A Study of Panel Loads and Centers of Pressure of Three Different Cruciform Aft-Tail Control Surfaces of a Wingless Missile from Mach 1.60 to 3.70

An investigation was made of the forces and moments on the cruciform aft-tail control surfaces of a wingless missile model to determine the variation of panel load and center of pressure with angle of attack, tail deflection, model roll angle, and Mach number. Also, a limited force-moment and surface-pressure investigation was made on a noncircular aft end. These investigations were made in a unitary plan wind tunnel at Mach numbers of 1.60, 2.36, and 3.70 and at a Reynolds number per meter of 6,600,000. The cruciform aft-tail results indicate very little variation in the center of pressure for the highly loaded windward tail. The noncircular aft-end test results indicate no significant effect of the fin unporting on the fin loads

Chronic opioid analgesic usage post‐kidney transplantation and clinical outcomes

Chronic opioid usage ( COU ) is common among patients with end‐stage renal disease ( ESRD ) qualified for kidney transplantation and associated with inferior post‐transplant outcomes. The magnitude of COU after kidney transplantation and its impact on transplant outcomes remain unknown. We performed a single‐center retrospective study aimed to describe the prevalence of COU during the first year, to identify the predictors of COU and to determine the impact of COU on post‐transplant outcomes including the rates of hospitalization and acute rejection during the first year, as well as long‐term patient and graft survival. Among 1045 kidney transplant patients, 119 (11.4%) had required continued outpatient prescription of opioid analgesics during the first year after kidney transplantation, mostly for non‐surgery‐related pain (85%). A positive history of COU prior to transplantation was the strongest predictor of COU in the first year post‐transplantation (adjusted odds ratio [ AOR ] 4.31, p < 0.001). Patients with COU had more often hospital admission during the first year ( AOR 2.48, p = 0.001, for 1 or 2 admissions, and AOR 6.03, p < 0.001 for ≥3 admissions), but similar rate of acute rejection (19.3% vs. 15.7%, p = 0.31). During long‐term follow‐up, however, the patient and/or death‐censored kidney survival was not different. COU early post‐kidney transplantation, when clinically indicated and properly supervised, does not appear to affect the risk of death and death‐censored graft failure.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108587/1/ctr12414.pd

Extended-release morphine sulfate in treatment of severe acute and chronic pain

Morphine is the archetypal opioid analgesic. Because it is a short-acting opioid, its use has been limited to the management of acute pain. The development of extended-release formulations have resulted in the increased utilization of morphine in chronic pain conditions. This review documents the history of morphine use in pain treatment, and describes the metabolism, pharmacodynamics, formulations, and efficacy of the currently available extended-release morphine medications

Effects of Reynolds number and model support on the supersonic aerodynamic chacteristics of a 140 deg-included-angle cone

An investigation has been made in the Langley Unitary Plan wind tunnel to determine the effects of Reynolds number and sting-support interference on the static aerodynamic characteristics of a 140 deg-included-angle cone. Base pressures and forces and moments of the model were measured at Mach numbers of 1.50, 2.00, 2.94, and 4.00 for ratios of sting diameter to model diameter that varied from 0.125 to 0.500 through an angle-of-attack range from about minus 4 deg to 13 deg. The Reynolds number, based on model diameter 4.80 in. was varied from 161,000 to 415,000

Ultrasound-Guided Percutaneous Cryoneurolysis for the Treatment of Pain following Traumatic Rib Fracture: A Randomized, Active-Controlled, Participant- and Observer-Masked Study.

BACKGROUND: Traumatic rib fractures are associated with pain lasting weeks to months and a decreased ability to inspire deeply or cough to clear secretions. Ultrasound-guided percutaneous cryoneurolysis involves reversibly ablating peripheral nerve(s) using exceptionally low temperature with a transdermal probe, resulting in a prolonged nerve block with a duration measured in months. We hypothesized that cryoneurolysis would improve analgesia and inspired volume following rib fracture. METHODS: Adults with 1-6 traumatic rib fractures were randomized to either active cryoneurolysis and a sham peripheral nerve block (PNB), or sham cryoneurolysis and active PNB in a participant/observer-masked fashion. The primary endpoint was the maximum inspired volume the day after the procedure as measured with an incentive spirometer. RESULTS: The day after the procedure, the unadjusted median [IQR] maximum inspired volume for participants who received cryoneurolysis (n=11) was 2,250 mL [1,500; 2,500] versus 1,300 mL [750; 2,500] for PNB (n=9, mean difference 496; 95%CI -428 to 1420; t-test P=0.269). When adjusted for covariates (e.g., baseline lung volume), the cryoneurolysis group had an estimated 793 mL greater mean volume than PNB (95%CI 273 to 1,312; ANCOVA P=0.005). Improvement from baseline in maximum inspired volume for cryoneurolysis was 1,000 mL [1,000; 1,375] versus 300 mL [0; 1,000] for PNB (t-test P=0.002). This was equivalent to an improvement over baseline of 100% [90%, 188%] for cryoneurolysis versus 30% [0%, 50%] for PNB (t-test P=0.003). Average daily pain scores were generally lower for the cryoneurolysis group throughout the first month. Total cumulative oxycodone equivalents were 5 mg [0, 13] for cryoneurolysis vs 45 mg [43, 135] for PNB (t-test P=0.013). CONCLUSIONS: Ultrasound-guided percutaneous cryoneurolysis improves maximum inspired lung volume while concurrently decreasing pain and opioid consumption after traumatic rib fracture. These results should be considered preliminary, requiring confirmation with a trial including a larger sample size