Polydisperse spray flames in vortex flows

[EN] A new mathematical analysis of the dynamics of laminar spray diffusion flames in the vicinity of a vortex flow field is presented. The governing equations for a spray evaporating in an unsteady vortex are studied. New similarity solutions are found for the dynamics of the spray and the flame it supports. Analytical solutions for the spray flames are derived using Schvab-Zeldovich parameters, through which the radial evolution of the flames is found. The results based on the solution reveal the significant influence the droplets size has on the diffusion flame dynamics in the vicinity of vortical flows.Dagan, Y.; Katoshevski, D.; Greenberg, BJ. (2017). Polydisperse spray flames in vortex flows. En Ilass Europe. 28th european conference on Liquid Atomization and Spray Systems. Editorial Universitat Politècnica de València. 702-708. https://doi.org/10.4995/ILASS2017.2017.4716OCS70270

Heart Failure Patient Self-Care: An Evidence-Based Outpatient Management Program

Background: According to the American Heart Association, there are over 5 million people in the United States with heart failure (HF) and projections suggest the prevalence of HF will increase by 46% through 2030. HF is the most common cause of hospital admissions in the United States for patients age 65 years or older and despite improvement outcomes, national readmission rates remain high at 23%. Current guidelines recommend health professionals provide comprehensive HF education and counseling that is not only focused on knowledge, but also on skills of management and self-care behaviors. In order to achieve quality patient-centered care, the patient must actively participate in their plan of care. According to the evidence, self-care management programs in HF can improve self-care and decrease HF readmission and mortality rates Purpose: The purpose of this evidence-based practice project was to incorporate a HF self-care management program in an outpatient cardiology clinic to improve self-care behaviors and reduce hospital readmissions in HF patients recently discharged from the hospital. Practice Change: An evidence-based HF self-care management educational program led by an advanced practice-nursing student was implemented in an outpatient advanced HF clinic post hospital discharge. The program included an initial evaluation of self-care using a validated questionnaire, HF self-care education, 5 weekly telephone support calls, and reevaluation of self-care following the program. Results: Participants had statistically significant improvements in HF self-care maintenance, management, and confidence. The participants had no all-cause 30-day readmissions while 60 and 90-day readmission rates remained below 30%. This program also helped decrease HF all-cause 30-day readmissions to 15.7%. Implications: The findings from this project suggest that evidence-based outpatient self-care management programs can improve HF patient self-care and reduce readmission rates. This program supports the need for individualized HF outpatient self-care management programs that are designed and supported by advanced practice nurses and registered nurses to reduce readmissions and improve self-care behavior in patients with HF

The pharmacokinetics of nebulized nanocrystal budesonide suspension in healthy volunteers.

Nanocrystal budesonide (nanobudesonide) is a suspension for nebulization in patients with steroid-responsive pulmonary diseases such as asthma. The pharmacokinetics and safety of the product were compared to those of Pulmicort Respules. Sixteen healthy volunteers were administered nanobudesonide 0.5 and 1.0 mg, Pulmicort Respules 0.5 mg, and placebo in a four-way, randomized crossover design. All nebulized formulations were well tolerated, with no evidence of bronchospasm. Nebulization times were significantly shorter for nanobudesonide compared to Pulmicort Respules. Because of a low oral bioavailability, plasma concentration of budesonide is a good marker of lung-delivered dose. The pharmacokinetics of nanobudesonide 0.5 and 1.0 mg were approximately dose proportional with respect to Cmax, AUC(0-t), and AUC(0-infinity). Nanobudesonide 0.5 mg and Pulmicort Respules 0.5 mg exhibited similar AUCs, suggesting a similar extent of pulmonary absorption. A higher Cmax was noted with nanobudesonide 0.5 mg, and the tmax was significantly different, suggesting a more rapid rate of drug delivery of nanobudesonide 0.5 mg than Pulmicort Respules. In conclusion, nebulized nanobudesonide 0.5 mg was safe in healthy volunteers, with a similar extent of absorption as Pulmicort Respules

Life Stress and Inhibitory Control Deficits: Teaching BrainWise as a Neurocognitive Intervention in Vulnerable Populations

The chapter describes inhibitory control in the context of broader and related constructs, executive function and self-regulation. We discuss the adaptive functions of inhibitory control, as well as evidence that life stress, such as poverty, maltreatment, homelessness, and mental illness, negatively impacts individuals’ inhibitory control and overall self-regulation skills. Moreover, these stressors are known to disrupt the development and functioning of crucial brain systems underlying inhibitory control. Following this review, we discuss a critical thinking skills intervention, BrainWise, which is designed to teach inhibitory and self-regulation skills to children, youth and adults. We describe the implementation of the program, and review evidence for its effectiveness with various populations, including our recent study that demonstrated the success of BrainWise in teaching these skills to homeless men living in transitional housing. Finally, we describe our proposed future applications of this intervention to veterans suffering serious mental health challenges. Our overarching goals are to highlight the importance of inhibitory control and overall self-regulation, the vulnerability of these important skills to life stress, and the promise held by one neurocognitive intervention for improving inhibitory control in high-risk populations

Propulsion over a wide Mach number range

Criteria is presented to assess the relative merits of different propulsion systems. Previous references focus mainly on subsonic or low supersonic flight speeds. The main focus here is on a higher range, from low supersonic to orbital velocities. Air breathing propulsion systems for hypersonic flight persent the engine designer with circumstances that differ in important fundamental ways from those encountered in engines designed for operation at subsonic or low supersonic speeds. This analysis highlights the importance of various features of hypersonic engine design. Since the performance of hypersonic engines are energy limited, unlike low speed engines which are stagnation pressure limited, the efficient use of the energy of the fuel used is critical to minimize the take-off fuel mass fraction of the vehicle. Furthermore, since the required energy increase of a vehicle per incremental speed change increases with speed, the engine must be designed to operate efficiently at high speed. An analysis of engine performance in terms of entropy changes of the flow passing through the engine allows comparison of various engine designs as well as a convenient method to determine the effect of individual engine component efficiencies on overall engine performance

Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus.

BackgroundThe presence of concomitant Type II diabetic mellitus (T2DM) and depressive symptoms adversely affects individuals with symptomatic heart failure (HF).HypothesisIn presymptomatic stage B HF, this study hypothesized the presence of greater inflammation and depressive symptoms in T2DM as compared to non-T2DM Stage B patients.MethodsThis cross-sectional study examined clinical parameters, inflammatory biomarkers, and depressive symptoms in 349 T2DM and non-T2DM men with asymptomatic stage B HF (mean age 66.4 years ±10.1; range 30-91).ResultsFewer diabetic HF patients had left ventricular (LV) systolic dysfunction (P < .05) although more had LV diastolic dysfunction (P < .001). A higher percentage of T2DM HF patients were taking ACE-inhibitors, beta-blockers, calcium channel blockers, statins, and diuretics (P values < .05). T2DM HF patients had higher circulating levels of interleukin-6 (IL-6) (P < .01), tumor necrosis factor-alpha (P < .01), and soluble ST2 (sST2) (P < .01) and reported more somatic/affective depressive symptoms (Beck Depression Inventory II) (P < .05) but not cognitive/affective depressive symptoms (P = .20). Among all patients, in a multiple regression analysis predicting presence of somatic/affective depressive symptoms, sST2 (P = .026), IL-6 (P = .010), B-type natriuretic peptide (P = .016), and sleep (Pittsburgh Sleep Quality Index [P < .001]) were significant predictors (overall model F = 15.39, P < .001, adjusted R2 = .207).ConclusionsSomatic/affective but not cognitive/affective depressive symptoms are elevated in asymptomatic HF patients with T2DM patients. Linkages with elevated inflammatory and cardiac relevant biomarkers suggest shared pathophysiological mechanisms among T2DM HF patients with somatic depression, and these conditions are responsive to routine interventions, including behavioral. Copyright © 2019 John Wiley & Sons, Ltd

Echocardiographic predictors of clinical outcome in patients with left ventricular dysfunction enrolled in the SOLVD registry and trials: significance of left ventricular hypertrophy

OBJECTIVES To assess the relation of left ventricular (LV) and left atrial (LA) dimensions, ejection fraction (EF) and LV mass to subsequent clinical outcome of patients with LV dysfunction enrolled in the Studies of Left Ventricular Dysfunction (SOLVD) Registry and Trials. BACKGROUND Data are lacking on the relation of LV mass to prognosis in patients with LV dysfunction and on the interaction of LV mass with other measurements of LV size and function as they relate to clinical outcome. METHODS A cohort of 1,172 patients enrolled in the SOLVD Trials (n = 577) and Registry (n = 595) had baseline echocardiographic measurements and follow-up for 1 year. RESULTS After adjusting for age, New York Heart Association (NYHA) functional class, Trial vs. Registry and ischemic etiology, a 1-SD difference in EF was inversely associated with an increased risk of death (risk ratio, 1.62; p = 0.0008) and cardiovascular (CV) hospitalization (risk ratio, 1.59; p = 0.0001). Consequently, the other echo parameters were adjusted for EF in addition to age, NYHA functional class, Trial vs. Registry and ischemic etiology. A 1-SD difference in LV mass was associated with increased risk of death (risk ratio of 1.3, p = 0.012) and CV hospitalization (risk ratio of 1.17, p = 0.018). Similar results were observed with the LA dimension (mortality risk ratio, 1.32; p 5.0 cm was associated with increased mortality only. A protective effect of EF was noted in patients with LV mass ≥298 g (those in the group with EF >35% had lower mortality) but not in the group with LV mass 35% fared better) but not in the group with LV mass <298 g. These data support the development and use of drugs that can inhibit hypertrophy or alter its characteristics

Echocardiographic predictors of clinical outcome in patients with left ventricular dysfunction enrolled in the SOLVD registry and trials: significance of left ventricular hypertrophy

OBJECTIVES To assess the relation of left ventricular (LV) and left atrial (LA) dimensions, ejection fraction (EF) and LV mass to subsequent clinical outcome of patients with LV dysfunction enrolled in the Studies of Left Ventricular Dysfunction (SOLVD) Registry and Trials. BACKGROUND Data are lacking on the relation of LV mass to prognosis in patients with LV dysfunction and on the interaction of LV mass with other measurements of LV size and function as they relate to clinical outcome. METHODS A cohort of 1,172 patients enrolled in the SOLVD Trials (n = 577) and Registry (n = 595) had baseline echocardiographic measurements and follow-up for 1 year. RESULTS After adjusting for age, New York Heart Association (NYHA) functional class, Trial vs. Registry and ischemic etiology, a 1-SD difference in EF was inversely associated with an increased risk of death (risk ratio, 1.62; p = 0.0008) and cardiovascular (CV) hospitalization (risk ratio, 1.59; p = 0.0001). Consequently, the other echo parameters were adjusted for EF in addition to age, NYHA functional class, Trial vs. Registry and ischemic etiology. A 1-SD difference in LV mass was associated with increased risk of death (risk ratio of 1.3, p = 0.012) and CV hospitalization (risk ratio of 1.17, p = 0.018). Similar results were observed with the LA dimension (mortality risk ratio, 1.32; p 5.0 cm was associated with increased mortality only. A protective effect of EF was noted in patients with LV mass ≥298 g (those in the group with EF >35% had lower mortality) but not in the group with LV mass 35% fared better) but not in the group with LV mass <298 g. These data support the development and use of drugs that can inhibit hypertrophy or alter its characteristics