The Strutjet Rocket Based Combined Cycle Engine

The multi stage chemical rocket has been established over many years as the propulsion System for space transportation vehicles, while, at the same time, there is increasing concern about its continued affordability and rather involved reusability. Two broad approaches to addressing this overall launch cost problem consist in one, the further development of the rocket motor, and two, the use of airbreathing propulsion to the maximum extent possible as a complement to the limited use of a conventional rocket. In both cases, a single-stage-to-orbit (SSTO) vehicle is considered a desirable goal. However, neither the "all-rocket" nor the "all-airbreathing" approach seems realizable and workable in practice without appreciable advances in materials and manufacturing. An affordable system must be reusable with minimal refurbishing on-ground, and large mean time between overhauls, and thus with high margins in design. It has been suggested that one may use different engine cycles, some rocket and others airbreathing, in a combination over a flight trajectory, but this approach does not lead to a converged solution with thrust-to-mass, specific impulse, and other performance and operational characteristics that can be obtained in the different engines. The reason is this type of engine is simply a combination of different engines with no commonality of gas flowpath or components, and therefore tends to have the deficiencies of each of the combined engines. A further development in this approach is a truly combined cycle that incorporates a series of cycles for different modes of propulsion along a flight path with multiple use of a set of components and an essentially single gas flowpath through the engine. This integrated approach is based on realizing the benefits of both a rocket engine and airbreathing engine in various combinations by a systematic functional integration of components in an engine class usually referred to as a rocket-based combined cycle (RBCC) engine. RBCC engines exhibit a high potential for lowering the operating cost of launching payloads into orbit. Two sources of cost reductions can be identified. First, RBCC powered vehicles require only 20% takeoff thrust compared to conventional rockets, thereby lowering the thrust requirements and the replacement cost of the engines. Second, due to the higher structural and thermal margins achievable with RBCC engines coupled with a higher degree of subsystem redundance lower maintenance and operating cost are obtainable

Syncytiotrophoblast Microvesicles Released from Pre-Eclampsia Placentae Exhibit Increased Tissue Factor Activity

Background: Pre-eclampsia is a complication of pregnancy associated with activation of coagulation. It is caused by the placenta, which sheds increased amounts of syncytiotrophoblast microvesicles (STBM) into the maternal circulation. We hypothesized that STBM could contribute to the haemostatic activation observed in pre-eclampsia. Methodology/Principal Findings: STBM were collected by perfusion of the maternal side of placentae from healthy pregnant women and women with pre-eclampsia at caesarean section. Calibrated automated thrombography was used to assess thrombin generation triggered by STBM-borne tissue factor in platelet poor plasma (PPP). No thrombin was detected in PPP alone but the addition of STBM initiated thrombin generation in 14/16 cases. Pre-eclampsia STBM significantly shortened the lag time (LagT, P = 0.01) and time to peak thrombin generation (TTP, P = 0.005) when compared to normal STBM. Blockade of tissue factor eliminated thrombin generation, while inhibition of tissue factor pathway inhibitor significantly shortened LagT (p = 0.01) and TTP (P,0.0001), with a concomitant increase in endogenous thrombin potential. Conclusions/Significance: STBM triggered thrombin generation in normal plasma in a tissue factor dependent manner, indicating that TF activity is expressed by STBM. This is more pronounced in STBM shed from pre-eclampsia placentae. As more STBM are shed in pre-eclampsia these observations give insight into the disordered haemostasis observed in thi

The WOMAN Trial (World Maternal Antifibrinolytic Trial): tranexamic acid for the treatment of postpartum haemorrhage: an international randomised, double blind placebo controlled trial

<p>Abstract</p> <p>Background</p> <p>Each year, worldwide about 530,000 women die from causes related to pregnancy and childbirth. Of the deaths 99% are in low and middle income countries. Obstetric haemorrhage is the leading cause of maternal mortality, most occurring in the postpartum period. Systemic antifibrinolytic agents are widely used in surgery to prevent clot breakdown (fibrinolysis) in order to reduce surgical blood loss. At present there is little reliable evidence from randomised trials on the effectiveness of tranexamic acid in the treatment of postpartum haemorrhage.</p> <p>Methods</p> <p>The Trial aims to determine the effect of early administration of tranexamic acid on mortality, hysterectomy and other morbidities (surgical interventions, blood transfusion, risk of non-fatal vascular events) in women with clinically diagnosed postpartum haemorrhage. The use of health services and safety, especially thromboembolic effect, on breastfed babies will also be assessed. The trial will be a large, pragmatic, randomised, double blind, placebo controlled trial among 15,000 women with a clinical diagnosis of postpartum haemorrhage. All legally adult women with clinically diagnosed postpartum haemorrhage following vaginal delivery of a baby or caesarean section will potentially be eligible. The fundamental eligibility criterion is the responsible clinician's 'uncertainty' as to whether or not to use an antifibrinolytic agent in a particular woman with postpartum haemorrhage. Treatment will entail a dose of tranexamic acid (1 gram by intravenous injection) or placebo (sodium chloride 0.9%) will be given as soon as possible after randomisation. A second dose may be given if after 30 minutes bleeding continues, or if it stops and restarts within 24 hours after the first dose.</p> <p>The main analyses will be on an 'intention to treat' basis, irrespective of whether the allocated treatment was received or not. Subgroup analyses for the primary outcome will be based on type of delivery; administration or not of prophylactic uterotonics; and on whether the clinical decision to consider trial entry was based primarily on estimated blood loss alone or on haemodynamic instability. A study with 15,000 women will have over 90% power to detect a 25% reduction from 4% to 3% in the primary endpoint of mortality or hysterectomy.</p> <p>Trial registration</p> <p>Current Controlled Trials: ISRCTN76912190 and Clinicaltrials.gov ID: NCT00872469</p