Preface

Introduction to the volume

Determination of impact sensitivity of materials at high pressures

Compact device is used to determine impact sensitivity of material in static, high pressure, gaseous environment. It can also be instrumented to monitor and record pressure, temperature, and striker impact force. Device is used in conjunction with commercially available liquid oxygen impact tester which provides impact energy

Clinical Outcomes and Cost- effectiveness of Continuous Positive Airway Pressure to Manage Obstructive Sleep Apnea in Patients With Type 2Diabetes in the U. K.

OBJECTIVE To assess clinical outcomes and cost-effectiveness of using continuous positive airway pressure (CPAP) to manage obstructive sleep apnea (OSA) in patients with type 2 diabetes (T2D) from the perspective of the U.K.’s National Health Service (NHS). RESEARCH DESIGN AND METHODS Using a case-control design, 150 CPAP-treated patients with OSA and T2D were randomly selected from The Health Improvement Network (THIN) database (a nationally representative database of patients registered with general practitioners in the U.K.) and matched with 150 OSA and T2D patients from the same database who were not treated with CPAP. The total NHS cost and outcomes of patient management in both groups over 5 years and the cost-effectiveness of CPAP compared with no CPAP treatment were estimated. RESULTS Using CPAP was associated with significantly lower blood pressure at 5 years and increasingly lower HbA1c levels over 5 consecutive years compared with untreated OSA patients. At 5 years, the HbA1c level in the CPAP-treated group was 8.2% (66.0 mmol/mol) vs. 12.1% (108.4 mmol/mol) in the control group (P < 0.03). Use of CPAP significantly increased patients’ health status by 0.27 quality-adjusted life years (QALYs) per patient over 5 years (P < 0.001) and NHS management costs by £4,141 per patient over 5 years; the cost per QALY gained with CPAP was £15,337. CONCLUSIONS Initiating treatment with CPAP in OSA patients with T2D leads to significantly lower blood pressure and better controlled diabetes and affords a cost-effective use of NHS resources. These observations have the potential for treatment modification if confirmed in a prospective study

Design guide for high pressure oxygen systems

A repository for critical and important detailed design data and information, hitherto unpublished, along with significant data on oxygen reactivity phenomena with metallic and nonmetallic materials in moderate to very high pressure environments is documented. This data and information provide a ready and easy to use reference for the guidance of designers of propulsion, power, and life support systems for use in space flight. The document is also applicable to designs for industrial and civilian uses of high pressure oxygen systems. The information presented herein are derived from data and design practices involving oxygen usage at pressures ranging from about 20 psia to 8000 psia equal with thermal conditions ranging from room temperatures up to 500 F

Right ventricular responses to CPAP therapy in obstructive sleep apnoea: CMR analysis of the MOSAIC randomised trial

Effects of continuous positive airway pressure (CPAP) on right ventricular (RV) function in patients with untreated mild-to-moderate obstructive sleep apnea (OSA) are unclear. In this exploratory analysis of cardiac magnetic resonance (CMR)-derived indices of RV function in patients with minimally symptomatic OSA from the MOSAIC randomized control trial we found no effect of CPAP on RV CMR parameters. In those with lower RV ejection fraction and higher RV end-diastolic volume (EDV) at baseline, CPAP treatment appeared to improve RV function with a significant reduction in both RV EDV and RV end-systolic volume although between-group effects were not observed. These data suggest potential merit in a larger randomized study of CPAP in patients with mild-to-moderate OSA and a greater breadth of RV dysfunction

Column ratio mapping: a processing technique for atomic resolution high angle annular dark field(HAADF) images

An image processing technique is presented for atomic resolution high-angle annular dark-field (HAADF) images that have been acquired using scanning transmission electron microscopy (STEM). This technique is termed column ratio mapping and involves the automated process of measuring atomic column intensity ratios in high-resolution HAADF images. This technique was developed to provide a fuller analysis of HAADF images than the usual method of drawing single intensity line profiles across a few areas of interest. For instance, column ratio mapping reveals the compositional distribution across the whole HAADF image and allows a statistical analysis and an estimation of errors. This has proven to be a very valuable technique as it can provide a more detailed assessment of the sharpness of interfacial structures from HAADF images. The technique of column ratio mapping is described in terms of a [1 1 0]-oriented zinc-blende structured AlAs/GaAs superlattice using the 1 Å-scale resolution capability of the aberration-corrected SuperSTEM 1 instrument

MB 700 Anthropology for Christian Mission

Textbook: Cultural Anthropology: An Applied Perspective, fifth edition by Gary Ferraro Readings: Anthropology and Christian Mission: A Reader, Darrell Whiteman (ed.)Customs and Cultures by Eugene Nidahttps://place.asburyseminary.edu/syllabi/2521/thumbnail.jp

A crossover randomised controlled trial of oral mandibular advancement devices for obstructive sleep apnoea-hypopnoea (TOMADO)

Rationale Mandibular advancement devices (MADs) are used to treat obstructive sleep apnoea-hypopnoea syndrome (OSAHS) but evidence is lacking regarding their clinical and cost-effectiveness in less severe disease. Objectives To compare clinical- and cost-effectiveness of a range of MADs against no treatment in mild to moderate OSAHS. Measurements and methods This open-label, randomised, controlled, crossover trial was undertaken at a UK sleep centre. Adults with Apnoea-Hypopnoea Index (AHI) 5–<30/h and Epworth Sleepiness Scale (ESS) score ≥9 underwent 6 weeks of treatment with three nonadjustable MADs: self-moulded (SleepPro 1; SP1); semi-bespoke (SleepPro 2; SP2); fully-bespoke MAD (bMAD); and 4 weeks no treatment. Primary outcome was AHI scored by a polysomnographer blinded to treatment. Secondary outcomes included ESS, quality of life, resource use and cost. Main results 90 patients were randomised and 83 were analysed. All devices reduced AHI compared with no treatment by 26% (95% CI 11% to 38%, p=0.001) for SP1, 33% (95% CI 24% to 41%) for SP2 and 36% (95% CI 24% to 45%, p<0.001) for bMAD. ESS was 1.51 (95% CI 0.73 to 2.29, p<0.001, SP1) to 2.37 (95% CI 1.53 to 3.22, p<0.001, bMAD) lower than no treatment (p<0.001 for all). Compliance was lower for SP1, which was the least preferred treatment at trial exit. All devices were cost-effective compared with no treatment at a £20 000/quality-adjusted life year (QALY) threshold. SP2 was the most cost-effective up to £39 800/QALY. Conclusions Non-adjustable MADs achieve clinically important improvements in mild to moderate OSAHS and are cost-effective

Los Alamos x-ray characterization facilities for plasma diagnostics

A summary is given of characteristics of x-ray sources used by Los Alamos National Laboratory to calibrate various x-ray diagnostic packages and components. Included are D.C. sourcs in electron impact and fluorescence modes, a pulsed laser source for soft x rays with 100 ps time resolution, Febetron pulsed electron impact sources, and both EUV and x-ray synchrotron beamlines