On the Contribution of Turbulent Boundary Layers to the Noise inside a Fuselage

The following report deals i preliminary fashion with the transmission through a fuselage of random noise generated on the fuselage skin by a turbulent boundary layer. The concept of attenuation is abandoned and instead the problem is formulated as a sequence of two linear couplings: the turbulent boundary layer fluctuations excite the fuselage skin in lateral vibrations and the skin vibrations induce sound inside the fuselage. The techniques used are those required to determine the response of linear systems to random forcing functions of several variables. A certain degree of idealization has been resorted to. Thus the boundary layer is assumed locally homogeneous, the fuselage skin is assumed flat, unlined and free from axial loads and the "cabin" air is bounded only by the vibrating plate so that only outgoing waves are considered. Some of the details of the statistical description have been simplified in order to reveal the basic features of the problem. The results, strictly applicable only to the limiting case of thin boundary layers, show that the sound pressure intensity is proportional to the square of the free stream density, the square of cabin air density and inversely proportional to the first power of the damping constant and to the second power of the plate density. The dependence on free stream velocity and boundary layer thickness cannot be given in general without a detailed knowledge of the characteristics of the pressure fluctuations in the boundary layer (in particular the frequency spectrum). For a flat spectrum the noise intensity depends on the fifth power of the velocity and the first power of the boundary layer thickness. This suggests that boundary layer removal is probably not an economical means of decreasing cabin noise. In general, the analysis presented here only reduces the determination of cabin noise intensity to the measurement of the effect of any one of four variables (free stream velocity, boundary layer thiclkness, plate thickness or the characteristic velocity of propagation in the plate). The plate generates noise by vibrating in resonance over a wide range of frequencies and increasing the damping constant is consequently an effective method of decreasing noise generation. One of the main features of the results is that the relevent quantities upon which noise intensity depends are non-dimensional numbers in which boundary layer and plate properties enter as ratios. This is taken as an indication that in testing models of structures for boundary layer noise it is not sufficient to duplicate in the model the structural characteristics of the fuselage. One must match properly the characteristics of the exciting pressure fluctuations to that of the structure

The Splenic Injury Outcomes Trial: An American Association For the Surgery of Trauma Multi-Institutional Study

BACKGROUND: Delayed splenic hemorrhage after nonoperative management (NOM) of blunt splenic injury (BSI) is a feared complication, particularly in the outpatient setting. Significant resources, including angiography (ANGIO), are used in an effort to prevent delayed splenectomy (DS). No prospective, long-term data exist to determine the actual risk of splenectomy. The purposes of this trial were to ascertain the 180-day risk of splenectomy after 24 hours of NOM of BSI and to determine factors related to splenectomy. METHODS: Eleven Level I trauma centers participated in this prospective observational study. Adult patients achieving 24 hours of NOM of their BSI were eligible. Patients were followed up for 180 days. Demographic, physiologic, radiographic, injury-related information, and spleen-related interventions were recorded. Bivariate and multivariable analyses were used to determine factors associated with DS. RESULTS: A total of 383 patients were enrolled. Twelve patients (3.1%) underwent in-hospital splenectomy between 24 hours and 9 days after injury. Of 366 discharged with a spleen, 1 (0.27%) required readmission for DS on postinjury Day 12. No Grade I injuries experienced DS. The splenectomy rate after 24 hours of NOM was 1.5 per 1,000 patient-days. Only extravasation from the spleen at time of admission (ADMIT-BLUSH) was associated with splenectomy (odds ratio, 3.6; 95% confidence interval, 1.4–12.4). Of patients with ADMIT-BLUSH (n = 49), 17 (34.7%) did not have ANGIO with embolization (EMBO), and 2 of those (11.8%) underwent splenectomy; 32 (65.3%) underwent ANGIO with EMBO, and 2 of those (6.3%, p = 0.6020 compared with no ANGIO with EMBO) required splenectomy. CONCLUSION: Splenectomy after 24 hours of NOM is rare. After the initial 24 hours, no additional interventions are warranted for patients with Grade I injuries. For Grades II to V, close observation as an inpatient or outpatient is indicated for 10 days to 14 days. ADMIT-BLUSH is a strong predictor of DS and should lead to close observation or earlier surgical intervention. LEVEL OF EVIDENCE: Prognostic/epidemiological study, level III; therapeutic study, level IV

Advising adolescents on the use of psychotropic medication: attitudes among medical and psychology students

There is evidence that medical students are more aware of the benefits of psychotropic treatment than are members of the general public, and that the more knowledge students acquire about psychiatry and pharmacology, the more favorable their attitudes become towards psychotropic drugs and other treatments. Objectives: This study among students investigates the relationship between certain aspects of personality and attitudes towards advising adolescents with psychosocial problems about the use of psychotropic medication. Methods: Two groups of healthcare students were recruited from universities in Eastern France. 41 fourth-year medical students (MS) who had completed their psychiatry course, and 76 thirdyear psychology students (PS) in the faculty of human sciences. Respondents completed a selfadministered instrument (20 brief case studies, and a personality inventory) at the end of a lecture. Participation was voluntary and unpaid. Results: MS would recommend psychotropic drugs in 40% of the 20 cases, PS in 27%. MS who would prescribe psychotropic medication differed in personality profile from PS. MS with a tendency to experience anger and related states such as frustration, and who did not see fulfilling moral obligations as important were more likely to prescribe psychotropic drugs. Also more likely to recommend psychotropic drugs, but for different reasons, were PS who were susceptible to stress but not shy or socially anxious, who showed friendliness but little interest in others, and who lacked distance in their decision-making. Conclusion: Health promotion is not simply a matter of educating those young people who take psychotropic drugs – health professionals must also question the criteria that inform their decisions. It is as important to investigate the attitudes of the future health professionals (advisers or prescribers) as it is to focus on consumer-related issues

European guidelines on chronic mesenteric ischaemia - joint United European Gastroenterology, European Association for Gastroenterology, Endoscopy and Nutrition, European Society of Gastrointestinal and Abdominal Radiology, Netherlands Association of Hepatogastroenterologists, Hellenic Society of Gastroenterology, Cardiovascular and Interventional Radiological Society of Europe, and Dutch Mesenteric Ischemia Study group clinical guidelines on the diagnosis and treatment of patients with chronic mesenteric ischaemia

Chronic mesenteric ischaemia is a severe and incapacitating disease, causing complaints of post-prandial pain, fear of eating and weight loss. Even though chronic mesenteric ischaemia may progress to acute mesenteric ischaemia, chronic mesenteric ischaemia remains an underappreciated and undertreated disease entity. Probable explanations are the lack of knowledge and awareness among physicians and the lack of a gold standard diagnostic test. The underappreciation of this disease results in diagnostic delays, underdiagnosis and undertreating of patients with chronic mesenteric ischaemia, potentially resulting in fatal acute mesenteric ischaemia. This guideline provides a comprehensive overview and repository of the current evidence and multidisciplinary expert agreement on pertinent issues regarding diagnosis and treatment, and provides guidance in the multidisciplinary field of chronic mesenteric ischaemia

The uses of coherent structure (Dryden Lecture)

The concept of coherent structure in turbulent flow is a revolutionary idea which is being developed by evolutionary means. The main objective of this review is to list some solid achievements, showing what can be done by using the concept of coherent structure that cannot be done without it. The nature of structure is described in terms of some related concepts, including celerity, topology, and the phenomenon of coalescence and splitting of structure. The main emphasis is on the mixing layer, as the one flow whose structure is well enough understood so that technical applications are now being made in problems of mixing and chemistry. An attempt is made to identify some conceptual and experimental obstacles that stand in the way of progress in other technically important flows, particularly the turbulent boundary layer. A few comments are included about the role of structure in numerical simulations and in current work on manipulation and control of turbulent flow. Some recent developments are cited which suggest that the time is nearly right for corresponding advances to occur in turbulence modeling