Doctor of Philosophy

dissertationDue to the tremendous progress of modern medicine, more people are surviving cancer. A cancer diagnosis no longer connotes the end of life, but instead, a change in life. Recently, middle age and older adults with hematological cancer have become eligible for treatment with allogeneic hematopoietic cell transplantation (allo HCT), enabling them to survive their underlying cancer diagnosis. While some individuals fully recover from allo HCT, up to two thirds of allo HCT recipients develop new-onset diabetes. While research has been conducted on the physiological effect diabetes has on HCT outcomes, there is a knowledge gap regarding middle age and older adults' psychosocial response to the condition. The objective of this qualitative study was to explore the psychosocial experience of developing new-onset diabetes after allo HCT. Nineteen participants above 50 years of age were interviewed. Qualitative data generated through interviews were analyzed using constructivist grounded theory methods. The result was the mid-range theory of dealing with new-onset diabetes as a long-term effect of allo HCT. This theory had 4 stages; 1) finding out about diabetes, 2) formulating an understanding of diabetes in relation to cancer, 3) formulating a diabetes identity, and 4) dealing with diabetes after allo HCT. Three distinct patterns of movement through these stages emerged, depending on how participants recovered from their allo HCT. The first pattern occurred in the group of participants with no or minimal after allo HCT complications. The second pattern was seen in the group with episodic complications, iv and the third in those with ongoing complications. Two primary factors were responsible for these differences of moving through the stages, and ultimately, whether participants adapted to new-onset diabetes: the amount of treatment-related work and the perceptions of diabetes. The group with minimal complications was able to understand, identify, and integrate diabetes into their lives, while those with ongoing complications experienced barriers to socially constructing and identifying with their type of diabetes, and were subsequently unable to integrate diabetes into their lives. This mid-range theory provides a working framework for the development of clinical and educational interventions specific to this patient population

Investigation of Phase-Lagged Boundary Conditions for Turbulence Resolving Turbomachinery Simulations

The present work explores whether phase-lagged boundary conditions can be used to perform scale resolving simulations of turbomachines. The phase-lagged approach considered is based on storing the flow signal, both at the pitch-wise boundaries and the rotor-stator interface, as its temporal Fourier coefficients for a finite number of harmonics. The method is implemented in an in-house CFD solver, G3D::Flow, which can perform both URANS and hybrid RANS/LES simulations. In order to evaluate the performance of the phase-lagged boundary condition, a comparison is made with a sliding mesh simulation on a compressor cascade. Furthermore, the possibility of breaking an error feedback loop generated in the sampling process by including multiple blade passages is also investigated. It is found that this approach greatly improves convergence and accuracy of the sampling

Tactile thresholds are preserved yet complex sensory function is impaired over the lumbar spine of chronic non-specific low back pain patients. A preliminary investigation

Objectives: To investigate impairments in sensory function in chronic non-specific low back pain patients and the relationship between any impairment and the clinical features of the condition. Design: A cross-sectional case-control study. Setting: Laboratory based study. Participants: Nineteen chronic non-specific low back pain patients and nineteen healthy controls. Main Outcome measures: Tactile threshold, two point discrimination distance and accuracy at a task involving recognizing letters drawn over the skin of the lower back (graphaesthesia) were assessed over the lumbar spine in both groups. Pain duration, pain intensity, physical function, anxiety and depression were assessed by questionnaire in the back pain group Results: We found no difference in tactile threshold between the two groups (median difference 0.00 95% CI -0.04 – 0.04). There was a significant difference between controls and back pain patients for two point discrimination (mean difference 17.85 95% CI 5.93 – 29.77) and graphaesthesia accuracy (mean difference 6.13 95% CI 1.27-10.99). Low back pain patients had a larger lumbar two point discrimination distance threshold and a greater letter recognition error rate. In the patient group, we found no relationship between clinical profile and sensory function and no relationship between the sensory tests. Conclusions: These data support existing findings of perceptual abnormalities in chronic non-specific low back pain patients and are suggestive of cortical rather than peripheral sensory dysfunction. Amelioration of these abnormalities may present a target for therapeutic intervention

New measurement approaches for film thickness and wall temperature in falling film heat exchangers

Papers presented to the 11th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, South Africa, 20-23 July 2015.Falling film evaporation is used in various fields, e.g. food and pulp & paper industry. Evaporation is very energy intense and relatively small efficiency improvements to the techniques can lead to large savings in absolute numbers. Falling film evaporation is affected by the wave dynamics; hence further knowledge of the behaviour of the liquid film flow can promote efficiency improvements. In this work, two new measurement approaches have been investigated. The first approach is to use a laser triangulation scanner combined with a high-speed camera where the laser scanner continuously measures the film thickness along a vertical line, resolving the flow pattern in high detail. The second approach is to measure local wall temperatures, enabling calculation of local heat transfer coefficients at any desired location. These methods has been tested and evaluated in a falling film test facility. Both approaches have proven to give valuable insights into the process and the results are in good agreement with literature data.am201

Long-term Transplant Function After Thrombolytic Treatment Ex Vivo of Donated Kidneys Retrieved 4 to 5 Hours After Circulatory Death

Background.\ua0Using a novel thrombolytic technique, we present long-term transplant function, measured by creatinine and iohexol clearance, after utilizing kidneys from porcine donors with uncontrolled donation after circulatory deaths, with 4.5–5 h of warm ischemia.Methods.\ua0Pigs in the study group were subjected to simulated circulatory death. After 2 h, ice slush was inserted into the abdomen and 4.5 h after death, the kidneys were retrieved. Lys-plasminogen, antithrombin-III, and alteplase were injected through the renal arteries on the back table. Subsequent ex vivo perfusion was continued for 3 h at 15\ub0C, followed by 3 h with red blood cells at 32\ub0C, and then transplanted into pigs as an autologous graft as only renal support. Living-donor recipient pigs that did not receive ex vivo perfusion, and unilateral nephrectomized pigs served as the controls.Results.\ua0Pigs in the study group (n = 13), surviving 10 d or more were included, of which 7 survived for 3 mo. Four animals in the living-donor group (n = 6) and all 5 nephrectomized animals survived for 3 mo. Creatinine levels in the plasma and urine, neutrophil gelatinase-associated lipocalin levels, Kidney Injury Marker-1 expression, and iohexol clearance at 3 mo did not differ significantly between the study and living-donor groups. Histology and transmission electron microscopy after 3 mo showed negligible fibrosis and no other damage.Conclusions.\ua0The present method salvages kidneys from extended unontrolled donation after circulatory death using thrombolytic treatment while preserving histology and enabling transplantation after ex vivo reconditioning, with clinically acceptable late function after 3 mo, as measured by creatinine and iohexol clearance

Haptic pop-out of movable stimuli

When, in visual and haptic search, a target is easily found among distractors, this is called a pop-out effect. The target feature is then believed to be salient, and the search is performed in a parallel way. We investigated this effect with movable stimuli in a haptic search task. The task was to find a movable ball among anchored distractors or the other way round. Results show that reaction times were independent of the number of distractors if the movable ball was the target but increased with the number of items if the anchored ball was the target. Analysis of hand movements revealed a parallel search strategy, shorter movement paths, a higher average movement speed, and a narrower direction distribution with the movable target, as compared with a more detailed search for an anchored target. Taken together, these results show that a movable object pops out between anchored objects and this indicates that movability is a salient object feature. Vibratory signals resulting from the movable ball were found to be a reasonable explanation regarding the sensation responsible for the pop-out of movability

C-tactile afferent stimulating touch carries a positive affective value

The rewarding sensation of touch in affiliative interactions is hypothesized to be underpinned by a specialized system of nerve fibers called C-Tactile afferents (CTs), which respond optimally to slowly moving, gentle touch, typical of a caress. However, empirical evidence to support the theory that CTs encode socially relevant, rewarding tactile information in humans is currently limited. While in healthy participants, touch applied at CT optimal velocities (1-10cm/sec) is reliably rated as subjectively pleasant, neuronopathy patients lacking large myelinated afferents, but with intact C-fibres, report that the conscious sensation elicited by stimulation of CTs is rather vague. Given this weak perceptual impact the value of self-report measures for assessing the specific affective value of CT activating touch appears limited. Therefore, we combined subjective ratings of touch pleasantness with implicit measures of affective state (facial electromyography) and autonomic arousal (heart rate) to determine whether CT activation carries a positive affective value. We recorded the activity of two key emotion-relevant facial muscle sites (zygomaticus major—smile muscle, positive affect & corrugator supercilii—frown muscle, negative affect) while participants evaluated the pleasantness of experimenter administered stroking touch, delivered using a soft brush, at two velocities (CT optimal 3cm/sec & CT non-optimal 30cm/sec), on two skin sites (CT innervated forearm & non-CT innervated palm). On both sites, 3cm/sec stroking touch was rated as more pleasant and produced greater heart rate deceleration than 30cm/sec stimulation. However, neither self-report ratings nor heart rate responses discriminated stimulation on the CT innervated arm from stroking of the non-CT innervated palm. In contrast, significantly greater activation of the zygomaticus major (smiling muscle) was seen specifically to CT optimal, 3cm/sec, stroking on the forearm in comparison to all other stimuli. These results offer the first empirical evidence in humans that tactile stimulation that optimally activates CTs carries a positive affective valence that can be measured implicitly