Adaptive servoventilation improves cardiac function and respiratory stability

Cheyne–Stokes respiration (CSR) in patients with chronic heart failure (CHF) is of major prognostic impact and expresses respiratory instability. Other parameters are daytime pCO2, VE/VCO2-slope during exercise, exertional oscillatory ventilation (EOV), and increased sensitivity of central CO2 receptors. Adaptive servoventilation (ASV) was introduced to specifically treat CSR in CHF. Aim of this study was to investigate ASV effects on CSR, cardiac function, and respiratory stability. A total of 105 patients with CHF (NYHA ≥ II, left ventricular ejection fraction (EF) ≤ 40%) and CSR (apnoea–hypopnoea index ≥ 15/h) met inclusion criteria. According to adherence to ASV treatment (follow-up of 6.7 ± 3.2 months) this group was divided into controls (rejection of ASV treatment or usage <50% of nights possible and/or <4 h/night; n = 59) and ASV (n = 56) adhered patients. In the ASV group, ventilator therapy was able to effectively treat CSR. In contrast to controls, NYHA class, EF, oxygen uptake, 6-min walking distance, and NT-proBNP improved significantly. Moreover, exclusively in these patients pCO2, VE/VCO2-slope during exercise, EOV, and central CO2 receptor sensitivity improved. In CHF patients with CSR, ASV might be able to improve parameters of SDB, cardiac function, and respiratory stability

Cost-Effectiveness of Peer-Delivered Interventions for Cocaine and Alcohol Abuse among Women: A Randomized Controlled Trial

<div><h3>Aims</h3><p>To determine whether the additional interventions to standard care are cost-effective in addressing cocaine and alcohol abuse at 4 months (4 M) and 12 months (12 M) from baseline.</p> <h3>Method</h3><p>We conducted a cost-effectiveness analysis of a randomized controlled trial with three arms: (1) NIDA's Standard intervention (SI); (2) SI plus a Well Woman Exam (WWE); and, (3) SI, WWE, plus four Educational Sessions (4ES).</p> <h3>Results</h3><p>To obtain an additional cocaine abstainer, WWE compared to SI cost $7,223 at 4 M and$3,611 at 12 M. Per additional alcohol abstainer, WWE compared to SI cost $3,611 and$7,223 at 4 M and 12 M, respectively. At 12 M, 4ES was dominated (more costly and less effective) by WWE for abstinence outcomes.</p> <h3>Conclusions</h3><p>To our knowledge, this is the first cost-effectiveness analysis simultaneously examining cocaine and alcohol abuse in women. Depending on primary outcomes sought and priorities of policy makers, peer-delivered interventions can be a cost-effective way to address the needs of this growing, underserved population.</p> <h3>Trial Registration</h3><p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01235091">NCT01235091</a></p> </div

Scaling Parameters for Dynamic Diffusion-Reaction over Porous Catalysts

The effect of diffusion resistance in porous solid catalysts on reaction rate during periodic cycling of CO concentration is shown for CO oxidation over Pt/Al2O3 by numerical simulation. At some cycling frequencies, the average reaction rate during cycling is higher than the steady-state rate at the mean CO concentration, as expected for this nonlinear, reactant-inhibited reaction. In order to identify major aspects of dynamic diffusion-reaction behavior, a simple kinetic mechanism that shows the main features of CO oxidation and other reactions with significant inhibition by reactants is investigated. A single dimensionless parameter group, the dynamic diffusion coefficient, is added when going from steady-state to unsteady-state diffusion-reaction equations. In the dynamic diffusion coefficient, the rate at which the gas-phase reactant diffuses is reduced by the surface adsorption capacity of the catalyst. The frequency at which the peak average rate occurs is controlled by the dynamic diffusion coefficient

Mechanische Charakterisierung von Laser-Beschichtungen aus WC-verstärkten Hartlegierungen

Schichten aus hartstoffverstärkten Metallegierungen besitzen fast den Verschleißwiderstand von gesintertem Hartmetall. Der erfolgreiche Einsatz dieser Beschichtungen verlangt ihre beanspruchungsnahe Charakterisierung. Entscheidend für das Einsatzverhalten auf Umformwerkzeugen sind vor allem die Haft- und die Schlagfestigkeit. Zur Bestimmung beider Eigenschaften wurden im Fraunhofer IWS entsprechende Prüfverfahren entwickelt, die eine kostengünstige, entwicklungsbegleitende Optimierung der Beschichtungstechnologie ermöglichten. Beide Verfahren können auch zur Charakterisierung anderer Schichtsysteme eingesetzt werden

Erfassung und Modellierung der thermischen Wechselwirkungen von Umgebung und Maschine

In order to analyze the thermal behavior of machine tools under various practical conditions, a thermal cell can be used for experimental investigations at the Fraunhofer IWU. The article describes the metrological principles and procedure for thermal studies under defined boundary conditions

Déplacement du bolus dans l'oesophage et la jonction oesogastrique dans le reflux gastro-oesophagien et après fundoplicature (étude à partir d'enregistrements simultanés des bruits de déglutition et de séquences vidéoradiologiques)

Le but de cette étude était d analyser l organisation des 3 composantes du bolus dégluti (air mélange baryte), d évaluer leur temps de passage à travers la jonction œsogastrique, d établir des comparaisons avec les bruits xiphoïdiens à partir d acquisitions acoustiques et radiologiques simultanées chez des patients opérés d un reflux gastroœsophagien(NF). Les surfaces des trois composantes et leurs temps de transit étaient mesurés, la durée du signal xiphoïdien et le nombre de groupe de vibrations étaient évalués. L origine des bruits était déterminée. La décantation air-baryte était perturbée. Après NF, le passage du bolus était plus rapide. Avant NF, le bruit xiphoïdien était composé de groupes de vibrations plus nombreux et plus espacés. Après NF, la durée du bruit et le nombre de groupes de vibrations diminuaient. Le bruit xiphoïdien était généré par le passage de l air et d une partie du mélange à travers la jonction œsogastrique.TOURS-BU Médecine (372612103) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Sustainable increases of energy efficiency by holistically considered structures of factory systems

A number of efficient solutions are already in existence today for reducing specific energy and raw material needs, and they are continuously being improved. Since the competition between individual solutions for sustained energy efficiency may prove to be an obstacle to the system as a whole, the interaction of individual elements and sub-systems in complex domains must be considered in an integrated way with an eye to their reciprocal energy effects. What will be the impact of energy savings resulting from innovative approaches and intelligent solutions at a single systemic level on the system as a whole? Do they serve to reduce overall energy costs? What kinds of energy-related information are necessary to answer these questions? This article examines the issue of how dedicated energy savings in the production sector impact on the total energy requirement in factory systems. In one example, process and building are examined together in order to thereby recognize energy relationships. It was demonstrate that waste heat from machine tools has a significant impact on the factory hall climate and therefore on the heating needs of factory buildings. A model calculation demonstrated that energy savings at individual system levels are transferable to the entire system in direct proportion to the energy efficiency of the building