Boundary Element and Finite Element Coupling for Aeroacoustics Simulations

We consider the scattering of acoustic perturbations in a presence of a flow. We suppose that the space can be split into a zone where the flow is uniform and a zone where the flow is potential. In the first zone, we apply a Prandtl-Glauert transformation to recover the Helmholtz equation. The well-known setting of boundary element method for the Helmholtz equation is available. In the second zone, the flow quantities are space dependent, we have to consider a local resolution, namely the finite element method. Herein, we carry out the coupling of these two methods and present various applications and validation test cases. The source term is given through the decomposition of an incident acoustic field on a section of the computational domain's boundary.Comment: 25 page

Lorentz Transform and Staggered Finite Differences for Advective Acoustics

38 pagesWe study acoustic wave propagation in a uniform stationary flow. We develop a method founded on the Lorentz transform and a hypothesis of irrotationality of the acoustic perturbation. After a transformation of the space-time and of the unknown fields, we derive a system of partial differential equations that eliminates the external flow and deals with the classical case of non advective acoustics. A sequel of the analysis is a new set of perfectly matched layers equations in the spirit of the work of Berenger and Collino. The numerical implementation of the previous ideas is presented with the finite differences method HaWAY on cartesian staggered grids. Relevant numerical tests are proposed

Model of Intention for the model specification verification during the simulation architecture design process

International audienceNowadays, simulation technologies are becoming indispensable to support the design process, and notably during the verification and optimization phases. However, when building a simulation architecture that has to provide the systems architects with answers, simulations architects have to correctly specify the corresponding models required. In a MBSE concept, we propose to extend the concept of model of intention, to verify the specification of these models, to model suppliers by providing them with a Model Request Package. Models of Intention will allow an executable verification of the simulation architecture before the integration of the final models of realization

Sarilumab in adults hospitalised with moderate-to-severe COVID-19 pneumonia (CORIMUNO-SARI-1): An open-label randomised controlled trial

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Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial

International audienc

Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia

International audienceImportance Severe pneumonia with hyperinflammation and elevated interleukin-6 is a common presentation of coronavirus disease 2019 (COVID-19).Objective To determine whether tocilizumab (TCZ) improves outcomes of patients hospitalized with moderate-to-severe COVID-19 pneumonia.Design, Setting, and Particpants This cohort-embedded, investigator-initiated, multicenter, open-label, bayesian randomized clinical trial investigating patients with COVID-19 and moderate or severe pneumonia requiring at least 3 L/min of oxygen but without ventilation or admission to the intensive care unit was conducted between March 31, 2020, to April 18, 2020, with follow-up through 28 days. Patients were recruited from 9 university hospitals in France. Analyses were performed on an intention-to-treat basis with no correction for multiplicity for secondary outcomes.Interventions Patients were randomly assigned to receive TCZ, 8 mg/kg, intravenously plus usual care on day 1 and on day 3 if clinically indicated (TCZ group) or to receive usual care alone (UC group). Usual care included antibiotic agents, antiviral agents, corticosteroids, vasopressor support, and anticoagulants.Main Outcomes and Measures Primary outcomes were scores higher than 5 on the World Health Organization 10-point Clinical Progression Scale (WHO-CPS) on day 4 and survival without need of ventilation (including noninvasive ventilation) at day 14. Secondary outcomes were clinical status assessed with the WHO-CPS scores at day 7 and day 14, overall survival, time to discharge, time to oxygen supply independency, biological factors such as C-reactive protein level, and adverse events.Results Of 131 patients, 64 patients were randomly assigned to the TCZ group and 67 to UC group; 1 patient in the TCZ group withdrew consent and was not included in the analysis. Of the 130 patients, 42 were women (32%), and median (interquartile range) age was 64 (57.1-74.3) years. In the TCZ group, 12 patients had a WHO-CPS score greater than 5 at day 4 vs 19 in the UC group (median posterior absolute risk difference [ARD] −9.0%; 90% credible interval [CrI], −21.0 to 3.1), with a posterior probability of negative ARD of 89.0% not achieving the 95% predefined efficacy threshold. At day 14, 12% (95% CI −28% to 4%) fewer patients needed noninvasive ventilation (NIV) or mechanical ventilation (MV) or died in the TCZ group than in the UC group (24% vs 36%, median posterior hazard ratio [HR] 0.58; 90% CrI, 0.33-1.00), with a posterior probability of HR less than 1 of 95.0%, achieving the predefined efficacy threshold. The HR for MV or death was 0.58 (90% CrI, 0.30 to 1.09). At day 28, 7 patients had died in the TCZ group and 8 in the UC group (adjusted HR, 0.92; 95% CI 0.33-2.53). Serious adverse events occurred in 20 (32%) patients in the TCZ group and 29 (43%) in the UC group (P = .21).Conclusions and Relevance In this randomized clinical trial of patients with COVID-19 and pneumonia requiring oxygen support but not admitted to the intensive care unit, TCZ did not reduce WHO-CPS scores lower than 5 at day 4 but might have reduced the risk of NIV, MV, or death by day 14. No difference on day 28 mortality was found. Further studies are necessary for confirming these preliminary results.Trial Registration ClinicalTrials.gov Identifier: NCT0433180