SCALABLE HPC SIMULATIONS OF FLEXIBLE MULTIBODY INDEX-3 DYNAMIC SYSTEMS

In this paper a highly scalable parallel formulation of the primal-dual technique is presented for index-3 constrained flexible multi-body dynamics system. The key features of the primal-dual approach are constraint preservation, preserving the original order of accuracy of time integration operators that are employed, and faster convergence rates of nonlinear iterations for the solution of flexible multi-body dynamical systems. In addition, this technique not only preserves the underlying properties of time integration operators for ordinary differential equations, but also eliminates the need for index reduction, constraint stabilization and regularization approaches. The key features of the parallel formulation of rigid and flexible modeling and simulation technology are capabilities such as adaptive high/low fidelity modeling that is useful from the initial design concept stage to the intermediate and to the final design stages in a single seamless simulation environment. The examples considered illustrate the capabilities and scalability of the proposed high performance computing (HPC) approach for large-scale simulations

Surgical revascularization versus amputation for peripheral vascular disease in dialysis patients: a cohort study

BACKGROUND: Surgical treatment of peripheral vascular disease (PVD) in dialysis patients is controversial. METHODS: We examined the post-operative morbidity and mortality of surgical revascularization or amputation for PVD in a retrospective analysis of United States Renal Data System. Propensity scores for undergoing amputation were derived from a multivariable logistic regression model of amputation. RESULTS: Of the Medicare patients initiated on dialysis from Jan 1, 1995 to Dec 31, 1999, patients underwent surgical revascularization (n = 1,896) or amputation (n = 2,046) in the first 6 months following initiation of dialysis were studied. In the logistic regression model, compared to claudication, presence of gangrene had a strong association with amputation [odds ratio (OR) 19.0, 95% CI (confidence interval) 13.86–25.95]. The odds of dying within 30 days and within1 year were higher (30 day OR: 1.85, 95% CI: 1.45–2.36; 1 yr OR: 1.46, 95% CI: 1.25–1.71) in the amputation group in logistic regression model adjusted for propensity scores and other baseline factors. Amputation was associated with increased odds of death in patients with low likelihood of amputation (< 33(rd )percentile of propensity score) and moderate likelihood of amputation (33(rd )to 66(th )percentile) but not in high likelihood group (>66(th )percentile). The number of hospital days in the amputation and revascularization groups was not different. CONCLUSION: Amputation might be associated with higher mortality in dialysis patients. Where feasible, revascularization might be preferable over amputation in dialysis patients