Assessing pediatric nasal carriage of S. aureus & MRSA

Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) has become an increasing problem in the community. Nasal carriage of these bacteria has been shown to be a predisposing factor for infection and environmental contamination. This serious public health concern prompted an investigation to assess the pediatric nasal carriage of these bacteria in an effort to better understand the populations at risk and prevention of infection.^ This prospective study surveys 30 children from the Northwest Assistance Ministries (NAM) pediatric clinic from October 2008 to the present. Two nasal swabs were taken in 2-4 week intervals to determine S. aureus carrier status. Microbiologic tests were conducted to isolate and identify S. aureus from nasal cultures. Children with 2 cultures positive for S. aureus were classified as persistent carriers, those with 1 positive and 1 negative culture were classified as intermittent carriers, and those with 2 negative cultures were classified as noncarriers. This information was related to patient records and statistical analyses (X 2 and t-tests) were performed.^ Distribution of S. aureus carriage related to patient demographics (age, sex, & race) was showed no significant differences between S. aureus positive and S. aureus negative patient populations (p = 0.8). Additionally, the distribution of carrier status related to demographics also showed no significant difference (p = 0.8). Finally, the distribution of carrier status related to relevant medical history (immunizations current, past infection, & antibiotic use at time of swabbing) showed no significant difference (p = 0.4).^ This study is a snapshot of an ongoing study to assess the pediatric nasal carriage of S. aureus and MRSA. The inability to draw any reliable conclusion from the distribution of data is likely a result of an inadequate samples size. This is one of few studies assessing pediatric nasal carriage of S. aureus and targeting an underrepresented, Hispanic population is especially unique. Continuing this study allows for a better understanding of the epidemiology of this bacterium which will hopefully lead to appropriate interventions thus preventing future S. aureus infections.^

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among dental professionals

Background. MRSA (methicillin-resistant Staphylococcus aureus) is a multi-drug resistant bacterium that is quite prevalent in social environments where close person-to-person contact and crowding are an issue. In dental settings, the likelihood of transmission of MRSA may be higher than among other healthcare practitioners because of the close proximity between a patient's nose (where MRSA colonizes) and the field of procedure (the mouth) to the dental professional. Objective. To estimate the prevalence of MRSA nasal colonization among dental professionals (dentists and dental hygienists) in the Greater Houston Metropolitan Area, Texas, and analyze its associations with demographic, professional and personal protective equipment-related variables. Methods. 800 dental professionals (400 dentists and 400 dental hygienists) were randomly selected in the Greater Houston Metropolitan Area. Multiple waves of nasal swab kits and a self-administered questionnaire were mailed to increase the response rate of the study population. The swabs were cultured on chromagenic agar growth medium and bacterial growth results were evaluated after 18 hours. Positively selected bacterial colonies were confirmed as MRSA by further culturing these isolated bacteria on blood agar plates. Associations between positive nasal swabs and self-reported professional practice patterns, personal protective equipment use and demographics were analyzed using multiple logistic regression. Main Results. Completed questionnaires and nasal swabs were received from 496 study participants (68%). Fourteen cultures were positive for MRSA (4.2% among dentists and 1.6% among dental hygienists, p=0.07). After adjusting for gender, dental hygienists had a significantly lower prevalence of nasal colonization of MRSA as compared to dentists (OR: 0.20, 95% CI: 0.05–0.75). No other significant associations or interactions were found. Conclusion. The prevalence of nasal colonization with MRSA among dentists is similar to that reported for health care workers in general, whereas prevalence among dental hygienists is only slightly above that of the general population (1%). Differences in practice patterns and use of personal protective equipment did not explain this difference in this study, and was possibly due either to residual confounding or unexplored risk factors. Increased prevalence of MRSA among dentists warrants further investigation as to the reason for the increased rate and to allow implementation of measures to avoid transmission and progression to disease. ^

Three-dimensional flow instability in a lid-driven isosceles triangular cavity

Linear three-dimensional modal instability of steady laminar two-dimensional states developing in a lid-driven cavity of isosceles triangular cross-section is investigated theoretically and experimentally for the case in which the equal sides form a rectangular corner. An asymmetric steady two-dimensional motion is driven by the steady motion of one of the equal sides. If the side moves away from the rectangular corner, a stationary three-dimensional instability is found. If the motion is directed towards the corner, the instability is oscillatory. The respective critical Reynolds numbers are identified both theoretically and experimentally. The neutral curves pertinent to the two configurations and the properties of the respective leading eigenmodes are documented and analogies to instabilities in rectangular lid-driven cavities are discussed.

Effect of Aspect Ratio on the Three-Dimensional Global Instability Analysis of Incompressible Open Cavity Flows

The stability analysis of open cavity flows is a problem of great interest in the aeronautical industry. This type of flow can appear, for example, in landing gears or auxiliary power unit configurations. Open cavity flows is very sensitive to any change in the configuration, either physical (incoming boundary layer, Reynolds or Mach numbers) or geometrical (length to depth and length to width ratio). In this work, we have focused on the effect of geometry and of the Reynolds number on the stability properties of a threedimensional spanwise periodic cavity flow in the incompressible limit. To that end, BiGlobal analysis is used to investigate the instabilities in this configuration. The basic flow is obtained by the numerical integration of the Navier-Stokes equations with laminar boundary layers imposed upstream. The 3D perturbation, assumed to be periodic in the spanwise direction, is obtained as the solution of the global eigenvalue problem. A parametric study has been performed, analyzing the stability of the flow under variation of the Reynolds number, the L/D ratio of the cavity, and the spanwise wavenumber β. For consistency, multidomain high order numerical schemes have been used in all the computations, either basic flow or eigenvalue problems. The results allow to define the neutral curves in the range of L/D = 1 to L/D = 3. A scaling relating the frequency of the eigenmodes and the length to depth ratio is provided, based on the analysis results.

Wave-like Disturbances on the Downstream Wall of an Open Cavity

This contribution presents results of an incompressible two-dimensional flow over an open cavity of fixed aspect ratio (length/depth) L/D = 2 and the coupling between the three dimensional low frequency oscillation mode confined in the cavity and the wave-like disturbances evolving on the downstream wall of the cavity in the form of Tollmien-Schlichting waves. BiGlobal instability analysis is conducted to search the global disturbances superimposed upon a two-dimensional steady basic flow. The base solution is computed by the integration of the laminar Navier-Stokes equations in primitive variable formulation, while the eigenvalue problem (EVP) derived from the discretization of the linearized equations of motion in the BiGlobal framework is solved using an iterative procedure. The formulation of the BiGlobal EVP for the unbounded flow in the open cavity problem introduces additional difficulties regarding the flow-through boundaries. Local analysis has been utilized for the determination of the proper boundary conditions in the upper limit of the downstream region

Modeling Reflective Bistability in Vertical-Cavity Semiconductor Optical Amplifiers

The characteristics of optical bistability in a vertical- cavity semiconductor optical amplifier (VCSOA) operated in reflection are reported. The dependences of the optical bistability in VCSOAs on the initial phase detuning and on the applied bias current are analyzed. The optical bistability is also studied for different numbers of superimposed periods in the top distributed bragg reflector (DBR) that conform the internal cavity of the device. The appearance of the X-bistable and the clockwise bistable loops is predicted theoretically in a VCSOA operated in reflection for the first time, to the best of our knowledge. Moreover, it is also predicted that the control of the VCSOA’s top reflectivity by the addition of new superimposed periods in its top DBR reduces by one order of magnitude the input power needed for the assessment of the X- and the clockwise bistable loop, compared to that required in in-plane semiconductor optical amplifiers. These results, added to the ease of fabricating two-dimensional arrays of this kind of device could be useful for the development of new optical logic or optical signal regeneration devices.

Vertical-cavity semiconductor optical amplifiers (VCSOAs) as optical sensing elements

Semiconductor Optical Amplifiers (SOAs) have mainly found application in optical telecommunication networks for optical signal regeneration, wavelength switching or wavelength conversion. The objective of this paper is to report the use of semiconductor optical amplifiers for optical sensing taking into account their optical bistable properties. As it was previously reported, some semiconductor optical amplifiers, including Fabry-Perot and Distributed-Feedback Semiconductor Optical Amplifiers (FPSOAs and DFBSOAs), may exhibit optical bistability. The characteristics of the attained optical bistability in this kind of devices are strongly dependent on different parameters including wavelength, temperature or applied bias current and small variations lead to a change on their bistable properties. As in previous analyses for Fabry-Perot and DFB SOAs, the variations of these parameters and their possible application for optical sensing are reported in this paper for the case of the Vertical-Cavity Semiconductor Optical Amplifier (VCSOA). When using a VCSOA, the input power needed for the appearance of optical bistability is one order of magnitude lower than that needed in edge-emitting devices. This feature, added to the low manufacturing costs of VCSOAs and the ease to integrate them in 2-D arrays, makes the VCSOA a very promising device for its potential use in optical sensing applications.

Low-power vertical cavity NAND gate

The study of the Vertical-Cavity Semiconductor Optical Amplifiers (VCSOAs) for optical signal processing applications is increasing his interest. Due to their particular structure, the VCSOAs present some advantages when compared to their edge-emitting counterparts including low manufacturing costs, high coupling efficiency to optical fibers and the ease to fabricate 2-D arrays of this kind of devices. As a consequence, all-optical logic gates based on VCSOAs may be very promising devices for their use in optical computing and optical switching in communications. Moreover, since all the boolean logic functions can be implemented by combining NAND logic gates, the development of a Vertical-Cavity NAND gate would be of particular interest. In this paper, the characteristics of the dispersive optical bistability appearing on a VCSOA operated in reflection are studied. A progressive increment of the number of layers compounding the top Distributed Bragg Reflector (DBR) of the VCSOA results on a change on the shape of the appearing bistability from an S-shape to a clockwise bistable loop. This resulting clockwise bistability has high on-off contrast ratio and input power requirements one order of magnitude lower than those needed for edge-emitting devices. Based on these results, an all-optical vertical-cavity NAND gate with high on-off contrast ratio and an input power for operation of only 10|i\V will be reported in this paper.

On linear instability mechanisms in incompressible open cavity flow

A theoretical study of linear global instability of incompressible flow over a rectangular spanwise-periodic open cavity in an unconfined domain is presented. Comparisons with the limited number of results available in the literature are shown. Subsequently, the parameter space is scanned in a systematic manner, varying Reynolds number, incoming boundary-layer thickness and length-to-depth aspect ratio. This permits documenting the neutral curves and leading eigenmode characteristics of this flow. Correlations constructed using the results obtained collapse all available theoretical data on the three-dimensional instabilities.

Instability Analysis of Incompressible Open Cavity Flows

El problema del flujo sobre una cavidad abierta ha sido estudiado en profundidad en la literatura, tanto por el interés académico del problema como por sus aplicaciones prácticas en gran variedad de problemas ingenieriles, como puede ser el alojamiento del tren de aterrizaje de aeronaves, o el depósito de agua de aviones contraincendios. Desde hace muchos a˜nos se estudian los distintos tipos de inestabilidades asociadas a este problema: los modos bidimensionales en la capa de cortadura, y los modos tridimensionales en el torbellino de recirculación principal dentro de la cavidad. En esta tesis se presenta un estudio paramétrico completo del límite incompresible del problema, empleando la herramienta de estabilidad lineal conocida como BiGlobal. Esta aproximación permite contemplar la estabilidad global del flujo, y obtener tanto la forma como las características de los modos propios del problema físico, sean estables o inestables. El estudio realizado permite caracterizar con gran detalle todos los modos relevantes, así como la envolvente de estabilidad en el espacio paramétrico del problema incompresible (Mach nulo, variación de Reynolds, espesor de capa límite incidente, relación altura/profundidad de la cavidad, y longitud característica de la perturbación en la dirección transversal). A la luz de los resultados obtenidos se proponen una serie de relaciones entre los parámetros y características de los modos principales, como por ejemplo entre el Reynolds crítico de un modo, y la longitud característica del mismo. Los resultados numéricos se contrastan con una campaña experimental, siendo la principal conclusión de dicha comparación que los modos lineales están presentes en el flujo real saturado, pero que existen diferencias notables en frecuencia entre las predicciones teóricas y los experimentos. Para intentar determinar la naturaleza de dichas diferencias se realiza una simulación numérica directa tridimensional, y se utiliza un algoritmo de DMD (descomposición dinámica de modos) para describir el proceso de saturación. ABSTRACT The problem of the flow over an open cavity has been studied in depth in the literature, both for being an interesting academical problem and due to the multitude of industrial applications, like the landing gear of aircraft, or the water deposit of firefighter airplanes. The different types of instabilities appearing in this flow studied in the literature are two: the two-dimensional shear layer modes, and the three-dimensional modes that appear in the main recirculating vortex inside the cavity. In this thesis a parametric study in the incompressible limit of the problem is presented, using the linear stability analysis known as BiGlobal. This approximation allows to obtain the global stability behaviour of the flow, and to capture both the morphological features and the characteristics of the eigenmodes of the physical problem, whether they are stable or unstable. The study presented here characterizes with great detail all the relevant eigenmodes, as well as the hypersurface of instability on the parameter space of the incompressible problem (Mach equal to zero, and variation of the Reynolds number, the incoming boundary layer thickness, the length to depth aspect ratio of the cavity and the spanwise length of the perturbation). The results allow to construct parametric relations between the characteristics of the leading eigenmodes and the parameters of the problem, like for example the one existing between the critical Reynolds number and its characteristic length. The numerical results presented here are compared with those of an experimental campaign, with the main conclusion of said comparison being that the linear eigenmode are present in the real saturated flow, albeit with some significant differences in the frequencies of the experiments and those predicted by the theory. To try to determine the nature of those differences a three-dimensional direct numerical simulation, analyzed with Dynamic Mode Decomposition algorithm, was used to describe the process of saturation.

Linear instability analysis of incompressible flow over a cuboid cavity

Direct numerical simulations are performed to analyze the three-dimensional instability of flows over three-dimensional cavities. The flow structures at different Reynolds numbers are investigated by using the spectral-element solver nek5000. As the Reynolds number increasing, the lateral wall effects become more important, the recirculation zone shrinks, the front vortex increases and the flow structure inside of the cavity becomes more complex. Results show that the flow bifurcates from a steady state to an oscillatory regime beyond a value of Reynolds number Re = 1100.

Global instability analysis and control of three-dimensional long open cavity flow

The three-dimensional wall-bounded open cavity may be considered as a simplified geometry found in industrial applications such as leading gear or slotted flats on the airplane. Understanding the three-dimensional complex flow structure that surrounds this particular geometry is therefore of major industrial interest. At the light of the remarkable former investigations in this kind of flows, enough evidences suggest that the lateral walls have a great influence on the flow features and hence on their instability modes. Nevertheless, even though there is a large body of literature on cavity flows, most of them are based on the assumption that the flow is two-dimensional and spanwise-periodic. The flow over realistic open cavity should be considered. This thesis presents an investigation of three-dimensional wall-bounded open cavity with geometric ratio 6:2:1. To this aim, three-dimensional Direct Numerical Simulation (DNS) and global linear instability have been performed. Linear instability analysis reveals that the onset of the first instability in this open cavity is around Recr 1080. The three-dimensional shear layer mode with a complex structure is shown to be the most unstable mode. I t is noteworthy that the flow pattern of this high-frequency shear layer mode is similar to the observed unstable oscillations in supercritical unstable case. DNS of the cavity flow carried out at different Reynolds number from steady state until a nonlinear saturated state is obtained. The comparison of time histories of kinetic energy presents a clearly dominant energetic mode which shifts between low-frequency and highfrequency oscillation. A complete flow patterns from subcritical cases to supercritical case has been put in evidence. The flow structure at the supercritical case Re=1100 resembles typical wake-shedding instability oscillations with a lateral motion existed in the subcritical cases. Also, This flow pattern is similar to the observations in experiments. In order to validate the linear instability analysis results, the topology of the composite flow fields reconstructed by linear superposition of a three-dimensional base flow and its leading three-dimensional global eigenmodes has been studied. The instantaneous wall streamlines of those composited flows display distinguish influence region of each eigenmode. Attention has been focused on the leading high-frequency shear layer mode; the composite flow fields have been fully recognized with respect to the downstream wave shedding. The three-dimensional shear layer mode is shown to give rise to a typical wake-shedding instability with a lateral motions occurring downstream which is in good agreement with the experiment results. Moreover, the spanwise-periodic, open cavity with the same length to depth ratio has been also studied. The most unstable linear mode is different from the real three-dimensional cavity flow, because of the existence of the side walls. Structure sensitivity of the unstable global mode is analyzed in the flow control context. The adjoint-based sensitivity analysis has been employed to localized the receptivity region, where the flow is more sensible to momentum forcing and mass injection. Because of the non-normality of the linearized Navier-Stokes equations, the direct and adjoint field has a large spatial separation. The strongest sensitivity region is locate in the upstream lip of the three-dimensional cavity. This numerical finding is in agreement with experimental observations. Finally, a prototype of passive flow control strategy is applied.

DETERMINAÇÃO DA POSIÇÃO DE REPOUSO DA LÍNGUA EM INDIVÍDUOS COM OCLUSÃO DENTÁRIA NORMAL

O propósito neste estudo foi determinar a posição de repouso da língua em indivíduos com oclusão dentária normal e respiração nasal, por meio de telerradiografias em norma lateral realizadas após a ingestão de bário. A amostra foi composta por 66 radiografias de indivíduos brancos com oclusão dentária normal, sendo 26 do sexo masculino e 40 do sexo feminino, na faixa etária de 12 a 21 anos de idade, procedentes de escolas da região do Grande ABC Paulista. O critério utilizado para diagnóstico da oclusão normal foi As Seis Chaves para a Oclusão Normal preconizadas por Andrews (1972), devendo estar presentes no mínimo quatro das seis chaves, sendo obrigatória a presença da primeira chave de oclusão que é a da relação interarcos. As radiografias foram obtidas com o indivíduo em posição natural da cabeça após a ingestão de contraste de sulfato de bário para evidenciar o controle da língua. Posteriormente foi feito o desenho anatômico das estruturas pesquisadas, marcados os pontos cefalométricos, traçadas as linhas e os planos, e por último obtidas as seguintes medidas lineares: comprimento e altura da língua, distância do dorso da língua na sua porção média até o palato duro e a distância entre a ponta da língua e a incisal do incisivo inferior. Por meio dos resultados encontrados verificou-se que não existe um padrão único de posicionamento de repouso da língua dentro da cavidade oral, em pacientes respiradores nasais, variando muito sua distância até a incisal dos incisivos inferiores, bem como até o palato duro, havendo uniformidade apenas no fato da língua tocar o palato mole em todos os indivíduos da amostra. Não houve relação estatisticamente significante entre a posição de repouso da língua e os biotipos faciais e nem dimorfismo sexual.