We conduct experiments to study the effects of incorporation of carbon nanotubes (CNTs) coatings on the thermal performance of micro heat pipe (MHP) arrays. The microchannels of MHP are fully coated ...with CNTs which are functionalized through a thermal curing process. The cured CNTs coating manifests a superhydrophilic characteristic and fast water permeation property. The rapid water permeation through CNTs nanostructure enhances the evaporation at the evaporator section and the fluid circulation synergically in the MHP. For evaporation, the superhydrophilic highly permeable porous CNTs nanostructures increase the nucleation sites and promote film-wise evaporation which is more efficient than the bulk evaporation. For circulation of working fluid, an intricately interconnected CNTs networks facilitate the fluid transport with enhanced capillary pressure. The effective thermal conductivity, which denotes the overall performance of a micro heat pipe manifests a maximum enhancement of 202%; and the evaporator heat transfer coefficient which represents the evaporation strength is enhanced up to 61%. Computationally, molecular dynamics simulations are performed to investigate the fast water permeation property of CNTs nanostructure which leads to the anomalous thermal performance enhancement. This study provides interesting insight into the viability of incorporating CNTs nanostructures into an MHP for microscale cooling applications.
•CNTs-nanostructures are coated in MHPs for anomalously enhanced performance.•CNTs coatings induce superhydrophillicity and ultrafast water transport in MHPs.•Drastic temperature drop significantly prolong lifespan of electronics components.•Molecular dynamics simulations delineate the ultrafast water transport in CNTs.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The purposes of this article are to review the anatomy of the upper gastrointestinal tract; review techniques and contrast agents used in the fluoroscopic examination of the oropharynx and ...hypopharynx; provide a pictorial review of some important causes of oropharyngeal dysphagia; and link these causes to key findings in the clinical history to assist in establishing a clinical diagnosis.
Many important causes and presentations of oropharyngeal dysphagia are sometimes overlooked during conventional upper gastrointestinal studies. Videofluoroscopic evaluation for assessment of both structural abnormalities and motility disorders of the oropharynx by use of various compositions of barium contrast medium is the standard of practice. Using best-practices radiographic techniques and having knowledge of swallowing mechanisms and various diseases are important for assessment of dysphagia. Dynamic fluoroscopic imaging remains an essential tool for assessing functional disorders of swallowing. Detailed videofluoroscopic assessment can guide treatment decisions with the goal of decreasing the secondary complications of dysphagia.
A number of theological writers have averred that principally our Lord Jesus Christ came to die not only for our sin but also for our shame. After establishing the case for this by highlighting the ...honor-shame significance of the cross through both theological and psychological theory and research, this article further argues that Jesus did not die for our natural and healthy shame but for our corrupted shame. The paper then concludes by explaining from the theological, humanity, and missional perspectives, why it is important for us to make the distinction between healthy and corrupted shame that Jesus died for us.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Purpose To evaluate the efficacy and safety of phenylephrine 1.0%–ketorolac 0.3% (Omidria) for maintenance of mydriasis during, and reduction of ocular pain after, cataract surgery. Setting Twenty ...centers in the United States and the Netherlands. Design Prospective randomized clinical trials. Methods Patients having cataract surgery or refractive lens exchange were enrolled in 2 clinical trials. Phenylephrine 1.0%–ketorolac 0.3% or placebo was added to irrigation solution and administered intracamerally during the procedure. Integrated analyses of primary and secondary endpoints were conducted. Results The clinical trials comprised 808 patients (403 treatment and 405 placebo). Phenylephrine 1.0%–ketorolac 0.3% was superior to placebo for the maintenance of mydriasis during, and reduction of ocular pain following, cataract surgery. The mean area under the curve (AUC) change from baseline in pupil diameter was 0.08 mm for treatment compared with −0.50 mm for placebo ( P < .0001). The mean AUC of ocular pain visual analog scale scores within 12 hours postoperatively was 4.16 mm for the treatment group and 9.06 mm for the placebo group ( P < .001). Results of all secondary efficacy analyses demonstrated a significant treatment effect associated with phenylephrine 1.0%–ketorolac 0.3%. Treatment-emergent adverse events were as expected for a population having cataract surgery; no clinically significant differences in safety measures were observed between treatment groups. Conclusion In this integrated analysis, phenylephrine 1.0%–ketorolac 0.3% administered intracamerally with irrigation solution during cataract surgery was safe and effective for maintaining mydriasis during the procedure and reducing postoperative ocular pain. Financial Disclosure Dr. Schaaf is an employee and holds an equity interest in Omeros Corporation. Drs. Hovanesian, Sheppard, Trattler, Gayton, and Ng are consultants to Omeros Corporation. No other author has a financial or proprietary interest in any material or method mentioned.
Abstract To consider autonomic status as a predictor of anti-tumor necrosis factor (TNF) treatment response for inflammatory arthritis, we conducted an exploratory, double-blind, 52-week study with ...33 patients with rheumatoid (25) or psoriatic (8) arthritis using heart rate variability (HRV). All were assessed for parasympathetic, sympathetic, total power and tension index measures of autonomic reactivity at initiation of anti-TNF therapy with etanercept (15) or adalimumab (18). Clinical response was assessed at 6, 12, 26 and 52 weeks by internationally accepted outcome criteria (ACR20/50/70 and DAS28 response). Predictive value was demonstrated for all HRV assessments ( p -value range 0.001–0.032), except sympathetic ( p -value range 0.06–0.22), for ACR20, ACR50 and ACR70 at 52 weeks and at as early as 6 weeks for some measures. Only parasympathetic and tension index predicted DAS28 outcome ( p -value range 0.009–0.024). Poor anti-TNF response was associated with low parasympathetic, low total power, high sympathetic and high tension index measures, a profile also predominant in the prior anti-TNF failure subset (12). In conclusion, this unique, exploratory study suggests that HRV may be a novel, useful predictor of response to anti-TNF therapy in patients with inflammatory arthritis, and emphasizes the importance of autonomic influence of autoimmune disease expression.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
A consecutive case series was conducted evaluating proximal splenic artery embolization (SAE) with the AMPLATZER Vascular Plug 4 (AVP4) (St. Jude Medical, Inc, St. Paul, Minnesota) in eight patients ...with high-grade splenic trauma. Three proximal and five combined proximal and distal subselective coiling procedures were successfully performed. Mean time from device deployment to splenic artery occlusion was 4.5 minutes (range, 2.1-10.0 min; standard deviation, 2.8 min). There were no immediate complications. One patient developed a perisplenic abscess requiring percutaneous drainage and antibiotics. Results of this initial study show the suitability of the AVP4, with its ease of deployment without a guiding sheath and accurate placement, as a viable adjunct to nonoperative management of blunt splenic injury.
•We integrate carbon nanotubes into micro heat pipes (MHP) for enhanced performance.•A thermal resistance model is applied to estimate the pertinent parameters inside an MHP.•The evaporation and ...circulation rates of MHP are enhanced by 264% and 212%, respectively.•The optimized length ratio of MHP is obtained by minimizing the total thermal resistance.
The remarkable performance improvement and thermal optimization of micro heat pipes (MHPs) incorporated with carbon nanotubes (CNTs) of different density are analysed using a thermal resistance model. The ultrafast water transport characteristic of CNT-nanocapillaries induces large-surface-area water film where the evaporation, condensation, and condensate circulation processes, which govern the MHP's overall performance, are simultaneously enhanced. By employing a thermal resistance model, the pertinent parameters inside an MHP, which are not measurable due to the miniature size of the microchannels, are estimated. By benchmarking with the uncoated MHP, the condenser and evaporator heat transfer coefficients of the optimal 5 mg/CNTs MHPs are enhanced remarkably by the up to 249% and 264%, respectively. Furthermore, the circulation rate attains a maximum increase of 212%. Consequently, an enhancement up to 250% in the overall performance of MHP gauged by the effective thermal conductivity and a significant temperature drop of 20.8 °C on the heat source as compared to the uncoated MHP case are achieved. By minimizing the total thermal resistance of MHP, the optimized length ratio of the evaporator and condenser, which is useful in the optimal design of the MHP, can be obtained. The thermal resistance model serves as a useful analytical tool to provide insightful thermal analysis and optimized design of an MHP.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Hematopoietic stem-cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) is a serious complication with significant mortality and no approved therapy. HSCT-TMA results from ...endothelial injury, which activates the lectin pathway of complement. Narsoplimab (OMS721), an inhibitor of mannan-binding lectin-associated serine protease-2 (MASP-2), was evaluated for safety and efficacy in adults with HSCT-TMA.
In this single-arm open-label pivotal trial (NCT02222545), patients received intravenous narsoplimab once weekly for 4-8 weeks. The primary end point (response rate) required clinical improvement in two categories: (1) laboratory TMA markers (both platelet count and lactate dehydrogenase) and (2) organ function or freedom from transfusion. Patients receiving at least one dose (full analysis set FAS; N = 28) were analyzed.
The response rate was 61% in the FAS population. Similar responses were observed across all patient subgroups defined by baseline features, HSCT characteristics, and HSCT complications. Improvement in organ function occurred in 74% of patients in the FAS population. One-hundred-day survival after HSCT-TMA diagnosis was 68% and 94% in FAS population and responders, respectively, whereas median overall survival was 274 days in the FAS population. Narsoplimab was well tolerated, and adverse events were typical of this population, with no apparent safety signal of concern.
In this study, narsoplimab treatment was safe, significantly improved laboratory TMA markers, and resulted in clinical response and favorable overall survival.
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