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AbstractComplications related to methamphetamine use and abuse are common presentations seen in the emergency department. Standard management focuses on addressing the central nervous system and cardiovascular effects with the use of sedation and hemodynamic support. We describe a case report of a patient with methamphetamine toxicity and subsequent severe cardiomyopathy refractory to conventional management that responded to cardiovascular support with extracorporeal membrane oxygenation therapy (ECMO). A 22-year-old female was admitted in severe cardiogenic shock following intravenous administration of methamphetamine and oral fentanyl use. Despite aggressive treatment with benzodiazepines, intravenous fluids, vasopressors, vasodilators, antibiotics and inotropes, the patient’s clinical status deteriorated, and she suffered a cardiac arrest. The patient was successfully resuscitated, and following the return of spontaneous circulation, ECMO was initiated. After 82 hours the patient was successfully weaned from ECMO with the recovery of her left ventricular function and no neurologic sequelae. The patient developed leg ischemia requiring embolectomy and open repair as a complication of ECMO cannulation. In our case, ECMO was used successfully in treating severe cardiac dysfunction from acute methamphetamine-induced cardiomyopathy and was used as a bridge to recovery. The complications seen in this patient emphasize the potential risks associated with this intervention and highlight the need for careful patient selection.

We investigate a holographic description of k-strings in higher representations via D5-branes with world volume fluxes. The D-brane configurations are embedded in supergravity backgrounds dual to confining field theories in three and four dimensions. We compute the tensions and find qualitative agreement for the totally symmetric and totally antisymmetric representations with the results of other methods such as lattice as well as the Hamiltonian approach of Karabali and Nair. A one-loop computation on the D-brane configurations yields the Liischer term and allows us to confirm a previously proposed universal expression following from holography. [ABSTRACT FROM AUTHOR]

Experimental measurements of the effectiveness downstream of a slot airflow with the jet airflow normal to the wall have been performed in a wind tunnel. The separate and combined contributions of the slot and jet airflows to the effectiveness are established for a range of airflow conditions relevant to gas turbine combustors. Generally, the jet reduces the effectiveness. The major interactions between the airflows occur just downstream of the jet. Visualization studies using tufts and velocity and turbulence intensity profiles are reported.

Nitrogen flow through 13 idealized cracks has been measured and compared with theoretical predictions. Gas conditions covered upstream pressure and temperature ranges of between 10 and 50 bars and 277 and 295°K, respectively, exhausting to atmosphere. Hydraulic smooth, convergent and parallel cracks and rough parallel cracks were tested for depths varying from 6 to 810 μm. The effect of area change is adequately predicted from theory if a friction factor Reynolds number relationship is assumed. The remaining data are presented on the basis of a friction factor, Reynolds number, and hydraulic diameter/surface roughness parameter basis. Theoretical predictions are successful where roughness and flow are high enough for the results to be in the completely turbulent regimes. For the hydraulic smooth parallel cracks the flow is lower than predicted for laminar and turbulent flow and this discrepancy will be the subject for further investigations.