collection created an AIDS epidemic, where now up to 80 percent of adults in some villages are HIV infected. Today, illegal blood banks continue to operate in some areas. Moreover, better screening and blood testing do little to address the underlying cultural reluctance to give blood. This article examines what is at stake for blood donors in the circulation of blood through both the physical and the social bodies in China today. I argue that public health and social policy solutions require consideration of the symbolic meanings of blood and the body, kin relations, and gift exchange. China's HIV-contaminated blood procurement crisis demands a critical reexamination of the hidden processes embedded in a "circulatory system" that has inseparably bound the "gift of life" and a "commodity of death".

  8. Transfusion-associated circulatory overload in adult, medical emergency patients with perspectives on early warning practice

    DEFF Research Database (Denmark)

    Gosmann, Fanny; Nørgaard, Astrid; Rasmussen, Maj-Britt

    2018-01-01

    of transfusion-associated dyspnoea. Vital signs and changes in dyspnoea and blood pressure were registered within the frame of the Early Warning Score, and one case was documented as being transfusion-related in the medical record. No cases were reported to the haemovigilance system. DISCUSSION: The incidence...... to the haemovigilance system. The clinical implications are discussed within the frame of the Early Warning Score. METHODS: We conducted a retrospective audit of electronic hospital medical records of patients receiving blood transfusion in a single medical emergency unit. Patients were admitted during a 6-month period...... and data on symptoms and vital signs were extracted from the records. RESULTS: Of 4,353 consecutively admitted patients, 156 patients were transfused with a total of 411 blood components. The audit identified five cases of transfusion-associated circulatory overload (incidence 3.2%) and four cases...

  9. Circulatory adaptation to long-term high altitude exposure in Aymaras and Caucasians.

    Science.gov (United States)

    Stuber, Thomas; Scherrer, Urs

    2010-01-01

    About 30 million people live above 2500 m in the Andean Mountains of South America. Among them are 5.5 million Aymaras, an ethnic group with its own language, living on the altiplano of Bolivia, Peru, and northern Chile at altitudes of up to 4400 m. In this high altitude region traces of human population go back for more than 2000 years with constant evolutionary pressure on its residents for genetic adaptation to high altitude. Aymaras as the assumed direct descendents of the ancient cultures living in this region were the focus of much research interest during the last decades and several distinctive adaptation patterns to life at high altitude have been described in this ethnic group. The aim of this article was to review the physiology and pathophysiology of circulatory adaptation and maladaptation to longtime altitude exposure in Aymaras and Caucasians.

  10. Monitoring and assay procedures for krypton-85 used in circulatory tests

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Jr., J. M.; Williams, K. D.

    1963-11-15

    During the past five years, krypton-85 has been used extensively at the National Institutes of health and by the heart Catheterization laboratory in the identification of circulatory shunts. Several methods of assaying the incoming shipments of radioactive gas are given. These consist of ionization chamber measurements, gamma ray spectrometry, and gross photon counting of the cylinder surface with an end-window Geiger-Mueller tube. A device (consisting of a log-count-rate meter, recorder, and G.M. tube) is used to continuously monitor the laboratory. The method of calibrating this device is presented. A means for removing contaminated air from the vicinity of the operating table was devised. The results of air clearance studies of the room are included. (auth)

  11. Status of the Tidal Regenerator Engine for nuclear circulatory support systems

    International Nuclear Information System (INIS)

    Watelet, R.P.; Ruggles, A.E.; Torti, V.

    1976-01-01

    Based on the annular version of the Tidal Regenerator Engine, a packaged energy system for nuclear powered circulatory support systems was developed. Net power output of approximately 3 watts is delivered using a 33-watt heat source for an engine module volume of 0.7 liter and a weight of 1.6 kg. A higher efficiency dual cycle version of the annular engine using a Dowtherm A topping cycle on the basic steam cycle is also under development. Projected system output using this advanced engine is 5 watts for the same sized heat source. Life testing of critical components has demonstrated substantial reliability improvement over earlier designs. Of particular significance is the continuing operation of a complete implantable engine system after 1200 hours. Component life testing is continuing with over five thousand hours accumulated on two pump actuators employing welded metal bellows

  12. [Evaluation of circulatory state using pulse oximeter: 2. PI (perfusion index) x PVI (pleth variability index)].

    Science.gov (United States)

    Kaneda, Toru; Suzuki, Toshiyasu

    2009-07-01

    Pulse oximeter expressed by SpO2 is used for monitoring respiratory state during operation and in ICU. Perfusion index (PI) and pleth variability index (PVI) as new indexes are calculated from pulse oximeter (Masimo SET Radical-7, Masimo Corp., USA, 1998) waveforms. And these indices were used as parameters to evaluate the circulatory state. For PI calculation, the pulsatile infrared signal is indexed against the nonpulsatile infrared signal and expressed as a percentage. It might thus be of future value in assessment of perioperative changes in peripheral perfusion. PVI is a measure of a dynamic change in PI that occurs during complete respiratory cycle. It might be thought that PVI, an index automatically derived from the pulse oximeter waveform analysis, had potentially clinical applications for noninvasive hypovolemia detection and fluid responsiveness monitoring.

  13. Acute resistance exercise modulates microRNA expression profiles: Combined tissue and circulatory targeted analyses.

    Directory of Open Access Journals (Sweden)

    Randall F D'Souza

    Full Text Available A subset of short non-coding RNAs, microRNAs (miRs, have been identified in the regulation of skeletal muscle hypertrophy and atrophy. Expressed within cells, miRs are also present in circulation (c-miR and have a putative role in cross-tissue signalling. The aim of this study was to examine the impact of a single bout of high intensity resistance exercise (RE on skeletal muscle and circulatory miRs harvested simultaneously. Resistance trained males (n = 9, 24.6 ± 4.9 years undertook a single bout of high volume RE with venous blood and muscle biopsies collected before, 2 and 4hr post-exercise. Real time polymerase chain reaction (Rt-PCR analyses was performed on 30 miRs that have previously been shown to be required for skeletal muscle function. Of these, 6 miRs were significantly altered within muscle following exercise; miR-23a, -133a, -146a, -206, -378b and 486. Analysis of these same miRs in circulation demonstrated minimal alterations with exercise, although c-miR-133a (~4 fold, p = 0.049 and c-miR-149 (~2.4 fold; p = 0.006 were increased 4hr post-exercise. Thus a single bout of RE results in the increased abundance of a subset of miRs within the skeletal muscle, which was not evident in plasma. The lack a qualitative agreement in the response pattern of intramuscular and circulating miR expression suggests the analysis of circulatory miRs is not reflective of the miR responses within skeletal muscle after exercise.

  14. Miniature circulatory systems: A new exposure system for ecotoxicological effect assessments in riverine organisms.

    Science.gov (United States)

    Feiner, Mona; Beggel, Sebastian; Geist, Juergen

    2016-11-01

    Long-term effect assessments in ecotoxicological investigations are important, yet there is a lack of suitable exposure systems for these experiments that can be used for riverine species. A cost-efficient miniature circulatory system was developed that was evaluated for its applicability in long-term exposures in 2 stream-dwelling species: brown trout (Salmo trutta) and an amphipod (Gammarus roeseli). In an egg-to-fry exposure of S. trutta, the toxicity of 2 reverse osmosis concentrates was investigated as examples. Control hatching rate of yolk sac fry was 75 ± 7% and thus complies with the Organisation for Economic Co-operation and Development validity criterion (≥66%). The reverse osmosis concentrates did not impair the hatching rate in any tested concentration. In G. roeseli, mortality rates remained below 20% during a 21-d cultivation, fulfilling the common validity criterion in ecotoxicological testing. Mortality was significantly lower when the species was fed with conditioned alder leaves instead of an artificial shrimp food. Finally, a toxicity test on G. roeseli using copper as the test substance revealed median lethal concentration (LC50) values of 156 μg/L after 96 h and 99 μg/L after 264 h, which is in line with literature findings using other accepted exposure units. In conclusion, the miniature circulatory system provides a novel and cost-efficient exposure system for long-term investigations on riverine species that may also be applicable for other species of fishes and macroinvertebrates. Environ Toxicol Chem 2016;35:2827-2833. © 2016 SETAC. © 2016 SETAC.

  15. Neonatal aortic arch reconstruction avoiding circulatory arrest and direct arch vessel cannulation.

    Science.gov (United States)

    Tchervenkov, C I; Korkola, S J; Shum-Tim, D; Calaritis, C; Laliberté, E; Reyes, T U; Lavoie, J

    2001-11-01

    Aortic arch reconstruction in neonates routinely requires deep hypothermic circulatory arrest. We reviewed our experience with techniques of continuous low-flow cerebral perfusion (LFCP) avoiding direct arch vessel cannulation. Eighteen patients, with a median age of 11 days (range 1 to 85 days) and a mean weight of 3.2 +/- 0.8 kg, underwent aortic arch reconstruction with LFCP. Seven had biventricular repairs with arch reconstruction, 9 underwent the Norwood operation and 2 had isolated arch repairs. In 1 Norwood and 7 biventricular repair patients, LFCP was maintained by advancing the cannula from the distal ascending aorta into the innominate artery. In 8 of 9 Norwood patients, LFCP was maintained by directing the arterial cannula into the pulmonary artery confluence and perfusing the innominate artery through the right modified Blalock-Taussig shunt fully constructed before cannulation for cardiopulmonary bypass. In 2 patients requiring isolated arch reconstruction, the ascending aorta was cannulated and the cross-clamp was applied just distal to the innominate artery. LFCP was maintained at 0.6 +/- 0.2 L x min(-1) x m(-2) for 41.0 +/- 13.9 minutes at 18.5 degrees C +/- 1.1 degrees C. In 10 of the 18 patients, blood pressure during LFCP was 15 +/- 8 mm Hg remote from the innominate artery (left radial, umbilical or femoral arteries). In 8 of the 18 patients, right radial pressure during LFCP was 24 +/- 10 mm Hg. The mean mixed-venous saturation was 79.8% +/- 10% during LFCP. Two patients had preoperative seizures, whereas none had seizures postoperatively. One patient died. Neonatal aortic arch reconstruction is possible without circulatory arrest or direct arch vessel cannulation. These techniques maintained adequate mixed-venous oxygen saturations with no associated adverse neurologic outcomes.

  16. Fluoro jade-C staining in the assessment of brain injury after deep hypothermia circulatory arrest.

    Science.gov (United States)

    Wang, Ren; Ma, Wei-Guo; Gao, Guo-Dong; Mao, Qun-Xia; Zheng, Jun; Sun, Li-Zhong; Liu, Ying-Long

    2011-02-04

    To evaluate the efficacy of Fluoro Jade-C staining (FJC) in the assessment of brain injury after deep hypothermia circulatory arrest (DHCA). Six healthy adult miniature male pigs underwent DHCA, the rectal temperature was down to 18°C, circulation was stopped , circulatory arrest was maintained for 60 minutes. On postoperative day 1, perfusion-fixation was performed on brain tissue. Cerebral cortex, hippocampus, cerebellum were taken for sampling. FJC, hematoxylin-eosin staining (HE), nissl staining (NISSL), terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) were performed to detect the histological and pathological changes. Histological scores of all slices were ranked. Comparison between the FJC and other techniques was done by analysis of variance (ANOVA) according to histological scores. All animals survived the operation. On the cerebral cortex, in comparison of FJC between HE, NISSL and TUNEL, the p value was 0.90, 0.40, 0.16 respectively (p>0.05). On the hippocampus, the comparison of FJC with HE, NISSL and TUNEL had a p value of 0.12, 0.23, 0.62 respectively (p>0.05). On the cerebellum, in comparing FJC with HE, NISSL and TUNEL, the p value was 0.96, 0.77, 0.96 respectively (p>0.05). On representative regions, the results of FJC were in accordance with that of TUNEL, NISSL and HE. Furthermore, ascertainment of brain injury is easier with FJC. FJC is a reliable and convenient method to assess brain injury after DHCA. Copyright © 2010 Elsevier B.V. All rights reserved.

  17. Noninvasive optoacoustic system for rapid diagnostics and management of circulatory shock

    Science.gov (United States)

    Esenaliev, Rinat O.; Petrov, Irene Y.; Petrov, Yuriy; Kinsky, Michael; Prough, Donald S.

    2012-02-01

    Circulatory shock is lethal, if not promptly diagnosed and effectively treated. Typically, circulatory shock resuscitation is guided by blood pressure, heart rate, and mental status, which have poor predictive value. In patients, in whom early goaldirected therapy was applied using central venous oxygenation measurement, a substantial reduction of mortality was reported (from 46.5% to 30%). However, central venous catheterization is invasive, time-consuming and often results in complications. We proposed to use the optoacoustic technique for noninvasive, rapid assessment of central venous oxygenation. In our previous works we demonstrated that the optoacoustic technique can provide measurement of blood oxygenation in veins and arteries due to high contrast and high resolution. In this work we developed a novel optoacoustic system for noninvasive, automatic, real-time, and continuous measurement of central venous oxygenation. We performed pilot clinical tests of the system in human subjects with different oxygenation in the internal jugular vein and subclavian vein. A novel optoacoustic interface incorporating highly-sensitive optoacoustic probes and standard ultrasound imaging probes were developed and built for the study. Ultrasound imaging systems Vivid i and hand-held Vscan (GE Healthcare) as well as Site-Rite 5 (C.R. Bard) were used in the study. We developed a special algorithm for oxygenation monitoring with minimal influence of overlying tissue. The data demonstrate that the system provides precise measurement of venous oxygenation continuously and in real time. Both current value of the venous oxygenation and trend (in absolute values and for specified time intervals) are displayed in the system. The data indicate that: 1) the optoacoustic system developed by our group is capable of noninvasive measurement of blood oxygenation in specific veins; 2) clinical ultrasound imaging systems can facilitate optoacoustic probing of specific blood vessels; 3) the

  18. Effects of 12 days exposure to simulated microgravity on central circulatory hemodynamics in the rhesus monkey

    Science.gov (United States)

    Convertino, V. A.; Koenig, S. C.; Krotov, V. P.; Fanton, J. W.; Korolkov, V. I.; Trambovetsky, E. V.; Ewert, D. L.; Truzhennikov, A.; Latham, R. D.

    1998-01-01

    Central circulatory hemodynamic responses were measured before and during the initial 9 days of a 12-day 10 degrees head-down tilt (HDT) in 4 flight-sized juvenile rhesus monkeys who were surgically instrumented with a variety of intrathoracic catheters and blood flow sensors to assess the effects of simulated microgravity on central circulatory hemodynamics. Each subject underwent measurements of aortic and left ventricular pressures, and aortic flow before and during HDT as well as during a passive head-up postural test before and after HDT. Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure were measured, and dP/dt and left ventricular elastance was calculated from hemodynamic measurements. The postural test consisted of 5 min of supine baseline control followed by 5 minutes of 90 degrees upright tilt (HUT). Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure showed no consistent alterations during HDT. Left ventricular elastance was reduced in all animals throughout HDT, indicating that cardiac compliance was increased. HDT did not consistently alter left ventricular +dP/dt, indicating no change in cardiac contractility. Heart rate during the post-HDT HUT postural test was elevated compared to pre-HDT while post-HDT cardiac output was decreased by 52% as a result of a 54% reduction in stroke volume throughout HUT. Results from this study using an instrumented rhesus monkey suggest that exposure to microgravity may increase ventricular compliance without alternating cardiac contractility. Our project supported the notion that an invasively-instrumented animal model should be viable for use in spaceflight cardiovascular experiments to assess potential changes in myocardial function and cardiac compliance.

  19. Mechanics

    CERN Document Server

    Chester, W

    1979-01-01

    When I began to write this book, I originally had in mind the needs of university students in their first year. May aim was to keep the mathematics simple. No advanced techniques are used and there are no complicated applications. The emphasis is on an understanding of the basic ideas and problems which require expertise but do not contribute to this understanding are not discussed. How­ ever, the presentation is more sophisticated than might be considered appropri­ ate for someone with no previous knowledge of the subject so that, although it is developed from the beginning, some previous acquaintance with the elements of the subject would be an advantage. In addition, some familiarity with element­ ary calculus is assumed but not with the elementary theory of differential equations, although knowledge of the latter would again be an advantage. It is my opinion that mechanics is best introduced through the motion of a particle, with rigid body problems left until the subject is more fully developed. Howev...

  20. Assistive Technology

    Science.gov (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

  1. Proton-conducting beta"-alumina via microwave-assisted synthesis and mechanism of enhanced corrosion prevention of a zinc rich coating with electronic control

    Science.gov (United States)

    Kirby, Brent William

    Proton Conducting beta-alumina via Microwave Assisted Synthesis. The microwave assisted synthesis of proton conducting Mg- and Li-stabilized NH4+/H3O+ beta-alumina from a solution based gel precursor is reported. beta-alumina is a ceramic fast ion conductor containing two-dimensional sheets of mobile cations. Na +-beta-alumina is the most stable at the sintering temperatures (1740°C) reached in a modified microwave oven, and can be ion exchanged to the K+ form and then to the NH4+/H 3O+ form. beta-phase impurity is found to be 20% for Mg-stabilized material and 30-40% for Li-stabilized material. The composition of the proton conducting form produced here is deficient in NH4 + as compared to the target composition (NH4)1.00 (H3O)0.67Mg0.67Al10.33O 17. Average grain conductivity for Li-stabilized material at 150°C is 6.6x10-3 +/- 1.6x10-3 S/cm with 0.29 +/- 0.05 eV activation energy, in agreement with single crystal studies in the literature. Grain boundary conductivity is found to be higher in the Li-stabilized material. A hydrogen bond energy hypothesis is presented to explain these differences. Li-stabilized NH4+/H3O + beta-alumina is demonstrated as a fuel cell electrolyte, producing 28 muA/cm2 of electrical current at 0.5 V. Mechanism of Enhanced Corrosion Prevention of a Zinc Rich Coating with Electronic Control. A corrosion inhibition system consisting of high weight-loading zinc rich coating applied to steel panels is examined. An electronic control unit (ECU) consisting of a battery and a large capacitor in series with the panel is shown to improve corrosion protection upon immersion in 3% NaCl solution. Weekly solution changes to avoid zinc saturation in solution system were necessary to see well differentiated results. The corrosion product, hydrozincite [Zn5(CO3) 2(OH)6] is observed to deposit within the pores of the coating and on the surface as a barrier layer. Simonkolleite [Zn5(OH) 8Cl2·H2O] is found to form in place of the original zinc particles

  2. Assisted Living

    Science.gov (United States)

    ... it, too. Back to top What is the Cost for Assisted Living? Although assisted living costs less than nursing home ... Primarily, older persons or their families pay the cost of assisted living. Some health and long-term care insurance policies ...

  3. Circulatory shock in horses / Choque circulatório em equinos

    Directory of Open Access Journals (Sweden)

    José Monteira da Silva Filho

    2010-04-01

    Full Text Available Circulatory shock can be defined as an acute circulatory failure with an inadequate tissue delivery of oxygen and nutritive substrates to the tissues, resulting in generalised cellular hypoxia. Shock can be classified as cardiogenic, obstructive, hypovolaemic, or distributive. The pathophysiologic consequences of inadequate tissue perfusion are directly related to cell ischemia, inadequate O2 delivery, and the production of proinflammatory mediators. If abnormalities of tissue perfusion are allowed to persist, the function of vital organs will be impaired. The subsequent reperfusion will exacerbate organ dysfunction and, in severe cases, may culminate in multiple organ dysfunction syndrome. Early recognition of equine that are shocked and immediate provision of effective circulatory support is therefore essential. In all cases the objective is to restore oxygen delivery to the tissues while correcting the underlying cause. Delays in making the diagnosis and initiating treatment, as well as suboptimal resuscitation, contribute to the development of peripheral vascular failure and irreversible defects in oxygen use which can culminate in vital organ dysfunction.Choque circulatório pode ser definido como uma falha circulatória aguda com liberação inadequada de oxigênio e nutrientes aos tecidos, resultando em hipóxia celular. O choque pode ser classificado como cardiogênico, obstrutivo, hipovolêmico ou distributivo. As consequências fisiopatológicas da perfusão tecidual inadequada estão diretamente relacionadas à isquemia celular, liberação inadequada de O2 e produção de potentes mediadores inflamatórios. Caso as anormalidades de perfusão tecidual se perpetuem, a função de vários órgãos se torna inadequada. A consequente reperfusão poderá exacerbar a disfunção orgânica e, nos casos graves, culminar na síndrome da disfunção orgânica múltipla. O reconhecimento precoce de equinos em choque circulatório e o

  4. The ‘abdominal circulatory pump’: an auxiliary heart during exercise?

    Directory of Open Access Journals (Sweden)

    Barbara eUva

    2016-01-01

    Full Text Available Apart from its role as a flow generator for ventilation the diaphragm has a circulatory role. The cyclical abdominal pressure variations from its contractions cause swings in venous return from the splanchnic venous circulation. During exercise the action of the abdominal muscles may enhance this circulatory function of the diaphragm. Eleven healthy subjects (25±7yr, 70±11kg, 1.78±0.1m, 3F performed plantar flexion exercise at ∼4 METs. Changes in body volume (ΔVb and trunk volume (ΔVtr were measured simultaneously by double body plethysmography. Volume of blood shifts between trunk and extremities (Vbs was determined non-invasively as ΔVtr-ΔVb. Three types of breathing were studied: spontaneous (SE, rib cage (RCE, voluntary emphasized inspiratory rib cage breathing and abdominal (ABE, voluntary active abdominal expiration breathing.. During SE and RCE blood was displaced from the extremities into the trunk (on average 0.16± 0.33L and 0.48±0.55L, p<0.05 SE vs RCE, while during ABE it was displaced from the trunk to the extremities (0.22±0.20L p<0.001, p<0.05 RCE and SE vs ABE respectively. At baseline, Vbs swings (maximum to minimum amplitude were bimodal and averaged 0.13±0.08L. During exercise, Vbs swings consistently increased (0.42±0.34L, 0.40±0.26L, 0.46±0.21L, for SE, RCE and ABE respectively, all p<0.01 vs. baseline. It follows that during leg exercise significant bi-directional blood shifting occurs between the trunk and the extremities. The dynamics and partitioning of these blood shifts strongly depend on the relative predominance of the action of the diaphragm, the rib cage and the abdominal muscles. Depending on the partitioning between respiratory muscles for the act of breathing, the distribution of blood between trunk and extremities can vary by up to 1 L. We conclude that during exercise the abdominal muscles and the diaphragm might play a role of an ‘auxiliary heart’.

  5. Plasma coatings of nitrogen polymers on metal prostheses of the circulatory system

    International Nuclear Information System (INIS)

    Gomez J, L. M.

    2016-01-01

    This work has a study about the synthesis of poly aniline, poly allylamine and poly pyrrole doped with iodine onto metallic surfaces similar to stents for the circulatory system. Ar, water and hydrogen peroxide plasmas were used for eroding, conditioning and synthesizing polymers that potentially reduce some rejection reactions when stents are implanted in the human body. Stents are small metallic meshes that applied inside collapsed arteries or veins enlarge the diameter and restore the blood flow, however the metallic surfaces usually cause rejection reactions that obstruct the veins again. To give solutions to this problem, in this work is studied the synthesis of biocompatible polymer coatings on the stents that resist the blood flow forming a biocompatible interface between metal and blood. The metallic substrates were eroded and chemically prepared with Ar, H_2O and/or H_2O_2 glow discharges on which the polymers were synthesized by plasma. The coatings were morphologically characterized by optical, scanning electron and atomic force microscopy, the chemical structure was studied by infrared and photoelectron X-ray spectroscopy. The hydrophilicity was studied measuring the advance static contact angle and the adhesion was evaluated indirectly with scanning electron microscopy after two months submerged in buffered phosphate solutions. The results indicate that the polymers grew following the superficial morphology; that the conditioning with Ar ions erode the substrates and that the conditioning with H_2O or H_2O_2 erodes and activates the surface generating oxygen bridges which help in the polymer-metal adhesion. The chemical structure of the polymeric coatings contain crosslinked structures that correspond to links between monomers with the participation of all atoms, states that suggest monomer fragmentation and oxidation and states that indicate oxygen bridges in the polymers. The coatings had contact angles close to 90 degrees where is located the line

  6. Prologue: ventricular assist devices and total artificial hearts. A historical perspective.

    Science.gov (United States)

    Frazier, O H

    2003-02-01

    In the 1960s, when LVADs and TAHs were introduced into clinical use, researchers estimated that, with this technology, the problem of heart failure could be solved within 20 years. Unfortunately, the evolution of these devices has taken much longer than anticipated. Nevertheless, significant advances have been achieved in both cardiac assistance and replacement, and today's cardiac surgeons have a wide range of devices from which to choose (Table 4). This progress has largely been due to the support of the NHLBI, especially the Devices and Technology Division headed by John Watson, and of the devoted commitment of the investigators. Because of the long-term commitment required for both basic and clinical research, commercial medical technology companies are unable to assume this burden. Advances in mechanical circulatory support and replacement have benefited numerous patients worldwide who would otherwise have died of heart failure, and devices now exist for use as bridges to recovery, bridges to transplant, and destination therapy. The current challenge is to refine what we have and to apply these technologies to broader patient populations with maximal safety and at a reasonable cost.

  7. Calculation of the ALMA Risk of Right Ventricular Failure After Left Ventricular Assist Device Implantation.

    Science.gov (United States)

    Loforte, Antonio; Montalto, Andrea; Musumeci, Francesco; Amarelli, Cristiano; Mariani, Carlo; Polizzi, Vincenzo; Lilla Della Monica, Paola; Grigioni, Francesco; Di Bartolomeo, Roberto; Marinelli, Giuseppe

    2018-05-08

    Right ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88). The final study patients were randomly divided into derivation (79.8%, n = 206) and validation (20.1%, n = 52) cohorts. Fifty-seven preoperative risk factors were compared between patients who were successfully managed with an LVAD and those who required a BVAD. Nineteen variables demonstrated statistical significance on univariable analysis. Multivariable logistic regression analysis identified destination therapy (odds ratio [OR] 2.0 [1.7-3.9], p = 0.003), a pulmonary artery pulsatility index right ventricle/left ventricle end-diastolic diameter ratio >0.75 (OR 2.7 [1.5-5.5], p = 0.001), an right ventricle stroke work index 17 (OR 3.5 [1.9-6.9], p the major predictors of the need for BVAD. Using these data, we propose a simple risk calculator to determine the suitability of patients for isolated LVAD support in the era of continuous-flow mechanical circulatory support devices.

  8. A LabVIEW model incorporating an open-loop arterial impedance and a closed-loop circulatory system.

    Science.gov (United States)

    Cole, R T; Lucas, C L; Cascio, W E; Johnson, T A

    2005-11-01

    While numerous computer models exist for the circulatory system, many are limited in scope, contain unwanted features or incorporate complex components specific to unique experimental situations. Our purpose was to develop a basic, yet multifaceted, computer model of the left heart and systemic circulation in LabVIEW having universal appeal without sacrificing crucial physiologic features. The program we developed employs Windkessel-type impedance models in several open-loop configurations and a closed-loop model coupling a lumped impedance and ventricular pressure source. The open-loop impedance models demonstrate afterload effects on arbitrary aortic pressure/flow inputs. The closed-loop model catalogs the major circulatory waveforms with changes in afterload, preload, and left heart properties. Our model provides an avenue for expanding the use of the ventricular equations through closed-loop coupling that includes a basic coronary circuit. Tested values used for the afterload components and the effects of afterload parameter changes on various waveforms are consistent with published data. We conclude that this model offers the ability to alter several circulatory factors and digitally catalog the most salient features of the pressure/flow waveforms employing a user-friendly platform. These features make the model a useful instructional tool for students as well as a simple experimental tool for cardiovascular research.

  9. Determination of death after circulatory arrest by intensive care physicians: A survey of current practice in the Netherlands.

    Science.gov (United States)

    Wind, Jentina; van Mook, Walther N K A; Dhanani, Sonny; van Heurn, Ernest W L

    2016-02-01

    Determination of death is an essential part of donation after circulatory death (DCD). We studied the current practices of determination of death after circulatory arrest by intensive care physicians in the Netherlands, the availability of guidelines, and the occurrence of the phenomenon of autoresuscitation. The Determination of Cardiac Death Practices in Intensive Care Survey was sent to all intensive care physicians. Fifty-five percent of 568 Dutch intensive care physicians responded. Most respondents learned death determination from clinical practice. The most commonly used tests for death determination were flat arterial line tracing, flat electrocardiogram (standard 3-lead electrocardiogram), and fixed and dilated pupils. Rarely used tests were absence pulse by echo Doppler, absent blood pressure by noninvasive monitoring, and unresponsiveness to painful stimulus. No diagnostic test or procedure was uniformly performed, but 80% of respondents perceived a need for standardization of death determination. Autoresuscitation was witnessed by 37%, after withdrawal of treatment or after unsuccessful resuscitation. Extensive variability in the practice of determining death after circulatory arrest exists, and a need for guidelines and standardization, especially if organ donation follows death, is reported. Autoresuscitation is reported; this observation requires attention in further prospective observational studies. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Initial circulatory response to active standing in Parkinson's disease without typical orthostatic hypotension

    Directory of Open Access Journals (Sweden)

    Guillermo Delgado

    2014-03-01

    Full Text Available While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH, there is an initial response to the upright position which is uniquely associated with active standing (AS. We sought to assess this response and to compare it to that seen in young healthy controls (YHC. Method In 10 PD-TOH patients (8 males, 60±7 years, Hoehn and Yahr ≤3 the changes in systolic blood pressure (SBP and heart rate that occur in the first 30 seconds (sec of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Peñáz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32±8 years. Results The main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24±4 vs. 19±3 sec; p<0.05. Conclusion This delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis.

  11. Pediatric donation after circulatory determination of death (pDCD): A narrative review.

    Science.gov (United States)

    Weiss, Matthew J; Sherry, Wendy; Hornby, Laura

    2018-04-14

    Pediatric donation after circulatory death (pDCD) is an established pathway for organ donation. It remains, however, a relatively rare event worldwide, and most clinicians outside of the pediatric intensive care unit (PICU) are unfamiliar with it. The goal of this review is to introduce the processes and concepts of pDCD. While most children die in circumstances that would not allow pDCD, many children that die after withdrawal of life sustaining therapy (WLST) may be eligible for donation of some organs. The potential benefits of this practice to patients on the wait list are well known, but donation can also be an opportunity to honor a patient's or family's desire to altruistically improve the lives of others. Offering the possibility of donation requires careful attention to ethical principles to ensure that conflicts of interest are avoided and that the family is free to make an independent, fully informed decision. Doing so allows families and decision makers the autonomy to decide if donation is something they wish to incorporate into end-of-life care. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Brain ultrasonographic findings of late-onset circulatory dysfunction due to adrenal insufficiency in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su Mi; Chai, Jee Won [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    The aim of this study was to characterize the brain ultrasonographic findings of late-onset circulatory dysfunction (LCD) due to adrenal insufficiency (AI) in preterm infants. Among the 257 preterm infants born at <33 weeks of gestation between December 2009 and February 2014 at our institution, 35 preterm infants were diagnosed with AI. Brain ultrasonographic findings were retrospectively analyzed before and after LCD in 14 preterm infants, after exclusion of the other 21 infants with AI due to the following causes: death (n=2), early AI (n=5), sepsis (n=1), and patent ductus arteriosus (n=13). Fourteen of 257 infants (5.4%) were diagnosed with LCD due to AI. The age at LCD was a median of 18.5 days (range, 9 to 32 days). The last ultrasonographic findings before LCD occurred showed grade 1 periventricular echogenicity (PVE) in all 14 patients and germinal matrix hemorrhage (GMH) with focal cystic change in one patient. Ultrasonographic findings after LCD demonstrated no significant change in grade 1 PVE and no new lesions in eight (57%), grade 1 PVE with newly appearing GMH in three (21%), and increased PVE in three (21%) infants. Five infants (36%) showed new development (n=4) or increased size (n=1) of GMH. Two of three infants (14%) with increased PVE developed cystic periventricular leukomalacia (PVL) and rapid progression to macrocystic encephalomalacia. LCD due to AI may be associated with the late development of GMH, increased PVE after LCD, and cystic PVL with rapid progression to macrocystic encephalomalacia.

  13. A review of non-cancer effects, especially circulatory and ocular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Little, Mark P. [National Cancer Institute, Radiation Epidemiology Branch, Bethesda, MD (United States)

    2013-11-15

    There is a well-established association between high doses (>5 Gy) of ionizing radiation exposure and damage to the heart and coronary arteries, although only recently have studies with high-quality individual dosimetry been conducted that would enable quantification of this risk adjusting for concomitant chemotherapy. The association between lower dose exposures and late occurring circulatory disease has only recently begun to emerge in the Japanese atomic bomb survivors and in various occupationally exposed cohorts and is still controversial. Excess relative risks per unit dose in moderate- and low-dose epidemiological studies are somewhat variable, possibly a result of confounding and effect modification by well-known (but unobserved) risk factors. Radiation doses of 1 Gy or more are associated with increased risk of posterior subcapsular cataract. Accumulating evidence from the Japanese atomic bomb survivors, Chernobyl liquidators, US astronauts, and various other exposed groups suggests that cortical cataracts may also be associated with ionizing radiation, although there is little evidence that nuclear cataracts are radiogenic. The dose-response appears to be linear, although modest thresholds (of no more than about 0.6 Gy) cannot be ruled out. A variety of other non-malignant effects have been observed after moderate/low-dose exposure in various groups, in particular respiratory and digestive disease and central nervous system (and in particular neuro-cognitive) damage. However, because these are generally only observed in isolated groups, or because the evidence is excessively heterogeneous, these associations must be treated with caution. (orig.)

  14. Hyperdynamic circulatory changes in liver cirrhosis: Comparative evaluation by doppler ultrasonography with normal subjects

    International Nuclear Information System (INIS)

    Im, Dae Wook; Baik, Soon Koo; Suh, Jung In; Kim, Jae Woo; Park, Yong Soon; Kim, Hyun Soo; Lee, Dong Ki; Kwon, Sang Ok

    2001-01-01

    To evaluate the cardiovascular and splanchnic hemodynamic changes in patients with liver cirrhosis and to compare with those of the normal controls using doppler ultrasonography. A total of 129 patients including 23 of Child-Pugh class A, 24 of class A, 24 of class B, 30 of class C, and 52 of the control group were included. Cardiac output (CO), systemic vascular resistance index (SVRI), and blood flow and pulsatility index (PI) of the superior mesenteric artery (SMA) were evaluated and compared among each groups. CO and SMA blood flow in the cirrhotic group were significantly higher than those in the control group, and the increase in CO and SMA blood flow showed a statistically significant correlation with the degree of liver dysfunction (p 2 =0.230). Hyperdynamic circulatory changes such as increases in CO and splanchnic blood flow were present in patients with liver cirrhosis. These changes may contribute to the development and maintenance of the portal hypertension due to an increase in portal blood flow an increase in portal blood flow.

  15. A study of cerebral circulation, metabolism and MRI findings in patients with chronic cerebral circulatory insufficiency

    International Nuclear Information System (INIS)

    Kondo, Susumu

    1995-01-01

    Chronic cerebral circulatory insufficiency (CCCI) is a recently proposed clinical entity characterized by symptoms such as dizziness, a feeling of heavy-headedness or vague numbness without any neurological signs or organic vascular lesions on CT. In order to elucidate its pathogenesis, ultrasonic quantitative blood flow measurement system, positron emission tomography (PET) and MRI were employed to study three groups of subjects: 60 subjects with CCCI (group A), 44 subjects with risk factors for cerebrovascular disease but without neurological abnormalities (group B), and 40 normal healthy volunteers (group C). The results are summarized as follows: Mean common carotid blood flow decreased with age in all groups. Common carotid blood flow was lowest in group A and second lowest in group B in every decade of patient age. PET study revealed that CBF and CMRO 2 in all regions examined were significantly lower in group A than in group C. The incidence of MR signal abnormalities in the white matter increased with age. Group A had the highest incidence, and group C had the lowest. Reduction in mean common carotid blood flow and cerebral blood flow was associated with increasing incidence and severity of MR signal abnormalities. These findings indicate that CCCI is a pathologic condition closely related to diffuse cerebral low perfusion resulting from cerebral arteriosclerosis. The symptoms seen in this condition, which are apt to be taken lightly, may warn of impending ischemic stroke. (author)

  16. Clinical comparison of radionuclide cisternography and computed tomography in CSF circulatory disturbance

    International Nuclear Information System (INIS)

    Tanabe, Masaya; Futatsuki, Minoru; Tanaka, Hiroshi.

    1980-01-01

    Forty-three patients with abnormal cisternograms were classified into (1) NPH, (2) Postmeningitic hydrocephalus, (3) Posttraumatic hydrocephalus, (4) Postoperative hydrocephalus (tumor) (5) Postoperative hydrocephalus (vascular disease), (6) Meningitis, (7) Tumor, (8) Vascular disease, (9) Degenerative disease and (10) Miscellaneous. Cisternography was done by a scinticamera with 111 In-DTPA and all groups were scanned by IInd generation CT scanner. The result of the cisternography was not always compatible with the CT findings. We found a case of anatomically normal but functionally abnormal cisterns and ventricular system. In all classified disorder groups, the cisternography detected functioning cisterns in CSF dynamics but the CT visualized anatomically open cisterns. By the combined use of these two examinations, a local cisternal block was detected. Ten in 20 cases with operated (V-P shunt) hydrocephalus clinically improved. But the result of these techniques, failed to assess the effectiveness of the V-P shunt. V-P shunt was effective in 8 out of 14 cases with persistent ventricular reflux and delayed clearance, and in 9 out of 17 cases with total ventricular dilatation. We concluded that the combined use of the RI cisternography and the computed tomography was better than single examination to detect CSF circulatory disturbance but we were not satisfied with the joint use in the evaluation of the effect of V-P shunt. No adverse reaction was experienced in the 43 patients with 111 In-DTPA. (author)

  17. Expanding the donor lung pool: how many donations after circulatory death organs are we missing?

    Science.gov (United States)

    Chancellor, William Zachary; Charles, Eric J; Mehaffey, James Hunter; Hawkins, Robert B; Foster, Carrie A; Sharma, Ashish K; Laubach, Victor E; Kron, Irving L; Tribble, Curtis G

    2018-03-01

    The number of patients with end-stage pulmonary disease awaiting lung transplantation is at an all-time high, while the supply of available organs remains stagnant. Utilizing donation after circulatory death (DCD) donors may help to address the supply-demand mismatch. The objective of this study is to determine the potential donor pool expansion with increased procurement of DCD organs from patients who die at hospitals. The charts of all patients who died at a single, rural, quaternary-care institution between August 2014 and June 2015 were reviewed for lung transplant candidacy. Inclusion criteria were age 65 y (n = 497, 58%). Those without cancer totaled 778 (90.8%) and 512 (59%) did not have lung pathology. This leaves 85 patients qualifying for DCD lung donation (pediatric n = 10, young n = 75, and old n = 0). Potential donors were significantly more likely to have clear chest X-rays (24.3% versus 10.0%, P < 0.0001) and higher mean PaO2/FiO2 (342.1 versus 197.9, P < 0.0001) compared with ineligible patients. A significant number of DCD lungs are available every year from patients who die within hospitals. We estimate the use of suitable DCD lungs could potentially result in a significant increase in the number of lungs available for transplantation. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. A National Survey of Mentoring Practices for Young Investigators in Circulatory and Respiratory Health

    Science.gov (United States)

    Mottillo, Salvatore; Boyle, Pierre; Jacobi Cadete, Lindsay D.; Rouleau, Jean-Lucien; Eisenberg, Mark J.

    2016-01-01

    Background. Improving mentorship may help decrease the shortage of young investigators (graduate students, postdoctoral fellows, and new investigators) available to work as independent researchers in cardiovascular and respiratory health. Objectives. To determine (1) the mentoring practices for trainees affiliated with the Canadian Institutes of Health Research (CIHR), Institute of Circulatory and Respiratory Health (ICRH), (2) the positive attributes of mentors, and (3) the recommendations regarding what makes good mentorship. Methods. We conducted a survey and descriptive analysis of young investigators with a CIHR Training and Salary Award from 2010 to 2013 or who submitted an abstract to the ICRH 2014 Young Investigators Forum. Clinicians were compared to nonclinicians. Results. Of 172 participants, 7.0% had no mentor. Only 43.6% had defined goals and 40.7% had defined timelines, while 54.1% had informal forms of mentorship. A significant proportion (33.1%) felt that their current mentorship did not meet their needs. Among clinicians, 22.2% would not have chosen the same mentor again versus 11.4% of nonclinicians. All participants favored mentors who provided guidance on career and work-life balance. Suggestions for improved mentoring included formal mentorship, increased networking, and quality assurance. Conclusion. There is an important need to improve mentoring in cardiovascular and respiratory health. PMID:27445544

  19. Central respiratory and circulatory effects of Gymnodinium breve toxin in anaesthetized cats

    Science.gov (United States)

    Borison, Herbert L.; Ellis, Sydney; McCarthy, Lawrence E.

    1980-01-01

    1 In cats anaesthetized with pentobarbitone, observations were made on respiration, spontaneous and evoked diaphragmatic electromyograms, blood pressure, heart rate, indirectly-induced contractions of the anterior tibialis muscle and nictitating membrane, and electrical excitability of the inspiratory centre in the medulla oblongata. 2 Gymnodinium breve toxin (GBTX) was administered intravenously, intra-arterially to the brain, and intracerebroventricularly. Physiological effects were recorded while alveolar PCO2 was controlled at a constant level except when changes in gas tension were made in order to measure CO2-ventilatory responsiveness. 3 Adequate doses of GBTX given intravenously by bolus injection elicited a non-tachyphylactic reflex response triad of apnoea, hypotension and bradycardia mediated by the vagus nerves independently of arterial baroreceptor and chemoreceptor innervation. 4 After vagotomy, additional amounts of GBTX (i.v.) resulted in apneustic breathing, hypertension and tachycardia. The cardiovascular effects were abolished by ganglionic blockade with hexamethonium. 5 Smaller doses of GBTX were required intra-arterially and intracerebroventricularly than by the intravenous route of injection to produce respiratory irregularity and cardiovascular hyperactivity. 6 Evoked motor responses, electrical excitability of the medulla oblongata and CO2-ventilatory responsiveness were largely spared even though GBTX caused marked disturbances in respiratory rhythmicity and cardiovascular functions. 7 It is concluded that GBTX acts reflexly on vagally innervated receptors to evoke a Bezold-Jarisch effect but that the toxin further acts centrally to cause irregular breathholding and hypertension with tachycardia, leading ultimately to respiratory and circulatory failure. PMID:7191740

  20. A National Survey of Mentoring Practices for Young Investigators in Circulatory and Respiratory Health

    Directory of Open Access Journals (Sweden)

    Salvatore Mottillo

    2016-01-01

    Full Text Available Background. Improving mentorship may help decrease the shortage of young investigators (graduate students, postdoctoral fellows, and new investigators available to work as independent researchers in cardiovascular and respiratory health. Objectives. To determine (1 the mentoring practices for trainees affiliated with the Canadian Institutes of Health Research (CIHR, Institute of Circulatory and Respiratory Health (ICRH, (2 the positive attributes of mentors, and (3 the recommendations regarding what makes good mentorship. Methods. We conducted a survey and descriptive analysis of young investigators with a CIHR Training and Salary Award from 2010 to 2013 or who submitted an abstract to the ICRH 2014 Young Investigators Forum. Clinicians were compared to nonclinicians. Results. Of 172 participants, 7.0% had no mentor. Only 43.6% had defined goals and 40.7% had defined timelines, while 54.1% had informal forms of mentorship. A significant proportion (33.1% felt that their current mentorship did not meet their needs. Among clinicians, 22.2% would not have chosen the same mentor again versus 11.4% of nonclinicians. All participants favored mentors who provided guidance on career and work-life balance. Suggestions for improved mentoring included formal mentorship, increased networking, and quality assurance. Conclusion. There is an important need to improve mentoring in cardiovascular and respiratory health.

  1. Predicting Circulatory Diseases from Psychosocial Safety Climate: A Prospective Cohort Study from Australia

    Directory of Open Access Journals (Sweden)

    Harry Becher

    2018-02-01

    Full Text Available Circulatory diseases (CDs (including myocardial infarction, angina, stroke or hypertension are among the leading causes of death in the world. In this paper, we explore for the first time the impact of a specific aspect of organizational climate, Psychosocial Safety Climate (PSC, on CDs. We used two waves of interview data from Australia, with an average lag of 5 years (excluding baseline CDs, final n = 1223. Logistic regression was conducted to estimate the prospective associations between PSC at baseline on incident CDs at follow-up. It was found that participants in low PSC environments were 59% more likely to develop new CD than those in high PSC environments. Logistic regression showed that high PSC at baseline predicts lower CD risk at follow-up (OR = 0.98, 95% CI 0.96–1.00 and this risk remained unchanged even after additional adjustment for known job design risk factors (effort reward imbalance and job strain. These results suggest that PSC is an independent risk factor for CDs in Australia. Beyond job design this study implicates organizational climate and prevailing management values regarding worker psychological health as the genesis of CDs.

  2. Presence of Cytotoxic Extracellular Histones in Machine Perfusate of Donation After Circulatory Death Kidneys.

    Science.gov (United States)

    van Smaalen, Tim C; Beurskens, Daniëlle M H; Hoogland, E R Pieter; Winkens, Bjorn; Christiaans, Maarten H L; Reutelingsperger, Chris P; van Heurn, L W Ernest; Nicolaes, Gerry A F

    2017-04-01

    Extracellular histones are cytotoxic molecules that are related to cell stress and death. They have been shown to play a crucial role in multiple pathophysiologic processes like sepsis, inflammation, vascular dysfunction, and thrombosis. Their role in organ donation and graft function and survival is still unknown. The aim of this study was to assess whether an association exists between the presence of extracellular histones in machine perfusates and deceased donor kidney viability. Machine perfusates of 390 donations after circulatory death kidneys were analyzed for histone concentration, and corresponding graft function and survival were assessed. Extracellular histone concentrations were significantly higher in perfusates of kidneys with posttransplant graft dysfunction (primary nonfunction and delayed graft function) and were an independent risk factor for delayed graft function (odds ratio, 2.152; 95% confidence interval [95% CI], 1.199-3.863) and 1 year graft failure (hazard ratio, 1.386; 95% CI, 1.037-1.853), but not for primary nonfunction (odds ratio, 1.342; 95% CI, 0.900-2.002). One year graft survival was 12% higher in the group with low histone concentrations (P = 0.008) as compared with the group that contained higher histone concentrations. This study warrants future studies to probe for a possible role of cytotoxic extracellular histones in organ viability and suggests that quantitation of extracellular histones might contribute to assessment of posttransplant graft function and survival.

  3. Hyperdynamic circulatory changes in liver cirrhosis: Comparative evaluation by doppler ultrasonography with normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Im, Dae Wook; Baik, Soon Koo; Suh, Jung In; Kim, Jae Woo; Park, Yong Soon; Kim, Hyun Soo; Lee, Dong Ki; Kwon, Sang Ok [Yonsei University, Wonju College of Medicine, Wonju (Korea, Republic of)

    2001-12-15

    To evaluate the cardiovascular and splanchnic hemodynamic changes in patients with liver cirrhosis and to compare with those of the normal controls using doppler ultrasonography. A total of 129 patients including 23 of Child-Pugh class A, 24 of class A, 24 of class B, 30 of class C, and 52 of the control group were included. Cardiac output (CO), systemic vascular resistance index (SVRI), and blood flow and pulsatility index (PI) of the superior mesenteric artery (SMA) were evaluated and compared among each groups. CO and SMA blood flow in the cirrhotic group were significantly higher than those in the control group, and the increase in CO and SMA blood flow showed a statistically significant correlation with the degree of liver dysfunction (p<0.01). SVRI and SMA PI reflecting vascular resistance in the cirrhotic group were significantly lower than those in the control group, and the decrease in SVRI and SMA PI also showed a statistically significant correlation with the degree of liver dysfunction (p<0.01). SMA blood flow showed a statistically significant inverse relationship with SMA PI (R{sup 2}=0.230). Hyperdynamic circulatory changes such as increases in CO and splanchnic blood flow were present in patients with liver cirrhosis. These changes may contribute to the development and maintenance of the portal hypertension due to an increase in portal blood flow an increase in portal blood flow.

  4. Development and Performance Evaluation of a Re-Circulatory Vegetable Moisturizer

    Directory of Open Access Journals (Sweden)

    M. O. Sunmonu

    2016-08-01

    Full Text Available A re-circulatory vegetable moisturizer for preventing wilting in vegetables was developed and its performance evaluation carried out. Freshly harvested Amaranthus vegetables were used for the experiments. The temperature and relative humidity were monitored daily. The vitamin A of this produce was determined at intervals of two days for 9 days. The effects of the storage parameters (temperature and relative humidity on the nutritional value of the produce were determined using statistical analysis of variance (ANOVA. Further analysis by Duncan’s New Multiple Range Test (DNMRT was carried out to compare the means. The vegetable moisturizer was evaluated by comparing the change in nutritional (vitamin A of Amaranthus vegetable with hand wetting system and no wetting condition. The results showed that the moisturizer had higher mean vitamin A content (4.93mg/100gcompared to the mean vitamin A content of the manual wetting (4.88mg/100g and no wetting condition (4.57mg/100g. The sensory characteristics showed that the Moisturizer was more desirable when compared to the manual wetting and no wetting condition after nine days. It was concluded that the Moisturizer preserved the nutritional and sensory characteristics (texture and colour better than the manual and no wetting condition as a result of lower temperature, higher relative humidity and better water draining of the Moisturizer.

  5. Clinical comparison of radionuclide cisternography and computed tomography in CSF circulatory disturbance

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, M.; Futatsuki, M. (Tazuke Kofukai Medical Research Inst., Osaka (Japan). Kitano Hospital); Tanaka, H.

    1980-12-01

    Forty-three patients with abnormal cisternograms were classified into (1) NPH, (2) Postmeningitic hydrocephalus, (3) Posttraumatic hydrocephalus, (4) Postoperative hydrocephalus (tumor) (5) Postoperative hydrocephalus (vascular disease), (6) Meningitis, (7) Tumor, (8) Vascular disease, (9) Degenerative disease and (10) Miscellaneous. Cisternography was done by a scinticamera with /sup 111/In-DTPA and all groups were scanned by IInd generation CT scanner. The result of the cisternography was not always compatible with the CT findings. We found a case of anatomically normal but functionally abnormal cisterns and ventricular system. In all classified disorder groups, the cisternography detected functioning cisterns in CSF dynamics but the CT visualized anatomically open cisterns. By the combined use of these two examinations, a local cisternal block was detected. Ten in 20 cases with operated (V-P shunt) hydrocephalus clinically improved. But the result of these techniques, failed to assess the effectiveness of the V-P shunt. V-P shunt was effective in 8 out of 14 cases with persistent ventricular reflux and delayed clearance, and in 9 out of 17 cases with total ventricular dilatation. We concluded that the combined use of the RI cisternography and the computed tomography was better than single examination to detect CSF circulatory disturbance but we were not satisfied with the joint use in the evaluation of the effect of V-P shunt. No adverse reaction was experienced in the 43 patients with /sup 111/In-DTPA.

  6. Selective cerebral perfusion prevents abnormalities in glutamate cycling and neuronal apoptosis in a model of infant deep hypothermic circulatory arrest and reperfusion.

    Science.gov (United States)

    Kajimoto, Masaki; Ledee, Dolena R; Olson, Aaron K; Isern, Nancy G; Robillard-Frayne, Isabelle; Des Rosiers, Christine; Portman, Michael A

    2016-11-01

    Deep hypothermic circulatory arrest is often required for the repair of complex congenital cardiac defects in infants. However, deep hypothermic circulatory arrest induces neuroapoptosis associated with later development of neurocognitive abnormalities. Selective cerebral perfusion theoretically provides superior neural protection possibly through modifications in cerebral substrate oxidation and closely integrated glutamate cycling. We tested the hypothesis that selective cerebral perfusion modulates glucose utilization, and ameliorates abnormalities in glutamate flux, which occur in association with neuroapoptosis during deep hypothermic circulatory arrest. Eighteen infant male Yorkshire piglets were assigned randomly to two groups of seven (deep hypothermic circulatory arrest or deep hypothermic circulatory arrest with selective cerebral perfusion for 60 minutes at 18℃) and four control pigs without cardiopulmonary bypass support. Carbon-13-labeled glucose as a metabolic tracer was infused, and gas chromatography-mass spectrometry and nuclear magnetic resonance were used for metabolic analysis in the frontal cortex. Following 2.5 h of cerebral reperfusion, we observed similar cerebral adenosine triphosphate levels, absolute levels of lactate and citric acid cycle intermediates, and carbon-13 enrichment among three groups. However, deep hypothermic circulatory arrest induced significant abnormalities in glutamate cycling resulting in reduced glutamate/glutamine and elevated γ-aminobutyric acid/glutamate along with neuroapoptosis, which were all prevented by selective cerebral perfusion. The data suggest that selective cerebral perfusion prevents these modifications in glutamate/glutamine/γ-aminobutyric acid cycling and protects the cerebral cortex from apoptosis. © The Author(s) 2016.

  7. In situ neutron diffraction investigation of the collaborative deformation-transformation mechanism in TRIP-assisted steels at room and elevated temperatures

    Czech Academy of Sciences Publication Activity Database

    Muránsky, Ondrej; Šittner, P.; Zrník, J.; Oliver, E.C.

    2008-01-01

    Roč. 56, č. 14 (2008), s. 3367-3379 ISSN 1359-6454 Institutional research plan: CEZ:AV0Z10480505 Keywords : TRIP-assisted steel * austenite-to-martensite phase transformation * load partitioning Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders Impact factor: 3.729, year: 2008

  8. Comparison of the Incorporation of DHA in Circulatory and Neural Tissue When Provided as Triacylglycerol (TAG), Monoacylglycerol (MAG) or Phospholipids (PL) Provides New Insight into Fatty Acid Bioavailability.

    Science.gov (United States)

    Destaillats, Frédéric; Oliveira, Manuel; Bastic Schmid, Viktoria; Masserey-Elmelegy, Isabelle; Giuffrida, Francesca; Thakkar, Sagar K; Dupuis, Lénaïck; Gosoniu, Maria Laura; Cruz-Hernandez, Cristina

    2018-05-15

    Phospholipids (PL) or partial acylglycerols such as sn -1(3)-monoacylglycerol (MAG) are potent dietary carriers of long-chain polyunsaturated fatty acids (LC-PUFA) and have been reported to provide superior bioavailability when compared to conventional triacylglycerol (TAG). The main objective of the present study was to compare the incorporation of docosahexaenoic acid (DHA) in plasma, erythrocytes, retina and brain tissues in adult rats when provided as PL (PL-DHA) and MAG (MAG-DHA). Conventional dietary DHA oil containing TAG (TAG-DHA) as well as control chow diet were used to evaluate the potency of the two alternative DHA carriers over a 60-day feeding period. Fatty acid profiles were determined in erythrocytes and plasma lipids at time 0, 7, 14, 28, 35 and 49 days of the experimental period and in retina, cortex, hypothalamus, and hippocampus at 60 days. The assessment of the longitudinal evolution of DHA in erythrocyte and plasma lipids suggest that PL-DHA and MAG-DHA are efficient carriers of dietary DHA when compared to conventional DHA oil (TAG-DHA). Under these experimental conditions, both PL-DHA and MAG-DHA led to higher incorporations of DHA erythrocytes lipids compared to TAG-DHA group. After 60 days of supplementation, statistically significant increase in DHA level incorporated in neural tissues analyzed were observed in the DHA groups compared with the control. The mechanism explaining hypothetically the difference observed in circulatory lipids is discussed.

  9. Transfusion-associated circulatory overload (TACO: prevention, management, and patient outcomes

    Directory of Open Access Journals (Sweden)

    Roubinian NH

    2015-04-01

    Full Text Available Nareg H Roubinian,1,2 Edward L Murphy1–3 1Blood Systems Research Institute, 2Department of Laboratory Medicine, 3Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA Abstract: Transfusion-associated circulatory overload (TACO is acute pulmonary edema associated with left atrial hypertension or volume overload occurring within 6 hours following a blood transfusion. Recognized by physicians as a common complication of blood transfusion, its incidence has been difficult to measure because active surveillance is required to counteract underreporting; active surveillance indicates overall incidence rates as high as 1% per transfused patient. Recent clinical and translational research has focused on the development of electronic alert systems to measure TACO incidence and provide alerts to physicians regarding patients at high risk. Translational research regarding the utility of biomarkers such as brain natriuretic protein (BNP or N-terminal pro-BNP (NT-proBNP as diagnostic tools for TACO has been only moderately successful, but the search for other biomarkers continues. Prevention strategies can be developed based upon evidence derived from both observational studies and might include: using documented risk factors to highlight patients at risk, preferably using real-time analysis of electronic medical records; implementation of modified transfusion strategies to minimize the volume and infusion rate of blood products; consideration of prophylactic diuretic therapy; and heightened diagnostic awareness combined with rapid implementation of treatment. Randomized clinical trials will be required to test such strategies before they are widely implemented. Finally, the occurrence of TACO ought to be considered as a potentially avoidable medical complication that could be used to benchmark transfusion and critical care practice across hospitals. Keywords: blood transfusion, pulmonary edema, risk

  10. Use and Outcomes of Kidneys from Donation after Circulatory Death Donors in the United States.

    Science.gov (United States)

    Gill, John; Rose, Caren; Lesage, Julie; Joffres, Yayuk; Gill, Jagbir; O'Connor, Kevin

    2017-12-01

    Donation after circulatory death (DCD) donors are an important source of kidneys for transplantation, but DCD donor transplantation is less common in the United States than in other countries. In this study of national data obtained between 2008 and 2015, recovery of DCD kidneys varied substantially among the country's 58 donor service areas, and 25% of DCD kidneys were recovered in only four donor service areas. Overall, 20% of recovered DCD kidneys were discarded, varying from 3% to 33% among donor service areas. Compared with kidneys from neurologically brain dead (NBD) donors, DCD kidneys had a higher adjusted odds ratio of discard that varied from 1.25 (95% confidence interval [95% CI], 1.16 to 1.34) in kidneys with total donor warm ischemic time (WIT) of 10-26 minutes to 2.67 (95% CI, 2.34 to 3.04) in kidneys with total donor WIT >48 minutes. Among the 12,831 DCD kidneys transplanted, kidneys with WIT≤48 minutes had survival similar to that of NBD kidneys. DCD kidneys with WIT>48 minutes had a higher risk of allograft failure (hazard ratio, 1.23; 95% CI, 1.07 to 1.41), but this risk was limited to kidneys with cold ischemia time (CIT) >12 hours. We conclude that donor service area-level variation in the recovery and discard of DCD kidneys is large. Additional national data collection is needed to understand the potential to increase DCD donor transplantation in the United States. Strategies to minimize cold ischemic injury may safely allow increased use of DCD kidneys with WIT>48 minutes. Copyright © 2017 by the American Society of Nephrology.

  11. The application of multiple intelligence approach to the learning of human circulatory system

    Science.gov (United States)

    Kumalasari, Lita; Yusuf Hilmi, A.; Priyandoko, Didik

    2017-11-01

    The purpose of this study is to offer an alternative teaching approach or strategies which able to accommodate students’ different ability, intelligence and learning style. Also can gives a new idea for the teacher as a facilitator for exploring how to teach the student in creative ways and more student-center activities, for a lesson such as circulatory system. This study was carried out at one private school in Bandung involved eight students to see their responses toward the lesson that delivered by using Multiple Intelligence approach which is include Linguistic, Logical-Mathematical, Visual-Spatial, Musical, Bodily-Kinesthetic, Interpersonal, Intrapersonal, and Naturalistic. Students were test by using MI test based on Howard Gardner’s MI model to see their dominant intelligence. The result showed the percentage of top three ranks of intelligence are Bodily-Kinesthetic (73%), Visual-Spatial (68%), and Logical-Mathematical (61%). The learning process is given by using some different multimedia and activities to engaged their learning style and intelligence such as mini experiment, short clip, and questions. Student response is given by using self-assessment and the result is all students said the lesson gives them a knowledge and skills that useful for their life, they are clear with the explanation given, they didn’t find difficulties to understand the lesson and can complete the assignment given. At the end of the study, it is reveal that the students who are learned by Multiple Intelligence instructional approach have more enhance to the lesson given. It’s also found out that the students participated in the learning process which Multiple Intelligence approach was applied enjoyed the activities and have great fun.

  12. The Risk of Neurological Dysfunctions after Deep Hypothermic Circulatory Arrest with Retrograde Cerebral Perfusion.

    Science.gov (United States)

    Gatti, Giuseppe; Benussi, Bernardo; Currò, Placido; Forti, Gabriella; Rauber, Elisabetta; Minati, Alessandro; Gabrielli, Marco; Tognolli, Umberto; Sinagra, Gianfranco; Pappalardo, Aniello

    2017-12-01

    Retrograde cerebral perfusion (RCP) is a brain protection technique that is adopted generally for anticipated short periods of deep hypothermic circulatory arrest (DHCA). However, the real impact of this technique on cerebral protection during DHCA remains a controversial issue. For 344 (59.5%) of 578 consecutive patients (mean age, 66.9 ± 10.9 years) who underwent cardiovascular surgery under DHCA at the present authors' institution (1999-2015), RCP was the sole technique of cerebral protection that was adopted in addition to deep hypothermia. Surgery of the thoracic aorta was performed in 95.9% of these RCP patients; in 92 cases there was an aortic arch involvement. Outcomes were reviewed retrospectively. The focus was on postoperative neurological dysfunctions. There were 33 (9.6%) in-hospital deaths. Thirty-one (9%) patients had permanent neurological dysfunctions and 66 (19.1%) transitory neurological dysfunctions alone. Age older than 74 years (odds ratio [OR], 1.88, P = .023), surgery for acute aortic dissection (OR, 2.57; P = .0009), and DHCA time longer than 25 minutes (OR, 2.44; P = .0021) were predictors of neurological dysfunctions. The 10-year nonparametric estimate of freedom from all-cause death was 61.8% (95% confidence interval, 57.8%-65.8%). Permanent postoperative neurological dysfunctions were risk factors for cardiac or cerebrovascular death (hazard ratio, 2.6; P = .039) even after an adjusted survival analysis (P RCP, in addition to deep hypothermia, combines with a low risk of neurological dysfunctions provided that DHCA length is 25 minutes or less. Permanent postoperative neurological dysfunctions are predictors of poor late survival. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. [Identification of circulatory diseases and their risk during medical examination of an adult population: methodological aspects].

    Science.gov (United States)

    Kalinina, A M; Ipatov, P V; Kaminskaya, A K; Kushunina, D V

    2015-01-01

    To study the efficiency of a methodology for the active detection of coronary heart disease (CHD) and cerebrovascular diseases (CVD) during medical examination and to determine the need and possible ways of its improvement. The medical examinations of 19.4 million people (94.6% of all the citizens who had undergone medical examinations in all the regions of Russia in 2013) were analyzed and the methodological aspects of identification of the circulatory diseases (CDs) that were induced by coronary and cerebral vessel atherosclerosis and had common risk factors, primarily CHD and CVD, were assessed. The medical examinations revealed 2,915,445 cases of CDs and their suspicions, during which its clinical diagnosis was established in 57.2%. The suspected disease requiring that its diagnosis should be further specified; off-medical examinations revealed hypertension in more than 770,000 cases, CHD in 232,000, and CVD in 146,000. The proportion of stable angina pectoris of all angina cases was much higher at a young age (25.6%) than at middle (15.6%) and elderly (11.3%) ages. Brachiocephalic artery stenoses were detected in almost 13,000 cases. According to the official health statistics, within the years preceding the introduction of large-scale medical examinations, there was a slight rise in new CD cases among the adult population of Russia, which was more significant in 2013 (according to the preliminary data) than in 2012. The methodology for the active detection of CDs through a two-step medical examination, which is used during a follow-up, makes it possible to substantially increase detection rates for CDs. There has been shown to be a need for the better quality and completeness of diagnostic examination in real practice.

  14. Circulatory, respiratory and metabolic responses in Thoroughbred horses during the first 400 meters of exercise.

    Science.gov (United States)

    Littlejohn, A; Snow, D H

    1988-01-01

    These studies investigated circulatory, respiratory and metabolic responses in four Thoroughbred geldings during the first 400 metres of galloping (mean speed 14.4 +/- 0.38 m.s-1), cantering (mean speed 10.0 +/- 0.61 m.s-1) and walking (mean speed 1.58 +/- 0.05 m.s-1) from a standing start. A radio-controlled device which collected blood samples anaerobically during each 100 m section of the exercise track allowed analyses of changes in and functional relationships of the variables measured. During the 400 m gallop, the mean heart rate (HR) increased from 125 to 201 beats.min-1 and the haematocrit (Hct) from 0.513 to 0.589 l/l-1. The haemoglobin [Hb], lactate [LA] and potassium [K+] concentrations increased significantly, while the pH and the partial pressure of oxygen (PaO2) decreased significantly. The arterial partial pressure of carbon dioxide (PaCO2) and the plasma bicarbonate concentration did not change significantly. There were significant correlations between HR and Hct, HR and [Hb], HR and PaO2, HR and pH, HR and PvCO2, HR and [LA], HR and [K+], pH and [K+], Hct and PaO2, [Hb] and PaO2, PaCO2 and PaO2, [LA] and PaO2, pH and PaO2, [K+] and PaO2, stride frequency and PaO2. With the exception of the PvCO2 which increased significantly, changes in venous blood during the gallop were in the same direction as those of arterial blood. Thirty seconds before the start of the gallop, both HR and [Hb] were significantly higher than at rest, providing an approximate three-fold increase in oxygen delivery compared to that of the resting state.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. An original valveless artificial heart providing pulsatile flow tested in mock circulatory loops.

    Science.gov (United States)

    Tozzi, Piergiorgio; Maertens, Audrey; Emery, Jonathan; Joseph, Samuel; Kirsch, Matthias; Avellan, François

    2017-11-24

    We present the test bench results of a valveless total artificial heart that is potentially compatible with the pediatric population. The RollingHeart is a valveless volumetric pump generating pulsatile flow. It consists of a single spherical cavity divided into 4 chambers by 2 rotating disks. The combined rotations of both disks produce changes in the volumes of the 4 cavities (suction and ejection). The blood enters/exits the spherical cavity through 4 openings that are symmetrical to the fixed rotation axis of the first disk.Mock circulatory system: The device pumps a 37% glycerin solution through 2 parallel circuits, simulating the pulmonary and systemic circulations. Flow rates are acquired with a magnetic inductive flowmeter, while pressure sensors collect pressure in the left and right outflow and inflow tracts.In vitro test protocol: The pump is run at speeds ranging from 20 to 180 ejections per minute. The waveform of the pressure generated at the inflow and outflow of the 4 chambers and the flow rate in the systemic circulation are measured. At an ejection rate of 178 min-1, the RollingHeart pumps 5.3 L/min for a systemic maximal pressure gradient of 174 mmHg and a pulmonary maximal pressure gradient of 75 mmHg. The power input was 14 W, corresponding to an efficiency of 21%. The RollingHeart represents a new approach in the domain of total artificial heart. This preliminary study endorses the feasibility of a single valveless device acting as a total artificial heart.

  16. The OregonHeart Total Artificial Heart: Design and Performance on a Mock Circulatory Loop.

    Science.gov (United States)

    Glynn, Jeremy; Song, Howard; Hull, Bryan; Withers, Stanley; Gelow, Jill; Mudd, James; Starr, Albert; Wampler, Richard

    2017-10-01

    Widespread use of heart transplantation is limited by the scarcity of donor organs. Total artificial heart (TAH) development has been pursued to address this shortage, especially to treat patients who require biventricular support. We have developed a novel TAH that utilizes a continuously spinning rotor that shuttles between two positions to provide pulsatile, alternating blood flow to the systemic and pulmonary circulations without artificial valves. Flow rates and pressures generated by the TAH are controlled by adjusting rotor speed, cycle frequency, and the proportion of each cycle spent pumping to either circulation. To validate the design, a TAH prototype was placed in a mock circulatory loop that simulates vascular resistance, pressure, and compliance in normal and pathophysiologic conditions. At a systemic blood pressure of 120/80 mm Hg, nominal TAH output was 7.4 L/min with instantaneous flows reaching 17 L/min. Pulmonary artery, and left and right atrial pressures were all maintained within normal ranges. To simulate implant into a patient with severe pulmonary hypertension, the pulmonary vascular resistance of the mock loop was increased to 7.5 Wood units. By increasing pump speed to the pulmonary circulation, cardiac output could be maintained at 7.4 L/min as mean pulmonary artery pressure increased to 56 mm Hg while systemic blood pressures remained normal. This in vitro testing of a novel, shuttling TAH demonstrated that cardiac output could be maintained across a range of pathophysiologic conditions including pulmonary hypertension. These experiments serve as a proof-of-concept for the design, which has proceeded to in vivo testing. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  17. Controlled donation after circulatory death in the Netherlands: more organs, more efforts.

    Science.gov (United States)

    Leiden, H; Haase-Kromwijk, B; Hoitsma, A; Jansen, N

    2016-08-01

    The Netherlands was one of the first countries in Europe to stimulate controlled donation after circulatory death (cDCD) at a national level in addition to donation after brain death (DBD). With this program the number of organ transplants increased, but it also proved to have challenges as will be shown in this 15-year review. Data about deceased organ donation in the Netherlands, from 2000 until 2014, were analysed taking into account the whole donation process from donor referral to the number of organs transplanted. Donor referral increased by 58%, from 213 to 336 donors per year, and the number of organs transplanted rose by 42%. Meanwhile the contribution of cDCD donors increased from 14% in 2000 to 54% in 2014 among all referrals. The organs were transplanted from 92-99% of referred DBD donors, but this percentage was significantly lower for cDCD donors and also decreased from 86% in 2000-2002 to 67% in 2012-2014. In 16% of all referred cDCD donors, organs were not recovered because donors did not die within the expected two-hour time limit after withdrawal of life- upporting treatment. Furthermore, cDCD is more often performed at a higher donor age, which is associated with a lower percentage of transplanted organs. Although cDCD resulted in more transplants, the effort in donor recruitment is considerably higher. Important challenges in cDCD that need further attention are the time limit after withdrawal of life-supporting treatment and donor age, as well as the possibilities to stimulate non-renal transplants including the heart by machine preservation.

  18. Organs and organisations: Situating ethics in organ donation after circulatory death in the UK.

    Science.gov (United States)

    Cooper, Jessie

    2018-05-25

    Controlled organ donation after circulatory death (DCD) has recently been revived in the UK, as part of attempts to increase organ donation rates. The re-introduction of DCD has subsequently become the focus of bioethical controversy, since it necessitates intervening in the care of dying patients to obtain quality donor organs. Transplant policy responses to these concerns have generated new legal and ethical guidelines to address uncertainties around DCD, producing claims that the UK has overcome' the ethical challenge of DCD. In contrast, by drawing on Lynch's call to 'respecify' ethics, this paper argues that ethics in DCD cannot be reduced to abstract directives for practice, but, instead, are composed and dealt with as an organisational problem. To do this, I utilise data from an ethnographic study examining the production of the 'minority ethnic organ donor' within UK organ donation settings; in particular, the data pertains to a case hospital which was in the process of developing a DCD programme during the period of fieldwork. Findings show that the ethics of DCD are encountered as practical sets of problems, constructed in relation to particular institutional locales. I describe how these issues are worked-around by creating conditions to make DCD organisationally possible, and through the animation of standard procedures into acceptable forms of practice. I argue that ethics in DCD go far beyond normative bioethical principles, to encompass concerns around: the reputation of hospital Trusts, public perceptions of organ donation, the welfare of potential donor families, and challenges to the work of health professionals caring for dying patients. The paper enriches understanding of ethics in science and medicine by showing how ethics are assembled and negotiated as a practical-organisational concern, and calls for further examination of how DCD gets constructed as a potential problem and is made to happen in practice. Crown Copyright © 2018. Published by

  19. Circulatory and muscle metabolic responses to draught work compared to increasing trotting velocities.

    Science.gov (United States)

    Gottlieb, M; Essén-Gustavsson, B; Lindholm, A; Persson, S G

    1988-11-01

    Circulatory and muscle metabolic responses were studied in 10 horses which all performed incremental draught work at a low trotting speed on a treadmill (D-test) and also exercise with gradually increasing velocities (S-test). Exercise was continued until the horses could no longer maintain the weights above the floor or maintain speed trotting without changing gait to a gallop. Muscle biopsies were taken from the gluteus and the semitendinosus muscles before, and immediately after, exercise. The heart rate (HR) increased linearly with both increasing draught resistance and velocity and reached mean values of 212 and 203 beats/min, respectively. Blood lactate levels increased exponentially to mean values of 12.9 and 7.9 mmol/litre in the two tests. Both HR and blood lactate levels were significantly higher at the cessation of work in the D-test compared to the S-test. The relationship between HR and blood lactate response in the S-test was similar to that in the D-test. The red cell volume was determined after a standardised exercise tolerance test and was significantly correlated both to the weightloading and to the velocity, producing a HR of 200 beats/min. The changes seen in muscle glycogen and glucose-6-phosphate were similar in the two tests, whereas significantly higher lactate levels and lower creatine phosphate and adenosine triphosphate levels were seen in the D-test compared to the S-test. It was concluded that high oxidative capacity is of importance both for fast trotting and for draught work.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. International assistance. Licensing assistance project

    International Nuclear Information System (INIS)

    Aleev, A.

    1999-01-01

    Description of licensing assistance project for VATESI is presented. In licensing of unit No.1 of INPP VATESI is supported by many western countries. Experts from regulatory bodies or scientific organizations of those countries assist VATESI staff in reviewing documentation presented by INPP. Among bilateral cooperation support is provided by European Commission through Phare programme

  1. Beneficial aspects of real time flow measurements for the management of acute right ventricular heart failure following continuous flow ventricular assist device implantation

    Directory of Open Access Journals (Sweden)

    Spiliopoulos Sotirios

    2012-11-01

    Full Text Available Abstract Background Optimal management of acute right heart failure following the implantation of a left ventricular assist device requires a reliable estimation of left ventricular preload and contractility. This is possible by real-time pump blood flow measurements. Clinical case We performed implantation of a continuous flow left ventricular assist device in a 66 years old female patient with an end-stage heart failure on the grounds of a dilated cardiomyopathy. Real-time pump blood flow was directly measured by an ultrasonic flow probe placed around the outflow graft. Diagnosis The progressive decline of real time flow and the loss of pulsatility were associated with an increase of central venous pressure, inotropic therapy and progressive renal failure suggesting the presence of an acute right heart failure. Diagnosis was validated by echocardiography and thermodilution measurements. Treatment Temporary mechanical circulatory support of the right ventricle was successfully performed. Real time flow measurement proved to be a useful tool for the diagnosis and ultimately for the management of right heart failure including the weaning from extracorporeal membrane oxygenation.

  2. The role of cerebral hyperperfusion in postoperative neurologic dysfunction after left ventricular assist device implantation for end-stage heart failure.

    Science.gov (United States)

    Lietz, Katherine; Brown, Kevin; Ali, Syed S; Colvin-Adams, Monica; Boyle, Andrew J; Anderson, David; Weinberg, Alan D; Miller, Leslie W; Park, Soon; John, Ranjit; Lazar, Ronald M

    2009-04-01

    Cerebral hyperperfusion is a life-threatening syndrome that can occur in patients with chronically hypoperfused cerebral vasculature whose normal cerebral circulation was re-established after carotid endarterectomy or angioplasty. We sought to determine whether the abrupt restoration of perfusion to the brain after left ventricular assist device (LVAD) implantation produced similar syndromes. We studied the role of increased systemic flow after LVAD implantation on neurologic dysfunction in 69 consecutive HeartMate XVE LVAD (Thoratec, Pleasanton, Calif) recipients from October 2001 through June 2006. Neurologic dysfunction was defined as postoperative permanent or transient central change in neurologic status, including confusion, focal neurologic deficits, visual changes, seizures, or coma for more than 24 hours within 30 days after LVAD implantation. We found that 19 (27.5%) patients had neurologic dysfunction, including encephalopathy (n = 11), coma (n = 3), and other complications (n = 5). The multivariate analysis showed that an increase in cardiac index from the preoperative baseline value (relative risk, 1.33 per 25% cardiac index increase; P = .01) and a previous coronary bypass operation (relative risk, 4.53; P = .02) were the only independent predictors of neurologic dysfunction. Reduction of left ventricular assist device flow in 16 of the 19 symptomatic patients led to improvement of symptoms in 14 (87%) patients. Our findings showed that normal flow might overwhelm cerebral autoregulation in patients with severe heart failure, suggesting that cerebral hyperperfusion is possible in recipients of mechanical circulatory support with neurologic dysfunction.

  3. Conventional radiography and computed tomography of cardiac assist devices

    Energy Technology Data Exchange (ETDEWEB)

    Scheffel, Hans; Stolzmann, Paul; Desbiolles, Lotus; Leschka, Sebastian; Frauenfelder, Thomas; Schertler, Thomas; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Wilhelm, Markus J.; Lachat, Mario [University Hospital Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland)

    2009-09-15

    Patients intended for circulatory support by cardiac assist devices (CAD) usually suffer from end-stage acute or chronic heart failure. Since the introduction of CAD in 1963 by DeBakey and coworkers, the systems have gone through a substantial evolution and have been increasingly used in the intervening decades. The spectrum of CAD includes a variety of systems serving to assist the systolic function of the left ventricle, the right ventricle, or both. Conventional radiography and multislice spiral computed tomography (CT) are the most commonly used radiological techniques for imaging patients with a CAD. CT is very useful for evaluating CAD systems by using both two- and three-dimensional reconstructions of the volumetric data sets. The two techniques together allow for the comprehensive assessment of patients with devices by imaging the in- and outflow cannulae, the anastomoses, the position of the pump, as well as associated complications. A close collaboration with cardiac surgeons with expertise in the field of circulatory support is deemed necessary for adequate image interpretation. This article describes the technical diversity of the currently available CAD systems. The imaging characteristics on conventional radiography and multislice spiral CT as well as the typical complications of their use are demonstrated. (orig.)

  4. Nanoporous gold synthesized by plasma-assisted inert gas condensation: room temperature sintering, nanoscale mechanical properties and stability against high energy electron irradiation

    Science.gov (United States)

    Weyrauch, S.; Wagner, C.; Suckfuell, C.; Lotnyk, A.; Knolle, W.; Gerlach, J. W.; Mayr, S. G.

    2018-02-01

    With a plasma assisted gas condensation system it is possible to achieve high-purity nanoporous Au (np-Au) structures with minimal contaminations and impurities. The structures consist of single Au-nanoparticles, which partially sintered together due to their high surface to volume ratio. Through electron microscopy investigations a porosity  >50% with ligament sizes between 20-30 nm was revealed. The elastic modulus of the np-Au was determined via peak force quantitative nanomechanical mapping and resulted in values of 7.5  ±  1.5 GPa. The presented structures partially sintered at room temperature, but proved to be stable to electron irradiation with energies of 7 MeV up to doses of 100 MGy. The electron irradiation stability opens the venue for electron assisted functionalization with biomolecules.

  5. Final Report. SFAA No. DEFC02-98CH10961. Technical assistance for joint implementation and other supporting mechanisms and measures for greenhouse gas emissions mitigation

    Energy Technology Data Exchange (ETDEWEB)

    Knight, Denise

    2001-10-15

    IIEC, a division of CERF, has developed an extensive base of experience implementing activities that support climate action by developing USIJI projects in transitional countries within Asia, Latin America, Central and Eastern Europe, and southern Africa. IIEC has been able to provide a range of technical and policy assistance to governments and industry in support of sustainable energy use. IIEC continues to work in key countries with local partners to develop and implement energy efficiency policies and standards, develop site-specific projects, and assist governing bodies to establish national priorities and evaluation criteria for approving GHG-mitigation projects. As part of this project, IIEC focused on promoting a series of activities in Thailand and South Africa in order to identify GHG mitigation projects and work within the national approval process of those countries. The sections of this report outline the activities conducted in each country in order to achieve that goal.

  6. Sensitivity Analysis of Median Lifetime on Radiation Risks Estimates for Cancer and Circulatory Disease amongst Never-Smokers

    Science.gov (United States)

    Chappell, Lori J.; Cucinotta, Francis A.

    2011-01-01

    Radiation risks are estimated in a competing risk formalism where age or time after exposure estimates of increased risks for cancer and circulatory diseases are folded with a probability to survive to a given age. The survival function, also called the life-table, changes with calendar year, gender, smoking status and other demographic variables. An outstanding problem in risk estimation is the method of risk transfer between exposed populations and a second population where risks are to be estimated. Approaches used to transfer risks are based on: 1) Multiplicative risk transfer models -proportional to background disease rates. 2) Additive risk transfer model -risks independent of background rates. In addition, a Mixture model is often considered where the multiplicative and additive transfer assumptions are given weighted contributions. We studied the influence of the survival probability on the risk of exposure induced cancer and circulatory disease morbidity and mortality in the Multiplicative transfer model and the Mixture model. Risks for never-smokers (NS) compared to the average U.S. population are estimated to be reduced between 30% and 60% dependent on model assumptions. Lung cancer is the major contributor to the reduction for NS, with additional contributions from circulatory diseases and cancers of the stomach, liver, bladder, oral cavity, esophagus, colon, a portion of the solid cancer remainder, and leukemia. Greater improvements in risk estimates for NS s are possible, and would be dependent on improved understanding of risk transfer models, and elucidating the role of space radiation on the various stages of disease formation (e.g. initiation, promotion, and progression).

  7. [Mortality rates of circulatory system diseases and malignant neoplasms in Zagreb population younger than sixty-five--call for alarm].

    Science.gov (United States)

    Vizintin, Marina Polić; Mrcela, Nada Tomasović; Kovacić, Luka

    2012-12-01

    The aim of this work was to analyze the public health indicators for circulatory heart diseases and malignant neoplasms in the population younger than 65 in the City of Zagreb, Croatia, and compare them with the European Union (EU) countries. The purpose was to evaluate the situation and propose the public health preventive measures. The study population were Zagreb citizens aged 0-64 according to the 2001 census. Total Zagreb population was 779145, making 17.6% of total Croatian population. Data from the Croatian Bureau of Statistics and Dr Andrija Stampar Institute of Public Health were used. The standardized 0-64 mortality rates of the selected diseases 2006-2010 were used in the analysis. In 2010, the standardized mortality rates of all analyzed diseases were significantly higher in Zagreb population aged 0-64 than the EU averages except for cervical cancer. In 2010, the mortality rates in Zagreb population aged 0-64 were as follows: circulatory system diseases 61.22, ischemic heart disease 28.99, cerebrovascular diseases 12.51, malignant neoplasms 94.69, tracheal and lung cancer 24.92, breast cancer 21.08 and cervical cancer 2.05. Standardized mortality rates in Zagreb population aged 0-64 for circulatory system were lower than for Croatia (61.22 vs. 63.25), but higher for malignant neoplasms (94.69 vs. 91.2), except for cervical cancer (2.05 vs. 3.14). High standardized mortality rates for the selected diseases in the City of Zagreb, Croatia, were observed. The rates were higher in Zagreb population compared to EU averages except for cervical cancer. This situation urges revision of the public health strategy and implementation of more intensive preventive and screening measures to reduce the risk factors.

  8. A numerical method to enhance the performance of a cam-type electric motor-driven left ventricular assist device.

    Science.gov (United States)

    Huang, Huan; Yang, Ming; Lu, Cunyue; Xu, Liang; Zhuang, Xiaoqi; Meng, Fan

    2013-10-01

    Pulsatile left ventricular assist devices (LVADs) driven by electric motors have been widely accepted as a treatment of heart failure. Performance enhancement with computer assistance for this kind of LVAD has seldom been reported. In this article, a numerical method is proposed to assist the design of a cam-type pump. The method requires an integrated model of an LVAD system, consisting of a motor, a transmission mechanism, and a cardiovascular circulation. Performance indices, that is, outlet pressure, outlet flow, and pump efficiency, were used to select the best cam profile from six candidates. A prototype pump connected to a mock circulatory loop (MCL) was used to calibrate the friction coefficient of the cam groove and preliminarily evaluate modeling accuracy. In vitro experiments show that the mean outlet pressure and flow can be predicted with high accuracy by the model, and gross geometries of the measurements can also be reproduced. Simulation results demonstrate that as the total peripheral resistance (TPR) is fixed at 1.1 mm Hg.s/mL, the two-cycle 2/3-rise profile is the best. Compared with other profiles, the maximum increases of pressure and flow indices are 75 and 76%, respectively, and the maximum efficiency increase is over 51%. For different TPRs (0.5∼1.5 mm Hg.s/mL) and operation intervals (0.1∼0.4 s) in counterpulsation, the conclusion is also acceptable. © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

  9. Risk stratification in patients with advanced heart failure requiring biventricular assist device support as a bridge to cardiac transplantation.

    Science.gov (United States)

    Cheng, Richard K; Deng, Mario C; Tseng, Chi-hong; Shemin, Richard J; Kubak, Bernard M; MacLellan, W Robb

    2012-08-01

    Prior studies have identified risk factors for survival in patients with end-stage heart failure (HF) requiring left ventricular assist device (LVAD) support. However, patients with biventricular HF may represent a unique cohort. We retrospectively evaluated a consecutive cohort of 113 adult, end-stage HF patients at University of California Los Angeles Medical Center who required BIVAD support between 2000 and 2009. Survival to transplant was 66.4%, with 1-year actuarial survival of 62.8%. All patients were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Level 1 or 2 and received Thoratec (Pleasanton, CA) paracorporeal BIVAD as a bridge to transplant. Univariate analyses showed dialysis use, ventilator use, extracorporal membrane oxygenation use, low cardiac output, preserved LV ejection fraction (restrictive physiology), normal-to-high sodium, low platelet count, low total cholesterol, low high-density and high-density lipoprotein, low albumin, and elevated aspartate aminotransferase were associated with increased risk of death. We generated a scoring system for survival to transplant. Our final model, with age, sex, dialysis, cholesterol, ventilator, and albumin, gave a C-statistic of 0.870. A simplified system preserved a C-statistic of 0.844. Patients were divided into high-risk or highest-risk groups (median respective survival, 367 and 17 days), with strong discrimination between groups for death. We have generated a scoring system that offers high prognostic ability for patients requiring BIVAD support and hope that it may assist in clinical decision making. Further studies are needed to prospectively validate our scoring system. Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  10. Children and Youth: A Central Cause in the Circulatory Mechanisms of the League of Nations (1919-1939)

    Science.gov (United States)

    Droux, Joëlle

    2015-01-01

    In recent decades, historical studies of public policies on children and youth have paid scant attention to the transnational dimension which may have governed their emergence. This article focuses on the transnational perspective of social and cultural history, to understand the role that international organizations have played in disseminating…

  11. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) of the European Association for Cardio-Thoracic Surgery (EACTS)

    DEFF Research Database (Denmark)

    de By, Theo M M H; Mohacsi, Paul; Gahl, Brigitta

    2018-01-01

    of clinicians and scientists. This report includes updates of patient characteristics, implant frequency, mortality rates and adverse events. RESULTS: Fifty-two hospitals participated in the registry. This report is based on 2947 registered implants in 2681 patients. Survival of adult patients (>17 years of age...

  12. Local expansion in circulatory death kidney transplant activity improves wait-listed outcomes and addresses inequities of access to transplantation

    OpenAIRE

    Mirshekar-Syahkal, Bahar; Summers, Dominic; Bradbury, Lisa L; Aly, Mohamed; Bardsley, Victoria; Berry, Miriam; Norris, Joseph M; Torpey, Nick; Clatworthy, Menna Ruth; Bradley, J Andrew; Pettigrew, Gavin John

    2016-01-01

    In the UK, circulatory death (DCD) kidney transplant activity has increased rapidly, but marked regional variation persists. We report how increased DCD kidney transplant activity influenced wait-listed outcomes for a single centre. Between 2002/03 and 2011/12, 430 (54%) DCD and 361 (46%) DBD kidney-only transplants were performed in the Cambridge Transplant Centre, with a higher proportion of DCD donors fulfilling expanded criteria status (41% DCD vs 32% DBD; $\\small \\textit{P}$=0.01). Compa...

  13. Potential and Actual Neonatal Organ and Tissue Donation After Circulatory Determination of Death.

    Science.gov (United States)

    Stiers, Justin; Aguayo, Cecile; Siatta, Angela; Presson, Angela P; Perez, Richard; DiGeronimo, Robert

    2015-07-01

    The need for transplants continues to exceed organ and tissue donor availability. Although recent surgical advances have resulted in successful transplants using very small pediatric donors, including neonates, the actual practice of neonatal organ donation after circulatory determination of death (DCDD) remains uncommon. To describe the percentage of neonates potentially eligible for DCDD, including those who underwent successful donation, and reasons for ineligibility in those who did not in a single neonatal intensive care unit (NICU). We obtained data from the Children's Hospital Neonatal Database and Intermountain Donor Services (IDS) organ procurement records. The 136 deaths that occurred in the NICU of the Primary Children's Hospital, Salt Lake City, Utah, from January 1, 2010, through May 7, 2013, were reviewed retrospectively from January 12 through July 1, 2014, to determine potential eligibility for DCDD as determined by IDS minimum eligibility criteria (requirement of life-sustaining interventions and weight >2 kg). For patients who did not undergo DCDD, we reviewed records to determine the reasons for ineligibility. Potential eligibility for DCDD among neonates who died in the study NICU. Of 136 deaths in the NICU, 60 (44.1%) met criteria for DCDD; however, fewer than 10% were referred appropriately to the regional organ procurement organization for evaluation. Forty-five neonates (33.1%) ultimately died within 90 minutes of withdrawal of life-sustaining interventions and thus would have been eligible for organ donation based on warm ischemic time. The most common causes of death among the 60 potentially eligible neonatal donors were neonatal encephalopathy (n = 17) and multiple congenital anomalies (n = 14). Nonreferral or late referral by the medical team was the most frequent reason for donor ineligibility, including 49 neonates (36.0%). Overall, only 4 neonates (2.9%) underwent successful DCDD. Although almost half of all neonatal deaths

  14. Infectious and inflammatory disorders of the circulatory system as risk factors for stroke in Saudi children

    International Nuclear Information System (INIS)

    Salih, Mustafa A.; Al-Jarallah, Ahmed A.; Kentab, Anal Y.; Zahraa, Jihad N.; Abdel-Gader, Mohamed O.; Gadelrab, Mohamed O.; Alorainy, Ibrahim A.; Hassan, Hamdy H.

    2006-01-01

    Objective was to report on the role of infectious and inflammatory disorders as risk factors for stroke in a prospective and retrospective cohort of Saudi children. Children, who presented with stroke, were evaluated at the Division of Pediatric Neurology or admitted to King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the periods July 1992 to February 2001 (retrospective study) and February 2001 to March 2003 (prospective study). Investigations for suspected cases included haemostatic assays, microbiological and serological tests. Neuroimaging included cranial CT, MRI magnetic resonance angiography (MRA), magnetic resonance venography (MRV) and single photon emission computed tomography (SPECT) brain scan. Of the 104 Saudi children with stroke, seen during the combined study periods of 10 years and 7 months, infectious and inflammatory disorders of the circulatory systems were identified risk factors in 18 (17.3%). Five children had stroke following acute bacterial meningitis at ages ranging between 5-21 months. The causative organism was identified in 3 of them and consisted of Haemophilus influenza (in a 5-months-old girl), Streptococcus pneumonia (in a 21-months-old girl complicated by subdural empyema and sinovenous thrombosis), and Staphylococcus aureus in a 6-months-old boy who had an underlying chronic granulomatous disease. Unspecified meningitis/meningoencephalitis affected 4 patients, whereas 3 children had an underlying congenital infection as a cause for their stroke. Two of the latter 3 children were diagnosed to have congenital toxoplasmosis, and the third had congenital rubella syndrome. Two girls had stroke following septicemia at ages of one and 2 months. Neurobrucellosis caused stroke in 2 boys at the ages of 4 1/2 and 4 years. In both patients, neuroimaging revealed lacunar and other infects involving mainly the deep cerebral nuclei, secondary to occlusion of small penetrating end

  15. Steady-state mechanical squeezing and ground-state cooling of a Duffing anharmonic oscillator in an optomechanical cavity assisted by a nonlinear medium

    Science.gov (United States)

    Momeni, F.; Naderi, M. H.

    2018-05-01

    In this paper, we study theoretically a hybrid optomechanical system consisting of a degenerate optical parametric amplifier inside a driven optical cavity with a moving end mirror which is modeled as a stiffening Duffing-like anharmonic quantum mechanical oscillator. By providing analytical expressions for the critical values of the system parameters corresponding to the emergence of the multistability behavior in the steady-state response of the system, we show that the stiffening mechanical Duffing anharmonicity reduces the width of the multistability region while the optical parametric nonlinearity can be exploited to drive the system toward the multistability region. We also show that for appropriate values of the mechanical anharmonicity strength the steady-state mechanical squeezing and the ground-state cooling of the mechanical resonator can be achieved. Moreover, we find that the presence of the nonlinear gain medium can lead to the improvement of the mechanical anharmonicity-induced cooling of the mechanical motion, as well as to the mechanical squeezing beyond the standard quantum limit of 3 dB.

  16. Right heart failure and "failure to thrive" after left ventricular assist device: clinical predictors and outcomes.

    Science.gov (United States)

    Baumwol, Jay; Macdonald, Peter S; Keogh, Anne M; Kotlyar, Eugene; Spratt, Phillip; Jansz, Paul; Hayward, Christopher S

    2011-08-01

    This study determined predictors of early post-operative right heart failure (RHF) and its consequences, as well as predictors of those who clinically thrive longer term after insertion of a continuous-flow left ventricular assist device (LVAD). Pre-operative and latest follow-up data were analyzed for 40 consecutive patients who received third-generation centrifugal-flow LVADs. RHF was defined using previously described criteria, including post-operative inotropes, pulmonary vasodilator use, or right-sided mechanical support. Patients were also categorized according to clinical outcomes after LVAD insertion. LVADs were implanted as a bridge to transplantation (BTT) in 33 patients and as destination therapy in 7. Before LVAD implant, 22 patients were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) level 1, and 17 were at level 2. Temporary mechanical assistance was present in 50% of the cohort at LVAD implantation. The 6-month survival/progression to transplant was 92.5%. Average LVAD support time was 385 days (range, 21-1,011 days). RHF developed postoperatively in 13 of 40 patients (32.5%). RHF patients had more severe pre-operative tricuspid incompetence than non-RHF patients. The BTT patients with evidence of RHF had poorer survival to transplant (6 of 11 [54.5%]) than those without RHF (20 of 22 [90.9%]), p = 0.027). There were no other hemodynamic or echocardiographic predictors of short-term RHF. After LVAD, 22 of the 40 patients (55%) thrived clinically. For BTT patients, 20 of 21 (95%) of those who thrived progressed to transplant or were alive at latest follow-up vs 6 of 12 (50%) of those who failed to thrive (FTT; p thrived. Early post-operative RHF results in poorer survival/progression to transplantation for BTT patients and is predicted by greater pre-operative tricuspid incompetence. The most important predictor for those who will clinically thrive longer-term after LVAD insertion is younger age. Crown Copyright © 2011

  17. The mechanism of indium-assisted growth of (In)GaN nanorods: eliminating nanorod coalescence by indium-enhanced atomic migration.

    Science.gov (United States)

    Xu, Zhenzhu; Yu, Yuefeng; Han, Jinglei; Wen, Lei; Gao, Fangliang; Zhang, Shuguang; Li, Guoqiang

    2017-11-09

    Both well vertically aligned and uniformly separated (In)GaN nanorods (NRs) were successfully grown on Si(111) substrates by plasma-assisted molecular beam epitaxy. Effects of supplied indium (In) flux on the morphology of (In)GaN NRs were investigated systematically. The scanning electron microscopic analysis and transmission electron microscopic measurements revealed that the presence of In flux can help to inhibit NR coalescence and obtain well-separated (In)GaN NRs. By increasing the supplied In flux, the densities of (In)GaN NRs decreased and the axial growth rates increased. According to the energy dispersive X-ray spectrometry measurements and theoretical calculations, the increase of In content of the NRs enhanced Ga diffusion on the NR sidewalls, which resulted in an increased axial growth rate. A kinetic In-assisted growth model for the well-separated (In)GaN NRs is therefore proposed. The model explains that the presence of In flux not only reduces the density of (In)GaN NRs due to the increase in substrate surface migration of Ga adatoms at nucleation stage but also lead to a remarkable enhancement of axial growth rate at growth stage. Consequently, the NR coalescence was significantly suppressed. The results provide a demonstration of obtaining well-separated (In)GaN NRs and open up further possibility of developing (In)GaN NR-based optoelectronic devices.

  18. Astragalus Extract Mixture HT042 Increases Longitudinal Bone Growth Rate by Upregulating Circulatory IGF-1 in Rats

    Directory of Open Access Journals (Sweden)

    Donghun Lee

    2017-01-01

    Full Text Available Astragalus extract mixture HT042 is a standardized ingredient of health functional food approved by Korean FDA with a claim of “height growth of children.” HT042 stimulates bone growth rate and increases local IGF-1 expression in growth plate of rats which can be considered as direct stimulation of GH and its paracrine/autocrine actions. However, it remains unclear whether HT042 stimulates circulatory IGF-1 which also plays a major role to stimulate bone growth. To determine the effects on circulatory IGF-1, IGF-1 and IGFBP-3 expressions and phosphorylation of JAK2/STAT5 were evaluated in the liver after 10 days of HT042 administration. HT042 upregulated liver IGF-1 and IGFBP-3 mRNA expression, IGF-1 protein expression, and phosphorylation of JAK2/STAT5. HT042 also increased bone growth rate and proliferative zonal height in growth plate. In conclusion, HT042 stimulates bone growth rate via increment of proliferative rate by upregulation of liver IGF-1 and IGFBP-3 mRNA followed by IGF-1 protein expression through phosphorylation of JAK2/STAT5, which can be regarded as normal functioning of GH-dependent endocrine pathway.

  19. The human heart and the circulatory system as an interesting interdisciplinary topic in lessons of physics and biology

    International Nuclear Information System (INIS)

    Volná, M; Látal, F; Kubínek, R; Richterek, L

    2014-01-01

    Many topics which are closely related can be found in the national curriculum of the Czech Republic for physics and biology. One of them is the heart and the circulatory system in the human body. This topic was examined cross curriculum, a teaching module was created and the topic was chosen for our research. The task was to determine if the students of bachelor study are aware of connections between physics and biology within this topic and whether we can help them effectively to describe the corresponding physics phenomena in the human body connected, for example, with a heart attack or with the measurement of blood pressure. In this paper, the heart and the circulatory system are presented as suitable topics for an interdisciplinary teaching module which includes both theoretical and experimental parts. The module was evaluated by a group of first-year undergraduate students of physics at the Faculty of Science, Palacký University. The acquired knowledge was compared with another control group through a test. The highest efficiency of the module was evaluated on the basis of questions that covered the calculation problems. (paper)

  20. Head capsule, chephalic central nervous system and head circulatory system of an aberrant orthopteran, Prosarthria teretrirostris (Caelifera, Hexapoda).

    Science.gov (United States)

    Baum, Eileen; Hertel, Wieland; Beutel, Rolf Georg

    2007-01-01

    The head capsule, the circulatory system and the central nervous system of the head of Prosarthria teretrirostris (Proscopiidae) is described in detail, with special consideration of modifications resulting from the aberrant head shape. The transformations of the head are completely different from those found in phasmatodeans, which are also characterised by twig mimesis. The circulatory system is distinctly modified. A hitherto undescribed additional structure in the posterior head region very likely functions as a pulsatile organ. The cephalic central nervous system is strongly elongated, with changes in the position of the suboesophageal ganglion, the corpora cardiaca and the course of the nervus mandibularis. Three-dimensional reconstructions of these two organ systems in combination with the pharynx were made using Alias Maya 6.0 software. Comparisons with other representatives of Caelifera suggest a clade comprising Proscopiidae and Morabinae. The presence of a transverse muscle connecting the antennal ampullae in Prosarthria shows that this structure likely belongs to the groundplan of Orthoptera, even though it is missing in different representatives of this group. The transverse ampullary muscle is a potential synapomorphy of Orthoptera, Phasmatodea and Dictyoptera.

  1. Evaluation of cerebro-circulatory metabolic conditions and prognosis in hypertensive putaminal hemorrhage by 31P-MRS

    International Nuclear Information System (INIS)

    Deguchi, Itaru

    2000-01-01

    Phosphorus-31 nuclear magnetic resonance spectroscopy ( 31 P-MRS) provides a non-invasive means to obtain metabolic information. We studied cerebro-circulatory metabolic conditions in the subacute phase of hypertensive putaminal hemorrhage with 31 P-MRS and N-isopropyl-I-(123)-p-Iodoamphetamine single photon emission computed tomography ( 123 I-IMP SPECT). The subjects consisted of 33 cases of hypertensive putaminal hemorrhage. Upon evaluation of cerebral blood flow (CBF) around the ipsilateral frontal lobe cortex and examination by 123 I-IMP SPECT, they would broadly divided into the following three groups: (A) a group with high uptake on both the early image and delayed image, (B) a group with low uptake on the early image but with good redistribution, and (C) a group with low uptake on both images. In these groups 31 P-MRS in the ipsilateral frontal lobe cortex was measured for comparative analysis. In group A, the PCr/Pi ratio was 3.12±0.14 as opposed to 2.87±0.13 in group B, and the ratio was extremely depressed in group C, 1.96±0.16. These observations implied that a high level circulatory metabolic disorder was present in group C and that local viability or metabolic activity was relatively well maintained despite the low perfusion in group B with a satisfactory prognosis being expected due to their high functional level. (author)

  2. The effects of aprotinin on blood product transfusion associated with thoracic aortic surgery requiring deep hypothermic circulatory arrest.

    LENUS (Irish Health Repository)

    Seigne, P W

    2012-02-03

    OBJECTIVE: To compare the effects of aprotinin on blood product use and postoperative complications in patients undergoing thoracic aortic surgery requiring deep hypothermic circulatory arrest. DESIGN: A retrospective study. SETTING: A university hospital. PARTICIPANTS: Nineteen patients who underwent elective or urgent thoracic aortic surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The total number of units of packed red blood cells, fresh frozen plasma, and platelets was significantly less in the group that received aprotinin (p = 0.01, 0.04, and 0.01). The intraoperative transfusion of packed red blood cells and platelets, collection and retransfusion of cell saver, and postoperative transfusion of fresh frozen plasma were also significantly less in the aprotinin group (p = 0.01, 0.02, 0.01, and 0.05). No patient in either group sustained renal dysfunction or a myocardial infarction. Two patients who had not received aprotinin suffered from chronic postoperative seizures, and one patient who had received aprotinin sustained a perioperative stroke. CONCLUSIONS: Low-dose aprotinin administration significantly decreases blood product transfusion requirements in the setting of thoracic aortic surgery requiring deep hypothermic circulatory arrest, and it does not appear to be associated with renal or myocardial dysfunction.

  3. Oxidative Stress and Methods for Its Correction in Patients with Acute Coronary Circulatory Disorders During Perioperative Direct Myocardial Revascularization

    Directory of Open Access Journals (Sweden)

    M. V. Chumakov

    2008-01-01

    Full Text Available Objective: to study the effect of the antioxidant and cardioprotector mexicor on oxidative stress in patients with acute coronary circulatory disorders (ACCD during perioperative direct myocardial revascularization. Subjects and methods. The study included 33 patients with ACCD who had undergone coronary bypass surgery. Two groups (a study group and a control one were formed. Prior to surgery, all the patients received the maximum doses of antianginal and antihypertensive drugs. The study group patients additionally took mexicor. All patients were operated on under extracorporeal circulation and moderate hypothermia. Lipid peroxidation (LPO indices were estimated via measurements of the serum levels of dienic conjugates, malonic dialdehyde, and the degree of serum lipid oxidability. The serum antioxidative system (AOS was judged from the concentration of а-tocopherol and cerulo-plasmin. The oxidative stress coefficient K, an integral index, was calculated to evaluate LPO-AOS imbalance. Results. High oxidative stress was found to be detectable in patients with ACCD. Mexicor lowers oxidative stress, diminishes LPO-AOS imbalance, improves oxygen balance and cardiac contractility, and reduces the number of life-threatening cardiac arrhythmias. Conclusion. Mexicor diminishes oxidative stress in patients with ACCD in the perioperative period of coronary bypass surgery. Mexicor-induced stabilization of LPO positively affects better oxygen balance and cardiac contractility, thus reducing the number of perioperative complications. Key words: oxidative stress, dienic conjugates, malonic dialdehyde, а-tocopherol, ceruloplasmin, coronary bypass, acute coronary circulatory disorder, hemodynamics.

  4. Optoacoustic measurement of central venous oxygenation for assessment of circulatory shock: clinical study in cardiac surgery patients

    Science.gov (United States)

    Petrov, Irene Y.; Prough, Donald S.; Kinsky, Michael; Petrov, Yuriy; Petrov, Andrey; Henkel, S. Nan; Seeton, Roger; Salter, Michael G.; Esenaliev, Rinat O.

    2014-03-01

    Circulatory shock is a dangerous medical condition, in which blood flow cannot provide the necessary amount of oxygen to organs and tissues. Currently, its diagnosis and therapy decisions are based on hemodynamic parameters (heart rate, blood pressure, blood gases) and mental status of a patient, which all have low specificity. Measurement of mixed or central venous blood oxygenation via catheters is more reliable, but highly invasive and associated with complications. Our previous studies in healthy volunteers demonstrated that optoacoustic systems provide non-invasive measurement of blood oxygenation in specific vessels, including central veins. Here we report our first results of a clinical study in coronary artery bypass graft (CABG) surgery patients. We used a medical-grade OPO-based optoacoustic system developed in our laboratory to measure in real time blood oxygenation in the internal jugular vein (IJV) of these patients. A clinical ultrasound imaging system (GE Vivid e) was used for IJV localization. Catheters were placed in the IJV as part of routine care and blood samples taken via the catheters were processed with a CO-oximeter. The optoacoustic oxygenation data were compared to the CO-oximeter readings. Good correlation between the noninvasive and invasive measurements was obtained. The results of these studies suggest that the optoacoustic system can provide accurate, noninvasive measurements of central venous oxygenation that can be used for patients with circulatory shock.

  5. 76 FR 36548 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-06-22

    ... information related to the humanitarian device exemption for the Berlin Heart EXCOR Pediatric Ventricular Assist Device (VAD) sponsored by Berlin Heart, Inc. The Berlin Heart EXCOR Pediatric VAD device is a..., please contact AnnMarie Williams, Conference Management Staff, at 301-796-5966, at least 7 days in...

  6. Assisted Living

    Science.gov (United States)

    ... a resident's needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care. The Administration on Aging, a part of the U.S. Department of Health and Human Services (HHS), offers these suggestions to help you ...

  7. Assistive Devices

    Science.gov (United States)

    If you have a disability or injury, you may use a number of assistive devices. These are tools, products or types of equipment that help you perform tasks and activities. They may help you move around, see, communicate, eat, or get ...

  8. Growth mechanisms of plasma-assisted molecular beam epitaxy of green emission InGaN/GaN single quantum wells at high growth temperatures

    International Nuclear Information System (INIS)

    Yang, W. C.; Wu, C. H.; Tseng, Y. T.; Chiu, S. Y.; Cheng, K. Y.

    2015-01-01

    The results of the growth of thin (∼3 nm) InGaN/GaN single quantum wells (SQWs) with emission wavelengths in the green region by plasma-assisted molecular beam epitaxy are present. An improved two-step growth method using a high growth temperature up to 650 °C is developed to increase the In content of the InGaN SQW to 30% while maintaining a strong luminescence intensity near a wavelength of 506 nm. The indium composition in InGaN/GaN SQW grown under group-III-rich condition increases with increasing growth temperature following the growth model of liquid phase epitaxy. Further increase in the growth temperature to 670 °C does not improve the photoluminescence property of the material due to rapid loss of indium from the surface and, under certain growth conditions, the onset of phase separation

  9. The logistics and cost-effectiveness of circulatory support: advantages of the ABIOMED BVS 5000.

    Science.gov (United States)

    Couper, G S; Dekkers, R J; Adams, D H

    1999-08-01

    In 1994, the ABIOMED BVS 5000 was incorporated into our acute cardiac assist armamentarium. This report is a general overview of our experience. A hypothetical cost analysis focusing on specific devices and device-related personnel contrasted the BVS 5000 with our prior model of centrifugal pump use. In 3 years, 22 patients were supported with the BVS 5000, as a biventricular assist device in 40%, right ventricular assist device in 27%, and left ventricular assist device in 32%. Indications were postcardiotomy support in 12, acute myocarditis in 2, bridge to transplant in 4, and failed heart transplant in 4. The cost analysis was performed retrospectively. The actual cost of disposable blood pumps, including replacement pumps, and cannulae constituted the BVS cost. The hypothetical centrifugal costs included the disposables, replacement cones, as well as the labor costs of the continuous perfusionist coverage. Of the 22 patients, 10 (45%) were weaned and 13 (59%) were successfully discharged. Five patients were transplanted while on BVS 5000 support, accounting for a higher rate of discharge. Comparison of "actual" BVS costs with "projected" centrifugal costs revealed differences based upon the intended application of the BVS. In bridge-to-transplant patients with long duration of support, the daily cost of support was dramatically lower with the BVS 5000. For short-term postcardiotomy support, acute myocarditis, or failed transplant, the differences were small. Because the BVS 5000 was readily managed by the intensive care unit nursing staff, this system displaced centrifugal systems in our program. Outcome measures of weaning and successful discharge were improved relative to our prior experience with centrifugal pumps. Even without taking indirect costs into account, the hypothetical cost analysis supported continued use of the BVS system for acute cardiac assistance.

  10. Evaluation of mechanism of cold atmospheric pressure plasma assisted polymerization of acrylic acid on low density polyethylene (LDPE) film surfaces: Influence of various gaseous plasma pretreatment

    Science.gov (United States)

    Ramkumar, M. C.; Pandiyaraj, K. Navaneetha; Arun Kumar, A.; Padmanabhan, P. V. A.; Uday Kumar, S.; Gopinath, P.; Bendavid, A.; Cools, P.; De Geyter, N.; Morent, R.; Deshmukh, R. R.

    2018-05-01

    Owing to its exceptional physiochemical properties, low density poly ethylene (LDPE) has wide range of tissue engineering applications. Conversely, its inadequate surface properties make LDPE an ineffectual candidate for cell compatible applications. Consequently, plasma-assisted polymerization with a selected precursor is a good choice for enhancing its biocompatibility. The present investigation studies the efficiency of plasma polymerization of acrylic acid (AAC) on various gaseous plasma pretreated LDPE films by cold atmospheric pressure plasma, to enhance its cytocompatibility. The change in chemical composition and surface topography of various gaseous plasma pretreated and acrylic deposited LDPE films has been assessed by X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM). The changes in hydrophilic nature of surface modified LDPE films were studied by contact angle (CA) analysis. Cytocompatibility of the AAC/LDPE films was also studied in vitro, using RIN-5F cells. The results acquired by the XPS and AFM analysis clearly proved that cold atmospheric pressure (CAP) plasma assisted polymerization of AAC enhances various surface properties including carboxylic acid functional group density and increased surface roughness on various gaseous plasma treated AAC/LDPE film surfaces. Moreover, contact angle analysis clearly showed that the plasma polymerized samples were hydrophilic in nature. In vitro cytocompatibility analysis undoubtedly validates that the AAC polymerized various plasma pretreated LDPE films surfaces stimulate cell distribution and proliferation compared to pristine LDPE films. Similarly, cytotoxicity analysis indicates that the AAC deposited various gaseous plasma pretreated LDPE film can be considered as non-toxic as well as stimulating cell viability significantly. The cytocompatible properties of AAC polymerized Ar + O2 plasma pretreated LDPE films were found to be more pronounced compared to the other plasma pretreated

  11. Selective adsorption behavior of Cd(II) ion imprinted polymers synthesized by microwave-assisted inverse emulsion polymerization: Adsorption performance and mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Fang, E-mail: zhufang@tyut.edu.cn [College of Environmental Science and Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, 030024 (China); Li, Luwei [College of Environmental Science and Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, 030024 (China); Xing, Junde [College of Chemistry and Chemical Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, 030024 (China)

    2017-01-05

    Highlights: • Microwave assisted inverse emulsion polymerization was applied to prepare Cd(II) imprinted polymers. • The adsorption capacity was evaluated by static adsorption experiments. • Pseudo-second-order model and Langmuir adsorption isotherm model had the best agreement with the experimental data. • The adsorption was a spontaneous and endothermic process. • Cd(II) imprinted polymers have specific identification for Cd(II). - Abstract: Microwave-assisted inverse emulsion polymerization method was used to prepare Cd(II) imprinted polymer (IIP) by using β-cyclodextrin (β-CD) and acrylamide (AM) as functional monomer, epichlorohydrin (ECH) as crossing-linking agent, ammonium persulfate as initiator. The Cd(II) imprinted polymer was characterized by SEM, FTIR and TGA. The influences of initial concentration of Cd(II), pH values, temperature, time and competitive ions on adsorption capacity and recognition properties are investigated. Under the optimal conditions, the adsorption capacity could reach 107 mg/g. Furthermore, pseudo first order kinetic model, pseudo second order kinetic model and intra-particular diffusion model were used to describe the adsorption kinetic behavior. Results showed that the pseudo-second-order model (R{sup 2} 0.9928–0.9961) had the best agreement with the experimental data. Langmuir adsorption isotherm model described the experimental data well, which indicated that adsorption was mainly monolayer absorption. Moreover, the study of adsorption thermodynamics (ΔG{sup 0} < 0, ΔH{sup 0} > 0, ΔS{sup 0} > 0) suggested that the adsorption process was a spontaneous and endothermic process. Competitive selectivity experiment revealed that imprinted polymer could selectively recognize Cd(II). It provides a new idea for removing Cd(II) from aqueous solution.

  12. Selective adsorption behavior of Cd(II) ion imprinted polymers synthesized by microwave-assisted inverse emulsion polymerization: Adsorption performance and mechanism

    International Nuclear Information System (INIS)

    Zhu, Fang; Li, Luwei; Xing, Junde

    2017-01-01

    Highlights: • Microwave assisted inverse emulsion polymerization was applied to prepare Cd(II) imprinted polymers. • The adsorption capacity was evaluated by static adsorption experiments. • Pseudo-second-order model and Langmuir adsorption isotherm model had the best agreement with the experimental data. • The adsorption was a spontaneous and endothermic process. • Cd(II) imprinted polymers have specific identification for Cd(II). - Abstract: Microwave-assisted inverse emulsion polymerization method was used to prepare Cd(II) imprinted polymer (IIP) by using β-cyclodextrin (β-CD) and acrylamide (AM) as functional monomer, epichlorohydrin (ECH) as crossing-linking agent, ammonium persulfate as initiator. The Cd(II) imprinted polymer was characterized by SEM, FTIR and TGA. The influences of initial concentration of Cd(II), pH values, temperature, time and competitive ions on adsorption capacity and recognition properties are investigated. Under the optimal conditions, the adsorption capacity could reach 107 mg/g. Furthermore, pseudo first order kinetic model, pseudo second order kinetic model and intra-particular diffusion model were used to describe the adsorption kinetic behavior. Results showed that the pseudo-second-order model (R"2 0.9928–0.9961) had the best agreement with the experimental data. Langmuir adsorption isotherm model described the experimental data well, which indicated that adsorption was mainly monolayer absorption. Moreover, the study of adsorption thermodynamics (ΔG"0 0, ΔS"0 > 0) suggested that the adsorption process was a spontaneous and endothermic process. Competitive selectivity experiment revealed that imprinted polymer could selectively recognize Cd(II). It provides a new idea for removing Cd(II) from aqueous solution.

  13. Mortality from Circulatory System Diseases among French Uranium Miners: A Nested Case-Control Study.

    Science.gov (United States)

    Drubay, Damien; Caër-Lorho, Sylvaine; Laroche, Pierre; Laurier, Dominique; Rage, Estelle

    2015-05-01

    A significant association has been observed between radon exposure and cerebrovascular disease (CeVD) mortality among French uranium miners, but risk factors for circulatory system diseases (CSD) have not been previously considered. We conducted new analyses in the recently updated (through 2007) French cohort of uranium miners (n = 5,086), which included 442 deaths from CSD, 167 of them from ischemic heart disease (IHD) and 105 from CeVD. A nested case-control study was then set up to collect and investigate the influence of these risk factors on the relationships between mortality from CSD and occupational external gamma ray and internal ionizing radiation exposure (radon and long-lived radionuclides) in this updated cohort. The nested case-control study included miners first employed after 1955, still employed in 1976 and followed up through 2007. Individual information about CSD risk factors was collected from medical files for the 76 deaths from CSD (including 26 from IHD and 16 from CeVD) and 237 miners who had not died of CSD by the end of follow-up. The exposure-risk relationships were assessed with a Cox proportional hazard model weighted by the inverse sampling probability. A significant increase in all CSD and CeVD mortality risks associated with radon exposure was observed in the total cohort [hazard ratios: HRCSD/100 working level months (WLM) = 1.11, 95% confidence interval (1.01; 1.22) and HRCeVD/100 WLM = 1.25 (1.09; 1.43), respectively]. A nonsignificant exposure-risk relationship was observed for every type of cumulative ionizing radiation exposure and every end point [e.g., HRCSD/100WLM = 1.43 (0.71; 2.87)]. The adjustment for each CSD risk factor did not substantially change the exposure-risk relationships. When the model was adjusted for overweight, hypertension, diabetes, hypercholesterolemia and smoking status, the HR/100WLM for CSD, for example, was equal to 1.21 (0.54; 2.75); and when it was adjusted for risk factors selected with the

  14. Effect of l-lysine-assisted surface grafting for nano-hydroxyapatite on mechanical properties and in vitro bioactivity of poly(lactic acid-co-glycolic acid).

    Science.gov (United States)

    Liuyun, Jiang; Lixin, Jiang; Chengdong, Xiong; Lijuan, Xu; Ye, Li

    2016-01-01

    It is promising and challenging to study surface modification for nano-hydroxyapatite to improve the dispersion and enhance the mechanical properties and bioactivity of poly(lactic acid-co-glycolic acid). In this paper, we designed an effective new surface grafting with the assist of l-lysine for nano-hydroxyapatite, and the nano-hydroxyapatite surface grafted with the assist of l-lysine (g-nano-hydroxyapatite) was incorporated into poly(lactic acid-co-glycolic acid) to develop a series of g-nano-hydroxyapatite/poly(lactic acid-co-glycolic acid) nano-composites. The surface modification reaction for nano-hydroxyapatite, the mechanical properties, and in vitro human osteoblast-like cell (MG-63) response were characterized and investigated by Fourier transformation infrared, thermal gravimetric analysis, dispersion test, electromechanical universal tester, differential scanning calorimeter measurements, and in vitro cells culture experiment. The results showed that the grafting amount on the surface of nano-hydroxyapatite was enhanced with the increase of l-lysine, and the dispersion of nano-hydroxyapatite was improved more, so that it brought about better promotion crystallization and more excellent mechanical enhancement effect for poly(lactic acid-co-glycolic acid), comparing with the unmodified nano-hydroxyapatite. Moreover, the cells' attachment and proliferation results confirmed that the incorporation of the g-nano-hydroxyapatite into poly(lactic acid-co-glycolic acid) exhibited better biocompatibility than poly(lactic acid-co-glycolic acid). The above results indicated that the new surface grafting with the assist of l-lysine for nano-hydroxyapatite was an ideal novel surface modification method, which brought about better mechanical enhancement effect and in vitro bioactivity for poly(lactic acid-co-glycolic acid) with adding higher g-nano-hydroxyapatite content, suggesting it had a great potential to be used as bone fracture internal fixation materials

  15. Peer-Assisted Learning Programme: Supporting Students in High-Risk Subjects at the Mechanical Engineering Department at Walter Sisulu University

    Science.gov (United States)

    Makola, Qonda

    2017-01-01

    The majority of the students who enroll at the Walter Sisulu University (WSU) in South Africa are not equipped with the necessary academic/learning skills to cope with the university environment, especially in Mechanical Engineering. The Department of Higher Education and Training (2013, p. 17), further states that "students' support is…

  16. Foreign assistance

    International Nuclear Information System (INIS)

    1991-07-01

    This paper reports that providing energy assistance to developing countries remains a relatively low priority of the Agency for International Development. AID is helping some developing countries meet their energy needs, but this assistance varies substantially because of the agency's decentralized structure. Most AID energy funding has gone to a handful of countries-primarily Egypt and Pakistan. With limited funding in most other countries, AID concentrates on providing technical expertise and promoting energy policy reforms that will encourage both energy efficiency and leverage investment by the private sector and other donors. Although a 1989 congressional directive to pursue a global warming initiative has had a marginal impact on the agency's energy programming, many AID energy programs, including those directed at energy conservation, help address global warming concerns

  17. Synergetic effects during sputter-assisted depth profiling: growth-dominated topography development on InP and a model of the atomic mechanism

    International Nuclear Information System (INIS)

    Gries, W.H.; Miethe, K.

    1987-01-01

    Growth-dominated extreme topography development on ion-bombarded wafers of InP is reported and is explained in terms of the micro region model presented in summary form. This model postulates the existence of an ion-bombardment-produced ensemble of crystallites and non-crystalline aggregations of atoms (composed of the substrate material, of dopant and of oxygen from the native oxide layer) where the majority of InP micro regions is so small (nanometer dimensions) that most interstitials created in collision events between bombarding ions and atoms of the micro region can reach an interfacial boundary rather than recombine with a vacancy from the same or another collision event. These atoms are then transported via interfacial boundaries and over the surface to screw dislocations where crystal stubs proceed to grow until the damage rate by ion bombardment overtakes the growth rate. Ion-bombardment-induced compressive stresses favour diffusion towards the surface. Temperature transients within micro regions assist both interfacial diffusion and damage repair. The topography is a result of competition between growth and sputtering. Different growth rates cause different topographies. The development of an extreme topography can be suppressed by oxygen flooding of the sputtered surface, by simultaneous electron beam scanning, as well as by Cs + ion bombardment. (Author)

  18. A comprehensive structure-function analysis shed a new light on molecular mechanism by which a novel smart copolymer, NY-3-1, assists protein refolding.

    Science.gov (United States)

    Ye, Chaohui; Ilghari, Dariush; Niu, Jianlou; Xie, Yaoyao; Wang, Yan; Wang, Chao; Li, Xiaokun; Liu, Bailin; Huang, Zhifeng

    2012-08-31

    An in-depth understanding of molecular basis by which smart polymers assist protein refolding can lead us to develop a more effective polymer for protein refolding. In this report, to investigate structure-function relationship of pH-sensitive smart polymers, a series of poly(methylacrylic acid (MAc)-acrylic acid (AA))s with different MAc/AA ratios and molecular weights were synthesized and then their abilities in refolding of denatured lysozyme were compared by measuring the lytic activity of the refolded lysozyme. Based on our analysis, there were optimal MAc/AA ratio (44% MAc), M(w) (1700 Da), and copolymer concentration (0.1%, w/v) at which the highest yield of protein refolding was achieved. Fluorescence, circular dichroism, and RP-HPLC analysis reported in this study demonstrated that the presence of P(MAc-AA)s in the refolding buffer significantly improved the refolding yield of denatured lysozyme without affecting the overall structure of the enzyme. Importantly, our bioseparation analysis, together with the analysis of zeta potential and particle size of the copolymer in refolding buffers with different copolymer concentrations, suggested that the polymer provided a negatively charged surface for an electrostatic interaction with the denatured lysozyme molecules and thereby minimized the hydrophobic-prone aggregation of unfolded proteins during the process of refolding. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. A study of the mechanism of microwave-assisted ball milling preparing ZnFe{sub 2}O{sub 4}

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yingzhe; Wu, Yujiao [College of materials and metallurgical engineering, Guizhou Institute of Technology, Guiyang 550003 (China); 2011 Collaborative Innovation Center of Guizhou Province, Guiyang 550003 (China); Qin, Qingdong [College of materials and metallurgical engineering, Guizhou Institute of Technology, Guiyang 550003 (China); Wang, Fuchun [College of materials and metallurgical engineering, Guizhou Institute of Technology, Guiyang 550003 (China); 2011 Collaborative Innovation Center of Guizhou Province, Guiyang 550003 (China); Chen, Ding [College of Materials Science and Engineering, Hunan University, Changsha, Hunan 410082 (China)

    2016-07-01

    In this paper, well dispersed ZnFe{sub 2}O{sub 4} nano-particles with high magnetization saturation of 82.23 emu/g were first synthesized by microwave assisted ball milling and then the influences of pre-treatments and microwave powers to the progress were studied. It was found that under the both function of crack effect induced by ball milling and rotary motion induced by microwave the synthesized ferrtie nano-particles were well dispersed that is much different from the powders synthesized by normal high energy ball milling. The pre-treatment of ball milling can only enhance the reaction rate in the first several hours but the pre-irradiation of microwave can enhance the hole reaction rate. Further more, it was also been found that with increasing the microwave power, the more raw materials will converted into zinc ferrite in the first 5 h. 5 h latter the microwave power of 720 W is high enough for the coupling effect of microwave and ball milling with stirrer rotation speed of 256 rpm. - Highlights: • ZnFe{sub 2}O{sub 4} with 82.23 emu/g were synthesized without heat treatment. • The produced powder dispersed very well without any dispersant. • The pre-treatment of microwave enhanced the reaction rate much. • The pre-treatment of ball milling enhance chemical rate at beginning.

  20. Impact of ultrasonic assisted triangular lattice like arranged dispersion of nanoparticles on physical and mechanical properties of epoxy-TiO2 nanocomposites.

    Science.gov (United States)

    Goyat, M S; Ghosh, P K

    2018-04-01

    Emerging ex-situ technique, ultrasonic dual mixing (UDM) offers unique and hitherto unapproachable opportunities to alter the physical and mechanical properties of polymer nanocomposites. In this study, triangular lattice-like arranged dispersion of TiO 2 nanoparticles (average size ∼ 48 nm) in the epoxy polymer has been attained via concurrent use of a probe ultra-sonicator and 4 blades pitched impeller which collectively named as UDM technique. The UDM processing of neat epoxy reveals the generation of triangular lattice-like arranged nanocavities with nanoscale inter-cavity spacing. The UDM processing of epoxy-TiO 2 nanocomposites reveals two unique features such as partial and complete entrapping of the nanoparticles by the nanocavities leading the arranged dispersion of particles in the epoxy matrix. Pristine TiO 2 nanoparticles were dispersed in the epoxy polymer at loading fractions of up to 20% by weight. The results display that the arranged dispersion of nanoparticles is very effective at enhancing the glass transition temperature (T g ) and tensile properties of the epoxy at loading fractions of 10 wt%. We quantify a direct relationship among three important parameters such as nanoparticle content, cluster size, and inter-particle spacing. Our results offer a novel understanding of these parameters on the T g and tensile properties of the epoxy nanocomposites. The tensile fracture surfaces revealed several toughening mechanisms such as particle pull-out, plastic void growth, crack deflection, crack bridging and plastic deformation. We show that a strong nanoparticle-matrix interface led to the enhanced mechanical properties due to leading toughening mechanisms such as crack deflection, plastic deformation and particle pull-out. We showed that the UDM has an inordinate prospective to alter the dispersion state of nanoparticles in viscous polymer matrices. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. A Multicenter Study on Long-Term Outcomes After Lung Transplantation Comparing Donation After Circulatory Death and Donation After Brain Death

    NARCIS (Netherlands)

    van Suylen, Vincent; Luijk, B.; Hoek, R A S; van de Graaf, E. A.; Verschuuren, E A; Van De Wauwer, C; Bekkers, J A; Meijer, R C A; van der Bij, W; Erasmus, M E

    2017-01-01

    The implementation of donation after circulatory death category 3 (DCD3) was one of the attempts to reduce the gap between supply and demand of donor lungs. In the Netherlands, the total number of potential lung donors was greatly increased by the availability of DCD3 lungs in addition to the

  2. Capture of circulatory endothelial progenitor cells and accelerated re-endothelialization of a bio-engineered stent in human ex vivo shunt and rabbit denudation model

    NARCIS (Netherlands)

    K. Larsen (Katarína); C. Cheng (Caroline (Ka Lai)); D. Tempel (Dennie); S. Parker (Sherry); S. Yazdani (Saami); W.K. den Dekker (Wijnand); H.J. Houtgraaf (Jaco); R. de Jong (Renate); S. Swager-ten Hoor (Stijn); E. Ligtenberg (Erik); S.R. Hanson (Stephen); R. Rowland (Steve); F. Kolodgie (Frank); P.W.J.C. Serruys (Patrick); R. Virmani (Renu); H.J. Duckers (Henricus)

    2012-01-01

    textabstractThe Genous™ Bio-engineered R™ stent (GS) aims to promote vascular healing by capture of circulatory endothelial progenitor cells (EPCs) to the surface of the stent struts, resulting in accelerated re-endothelialization. Here, we assessed the function of the GS in comparison to bare-metal

  3. Utilization of organs from donors after circulatory death for vascularized pancreas and islet of Langerhans transplantation : recommendations from an expert group

    NARCIS (Netherlands)

    Berney, Thierry; Boffa, Catherine; Augustine, Titus; Badet, Lionel; de Koning, Eelco; Pratschke, Johann; Socci, Carlo; Friend, Peter

    2015-01-01

    Donation after circulatory death (DCD) donors are increasingly being used as a source of pancreas allografts for vascularized organ and islet transplantation. We provide practice guidelines aiming to increase DCD pancreas utilization. We review risk assessment and donor selection criteria. We report

  4. Plasma FITC-dextran exchange between the primary and secondary circulatory systems in the Atlantic cod, Gadus Morhua

    DEFF Research Database (Denmark)

    Fischer, Claes; Steffensen, John Fleng

    2008-01-01

    Fluorescein isothiocyanate dextran (FITC-dextran) exchange between the primary (PCS) and secondary (SCS) circulatory systems in the Atlantic cod, Gadus morhua (Linnaeus, 1752), were studied using 20-kDa (n = 4) and 500-kDa (n = 4) FITC-dextran. In order to give a qualitative perspective...... of the general connection between the PCS and SCS, distribution of plasma-borne tracers (FITC-dextran) in the PCS and SCS were examined. In this study, a total of eight cod were cannulated in the ventral aorta (PCS) and dorsal cutaneous vessel (SCS), for investigation of FITC-dextran disappearance in the PCS...... and its subsequent appearance in the SCS. FITC-dextran of both sizes was found to be in equilibrium between the PCS and SCS in less than 20 min. This indicates a profound connection between the PCS and SCS in the Atlantic cod, and rapid mixing of tracers between the PCS and SCS. The destination...

  5. Acylated Ghrelin and Circulatory Oxidative Stress Markers Responses to Acute Resistance and Aerobic Exercise in Postmenopausal Women.

    Science.gov (United States)

    Carteri, Randhall B; Lopes, André Luis; Schöler, Cinthia M; Correa, Cleiton Silva; Macedo, Rodrigo C; Gross, Júlia Silveira; Kruger, Renata Lopes; Homem de Bittencourt, Paulo I; Reischak-Oliveira, Álvaro

    2016-06-01

    Since exercise increases the production of reactive oxygen species in different tissues, the objective of this study is to evaluate, compare and correlate the acute effects of aerobic and resistance exercise in circulatory markers of oxidative stress and acylated ghrelin (AG) in postmenopausal women. Ten postmenopausal women completed different protocols: a control session (CON), an aerobic exercise session (AERO); and a single-set (SSR) or 3-set (MSR) resistance exercise protocol. After exercise, both MSR (P = .06) and AERO (P = .02) sessions showed significant increased lipid peroxidation compared with baseline levels. CON and SSR sessions showed no differences after exercise. No differences were found between sessions at any time for total glutathione, glutathione dissulfide or AG concentrations. Exercise significantly increased lipid peroxidation compared with baseline values. As pro oxidant stimuli is necessary to promote chronic adaptations to the antioxidant defenses induced by exercise, our findings are important to consider when evaluating exercise programs prescription variables aiming quality of life in this population.

  6. Long-term results after lung transplantation using organs from circulatory death donors: a propensity score-matched analysis†.

    Science.gov (United States)

    Sabashnikov, Anton; Patil, Nikhil P; Popov, Aron-Frederik; Soresi, Simona; Zych, Bartlomiej; Weymann, Alexander; Mohite, Prashant N; García Sáez, Diana; Zeriouh, Mohamed; Wahlers, Thorsten; Choi, Yeong-Hoon; Wippermann, Jens; Wittwer, Thorsten; De Robertis, Fabio; Bahrami, Toufan; Amrani, Mohamed; Simon, André R

    2016-01-01

    Due to organ shortage in lung transplantation (LTx), donation after circulatory death (DCD) has been implemented in several countries, contributing to an increasing number of organs transplanted. We sought to assess long-term outcomes after LTx with organs procured following circulatory death in comparison with those obtained from donors after brain death (DBD). Between January 2007 and November 2013, 302 LTxs were performed in our institution, whereby 60 (19.9%) organs were retrieved from DCD donors. We performed propensity score matching (DCD:DBD = 1:2) based on preoperative donor and recipient factors that were significantly different in univariate analysis. After propensity matching, there were no statistically significant differences between the groups in terms of demographics and preoperative donor and recipient characteristics. There were no significant differences regarding intraoperative variables and total ischaemic time. Patients from the DCD group had significantly higher incidence of primary graft dysfunction grade 3 at the end of the procedure (P = 0.014), and significantly lower pO2/FiO2 ratio during the first 24 h after the procedure (P = 0.018). There was a trend towards higher incidence of the need for postoperative extracorporeal life support in the DCD group. Other postoperative characteristics were comparable. While the overall cumulative survival was not significantly different, the DCD group had significantly poorer results in terms of bronchiolitis obliterans syndrome (BOS)-free survival in the long-term follow-up. Long-term results after LTx with organs procured following DCD are in general comparable with those obtained after DBD LTx. However, patients transplanted using organs from DCD donors have a predisposition for development of BOS in the longer follow-up. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  7. The physiology of dinosaurs: circulatory and respiratory function in the largest animals ever to walk the earth.

    Science.gov (United States)

    Pierson, David J

    2009-07-01

    The cardiopulmonary physiology of dinosaurs-and especially of the long-necked sauropods, which grew much larger than any land animals before or since-should be inherently fascinating to anyone involved in respiratory care. What would the blood pressure be in an animal 12 m (40 ft) tall? How could airway resistance and dead space be overcome while breathing through a trachea 9 m (30 ft) long? The last decade has seen a dramatic increase in evidence bearing on these questions. Insight has come not only from new fossil discoveries but also from comparative studies of living species, clarification of evolutionary relationships, new evaluation techniques, computer modeling, and discoveries about the earth's ancient atmosphere. Pumping a vertical column of blood 8 m (26 ft) above the heart would probably require an arterial blood pressure > 600 mm Hg, and the implications of this for cardiac size and function have led to the proposal of several alternative cardiopulmonary designs. Diverse lines of evidence suggest that the giant sauropods were probably warm-blooded and metabolically active when young, but slowed their metabolism as they approached adult size, which diminished the load on the circulatory system. Circulatory considerations leave little doubt that the dinosaurs had 4-chambered hearts. Birds evolved from dinosaurs, and the avian-type air-sac respiratory system, which is more efficient than its mammalian counterpart, may hold the answer to the breathing problems posed by the sauropods' very long necks. Geochemical and other data indicate that, at the time the dinosaurs first appeared, the atmospheric oxygen concentration was only about half of what it is today, and development of the avian-type respiratory system may have been key in the dinosaurs' evolutionary success, enabling them to out-compete the mammals and dominate the land for 150 million years.

  8. Dendrimer Brain Uptake and Targeted Therapy for Brain Injury in a Large Animal Model of Hypothermic Circulatory Arrest

    Science.gov (United States)

    2015-01-01

    Treatment of brain injury following circulatory arrest is a challenging health issue with no viable therapeutic options. Based on studies in a clinically relevant large animal (canine) model of hypothermic circulatory arrest (HCA)-induced brain injury, neuroinflammation and excitotoxicity have been identified as key players in mediating the brain injury after HCA. Therapy with large doses of valproic acid (VPA) showed some neuroprotection but was associated with adverse side effects. For the first time in a large animal model, we explored whether systemically administered polyamidoamine (PAMAM) dendrimers could be effective in reaching target cells in the brain and deliver therapeutics. We showed that, upon systemic administration, hydroxyl-terminated PAMAM dendrimers are taken up in the brain of injured animals and selectively localize in the injured neurons and microglia in the brain. The biodistribution in other major organs was similar to that seen in small animal models. We studied systemic dendrimer–drug combination therapy with two clinically approved drugs, N-acetyl cysteine (NAC) (attenuating neuroinflammation) and valproic acid (attenuating excitotoxicity), building on positive outcomes in a rabbit model of perinatal brain injury. We prepared and characterized dendrimer-NAC (D-NAC) and dendrimer-VPA (D-VPA) conjugates in multigram quantities. A glutathione-sensitive linker to enable for fast intracellular release. In preliminary efficacy studies, combination therapy with D-NAC and D-VPA showed promise in this large animal model, producing 24 h neurological deficit score improvements comparable to high dose combination therapy with VPA and NAC, or free VPA, but at one-tenth the dose, while significantly reducing the adverse side effects. Since adverse side effects of drugs are exaggerated in HCA, the reduced side effects with dendrimer conjugates and suggestions of neuroprotection offer promise for these nanoscale drug delivery systems. PMID:24499315

  9. Dendrimer brain uptake and targeted therapy for brain injury in a large animal model of hypothermic circulatory arrest.

    Science.gov (United States)

    Mishra, Manoj K; Beaty, Claude A; Lesniak, Wojciech G; Kambhampati, Siva P; Zhang, Fan; Wilson, Mary A; Blue, Mary E; Troncoso, Juan C; Kannan, Sujatha; Johnston, Michael V; Baumgartner, William A; Kannan, Rangaramanujam M

    2014-03-25

    Treatment of brain injury following circulatory arrest is a challenging health issue with no viable therapeutic options. Based on studies in a clinically relevant large animal (canine) model of hypothermic circulatory arrest (HCA)-induced brain injury, neuroinflammation and excitotoxicity have been identified as key players in mediating the brain injury after HCA. Therapy with large doses of valproic acid (VPA) showed some neuroprotection but was associated with adverse side effects. For the first time in a large animal model, we explored whether systemically administered polyamidoamine (PAMAM) dendrimers could be effective in reaching target cells in the brain and deliver therapeutics. We showed that, upon systemic administration, hydroxyl-terminated PAMAM dendrimers are taken up in the brain of injured animals and selectively localize in the injured neurons and microglia in the brain. The biodistribution in other major organs was similar to that seen in small animal models. We studied systemic dendrimer-drug combination therapy with two clinically approved drugs, N-acetyl cysteine (NAC) (attenuating neuroinflammation) and valproic acid (attenuating excitotoxicity), building on positive outcomes in a rabbit model of perinatal brain injury. We prepared and characterized dendrimer-NAC (D-NAC) and dendrimer-VPA (D-VPA) conjugates in multigram quantities. A glutathione-sensitive linker to enable for fast intracellular release. In preliminary efficacy studies, combination therapy with D-NAC and D-VPA showed promise in this large animal model, producing 24 h neurological deficit score improvements comparable to high dose combination therapy with VPA and NAC, or free VPA, but at one-tenth the dose, while significantly reducing the adverse side effects. Since adverse side effects of drugs are exaggerated in HCA, the reduced side effects with dendrimer conjugates and suggestions of neuroprotection offer promise for these nanoscale drug delivery systems.

  10. Time Course of Changes in Extravascular Lung Water Index, Intracranial and Cerebral Perfusion Pressures in Acute Cerebral Circulatory Disorders

    Directory of Open Access Journals (Sweden)

    Yu. A. Churlyaev

    2009-01-01

    Full Text Available Objective: to study the time course of changes in extravascular lung water index (ELWI and intracranial and cerebral perfusion pressures (ICP and CPP and to determine their possible relationships in acute cerebral circulatory disorders (ACCD. Subject and methods. ELWI, pulmonary vascular permeability index (PVPI, ICP, CPP, and central hemodynamics were studied by transpulmonary thermodilution and current X-ray studies were conducted in 18 patients on days 1, 3, 5, and 7 of ACCD. Results. Examinations revealed a supratentorial dislocation of the brain in 6 persons; its subtento-rial dislocation was found in 1 case; supra- and subtentorial dislocations were seen in 6. In patients, ELWI and PVPI increased from days 1 and 5, respectively. The high baseline ICP increased over time. CPP remained unchanged. Preserved left ventricular contractility, enhanced myocardial one, a significant direct correlation between ELWI and PVPI, as well as their increase confirmed that the noncardiogenic genesis was responsible for increased ELWI. A direct significant correlation was found between ICP and ELWI, ICP and PVPI. Against this background, acute respiratory distress syndrome developed in 14 patients with pneumonia evolving in its presence in 7 patients. Conclusion. In ACCD, ELWI increases in the first 24 hours of the acute period. One of its causes is, along with others, primary and/or secondary damage to the brainstem structures with elevated ICP and progressive brain dislocation. The determination of ICP, unlike CPP, is crucial in the diagnosis and treatment of primary/secondary brain injuries and in prognosis. Key words: acute cerebral circulatory disorder, extravascular lung fluid, pulmonary vascular permeability, intracranial pressure, cerebral perfusion pressure, acute respiratory distress syndrome.

  11. Effects of Particulate Matter and Its Chemical Constituents on Elderly Hospital Admissions Due to Circulatory and Respiratory Diseases

    Directory of Open Access Journals (Sweden)

    Tatiane Morais Ferreira

    2016-09-01

    Full Text Available Various fractions of particulate matter have been associated with increased mortality and morbidity. The purpose of our study is to analyze the associations between concentrations of PM2.5, PM2.5–10, PM10 and their chemical constituents (soluble ions with hospital admissions due to circulatory and respiratory diseases among the elderly in a medium-sized city in Brazil. A time series study was conducted using Poisson regression with generalized additive models adjusted for confounders. Statistically significant associations were identified between PM10 and PM2.5–10 and respiratory diseases. Risks of hospitalization increased by 23.5% (95% CI: 13.5; 34.3 and 12.8% (95% CI: 6.0; 20.0 per 10 μg/m3 of PM2.5-10 and PM10, respectively. PM2.5 exhibited a significant association with circulatory system diseases, with the risk of hospitalization increasing by 19.6% (95% CI: 6.4; 34.6 per 10 μg/m3. Regarding the chemical species; SO42−, NO3−, NH4+ and K+ exhibited specific patterns of risk, relative to the investigated outcomes. Overall, SO42− in PM2.5–10 and K+ in PM2.5 were associated with increased risk of hospital admissions due to both types of diseases. The results agree with evidence indicating that the risks for different health outcomes vary in relation to the fractions and chemical composition of PM10. Thus, PM10 speciation studies may contribute to the establishment of more selective pollution control policies.

  12. Minimally Invasive Implantation of HeartWare Assist Device and Simultaneous Tricuspid Valve Reconstruction Through Partial Upper Sternotomy.

    Science.gov (United States)

    Hillebrand, Julia; Hoffmeier, Andreas; Djie Tiong Tjan, Tonny; Sindermann, Juergen R; Schmidt, Christoph; Martens, Sven; Scherer, Mirela

    2017-05-01

    Left ventricular assist device (LVAD) implantation is a well-established therapy to support patients with end-stage heart failure. However, the operative procedure is associated with severe trauma. Third generation LVADs like the HeartWare assist device (HeartWare, Inc., Framingham, MA, USA) are characterized by enhanced technology despite smaller size. These devices offer new minimally invasive surgical options. Tricuspid regurgitation requiring valve repair is frequent in patients with the need for mechanical circulatory support as it is strongly associated with ischemic and nonischemic cardiomyopathy. We report on HeartWare LVAD implantation and simultaneous tricuspid valve reconstruction through minimally invasive access by partial upper sternotomy to the fifth left intercostal space. Four male patients (mean age 51.72 ± 11.95 years) suffering from chronic heart failure due to dilative (three patients) and ischemic (one patient) cardiomyopathy and also exhibiting concomitant tricuspid valve insufficiency due to annular dilation underwent VAD implantation and tricuspid valve annuloplasty. Extracorporeal circulation was established via the ascending aorta, superior vena cava, and right atrium. In all four cases the LVAD implantation and tricuspid valve repair via partial median sternotomy was successful. During the operative procedure, no conversion to full sternotomy was necessary. One patient needed postoperative re-exploration because of pericardial effusion. No postoperative focal neurologic injury was observed. New generation VADs are advantageous because of the possibility of minimally invasive implantation procedure which can therefore minimize surgical trauma. Concomitant tricuspid valve reconstruction can also be performed simultaneously through partial upper sternotomy. Nevertheless, minimally invasive LVAD implantation is a challenging operative technique. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals

  13. Morphogenesis and crystallization of ZnS microspheres by a soft template-assisted hydrothermal route: synthesis, growth mechanism, and oxygen sensitivity.

    Science.gov (United States)

    Yang, Liangbao; Han, Jun; Luo, Tao; Li, Minqiang; Huang, Jiarui; Meng, Fanli; Liu, Jinhuai

    2009-01-05

    Almost monodisperse ZnS microspheres have been synthesized on a large scale by a hydrothermal route, in which tungstosilicate acid (TSA) was used as a soft template. By controlling the reaction conditions, such as reaction temperature, pH value of the solutions, and the reaction medium, almost monodisperse microspheres can be synthesized. The structure of these microspheres is sensitive to the reaction conditions. The growth mechanism of these nearly monodisperse microspheres was examined. Oxygen sensing is realized from ZnS microspheres. The current through the ZnS microspheres under UV illumination increases as the oxygen concentration decreases.

  14. Growth mechanism and elemental distribution of beta-Ga2O3 crystalline nanowires synthesized by cobalt-assisted chemical vapor deposition.

    Science.gov (United States)

    Wang, Hui; Lan, Yucheng; Zhang, Jiaming; Crimp, Martin A; Ren, Zhifeng

    2012-04-01

    Long beta-Ga2O3 crystalline nanowires are synthesized on patterned silicon substrates using chemical vapor deposition technique. Advanced electron microscopy indicates that the as-grown beta-Ga2O3 nanowires are consisted of poly-crystalline (Co, Ga)O tips and straight crystalline beta-Ga2O3 stems. The catalytic cobalt not only locates at the nanowire tips but diffuses into beta-Ga2O3 nanowire stems several ten nanometers. A solid diffusion growth mechanism is proposed based on the spatial elemental distribution along the beta-Ga2O3 nanowires at nanoscale.

  15. Dose-response relationship analysis for cancer and circulatory system disease mortality risks among uranium miners

    International Nuclear Information System (INIS)

    Drubay, Damien

    2015-01-01

    The relation between lung cancer risk and radon exposure has been clearly established, especially from the studies on uranium miner cohorts. But the association between radon exposure and extrapulmonary cancers and non-cancer diseases remains not well known. Moreover, the health risks associated with the other mining-related ionizing radiation exposures are still under consideration. The aim of this thesis is to contribute to the estimation of the radio-induced health risks at low-doses through the analysis of the kidney cancer and Circulatory System Disease (CSD) mortality risks among uranium miners. Kidney cancer mortality risk analyses were performed from the French cohort of uranium miners (n=5086; follow-up period: 1946-2007), the post-55 cohort (n=3,377; follow-up period: 1957-2007) and the German cohort of the Wismut (n=58,986; follow-up period: 1946-2003) which included 24, 11 and 174 deaths from kidney cancer, respectively. The exposures to radon and its short-lived progeny (expressed in Working Level Month WLM), to uranium ore dust (kBqh.m -3 ) and to external gamma rays (mSv) were estimated for each miners and the equivalent kidney dose was calculated. The dose-response relation was refined considering two responses: the instantaneous risk of kidney cancer mortality (corresponding to the classical analysis, Cause specific Hazard Ratio (CSHR) estimated with the Cox model) and its occurrence probability during the followup (Sub-distribution Hazard Ratio (SHR) estimated with the Fine and Gray model). An excess of kidney cancer mortality was observed only in the French cohort (SMR = 1.62 CI95%[1.04; 2.41]). In the Wismut cohort, a decrease of the kidney cancer mortality was observed (0.89 [0.78; 0.99]). For these three cohorts, the occupational radiological exposures (or the equivalent kidney dose) were significantly associated neither with the risk of kidney cancer mortality (e.g. CSHRWismut-radon/100 WLM=1.023 [0.993; 1.053]), nor with its occurrence

  16. Particle size effect on microwave absorbing of La0.67Ba0.33Mn0.94Ti0.06O3 powders prepared by mechanical alloying with the assistance of ultrasonic irradiation

    International Nuclear Information System (INIS)

    Saptari, Sitti Ahmiatri; Manaf, Azwar; Kurniawan, Budhy

    2016-01-01

    Doped manganites have attracted substantial interest due to their unique chemical and physics properties, which makes it possible to be used for microwave absorbing materials. In this paper we report synthesizes and characterization of La 0.67 Ba 0.33 Mn 0.94 Ti 0.06 O 3 powders prepared by mechanical alloying with the assistance of a high power ultrasonic treatment. After solid state reaction, the presence of single phase was confirmed by X-ray Diffraction (XRD). Refinement results showed that samples are single phase with monoclinic structure. It was found that powder materials derived from mechanical alloying results in large variation in the particle size. A significant improvement was obtained upon subjecting the mechanically milled powder materials to an ultrasonication treatment for a relatively short period of time. As determined by particle size analyzer (PSA), the mean particle size gradually decreased from the original size of 5.02 µm to 0.36 µm. Magnetic properties were characterized by VSM, and hysteresis loops results showed that samples are soft magnetic. It was found that when the mean particle size decreases, saturation was increases and coersitivity was decreases. Microwave absorption properties were investigated in the frequency range of 8-12 GHz using vector network analyzer. An optimal reflection loss of 24.44 dB is reached at 11.4 GHz.

  17. Mechanical ventilator - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007240.htm Mechanical ventilator - infants To use the sharing features on this page, please enable JavaScript. A mechanical ventilator is a machine that assists with breathing. ...

  18. Ultrasonic-assisted synthesis of polyvinyl alcohol/phytic acid polymer film and its thermal stability, mechanical properties and surface resistivity.

    Science.gov (United States)

    Li, Jihui; Li, Yongshen; Song, Yunna; Niu, Shuai; Li, Ning

    2017-11-01

    In this paper, polyvinyl alcohol/phytic acid polymer (PVA/PA polymer) was synthesized through esterification reaction of PVA and PA in the case of acidity and ultrasound irradiation and characterized, and PVA/PA polymer film was prepared by PVA/PA polymer and characterized, and the influence of dosage of PA on the thermal stability, mechanical properties and surface resistivity of PVA/PA polymer film were researched, and the influence of sonication time on the mechanical properties of PVA/PA polymer film was investigated. Based on those, it was concluded that the hydroxyl group on the chain of PVA and the phosphonic group on PA were connected together in the form of phosphonate bond, and the hydroxyl group on the chain of PVA were connected together in the form of ether bond after the intermolecular dehydration; in the meantime, it was also confirmed that PVA/PA polymer film prepared from 1.20mL of PA not only had the high thermal stability and favorable ductility but also the low surface resistivity in comparison with PVA/PA polymer film with 0.00mL of PA, and the ductility of PVA/PA polymer film was very sensitive to the sonication time. Copyright © 2017. Published by Elsevier B.V.

  19. Nuclear Mechanics in Cancer

    Science.gov (United States)

    Denais, Celine; Lammerding, Jan

    2015-01-01

    Despite decades of research, cancer metastasis remains an incompletely understood process that is as complex as it is devastating. In recent years, there has been an increasing push to investigate the biomechanical aspects of tumorigenesis, complementing the research on genetic and biochemical changes. In contrast to the high genetic variability encountered in cancer cells, almost all metastatic cells are subject to the same physical constraints as they leave the primary tumor, invade surrounding tissues, transit through the circulatory system, and finally infiltrate new tissues. Advances in live cell imaging and other biophysical techniques, including measurements of subcellular mechanics, have yielded stunning new insights into the physics of cancer cells. While much of this research has been focused on the mechanics of the cytoskeleton and the cellular microenvironment, it is now emerging that the mechanical properties of the cell nucleus and its connection to the cytoskeleton may play a major role in cancer metastasis, as deformation of the large and stiff nucleus presents a substantial obstacle during the passage through the dense interstitial space and narrow capillaries. Here, we present an overview of the molecular components that govern the mechanical properties of the nucleus and we discuss how changes in nuclear structure and composition observed in many cancers can modulate nuclear mechanics and promote metastatic processes. Improved insights into this interplay between nuclear mechanics and metastatic progression may have powerful implications in cancer diagnostics and therapy and may reveal novel therapeutic targets for pharmacological inhibition of cancer cell invasion. PMID:24563360

  20. Microwave and ultrasound-assisted synthesis of poly(vinyl chloride)/riboflavin modified MWCNTs: Examination of thermal, mechanical and morphology properties.

    Science.gov (United States)

    Abdolmaleki, Amir; Mallakpour, Shadpour; Azimi, Faezeh

    2018-03-01

    This study focused on the preparation and investigation of physicochemical features of new poly(vinyl chloride) (PVC) nanocomposites (NCs) including different amounts of carboxylated multi-walled carbon nanotubes (MWCNTs-COOH) functionalized with riboflavin (RIB). Firstly, to increase the hydrophilicity of MWCNTs, the surface of them was functionalized by incorporating and formation of ester groups with RIB as a low cost and environmentally friendly biomolecule through ultrasound and microwave irradiations. Afterwards, PVC/RIB-MWCNTs NCs were fabricated via the solution casting and ultrasonic dispersion methods. Prepared NCs were examined by X-ray diffraction, thermogravimetric analysis, field emission scanning electron microscopy, transmission electron micrograph, and Raman spectroscopy. The PVC/RIB-MWCNTs NCs (12wt%) showed the higher mechanical and thermal behavior as compared to other concentration of MWCNTs. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Binding Characteristics of Sphingosine-1-Phosphate to ApoM hints to Assisted Release Mechanism via the ApoM Calyx-Opening

    Science.gov (United States)

    Zhang, Hansi; Pluhackova, Kristyna; Jiang, Zhenyan; Böckmann, Rainer A.

    2016-08-01

    Sphingosine-1-phosphate (S1P) is a lysophospholipid mediator carried by the HDL-associated apoM protein in blood, regulating many physiological processes by activating the G protein-coupled S1P receptor in mammals. Despite the solved crystal structure of the apoM-S1P complex, the mechanism of S1P release from apoM as a part of the S1P pathway is unknown. Here, the dynamics of the wild type apoM-S1P complex as well as of mutants were investigated by means of atomistic molecular dynamics simulations. The potential of mean force for S1P unbinding from apoM reflected a large binding strength of more than 60 kJ/mol. This high unbinding free energy for S1P underlines the observed specificity of the physiological effects of S1P as it suggests that the spontaneous release of S1P from apoM is unlikely. Instead, S1P release and thus the control of this bioactive lipid probably requires the tight interaction with other molecules, e.g. with the S1P receptor. Mutations of specific S1P anchoring residues of apoM decreased the energetic barrier by up to 20 kJ/mol. Moreover, the ligand-free apoM protein is shown to adopt a more open upper hydrophilic binding pocket and to result in complete closure of the lower hydrophobic cavity, suggesting a mechanism for adjusting the gate for ligand access.

  2. Heat Generation in Axial and Centrifugal Flow Left Ventricular Assist Devices.

    Science.gov (United States)

    Yost, Gardner; Joseph, Christine Rachel; Royston, Thomas; Tatooles, Antone; Bhat, Geetha

    Despite increasing use of left ventricular assist devices (LVADs) as a surgical treatment for advanced heart failure in an era of improved outcomes with LVAD support, the mechanical interactions between these pumps and the cardiovascular system are not completely understood. We utilized an in vitro mock circulatory loop to analyze the heat production incurred by operation of an axial flow and centrifugal flow LVAD. A HeartMate II and a HeartWare HVAD were connected to an abbreviated flow loop and were implanted in a viscoelastic gel. Temperature was measured at the surface of each LVAD. Device speed and fluid viscosity were altered and, in the HeartMate II, as artificial thrombi were attached to the inflow stator, impeller, and outflow stator. The surface temperatures of both LVADs increased in all trials and reached a plateau within 80 minutes of flow initiation. Rate of heat generation and maximum system temperature were greater when speed was increased, when viscosity was increased, and when artificial thrombi were attached to the HeartMate II impeller. Normal operation of these two widely utilized LVADs results in appreciable heat generation in vitro. Increased pump loading resulted in more rapid heat generation, which was particularly severe when a large thrombus was attached to the impeller of the HeartMate II. While heat accumulation in vivo is likely minimized by greater dissipation in the blood and soft tissues, focal temperature gains with the pump housing of these two devices during long-term operation may have negative hematological consequences.

  3. Schisandra chinensis peptidoglycan-assisted transmembrane transport of lignans uniquely altered the pharmacokinetic and pharmacodynamic mechanisms in human HepG2 cell model.

    Directory of Open Access Journals (Sweden)

    Charng-Cherng Chyau

    Full Text Available Schisandra chinensis (Turz Baill (S. chinensis (SC fruit is a hepatoprotective herb containing many lignans and a large amount of polysaccharides. A novel polysaccharide (called SC-2 was isolated from SC of MW 841 kDa, which exhibited a protein-to-polysaccharide ratio of 0.4089, and showed a characteristic FTIR spectrum of a peptidoglycan. Powder X-ray diffraction revealed microcrystalline structures within SC-2. SC-2 contained 10 monosaccharides and 15 amino acids (essential amino acids of 78.12%w/w. In a HepG2 cell model, SC-2 was shown by MTT and TUNEL assay to be completely non-cytotoxic. A kinetic analysis and fluorescence-labeling technique revealed no intracellular disposition of SC-2. Combined treatment of lignans with SC-2 enhanced the intracellular transport of schisandrin B and deoxyschisandrin but decreased that of gomisin C, resulting in alteration of cell-killing bioactivity. The Second Law of Thermodynamics allows this type of unidirectional transport. Conclusively, SC-2 alters the transport and cell killing capability by a "Catcher-Pitcher Unidirectional Transport Mechanism".

  4. Residual stress and its effect on the mechanical properties of Y-doped Mg alloy fabricated via back-pressure assisted equal channel angular pressing (ECAP-BP)

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Jianghua, E-mail: j_shen@live.cn [Department of Mechanical Engineering, University of North Carolina at Charlotte, Charlotte, NC 28223-0001 (United States); School of Aeronautics, Northwestern Polytechnical University, Xi’an 710072 (China); Gärtnerová, Viera [Laboratory of Nanostructures and Nanomaterials, Institute of Physics of the ASCR, Na Slovance 2, CZ – 182 21, Prague 8 (Czech Republic); Kecskes, Laszlo J. [US Army Research Laboratory, Aberdeen Proving Ground, MD 21005-5069 (United States); Kondoh, Katsuyoshi [Joining and Welding Research Institute, Osaka University, 11-1 Mihogaoka, Ibaragi, Osaka 567-0047 (Japan); Jäger, Aleš, E-mail: jager@fzu.cz [Laboratory of Nanostructures and Nanomaterials, Institute of Physics of the ASCR, Na Slovance 2, CZ – 182 21, Prague 8 (Czech Republic); Wei, Qiuming [Department of Mechanical Engineering, University of North Carolina at Charlotte, Charlotte, NC 28223-0001 (United States)

    2016-07-04

    In this study, pure magnesium (Mg) and Mg-0.6 wt% yttrium (Y) binary alloy were fabricated via casting followed by room temperature equal channel angular pressing (ECAP) using an applied back pressure (BP). Microstructural examination after ECAP-BP revealed a fine-grained Mg-Y alloy with a high residual stress level, whereas, the pure Mg exhibited a well-recrystallized microstructure with uniform and equiaxed grains, but retaining very little residual stress. The Y atoms were present in the Mg matrix as solid solutes and acted as dislocation and grain boundary blockers, thus suppressing dynamic recovery and/or recrystallization during the ECAP process. The Mg-Y alloy had an average grain size of ~400 nm, approximately one order smaller than that of pure Mg. The combination of high residual stress and ultrafine grains of the Mg-Y alloy gave rise to a significant difference in its mechanical behavior from that of the pure Mg, under both quasi-static and dynamic compressive loading.

  5. Sodium bicarbonate use and the risk of hypernatremia in thoracic aortic surgical patients with metabolic acidosis following deep hypothermic circulatory arrest

    Directory of Open Access Journals (Sweden)

    Kamrouz Ghadimi

    2016-01-01

    Full Text Available Objective: Metabolic acidosis after deep hypothermic circulatory arrest (DHCA for thoracic aortic operations is commonly managed with sodium bicarbonate (NaHCO 3 . The purpose of this study was to determine the relationships between total NaHCO 3 dose and the severity of metabolic acidosis, duration of mechanical ventilation, duration of vasoactive infusions, and Intensive Care Unit (ICU or hospital length of stay (LOS. Methods: In a single center, retrospective study, 87 consecutive elective thoracic aortic operations utilizing DHCA, were studied. Linear regression analysis was used to test for the relationships between the total NaHCO 3 dose administered through postoperative day 2, clinical variables, arterial blood gas values, and short-term clinical outcomes. Results: Seventy-five patients (86% received NaHCO 3 . Total NaHCO 3 dose averaged 136 ± 112 mEq (range: 0.0-535 mEq per patient. Total NaHCO 3 dose correlated with minimum pH (r = 0.41, P < 0.0001, minimum serum bicarbonate (r = −0.40, P < 0.001, maximum serum lactate (r = 0.46, P = 0.007, duration of metabolic acidosis (r = 0.33, P = 0.002, and maximum serum sodium concentrations (r = 0.29, P = 0.007. Postoperative hypernatremia was present in 67% of patients and peaked at 12 h following DHCA. Eight percent of patients had a serum sodium ≥ 150 mEq/L. Total NaHCO 3 dose did not correlate with anion gap, serum chloride, not the duration of mechanical ventilator support, vasoactive infusions, ICU or hospital LOS. Conclusion: Routine administration of NaHCO 3 was common for the management of metabolic acidosis after DHCA. Total dose of NaHCO 3 was a function of the severity and duration of metabolic acidosis. NaHCO 3 administration contributed to postoperative hypernatremia that was often severe. The total NaHCO 3 dose administered was unrelated to short-term clinical outcomes.

  6. Enhanced mechanical properties and cytocompatibility of electrospun poly(L-lactide) composite fiber membranes assisted by polydopamine-coated halloysite nanotubes

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Chuang; Zou, Ziping [Biomaterial Research Laboratory, Department of Material Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632 (China); Luo, Binghong, E-mail: tluobh@jnu.edu.cn [Biomaterial Research Laboratory, Department of Material Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632 (China); Engineering Research Center of Artificial Organs and Materials, Ministry of Education, Guangzhou 510632 (China); Wen, Wei [Biomaterial Research Laboratory, Department of Material Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632 (China); Engineering Research Center of Artificial Organs and Materials, Ministry of Education, Guangzhou 510632 (China); Li, Huihua [Biomaterial Research Laboratory, Department of Material Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632 (China); Liu, Mingxian [Biomaterial Research Laboratory, Department of Material Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632 (China); Engineering Research Center of Artificial Organs and Materials, Ministry of Education, Guangzhou 510632 (China); Zhou, Changren, E-mail: tcrz9@jnu.edu.cn [Biomaterial Research Laboratory, Department of Material Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632 (China); Engineering Research Center of Artificial Organs and Materials, Ministry of Education, Guangzhou 510632 (China)

    2016-04-30

    Graphical abstract: - Highlights: • D-HNTs was prepared by a facile approach based on the self-polymerization of DOPA. • The D-HNTs can disperse more uniformly in PLLA matrix than untreated HNTs. • The interfacial adhesion between D-HNTs and PLLA matrix was obviously improved. • D-HNTs/PLLA fiber membrane has better tensile properties compared with HNTs/PLLA. • The D-HNTs/PLLA fiber membrane is favorable to cell adhesion and proliferation. - Abstract: To improve the dispersion and interfacial interaction between halloysite nanotubes (HNTs) and poly(L-lactide) (PLLA) matrix, and hence to increase the mechanical properties and cytocompatibility of the HNTs/PLLA composite, a facile approach was developed to prepare polydopamine-coated HNTs (D-HNTs) by the self-polymerization of dopamine (DOPA), and then HNTs and D-HNTs were further introduced into PLLA matrix to fabricate HNTs/PLLA and D-HNTs/PLLA fiber membranes based on electrospinning technique. The successful immobilization of the polydopamine (PDOPA) coating on the surfaces of HNTs was confirmed, and such PDOPA coating played an important role in improving the interfacial interaction between the nanotubes and PLLA matrix. The D-HNTs were dispersed in the matrix more uniformly than untreated HNTs, and relative smooth and uniform fiber were obtained for the D-HNTs/PLLA fiber membrane. As a result, the tensile strength and modulus of the D-HNTs/PLLA fiber membrane were obviously superior to those of the HNTs/PLLA fiber membrane. Cell culture results revealed that D-HNTs/PLLA fiber membrane was more effectively to promote MC3T3-E1 cells adhesion and proliferation than neat PLLA and HNTs/PLLA fiber membrane.

  7. Enhanced mechanical properties and cytocompatibility of electrospun poly(L-lactide) composite fiber membranes assisted by polydopamine-coated halloysite nanotubes

    International Nuclear Information System (INIS)

    Luo, Chuang; Zou, Ziping; Luo, Binghong; Wen, Wei; Li, Huihua; Liu, Mingxian; Zhou, Changren

    2016-01-01

    Graphical abstract: - Highlights: • D-HNTs was prepared by a facile approach based on the self-polymerization of DOPA. • The D-HNTs can disperse more uniformly in PLLA matrix than untreated HNTs. • The interfacial adhesion between D-HNTs and PLLA matrix was obviously improved. • D-HNTs/PLLA fiber membrane has better tensile properties compared with HNTs/PLLA. • The D-HNTs/PLLA fiber membrane is favorable to cell adhesion and proliferation. - Abstract: To improve the dispersion and interfacial interaction between halloysite nanotubes (HNTs) and poly(L-lactide) (PLLA) matrix, and hence to increase the mechanical properties and cytocompatibility of the HNTs/PLLA composite, a facile approach was developed to prepare polydopamine-coated HNTs (D-HNTs) by the self-polymerization of dopamine (DOPA), and then HNTs and D-HNTs were further introduced into PLLA matrix to fabricate HNTs/PLLA and D-HNTs/PLLA fiber membranes based on electrospinning technique. The successful immobilization of the polydopamine (PDOPA) coating on the surfaces of HNTs was confirmed, and such PDOPA coating played an important role in improving the interfacial interaction between the nanotubes and PLLA matrix. The D-HNTs were dispersed in the matrix more uniformly than untreated HNTs, and relative smooth and uniform fiber were obtained for the D-HNTs/PLLA fiber membrane. As a result, the tensile strength and modulus of the D-HNTs/PLLA fiber membrane were obviously superior to those of the HNTs/PLLA fiber membrane. Cell culture results revealed that D-HNTs/PLLA fiber membrane was more effectively to promote MC3T3-E1 cells adhesion and proliferation than neat PLLA and HNTs/PLLA fiber membrane.

  8. Magnetic properties and coercivity mechanism of Sm{sub 1-x}Pr{sub x}Co{sub 5} (x=0-0.6) nanoflakes prepared by surfactant-assisted ball milling

    Energy Technology Data Exchange (ETDEWEB)

    Xu, M. L.; Yue, M., E-mail: yueming@bjut.edu.cn; Wu, Q.; Li, Y. Q.; Lu, Q. M. [College of Materials Science and Engineering, Beijing University of Technology, Beijing 100124 (China)

    2016-05-15

    Sm{sub 1-x}Pr{sub x}Co{sub 5} (x=0-0.6) nanoflakes with CaCu{sub 5} structure were successfully prepared by surfactant-assisted high-energy ball milling (SAHEBM). The crystal structure and magnetic properties of Sm{sub 1-x}Pr{sub x}Co{sub 5} (x=0-0.6) nanoflakes were studied by X-ray diffraction and vibrating sample magnetometer. Effects of Pr addition on the structure, magnetic properties and coercivity mechanism of Sm{sub 1-x}Pr{sub x}Co{sub 5} nanoflakes were systematically investigated. XRD results show that all the nanoflakes have a hexagonal CaCu{sub 5}-type (Sm, Pr){sub 1}Co{sub 5} main phase and the (Sm, Pr){sub 2}Co{sub 7} impurity phase, and all of the samples exhibit a strong (00l) texture after magnetic alignment. As the Pr content increases, remanence firstly increases, then slightly reduced, while anisotropy field (H{sub A}) and H{sub ci} of decrease monotonically. Maximum energy product [(BH){sub max}] of the flakes increases first, peaks at 24.4 MGOe with Pr content of x = 0.4, then drops again. Magnetization behavior analysis indicate that the coercivity mechanism is mainly controlled by inhomogeneous domain wall pinning, and the pinning strength weakens with the increased Pr content, suggesting the great influence of H{sub A} on the coercivity of flakes.

  9. Mechanism-Based Modeling of Hydrogen Environment Assisted Cracking (HEAC) in High Strength Alloys for Marine Applications: Prediction of Monel K-500 HEAC for Select Environmental and Mechanical Conditions

    Science.gov (United States)

    2012-10-15

    0.45 .015 .0005 Si = 0.08, Cr = 0.04, Zr = 0.03, Nb , Ta, W, V < 0.01, Bi, Pb, Ag, Sn< 0.0005 wt pet Page | 7 Table 2. Mechanical Properties...analysis and contribute to dcPD increase due to plasticity-based resistivity increase. Additionally, crack surface electrical contact which changes during...STTR-II sponsored). Task 2-3 Produce laboratory measurements of HEAC resistance (KIH, da/dtn, and da/dt vs. stress intensity factor) for a single

  10. KLK5 induces shedding of DPP4 from circulatory Th17 cells in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Titli Nargis

    2017-11-01

    Conclusions: Our study provides mechanistic insights into the molecular interaction between KLK5 and DPP4 as well as CD4+ T cell derived KLK5 mediated enzymatic cleavage of DPP4 from cell surface. Thus, our study uncovers a hitherto unknown cellular source and mechanism behind enhanced plasma DPP4 activity in T2DM.

  11. Circulatory response evoked by a 3 s bout of dynamic leg exercise in humans

    NARCIS (Netherlands)

    Wieling, W.; Harms, M. P.; ten Harkel, A. D.; van Lieshout, J. J.; Sprangers, R. L.

    1996-01-01

    1. The mechanisms underlying the pronounced transient fall in arterial blood pressure evoked by a 3 s bout of bicycle exercise were investigated in twenty healthy young adults and four patients with hypoadrenergic orthostatic hypotension. 2. In healthy subjects a 3 s bout of upright cycling induced

  12. Regional perfusion by extracorporeal membrane oxygenation of abdominal organs from donors after circulatory death: a systematic review.

    Science.gov (United States)

    Shapey, Iestyn M; Muiesan, Paolo

    2013-12-01

    Organs from donors after circulatory death (DCDs) are particularly susceptible to the effects of warm ischemia injury. Regional perfusion (RP) by extracorporeal membrane oxygenation (ECMO) is increasingly being advocated as a useful remedy to the effects of ischemia/reperfusion injury, and it has been reported to enable the transplantation of organs from donors previously deemed unsuitable. The MEDLINE, Embase, and Cochrane databases were searched, and articles published between 1997 and 2013 were obtained. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two hundred ten articles were identified, and 11 were eligible for inclusion. Four hundred eighty-two kidneys and 79 livers were transplanted from regional perfusion-supported donor after circulatory death (RP-DCD) sources. One-year graft survival was lower with uncontrolled RP-DCD liver transplantation, whereas 1-year patient survival was similar. Primary nonfunction and ischemic cholangiopathy were significantly more frequent with RP-DCDs versus donors after brain death (DBDs), but there was no difference in postoperative mortality between the 2 groups. The 1-year patient and graft survival rates for RP-DCD kidney transplantation were better than the rates with standard DCDs and were comparable to, if not better than, the rates with DBDs. At experienced centers, delayed graft function (DGF) for kidney transplantation from RP-DCDs was much less frequent in comparison with all other donor types. In conclusion, RP aids the recovery of DCD organs from ischemic injury and enables transplantation with acceptable survival. RP may help to increase the donor pool, but its benefits must still be balanced with the recognition of significantly higher rates of complications in liver transplantation. In kidney transplantation, significant reductions in DGF can be obtained with RP, and there are potentially important implications for long

  13. Life expectancy and death by diseases of the circulatory system in patients with bipolar disorder or schizophrenia in the Nordic countries

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk; Wahlbeck, Kristian; Hällgren, Jonas

    2013-01-01

    Excess mortality from diseases and medical conditions (natural death) in persons with psychiatric disorders has been extensively reported. Even in the Nordic countries with well-developed welfare systems, register based studies find evidence of an excess mortality. In recent years, cardiac...... mortality and death by diseases of the circulatory system has seen a decline in all the Nordic countries, but a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular...... disease. The aim of this study was to compare the mortality by diseases of the circulatory system among patients with bipolar disorder or schizophrenia in the three Nordic countries Denmark, Sweden, and Finland. Furthermore, the aim was to examine and compare life expectancy among these patients. Cause...

  14. Is there an association of circulatory hospitalizations independent of mining employment in coal-mining and non-coal-mining counties in west virginia?

    Science.gov (United States)

    Talbott, Evelyn O; Sharma, Ravi K; Buchanich, Jeanine; Stacy, Shaina L

    2015-04-01

    Exposures associated with coal mining activities, including diesel fuel exhaust, products used in coal processing, and heavy metals and other forms of particulate matter, may impact the health of nearby residents. We investigated the relationships between county-level circulatory hospitalization rates (CHRs) in coal and non-coal-mining communities of West Virginia, coal production, coal employment, and sociodemographic factors. Direct age-adjusted CHRs were calculated using West Virginia hospitalizations from 2005 to 2009. Spatial regressions were conducted to explore associations between CHR and total, underground, and surface coal production. After adjustment, neither total, nor surface, nor underground coal production was significantly related to rate of hospitalization for circulatory disease. Our findings underscore the significant role sociodemographic and behavioral factors play in the health and well-being of coal mining communities.

  15. Mesenchymal stromal cell-derived extracellular vesicles attenuate lung ischemia-reperfusion injury and enhance reconditioning of donor lungs after circulatory death.

    Science.gov (United States)

    Stone, Matthew L; Zhao, Yunge; Robert Smith, J; Weiss, Mark L; Kron, Irving L; Laubach, Victor E; Sharma, Ashish K

    2017-12-21

    Lung ischemia-reperfusion (IR) injury after transplantation as well as acute shortage of suitable donor lungs are two critical issues impacting lung transplant patients. This study investigates the anti-inflammatory and immunomodulatory role of human mesenchymal stromal cells (MSCs) and MSC-derived extracellular vesicles (EVs) to attenuate lung IR injury and improve of ex-vivo lung perfusion (EVLP)-mediated rehabilitation in donation after circulatory death (DCD) lungs. C57BL/6 wild-type (WT) mice underwent sham surgery or lung IR using an in vivo hilar-ligation model with or without MSCs or EVs. In vitro studies used primary iNKT cells and macrophages (MH-S cells) were exposed to hypoxia/reoxygenation with/without co-cultures with MSCs or EVs. Also, separate groups of WT mice underwent euthanasia and 1 h of warm ischemia and stored at 4 °C for 1 h followed by 1 h of normothermic EVLP using Steen solution or Steen solution containing MSCs or EVs. Lungs from MSCs or EV-treated mice had significant attenuation of lung dysfunction and injury (decreased edema, neutrophil infiltration and myeloperoxidase levels) compared to IR alone. A significant decrease in proinflammatory cytokines (IL-17, TNF-α, CXCL1 and HMGB1) and upregulation of keratinocyte growth factor, prostaglandin E2 and IL-10 occurred in the BAL fluid from MSC or EV-treated mice after IR compared to IR alone. Furthermore, MSCs or EVs significantly downregulated iNKT cell-produced IL-17 and macrophage-produced HMGB1 and TNF-α after hypoxia/reoxygenation. Finally, EVLP of DCD lungs with Steen solution including MSCs or EVs provided significantly enhanced protection versus Steen solution alone. Co-cultures of MSCs or EVs with lung endothelial cells prevents neutrophil transendothelial migration after exposure to hypoxia/reoxygenation and TNF-α/HMGB1 cytomix. These results suggest that MSC-derived EVs can attenuate lung inflammation and injury after IR as well as enhance EVLP-mediated reconditioning of

  16. Utilization of organs from donors after circulatory death for vascularized pancreas and islet of Langerhans transplantation: recommendations from an expert group.

    Science.gov (United States)

    Berney, Thierry; Boffa, Catherine; Augustine, Titus; Badet, Lionel; de Koning, Eelco; Pratschke, Johann; Socci, Carlo; Friend, Peter

    2016-07-01

    Donation after circulatory death (DCD) donors are increasingly being used as a source of pancreas allografts for vascularized organ and islet transplantation. We provide practice guidelines aiming to increase DCD pancreas utilization. We review risk assessment and donor selection criteria. We report suggested factors in donor and recipient clinical management and provide an overview of the activities and outcomes of vascularized pancreas and islet transplantation. © 2015 Steunstichting ESOT.

  17. Alkaline Phosphatase for the Prevention of Intestinal and Renal Injury in a Rat Model of Cardiopulmonary Bypass with Deep Hypothermic Circulatory Arrest

    Science.gov (United States)

    2017-09-01

    prevention of intestinal and kidney injury after pediatric cardiopulmonary bypass with deep hypothermic circulatory arrest. In this model, we place 5-10kg...first abstract submissions to either Pediatric Academic Society or American Thoracic Society meetings by November. Secondary analysis of serum...rats. Transition to the piglet model also had multiple benefits beyond greater consistency of surgical approach. We now have a true pediatric model and

  18. Exoskeleton plantarflexion assistance for elderly.

    Science.gov (United States)

    Galle, S; Derave, W; Bossuyt, F; Calders, P; Malcolm, P; De Clercq, D

    2017-02-01

    Elderly are confronted with reduced physical capabilities and increased metabolic energy cost of walking. Exoskeletons that assist walking have the potential to restore walking capacity by reducing the metabolic cost of walking. However, it is unclear if current exoskeletons can reduce energy cost in elderly. Our goal was to study the effect of an exoskeleton that assists plantarflexion during push-off on the metabolic energy cost of walking in physically active and healthy elderly. Seven elderly (age 69.3±3.5y) walked on treadmill (1.11ms 2 ) with normal shoes and with the exoskeleton both powered (with assistance) and powered-off (without assistance). After 20min of habituation on a prior day and 5min on the test day, subjects were able to walk with the exoskeleton and assistance of the exoskeleton resulted in a reduction in metabolic cost of 12% versus walking with the exoskeleton powered-off. Walking with the exoskeleton was perceived less fatiguing for the muscles compared to normal walking. Assistance resulted in a statistically nonsignificant reduction in metabolic cost of 4% versus walking with normal shoes, likely due to the penalty of wearing the exoskeleton powered-off. Also, exoskeleton mechanical power was relatively low compared to previously identified optimal assistance magnitude in young adults. Future exoskeleton research should focus on further optimizing exoskeleton assistance for specific populations and on considerate integration of exoskeletons in rehabilitation or in daily life. As such, exoskeletons should allow people to walk longer or faster than without assistance and could result in an increase in physical activity and resulting health benefits. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Minimal alteration in the ratio of circulatory fetal DNA to fetal corticotropin-releasing hormone mRNA level in preeclampsia.

    Science.gov (United States)

    Zhong, Xiao Yan; Holzgreve, Wolfgang; Gebhardt, Stefan; Hillermann, Renate; Tofa, Kashefa Carelse; Gupta, Anurag Kumar; Huppertz, Berthold; Hahn, Sinuhe

    2006-01-01

    We have recently observed that fetal DNA and fetal corticotropin-releasing hormone (CRH) mRNA are associated with in vitro generated syncytiotrophoblast-derived microparticles, and that the ratio of fetal DNA to mRNA (CRH) varied according to whether the particles were derived by predominantly apoptotic, apo-necrotic or necrotic pathways. Hence, we examined whether these ratios varied in maternal plasma samples taken from normotensive and preeclamptic pregnancies in vivo. Maternal plasma samples were collected from 18 cases with preeclampsia and 29 normotensive term controls. Circulatory fetal CRH mRNA and DNA levels were quantified by real-time PCR and RT-PCR. Circulatory fetal mRNA and fetal DNA levels were significantly elevated in the preeclampsia study group when compared to normotensive controls. Alterations in the fetal mRNA to DNA ratio between the study and control groups were minimal, even when stratified into early (34 weeks of gestation) onset preeclampsia. Our data suggest that although circulatory fetal DNA and mRNA levels are significantly elevated in preeclampsia, the ratios in maternal plasma are not dramatically altered. Copyright 2006 S. Karger AG, Basel.

  20. The role of perfusion lung scanning and diffusion capacity for early diagnosis of micro circulatory disturbances in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Petrova, D.; Shoshlov, P.; Hadjikostova, H.

    2002-01-01

    The development of chronic obstructive pulmonary disease (COPD) and the frequent inflammatory exacerbations with development of respiratory failure lead to changes in the micro circulatory and an increased risk of lung thrombotic and thromboembolic complication. The aim of the study was to establish the possibility of the perfusion lung scanning and diffusion capacity for early diagnosis of pulmonary micro circulatory disturbances in COPD with mild and moderate respiratory failure. 59 COPD patients were investigated. The data presented significant segmental disorders. Only in 5 (8.47%) of them the perfusion lung scintigrams were normal. In 23 of the patients, single-breath diffusing capacity (DICO) and its two components: membranous component (Dm) and capillary blood component (Vc) were determined. DICO was lower especially Vc the mean sign of micro circulatory disorders. A relationship between the degree of hypoxaemia and the changes found in the perfusion scintigraphy was found. Changes in the pulmonary lung scanning and in the diffusion capacity in COPD with mild respiratory failure seem to be an early diagnostic test. The early anticoagulant and desaggregant prevention may decrease the risk of thrombotic complications in the development of the disease. (authors)

  1. Potential therapeutic agents for circulatory diseases from Bauhinia glauca Benth.subsp. pernervosa. (Da Ye Guan Men).

    Science.gov (United States)

    Tang, Yingzhan; Ling, Junhong; Zhang, Peng; Zhang, Xiangrong; Zhang, Na; Wang, Wenli; Li, Jiayuan; Li, Ning

    2015-08-15

    Because of platelets as critical factor in the formation of pathogenic thrombi, anti-platelet activities have been selected as therapeutic target for various circulatory diseases. In order to find potential therapeutic agents, bioassay-directed separation of Bauhinia glauca Benth.subsp. pernervosa. (called Da Ye Guan Men as a traditional Chinese medicine) was performed to get 29 main components (compounds 1-29) from the bioactive part of this herbal. It was the first time to focus on the composition with anti-platelet aggregation activities for this traditional Chinese medicine. The constituents, characterized from the effective extract, were established on the basis of extensive spectral data analysis. Then their anti-platelet aggregation effects were evaluated systematically. On the basis of the chemical profile and biological assay, it was suggested that the flavonoid composition (5 and 18) should be responsible for the anti-platelet aggregation of the herbal because of their significant activities. The primary structure and activity relationship was also discussed briefly. Copyright © 2015. Published by Elsevier Ltd.

  2. ASSOCIATIONS BETWEEN MACULAR EDEMA AND CIRCULATORY STATUS IN EYES WITH RETINAL VEIN OCCLUSION: An Adaptive Optics Scanning Laser Ophthalmoscopy Study.

    Science.gov (United States)

    Iida, Yuto; Muraoka, Yuki; Uji, Akihito; Ooto, Sotaro; Murakami, Tomoaki; Suzuma, Kiyoshi; Tsujikawa, Akitaka; Arichika, Shigeta; Takahashi, Ayako; Miwa, Yuko; Yoshimura, Nagahisa

    2017-10-01

    To investigate associations between parafoveal microcirculatory status and foveal pathomorphology in eyes with macular edema (ME) secondary to retinal vein occlusion (RVO). Ten consecutive patients (10 eyes) with acute retinal vein occlusion were enrolled, 9 eyes of which received intravitreal ranibizumab (IVR) injections. Foveal morphologic changes were examined via optical coherence tomography (OCT), and parafoveal circulatory status was assessed via adaptive optics scanning laser ophthalmoscopy (AO-SLO). The mean parafoveal aggregated erythrocyte velocity (AEV) measured by adaptive optics scanning laser ophthalmoscopy in eyes with retinal vein occlusion was 0.99 ± 0.43 mm/second at baseline, which was significantly lower than that of age-matched healthy subjects (1.41 ± 0.28 mm/second, P = 0.042). The longitudinal adaptive optics scanning laser ophthalmoscopy examinations of each patient showed that parafoveal AEV was strongly inversely correlated with optical coherence tomography-measured central foveal thickness (CFT) over the entire observation period. Using parafoveal AEV and central foveal thickness measurements obtained at the first and second examinations, we investigated associations between differences in parafoveal AEV and central foveal thickness, which were significantly and highly correlated (r = -0.84, P = 0.002). Using adaptive optics scanning laser ophthalmoscopy in eyes with retinal vein occlusion macular edema, we could quantitatively evaluate the parafoveal AEV. A reduction or an increase in parafoveal AEV may be a clinical marker for the resolution or development/progression of macular edema respectively.

  3. Progression of Mortality due to Diseases of the Circulatory System and Human Development Index in Rio de Janeiro Municipalities

    Directory of Open Access Journals (Sweden)

    Gabriel Porto Soares

    Full Text Available Abstract Background: Diseases of the circulatory system (DCS are the major cause of death in Brazil and worldwide. Objective: To correlate the compensated and adjusted mortality rates due to DCS in the Rio de Janeiro State municipalities between 1979 and 2010 with the Human Development Index (HDI from 1970 onwards. Methods: Population and death data were obtained in DATASUS/MS database. Mortality rates due to ischemic heart diseases (IHD, cerebrovascular diseases (CBVD and DCS adjusted by using the direct method and compensated for ill-defined causes. The HDI data were obtained at the Brazilian Institute of Applied Research in Economics. The mortality rates and HDI values were correlated by estimating Pearson linear coefficients. The correlation coefficients between the mortality rates of census years 1991, 2000 and 2010 and HDI data of census years 1970, 1980 and 1991 were calculated with discrepancy of two demographic censuses. The linear regression coefficients were estimated with disease as the dependent variable and HDI as the independent variable. Results: In recent decades, there was a reduction in mortality due to DCS in all Rio de Janeiro State municipalities, mainly because of the decline in mortality due to CBVD, which was preceded by an elevation in HDI. There was a strong correlation between the socioeconomic indicator and mortality rates. Conclusion: The HDI progression showed a strong correlation with the decline in mortality due to DCS, signaling to the relevance of improvements in life conditions.

  4. Hypothermic oxygenated machine perfusion reduces bile duct reperfusion injury after transplantation of donation after circulatory death livers

    Science.gov (United States)

    van Rijn, Rianne; van Leeuwen, Otto B.; Matton, Alix P. M.; Burlage, Laura C.; Wiersema‐Buist, Janneke; van den Heuvel, Marius C.; de Kleine, Ruben H. J.; de Boer, Marieke T.; Gouw, Annette S. H.

    2018-01-01

    Dual hypothermic oxygenated machine perfusion (DHOPE) of the liver has been advocated as a method to reduce ischemia/reperfusion injury (IRI). This study aimed to determine whether DHOPE reduces IRI of the bile ducts in donation after circulatory death (DCD) liver transplantation. In a recently performed phase 1 trial, 10 DCD livers were preserved with DHOPE after static cold storage (SCS; http://www.trialregister.nl NTR4493). Bile duct biopsies were obtained at the end of SCS (before DHOPE; baseline) and after graft reperfusion in the recipient. Histological severity of biliary injury was graded according to an established semiquantitative grading system. Twenty liver transplantations using DCD livers not preserved with DHOPE served as controls. Baseline characteristics and the degree of bile duct injury at baseline (end of SCS) were similar between both groups. In controls, the degree of stroma necrosis (P = 0.002) and injury of the deep peribiliary glands (PBG; P = 0.02) increased after reperfusion compared with baseline. In contrast, in DHOPE‐preserved livers, the degree of bile duct injury did not increase after reperfusion. Moreover, there was less injury of deep PBG (P = 0.04) after reperfusion in the DHOPE group compared with controls. In conclusion, this study suggests that DHOPE reduces IRI of bile ducts after DCD liver transplantation. Liver Transplantation 24 655–664 2018 AASLD. PMID:29369470

  5. Tension pneumomediastnum: A rare cause of acute intraoperative circulatory collapse in the setting of unremarkable TEE findings.

    Science.gov (United States)

    Weaver, Jonathan B; Kumar, Avinash B

    2017-02-01

    Case report. Operating room. 25YF, ASA IV E who underwent an emergent decompressive craniectomy for refractory intracranial hypertension secondary to acute intracranial hemorhage. A 25Y caucasian female presented with acute intracranial hemorrhage with intraventricular extension secondary to Moya Moya disease. Post admisison, she underwent an emergent decompressive craniectomy for medically refractory intracranial hypertension. Introperatively (post dural closure and bone flap removal) the patient developed acutely worsening peak and plateau pressures followed by pulseless electrical activity necessitating CPR with epinephrine and Vasopressin before return of circulation before return of circulation. Intraoperative TEE done during return of circulation, was essentially non diagnostic, the patient had normal breath sounds throughout, and non-contributory bronchoscopy findings. EKG, arterial blood pressure, heart rate, resp. rate, introperative tranesophageal echocardiogram (TEE), Pulse oximetry, serial arterial blood gases, introperative bronchoscopy, ventilatory peak pressures. A post operative chest CT revealed extensive pneumomediastinum with subcutaneous emphysema. The focussed introperative echocardiogram showed preserved left ventricular function and no evidence of tamponade physiology. Tension pneumomediastinum was the likely etiologic factor for the acute hemodynamic collapse and should be considered in the differential diagnosis of intraoperative circulatory arrest. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Chronic Deep Brain Stimulation of the Hypothalamic Nucleus in Wistar Rats Alters Circulatory Levels of Corticosterone and Proinflammatory Cytokines

    Science.gov (United States)

    Calleja-Castillo, Juan Manuel; De La Cruz-Aguilera, Dora Luz; Manjarrez, Joaquín; Velasco-Velázquez, Marco Antonio; Morales-Espinoza, Gabriel; Moreno-Aguilar, Julia; Hernández, Maria Eugenia; Aguirre-Cruz, Lucinda

    2013-01-01

    Deep brain stimulation (DBS) is a therapeutic option for several diseases, but its effects on HPA axis activity and systemic inflammation are unknown. This study aimed to detect circulatory variations of corticosterone and cytokines levels in Wistar rats, after 21 days of DBS-at the ventrolateral part of the ventromedial hypothalamic nucleus (VMHvl), unilateral cervical vagotomy (UCVgX), or UCVgX plus DBS. We included the respective control (C) and sham (S) groups (n = 6 rats per group). DBS treated rats had higher levels of TNF-α (120%; P < 0.01) and IFN-γ (305%; P < 0.001) but lower corticosterone concentration (48%; P < 0.001) than C and S. UCVgX animals showed increased corticosterone levels (154%; P < 0.001) versus C and S. UCVgX plus DBS increased IL-1β (402%; P < 0.001), IL-6 (160%; P < 0.001), and corsticosterone (178%; P < 0.001 versus 48%; P < 0.001) compared with the C and S groups. Chronic DBS at VMHvl induced a systemic inflammatory response accompanied by a decrease of HPA axis function. UCVgX rats experienced HPA axis hyperactivity as result of vagus nerve injury; however, DBS was unable to block the HPA axis hyperactivity induced by unilateral cervical vagotomy. Further studies are necessary to explore these findings and their clinical implication. PMID:24235973

  7. Receptor-mediated oral delivery of a bioencapsulated green fluorescent protein expressed in transgenic chloroplasts into the mouse circulatory system.

    Science.gov (United States)

    Limaye, Arati; Koya, Vijay; Samsam, Mohtashem; Daniell, Henry

    2006-05-01

    Oral delivery of biopharmaceutical proteins expressed in plant cells should reduce their cost of production, purification, processing, cold storage, transportation, and delivery. However, poor intestinal absorption of intact proteins is a major challenge. To overcome this limitation, we investigate here the concept of receptor-mediated oral delivery of chloroplast-expressed foreign proteins. Therefore, the transmucosal carrier cholera toxin B-subunit and green fluorescent protein (CTB-GFP), separated by a furin cleavage site, was expressed via the tobacco chloroplast genome. Polymerase chain reaction (PCR) and Southern blot analyses confirmed site-specific transgene integration and homoplasmy. Immunoblot analysis and ELISA confirmed expression of monomeric and pentameric forms of CTB-GFP, up to 21.3% of total soluble proteins. An in vitro furin cleavage assay confirmed integrity of the engineered furin cleavage site, and a GM1 binding assay confirmed the functionality of CTB-GFP pentamers. Following oral administration of CTB-GFP expressing leaf material to mice, GFP was observed in the mice intestinal mucosa, liver, and spleen in fluorescence and immunohistochemical studies, while CTB remained in the intestinal cell. This report of receptor-mediated oral delivery of a foreign protein into the circulatory system opens the door for low-cost production and delivery of human therapeutic proteins.

  8. Progression of Mortality due to Diseases of the Circulatory System and Human Development Index in Rio de Janeiro Municipalities

    Science.gov (United States)

    Soares, Gabriel Porto; Klein, Carlos Henrique; Silva, Nelson Albuquerque de Souza e; de Oliveira, Glaucia Maria Moraes

    2016-01-01

    Background Diseases of the circulatory system (DCS) are the major cause of death in Brazil and worldwide. Objective To correlate the compensated and adjusted mortality rates due to DCS in the Rio de Janeiro State municipalities between 1979 and 2010 with the Human Development Index (HDI) from 1970 onwards. Methods Population and death data were obtained in DATASUS/MS database. Mortality rates due to ischemic heart diseases (IHD), cerebrovascular diseases (CBVD) and DCS adjusted by using the direct method and compensated for ill-defined causes. The HDI data were obtained at the Brazilian Institute of Applied Research in Economics. The mortality rates and HDI values were correlated by estimating Pearson linear coefficients. The correlation coefficients between the mortality rates of census years 1991, 2000 and 2010 and HDI data of census years 1970, 1980 and 1991 were calculated with discrepancy of two demographic censuses. The linear regression coefficients were estimated with disease as the dependent variable and HDI as the independent variable. Results In recent decades, there was a reduction in mortality due to DCS in all Rio de Janeiro State municipalities, mainly because of the decline in mortality due to CBVD, which was preceded by an elevation in HDI. There was a strong correlation between the socioeconomic indicator and mortality rates. Conclusion The HDI progression showed a strong correlation with the decline in mortality due to DCS, signaling to the relevance of improvements in life conditions. PMID:27849263

  9. C-reactive protein, Rheumatoid factor and circulatory immune complex as markers for monitoring treatment of infective endocarditis

    International Nuclear Information System (INIS)

    Alavi, S.M.; Ahmadi, F.; Nashibi, R.

    2010-01-01

    Objectives: To evaluate the diagnostic usefulness of serum C-reactive protein (CRP), rheumatoid factor (RF) and circulatory immune complex (CIC) determinations in monitoring the outcome of infective endocarditis (IE). Methodology: In this prospective analytic descriptive study CRP, RF and CIC were measured on admission and 4 weeks after initiation of standard antibiotic regimen in 30 hospitalized patients with IE in an educational hospital between 2006 and 2007 in Ahvaz a city south west Iran . Duke criteria were used for diagnosis of IE. CRP and RF were examined using quantitative neflometry (Binding site kit, UK) and CIC was detected by semi quantitative immune diffusion (Baharafshan SIRD kit, Iran). Data were evaluated using statistical analyses in SPSS (version 12, USA) software for windows. Results: The fall in serum C-reactive protein or RF was significant (P= 0.05). Only two of the 30 patients, who had elevated CRP, RF and CIC week four failed to response and one needed cardiac surgery. Conclusions: The C-reactive protein proved to be a good tool for monitoring the treatment of IE. Also RF proved useful in the assessment of patients with IE, but the value of CIC was negligible. (author)

  10. Improving the Outcomes of Organs Obtained From Controlled Donation After Circulatory Death Donors Using Abdominal Normothermic Regional Perfusion.

    Science.gov (United States)

    Miñambres, E; Suberviola, B; Dominguez-Gil, B; Rodrigo, E; Ruiz-San Millan, J C; Rodríguez-San Juan, J C; Ballesteros, M A

    2017-08-01

    The use of donation after circulatory death (DCD) has increased significantly during the past decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared with donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow before organ recovery in cDCD has been proposed as better than rapid recovery to reverse the effect of ischemia and improve recipients' outcome. Here, the first Spanish series using abdominal nRP as an in situ conditioning method is reported. A specific methodology to avoid restoring circulation to the brain after death determination is described. Twenty-seven cDCD donors underwent abdominal nRP during at least 60 min. Thirty-seven kidneys, 11 livers, six bilateral lungs, and one pancreas were transplanted. The 1-year death-censored kidney survival was 91%, and delayed graft function rate was 27%. The 1-year liver survival rate was 90.1% with no cases of ischemic cholangiopathy. Transplanted lungs and pancreas exhibited primary function. The use of nRP may represent an advance to increase the number and quality of grafts in cDCD. Poor results in cDCD livers could be reversed with nRP. Concerns about restoring brain circulation after death are easily solved. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  11. Outflow occlusion for circulatory arrest in dogs "Outfow occlusion" para parada circulatória em cães

    Directory of Open Access Journals (Sweden)

    James N.B.M. de Andrade

    2009-02-01

    Full Text Available The purpose of this study was to evaluate the possibility of producing circulatory arrest by occlusion of the pulmonary trunk as an alternative to the venous inflow occlusion through the left hemithorax. Eight healthy mongrel dogs were divided in two groups. Group I underwent 4 minutes of outflow occlusion and Group II was submitted to 8 minutes of circulatory arrest. Outflow occlusion was performed through left thoracotomy and pericardiotomy by passing a Rumel tourniquet around the pulmonary trunk. Physical examination, electrocardiography, echocardiography, blood gas analyses, hemodynamic, and oxygen transport variables were obtained before and after the procedure. The dogs from Group I did not have any clinical, electrocardiographic, echocardiographic, or hemo-dynamic abnormalities after anesthetic recover. In the Group II, only one dog survived, which had no clinical, electrocardiographic, or echocardiographic abnormalities. In this last dog, just after releasing the occlusion, it was detected increases in the following parameters: heart rate (HR, systolic, diastolic and mean arterial blood pressure (SAP; DAP; MAP, pulmonary artery pressure (PAP, pulmonary wedge pressure (PWP, central venous pressure (CVP, cardiac output (CO, systolic index (SI, cardiac index (CI, left and right ventricular stroke work (LVSW; RVSW, oxygen delivery index (DO2, oxygen consumption index (VO2, and oxygen extraction (O2 ext. Moreover, the oxygen content of arterial and mixed venous blood (CaO2; CvO2, and the arterial and mixed venous partial pressure of oxygen (PaO2; PvO2 were decreased 5 minutes after circulatory arrest. Outflow occlusion is a feasible surgical procedure for period of 4 minutes of circulatory arrest.O objetivo deste estudo foi avaliar a possibilidade de se produzir uma parada circulatória pela oclusão do tronco pulmonar, como alternativa ao "inflow occlusion", pelo hemitórax esquerdo. Oito cães sem raça definida foram divididos em dois

  12. Assisted Vaginal Delivery

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Assisted Vaginal Delivery Home For Patients Search FAQs Assisted Vaginal ... Vaginal Delivery FAQ192, February 2016 PDF Format Assisted Vaginal Delivery Labor, Delivery, and Postpartum Care What is ...

  13. Gas Assisted Mechanical Expression of Cocoa Nibs

    NARCIS (Netherlands)

    Venter, M.J.

    2006-01-01

    The objective of this thesis was to investigate the expression of cocoa nibs and a way to optimise the cocoa butter yield (defined as the mass of cocoa butter recovered as a percentage of the total cocoa butter content) obtainable from cocoa nibs without modifying the composition of the cocoa

  14. Plasma Assisted Combustion Mechanism for Small Hydrocarbons

    Science.gov (United States)

    2015-01-01

    fast ionization wave. Combust.  Theory Modeling, 2001. V.5 pp.97‐129.  N.A.Popov. Effect of a  Pulsed  High‐Current  Discharge  on Hydrogen–Air  Mixtures... Discharge Tube Mono- chro- mator PM Pressure Gauge Electric Gauge Physics of Nonequilibrium  Systems Laboratory Hexane Oxidation by  Pulsed  Nanosecond...Pathways: C2H4‐air  Where PAC Experimental Data is Available Avalanche  to Streamer Transition in Uniform  Electric Field (air, 1 bar, 300 K, 1 cm

  15. Canine assisted reading

    OpenAIRE

    Sever, Jerneja

    2016-01-01

    The diploma thesis presents various aspects of animals included in animal-assisted interventions. In theoretical part, I introduced different possible ways of animal-assisted interventions: animal-assisted therapy, animal-assisted activities and animal-assisted education. Animals became common visitors in educational settings all over the world. I presented positive influences on various aspects of human life, as well limitations when animal-assisted interventions are not possible to perform ...

  16. Signaling at the cell surface in the circulatory and ventilatory systems

    CERN Document Server

    Thiriet, Marc

    2012-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanisms when the vessel lumen caliber varies markedly. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning. Volume 3 is devoted to the set of mediators of the cell surface, especially ion and molecular carriers and catalytic receptors that, once liganded and activated, initiat...

  17. Endurance training in mild hypertension - effects on ambulatory blood pressure and neural circulatory control.

    Science.gov (United States)

    Narkiewicz; Somers

    1997-10-01

    This review examines the effects of a single bout of exercise and of endurance training on blood pressure in patients with hypertension. Possible autonomic mechanisms that mediate these changes in blood pressure are reviewed briefly. Blood pressure rises during exercise. During the second half hour after exercise blood pressure is lower. This p;ost-exercise reduction in blood pressure is associated with a decrease in muscle sympathetic nerve activity, an increase in baroreflex gain and a reduction in the level of blood pressure (set point) at which baroreflex activation occurs. The post-exercise fall in blood pressure appears to be limited to several hours and is not likely to explain any chronic reduction in blood pressure from endurance training. Endurance training elicits modest (approximately 4-5 mmHg) reductions in blood pressure. Because of the intrinsic variability of blood pressure, the decreases in blood pressure after endurance training is evident, especially when multiple measurements of blood pressure are obtained. Studies using 24 h blood pressure measurements suggest that, although endurance training lowers daytime blood pressure, blood pressure during sleep remains unchanged. The mechanism underlying the reduction in blood pressure in endurance training is not known. Although physical fitness is known to attenuate the sympathetic response to acute exercise, whether resting sympathetic drive is decreased with endurance training remains controversial. The slowing of heart rate that accompanies endurance training is also associated with an increase in variability of heart rate. The slower heart rate, increased variability of heart rate and lower blood pressure after endurance training are accompanied by an increase in baroreflex sensitivity. Even though the antihypertensive effect of endurance training is modest, the favourable effects of physical fitness on other risk factors for cardiovascular disease make exercise training an important approach in

  18. Mechanical design in arteries.

    Science.gov (United States)

    Shadwick, R E

    1999-12-01

    The most important mechanical property of the artery wall is its non-linear elasticity. Over the last century, this has been well-documented in vessels in many animals, from humans to lobsters. Arteries must be distensible to provide capacitance and pulse-smoothing in the circulation, but they must also be stable to inflation over a range of pressure. These mechanical requirements are met by strain-dependent increases in the elastic modulus of the vascular wall, manifest by a J-shaped stress-strain curve, as typically exhibited by other soft biological tissues. All vertebrates and invertebrates with closed circulatory systems have arteries with this non-linear behaviour, but specific tissue properties vary to give correct function for the physiological pressure range of each species. In all cases, the non-linear elasticity is a product of the parallel arrangement of rubbery and stiff connective tissue elements in the artery wall, and differences in composition and tissue architecture can account for the observed variations in mechanical properties. This phenomenon is most pronounced in large whales, in which very high compliance in the aortic arch and exceptionally low compliance in the descending aorta occur, and is correlated with specific modifications in the arterial structure.

  19. Statistical mechanics

    CERN Document Server

    Davidson, Norman

    2003-01-01

    Clear and readable, this fine text assists students in achieving a grasp of the techniques and limitations of statistical mechanics. The treatment follows a logical progression from elementary to advanced theories, with careful attention to detail and mathematical development, and is sufficiently rigorous for introductory or intermediate graduate courses.Beginning with a study of the statistical mechanics of ideal gases and other systems of non-interacting particles, the text develops the theory in detail and applies it to the study of chemical equilibrium and the calculation of the thermody

  20. Educating Organizational Consumers about Employee Assistance Programs.

    Science.gov (United States)

    Roman, Paul M.; And Others

    1987-01-01

    Provides an overview of the value of employee assistance programs (EAP) as mechanisms to solve organizational problems. The article is based on a field study of 480 EAPs in private sector organizations with 500 or more employees. (JOW)

  1. Feasibility investigations on a novel micro-manufacturing process for fabrication of fuel cell bipolar plates: Internal pressure-assisted embossing of micro-channels with in-die mechanical bonding

    Energy Technology Data Exchange (ETDEWEB)

    Koc, Muammer [NSF I/UCR Center for Precision Forming (CPF), Department of Mechanical Engineering, Virginia Commonwealth University (VCU), Richmond, VA (United States); Mahabunphachai, Sasawat [NSF I/UCR Center for Precision Forming (CPF), Department of Mechanical Engineering, Virginia Commonwealth University (VCU), Richmond, VA (United States); Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI (United States)

    2007-10-25

    In this paper, we present the results of our studies on conceptual design and feasibility experiments towards development of a novel hybrid manufacturing process to fabricate fuel cell bipolar plates that consists of multi-array micro-channels on a large surface area. The premises of this hybrid micro-manufacturing process stem from the use of an internal pressure-assisted embossing process (cold or warm) combined with mechanical bonding of double bipolar plates in a single-die and single-step operation. Such combined use of hydraulic and mechanical forming forces and in-process bonding will (a) enable integrated forming of micro-channels on both surfaces (as anode and cathode flow fields) and at the middle (as cooling channels), (b) reduce the process steps, (c) reduce variation in dimensional tolerances and surface finish, (d) increase the product quality, (e) increase the performance of fuel cell by optimizing flow-field designs and ensuring consistent contact resistance, and (f) reduce the overall stack cost. This paper explains two experimental investigations that were performed to characterize and evaluate the feasibility of the conceptualized manufacturing process. The first investigation involved hydroforming of micro-channels using thin sheet metals of SS304 with a thickness of 51 {mu}m. The width of the channels ranged from 0.46 to 1.33 mm and the height range was between 0.15 and 0.98 mm. Our feasibility experiments resulted in that different aspect ratios of micro-channels could be fabricated using internal pressure in a controllable manner although there is a limit to very sharp channel shapes (i.e., high aspect ratios with narrow channels). The second investigation was on the feasibility of mechanical bonding of thin sheet metal blanks. The effects of different process and material variables on the bond quality were studied. Successful bonding of various metal blanks (Ni201, Al3003, and SS304) was obtained. The experimental results from both

  2. Single-center experience of the bridge-to-bridge strategy using the Nipro paracorporeal ventricular assist device.

    Science.gov (United States)

    Yoshitake, Shuichi; Kinoshita, Osamu; Nawata, Kan; Hoshino, Yasuhiro; Itoda, Yoshifumi; Kimura, Mitsutoshi; Yamauchi, Haruo; Ono, Minoru

    2018-06-25

    Currently, we use the Nipro paracorporeal VAD (p-VAD) for initial short-term ventricular support, as a bridge to decision (BTD) or a bridge to candidacy (BTC) treatment, in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1 and 2 patients. However, it is possible that compared to patients with primary implantable-VADs (P-iVAD), the bridge-to-bridge (BTB) patients are more likely to develop complications. This retrospective study used data from 24 consecutive BTB patients who were initially implanted with Nipro p-VAD as BTD or BTC treatments between April 2011 and March 2016, and subsequently underwent conversion to an i-VAD. The data from 72 patients who underwent a primary i-VAD (P-iVAD) procedure were used for comparison. Between the two groups, there was no significant difference in the incidence of infectious events (p = 0.72) or stroke (p = 0.44). Orthotropic heart transplantation was performed in 6 of the 24 patients in the BTB group and in 21 of the 72 patients in the P-iVAD group. The 1- and 2-year survival rates were 95.8% and 95.8% in the BTB group and 91% and 85.8% in the P-iVAD group; these values were not significantly different between groups (p = 0.91). Based on these results we conclude that BTB using Nipro p-VAD is a reasonable strategy for treating patients with severe decompensated end-stage heart failure.

  3. Incidence and distribution of transplantable organs from donors after circulatory determination of death in U.S. intensive care units.

    Science.gov (United States)

    Halpern, Scott D; Hasz, Richard D; Abt, Peter L

    2013-04-01

    All U.S. acute care hospitals must maintain protocols for recovering organs from donors after