Withdrawal Process Research Articles

Ethical Challenges and Implications of Deactivating Mechanical Circulatory Support for Patients With Preserved Cognitive Function.

Ethical Challenges and Implications of Deactivating Mechanical Circulatory Support for Patients With Preserved Cognitive Function.

Hydrogen Relative Permeability Hysteresis in Underground Storage

AbstractImplementation of the hydrogen economy for emission reduction will require storage facilities, and underground hydrogen storage (UHS) in porous media offers a readily available large‐scale option. Lack of studies on multiphase hydrogen flow in porous media is one of the several barriers for accurate predictions of UHS. This paper reports, for the first time, measurements of hysteresis in hydrogen‐water relative permeability in a sandstone core under shallow storage conditions. We use the steady state technique to measure primary drainage, imbibition and secondary drainage relative permeabilities, and extend laboratory measurements with numerical history matching and capillary pressure measurements to cover the whole mobile saturation range. We observe that gas and water relative permeabilities show strong hysteresis, and nitrogen as substitute for hydrogen in laboratory assessments should be used with care. Our results serve as calibrated input to field scale numerical modeling of hydrogen injection and withdrawal processes during porous media UHS.

Divining the UK’s national interest: MPs’ parliamentary discourse and the Brexit withdrawal process

Divining the UK’s national interest: MPs’ parliamentary discourse and the Brexit withdrawal process

Cardiac function unchanged following reanimation with normothermic regional perfusion in donation after circulatory death.

ObjectivesTo determine whether hearts reanimated with normothermic regional perfusion (NRP) have clinically detectable changes in function using echocardiography comparing the prearrest and post-NRP imaging. As heart transplantation from donation after circulatory death (DCD) continues to increase, preliminary results suggest outcomes comparable with donation after brain death. It is unknown whether the obligatory period of warm ischemia experienced during DCD withdrawal process causes immediate changes in cardiac allograft function following in situ reanimation.MethodsWe retrospectively reviewed and compared predonation with postreanimation echocardiographic findings in all DCD donors at our institution from January to October 2021. All DCD donor organs were reanimated with in situ thoracoabdominal NRP after circulatory death. Echocardiographic assessment included (1) 2-dimensional and speckle-tracking measures of chamber size and function; (2) ejection fraction; (3) fractional area change; and (4) global longitudinal strain.ResultsAltogether, 4 DCD heart donations were performed during the study period. Basic demographics and withdrawal ischemic time periods are reported. There were no changes in left ventricular ejection fraction and right ventricular fractional area change when comparing the predonation and the postreanimation echocardiogram. There was a minimal, nonstatistically significant decrease in left ventricular global longitudinal strain and right ventricular free-wall systolic strain in 3 of the 4 donors following reanimation.ConclusionsDCD cardiac allografts reanimated with NRP demonstrated no change in echocardiographic parameters used for a standard predonation donor heart evaluation. Findings suggest cardiac function of DCD allografts reanimated with thoracoabdominal NRP is not adversely impacted by limited period of warm ischemia following circulatory arrest.

The normal force evolution of the substrate during the withdrawal process

AbstractThe evolution of normal force on the smooth plate immersed in Newtonian and yield stress fluids was investigated during the dip coating. The influences of withdrawal velocity, liquid rheological property, and plate roughness were elaborated. For all fluids, the variation of force versus the withdrawing height was divided into four stages. Importantly, the control forces for coating in each stage were determined, which are in turn viscous force‐capillary, viscous force‐gravity, capillary‐viscous force, and gravity. The critical value of normal force controlled from capillary to viscous effect during drainage was adopted to calculate the surface tension. The possibility of measuring the surface tension was verified under the negligible interference of viscous effect and film instability through a detailed analysis on the evolution of force in a series of tests. Accordingly, the applicable conditions with the low withdrawal speed, high viscosity, and rough surface were finally achieved. This work can provide a theoretical basis for the film‐formation mechanism and surface tension measurement in dip coating.

Capillary condensation and evaporation of n-butane and iso-butane in nanoporous media: Experimental study of the effects of pore size and temperature using an automated gravimetric apparatus

Understanding the confinement-induced phase behavior of fluids stored in nanometer-sized pores of solid materials is paramount in various science and engineering applications. Experimental findings describing fluid phase behavior in confinement are often used to develop the efficient and accurate equation of state models that can then provide a cost-effective approach to predict such information for different applications. However, there is a scarcity of experimental data in the literature that can offer insights into the confinement effects under varying conditions. The present work endeavors to provide new experimental data on the effects of pore size and temperature on the confined phase behavior of two chemical species (n-Butane and iso-Butane) and thereby improve the current understanding of the impact of these parameters on capillary condensation, evaporation, and hysteresis. We use a patented gravimetric apparatus that was upgraded in this study by the development and incorporation of advanced automated data acquisition modules. The automation module improved the data collection quality by fine-tuning the fluid injection and withdrawal processes which significantly enhanced the accuracy and precision of the measured isotherms. The capillary condensation and evaporation processes were then studied using a nanoporous material known as Mobil Composition of Matter No. 41 (MCM-41), a mesoporous medium with well-defined pore shape and sizes. The isotherms were obtained for a wide range of temperatures (−7, −3, 0, 7, 8.7, 17, and 27 °C) and using MCM-41 with various pore sizes (60, 80, 100, and 120 Å). The accuracy of the measurements was validated against the phase behavior data of bulk n-Butane and iso-Butane reported by the National Institute of Standards and Technology (NIST). The capillary condensation pressures obtained from the isotherms for different pore sizes agreed with the trends reported in the literature. The results show that the capillary condensation pressures of the fluids increase with the pore size and temperature. The measured isotherms and capillary condensation pressures provide new data sets on the condensation characteristics of n-Butane and iso-Butane. They are expected to contribute to the fundamental understanding of the confined phase behavior of hydrocarbons and thereby advance the development of improved equations of state models that can accurately describe the phase behavior of fluids in nanoporous media. PC-SAFT/Laplace EOS was used to model the phase behavior of the fluids under confinement. The predictions from the PC-SAFT model agree with previous data therefore the results from this study can be integrated into building more robust models.

Оптимальные затраты на комбинированный увод крупногабаритных объектов космического мусора с использованием электрореактивной двигательной установки

The article proposes the development of a method for the combined deorbiting large space debris objects from low Earth orbits, performed using an electric propulsion engine and an aerodynamic sailing device. Simulation modeling of the combined deorbiting was carried out for various combinations of parameters of deorbit scheme, such as the altitude of the initial orbit, the phase of solar activity at the moment of deorbiting start, the ballistic coefficient, the time of active operation of the control system, and the time of one battery charge. Analytical dependences of the minimum increment in the velocity of an electric propulsion system, gained in one impulse, and the minimum number of impulses on the parameters of the deorbiting scheme, necessary to ensure the withdrawal for 25 years, are determined. Sectors of the solar activity phase at the moment of the deorbiting start providing optimal energy costs for the withdrawal process, are identified. The results obtained are of practical interest for the problems of designing modern means of deorbiting large space objects from low Earth orbits at enterprises in the rocket and space industry.

Prevention of medication overuse and medication overuse headache in patients with migraine: a randomized, controlled, parallel, allocation-blinded, multicenter, prospective trial using a mobile software application

BackgroundOverall, 55% of the German population suffers from primary episodic headaches according to recent studies. Inadequate management of headache disorders is a significant medical problem. The prevalence of medication overuse headache (MOH) is about 1% with an estimated number of 800,000 people in Germany. Medication overuse (MO) and MOH are usually managed through a complex process of medication withdrawal and initiating of prophylaxis. However, patients who were successfully treated for MO or MOH have a high relapse rate in the following 2 years. Previously, continued monitoring of self-reported medication intake demonstrated lower relapse rates. The prevalence and burden of MO and MOH are high, and effective strategies to prevent the development of a relapse into MOH or de novo MOH are still missing. Therefore, the MOH trial was designed to assess the effects of combining self-reported medication intake with daily monitoring of the entered data and a personalized patient-specific medication intake feedback system in an easy-accessible app-based platform in order to prevent the development and relapse of MO(H).MethodsThe MOH trial is a randomized, controlled, parallel, multicenter, prospective trial. A total of 624 migraine patients with frequent migraine attacks and 336 patients who underwent treatment for MO(H) will be randomly allocated to use either a customized app with or without individual feedback regarding their self-reported medication intake for 12 months. The primary outcome will be the proportion of patients developing MO or MOH for at least 3 consecutive months between baseline and end of study visits.DiscussionThis trial will assess the effects of providing patients with feedback regarding their self-reported use of migraine medications and migraine days using a mobile software on the development or prevention of MO(H). We hypothesize that the development of MO(H) in patients with frequent episodic migraine (EM) or chronic migraine (CM) and relapse after treatment of MO(H) can be reduced by a feedback system. If this trial proves that using an app with specific and unspecific messaging to the patient is successful, this method, which is now investigated mainly in specialized headache centers, could later be extended to primary care, thus providing benefits for a broader patient group.Trial registrationGerman Clinical Trials Register DRKS00025961. Registered on 04 August 2021.

Behavioral changes observed in substance users in Turkey during the COVID-19 pandemic

ABSTRACT Purpose The aim of this study was to investigate how the drug use behaviors of addicted individuals have been affected by the regulations imposed due to the coronavirus disease 2019 (COVID-19) pandemic, such as quarantine, social isolation, and social distancing, by examining the factors of individuals with alcohol/substance use disorder, such as their levels and frequency of use, withdrawal process, and cravings before and during the COVID-19 pandemic. Method The sample of the study consisted of 416 individuals who applied to the Green Crescent Consultancy Center (YEDAM), which provides out-patient psychosocial support to alcohol/substance users, such as those using alcohol, substances, and both alcohol and substances. Individuals who applied to the center in the 3 months prior to the COVID-19 pandemic, whose initial examination was conducted, and who had been assessed at least 3 times, were included in the study. A questionnaire was prepared by the authors to examine the addictive behaviors of the individuals during the COVID-19 pandemic. In addition to the survey, the Addiction Profile Index (API) was used. The survey was administered by clinical psychologists. The interviews were conducted by telephone. The individuals who were surveyed consisted of those who had seen and were continuing to see clinical psychologists. Data was collected between May 3rd and 8th, 2020. The data obtained from the questionnaire and from the API forms filled out during the initial application by the individuals were combined. The follow-up phases were categorized and evaluated in 3 different periods. A similar categorization was made for the number of interviews. Comparisons of the addiction characteristics and mental states of those continuing to use alcohol/substances before and during the COVID-19 pandemic and those who did not continue to use, were conducted by evaluating the API sub-scales using the t test. Results The rate of those who said that they did not buy any substances during the COVID-19 pandemic, was 64.4%, while for those who said that they bought it from different sellers during the pandemic was 28.7%. Of those who did not use or infrequently used alcohol/substances before the pandemic, 91% continued to not use alcohol/substances during the pandemic. The rate of those who regularly used alcohol/substances before the pandemic, but discontinued using alcohol/substances or used it less frequently during the pandemic, was 49.1% (N = 52), and those who did not use or infrequently used alcohol/substances before the pandemic, but started to use alcohol/substance regularly, was 9% (N = 28). Conclusion Negative circumstances and a lack of social support were the main factors appeared to have increased substance use during the COVID-19 pandemic. Key health responses, such as following hygiene and social distancing rules and family factors, appear to be protective.

Post-Brexit Europeanization: re-thinking the continuum of British policies, polity, and politics trajectories

What is the impact of the UK’s withdrawal from the EU on British policies, polity and politics and their future trajectories? This question has been overlooked so far, as many observers have focused on the identity, cultural, and political reasons behind the Brexit vote or scrutinized closely the process of withdrawal. The de-Europeanization literature has tried to capture the new dynamics behind the impact of Brexit on the domestic scene by understanding it as a will to dismantle policies and politics previously Europeanized. On the contrary, we argue here that Brexit is not necessarily the end of UK’s engagement with the EU. This editorial and this special issue provide a more nuanced explanation and support the idea that Brexit is not putting an end to the EU’s influence over British public policies. In fact, we identify several pathways to the EU–UK relationship which can be conceptualized along a continuum from de-Europeanization to re-engagement scenarios. Building on the literature that has suggested the trajectories of disengagement and de-Europeanization, this editorial more specifically contributes to the debate by coining the concept of continued engagement and re-engagement and highlighting the need to analyse British politics, policies, and polity in relation to the EU through a variety of pathways.

Prevention of disease flares by risk-adapted stratification of therapy withdrawal in juvenile idiopathic arthritis: results from the PREVENT-JIA trial

ObjectivesTo investigate the ability of high-sensitivity C-reactive protein (hsCRP) and S100A12 to serve as predictive biomarkers of successful drug withdrawal in children with clinical remission of juvenile idiopathic arthritis (JIA).MethodsThis...

Analysis of the Application of Management Control System for Fiduciary Installment Credit (KREASI) at PT Pegadaian Medan City Region

Management control system is a system used to influence its members to implement strategies efficiently and effectively in order to achieve organizational goals. The purpose of this study was to determine how the implementation of the management control system at PT Pegadaian Medan City Region. PT. Pawnshops also require a control in order to achieve the company's overall goals. This control is preventive and repressive control. To achieve this goal requires a good management control system so that the credit is not problematic. The purpose of this study is the application of a management control system for the distribution of Fiduciary Installment Loans (KREASI) at PT Pegadaian Manado City Region. The analytical method used is descriptive analysis. The results of the analysis show that the process of providing Installment Loans for the Fiduciary System (KREASI), at PT. The Manado Regional Pawnshop has been carried out well by competent employees in their respective fields who have high honesty and dedication in carrying out their duties. Separation of duties has also been carried out well in each process of providing Fiduciary Installment Loans (KREASI), at PT. Manado Regional Pawnshop. PT Pegadaian Manado Region has implemented proper authorization procedures in all processes of providing Fiduciary Installment Loans (KREASI), namely at the time of the mortgage loan application process, the authorized officer is the estimator, during the pawn credit analysis process the authorized officer to analyze credit is the Power of Attorney Credit (KPK), during the credit withdrawal process the authorized officer is the cashier, while for the monitoring process the officer authorized to carry out supervision is the branch head

Withdrawal of lands for construction and reconstruction of federal roads

The article discusses in detail the process of withdrawal of lands for the needs of construction or reconstruction of federal highways. The main features and problematic points of land withdrawal are considered in this article.

THEORETICAL APPROACHES TO RESEARCH THE ROLLING PROCESS OF THE DRIVEN WHEEL SIDE DRAWER ON A WINTER ROAD

The stability of the movement of motor vehicles in the cold season is ensured by the ability of car tires to create lateral reactions on winter roads. The lateral adhesion of the tire to the support surface is evaluated by its lateral withdrawal characteristics, which determine the coefficient of lateral adhesion and the critical angle of the tire withdrawal. With the use of chemical deicing materials, the coupling properties of tires have significantly deteriorated, especially in the lateral direction. The lack of knowledge about the processes of movement of a tire with lateral withdrawal on a winter road covered with chemical deicing materials determines the relevance of scientific research.
 The article discusses the non-stationary characteristics of the lateral withdrawal of Amtel NordMaster175/70R13 passenger friction tires, obtained from the results of their tests on a winter public road covered with rolled snow and sand-salt mixture. The graphs show that the use of sodium chloride reduces the lateral grip of friction tires and the stability of motor vehicles.
 Purpose – obtaining non-stationary characteristics of lateral withdrawal of passenger friction tires on a road covered with rolled snow and sand-salt mixture, and estimated parameters of lateral traction.
 Methodology: a road test method using the methodology and tire tester developed by the author to study the unsteady lateral withdrawal of automobile tires.
 Results: The unsteady characteristics of the lateral withdrawal of Amtel NordMaster 175/70R13 passenger friction tires were obtained, the coefficients of lateral adhesion and critical withdrawal angles were determined.
 Practical implications: the obtained results are necessary to correct the mathematical model that allows performing an analytical study of the processes of lateral withdrawal of automobile tires on roads with winter slipperiness.

Analysis of the Reasons Why US and Russia Withdrew from the INF Treaty Successively Based on the Levels of Analysis

The Intermediate-Range Nuclear Forces Treaty (INF Treaty) is a milestone in the history of arms control negotiations between the United States and the Soviet Union, but there are continuous disputes during its existence. From February 2, 2019, the United States announced the suspension of its obligations under the INF Treaty and officially started the withdrawal process. On the same day, the Russian president also announced the suspension of implementation. The factors behind the successive withdrawal are complicated and are related to the development of the international arms control system in the future. This papermainly focuses on the analysis of the reasons for the withdrawal by comparing the two sides under the same perspective through the levels of analysis.

Abstract 14452: Echocardiographic Evaluation of Donor Cardiac Structure and Function Following Reanimation Using Normothermic Regional Perfusion in Donation After Circulatory Death

Introduction: As heart transplantation from donation after circulatory death (DCD) continues to increase, preliminary results suggest outcomes comparable to donation after brain death. It is unknown if the obligatory period of warm ischemia experienced during DCD withdrawal process causes immediate changes in cardiac allograft function. Methods: We retrospectively reviewed and compared pre-donation with post reanimation echocardiographic findings in all DCD donors at our institution from Jan to March 2021. All DCD donor organs were reanimated with in-situ thoracoabdominal normothermic regional perfusion (NRP) after circulatory death. Echocardiographic assessment included: a) 2-dimensional and speckle-tracking measures of chamber size and function; b) ejection fraction (EF); c) fractional area change (FAC); and d) global longitudinal strain (GLS). Results: Altogether 3 DCD heart donations were performed during the study period. Basic demographics and withdrawal ischemic time periods are depicted in Table 1. There were no changes in LV EF and RV FAC when comparing the pre-donation and the post-reanimation echocardiogram. There was a minimal decrease in LV GLS and RV free-wall systolic strain in 2 of the 3 donors following reanimation (Table 2). Conclusions: DCD cardiac allografts reanimated with NRP demonstrated no change in echocardiographic parameters used for a standard donor heart evaluation and were successfully transplanted. Findings suggest donor cardiac function is not clinically different from the pre-donation in DCD hearts reanimated after a relatively short functional ischemic time and without need for inotropic support.

Giving Up Our Cultural Addiction

This article will begin with an overview of the sources of our cultural addiction to patriarchal culture and its values in Western cultures. Of particular importance to this was the development of the daughter languages of Sanskrit with their dualistic structure. A further major source lies in the Biblical Genesis creation text and subsequent Western philosophy and theology. These things together supported the delusional consciousness which led to individual suffering and the exploitation of others and the earth. The article will then look briefly at some of this addiction’s manifestations and their effects and then explain how Buddhist practice can help with the withdrawal process and foster a ‘new’ way of life although it must be acknowledged that there are real questions as to whether Buddhist practice will be used extensively enough to do so in time to save us from ourselves.

Humiliating and dividing the nation in the British pro-Brexit press: a corpus-assisted analysis

ABSTRACT Since the United Kingdom’s referendum on European Union (EU) membership in 2016, a new political cleavage of Remainers and Leavers has developed (Kelley, N. [2019]. British social attitudes survey: Britain’s shifting identities and attitudes. (36). National Centre for Research). This paper explores how five pro-Brexit newspapers discursively construct political division in Britain in relation to two key events in the final year of Britain’s EU membership: the extension of the withdrawal process past the original date of March, and the introduction of the Benn Act in September. The paper reveals two primary discursive constructions of division in Britain: a divide between incompetent and arrogant political officials and an innocent, suffering public, and an identity cleavage between pro-Remain ‘elites’ and ‘ordinary’ Leave-voting citizens. The study argues that the construction of these divisions threatens a collective national identity in Britain at a time when it is most required. It concludes that by apportioning blame for socio-political divisions, the newspapers obfuscate their role in contributing to disunity in the UK.

Later is not necessarily better: limitations of survival analysis in studies of long-term drug treatment of psychiatric conditions

Survival analysis is routinely used to assess differences between groups in relapse prevention and treatment discontinuation studies involving people with long-term psychiatric conditions. The actual outcome in survival analysis is...

PRATYAHARA REGARDING TO SWAMI KRIPALVANANDJI : A STUDY

The goal of human life is possible through the study of YogaDarshan of Sage Patanjali. He described yogain series of eight limbs. The highest goal of human life is self realisation. The practice of Pratyahara is very important and essential restraint among other limbs of yoga. The Prana is the major driving force in the body and all the actions are performed with its help. To cycle the transmigration, one has to perform the practical of Pratyahara. There is no entry in to meditation without Pratyahara. because the release of prana leads the seeker to Pratyahara. So the study of this paper is an attempt to understand the Pratyahara. Sense organs are of five types i.e.1. Ears, 2. Eyes., 3. Tongue,4. Nose,5. Skin. They are required to withdraw from their respective subjects, i.e. Listen, Sight, Taste, Smell, Touch. Pratyahara is the process of withdrawal of mind from senses and withdrawal of senses from their respective subject. They are as under (1) Ears are attached with wordssound it is possible through the process of Nadanusandhan. (2) Eyes can see the God everywhere to control the sense of seeing. (3) Skin can feel the touching the presence of God at the inner self. (4) Taste of tongue can recognise the virtues of God. (5) Nose can recognisethe airfor fragment and obnoxious, odour and control of breathalso. Pratyahara is so difficult for the seeker and common man but ancient sage of Veda make it easy to achieve the goal of life through the process of yoga and Pratyahara, Knowledge of Pratyahara eliminates the enemies of human being such as selfishness, greediness, desire, ego, etc., and to behave with others positively