Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.

Latent track radius of PTFE irradiated with high energy ion beam

PTFE foils were irradiated with different ion beams (Xe, Au and U) with energies up to 1.5 GeV and fluences between 1 x 10(8) and 1 x 10(13) ions/cm(2) at room temperature. The induced modifications in the polymer were analyzed by FTIR, UV-Vis spectroscopy, and XRD. In the FTIR spectra, the CF2 degradation accompanied by the formation of CF3 terminal and side groups were observed. In the UV-Vis spectra, the observed increase in the absorption at UV wavelengths is an indication of polymer carbonization. From XRD, the amorphization of the material was evidenced by the decrease in the intensity of the main diffraction peak. An exponential fit of the intensity of the IR absorption peaks resulted in the following values: 2.9 +/- 0.8; 4.5 +/- 0.9 and 5.6 +/- 0.8 nm for the latent track radius after irradiation with Xe, Au and U beams, respectively. (C) 2011 Elsevier B.V. All rights reserved.

Quantum motion in superposition of Aharonov-Bohm with some additional electromagnetic fields

The structure of additional electromagnetic fields to the Aharonov-Bohm field, for which the Schrodinger, Klein-Gordon, and Dirac equations can be solved exactly are described and the corresponding exact solutions are found. It is demonstrated that aside from the known cases (a constant and uniform magnetic field that is parallel to the Aharonov-Bohm solenoid, a static spherically symmetrical electric field, and the field of a magnetic monopole), there are broad classes of additional fields. Among these new additional fields we have physically interesting electric fields acting during a finite time or localized in a restricted region of space. There are additional time-dependent uniform and isotropic electric fields that allow exact solutions of the Schrodinger equation. In the relativistic case there are additional electric fields propagating along the Aharonov-Bohm solenoid with arbitrary electric pulse shape. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4714352]

Fourier´s law from a chain of coupled anharmonic oscillators under energy conserving shot noise.

We analyze the transport of heat along a chain of particles interacting through anharmonic potentials consisting of quartic terms in addition to harmonic quadratic terms and subject to heat reservoirs at its ends. Each particle is also subject to an impulsive shot noise with exponentially distributed waiting times whose effect is to change the sign of its velocity, thus conserving the energy of the chain. We show that the introduction of this energy conserving stochastic noise leads to Fourier's law. That is for large system size L the heat current J behaves as J ‘approximately’ 1/L, which amounts to say that the conductivity k is constant. The conductivity is related to the current by J = kΔT/L, where ΔT is the difference in the temperatures of the reservoirs. The behavior of heat conductivity k for small intensities¸ of the shot noise and large system sizes L are obtained by assuming a scaling behavior of the type k = ‘L POT a Psi’(L’lambda POT a/b’) where a and b are scaling exponents. For the pure harmonic case a = b = 1, characterizing a ballistic conduction of heat when the shot noise is absent. For the anharmonic case we found values for the exponents a and b smaller then 1 and thus consistent with a superdiffusive conduction of heat without the shot noise. We also show that the heat conductivity is not constant but is an increasing function of temperature.

Stopping power and depth dose profile of H+ and He+ ion beams in hydroxyapatite thin films.

Hadron therapy is a promising technique to treat deep-seated tumors. For an accurate treatment planning, the energy deposition in the soft and hard human tissue must be well known. Water has been usually employed as a phantom of soft tissues, but other biomaterials, such as hydroxyapatite (HAp), used as bone substitute, are also relevant as a phantom for hard tissues. The stopping power of HAp for H+ and He+ beams has been studied experimentally and theoretically. The measurements have been done using the Rutherford backscattering technique in an energy range of 450-2000 keV for H+ and of 400-5000 keV for He+ projectiles. The theoretical calculations are based in the dielectric formulation together with the MELF-GOS (Mermin Energy-Loss Function – Generalized Oscillator Strengths) method [1] to describe the target excitation spectrum. A quite good agreement between the experimental data and the theoretical results has been found. The depth dose profile of H+ and He+ ion beams in HAp has been simulated by the SEICS (Simulation of Energetic Ions and Clusters through Solids) code [2], which incorporates the electronic stopping force due to the energy loss by collisions with the target electrons, including fluctuations due to the energy-loss straggling, the multiple elastic scattering with the target nuclei, with their corresponding nuclear energy loss, and the dynamical charge-exchange processes in the projectile charge state. The energy deposition by H+ and He+ as a function of the depth are compared, at several projectile energies, for HAp and liquid water, showing important differences.

Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients

Purpose: To assess the correlation between MRI findings of the pancreas with those of the heart and liver in patients with beta thalassemia; to compare the pancreas T2* MRI results with glucose and ferritin levels and labile plasma iron (LPI). Materials and methods: We retrospectively evaluated chronically transfused patients, testing glucose with enzymatic tests, serum ferritin with chemiluminescence, LPI with cellular fluorescence, and T2* MRI to assess iron content in the heart, liver, and pancreas. MRI results were compared with one another and with serum glucose, ferritin, and LPI. Liver iron concentration (LIC) was determined in 11 patients' liver biopsies by atomic absorption spectrometry. Results: 289 MRI studies were available from 115 patients during the period studied. 9.4% of patients had overt diabetes and an additional 16% of patients had impaired fasting glucose. Both pancreatic and cardiac R2* had predictive power (p < 0.0001) for identifying diabetes. Cardiac and pancreatic R2* were modestly correlated with one another (r(2) = 0.20, p < 0.0001). Both were weakly correlated with LIC (r(2) = 0.09, p < 0.0001 for both) and serum ferritin (r(2) = 0.14, p < 0.0001 and r(2) = 0.03, p < 0.02, respectively). None of the three served as a screening tool for single observations. There is a strong log-log, or power-law, relationship between ratio of signal intensity (SIR) values and pancreas R2* with an r(2) of 0.91. Conclusions: Pancreatic iron overload can be assessed by MRI, but siderosis in other organs did not correlate significantly with pancreatic hemosiderosis. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Analysis Methodology for Vortex-Induced Motion (VIM) of a Monocolumn Platform Applying the Hilbert-Huang Transform Method

Vortex-induced motion (VIM) is a highly nonlinear dynamic phenomenon. Usual spectral analysis methods, using the Fourier transform, rely on the hypotheses of linear and stationary dynamics. A method to treat nonstationary signals that emerge from nonlinear systems is denoted Hilbert-Huang transform (HHT) method. The development of an analysis methodology to study the VIM of a monocolumn production, storage, and offloading system using HHT is presented. The purposes of the present methodology are to improve the statistics analysis of VIM. The results showed to be comparable to results obtained from a traditional analysis (mean of the 10% highest peaks) particularly for the motions in the transverse direction, although the difference between the results from the traditional analysis for the motions in the in-line direction showed a difference of around 25%. The results from the HHT analysis are more reliable than the traditional ones, owing to the larger number of points to calculate the statistics characteristics. These results may be used to design risers and mooring lines, as well as to obtain VIM parameters to calibrate numerical predictions. [DOI: 10.1115/1.4003493]

MATHEMATICAL ANALYSIS OF MAXIMUM POWER GENERATED BY PHOTOVOLTAIC SYSTEMS AND FITTING CURVES FOR STANDARD TEST CONDITIONS

The rural electrification is characterized by geographical dispersion of the population, low consumption, high investment by consumers and high cost. Moreover, solar radiation constitutes an inexhaustible source of energy and in its conversion into electricity photovoltaic panels are used. In this study, equations were adjusted to field conditions presented by the manufacturer for current and power of small photovoltaic systems. The mathematical analysis was performed on the photovoltaic rural system I- 100 from ISOFOTON, with power 300 Wp, located at the Experimental Farm Lageado of FCA/UNESP. For the development of such equations, the circuitry of photovoltaic cells has been studied to apply iterative numerical methods for the determination of electrical parameters and possible errors in the appropriate equations in the literature to reality. Therefore, a simulation of a photovoltaic panel was proposed through mathematical equations that were adjusted according to the data of local radiation. The results have presented equations that provide real answers to the user and may assist in the design of these systems, once calculated that the maximum power limit ensures a supply of energy generated. This real sizing helps establishing the possible applications of solar energy to the rural producer and informing the real possibilities of generating electricity from the sun.