Modeling of Spray Combustion under Cryogenic and High Pressure Conditions

The paper concerns both the numerical and experimental investigation of turbulent liquid oxygen/hydrogen spray combustion for elevated subcritical pressure and cryogenic inlet temperature conditions. In particular, the combustion in the single injector combustion chamber is studied where experimental data are obtained for gas phase temperature and both droplet size and velocities. The model uses an Eulerian--Lagrangian formulation for the gas and the liquid phase, respectively. Detailed models for droplet heating and vaporization in a convective flow field are employed, and detailed gas phase reactions are accounted for through use of a flamelet model for turbulent spray combustion. The results show a very good agreement between experimental and computational spray characteristics. The computed gas phase temperature lies somewhat above the experimental values which is associated with CARS single shot measurements and incomplete data for the initial conditions of the combustion process

Changing the Surgical Residency: A Mixed-Methods Study of Residents’ and Faculty Experiences One Year After Implementation

Objective: To evaluate a reformed surgical residency curriculum aimed at addressing emerging practice models, enhancing residents’ educational experience, and improving the quality/continuity of patient care by reducing the service size and enhancing attending-resident interactions. Methods: A mixed-methods study of the surgical training program following curriculum reform including: 1) focus group and individual qualitative interviews with residents, attendings, nurses, and advanced practice providers to explore stakeholder perspectives on curriculum reform, 2) time study of surgical resident activities, and 3) quantitative assessment of surgical case logs. Results: Qualitative interviews demonstrated disparate knowledge and attitudes regarding the goals of the curriculum with emergence of several themes during transcript analysis including: Goals of the Change, Learning and Educational Value, Communication, Teamwork, Service, and Quality of Life. Both positive aspects of curriculum reform (e.g., improved focus on resident education and balance between educational and service activities, communication, and opportunity for direct feedback and observation) and negative ones (e.g., lack of role clarity, insufficient workforce) were identified. Despite limitations, the time study revealed variability in resident activities by post-graduate year with more time spent on indirect patient care activities in the early years and more time in the OR and one-on-one with attendings later. Quantitative analysis of surgical case logs, previously published, showed no significant decrease in number of cases for residents by either training level or role. Conclusions: This single-institution mixed methods study suggests that a reformed surgical residency curriculum improved residents’ educational experiences and the balance between educational and service activities without affecting operative volume. Multiple modalities of assessment are essential to identify the various positive and negative aspects of an educational intervention

Misapplication of the Tarasoff duty to driving cases: A call for a reframing of theory

In the years since the original Tarasoff cases created a new duty for psychotherapists toward third parties harmed by patients' violence, a series of cases nationwide-so called "driving casesv-have applied Tarasoff-like reasoning to situations where a patient injured others while driving a car. Our thesis in this paper is that such application is inappropriate since it represents an unjustified and largely unexamined assumption that driving injury is an expression of the mental-illnessderived intended violence that justifies the Tarasoff duty and its inevitable associated breach of confidentiality. We suggest to the contrary that driving cases almost invariably result from a patient's negligent driving rather than intentional violence stemming from mental illness; that clinicians in most instances have almost no capacity, training, or clinical bases on which to predict a patient's future negligence, violence aside; and that the theory of driving cases should be revised

Epistemic Beliefs: Relationship to Future Expectancies and Quality of Life in Cancer Patients.

CONTEXT: Expectations about the future (future expectancies) are important determinants of psychological well-being among cancer patients, but the strategies patients use to maintain positive and cope with negative expectancies are incompletely understood. OBJECTIVES: To obtain preliminary evidence on the potential role of one strategy for managing future expectancies: the adoption of epistemic beliefs in fundamental limits to medical knowledge. METHODS: A sample of 1307 primarily advanced-stage cancer patients participating in a genomic tumor testing study in community oncology practices completed measures of epistemic beliefs, positive future expectancies, and mental and physical health-related quality of life (HRQOL). Descriptive and linear regression analyses were conducted to assess the relationships between these factors and test two hypotheses: 1) epistemic beliefs affirming fundamental limits to medical knowledge ( fallibilistic epistemic beliefs ) are associated with positive future expectancies and mental HRQOL, and 2) positive future expectancies mediate this association. RESULTS: Participants reported relatively high beliefs in limits to medical knowledge (M = 2.94, s.d.=.67) and positive future expectancies (M = 3.01, s.d.=.62) (range 0-4), and relatively low mental and physical HRQOL. Consistent with hypotheses, fallibilistic epistemic beliefs were associated with positive future expectancies (b = 0.11, SE=.03, P\u3c 0.001) and greater mental HRQOL (b = 0.99, SE=.34, P = 0.004); positive expectancies also mediated the association between epistemic beliefs and mental HRQOL (Sobel Z=4.27, P\u3c0.001). CONCLUSIONS: Epistemic beliefs in limits to medical knowledge are associated with positive future expectancies and greater mental HRQOL; positive expectancies mediate the association between epistemic beliefs and HRQOL. More research is needed to confirm these relationships and elucidate their causal mechanisms

False claims about false memory research

Pezdek and Lam [Pezdek, K. & Lam, S. (2007). What research paradigms have cognitive psychologists used to study “False memory,” and what are the implications of these choices? Consciousness and Cognition] claim that the majority of research into false memories has been misguided. Specifically, they charge that false memory scientists have been (1) misusing the term “false memory,” (2) relying on the wrong methodologies to study false memories, and (3) misapplying false memory research to real world situations. We review each of these claims and highlight the problems with them. We conclude that several types of false memory research have advanced our knowledge of autobiographical and recovered memories, and that future research will continue to make significant contributions to how we understand memory and memory errors

Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine

DepoCyte is a slow-release formulation of cytarabine designed for intrathecal administration. The goal of this multi-centre cohort study was to determine the safety and efficacy of DepoCyte for the intrathecal treatment of neoplastic meningitis due to breast cancer. DepoCyte 50 mg was injected once every 2 weeks for one month of induction therapy; responding patients were treated with an additional 3 months of consolidation therapy. All patients had metastatic breast cancer and a positive CSF cytology or neurologic findings characteristic of neoplastic meningitis. The median number of DepoCyte doses was 3, and 85% of patients completed the planned 1 month induction. Median follow up is currently 19 months. The primary endpoint was response, defined as conversion of the CSF cytology from positive to negative at all sites known to be positive, and the absence of neurologic progression at the time the cytologic conversion was documented. The response rate among the 43 evaluable patients was 28% (CI 95%: 14–41%); the intent-to-treat response rate was 21% (CI 95%: 12–34%). Median time to neurologic progression was 49 days (range 1–515(+)); median survival was 88 days (range 1–515(+)), and 1 year survival is projected to be 19%. The major adverse events were headache and arachnoiditis. When drug-related, these were largely of low grade, transient and reversible. Headache occurred on 11% of cycles; 90% were grade 1 or 2. Arachnoiditis occurred on 19% of cycles; 88% were grade 1 or 2. DepoCyte demonstrated activity in neoplastic meningitis due to breast cancer that is comparable to results reported with conventional intrathecal agents. However, this activity was achieved with one fourth as many intrathecal injections as typically required in conventional therapy. The every 2 week dose schedule is a major advantage for both patients and physicians. © 2001 Cancer Research Campaign http://www.bjcancer.co

Vascular phenotype in angiogenic and non-angiogenic lung non-small cell carcinomas

We have previously described a group of non-small cell lung carcinomas without morphological evidence of neo-angiogenesis. In these tumours neoplastic cells fill up the alveoli and the only vessels present appear to belong to the trapped alveolar septa. In the present study we have characterised the phenotype of the vessels present in these non-angiogenic tumours, in normal lung and in angiogenic non-small cell lung carcinomas. The vessels, identified by the expression of CD31, were scored as mature when expressing the epitope LH39 in the basal membrane and as newly formed when expressing αVβ3 on the endothelial cells and/or lacking LH39 expression. In the nine putative non-angiogenic cases examined, the vascular phenotype of all the vessels was the same as that of alveolar vessels in normal lung: LH39 positive and αVβ3 variable or negative. Instead in 104 angiogenic tumours examined, only a minority of vessels (mean 13.1%; range 0–60%) expressed LH39, while αVβ3 (in 45 cases) was strongly expressed on many vessels (mean 55.5%; range 5–90%). We conclude that in putative non-angiogenic tumours the vascular phenotype is that of normal vessels and there is no neo-angiogenesis. This type of cancer may be resistant to some anti-angiogenic therapy and different strategies need to be developed

From Sound to Significance: Exploring the Mechanisms Underlying Emotional Reactions to Music

A common approach to studying emotional reactions to music is to attempt to obtain direct links between musical surface features such as tempo and a listener’s responses. however, such an analysis ultimately fails to explain why emotions are aroused in the listener. in this article we explore an alternative approach, which aims to account for musical emotions in terms of a set of psychological mechanisms that are activated by different types of information in a musical event. this approach was tested in 4 experiments that manipulated 4 mechanisms (brain stem reflex, contagion, episodic memory, musical expectancy) by selecting existing musical pieces that featured information relevant for each mechanism. the excerpts were played to 60 listeners, who were asked to rate their felt emotions on 15 scales. skin conductance levels and facial expressions were measured, and listeners reported subjective impressions of relevance to specific mechanisms. results indicated that the target mechanism conditions evoked emotions largely as predicted by a multimechanism framework and that mostly similar effects occurred across the experiments that included different pieces of music. we conclude that a satisfactory account of musical emotions requires consideration of how musical features and responses are mediated by a range of underlying mechanisms