65 research outputs found
TDI noises transfer functions for LISA
The LISA mission is the future space-based gravitational wave (GW)
observatory of the European Space Agency. It is formed by 3 spacecraft
exchanging laser beams in order to form multiple real and virtual
interferometers. The data streams to be used in order to extract the large
number and variety of GW sources are Time-Delay Interferometry (TDI) data. One
important processing to produce these data is the TDI on-ground processing
which recombines multiple interferometric on-board measurements to remove
certain noise sources from the data such as laser frequency noise or spacecraft
jitter. The LISA noise budget is therefore expressed at the TDI level in order
to account for the different TDI transfer functions applied for each noise
source and thus estimate their real weight on mission performance. In order to
derive a usable form of these transfer functions, a model of the beams, the
measurements, and TDI have been developed, and several approximation have been
made. A methodology for such a derivation has been established, as well as
verification procedures. It results in a set of transfer functions, which are
now used by the LISA project, in particular in its performance model. Using
these transfer functions, realistic noise curves for various instrumental
configurations are provided to data analysis algorithms and used for instrument
design.Comment: 15 pages, 7 figure
Right-to-left shunt with hypoxemia in pulmonary hypertension
<p>Abstract</p> <p>Background</p> <p>Hypoxemia is common in pulmonary hypertension (PH) and may be partly related to ventilation/perfusion mismatch, low diffusion capacity, low cardiac output, and/or right-to-left (RL) shunting.</p> <p>Methods</p> <p>To determine whether true RL shunting causing hypoxemia is caused by intracardiac shunting, as classically considered, a retrospective single center study was conducted in consecutive patients with precapillary PH, with hypoxemia at rest (PaO<sub>2 </sub>< 10 kPa), shunt fraction (Qs/Qt) greater than 5%, elevated alveolar-arterial difference of PO<sub>2 </sub>(AaPO<sub>2</sub>), and with transthoracic contrast echocardiography performed within 3 months.</p> <p>Results</p> <p>Among 263 patients with precapillary PH, 34 patients were included: pulmonary arterial hypertension, 21%; PH associated with lung disease, 47% (chronic obstructive pulmonary disease, 23%; interstitial lung disease, 9%; other, 15%); chronic thromboembolic PH, 26%; miscellaneous causes, 6%. Mean pulmonary artery pressure, cardiac index, and pulmonary vascular resistance were 45.8 ± 10.8 mmHg, 2.2 ± 0.6 L/min/m<sup>2</sup>, and 469 ± 275 dyn.s.cm<sup>-5</sup>, respectively. PaO<sub>2 </sub>in room air was 6.8 ± 1.3 kPa. Qs/Qt was 10.2 ± 4.2%. AaPO<sub>2 </sub>under 100% oxygen was 32.5 ± 12.4 kPa. Positive contrast was present at transthoracic contrast echocardiography in 6/34 (18%) of patients, including only 4/34 (12%) with intracardiac RL shunting. Qs/Qt did not correlate with hemodynamic parameters. Patients' characteristics did not differ according to the result of contrast echocardiography.</p> <p>Conclusion</p> <p>When present in patients with precapillary PH, RL shunting is usually not related to reopening of patent <it>foramen ovale</it>, whatever the etiology of PH.</p
Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.
RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Modélisation et commande cinématique des manipulateurs mobiles à roues
TOULOUSE3-BU Sciences (315552104) / SudocSudocFranceF
Conditions associated with severe carbon monoxide diffusion coefficient reduction
International audienceObjective To identify conditions associated with severe carbon monoxide transfer coefficient reduction (Kco 35 mmHg) in 63% of cases. Conclusion Severe Kco reduction is frequently related to pulmonary hypertension, especially when associated with emphysema and/or interstitial lung disease. Systematic echocardiography is thus warranted in any patient with severe Kco diminution
Pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia
International audiencePulmonary arteriovenous malformations (PAVMs) associated with hereditary hemorrhagic telangiectasia may cause severe cerebral complications that may be prevented by embolization therapy. We retrospectively compared the diagnostic value of noninvasive tests for the screening of treatable (amenable to embolization) PAVMs in a series of 105 patients, using chest computerized tomography (CT) and/or pulmonary angiography as a "gold standard." Patients had assessment of dyspnea, chest radiograph, alveolar-arterial PO2 gradient under 100% oxygen (AaPO(2)), contrast echocardiography, and radionuclide perfusion lung scanning. Contrast echocardiography in the supine position was the most sensitive test (93%). The sensitivity of self-reported dyspnea (59%), chest radiograph alone (70%), measurement Of AaPO(2) by the 100% oxygen method (62%), or radionuclide lung scanning (71%), was not suitable for efficient screening. A 100% sensitivity and negative predictive value could be obtained when combining anteroposterior chest radiograph and contrast echocardiography. Our data support a screening algorithm based on the combined use of contrast echocardiography and anteroposterior chest radiograph, followed by chest CT if either test is positive. An alternative is to screen directly by chest CT. However, this algorithm may obviate the need for chest CT in patients without PAVM, who represent a majority of patients with hereditary hemorrhagic telangiectasia
When vitamin deficiency mimics thrombotic thrombocytopenic purpura.
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Breathing Thorax Simulation based on Pleura Behaviour and Rib Kinematics
International audienceTo monitor a lung mechanical model and then predict tumour motion we proposed a approach based on the pleura physiology. By comparing the predictions to landmarks set by medical experts, we observed better results with regards to the one obtained with approaches found in the literature. Beside, we focus on the rib cage kinematics, which play a significant role in the pleura outer-surface motion and therefore in the lung motion. We proposed a kinematic model of the rib cage based on the finite helical axis method and we show out interesting results
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