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Background: Intravenous immunoglobulin (IVIG) may benefit many inflammatory central nervous system (CNS) disorders based on multiple immunomodulatory effects. IVIg is being used in inflammatory CNS conditions however robust evidence and guidelines are lacking in many disorders. Over the last 5 years, the percentage of IVIg used for CNS indications within neurology almost doubled in British Columbia (BC), Canada. Clear local guidelines may guide rational use. Methods: Consensus guidelines for IVIG use for CNS indications were developed by a panel of subspecialty neurologists and the Provincial Blood Coordinating Office, informed by focused literature review. Guidelines were structured similarly to existing BC peripheral nervous system guidelines and Australian Consensus Guidelines. Utilization and efficacy will be monitored provincewide on an ongoing basis. Results: Categories of conditions for Conditionally Approved (N=11) and Exceptional Circumstance Use (N=5) were created based on level of evidence for efficacy. Dosing and monitoring recommendations were made and outcomes measures defined. Rationale for Not Indicated conditions (N=2) was included. Guidelines were distributed to BC neurologists for feedback. This system will be re-evaluated after 1 year. Conclusions: IVIG use in CNS inflammatory conditions has an emerging role. Guidelines for use and monitoring of outcomes will help improve resource utilization and provide further evidence regarding effectiveness.
In this study, the aerodynamic characteristics of a vertical-axis wind turbine blade coupled with a high-lift device, such as the Gurney flap at the trailing edge, are investigated. For numerical analysis, the force element theory is used to understand how the Gurney flap influences the force evolution of the lift-type vertical-axis wind turbine. This study shows that the lift and drag can be respectively approximated into four elements, which are induced by volume vorticity, rotational velocity, angular acceleration and surface friction of the flow around the blades. Based on the perspective of the force element theory, the present simulation provides a clear picture of how the Gurney flap influences the formation of the aerodynamic force elements during a rotational cycle for a vertical-axis wind turbine. Simulation results show that the contributions mainly result from the surface vorticities, the rotational acceleration of the airfoil, and the acceleration of the surface.
Two solid state anaerobic digesters (SSADs), 15 L each, were set up for co-digestion of switchgrass with primary digestate of a liquid anaerobic digester (LAD) and the recirculating leachate. Both the LAD and two SSADs were operated at 50°C. The results showed that the bioreactors were not started up stably until day 16 and day 47 for reactors A and B, respectively. The supplement of LAD digestate or injection of sodium hydroxide (NaOH) into the recirculating leachate readily reinitiated the biogas production to normal daily high rates of the two individual SSADs, one on day 16 and the other on day 47. In contrast to reactor A, there was a longer lag phase for bioreactor B, however, it showed 46.2% [77.9 vs 53.3 L kg−1 volatile solid (VS)] more cumulative biogas yields, and higher reduction rate of total solid, VS, cellulose and hemicellulose of 29.5, 31, 40.6 and 15%, respectively, which was likely due to optimized pH and NaOH pretreated switchgrass during start-up period. Methane contents of biogas increased gradually and stabilized at 50% for both reactors, indicating a normal operation of anaerobic digestion lasted for at least 100 days. The determined parameters of digested residues met China organic fertilizer standard (NY 525-2012) except for high moisture and low total nutrient contents. Therefore, the product of SSAD has the potential value of organic fertilizer. It is concluded that the LAD digestate can be reused as inoculums by co-digestion with agricultural residues for biogas and organic fertilizer production in SSAD.
In order to analyze the boiling and capillary limitations of two-phase heat transport devices, the existing models developed by Chi and Peterson and the existing experimental data carried out with various micro channel wick structures from literature were collected for benchmark. It was found that the dominant parameters for boiling and capillary limitations were the nucleation sites and structure geometries of the micro channels, and important parameters were considered to modify the models empirically. It was also found that for micro channel structures the inclined angle is sensitive to the capillary limitations and not to boiling limitations. By properly estimating the nucleation sites and empirical coefficients for micro channels needed by the newly modified models, the boiling and capillary limitations can be accurately predicted, and hence the applicability of the modified models is confirmed. Based on this, a numerical analysis was then carried out to investigate the trends of boiling and capillary limitations of the micro channel wick structures. Effects of the channel geometries and arrangement were taken into account, including the aspect ratio and structure size of the micro channels. Furthermore, the effects of inclined angle and contact angle were also analyzed. The present results can provide a design reference of performance trends of micro channel wick structures.
Better performance due to repeated testing can bias long-term trajectories of cognitive aging and correlates of change. We examined whether retest effects differ as a function of individual differences pertinent to cognitive aging: race/ethnicity, age, sex, language, years of education, literacy, and dementia risk factors including apolipoprotein E ε4 status, baseline cognitive performance, and cardiovascular risk. We used data from the Washington Heights-Inwood Columbia Aging Project, a community-based cohort of older adults (n=4073). We modeled cognitive change and retest effects in summary factors for general cognitive performance, memory, executive functioning, and language using multilevel models. Retest effects were parameterized in two ways, as improvement between the first and subsequent testings, and as the square root of the number of prior testings. We evaluated whether the retest effect differed by individual characteristics. The mean retest effect for general cognitive performance was 0.60 standard deviations (95% confidence interval [0.46, 0.74]), and was similar for memory, executive functioning, and language. Retest effects were greater for participants in the lowest quartile of cognitive performance (many of whom met criteria for dementia based on a study algorithm), consistent with regression to the mean. Retest did not differ by other characteristics. Retest effects are large in this community-based sample, but do not vary by demographic or dementia-related characteristics. Differential retest effects may not limit the generalizability of inferences across different groups in longitudinal research. (JINS, 2015, 21, 506–518)
Transparent films of platinum nanoparticles on graphene nanohybrids were synthesized in a two-step process. Reduction of homogeneously dispersed Pt precursor and graphene in water and solution coating/annealing afforded thin films with high catalytic performance as counter electrodes in dye-sensitized solar cells (DSSC). The requisite dispersant consisting of poly(oxyethylene)-(POE) segments and cyclic imide functionalities allowed the in-situ reduction of dihydrogen hexachloroplatinate by ethanol and the formation of nanohybrids of graphene-supported Pt nanoparticles at 4.0 nm diameter. Characterizations of polymeric dispersants by Fourier-transform infrared spectroscopy, thermogravimetric analysis, and nanohybrids by transmission electron microscope were performed. After screening various compositions of Pt/graphene, the nanohybrid film at the specific ratio of 5/1 by weight was fabricated into a counter electrode (CE) for DSSC by the solution casting method. The evaluation of cell performance demonstrated the most improved power conversion efficiency of 8.00%. This is significant achievement in comparison with 7.14% for the DSSC with the conventional platinum sputtered CE. Furthermore, the solution casting method allows the preparation of transparent CE films that are suitable for using as rear-illuminated DSSC. The approach was proven to be feasible by measuring the cell efficiency under rear light illumination. The power efficiency up to 7.01%, comparable to 8.00% by a normally front illumination, has been accomplished. In contrast, the rear illumination at merely 2.36% efficiency was obtained for the DSSC with sputtered platinum CE. Analyses of cyclic voltammetry, electrochemical impedance spectra were well correlated to the high efficiency of the performance caused by this nanohybrid film.
This paper proposes a complete basis set for analyzing elastic wave scattering in half-space. The half-space is an isotropic, linear, and homogeneous medium except for a finite inhomogeneity. The wave bases are obtained by combining buried source functions and their reflected counter-waves generated from the infinite-plane boundary. The source functions are the vector wave functions of infinite-space. Based on the source functions expressed in the Fourier expansion form, the reflected counter-waves are easily obtained by solving the infinite-plane boundary conditions. Few representations adopt Wely's integration, but the Fourier expansion is developed from it and applied to decouple the angular-differential terms of the vector wave functions. In addition to the scattering of the finite inhomogeneity, the transition matrix method is extended to express the surface boundary conditions. For the numerical application in this paper, the P- and the SV- waves are assumed as the incoming fields. As an example, this paper computes stress concentrations around a cavity. The steepest-descent path method yielding the optimum integral paths is used to ensure the numerical convergence of the wave bases in the Fourier expansion. The resultant patterns from these approaches are compared with those obtained from numerical simulations.
The purpose of this study was to understand the seasonal, geographical and clinical characteristics of Taiwanese patients hospitalized for non-typhoidal Salmonella (NTS) infections and their economic burden. Hospital data obtained from the Taiwan National Health Insurance (NHI) database between 2006 and 2008 were analysed. Infants had the highest annual incidence of 525 cases/100 000 person-years. Elderly patients aged >70 years had the highest in-hospital mortality rate (2·6%). Most (82·6%) gastroenteritis occurred in children aged <10 years. Septicaemia, pneumonia, arthritis and osteomyelitis occurred mainly in patients aged >50 years. A median medical cost for NTS-associated hospitalizations was higher for patients with septicaemia than for those with gastroenteritis. Seasonal variation of NTS-associated hospitalizations was correlated with temperature in different areas of Taiwan. In summary, infants had a high incidence of NTS-associated hospitalizations. However, the elderly had a higher in-hospital mortality rate and more invasive NTS infections than children.
Non-typhoidal Salmonella (NTS) is a common pathogen causing foodborne infections, bacteraemia, and extra-intestinal focal infections (EFIs) in humans. The study compares the clinical characteristics of elderly patients with NTS bacteraemia with those of young adults. Of 272 adults with NTS bacteraemia identified in this study, 162 (59·6%) were aged ⩾55 years. EFIs were observed in 36% of the 162 patients. The most common EFIs in the elderly patients (⩾55 years) was mycotic aneurysm, followed by pulmonary infections and bone/joint infections. Elderly patients more often had chronic heart, lung, renal and malignant diseases, had more EFIs, and a higher 30-day mortality rate. Independent factors of 30-day mortality in elderly patients were solid-organ tumour [adjusted odds ratio (aOR) 4·4, P=0·003], mycotic aneurysm (aOR 3·7, P=0·023) and shock (aOR 12·1, P<0·0001). HIV infection, autoimmune diseases, and receipt of immunosuppressive therapy were more often observed in young patients.
We used a precision two-circle goniometer mounted to the stage of a compound microscope to determine the optical alignment and to measure the entrance aperture diameter of individual cuticular cones in the dioptric array of the lateral eye of juvenile horseshoe crabs in order to learn about the development of the visual field. Our results show that the extent of the visual field of juvenile horseshoe crabs with prosomal lengths about 20% ofadult size (14–21 mm) is about 70% that of the visual field of adult horseshoe crabs (prosomal lengths: 100+ mm). The visual field of such juvenile animals covers between 77 and 85 deg vertically and 140 and 145 deg horizontally. Assuming that the dioptric array is uniform and square packed, the average interommatidial angle of the juvenile animals is between 5.6 and 6.0 deg as compared to 4.6 deg for an adult animal. The diameter of the entrance aperture of individual cuticular cones increases markedly with increasing animal size. In addition, we noted a statistically significant trend for entrance aperture diameters to increase from anterior to posterior within the eye for animals of all sizes. There may be a slight trend for entrance aperture diameters to increase from dorsal to ventral within the eye. Our results indicate that the extent of the visual field and the resolution of the lateral eye approach adult values in advance of animals' reaching sexual maturity.
This study investigates the problem of non-Newtonian liquid evaporation from an impermeable vertical plate in a porous medium under mixed convection conditions. The analysis examines the effects of non-Darcian flow phenomena on the evaporation process and investigates the heat and mass transfer characteristics under a range of flow conditions in the aiding and opposing flow types. The parameters of interest include Rak,non, Pex,non, Pr and Sc. The data required for the calculations include a fixed wall temperature of Tw = 45°C, a free flow temperature of T∞ = 20°C and an air free flow rate of u∞ = 4m/sec and the corresponding humidity of 50% flows over fixed temperature and moist wall.
The results indicate that an increasing buoyancy force enhances the mixing effect and therefore improves the rate of heat transfer, the latent heat flux is the primary mode of heat transfer in evaporation processes and the velocity gradient at the wall increases with an increasing buoyancy effect. Furthermore, the evaporation rate increases with a reducing flow index and an increasing buoyancy effect.
The development of elbow arthroplasties has significantly improved the quality of life for many patients suffering from disabling elbow disorders. However, the high complication rate such as loosening and instability limits the long term use of total elbow replacement (TER). In the present study, biomechanical analyses on patients with unilateral nonconstrained (Souter-Strathclyde) and semiconstrained (Coonard-Morrey) TER subjects were performed to investigate differences of their motion patterns under unloaded and loaded conditions. In a biomechanical laboratory, each subject performed vertical and horizontal elbow flexion/extension first without and then with external loading (5 lb). The kinematic data were measured using 3D motion analysis system and the motion axis of the elbow was calculated by a well-defined mathematic model. During these tests, the upperarm was fixed with a special fixation device and their forearms fully supinated. The elbow motion patterns of the affected sides were compared with those of the normal sides and between different conditions. The results revealed that the elbows moved about a relatively fixed axis both in the semiconstrained and nonconstrained groups in the vertical flexion/extension with or without external loading, compatible with the normal elbows. However, the nonconstrained elbows were less stable during horizontal flexion/externsion motion with or without external loading and the elbow axis moved significantly, indicating of less stability. We conclude that this methodology of elbow motion analysis is acceptable and can be widely recommended for total elbow study. Moreover, the nonconstrained TER is less stable than the semiconstrained TER during the horizontal movement, which was compatible with previous clinical results. The patients with nonconstrained TER are suggested to avoid using their elbows in horizontal motion, especially in loaded conditions.
Supersonic nozzle flows of a condensable vapour are considered in the high activation limit for homogeneous nucleation. Conditions are determined under which the final collapse of the supersaturated state is described by a condensation shock. It is shown that the shock zone is associated with droplet growth: droplet production occurs in a thin layer upstream of the growth region. Some new scaling laws are obtained for the structure of the production layer.
An experimental investigation was conducted to describe the fluid flow about oscillating flat plates and to determine the magnitude and nature of forces acting on the plates at low Reynolds numbers. In the experiment, the Reynolds number was varied from 1·01 to 1057·0; three period parameters, 1·57, 2·07 and 4·71, were applied; two fluids, water and SAE 30 motor oil, and three flat plates of various sizes with or without end plates were used. The analysis of data resulted in graphical presentation of the relationships among the drag coefficient, the Reynolds number and period parameter. The drag coefficient becomes less dependent on the Reynolds number for values greater than 250. The relationship between the drag coefficient and period parameter is pronounced throughout the entire range of the Reynolds number tested.
Background and objective: The expression of P-selectin on the surface of platelets and platelet–leucocyte conjugate formation are considered to be an indicator of platelet activation in thrombotic and inflammatory disease. Midazolam is a widely used sedative and anaesthetic induction agent. It may inhibit platelet aggregation and suppress interleukin-6 and -8 response in human leucocytes, but any effect on the adhesion of activated platelets to leucocytes remains obscure. We have examined the influence of midazolam on adenosine diphosphate (ADP)-induced platelet surface P-selectin expression and platelet–leucocyte aggregation in whole blood.
Methods: Human whole blood was stimulated with 2 × 10−5M ADP in the presence of midazolam (3 × 10−4 to 3 × 10−6M). Samples were stained with a fluorochrome-conjugated CD62P and CD41a antibody for detecting human platelet P-selectin antigens. The leucocyte subpopulations were separately gated and platelet–leucocyte aggregates were defined as cells found positive for CD45 and CD62P. All samples were analysed and were electronically separated into specific cell types (platelets, neutrophils, monocytes and lymphocytes) according to their typical forward/side scattering by flow cytometry.
Results: Midazolam significantly inhibited ADP-induced platelet P-selectin expression and attenuated platelet–leucocyte aggregation (mainly in neutrophils and monocytes) in a dose-dependent manner with a maximum inhibitory effect at 3 × 10−4M (P < 0.01).
Conclusions: This study demonstrated that midazolam decreases the ADP-induced expression of platelet surface P-selectin and platelet–leucocyte aggregation.
Laser-induced fluorescence (LIF) diagnostics and highspeed, real-time digital image acquisition techniques are combined to map the composition field in a water mixing layer. A fluorescent dye, which is premixed with the lowspeed freestream fluid and dilutes by mixing with the highspeed fluid, is used to monitor the relative concentration of high-speed to low-speed fluid in the layer.
The three digital LIF pictures shown here were obtained by imaging the laser-induced fluorescence originating from a collimated argon ion laser beam, extending across the transverse dimension of the shear layer, onto a 512–element linear photodiode array. Each picture represents 384 contiguous scans, each at 400 points across the layer, for a total of 153 600 point measurements of concentration. The vertical axis maps onto 40 mm of the transverse coordinate of the shear layer, and the horizontal axis is time increasing from right to left for a total flow real time of 307 msec. The pseudocolor assignment is linear in the mixture fraction (ξ) and is arranged as follows: red-unmixed fluid from the low-speed stream (ξ=0); blue-unmixed fluid from the high-speed stream (ξ=1); and the rest of the spectrum corresponds to intermediate compositions.
Figures 1 and 2, a single vortex and pairing vortices, respectively, show the composition field before the mixing transition. The Reynolds number based on the local visual thickness of the layer and the velocity difference across the layer is Re=1750 with U2/U1=0.46 and U1=13 cm/sec. Note the large excess of high-speed stream fluid in the cores of the structures.
This paper develops an analytical model for the plastic collapse of a statically indeterminate rectangular beam containing a crack. Limit analysis, elastic-plastic fracture mechanics, compliance and J-integral concepts are used to study JIC and dJ/da that influence the crack propagation. The relations among the plastic hinge, applied load, linear displacement, rotational angle and crack growth leads to a better understanding of the problem as a consequence of this study. The conclusions are: (1) Unstable ductile fracture occurs at the crack propagates before plastic collapse or at dJ/da is smaller than the minimum critical value. (2) LBB (leak-before-break) characteristic of the statically indeterminate rectangular beam is valid if the crack propagates before plastic collapse.
The aim of the study was to elucidate the epidemiological features of Hepatitis C virus (HCV) infection among teenagers in an endemic area by conducting a mass screening study. We also investigated the clinical outcome of the anti-HCV-positive subjects by conducting subsequent short-term and long-term follow-up studies. All 2837 students of two junior middle schools in Tzukuan, aged 13–16 years, were invited to be screened for anti-HCV, HBsAg, AST and ALT in October 1995. A total of 2726 (96%) students responded. Anti-HCV, HCV RNA and aminotransferase levels were evaluated among anti-HCV-positive students 1 month and 30 months later, respectively. A total of 38 (1·4%; M/F = 22/16) participants were anti-HCV-positive. The anti-HCV-positive students had higher rates of exposures to transfusion, anti-HCV-positive families and surgery. The prevalence (2·8%) of the 7 maritime villages was markedly higher than that (0·7%) of the other 8 villages (P < 0·001). Subsequent follow-up studies demonstrated that there might be 5 cases of acute or recent HCV infection, and 6 cases who had recovered from chronic HCV infection.