935 resultados para Extracorporeal circulation


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This paper presents data on residents’ use of common stairways and lifts (vertical circulation spaces) in multi-storey apartment buildings (MSABs) in Brisbane, Australia. Vertical movement is a defining aspect of multi-storey living and the energy consumed by lifts contributes significantly to the energy budget of the typical MSAB. The purpose is to investigate whether a reappraisal of vertical circulation design, through the lens of residents’ requirements, might contribute to energy reductions in this building type. Data was gathered on a theoretical sample of MSAB ranging from five decades old to very recent schemes. 90 residents were surveyed about their day-to-day experiences of circulation and access systems. The results showed that residents mainly chose to use the stairs for convenience and exercise. Building management regimes that limited residents’ access to collective spaces were the main impediment to discretionary stair use. Only two buildings did not have fully enclosed stairwells and these had the highest stair usage, suggesting that stair design, and building governance are two areas that might be worthy of attention. The more that circulation design is focussed on limiting access, the less opportunities there are for personal choice, incidental social interaction and casual surveillance of collective spaces. The more that design of vertical circulation spaces in MSAB meets residents’ needs the less likely they are to be reliant on continuous energy supply for normal functioning.

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Background: Transthoracic echocardiography (TTE) during extra corporeal membrane oxygenation (ECMO) is important but can be technically challenging. Contrast-specific TTE can improve imaging in suboptimal studies. These contrast microspheres are hydrodynamically labile structures. This study assessed the feasibility of contrast echocardiography (CE) during venovenous (VV) ECMO in a validated ovine model. Method: Twenty-four sheep were commenced on VV ECMO. Parasternal long-axis (Plax) and short-axis (Psax) views were obtained pre- and postcontrast while on VV ECMO. Endocardial definition scores (EDS) per segment were graded: 1 = good, 2 = suboptimal 3 = not seen. Endocardial border definition score index (EBDSI) was calculated for each view. Endocardial length (EL) in the Plax view for the left ventricle (LV) and right ventricle (RV) was measured. Results: Summation EDS data for the LV and RV for unenhanced TTE (UE) versus CE TTE imaging: EDS 1 = 289 versus 346, EDS 2 = 38 versus 10, EDS 3 = 33 versus 4, respectively. Wilcoxon matched-pairs rank-sign tests showed a significant ranking difference (improvement) pre- and postcontrast for the LV (P < 0.0001), RV (P < 0.0001) and combined ventricular data (P < 0.0001). EBDSI for CE TTE was significantly lower than UE TTE for the LV (1.05 ± 0.17 vs. 1.22 ± 0.38, P = 0.0004) and RV (1.06 ± 0.22 vs. 1.42 ± 0.47, P = 0.0.0006) respectively. Visualized EL was significantly longer in CE versus UE for both the LV (58.6 ± 11.0 mm vs. 47.4 ± 11.7 mm, P < 0.0001) and the RV (52.3 ± 8.6 mm vs. 36.0 ± 13.1 mm, P < 0.0001), respectively. Conclusions: Despite exposure to destructive hydrodynamic forces, CE is a feasible technique in an ovine ECMO model. CE results in significantly improved EDS and increased EL.

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In this study, the nature of basin-scale hydroclimatic association for Indian subcontinent is investigated. It is found that, the large-scale circulation information from Indian Ocean is also equally important in addition to the El Nino-Southern Oscillation (ENSO), owing to the geographical location of Indian subcontinent. The hydroclimatic association of the variation of monsoon inflow into the Hirakud reservoir in India is investigated using ENSO and EQUatorial INdian Ocean Oscillation (EQUINOO, the atmospheric part of Indian Ocean Dipole mode) as the large-scale circulation information from tropical Pacific Ocean and Indian Ocean regions respectively. Individual associations of ENSO & EQUINOO indices with inflow into Hirakud reservoir are also assessed and found to be weak. However, the association of inflows into Hirakud reservoir with the composite index (CI) of ENSO and EQUINOO is quite strong. Thus, the large-scale circulation information from Indian Ocean is also important apart form the ENSO. The potential of the combined information of ENSO and EQUINOO for predicting the inflows during monsoon is also investigated with promising results. The results of this study will be helpful to water resources managers due to fact that the nature of monsoon inflow is becoming available as an early prediction.

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Background The Circle of Willis (CoW) is the most important collateral pathway of the cerebral artery. The present study aims to investigate the collateral capacity of CoW with anatomical variation when unilateral internalcarotid artery (ICA) is occluded. Methods Basing on MRI data, we have reconstructed eight 3D models with variations in the posterior circulation of the CoW and set four different degrees of stenosis in the right ICA, namely 24%, 43%, 64% and 79%, respectively. Finally, a total of 40 models are performed with computational fluid dynamics simulations. All of the simulations share the same boundary condition with static pressure and the volume flow rate (VFR) are obtained to evaluate their collateral capacity. Results As for the middle cerebral artery (MCA) and the anterior cerebral artery (ACA), the transitional-type model possesses the best collateral capacity. But for the posterior cerebral artery (PCA), unilateral stenosis of ICA has the weakest influence on the unilateral posterior communicating artery (PCoA) absent model. We also find that the full fetal-type posterior circle of Willis is an utmost dangerous variation which must be paid more attention. Conclusion The results demonstrate that different models have different collateral capacities in coping stenosis of unilateral ICA and these differences can be reflected by different outlets. The study could be used as a reference for neurosurgeon in choosing the best treatment strategy.

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5 Coin set. 1 Agora; 5 Agorot; 10 Agorot; 1/2 New Sheqel; 1 New Sheqel. All of the coins have Hanukkiyot on the obverse side.

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5 coin set: 5 Agorot; 10 Agorot; 1/2 New Sheqel; 1 New Sheqel; 5 New Sheqalim. All of the coins have on the obverse side Hanukkiyot and word Hanukka.

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A zonally averaged version of the Goddard Laboratory for Atmospheric Sciences (GLAS) climate model is used to study the sensitivity of the northern hemisphere (NH) summer mean meridional circulation to changes in the large scale eddy forcing. A standard solution is obtained by prescribing the latent heating field and climatological horizontal transports of heat and momentum by the eddies. The radiative heating and surface fluxes are calculated by model parameterizations. This standard solution is compared with the results of several sensitivity studies. When the eddy forcing is reduced to 0.5 times or increased to 1.5 times the climatological values, the strength of the Ferrel cells decrease or increase proportionally. It is also seen that such changes in the eddy forcing can influence the strength of theNH Hadley cell significantly. Possible impact of such changes in the large scale eddy forcing on the monsoon circulation via changes in the Hadley circulation is discussed. Sensitivity experiments including only one component of eddy forcing at a time show that the eddy momentum fluxes seem to be more important in maintaining the Ferrel cells than the eddy heat fluxes. In the absence of the eddy heat fluxes, the observed eddy momentum fluxes alone produce subtropical westerly jets which are weaker than those in the standard solution. On the other hand, the observed eddy heat fluxes alone produce subtropical westerly jets which are stronger than those in the standard solution.

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The matrix of blood is a liquid plasma that transports molecules and blood cells within vessels lined by endothelial cells. High-mobility group B1 (HMGB1) is a protein expressed in blood cells. Under normal circumstances, HMGB1 is virtually absent from plasma, but during inflammation or trauma its level in plasma is increased. In resting and quiescent cells, HMGB1 is usually localized in the intracellular compartment, with the exception of motile cells that express HMGB1 on their outer surface to mediate cell migration. During cell transformation or immune cell activation HMGB1 can be actively secreted outside of the cell. Further, when a cell is damaged, HMGB1 can passively leak into extracellular environment. Extracellular HMGB1 can then participate in regulation of the immune response and under some conditions it can mediate lethality in systemic inflammatory response. The aim of this study was to evaluate the expression and functions of HMGB1 in cells of the vascular system and to investigate the prognostic value of circulating HMGB1 in severe sepsis and septic shock. HMGB1 was detected in platelets, leukocytes, and endothelial cells. HMGB1 was released from platelets and leukocytes, and it was found to mediate their adhesive and migratory functions. During severe infections the plasma levels of HMGB1 were elevated; however, no direct correlation with lethality was found. Further, the analysis of proinflammatory mechanisms suggested that HMGB1 forms complexes with other molecules to activate the immune system. In conclusion, HMGB1 is expressed in the cells of the vascular system, and it participates in inflammatory mechanisms by activating platelets and leukocytes and by mediating monocyte migration.

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An Ocean General Circulation Model of the Indian Ocean with high horizontal (0.25 degrees x 0.25 degrees) and vertical (40 levels) resolutions is used to study the dynamics and thermodynamics of the Arabian Sea mini warm pool (ASMWP), the warmest region in the northern Indian Ocean during January-April. The model simulates the seasonal cycle of temperature, salinity and currents as well as the winter time temperature inversions in the southeastern Arabian Sea (SEAS) quite realistically with climatological forcing. An experiment which maintained uniform salinity of 35 psu over the entire model domain reproduces the ASMWP similar to the control run with realistic salinity and this is contrary to the existing theories that stratification caused by the intrusion of low-salinity water from the Bay of Bengal into the SEAS is crucial for the formation of ASMWP. The contribution from temperature inversions to the warming of the SEAS is found to be negligible. Experiments with modified atmospheric forcing over the SEAS show that the low latent heat loss over the SEAS compared to the surroundings, resulting from the low winds due to the orographic effect of Western Ghats, plays an important role in setting up the sea surface temperature (SST) distribution over the SEAS during November March. During March-May, the SEAS responds quickly to the air-sea fluxes and the peak SST during April-May is independent of the SST evolution during previous months. The SEAS behaves as a low wind, heat-dominated regime during November-May and, therefore, the formation and maintenance of the ASMWP is not dependent on the near surface stratification.

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We respond to Dikpati et al.'s criticism of our recent solar dynamo model. A different treatment of the magnetic buoyancy is the most probable reason for their different results.

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"In this study, for the first time, two distinct genetic lineages of Puumala virus (PUUV) were found within a small sampling area and within a single host genetic lineage (Ural mtDNA) at Pallasjarvi, northern Finland. Lung tissue samples of 171 bank voles (Myodes glareolus) trapped in September 1998 were screened for the presence of PUUV nucleocapsid antigen and 25 were found to be positive. Partial sequences of the PUUV small (S), medium (M) and large (L) genome segments were recovered from these samples using RT-PCR. Phylogenetic analysis revealed two genetic groups of PUUV sequences that belonged to the Finnish and north Scandinavian lineages. This presented a unique opportunity to study inter-lineage reassortment in PUUV; indeed, 32% of the studied bank voles appeared to carry reassortant virus genomes. Thus, the frequency of inter-lineage reassortment in PUUV was comparable to that of intra-lineage reassortment observed previously (Razzauti, M., Plyusnina, A., Henttonen, H. & Plyusnin, A. (2008). J Gen Virol 89, 1649-1660). Of six possible reassortant S/M/L combinations, only two were found at Pallasjarvi and, notably, in all reassortants, both S and L segments originated from the same genetic lineage, suggesting a non-random pattern for the reassortment. These findings are discussed in connection to PUUV evolution in Fermoscandia."

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The mathematical model developed by Hansen and Rattray based on Pritchard's equations for a coastal-plain estuary has been analysed to study the circulation and salinity distributions in coastal inlets with constant width and depth. Numerical solutions of the basic equations have been obtained without placing any restriction on Rayleigh numbers. A noteworthy contribution of the present analysis is that solutions of equations have been obtained for higher Rayleigh numbers, which was not possible in the earlier model. It is found that the effect of higher Rayleigh numbers is to increase the vertical advection, making the salinities in the upper and lower layers more uniform with a distinct halocline near the mid-depths. Solutions are discussed for some special cases of practical interest.

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Meridional circulation is an important ingredient in flux transport dynamo models. We have studied its importance on the period, the amplitude of the solar cycle, and also in producing Maunder-like grand minima in these models. First, we model the periods of the last 23 sunspot cycles by varying the meridional circulation speed. If the dynamo is in a diffusion-dominated regime, then we find that most of the cycle amplitudes also get modeled up to some extent when we model the periods. Next, we propose that at the beginning of the Maunder minimum the amplitude of meridional circulation dropped to a low value and then after a few years it increased again. Several independent studies also favor this assumption. With this assumption, a diffusion-dominated dynamo is able to reproduce many important features of the Maunder minimum remarkably well. If the dynamo is in a diffusion-dominated regime, then a slower meridional circulation means that the poloidal field gets more time to diffuse during its transport through the convection zone, making the dynamo weaker. This consequence helps to model both the cycle amplitudes and the Maunder-like minima. We, however, fail to reproduce these results if the dynamo is in an advection-dominated regime.

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The impact of moisture anomalies on the circulation of the south-west Indian monsoon has been studied with a general circulation model. Newtonian relaxation is adopted to subject the model atmosphere under sustained moisture anomalies. The impact of negative anomalies of moisture was seen as a divergent circulation anomaly, while the positive anomaly was a stronger convergent anomaly. Although the humidity fields display a resilient behaviour, and relax back to normal patterns 1–2 days after the forcing terms in humidity are withdrawn, the circulation anomalies created by the moisture variation keeps growing. A feedback between positive moisture anomalies and low level convergence exists, which is terminated in the absence of external forcings.