166 research outputs found
fatigue damage and stiffness evolution in composite laminates a damage based framework
Abstract A damage-based design procedure has been developed by the authors to predict the damage evolution and the stiffness degradation in polymeric composite laminates under fatigue loading. For a safe and reliable design against fatigue degradation and failure, the initiation of the main damage mechanisms (off-axis cracks, delamination and fiber failure) as well as their evolution are considered and suitable models are proposed for the quantitative assessment of the lifetime associated to each mechanism. In parallel, the stiffness degradation deriving from the damage evolution over the fatigue life is properly described. After the illustration of the overall damage-based strategy, the paper discusses in details the analysis and modelling of the off-axis crack initiation and propagation. The initiation of cracks in the off axis plies has been proved to be the consequence of a damage process occurring at the microscopic scale since the early stages of fatigue. On this basis, crack initiation prediction is based on the use of local stress parameters: Local Hydrostatic Stress, LHS, and Local Maximum Principal Stress, LMPS, depending on the local degree of multiaxiality of the stress state and accounting for the statistical distribution of the local laminate strength. The propagation phase is then quantified by using a conventional fracture mechanics approach. The model has been implemented in a Matlab procedure for the quantitative evaluation of the crack density in each ply of a laminate during its entire fatigue life. The knowledge of the crack density trend allows the description of the laminate stiffness evolution taking advantage of another model recently developed by the authors, valid for a generic laminate configuration and accounting for the interaction between cracks in the neighbouring plies
Proteinuria in focal segmental glomerulosclerosis: role of circulating factors and therapeutic approach.
The clinical course of primary Focal Segmental Glomerulosclerosis (FSGS) is frequently complicated by nephrotic range proteinuria and progression to renal failure. The high recurrence rate of the disease in transplanted kidney suggests the hypothesis that such patients have a circulating factor that alters glomerular capillary permeability. In recent years some authors found that serum from patients with FSGS increases glomerular permeability to albumin and partially identified the permeability factor (PF) as a protein of 30-50 Kd m.w. The removal of this protein by means of Plasma Exchange (PE) or plasma Immunoadsorption by Protein A (IA) decreased proteinuria. In this report we provide preliminary data about the prevalence of PF and the therapeutic effect of its removal by IA, in 3 pts with recurrence in the transplanted kidney, and 4 with FSGS of the native kidneys. They were resistant to corticosteroids (CS) and immunosuppressive (IS) therapy. 10 IA sessions were performed in 4 weeks: if a remission was achieved IA was gradually tapered. The level of PF in the serum was measured by an in vitro assay to determine the glomerular permeability to albumin. The FSGS was histologically proven in all cases and the degree of evolution was evaluated. PF levels, serum creatinine, daily proteinuria and serum albumin were monitored. The 3 patients with recurrent FSGS had a normalization of the PF levels; 2 had a clinical remission. In FSGS of native kidneys PF was elevated in 3/4 cases; 1 had a clinical remission; 2 with extensive sclerohyalinosis and 1 without PF levels did not improve. Our results confirm that most patients with FSGS have high PF serum levels and suggest that its removal can be beneficial
Volume Assessment in Mechanically Ventilated Critical Care Patients Using Bioimpedance Vectorial Analysis, Brain Natriuretic Peptide, and Central Venous Pressure
Purpose. Strategies for volume assessment of critically ill patients are limited, yet early goal-directed therapy improves outcomes. Central venous pressure (CVP), Bioimpedance Vectorial Analysis (BIVA), and brain natriuretic peptide (BNP) are potentially useful tools. We studied the utility of these measures, alone and in combination, to predict changing oxygenation. Methods. Thirty-four mechanically ventilated patients, 26 of whom had data beyond the first study day, were studied. Relationships were assessed between CVP, BIVA, BNP, and oxygenation index (O2I) in a cross-sectional (baseline) and longitudinal fashion using both univariate and multivariable modeling. Results. At baseline, CVP and O2I were positively correlated (R = 0.39; P = .021), while CVP and BIVA were weakly correlated (R = −0.38; P = .025). The association between slopes of variables over time was negligible, with the exception of BNP, whose slope was correlated with O2I (R = 0.40; P = .044). Comparing tertiles of CVP, BIVA, and BNP slopes with the slope of O2I revealed only modest agreement between BNP and O2I (kappa = 0.25; P = .067). In a regression model, only BNP was significantly associated with O2I; however, this was strengthened by including CVP in the model. Conclusions. BNP seems to be a valuable noninvasive measure of volume status in critical care and should be assessed in a prospective manner
Psychological treatments and psychotherapies in the neurorehabilitation of pain. Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation
BACKGROUND:
It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams.
OBJECTIVES:
To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases.
METHODS:
A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions.
RESULTS:
The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache.
CONCLUSIONS:
Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the pape
Coalition Formation and the Ancillary Benefits of Climate Policy
Several studies found ancillary benefits of environmental policy to be of considerable size. These additional private benefits imply not only higher cooperative but also noncooperative abatement targets. However, beyond these largely undisputed important quantitative effects, there are qualitative and strategic implications associated with ancillary benefits: climate policy is no longer a pure but an impure public good. In this paper, we investigate these implications in a setting of non-cooperative coalition formation. In particular, we address the following questions. 1) Do ancillary benefits increase participation in international environmental agreements? 2) Do ancillary benefits raise the success of these treaties in welfare terms
Gaia-ESO Survey: INTRIGOSS - A New Library of High-resolution Synthetic Spectra
We present a high resolution synthetic spectral library, INTRIGOSS, designed
for studying FGK stars. The library is based on atmosphere models computed with
specified individual element abundances via ATLAS12 code. Normalized SPectra
(NSP) and surface Flux SPectra (FSP), in the 4830-5400 A, wavelength range,
were computed with the SPECTRUM code. INTRIGOSS uses the solar composition by
Grevesse et al. 2007 and four [alpha/Fe] abundance ratios and consists of
15,232 spectra. The synthetic spectra are computed with astrophysical gf-values
derived by comparing synthetic predictions with a very high SNR solar spectrum
and the UVES-U580 spectra of five cool giants. The validity of the NSPs is
assessed by using the UVES-U580 spectra of 2212 stars observed in the framework
of the Gaia-ESO Survey and characterized by homogeneous and accurate
atmospheric parameter values and by detailed chemical compositions. The greater
accuracy of NSPs with respect to spectra from the AMBRE, GES_Grid, PHOENIX,
C14, and B17 synthetic spectral libraries is demonstrated by evaluating the
consistency of the predictions of the different libraries for the UVES-U580
sample stars. The validity of the FSPs is checked by comparing their prediction
with both observed spectral energy distribution and spectral indices. The
comparison of FSPs with SEDs derived from ELODIE, INDO--U.S., and MILES
libraries indicates that the former reproduce the observed flux distributions
within a few percent and without any systematic trend. The good agreement
between observational and synthetic Lick/SDSS indices shows that the predicted
blanketing of FSPs well reproduces the observed one, thus confirming the
reliability of INTRIGOSS FSPs
Bioreactor technologies to support liver function in vitro
Liver is a central nexus integrating metabolic and immunologic homeostasis in the human body, and the direct or indirect target of most molecular therapeutics. A wide spectrum of therapeutic and technological needs drives efforts to capture liver physiology and pathophysiology in vitro, ranging from prediction of metabolism and toxicity of small molecule drugs, to understanding off-target effects of proteins, nucleic acid therapies, and targeted therapeutics, to serving as disease models for drug development. Here we provide perspective on the evolving landscape of bioreactor-based models to meet old and new challenges in drug discovery and development, emphasizing design challenges in maintaining long-term liver-specific function and how emerging technologies in biomaterials and microdevices are providing new experimental models.National Institutes of Health (U.S.) (R01 EB010246)National Institutes of Health (U.S.) (P50-GM068762-08)National Institutes of Health (U.S.) (R01-ES015241)National Institutes of Health (U.S.) (P30-ES002109)5UH2TR000496-02National Science Foundation (U.S.). Emergent Behaviors of Integrated Cellular Systems (CBET-0939511)United States. Defense Advanced Research Projects Agency. Microphysiological Systems Program (W911NF-12-2-0039
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