177 research outputs found

    Onset of absolutely unstable behaviour in the Stokes layer: a Floquet approach to the Briggs method

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    For steady flows, the Briggs (Electron-Stream Interaction with Plasmas. MIT Press,1964) method is a well-established approach for classifying disturbances as either convectively or absolutely unstable. Here, the framework of the Briggs method is adapted to temporally periodic flows, with Floquet theory utilised to account for the time periodicity of the Stokes layer. As a consequence of the antiperiodicity of the flow, symmetry constraints are established that are used to describe the pointwise evolution of the disturbance, with the behaviour governed by harmonic and subharmonics modes. On coupling the symmetry constraints with a cusp-map analysis, multiple harmonic and subharmonic cusps are found for each Reynolds number of the flow. Therefore, linear disturbances experience subharmonic growth about fixed spatial locations. Moreover, the growth rate associated with the pointwise development of the disturbance matches the growth rate of the disturbance maximum. Thus, the onset of the Floquet instability (Blennerhassett & Bassom, J. Fluid Mech., vol. 464, 2002, pp. 393–410) coincides with the onset of absolutely unstable behaviour. Stability characteristics are consistent with the spatio-temporal disturbance development of the family-tree structure that has hitherto only been observed numerically via simulations of the linearised Navier–Stokes equations (Thomas et al., J. Fluid Mech., vol. 752, 2014, pp. 543–571; Ramage et al., Phys. Rev. Fluids, vol. 5, 2020, 103901)

    Thermo-Mechanical Fatigue Crack Growth of RR1000

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    Non-isothermal conditions during flight cycles have long led to the requirement for thermo-mechanical fatigue (TMF) evaluation of aerospace materials. However, the increased temperatures within the gas turbine engine have meant that the requirements for TMF testing now extend to disc alloys along with blade materials. As such, fatigue crack growth rates are required to be evaluated under non-isothermal conditions along with the development of a detailed understanding of related failure mechanisms. In the current work, a TMF crack growth testing method has been developed utilising induction heating and direct current potential drop techniques for polycrystalline nickel-based superalloys, such as RR1000. Results have shown that in-phase (IP) testing produces accelerated crack growth rates compared with out-of-phase (OOP) due to increased temperature at peak stress and therefore increased time dependent crack growth. The ordering of the crack growth rates is supported by detailed fractographic analysis which shows intergranular crack growth in IP test specimens, and transgranular crack growth in 90° OOP and 180° OOP tests. Isothermal tests have also been carried out for comparison of crack growth rates at the point of peak stress in the TMF cycles

    Improved pressure contour analysis for estimating cardiac stroke volume using pulse wave velocity measurement.

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    peer reviewedBACKGROUND: Pressure contour analysis is commonly used to estimate cardiac performance for patients suffering from cardiovascular dysfunction in the intensive care unit. However, the existing techniques for continuous estimation of stroke volume (SV) from pressure measurement can be unreliable during hemodynamic instability, which is inevitable for patients requiring significant treatment. For this reason, pressure contour methods must be improved to capture changes in vascular properties and thus provide accurate conversion from pressure to flow. METHODS: This paper presents a novel pressure contour method utilizing pulse wave velocity (PWV) measurement to capture vascular properties. A three-element Windkessel model combined with the reservoir-wave concept are used to decompose the pressure contour into components related to storage and flow. The model parameters are identified beat-to-beat from the water-hammer equation using measured PWV, wave component of the pressure, and an estimate of subject-specific aortic dimension. SV is then calculated by converting pressure to flow using identified model parameters. The accuracy of this novel method is investigated using data from porcine experiments (N = 4 Pietrain pigs, 20-24.5 kg), where hemodynamic properties were significantly altered using dobutamine, fluid administration, and mechanical ventilation. In the experiment, left ventricular volume was measured using admittance catheter, and aortic pressure waveforms were measured at two locations, the aortic arch and abdominal aorta. RESULTS: Bland-Altman analysis comparing gold-standard SV measured by the admittance catheter and estimated SV from the novel method showed average limits of agreement of +/-26% across significant hemodynamic alterations. This result shows the method is capable of estimating clinically acceptable absolute SV values according to Critchely and Critchely. CONCLUSION: The novel pressure contour method presented can accurately estimate and track SV even when hemodynamic properties are significantly altered. Integrating PWV measurements into pressure contour analysis improves identification of beat-to-beat changes in Windkessel model parameters, and thus, provides accurate estimate of blood flow from measured pressure contour. The method has great potential for overcoming weaknesses associated with current pressure contour methods for estimating SV

    Insulin Sensitivity and Sepsis Score: A Correlation between Model-based Metric and Sepsis Scoring System in Critically Ill Patients

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    Sepsis is highly correlated with mortality and morbidity. Sepsis is a clinical condition demarcated as the existence of infection and systemic inflammatory response syndrome, SIRS. Confirmation of infection requires a blood culture test, which requires incubation, and thus results take at least 48 h for a syndrome that requires early direct treatment. Since sepsis has a strong inflammatory component, it is hypothesized that metabolic markers affected by inflammation, such as insulin sensitivity, might provide a metric for more rapid, real-time diagnosis. This study uses clinical data from 30 sepsis patients (7624 h in ICU) of whom 60% are male. Median age and median Apache II score are 63 years and 19, respectively. Model-identified insulin sensitivity (SI) profiles were obtained for each patient, and insulin sensitivity and its hourly changes were correlated with modified hourly sepsis scores (SSH1). SI profiles and values were similar across the cohort. The sepsis score is highly variable and changes rapidly. The modified hourly sepsis score, SSH1, shows a better relation with insulin sensitivity due to less fluctuation in the SIRS element. Median SI and median SI of the cohort is 0.4193e-3 and 0.004253e-3 L/mU.min, respectively. Additionally, median SI are 4.392 × 10−4 L/mU min (SSH1 = 0), 4.153 × 10−4 L/mU min (SSH1 = 1), 3.752 × 10−4 L/mU min (SSH1 = 2) and 2.353 × 10−4 L/mU min (SSH1 = 3). Significant relationship between insulin sensitivity across different SSH1 groups was observed (p < 0.05) even when corrected for multiple comparisons. CDF of SI indicates that insulin sensitivity is more significant when comparing an hourly sepsis score at a very distinguished level

    Efficacy and Safety of SPRINT and STAR Protocol on Malaysian Critically-ill Patients

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    Intensive care unit patients may have a better glycaemic management with the right control protocol. Results of virtual trial performance on Malaysian critically-ill patients adopting a model-derived and model-based control protocol known as SPRINT and STAR are presented in this paper. These ICU patients have been treated by intensive sliding-scale insulin infusion. The effectiveness and safety of glycaemic control are then analysed. Results showed that patient safety improved by 83% with SPRINT and STAR protocol as the number of hypoglycaemic patients significantly reduced (BG<;2.2 mmol/L). Percentage of time within desired bands and median BG improves in both SPRINT and STAR. However, the improvements are associated with higher number of BG measurements (workload)

    Performance of stochastic targeted blood glucose control protocol by virtual trials in the Malaysian intensive care unit

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    Background and objective: Blood glucose variability is common in healthcare and it is not related or influ- enced by diabetes mellitus. To minimise the risk of high blood glucose in critically ill patients, Stochastic Targeted Blood Glucose Control Protocol is used in intensive care unit at hospitals worldwide. Thus, this study focuses on the performance of stochastic modelling protocol in comparison to the current blood glucose management protocols in the Malaysian intensive care unit. Also, this study is to assess the ef- fectiveness of Stochastic Targeted Blood Glucose Control Protocol when it is applied to a cohort of diabetic patients. Methods: Retrospective data from 210 patients were obtained from a general hospital in Malaysia from May 2014 until June 2015, where 123 patients were having comorbid diabetes mellitus. The comparison of blood glucose control protocol performance between both protocol simulations was conducted through blood glucose fitted with physiological modelling on top of virtual trial simulations, mean calculation of simulation error and several graphical comparisons using stochastic modelling. Results: Stochastic Targeted Blood Glucose Control Protocol reduces hyperglycaemia by 16% in diabetic and 9% in nondiabetic cohorts. The protocol helps to control blood glucose level in the targeted range of 4.0–10.0 mmol/L for 71.8% in diabetic and 82.7% in nondiabetic cohorts, besides minimising the treatment hour up to 71 h for 123 diabetic patients and 39 h for 87 nondiabetic patients. Conclusion: It is concluded that Stochastic Targeted Blood Glucose Control Protocol is good in reducing hyperglycaemia as compared to the current blood glucose management protocol in the Malaysian inten- sive care unit. Hence, the current Malaysian intensive care unit protocols need to be modified to enhance their performance, especially in the integration of insulin and nutrition intervention in decreasing the hyperglycaemia incidences. Improvement in Stochastic Targeted Blood Glucose Control Protocol in terms of u en model is also a must to adapt with the diabetic cohort

    Low cost circulatory pressure acquisition and fluid infusion rate measurement system for clinical research

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    Acquiring patient physiological waveforms is useful for studying hemodynamic management and developing medical monitoring systems. A low cost, Arduino controlled data acquisition system acquires arterial pressure waveforms (Edwards Lifesciences TruWave compatible) and measures fluid infusion rate using hanging scales. This system can be used at the same time as a clinical monitor, enabling recording of patient arterial pressure and fluid delivery for clinical research. The system is powered via a USB connection, which additionally provides serial output, aiding compatibility and customisation. A simple software user interface, developed in Python, shows outputs. Each data acquisition system, including all necessary connection cables costs ̃US$90 and is multiple-use

    Efficacy and safety of SPRINT and STAR protocol on Malaysian critically-ill patients

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    Abstract—Intensive care unit patients may have a better glycaemic management with the right control protocol. Results of virtual trial performance on Malaysian critically-ill patients adopting a model-derived and model-based control protocol known as SPRINT and STAR are presented in this paper. These ICU patients have been treated by intensive sliding-scale insulin infusion. The effectiveness and safety of glycaemic control are then analysed. Results showed that patient safety improved by 83% with SPRINT and STAR protocol as the number of hypoglycaemic patients significantly reduced (BG<2.2 mmol/L). Percentage of time within desired bands and median BG improves in both SPRINT and STAR. However the improvements are associated with higher number of BG measurements (workload)
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