Influence of Helmet Use in Facial Trauma and Moderate Traumatic Brain Injury Victims of Motorcycle Accidents

Objective: The objective of this research was to study the influence of the use of helmet in facial trauma victims of motorcycle accidents with moderate traumatic brain injury. Methods: We retrospectively reviewed the incidence of facial injuries in helmeted and nonhelmeted victims with moderate traumatic brain injury at a referral trauma hospital. Results: The sample consisted of 272 patients predominantly men (94.5%) and between 21 and 40 years old (62.9%). The majority of patients were using helmet (80.1%). The occurrence of facial fractures was most frequent for zygomatic bone (51.8%), followed by mandible (18.8%) and nasal bones (9.2%). Conclusions: Individuals in the most productive age group are most affected, which causes a great loss to financial and labor systems. It is important to take measures to alert the public regarding the severity of injuries likely to occur in motorcycle-related accidents and ways to prevent them.

REALISTIC IVUS IMAGE GENERATION IN DIFFERENT INTRALUMINAL PRESSURES

Intravascular ultrasound (IVUS) phantoms are important to calibrate and evaluate many IVUS imaging processing tasks. However, phantom generation is never the primary focus of related works; hence, it cannot be well covered, and is usually based on more than one platform, which may not be accessible to investigators. Therefore, we present a framework for creating representative IVUS phantoms, for different intraluminal pressures, based on the finite element method and Field II. First, a coronary cross-section model is selected. Second, the coronary regions are identified to apply the properties. Third, the corresponding mesh is generated. Fourth, the intraluminal force is applied and the deformation computed. Finally, the speckle noise is incorporated. The framework was tested taking into account IVUS contrast, noise and strains. The outcomes are in line with related studies and expected values. Moreover, the framework toolbox is freely accessible and fully implemented in a single platform. (E-mail: fernando.okara@gmail.com) (c) 2012 World Federation for Ultrasound in Medicine & Biology.

Predicted preoperative maximal static respiratory pressures in adult cardiac surgeries: evaluation of two formulas

Objectives: Cardiac surgery (CC) determines systemic and pulmonary changes that require special care. What motivated several studies conducted in healthy subjects to assess muscle strength were the awareness of the importance of respiratory muscle dysfunction in the development of respiratory failure. These studies used maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) values. This study examined the concordance between the values predicted by the equations proposed by Black & Hyatt and Neder, and the measured values in cardiac surgery (CS) patients. Methods: Data were collected from preoperative evaluation forms. The Lin coefficient and Bland-Altman plots were used for statistical concordance analysis. The multiple linear regression and analysis of variance (ANOVA) were used to produce new formulas. Results: There were weak correlations of 0.22 and 0.19 in the MIP analysis and of 0.10 and 0.32 in the MEP analysis, for the formulas of Black & Hyatt and Neder, respectively. The ANOVA for both MIP and MEP were significant (P <0.0001), and the following formulas were developed: MIP = 88.82 - (0.51 x age) + (19.86 x gender), and MEP = 91.36 -(030 x age) + (29.92 x gender). Conclusions: The Black and Hyatt and Neder formulas predict highly discrepant values of MIP and MEP and should not be used to identify muscle weakness in CS patients.

Moderate/severe erectile dysfunction in patients with antiphospholipid syndrome

Purpose: To evaluate sexual function of antiphospholipid syndrome (APS) patients using the Brazilian version of the validated International Index of Erectile Function (IIEF). Materials and methods: Eleven APS male patients (Sapporo criteria) were age and race-matched with 22 healthy controls. Demographic and clinical data, drug use and antiphospholipid antibodies were evaluated. The IIEF was also self-applied. Results: Mean age (p = 0.114), frequency of Caucasian race (p = 1.00) and married status (p = 0.438) were similar in APS and controls. Mean disease duration was 8.8 +/- 4.6 years. Erectile dysfunction (ED) was frequently observed in APS versus controls (45.5 vs. 4.5%, p = 0.0096), especially moderate/severe ED (p = 0.0081). The total IIEF score (49.6 vs. 67.1, p = 0.019), erectile function (19.6 vs. 28.1, p = 0.005) and intercourse satisfaction (7.8 vs. 11.9, p = 0.009) were lower in patients than in controls. No differences were seen in orgasmic function (p = 0.114), sexual desire (p = 0.123) or overall satisfaction (p = 0.097) between the groups. The comparison between APS patients with ED (n = 5) and without ED (n = 6) revealed more arterial events in APS with ED (100 vs. 16.7%, p = 0.0152), and also longer disease duration (12 [7-16] vs. 5.5 [2-13] years, p = 0.031). A trend towards lower venous events (20 vs. 83.3%, p = 0.0801) and higher renal thrombotic microangiopathy (60% vs. 0, p = 0.0606) was observed in APS patients with ED. Demographics, clinical manifestations, smoking and antiphospholipid antibodies positivity were similar in both groups. Conclusion: To our knowledge, this was the first study that demonstrated moderate/severe ED in almost 50% of cases of a rare autoimmune disease. This alteration was linked to arterial events and longer disease duration. Lupus (2012) 21, 319-323.

Regular and moderate exercise before experimental sepsis reduces the risk of lung and distal organ injury

de Araujo CC, Silva JD, Samary CS, Guimaraes IH, Marques PS, Oliveira GP, do Carmo LGRR, Goldenberg RC, Bakker-Abreu I, Diaz BL, Rocha NN, Capelozzi VL, Pelosi P, Rocco PRM. Regular and moderate exercise before experimental sepsis reduces the risk of lung and distal organ injury. J Appl Physiol 112: 1206-1214, 2012. First published January 19, 2012; doi:10.1152/japplphysiol.01061.2011.-Physical activity modulates inflammation and immune response in both normal and pathologic conditions. We investigated whether regular and moderate exercise before the induction of experimental sepsis reduces the risk of lung and distal organ injury and survival. One hundred twenty-four BALB/c mice were randomly assigned to two groups: sedentary (S) and trained (T). Animals in T group ran on a motorized treadmill, at moderate intensity, 5% grade, 30 min/day, 3 times a week for 8 wk. Cardiac adaptation to exercise was evaluated using echocardiography. Systolic volume and left ventricular mass were increased in T compared with S group. Both T and S groups were further randomized either to sepsis induced by cecal ligation and puncture surgery (CLP) or sham operation (control). After 24 h, lung mechanics and histology, the degree of cell apoptosis in lung, heart, kidney, liver, and small intestine villi, and interleukin (IL)-6, KC (IL-8 murine functional homolog), IL-1 beta, IL-10, and number of cells in bronchoalveolar lavage (BALF) and peritoneal lavage (PLF) fluids as well as plasma were measured. In CLP, T compared with S groups showed: 1) improvement in survival; 2) reduced lung static elastance, alveolar collapse, collagen and elastic fiber content, number of neutrophils in BALF, PLF, and plasma, as well as lung and distal organ cell apoptosis; and 3) increased IL-10 in BALF and plasma, with reduced IL-6, KC, and IL-1 beta in PLF. In conclusion, regular and moderate exercise before the induction of sepsis reduced the risk of lung and distal organ damage, thus increasing survival.

A new enrichment space for the treatment of discontinuous pressures in multi-fluid flows

In this work, a new enrichment space to accommodate jumps in the pressure field at immersed interfaces in finite element formulations, is proposed. The new enrichment adds two degrees of freedom per element that can be eliminated by means of static condensation. The new space is tested and compared with the classical P1 space and to the space proposed by Ausas et al (Comp. Meth. Appl. Mech. Eng., Vol. 199, 10191031, 2010) in several problems involving jumps in the viscosity and/or the presence of singular forces at interfaces not conforming with the element edges. The combination of this enrichment space with another enrichment that accommodates discontinuities in the pressure gradient has also been explored, exhibiting excellent results in problems involving jumps in the density or the volume forces. Copyright (c) 2011 John Wiley & Sons, Ltd.

Muscular and pulmonary O2 uptake kinetics during moderate- and high-intensity sub-maximal knee-extensor exercise in humans

[EN] The purpose of this investigation was to determine the contribution of muscle O(2) consumption (mVO2) to pulmonary O(2) uptake (pVO2) during both low-intensity (LI) and high-intensity (HI) knee-extension exercise, and during subsequent recovery, in humans. Seven healthy male subjects (age 20-25 years) completed a series of LI and HI square-wave exercise tests in which mVO2 (direct Fick technique) and pVO2 (indirect calorimetry) were measured simultaneously. The mean blood transit time from the muscle capillaries to the lung (MTTc-l) was also estimated (based on measured blood transit times from femoral artery to vein and vein to artery). The kinetics of mVO2 and pVO2 were modelled using non-linear regression. The time constant (tau) describing the phase II pVO2 kinetics following the onset of exercise was not significantly different from the mean response time (initial time delay + tau) for mVO2 kinetics for LI (30 +/- 3 vs 30 +/- 3 s) but was slightly higher (P < 0.05) for HI (32 +/- 3 vs 29 +/- 4 s); the responses were closely correlated (r = 0.95 and r = 0.95; P < 0.01) for both intensities. In recovery, agreement between the responses was more limited both for LI (36 +/- 4 vs 18 +/- 4 s, P < 0.05; r = -0.01) and HI (33 +/- 3 vs 27 +/- 3 s, P > 0.05; r = -0.40). MTTc-l was approximately 17 s just before exercise and decreased to 12 and 10 s after 5 s of exercise for LI and HI, respectively. These data indicate that the phase II pVO2 kinetics reflect mVO2 kinetics during exercise but not during recovery where caution in data interpretation is advised. Increased mVO2 probably makes a small contribution to during the first 15-20 s of exercise.

Development of Clinical Decision Support Systems based on Mathematical Models of Physiological Systems

In the last years of research, I focused my studies on different physiological problems. Together with my supervisors, I developed/improved different mathematical models in order to create valid tools useful for a better understanding of important clinical issues. The aim of all this work is to develop tools for learning and understanding cardiac and cerebrovascular physiology as well as pathology, generating research questions and developing clinical decision support systems useful for intensive care unit patients. I. ICP-model Designed for Medical Education We developed a comprehensive cerebral blood flow and intracranial pressure model to simulate and study the complex interactions in cerebrovascular dynamics caused by multiple simultaneous alterations, including normal and abnormal functional states of auto-regulation of the brain. Individual published equations (derived from prior animal and human studies) were implemented into a comprehensive simulation program. Included in the normal physiological modelling was: intracranial pressure, cerebral blood flow, blood pressure, and carbon dioxide (CO2) partial pressure. We also added external and pathological perturbations, such as head up position and intracranial haemorrhage. The model performed clinically realistically given inputs of published traumatized patients, and cases encountered by clinicians. The pulsatile nature of the output graphics was easy for clinicians to interpret. The manoeuvres simulated include changes of basic physiological inputs (e.g. blood pressure, central venous pressure, CO2 tension, head up position, and respiratory effects on vascular pressures) as well as pathological inputs (e.g. acute intracranial bleeding, and obstruction of cerebrospinal outflow). Based on the results, we believe the model would be useful to teach complex relationships of brain haemodynamics and study clinical research questions such as the optimal head-up position, the effects of intracranial haemorrhage on cerebral haemodynamics, as well as the best CO2 concentration to reach the optimal compromise between intracranial pressure and perfusion. We believe this model would be useful for both beginners and advanced learners. It could be used by practicing clinicians to model individual patients (entering the effects of needed clinical manipulations, and then running the model to test for optimal combinations of therapeutic manoeuvres). II. A Heterogeneous Cerebrovascular Mathematical Model Cerebrovascular pathologies are extremely complex, due to the multitude of factors acting simultaneously on cerebral haemodynamics. In this work, the mathematical model of cerebral haemodynamics and intracranial pressure dynamics, described in the point I, is extended to account for heterogeneity in cerebral blood flow. The model includes the Circle of Willis, six regional districts independently regulated by autoregulation and CO2 reactivity, distal cortical anastomoses, venous circulation, the cerebrospinal fluid circulation, and the intracranial pressure-volume relationship. Results agree with data in the literature and highlight the existence of a monotonic relationship between transient hyperemic response and the autoregulation gain. During unilateral internal carotid artery stenosis, local blood flow regulation is progressively lost in the ipsilateral territory with the presence of a steal phenomenon, while the anterior communicating artery plays the major role to redistribute the available blood flow. Conversely, distal collateral circulation plays a major role during unilateral occlusion of the middle cerebral artery. In conclusion, the model is able to reproduce several different pathological conditions characterized by heterogeneity in cerebrovascular haemodynamics and can not only explain generalized results in terms of physiological mechanisms involved, but also, by individualizing parameters, may represent a valuable tool to help with difficult clinical decisions. III. Effect of Cushing Response on Systemic Arterial Pressure. During cerebral hypoxic conditions, the sympathetic system causes an increase in arterial pressure (Cushing response), creating a link between the cerebral and the systemic circulation. This work investigates the complex relationships among cerebrovascular dynamics, intracranial pressure, Cushing response, and short-term systemic regulation, during plateau waves, by means of an original mathematical model. The model incorporates the pulsating heart, the pulmonary circulation and the systemic circulation, with an accurate description of the cerebral circulation and the intracranial pressure dynamics (same model as in the first paragraph). Various regulatory mechanisms are included: cerebral autoregulation, local blood flow control by oxygen (O2) and/or CO2 changes, sympathetic and vagal regulation of cardiovascular parameters by several reflex mechanisms (chemoreceptors, lung-stretch receptors, baroreceptors). The Cushing response has been described assuming a dramatic increase in sympathetic activity to vessels during a fall in brain O2 delivery. With this assumption, the model is able to simulate the cardiovascular effects experimentally observed when intracranial pressure is artificially elevated and maintained at constant level (arterial pressure increase and bradicardia). According to the model, these effects arise from the interaction between the Cushing response and the baroreflex response (secondary to arterial pressure increase). Then, patients with severe head injury have been simulated by reducing intracranial compliance and cerebrospinal fluid reabsorption. With these changes, oscillations with plateau waves developed. In these conditions, model results indicate that the Cushing response may have both positive effects, reducing the duration of the plateau phase via an increase in cerebral perfusion pressure, and negative effects, increasing the intracranial pressure plateau level, with a risk of greater compression of the cerebral vessels. This model may be of value to assist clinicians in finding the balance between clinical benefits of the Cushing response and its shortcomings. IV. Comprehensive Cardiopulmonary Simulation Model for the Analysis of Hypercapnic Respiratory Failure We developed a new comprehensive cardiopulmonary model that takes into account the mutual interactions between the cardiovascular and the respiratory systems along with their short-term regulatory mechanisms. The model includes the heart, systemic and pulmonary circulations, lung mechanics, gas exchange and transport equations, and cardio-ventilatory control. Results show good agreement with published patient data in case of normoxic and hyperoxic hypercapnia simulations. In particular, simulations predict a moderate increase in mean systemic arterial pressure and heart rate, with almost no change in cardiac output, paralleled by a relevant increase in minute ventilation, tidal volume and respiratory rate. The model can represent a valid tool for clinical practice and medical research, providing an alternative way to experience-based clinical decisions. In conclusion, models are not only capable of summarizing current knowledge, but also identifying missing knowledge. In the former case they can serve as training aids for teaching the operation of complex systems, especially if the model can be used to demonstrate the outcome of experiments. In the latter case they generate experiments to be performed to gather the missing data.

Constraints on mantle melting from major and trace element systematics in residual abyssal peridotites

ZusammenfassungDie Bildung von mittelozeanischen Rückenbasalten (MORB) ist einer der wichtigsten Stoffflüsse der Erde. Jährlich wird entlang der 75.000 km langen mittelozeanischen Rücken mehr als 20 km3 neue magmatische Kruste gebildet, das sind etwa 90 Prozent der globalen Magmenproduktion. Obwohl ozeanische Rücken und MORB zu den am meisten untersuchten geologischen Themenbereichen gehören, existieren weiterhin einige Streit-fragen. Zu den wichtigsten zählt die Rolle von geodynamischen Rahmenbedingungen, wie etwa Divergenzrate oder die Nähe zu Hotspots oder Transformstörungen, sowie der absolute Aufschmelzgrad, oder die Tiefe, in der die Aufschmelzung unter den Rücken beginnt. Diese Dissertation widmet sich diesen Themen auf der Basis von Haupt- und Spurenelementzusammensetzungen in Mineralen ozeanischer Mantelgesteine.Geochemische Charakteristika von MORB deuten darauf hin, dass der ozeanische Mantel im Stabilitätsfeld von Granatperidotit zu schmelzen beginnt. Neuere Experimente zeigen jedoch, dass die schweren Seltenerdelemente (SEE) kompatibel im Klinopyroxen (Cpx) sind. Aufgrund dieser granatähnlichen Eigenschaft von Cpx wird Granat nicht mehr zur Erklärung der MORB Daten benötigt, wodurch sich der Beginn der Aufschmelzung zu geringeren Drucken verschiebt. Aus diesem Grund ist es wichtig zu überprüfen, ob diese Hypothese mit Daten von abyssalen Peridotiten in Einklang zu bringen ist. Diese am Ozeanboden aufgeschlossenen Mantelfragmente stellen die Residuen des Aufschmelz-prozesses dar, und ihr Mineralchemismus enthält Information über die Bildungs-bedingungen der Magmen. Haupt- und Spurenelementzusammensetzungen von Peridotit-proben des Zentralindischen Rückens (CIR) wurden mit Mikrosonde und Ionensonde bestimmt, und mit veröffentlichten Daten verglichen. Cpx der CIR Peridotite weisen niedrige Verhältnisse von mittleren zu schweren SEE und hohe absolute Konzentrationen der schweren SEE auf. Aufschmelzmodelle eines Spinellperidotits unter Anwendung von üblichen, inkompatiblen Verteilungskoeffizienten (Kd's) können die gemessenen Fraktionierungen von mittleren zu schweren SEE nicht reproduzieren. Die Anwendung der neuen Kd's, die kompatibles Verhalten der schweren SEE im Cpx vorhersagen, ergibt zwar bessere Resultate, kann jedoch nicht die am stärksten fraktionierten Proben erklären. Darüber hinaus werden sehr hohe Aufschmelzgrade benötigt, was nicht mit Hauptelementdaten in Einklang zu bringen ist. Niedrige (~3-5%) Aufschmelzgrade im Stabilitätsfeld von Granatperidotit, gefolgt von weiterer Aufschmelzung von Spinellperidotit kann jedoch die Beobachtungen weitgehend erklären. Aus diesem Grund muss Granat weiterhin als wichtige Phase bei der Genese von MORB betrachtet werden (Kapitel 1).Eine weitere Hürde zum quantitativen Verständnis von Aufschmelzprozessen unter mittelozeanischen Rücken ist die fehlende Korrelation zwischen Haupt- und Spuren-elementen in residuellen abyssalen Peridotiten. Das Cr/(Cr+Al) Verhältnis (Cr#) in Spinell wird im Allgemeinen als guter qualitativer Indikator für den Aufschmelzgrad betrachtet. Die Mineralchemie der CIR Peridotite und publizierte Daten von anderen abyssalen Peridotiten zeigen, dass die schweren SEE sehr gut (r2 ~ 0.9) mit Cr# der koexistierenden Spinelle korreliert. Die Auswertung dieser Korrelation ergibt einen quantitativen Aufschmelz-indikator für Residuen, welcher auf dem Spinellchemismus basiert. Damit kann der Schmelzgrad als Funktion von Cr# in Spinell ausgedrückt werden: F = 0.10×ln(Cr#) + 0.24 (Hellebrand et al., Nature, in review; Kapitel 2). Die Anwendung dieses Indikators auf Mantelproben, für die keine Ionensondendaten verfügbar sind, ermöglicht es, geochemische und geophysikalischen Daten zu verbinden. Aus geodynamischer Perspektive ist der Gakkel Rücken im Arktischen Ozean von großer Bedeutung für das Verständnis von Aufschmelzprozessen, da er weltweit die niedrigste Divergenzrate aufweist und große Transformstörungen fehlen. Publizierte Basaltdaten deuten auf einen extrem niedrigen Aufschmelzgrad hin, was mit globalen Korrelationen im Einklang steht. Stark alterierte Mantelperidotite einer Lokalität entlang des kaum beprobten Gakkel Rückens wurden deshalb auf Primärminerale untersucht. Nur in einer Probe sind oxidierte Spinellpseudomorphosen mit Spuren primärer Spinelle erhalten geblieben. Ihre Cr# ist signifikant höher als die einiger Peridotite von schneller divergierenden Rücken und ihr Schmelzgrad ist damit höher als aufgrund der Basaltzusammensetzungen vermutet. Der unter Anwendung des oben erwähnten Indikators ermittelte Schmelzgrad ermöglicht die Berechnung der Krustenmächtigkeit am Gakkel Rücken. Diese ist wesentlich größer als die aus Schweredaten ermittelte Mächtigkeit, oder die aus der globalen Korrelation zwischen Divergenzrate und mittels Seismik erhaltene Krustendicke. Dieses unerwartete Ergebnis kann möglicherweise auf kompositionelle Heterogenitäten bei niedrigen Schmelzgraden, oder auf eine insgesamt größere Verarmung des Mantels unter dem Gakkel Rücken zurückgeführt werden (Hellebrand et al., Chem.Geol., in review; Kapitel 3).Zusätzliche Informationen zur Modellierung und Analytik sind im Anhang A-C aufgeführt

Weiterentwicklung einer Produktionsanlage und der Speicherungs- bzw. Transportkonzepte für hochpolarisiertes 3He

Der Bedarf an hyperpolarisiertem 3He in Medizin und physikalischer Grundlagenforschung ist in den letzten ca. 10-15 Jahren sowohl in Bezug auf die zu Verfügung stehende Menge, als auch auf den benötigten Grad der Kernspinpolarisation stetig gestiegen. Gleichzeitig mußten Lösungen für die polarisationserhaltende Speicherung und den Transport gefunden werden, die je nach Anwendung anzupassen waren. Als Ergebnis kann mit dieser Arbeit ein in sich geschlossenes Gesamtkonzept vorgestellt werden, daß sowohl die entsprechenden Mengen für klinische Anwendungen, als auch höchste Polarisation für physikalische Grundlagenfor-schung zur Verfügung stellen kann. Verschiedene unabhängige Polarimetriemethoden zeigten in sich konsistente Ergebnisse und konnten, neben ihrer eigenen Weiterentwicklung, zu einer verläßlichen Charakterisierung des neuen Systems und auch der Transportzellen und –boxen eingesetzt werden. Die Polarisation wird mittels „Metastabilem Optischen Pumpen“ bei einem Druck von 1 mbar erzeugt. Dabei werden ohne Gasfluß Werte von P = 84% erreicht. Im Flußbetrieb sinkt die erreichbare Polarisation auf P ≈ 77%. Das 3He kann dann weitgehend ohne Polarisationsver-luste auf mehrere bar komprimiert und zu den jeweiligen Experimenten transportiert werden. Durch konsequente Weiterentwicklung der vorgestellten Polarisationseinheit an fast allen Komponenten kann somit jetzt bei einem Fluß von 0,8 barl/h eine Polarisation von Pmax = 77% am Auslaß der Apparatur erreicht werden. Diese skaliert linear mit dem Fluß, sodaß bei 3 barl/h die Polarisation immer noch bei ca. 60% liegt. Dabei waren die im Rahmen dieser Arbeit durchgeführten Verbesserungen an den Lasern, der Optik, der Kompressionseinheit, dem Zwischenspeicher und der Gasreinigung wesentlich für das Erreichen dieser Polarisatio-nen. Neben dem Einsatz eines neuen Faserlasersystems ist die hohe Gasreinheit und die lang-lebige Kompressionseinheit ein Schlüssel für diese Leistungsfähigkeit. Seit Herbst 2001 er-zeugte das System bereits über 2000 barl hochpolarisiertes 3He und ermöglichte damit zahl-reiche interdisziplinäre Experimente und Untersuchungen. Durch Verbesserungen an als Prototypen bereits vorhandenen Transportboxen und durch weitgehende Unterdrückung der Wandrelaxation in den Transportgefäßen aufgrund neuer Erkenntnisse über deren Ursachen stellen auch polarisationserhaltende Transporte über große Strecken kein Problem mehr dar. In unbeschichteten 1 Liter Kolben aus Aluminosilikatglä-sern werden nun problemlos Speicherzeiten von T1 > 200h erreicht. Im Rahmen des europäi-schen Forschungsprojektes „Polarized Helium to Image the Lung“ wurden während 19 Liefe-rungen 70barl 3He nach Sheffield (UK) und bei 13 Transporten 100 barl nach Kopenhagen (DK) per Flugzeug transportiert. Zusammenfassend konnte gezeigt werden, daß die Problematik der Kernspinpolarisationser-zeugung von 3He, die Speicherung, der Transport und die Verwendung des polarisierten Ga-ses in klinischer Diagnostik und physikalischen Grundlagenexperimenten weitgehend gelöst ist und das Gesamtkonzept die Voraussetzungen für allgemeine Anwendungen auf diesen Gebieten geschaffen hat.

Three dimensional seismic imaging and earthquake locations in a complex, segmented fault region in Southern Apennines (Italy)

The southern Apennines of Italy have been experienced several destructive earthquakes both in historic and recent times. The present day seismicity, characterized by small-to-moderate magnitude earthquakes, was used like a probe to obatin a deeper knowledge of the fault structures where the largest earthquakes occurred in the past. With the aim to infer a three dimensional seismic image both the problem of data quality and the selection of a reliable and robust tomographic inversion strategy have been faced. The data quality has been obtained to develop optimized procedures for the measurements of P- and S-wave arrival times, through the use of polarization filtering and to the application of a refined re-picking technique based on cross-correlation of waveforms. A technique of iterative tomographic inversion, linearized, damped combined with a strategy of multiscale inversion type has been adopted. The retrieved P-wave velocity model indicates the presence of a strong velocity variation along a direction orthogonal to the Apenninic chain. This variation defines two domains which are characterized by a relatively low and high velocity values. From the comparison between the inferred P-wave velocity model with a portion of a structural section available in literature, the high velocity body was correlated with the Apulia carbonatic platforms whereas the low velocity bodies was associated to the basinal deposits. The deduced Vp/Vs ratio shows that the ratio is lower than 1.8 in the shallower part of the model, while for depths ranging between 5 km and 12 km the ratio increases up to 2.1 in correspondence to the area of higher seismicity. This confirms that areas characterized by higher values are more prone to generate earthquakes as a response to the presence of fluids and higher pore-pressures.

Laser shock peening treatment to control and moderate fatigue crack growth in aircraft structure based on residual stress engineering approach

Laser Shock Peening (LSP) is a surface enhancement treatment which induces a significant layer of beneficial compressive residual stresses of up to several mm underneath the surface of metal components in order to improve the detrimental effects of the crack growth behavior rate in it. The aim of this thesis is to predict the crack growth behavior in metallic specimens with one or more stripes which define the compressive residual stress area induced by the Laser Shock Peening treatment. The process was applied as crack retardation stripes perpendicular to the crack propagation direction with the object of slowing down the crack when approaching the peened stripes. The finite element method has been applied to simulate the redistribution of stresses in a cracked model when it is subjected to a tension load and to a compressive residual stress field, and to evaluate the Stress Intensity Factor (SIF) in this condition. Finally, the Afgrow software is used to predict the crack growth behavior of the component following the Laser Shock Peening treatment and to detect the improvement in the fatigue life comparing it to the baseline specimen. An educational internship at the “Research & Technologies Germany – Hamburg” department of AIRBUS helped to achieve knowledge and experience to write this thesis. The main tasks of the thesis are the following: •To up to date Literature Survey related to “Laser Shock Peening in Metallic Structures” •To validate the FE model developed against experimental measurements at coupon level •To develop design of crack growth slowdown in Centered Cracked Tension specimens based on residual stress engineering approach using laser peened strip transversal to the crack path •To evaluate the Stress Intensity Factor values for Centered Cracked Tension specimens after the Laser Shock Peening treatment via Finite Element Analysis •To predict the crack growth behavior in Centered Cracked Tension specimens using as input the SIF values evaluated with the FE simulations •To validate the results by means of experimental tests

Increasing abdominal pressure with and without PEEP: effects on intra-peritoneal, intra-organ and intra-vascular pressures

Intra-organ and intra-vascular pressures can be used to estimate intra-abdominal pressure. The aim of this prospective, interventional study was to assess the effect of PEEP on the accuracy of pressure estimation at different measurement sites in a model of increased abdominal pressure.

The effects of mechanical ventilation on hepato-splanchnic perfusion

PURPOSE OF REVIEW: Mechanical ventilation is a cornerstone of ICU treatment. Because of its interaction with blood flow and intra-abdominal pressure, mechanical ventilation has the potential to alter hepato-splanchnic perfusion, abdominal organ function and thereby outcome of the most critically ill patients. RECENT FINDINGS: Mechanical ventilation can alter hepato-splanchnic perfusion, but the effects are minimal (with moderate inspiratory pressures, tidal volumes, and positive end-expiratory pressure levels) or variable (with high ones). Routine nursing procedures may cause repeated episodes of inadequate hepato-splanchnic perfusion in critically ill patients, but an association between perfusion and multiple organ dysfunction cannot yet be determined. Clinical research continues to be challenging as a result of difficulties in measuring hepato-splanchnic blood flow at the bedside. SUMMARY: Mechanical ventilation and attempts to improve oxygenation such as intratracheal suctioning and recruitment maneuvers, may have harmful consequences in patients with already limited cardiovascular reserves or deteriorated intestinal perfusion. Due to difficulties in assessing hepato-splanchnic perfusion, such effects are often not detected.