Risk factors for central venous catheter-related infections in surgical and intensive care units. The Central Venous Catheter-Related Infections Study Group.

To identify avoidable risk factors for central venous catheter (CVC) infections in patients undergoing short-term catheterization

Fire in the Operating Room During Hypospadias Repair

Fire in the operating room (OR) is a very distressful and shocking occurrence with potential dramatic consequences. Despite safety rules and rigorous recommendations, such unintentional events do occur every so often. Notably, the vast majority of cases have been reported in the adult population, with very few pediatric cases described to date. Herein, we report on a 16-month-old boy undergoing reconstructive surgery for penoscrotal hypospadias, who experienced an OR fire most likely related to the use of alcohol-based solution ignited by monopolar electrocautery

Phase-averaged characterization of turbulent isothermal free swirling jet after vortex breakdown

This work mainly focused on the near-exit region of a round isothermal free swirling jet to characterize the effect of swirl on the flow field and to identify large coherent structures. 3C-2D PIV was employed to capture the instantaneous flow field close to the nozzle exit for non-swirling (S=0) and a high swirling jets (S=1.26) both with a Reynolds number of 21800. At swirl level of 1.26 the pressure fluctuations measured by a capacitive microphone indicate the existence of periodic instability, the so called precessing vortex core (PVC). A three-component proper orthogonal decomposition (POD) applied to the instantaneous velocity fields allow to identify the dominant flow structure associated to the PVC. The time coefficients of the two first most energetic POD modes were used to reconstruct the phase of the oscillatory motion in the swirling flow. The phase information was then used to conditionally average the instantaneous velocity field s, this allowed the 3D structure of the PVC to be reconstructed. The instantaneous minima of negative swirling strength values calculated from the instantaneous velocity field revealed the presence of two helical structures located in the inner and outer shear layers. By phase averaging the instantaneous swirling strength maps, the 3D helical vortex structure was reconstructed . The two co-winding counter-rotating helical structure fade out at an axial location of approximately z/ D = 1.5. The findings evidence that the combined application of PIV, POD and frequency analysis using capacitive microphone can provide detailed observations of coherent fluctuations ind uced by vortex precession

DMD Analysis of Experimental PIV Data of a Swirled Jet

This paper concerns the study of high Reynolds and high swirl number flow through the use of PIV measurements and Dynamic Mode Decomposition (DMD) analysis. Principles governing DMD are briefly recalled, then the use of DMD is demonstrated by analysing the acquired PIV data in order to study the dominant dynamics of the system and extracting relevant morphology via DMD modes, focusing the attention on phenomenon known as Precessing Vortex Core (PVC)

Posttransplant lymphoproliferative disorders in neuronal xenotransplanted macaques

Posttransplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of lymphoid proliferations that occur in the setting of depressed T-cell function due to immunosuppressive therapy used following solid organ transplantation, hematopoietic stem cell transplantation, and also xenotransplantation. In the present study, 28 immunosuppressed parkinsonian Macaca fascicularis were intracerebrally injected with wild-type or CTLA4-Ig transgenic porcine xenografts to identify a suitable strategy to enable long-term cell survival, maturation, and differentiation. Nine of 28 (32%) immunosuppressed primates developed masses compatible with PTLD, located mainly in the gastrointestinal tract and/or nasal cavity. The masses were classified as monomorphic PTLD according to the World Health Organization classification. Immunohistochemistry and polymerase chain reaction (PCR) analyses revealed that the PTLDs were associated with macaca lymphocryptovirus as confirmed by double-labeling immunohistochemistry for CD20 and Epstein-Barr nuclear antigen 2 (EBNA-2), where the viral protein was located within the CD20+ neoplastic B cells. In sera from 3 distinct phases of the experimental life of the primates, testing by quantitative PCR revealed a progression of the viral load that paralleled the PTLD progression and no evidence of zoonotic transmission of porcine lymphotropic herpesvirus through xenoneuronal grafts. These data suggest that monitoring the variation of macaca lymphocryptovirus DNA in primates could be used as a possible early diagnostic tool for PTLD progression, allowing preemptive treatment such as immunosuppression therapy reduction

Experimental and numerical analysis of supersonic blade profiles developed for highly loaded impulse type steam turbine stages

The paper describes the results of a numerical and experimental research program addressing the aerodynamic investigation on the performance of blade profiles specifically developed for application in highly loaded impulse type turbine stages. The industrial requirements driving toward the adoption of highly loaded stage solutions are presented, along with an estimation of the profiles operating parameters. Two stator vanes and one rotor blade profile have been developed and extensively tested by means of flow field measurements and schlieren visualization in a transonic blow-down wind tunnel for linear cascades. Experimental results for the relevant operating conditions are presented, providing validation data for the CFD model used for blade design and evidencing that the main goals of the design optimization procedure have been achieved

AN EXPERIMENTAL INVESTIGATION ON ISOTHERMAL FREE SWIRLING JET

This paper reports an experimental investigation on the dynamics of turbulent unconfined swirling flows. Isothermal free swirling jets with five different swirl numbers (S) and fixed Reynolds number (Re = 21800) are investigated to analyze the effect of swirl intensity on the recirculation, vortex breakdown and the occurrence of the precession vortex core (PVC) by means of 3C-2D Stereoscopic Particle image velocimetry (PIV). The contours and radial profiles of mean axial velocity confirmed the central recirculation zone (CRZ) for high swirl number. The importance of central recirculation zone is to ensure a good mixing of air/ fuel and combustion products and to generate a low velocity region for flame stabilization. Results shows that swirl intensity increases the backflow rate in the recirculation zone and jet spreads almost linearly with a higher spread rate as compared to non swirling flow. The frequency characteristics have been measured with a capacitive microphone. The frequency spectrum indicates the presence of periodic oscillation related to the existence of PVC. The Strouhal number associated with the frequency of the PVC vary almost linearly with swirl intensity

Experimental Observation of Non-Ideal Nozzle Flow of Siloxane Vapor MDM

The first experimental results from the Test-Rig for Organic Vapors (TROVA) at Politecnico di Milano are reported. The facility implements an Organic Rankine Cycle (ORC) where the expansion process takes place within a straight axis convergent-divergent nozzle, which is the simplest geometry representative of an ORC turbine blade passage. In order to reduce the required input thermal power, a batch operating mode was selected for the plant. Experimental runs with air allowed to verify the throttling valve operation and the measurement techniques, which include total pressure and temperature measurements in the settling chamber, static pressure measurements along the nozzle axis. A double-passage Schlieren technique is used to visualize the flow field in the nozzle throat and divergent section and to determine the position of shock waves within the flow field. The first experimental observation of non-ideal nozzle flows are presented for the expansion of siloxane fluid MDM (C8H24O2Si3, octamethyltrisiloxane) for vapor expansion in the close proximity of the liquid-vapor saturation curve, at relatively low pressure of operation. A supersonic flow is attained within the divergent section of the nozzle, as demonstrated by the observation of an oblique shock wave at the throat section, where a 0.1 mm recessed step is located. Schlieren visualizations are limited by the occurrence of condensation along the mirror side of the nozzle. Pressure measurements are compatible with the observed flow field

Search for strange quark matter and Q-balls with the SLIM experiment

We report on the search for Strange Quark Matter (SQM) and charged Q-balls with the SLIM experiment at the Chacaltaya High Altitude Laboratory (5230 m a.s.l.) from 2001 to 2005. The SLIM experiment was a 427 m$^{2}$ array of Nuclear Track Detectors (NTDs) arranged in modules of $24 \times 24$ cm$^{2}$ area. SLIM NTDs were exposed to the cosmic radiation for 4.22 years after which they were brought back to the Bologna Laboratory where they were etched and analyzed. We estimate the properties and energy losses in matter of nuclearites (large SQM nuggets), strangelets (small charged SQM nuggets) and Q-balls; and discuss their detection with the SLIM experiment. The flux upper limits in the CR of such downgoing particles are at the level of $1.3 10^{-15}$/cm$^{2}$/s/sr (90% CL).Comment: 4 pages, 7 eps figures. Talk given at the 24th International Conference on Nuclear Tracks in Solids, Bologna, Italy, 1-5 September 200

Efficacy and tolerability of switching to a dual therapy with darunavir/ritonavir plus raltegravir in HIV-infected patients with HIV-1 RNA <= 50 cp/mL

Background: Nucleos(t)ide reverse transcriptase inhibitors (NRTI) toxicity may represent a threat for long-term success of combined antiretroviral therapy. Some studies have suggested a possible improvement of NRTI-related toxicity after switching to NRTI-sparing regimens. Objectives: We aimed to explore the efficacy and tolerability of switching to darunavir/ritonavir (DRV/r) plus raltegravir (RAL) while having a viral load (VL) ≤50 copies/mL in the clinical setting. Study design: Treatment-experienced HIV 1-infected patients enrolled in the ICONA Foundation Study cohort were included if they switched their current regimen to DRV/r + RAL with a HIV-RNA ≤50 copies/mL. Different definitions of virological failure (VF) and treatment failure (TF) were employed. Kaplan–Meier curves and Cox regression models were performed to estimate time to event probability. Results: We included 72 HIV-infected patients, 22 (31%) of these were female, 31 (43%) men who have sex with men (MSM) amd 15 (21%) had hepatitis co-infections. Median age was 44 (IQR: 35-50) years amd CD4 count was 389 (IQR 283-606) cells/mmc. Median follow-up time for TF was 24 (IQR 9–31) months. Twenty-five discontinuations occurred (60% simplifications); only 2 (8%) were toxicity-driven (lipid elevations). The probability of VF (confirmed VL >50 copies/mL) was estimated at 7% [95% confidence interval (CI) 1–13%] by 12 and 9% (95% CI 2–16%) by 24 months. When considering TF, we found a probability of stop/intensification/single VL > 200 copies/mL of 13% (95% CI 1–17%) and 22% (95% CI 11–33%) by 12 and 24 months. Female gender (adjusted relative hazard, ARH = 0.10; 95% CI 0.01–0.74; p = 0.024) and older age (AHR = 0.50 per 10 years older; 95% CI 0.25–0.99; p = 0.045) were associated with a lower risk of TF. A previous PI failure was strongly associated with TF (AHR = 52.6, 95% CI 3.6–779; p = 0.004). Conclusions: DRV/r + RAL is a valuable NRTI-sparing option, especially in female and older patients, with a relatively low risk of VF and good tolerability after 2 years since start in an ART-experienced population. However, previous PI-failure should be a limiting factor for this strategy