Impact of pulmonary vascular stiffness and vasodilator treatment in pediatric pulmonary hypertension: 21 patient-specific fluid-structure interaction studies

Recent clinical studies of pulmonary arterial hypertension (PAH) have found correlations between increased pulmonary vascular stiffness (PVS) and poorer disease outcomes. However, mechanistic questions remain about the relationships amongst PVS, RV power, and vascular hemodynamics in the setting of progressive PAH that are difficult or impossible to answer using direct measurements. Clinically validated patient-specific computational modeling may allow exploration of these issues through perturbation-based predictive testing. Here we use a simple patient-specific model to answer four questions: how do hemodynamics change as PAH worsens? How does increasing PVS impact hemodynamics and RV power? For a patient with moderate PAH, what are the consequences if the pressures increase modestly yet sufficiently to engage collagen in those vessels? What impact does pressure-reducing vasodilator treatment have on hemodynamics? Twenty-one sets of model-predicted impedance and mean PA pressure (mPAP) show good agreement with clinical measurements, thereby validating the model. Worsening was modeled using data from three PAH outcomes groups; these show not only the expected increase in mPAP, but also an increase in pressure pulsatility. Interestingly, chronically increasing mPAP decreased WSS, suggesting that increased PA cross-sectional area affected WSS greater than increased PVS. For a patient with moderately high PVR (12.7 WU) with elastin-based upstream vascular remodeling, moving from elastin-dominant vessel behavior to collagen-dominant behavior caused substantial increases in mPAP, pressure and WSS pulsatility. For the same patient, reducing PVR through a simulated vasodilator to a value equivalent to mild PAH did not decrease pressure pulsatility and dramatically increased WSS pulsatility. Overall, these results suggest a close association between PVS and hemodynamics and that hemodynamics may play an important role in progressing PAH. These support the hypothesis that treatments should target decreasing or reversing upstream vascular remodeling in addition to decreasing mean pressures.     

Analysis of patients referred to the gastroenterology service of a VA medical center

We recorded clinical information over a 12-month period on consecutive consultations to the gastroenterology service of the Durham VA Medical Center. Of 902 consultations, 789 were prospectively collected. Eighty-five percent of the patients were between 40 and 70 years old. Seventy-five percent of the referrals were from the internal medicine service. The most frequent reasons for consultation were abdominal pain (19%), GI bleeding (active, 16%; occult, 9%), abnormal results of liver tests (18%), and request for a procedure (11%). Diseases of the liver (32%) and "peptic diseases" (30%) were the most common diagnoses. One or more procedures were done in 71% of consultations. When these data are compared with those of a practicing gastroenterologist, using an identical instrument, it is apparent that trainees' experience with structurally identifiable gastroenterologic disease and with a variety of procedures was similar in scope. There were, however, differences in that the physicians at the VA saw substantially fewer patients with so-called "functional" illness. If these data are applicable to other VA Medical Centers, then the training of physicians in gastroenterology at a VA Medical Center should probably be broadened.     

Methods of combined antenatal diagnosis of maturity

A combined diagnosis of maturity is described, which is harmless in a correct technique. The method can be carried out in each of obstetrical hospital together with a routine laboratory. By means of the combined diagnosis a "maturity-index" is performed, which permits a certain assessment of the survival-chance of the praemature delivered children. In connection with the ultrasound-cephalometrie also there is an exact evidence to the duration of pregnancy and the tendence of intrauterine growth of the fetus.     

Measuring hydraulic properties of geotextiles after installation damage

Since geotextiles have been progressively incorporated into coastal protection structures, the influence of installation damage on them has been the primary concern. During installation/construction, geotextiles are repeatedly subjected to high mechanical stresses which often exceed service stress. It is therefore vital to evaluate the mechanical and hydraulic damage and determine the consequences of these damages to better develop criteria for selection of suitable products. As these damages could reduce the material's mechanical strength and hydraulic efficiency, or in the severest form of damage, puncturing, would end the separation function. The properties investigated in this paper include the permittivity and apparent opening size (AOS) of geotextiles. Generally, the greater the drop energy of armour units applied to geotextiles, the greater the potential for damage. Findings show that the residual permittivity could increase significantly, 45% during installation. The preliminary design of coastal structures will be optimised as engineers and designers can better estimate the amount of damage on geotextiles upon installation.     

A graph coloring constructive hyper-heuristic for examination timetabling problems

In this work we investigate a new graph coloring constructive hyper-heuristic for solving examination timetabling problems. We utilize the hierarchical hybridizations of four low level graph coloring heuristics, these being largest degree, saturation degree, largest colored degree and largest enrollment. These are hybridized to produce four ordered lists. For each list, the difficulty index of scheduling the first exam is calculated by considering its order in all lists to obtain a combined evaluation of its difficulty. The most difficult exam to be scheduled is scheduled first (i.e. the one with the minimum difficulty index). To improve the effectiveness of timeslot selection, a?roulette wheel selection mechanism is included in the algorithm to probabilistically select an appropriate timeslot for the chosen exam. We test our proposed approach on the most widely used un-capacitated Carter benchmarks and also on the recently introduced examination timetable dataset from the 2007 International Timetabling Competition. Compared against other methodologies, our results demonstrate that the graph coloring constructive hyper-heuristic produces good results and outperforms other approaches on some of the benchmark instances.     

Novel temperature measurement method & thermodynamic investigations of amorphous polymers during high rate deformation

Polymers are frequently used in applications in which they may be exposed to high rate or impact loading, and there is growing industrial importance in understanding their mechanical behavior at different strain rates. An important aspect of this is the temperature rise due to adiabatic conditions in high rate loading. This paper describes research that has been performed to measure the temperature rise that occurs in specimens undergoing rapid deformation. A novel thermocouple design is presented and applied to PMMA and 20 wt% DINP-plasticized PVC, deformed at moderate and high strain rates. The measurements are accompanied by investigations of strain energy.     

The DOE advanced gas reactor fuel development and qualification program

The high outlet temperatures and high thermal-energy conversion efficiency of modular high-temperature gas-cooled reactors (HTGRs) enable an efficient and cost-effective integration of the reactor system with non-electricity-generation applications, such as process heat and/or hydrogen production, for the many petrochemical and other industrial processes that require temperatures between 300°C and 900°C. The U.S. Department of Energy (DOE) has selected the HTGR concept for the Next Generation Nuclear Plant (NGNP) Project as a transformative application of nuclear energy that will demonstrate emissions-free nuclear-assisted electricity, process heat, and hydrogen production, thereby reducing greenhouse-gas emissions and enhancing energy security. The objective of the DOE Advanced Gas Reactor (AGR) Fuel Development and Qualification program is to qualify tristructural isotropic (TRISO)-coated particle fuel for use in HTGRs. An overview of the program and recent progress is presented.     

Fibre diffraction in the analysis of filamentous virus structure

In many plant and bacterial viruses, a filamentous nucleocapsid makes up the entire virus particle. These viruses usually form fibres naturally, but they do not crystallize. Fibre diffraction has therefore been the method of choice for structural studies, aided in recent years by cryo-electron microscopy (EM) and solid state nuclear magnetic resonance (ssNMR). Filamentous viruses, particularly tobacco mosaic virus (TMV), have been important in developing fibre diffraction methods, and fibre diffraction allowed TMV to be among the first virus structures determined. Structures of several viruses related to TMV and several filamentous bacterial viruses have been determined at resolutions of 3?Å or better, and lower resolution structures have been determined by fibre diffraction, sometimes in conjunction with other methods, for many other, unrelated, filamentous viruses.     

Site‐Selectively Coated,Densely‐Packed Microprojection Array Patches for Targeted Delivery of Vaccines to Skin

Densely packed dry‐coated microprojections are shown to deliver vaccines to targeted locations within the skin that are rich in immune cells, thus inducing protective immune responses against a lethal virus challenge. Selectively limiting the antigen coating to the tips of the projections, which penetrate the skin, would significantly reduce the amount of vaccine required in immunization. In this paper a simple technique, dip‐coating the microprojections, is introduced to meet this goal. By increasing the coating solution viscosity, an otherwise strong capillary action is mitigated and the desired controlled coating length on projections is achieved. Following application to the skin, most of the coated vaccine material is rapidly released from the projections (82.6% in mass within 2 min) to the target locations within the skin strata and a potent immune response is induced when a conventional influenza vaccine (Fluvax) is tested in a mouse model. The utility of this coating approach to a variety of molecules representative of vaccines (e.g., chicken egg ovalbumin (OVA) protein, DNA, and fluorescent dyes) is demonstrated. These collective attributes, together with the simplicity of the approach, position the dip‐coating method for practical utility in large vaccination campaigns.