Multiple Trophic Levels in Soft-Bottom Communities

In order to assess the general applicability of recent field experiments with predatory infauna, we searched the literature and found 48 well-documented cases of infaunal consumption by such predators. In 63 % of the cases detailed enough to make a determination, the predators ate other predators. Multiple trophic levels within the infauna are probably a common feature of many soft-bottom communities

In Search of the “Vulnerable Plaque” Can it Be Localized and Will Focal Regional Therapy Ever Be an Option for Cardiac Prevention?

The search to find the location of future plaque ruptures or plaque erosions leading to myocardial infarction (so-called “vulnerable plaques”) is an important area of cardiovascular research. Systemic therapy, including use of statins, targets the vulnerable patient. However, adverse events cannot be completely eliminated with the appropriate application of systemic therapies and thus has given rise to the possibility of local or regional therapy of “vulnerable plaques” to prevent future events. Until now, no criteria have been developed for consideration of this therapy. For such a strategy to work, there should be several prerequisites. These involve the identification of susceptible lesions, the number of lesions, their natural history, and proof that an interventional technique is preferable to medical therapy alone. The greatest deficiency relates to the fact that until the natural history of presumed “vulnerable plaques” is known one can never truly identify what constitutes a “vulnerable plaque.” Much work needs to be done in this area, but ongoing and new trials should provide important information that could potentially change drastically how coronary artery disease is diagnosed and treated

The pathophysiology of cigarette smoking and cardiovascular disease An update

AbstractCigarette smoking (CS) continues to be a major health hazard, and it contributes significantly to cardiovascular morbidity and mortality. Cigarette smoking impacts all phases of atherosclerosis from endothelial dysfunction to acute clinical events, the latter being largely thrombotic. Both active and passive (environmental) cigarette smoke exposure predispose to cardiovascular events. Whether there is a distinct direct dose-dependent correlation between cigarette smoke exposure and risk is debatable, as some recent experimental clinical studies have shown a non-linear relation to cigarette smoke exposure. The exact toxic components of cigarette smoke and the mechanisms involved in CS-related cardiovascular dysfunction are largely unknown, but CS increases inflammation, thrombosis, and oxidation of low-density lipoprotein cholesterol. Recent experimental and clinical data support the hypothesis that cigarette smoke exposure increases oxidative stress as a potential mechanism for initiating cardiovascular dysfunction

Management of Agitation During the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic caused by the coronavirus SARS-CoV-2 has radically altered delivery of care in emergency settings. Unprecedented hardship due to ongoing fears of exposure and threats to personal safety, along with societal measures enacted to curb disease transmission, have had broad psychosocial impact on patients and healthcare workers alike. These changes can significantly affect diagnosing and managing behavioral emergencies such as agitation in the emergency department. On behalf of the American Association for Emergency Psychiatry, we highlight unique considerations for patients with severe behavioral symptoms and staff members managing symptoms of agitation during COVID-19. Early detection and treatment of agitation, precautions to minimize staff hazards, coordination with security personnel and psychiatric services, and avoidance of coercive strategies that cause respiratory depression will help mitigate heightened risks to safety caused by this outbreak

Isolated chronic mitral regurgitation with preserved systolic left ventricular function and severe pulmonary hypertension

AbstractPulmonary hypertension in chronic mitral valve disease has been related most commonly to left ventricular dysfunction or mitral stenosis; its association with chronic, isolated mitral regurgitation and preserved left ventricular systolic function is unclear. In 41 catheterized patients with chronic mitral regurgitation (known history of mitral regurgitation for >18 months) and preserved left ventricular systolic function (ejection fraction >0.55), historic, electrocardiographic, echocardiographic and hemodynamic variables were analyzed. Ten patients (Group 1) had normal pulmonary artery systolic pressure (>30 mm Hg), whereas 31 patients had pulmonary hypertension. Pulmonary artery systolic pressure was mildly increased (30 to 49 mm Hg) in 13 patients (Group II) and was >50 mm Hg in 18 patients (Group III).Univariate analysis showed the more frequent occurrence of male gender and ruptured chordae tendineae in the groups with pulmonary hypertension. Mean pulmonary capillary wedge pressure, size of the V wave in pulmonary capillary wedge pressure and pulmonary arteriole resistance were higher, whereas cardiac index was lower in the hypertension groups. Multivariate stepwise analysis revealed higher mean pulmonary capillary wedge pressure and pulmonary arteriole resistance as the only variables independently differing among groups.In conclusion, pulmonary hypertension occurs frequently (76% of cases) in patients with chronic, isolated mitral regurgitation with preserved left ventricular systolic function. In these patients, a severe increase in pulmonary capillary wedge pressure is associated with elevation in pulmonary artery resistance, a finding similar to that in mitral stenosis

Acoustic characterisation of a small high-speed centrifugal compressor with casing treatment: an experimental study

[EN] With the advancements in manufacturing, materials and computational methods, turbomachinery designs have become more efficient providing higher specific power and reliability with lower weight and cost. The rotational speed of turbomachines has increased while the overall machine size has decreased for a similar power output leading to the pervasive presence of small, high-speed turbomachines, specifically centrifugal compressors in helicopters, unmanned aerial vehicles (UAVs), auxiliary power units (APUs), turbochargers and micro gas turbines. In addition to superior aerodynamic performance over a wide range, increased operating speeds have made the acoustic emissions of small centrifugal compressors a critical aspect of design. Therefore, this work presents an experimental campaign to characterise the acoustic behaviour of a compressor with an intent to quantify the dominant features of the flow-induced noise for design and near surge operating conditions. Furthermore, the campaign is extended to establish the impact of the ported shroud casing treatment and operating speed on the acoustic emission of the compressor. The in-duct noise measurement method is used in this work to quantify the noise generated in the compressor by measuring pressure fluctuations near the inducer and diffuser while the propagation of the generated noise to the ducts is computed from an array of piezoelectric sensors. Spectra at the design operating point are dominated by tonal noise while broadband noise content is the dominant feature of spectra for near surge operation. Although the ported shroud cavity does not significantly alter the overall noise levels of the compressor operating at design condition, it does seem to propagate tonal noise. For near surge operation, the casing treatment positively impacts the acoustic emission with a reduction of approximately 10 dB in the range up to the blade pass frequency. Furthermore, various broadband features are also observed to be alleviated by the casing treatment. (C) 2019 Elsevier Masson SAS. All rightsThe project was sponsored and supported by BorgWarner Turbo Systems and the Regional Growth Fund (RGF Grant Award 01.09.07.01/1789C). The authors would like to thank BorgWarner Turbo Systems for permission to publish the results presented in this paper.Sharma, S.; Broatch, A.; Garcia Tiscar, J.; Allport, JM.; Nickson, AK. (2019). Acoustic characterisation of a small high-speed centrifugal compressor with casing treatment: an experimental study. Aerospace Science and Technology. 95:1-15. https://doi.org/10.1016/j.ast.2019.1055181159

Acoustic and pressure characteristics of a ported shroud turbocompressor operating at near surge conditions

[EN] The operation of compressor at lower mass flow rates is limited by surge which is marked by large fluctuations in operational variables and accompanied by significant increase in noise. Ported shroud casing treatment is a widely used method to control the flow near unstable conditions in order to obtain a stable operation and enhance deep surge margin. The research on the acoustic effects of the ported shroud design is limited. Therefore, this paper numerically characterises the acoustic features of a turbocharger compressor with ported shroud design operating at marginal or soft surge conditions and investigates the correlation between acoustic characteristics and the spatial flow structures. The acoustic and the flow field features are analysed using spectral signatures obtained from an experimentally validated numerical model using both performance and acoustic measurements. Propagation of the frequency content through the ducts has been estimated with the aid of the beamforming and method of characteristics to enhance the content coming from the compressor. Expected acoustic phenomena such as rotating order tones and blade passing peaks are correctly identified in the modelled spectrum with the limitation to capture the specific broadband features. Hence, the numerical model can be used to further the research encompassing the impact these flow enhancement solutions have on the noise emission of the turbocharger. Inspection of the flow field shows radially exiting fluid at the ported shroud slot leading to the formation of the high-speed jets exiting the ported shroud cavity. Circumferential propagation of the stall cells is also identified in the impeller. Further inspection of the pressure field through modal decomposition implies the localisation of the energetic noise sources in the impeller downstream components. The influence of the ported shroud cavity on the acoustic characteristic of the compressor is not significant and is limited to the propagation of the tonal noise in the direction of impeller upstream. (C) 2019 Elsevier Ltd. All rights reserved.The project is sponsored and supported by BorgWarner Turbo Systems and the Regional Growth Fund (RGF Grant Award 01.09.07.01/1789C). The authors would like to thank BorgWarner Turbo Systems for permission to publish the results presented in this paper. The support of the HPC group at the University of Huddersfield is gratefully acknowledged.Sharma, S.; Broatch, A.; Garcia Tiscar, J.; Nickson, AK.; Allport, JM. (2019). Acoustic and pressure characteristics of a ported shroud turbocompressor operating at near surge conditions. Applied Acoustics. 148:434-447. https://doi.org/10.1016/j.apacoust.2019.01.005S43444714

H-Diplo Roundtable XX-20 on Matthew J. Ambrose. The Control Agenda: A History of the Strategic Arms Limitation Talks

A set of reviews of Matthew J. Ambrose\u27s The Control Agenda: A History of the Strategic Arms Limitation Talks, with a response from the author

Effect of nitroglycerin during hemodynamic estimation of valve orifice in patients with mitral stenosis

In patients with mitral stenosis, valve orifice calculations using pulmonary capillary wedge pressure as a substitute for left atrial pressure may overestimate the severity of disease. Previous studies have shown that mitral valve area determined from transseptal left atrial pressure measurements exceeds that area derived from pulmonary wedge pressure measurements. This is probably due to pulmonary venoconstriction, which is reversed by nitroglycerin. Nitroglycerin, 0.4 mg, was administered sublingually to 20 patients with mitral valve disease during preoperative cardiac catheterization using the pulmonary capillary wedge pressure as the proximal hydraulic variable. At the time of peak hypotensive effect, 3 to 5 minutes after nitroglycerin administration, the mean pulmonary capillary wedge pressure decreased from 23 ± 2 (mean ± SEM) to 19 ± 2 mm Hg (p < 0.005). The mean diastolic transmitral pressure gradient (12.6 ± 1.2 mm Hg before and 11.5 ± 1.0 mm Hg after nitroglycerin; p = NS) and cardiac output (4.0 ± 0.3 to 4.1 ± 0.3 liters/min; p = NS) did not change significantly. Nevertheless, the hemodynamic mitral orifice area, calculated using the Gorlin formula, increased from 0.8 ± 0.1 to 1.1 ± 0.2 cm2(p < 0.05). In 12 patients with isolated mitral stenosis, without regurgitation, the mitral valve orifice area after nitroglycerin was 0.4 ± 0.2 cm2larger than it was before drug administration (p < 0.05).Administration of nitroglycerin during evaluation of mitral stenosis eliminates pulmonary venoconstriction, which raises the pulmonary capillary wedge pressure above the left atrial pressure in some patients. Nitroglycerin may add diagnostic accuracy without transseptal catheterization. Whether this response to nitroglycerin has direct therapeutic value in patients with mitral valve obstruction has yet to be determined

Angiographic progression of coronary artery disease and the development of myocardial infarction

AbstractThere are few data on angiographic coronary artery anatomy in patients whose coronary artery disease progresses to myocardial infarction. In this retrospective analysis, progression of coronary artery disease between two cardiac catheterization procedures is described in 38 patients: 23 patients (Group I) who had a myocardial infarction between the two studies and 15 patients (Group II) who presented with one or more new total occlusions at the second study without sustaining an intervening infarction.In Group I the median percent stenosis on the initial angiogram of the artery related to the infarct at restudy was significantly less than the median percent stenosis of lesions that subsequently were the site of a new total occlusion in Group II (48 versus 73.5%, p < 0.05). In the infarctrelated artery in Group I, only 5 (22%) of 23 lesions were initially >70%, whereas in Group II, 11 (61%) of 18 lesions that progressed to total occlusion were initially >70% (p < 0.01). In Group I, patients who developed a Q wave infarction had less severe narrowing at initial angiography in the subsequent infarct-related artery (34%) than did patients who developed a non-Q wave infarction (80%) (p < 0.05). Univariate and multivariate analysis of angiographic and clinical characteristics present at initial angiography in Group I revealed proximal lesion location as the only significant predictor of evolution of lesions ≥ 50% to infarction.This irrespective study suggests that myocardial infarction frequently develops from previously nonsevere lesions. In addition, it is often difficult to predict the location of a subsequent infarct from analysis of the first coronary angiogram. Non-Q wave infarction is usually preceded by a more severe pre-existing stenosis than is a Q wave infarction, perhaps indicating some degree of prior myocardial protection. A prospective evaluation will be necessary to confirm these findings