Hemodialysis catheter integrity during mechanical power injection of iodinated contrast medium for computed tomography angiography.

PURPOSE: CT angiography (CTA) requires vascular access with flow rates of 5-7 mL/s. Hemodialysis (HD) is performed at 6-10 mL/s. The purpose of our study is to evaluate the structural integrity of HD catheters in the administration of contrast media via a mechanical power injector under varying conditions. METHODS: Four HD catheters were evaluated in an in vitro study. Tested were contrast media type (iopamidol 300 and 370 mgI/mL), temperature (25 and 37 °C), catheter diameter (14 Fr to 16 Fr all with double-lumen capacity), catheter length (19-32 cm), and simultaneous double-lumen or single-lumen injection within each of the catheters. Peak plateau pressures (psi) were recorded with flow rates from 5 to 20 mL/s in 5 mL/s increments. In total, 864 unique injections were performed. RESULTS: No catheter failure (bulging/rupture) was observed in 864 injections. Maximum pressure for single-lumen injection was 51.7 psi (double-lumen: 26.3 psi). Peak pressures were significantly lower in simultaneous double-lumen vs. single-lumen injections (p < 0.001) and low vs. high viscosity contrast media (p < 0.001). Neither larger vs. smaller diameter lumens (p = 0.221) nor single-lumen injection in arterial vs. venous (p = 0.834) were significantly different. CONCLUSION: HD catheters can be used to safely administer iodinated contrast media via mechanical power injection in in vitro operating conditions. Maximum peak pressure is below the manufacturer's 30 psi limit at flow rates up to 20 mL/s in double-lumen injections and up to 10 mL/s in single-lumen injections, which is higher than the usual maximum of 8 mL/s for CT angiography in clinical settings.

Trinomial decompression sickness model using full, marginal, and non-event outcomes.

Decompression sickness (DCS) is a condition associated with reductions in ambient pressure during underwater diving and altitude exposure. Determining the risk of DCS from a dive exposure remains an active area of research, with the goal of developing safe decompression schedules to mitigate the occurrence of DCS. This work develops a probabilistic model for the trinomial outcome of full, marginal, and no DCS. The model treats full DCS and marginal DCS as separate, fully weighted hierarchical events. Six variants of exponential-exponential (EE) and linear-exponential (LE) decompression models were optimized to fit dive outcomes from the BIG292 empirical human dive trial data of 3322 exposures. Using the log likelihood difference test, the LE1 trinomial marginal model was determined to provide the best fit for the data. The LE1 trinomial marginal model can be used to better understand decompression schedules, expanding upon binomial models which treat marginal DCS as either a fractionally weighted event or a non-event. Future work could investigate whether the use of marginal DCS cases improves multinomial probabilistic DCS model performance. Model improvement could include the addition of a fourth outcome, where full DCS is split and categorized as serious or mild DCS, creating a tetranomial model with serious, mild, marginal, and no DCS outcomes for comparison with the presently developed model.

A study of decompression sickness using recorded depth-time profiles.

Introduction: 122,129 dives by 10,358 recreational divers were recorded by dive computers from 11 manufacturers in an exploratory study of how dive profile, breathing gas (air or nitrox [N2/O2] mixes), repetitive diving, gender, age, and dive site conditions influenced observed decompression sickness (DCSobs). Thirty-eight reports were judged as DCS. Overall DCSobs was 3.1 cases/104 dives. Methods: Three dive groups were studied: Basic (live-aboard and shore/dayboat), Cozumel Dive Guides, and Scapa Flow wreck divers. A probabilistic decompression model, BVM(3), controlled dive profile variability. Chi-squared test, t-test, logistic regression, and log-rank tests evaluated statistical associations. Results: (a) DCSobs was 0.7/104 (Basic), 7.6/104 (Guides), and 17.3/104 (Scapa) and differed after control for dive variability (p ≺ 0.001). (b) DCSobs was greater for 22%-29% nitrox (12.6/104) than for 30%-50% nitrox (2.04/104) (p ≤ 0.0064) which did not differ from air (2.97/10104). (c) For daily repetitive dives (≺12-hour surface intervals (SI)), DCS occurred only following one or two dives (4.3/10104 DCSobs; p ≺ 0.001) where SIs were shorter than after three or more dives. (d) For multiday repetitive dives (SIs ≺ 48 hours), DCS was associated with high multiday repetitive dive counts only for Guides (p = 0.0018). (e) DCSobs decreased with age at 3%/year (p ≤ 0.0144). (f) Males dived deeper (p ≺ 0.001) but for less time than females (p ≺ 0.001). Conclusion: Collecting dive profiles with dive computers and controlling for profile variability by probabilistic modeling was feasible, but analytical results require independent confirmation due to limited observed DCS. Future studies appear promising if more DCS cases are gathered, stakeholders cooperate, and identified data collection problems are corrected.

Probabilistic pharmacokinetic models of decompression sickness in humans: Part 2, coupled perfusion-diffusion models.

Decompression sickness (DCS) can be experienced following a reduction in ambient pressure; such as that associated with diving or ascent to high altitudes. DCS is believed to result when supersaturated inert gas dissolved in biological tissues exits solution and forms bubbles. Models to predict the probability of DCS are typically based on nitrogen and/or helium gas uptake and washout in several theoretical tissues, each represented by a single perfusion-limited compartment. It has been previously shown that coupled perfusion-diffusion compartments are better descriptors than solely perfusion-based models of nitrogen and helium uptake and elimination kinetics observed in the brain and skeletal muscle of sheep. In this work, we examine the application of these coupled pharmacokinetic structures with at least one diffusion compartment to the prediction of the incidence of decompression sickness in humans. We compare these models to LEM-NMRI98, a well-described U.S. Navy gas content model, consisting of three uncoupled perfusion-limited compartments incorporating oxygen and linear-exponential kinetics. Pharmacokinetic gas content models with a diffusion component describe the probability of DCS in human bounce dives made with air, single non-air bounce dives, and oxygen decompression dives better than LEM-NMRI98. However, for the full data set, LEM-NMRI98 remains the best descriptor of the data.

Iso-risk air no decompression limits after scoring marginal decompression sickness cases as non-events.

Decompression sickness (DCS) in humans is associated with reductions in ambient pressure that occur during diving, aviation, or certain manned spaceflight operations. Its signs and symptoms can include, but are not limited to, joint pain, radiating abdominal pain, paresthesia, dyspnea, general malaise, cognitive dysfunction, cardiopulmonary dysfunction, and death. Probabilistic models of DCS allow the probability of DCS incidence and time of occurrence during or after a given hyperbaric or hypobaric exposure to be predicted based on how the gas contents or gas bubble volumes vary in hypothetical tissue compartments during the exposure. These models are calibrated using data containing the pressure and respired gas histories of actual exposures, some of which resulted in DCS, some of which did not, and others in which the diagnosis of DCS was not clear. The latter are referred to as marginal DCS cases. In earlier works, a marginal DCS event was typically weighted as 0.1, with a full DCS event being weighted as 1.0, and a non-event being weighted as 0.0. Recent work has shown that marginal DCS events should be weighted as 0.0 when calibrating gas content models. We confirm this indication in the present work by showing that such models have improved performance when calibrated to data with marginal DCS events coded as non-events. Further, we investigate the ramifications of derating marginal events on model-prescribed air diving no-stop limits.

Bimodal decompression sickness onset times are not related to dive type or event severity.

Human decompression sickness (DCS) is a condition associated with depressurization during underwater diving. Human research dive trial data containing dive outcome (DCS, no-DCS) and symptom information are used to calibrate probabilistic DCS models. DCS symptom onset time information is visualized using occurrence density functions (ODF) which plot the DCS onset rate per unit time. For the BIG292 human dive trial data set, a primary U.S. Navy model calibration set, the ODFs are bimodal, however probabilistic models do not produce bimodal ODFs. We investigate the source of bimodality by partitioning the BIG292 data based on dive type, DCS event severity, DCS symptom type, institution, and chronology of dive trial. All but one variant of data partitioning resulted in a bimodal or ambiguously shaped ODF, indicating that ODF bimodality is not related to the dive type or the DCS event severity. Rather, we find that the dive trial medical surveillance protocol used to determine DCS symptom onset time may have biased the reported event window. Thus, attempts to develop probabilistic DCS models that reproduce BIG292 bimodality are unlikely to result in an improvement in model performance for data outside of the calibration set.

Probabilistic pharmacokinetic models of decompression sickness in humans, part 1: Coupled perfusion-limited compartments.

Decompression sickness (DCS) is a disease caused by gas bubbles forming in body tissues following a reduction in ambient pressure, such as occurs in scuba diving. Probabilistic models for quantifying the risk of DCS are typically composed of a collection of independent, perfusion-limited theoretical tissue compartments which describe gas content or bubble volume within these compartments. It has been previously shown that 'pharmacokinetic' gas content models, with compartments coupled in series, show promise as predictors of the incidence of DCS. The mechanism of coupling can be through perfusion or diffusion. This work examines the application of five novel pharmacokinetic structures with compartments coupled by perfusion to the prediction of the probability and time of onset of DCS in humans. We optimize these models against a training set of human dive trial data consisting of 4335 exposures with 223 DCS cases. Further, we examine the extrapolation quality of the models on an additional set of human dive trial data consisting of 3140 exposures with 147 DCS cases. We find that pharmacokinetic models describe the incidence of DCS for single air bounce dives better than a single-compartment, perfusion-limited model. We further find the U.S. Navy LEM-NMRI98 is a better predictor of DCS risk for the entire training set than any of our pharmacokinetic models. However, one of the pharmacokinetic models we consider, the CS2T3 model, is a better predictor of DCS risk for single air bounce dives and oxygen decompression dives. Additionally, we find that LEM-NMRI98 outperforms CS2T3 on the extrapolation data.

The probability and severity of decompression sickness.

Decompression sickness (DCS), which is caused by inert gas bubbles in tissues, is an injury of concern for scuba divers, compressed air workers, astronauts, and aviators. Case reports for 3322 air and N2-O2 dives, resulting in 190 DCS events, were retrospectively analyzed and the outcomes were scored as (1) serious neurological, (2) cardiopulmonary, (3) mild neurological, (4) pain, (5) lymphatic or skin, and (6) constitutional or nonspecific manifestations. Following standard U.S. Navy medical definitions, the data were grouped into mild-Type I (manifestations 4-6)-and serious-Type II (manifestations 1-3). Additionally, we considered an alternative grouping of mild-Type A (manifestations 3-6)-and serious-Type B (manifestations 1 and 2). The current U.S. Navy guidance allows for a 2% probability of mild DCS and a 0.1% probability of serious DCS. We developed a hierarchical trinomial (3-state) probabilistic DCS model that simultaneously predicts the probability of mild and serious DCS given a dive exposure. Both the Type I/II and Type A/B discriminations of mild and serious DCS resulted in a highly significant (p << 0.01) improvement in trinomial model fit over the binomial (2-state) model. With the Type I/II definition, we found that the predicted probability of 'mild' DCS resulted in a longer allowable bottom time for the same 2% limit. However, for the 0.1% serious DCS limit, we found a vastly decreased allowable bottom dive time for all dive depths. If the Type A/B scoring was assigned to outcome severity, the no decompression limits (NDL) for air dives were still controlled by the acceptable serious DCS risk limit rather than the acceptable mild DCS risk limit. However, in this case, longer NDL limits were allowed than with the Type I/II scoring. The trinomial model mild and serious probabilities agree reasonably well with the current air NDL only with the Type A/B scoring and when 0.2% risk of serious DCS is allowed.

From the track to the ocean: Using flow control to improve marine bio-logging tags for cetaceans.

Bio-logging tags are an important tool for the study of cetaceans, but superficial tags inevitably increase hydrodynamic loading. Substantial forces can be generated by tags on fast-swimming animals, potentially affecting behavior and energetics or promoting early tag removal. Streamlined forms have been used to reduce loading, but these designs can accelerate flow over the top of the tag. This non-axisymmetric flow results in large lift forces (normal to the animal) that become the dominant force component at high speeds. In order to reduce lift and minimize total hydrodynamic loading this work presents a new tag design (Model A) that incorporates a hydrodynamic body, a channel to reduce fluid speed differences above and below the housing and wing to redirect flow to counter lift. Additionally, three derivatives of the Model A design were used to examine the contribution of individual flow control features to overall performance. Hydrodynamic loadings of four models were compared using computational fluid dynamics (CFD). The Model A design eliminated all lift force and generated up to ~30 N of downward force in simulated 6 m/s aligned flow. The simulations were validated using particle image velocimetry (PIV) to experimentally characterize the flow around the tag design. The results of these experiments confirm the trends predicted by the simulations and demonstrate the potential benefit of flow control elements for the reduction of tag induced forces on the animal.

Analytic gain in probabilistic decompression sickness models.

Decompression sickness (DCS) is a disease known to be related to inert gas bubble formation originating from gases dissolved in body tissues. Probabilistic DCS models, which employ survival and hazard functions, are optimized by fitting model parameters to experimental dive data. In the work reported here, I develop methods to find the survival function gain parameter analytically, thus removing it from the fitting process. I show that the number of iterations required for model optimization is significantly reduced. The analytic gain method substantially improves the condition number of the Hessian matrix which reduces the model confidence intervals by more than an order of magnitude.

Contrast-enhanced magnetic resonance angiography: first-pass arterial enhancement as a function of gadolinium-chelate concentration, and the saline chaser volume and injection rate.

OBJECTIVE: To evaluate the effect of the contrast medium (CM) concentration and the saline chaser volume and injection rate on first-pass aortic enhancement characteristics in contrast-enhanced magnetic resonance angiography using a physiologic flow phantom. MATERIALS AND METHODS: Imaging was performed on a 3.0-T magnetic resonance system (MAGNETOM Trio, Siemens Healthcare Solutions, Inc, Erlangen, Germany) using a 2-dimensional fast low angle shot T1-weighted sequence (repetition time, 500 milliseconds; echo time, 1.23 milliseconds; flip angle, 8 degrees; 1 frame/s × 60 seconds). The following CM concentrations injected at 2 mL/s were used with 3 different contrast agents (gadolinium [Gd]-BOPTA, Gd-HP-DO3A, Gd-DTPA): 20 mL of undiluted CM (100%) and 80%, 40%, 20%, 10%, 5%, and 2.5% of the full amount, all diluted in saline to a volume of 20 mL to ensure equal bolus volume. The CM was followed by saline chasers of 20 to 60 mL injected at 2 mL/s and 6 mL/s. Aortic signal intensity (SI) was measured, and normalized SI versus time (SI/Tn) curves were generated. The maximal SI (SI(max)), bolus length, and areas under the SI/Tn curve were calculated. RESULTS: Decreasing the CM concentration from 100% to 40% resulted in a decrease of SI(max) to 86.1% (mean). Further decreasing the CM concentration to 2.5% decreased SI(max) to 5.1% (mean). Altering the saline chaser volume had no significant effect on SI(max). Increasing the saline chaser injection rate had little effect (mean increase, 2.2%) on SI(max) when using ≥40% of CM. There was a larger effect (mean increase, 19.6%) when ≤20% of CM were used. Bolus time length was significantly shorter (P < 0.001), and area under the SI/T(n) curve was significantly smaller (P < 0.01) for the CM protocols followed by a saline chaser injected at 6 mL/s compared with a saline chaser injected at 2 mL/s. CONCLUSION: With 40% of CM and a fast saline chaser, SImax close to that with undiluted CM can be achieved. An increased saline chaser injection rate has a more pronounced effect on aortic enhancement characteristics at lower CM concentrations than at higher CM concentrations.

Improved aortic enhancement in CT angiography using slope-based triggering with table speed optimization: a pilot study.

To assess whether a scan triggering technique based on the slope of the time-attenuation curve combined with table speed optimization may improve arterial enhancement in aortic CT angiography compared to conventional threshold-based triggering techniques. Measurements of arterial enhancement were performed in a physiologic flow phantom over a range of simulated cardiac outputs (2.2-8.1 L/min) using contrast media boluses of 80 and 150 mL injected at 4 mL/s. These measurements were used to construct computer models of aortic attenuation in CT angiography, using cardiac output, aortic diameter, and CT table speed as input parameters. In-plane enhancement was calculated for normal and aneurysmal aortic diameters. Calculated arterial enhancement was poor (<150 HU) along most of the scan length using the threshold-based triggering technique for low cardiac outputs and the aneurysmal aorta model. Implementation of the slope-based triggering technique with table speed optimization improved enhancement in all scenarios and yielded good- (>200 HU; 13/16 scenarios) to excellent-quality (>300 HU; 3/16 scenarios) enhancement in all cases. Slope-based triggering with table speed optimization may improve the technical quality of aortic CT angiography over conventional threshold-based techniques, and may reduce technical failures related to low cardiac output and slow flow through an aneurysmal aorta.

The tubercles on humpback whales' flippers: application of bio-inspired technology.

The humpback whale (Megaptera novaeangliae) is exceptional among the large baleen whales in its ability to undertake aquabatic maneuvers to catch prey. Humpback whales utilize extremely mobile, wing-like flippers for banking and turning. Large rounded tubercles along the leading edge of the flipper are morphological structures that are unique in nature. The tubercles on the leading edge act as passive-flow control devices that improve performance and maneuverability of the flipper. Experimental analysis of finite wing models has demonstrated that the presence of tubercles produces a delay in the angle of attack until stall, thereby increasing maximum lift and decreasing drag. Possible fluid-dynamic mechanisms for improved performance include delay of stall through generation of a vortex and modification of the boundary layer, and increase in effective span by reduction of both spanwise flow and strength of the tip vortex. The tubercles provide a bio-inspired design that has commercial viability for wing-like structures. Control of passive flow has the advantages of eliminating complex, costly, high-maintenance, and heavy control mechanisms, while improving performance for lifting bodies in air and water. The tubercles on the leading edge can be applied to the design of watercraft, aircraft, ventilation fans, and windmills.

A simplified mass-transfer model for visual pigments in amphibian retinal-cone outer segments.

When radiolabeled precursors and autoradiography are used to investigate turnover of protein components in photoreceptive cone outer segments (COSs), the labeled components--primarily visual pigment molecules (opsins)--are diffusely distributed along the COS. To further assess this COS labeling pattern, we derive a simplified mass-transfer model for quantifying the contributions of advective and diffusive mechanisms to the distribution of opsins within COSs of the frog retina. Two opsin-containing regions of the COS are evaluated: the core axial array of disks and the plasmalemma. Numerical solutions of the mass-transfer model indicate three distinct stages of system evolution. In the first stage, plasmalemma diffusion is dominant. In the second stage, the plasmalemma density reaches a metastable state and transfer between the plasmalemma and disk region occurs, which is followed by an increase in density that is qualitatively similar for both regions. The final stage consists of both regions slowly evolving to the steady-state solution. Our results indicate that autoradiographic and cognate approaches for tracking labeled opsins in the COS cannot be effective methodologies for assessing new disk formation at the base of the COS.

Contrast material administration protocols for 64-MDCT angiography: altering volume and rate and use of a saline chaser to better match the imaging window--physiologic phantom study.

OBJECTIVE: The purpose of our study was to evaluate the effect of varying volumes and rates of contrast material, use of a saline chaser, and cardiac output on aortic enhancement characteristics in MDCT angiography (MDCTA) using a physiologic phantom. MATERIALS AND METHODS: Volumes of 75, 100, and 125 mL of iopamidol, 370 mg I/mL, were administered at rates of 4, 6, and 8 mL/s. The effect of a saline chaser (50 mL of normal saline, 8 mL/s) was evaluated for each volume and rate combination. Normal, reduced (33% and 50%), and increased (25%) cardiac outputs were simulated. Peak aortic enhancement and duration of peak aortic enhancement were recorded. Analysis of variance models were run with these effects, and the estimated mean levels for the sets of factor combinations were determined. RESULTS: Lowering the volume of contrast material resulted in reduced peak enhancement (example, -56.2 HU [p < 0.0001] with 75 vs 125 mL) and reduced duration of 75% peak enhancement (example, -9.0 seconds [p < 0.0001] with 75 vs 125 mL). Increasing the rate resulted in increased peak enhancement (example, 104.5 HU [p < 0.0001] with a rate of 8 vs 4 mL/s) and decreased duration of 75% peak enhancement (example, -13.0 seconds [p < 0.001]). Use of a saline chaser resulted in increased peak enhancement, and this increase was inversely proportional to contrast material volume. Peak enhancement increased when reduced cardiac output was simulated. Peak enhancement decreased when increased cardiac output was simulated. CONCLUSION: Reducing contrast material volume from 125 to 75 mL, increasing the rate to 6 or 8 mL/s, and use of a saline chaser result in an aortic enhancement profile that better matches the approximately 5-second imaging window possible with 64-MDCTA of the abdomen and pelvis. Even smaller volumes of contrast material may be adequate in patients with reduced cardiac output.

Central venous catheter integrity during mechanical power injection of iodinated contrast medium.

PURPOSE: To evaluate a widely used nontunneled triple-lumen central venous catheter in order to determine whether the largest of the three lumina (16 gauge) can tolerate high flow rates, such as those required for computed tomographic angiography. MATERIALS AND METHODS: Forty-two catheters were tested in vitro, including 10 new and 32 used catheters (median indwelling time, 5 days). Injection pressures were continuously monitored at the site of the 16-gauge central venous catheter hub. Catheters were injected with 300 and 370 mg of iodine per milliliter of iopamidol by using a mechanical injector at increasing flow rates until the catheter failed. The infusion rate, hub pressure, and location were documented for each failure event. The catheter pressures generated during hand injection by five operators were also analyzed. Mean flow rates and pressures at failure were compared by means of two-tailed Student t test, with differences considered significant at P < .05. RESULTS: Injections of iopamidol with 370 mg of iodine per milliliter generate more pressure than injections of iopamidol with 300 mg of iodine per milliliter at the same injection rate. All catheters failed in the tubing external to the patient. The lowest flow rate at which catheter failure occurred was 9 mL/sec. The lowest hub pressure at failure was 262 pounds per square inch gauge (psig) for new and 213 psig for used catheters. Hand injection of iopamidol with 300 mg of iodine per milliliter generated peak hub pressures ranging from 35 to 72 psig, corresponding to flow rates ranging from 2.5 to 5.0 mL/sec. CONCLUSION: Indwelling use has an effect on catheter material property, but even for used catheters there is a substantial safety margin for power injection with the particular triple-lumen central venous catheter tested in this study, as the manufacturer's recommendation for maximum pressure is 15 psig.

A computationally advantageous system for fitting probabilistic decompression models to empirical data.

To investigate the nature and mechanisms of decompression sickness (DCS), we developed a system for evaluating the success of decompression models in predicting DCS probability from empirical data. Model parameters were estimated using maximum likelihood techniques. Exact integrals of risk functions and tissue kinetics transition times were derived. Agreement with previously published results was excellent including: (a) maximum likelihood values within one log-likelihood unit of previous results and improvements by re-optimization; (b) mean predicted DCS incidents within 1.4% of observed DCS; and (c) time of DCS occurrence prediction. Alternative optimization and homogeneous parallel processing techniques yielded faster model optimization times.

Modifying peripheral IV catheters with side holes and side slits results in favorable changes in fluid dynamic properties during the injection of iodinated contrast material.

OBJECTIVE: The purpose of this study was to compare a standard peripheral end-hole angiocatheter with those modified with side holes or side slits using experimental optical techniques to qualitatively compare the contrast material exit jets and using numeric techniques to provide flow visualization and quantitative comparisons. MATERIALS AND METHODS: A Schlieren imaging system was used to visualize the angiocatheter exit jet fluid dynamics at two different flow rates. Catheters were modified by drilling through-and-through side holes or by cutting slits into the catheters. A commercial computational fluid dynamics package was used to calculate numeric results for various vessel diameters and catheter orientations. RESULTS: Experimental images showed that modifying standard peripheral IV angiocatheters with side holes or side slits qualitatively changed the overall flow field and caused the exiting jet to become less well defined. Numeric calculations showed that the addition of side holes or slits resulted in a 9-30% reduction of the velocity of contrast material exiting the end hole of the angiocatheter. With the catheter tip directed obliquely to the wall, the maximum wall shear stress was always highest for the unmodified catheter and was always lowest for the four-side-slit catheter. CONCLUSION: Modified angiocatheters may have the potential to reduce extravasation events in patients by reducing vessel wall shear stress.

Marginal DCS events: their relation to decompression and use in DCS models.

We consider the nature and utility of marginal decompression sickness (DCS) events in fitting probabilistic decompression models to experimental dive trial data. Previous works have assigned various fractional weights to marginal DCS events, so that they contributed to probabilistic model parameter optimization, but less so than did full DCS events. Inclusion of fractional weight for marginal DCS events resulted in more conservative model predictions. We explore whether marginal DCS events are correlated with exposure to decompression or are randomly occurring events. Three null models are developed and compared with a known decompression model that is tuned on dive trial data containing only marginal DCS and non-DCS events. We further investigate the technique by which marginal DCS events were previously included in parameter optimization, explore the effects of fractional weighting of marginal DCS events on model optimization, and explore the rigor of combining data containing full and marginal DCS events for probabilistic DCS model optimization. We find that although marginal DCS events are related to exposure to decompression, empirical dive data containing marginal and full DCS events cannot be combined under a single DCS model. Furthermore, we find analytically that the optimal weight for a marginal DCS event is 0. Thus marginal DCS should be counted as no-DCS events when probabilistic DCS models are optimized with binomial likelihood functions. Specifically, our study finds that inclusion of marginal DCS events in model optimization to make the dive profiles more conservative is counterproductive and worsens the model's fit to the full DCS data.

Lift and drag performance of odontocete cetacean flippers.

Cetaceans (whales, dolphins and porpoises) have evolved flippers that aid in effective locomotion through their aquatic environments. Differing evolutionary pressures upon cetaceans, including hunting and feeding requirements, and other factors such as animal mass and size have resulted in flippers that are unique among each species. Cetacean flippers may be viewed as being analogous to modern engineered hydrofoils, which have hydrodynamic properties such as lift coefficient, drag coefficient and associated efficiency. Field observations and the collection of biological samples have resulted in flipper geometry being known for most cetacean species. However, the hydrodynamic properties of cetacean flippers have not been rigorously examined and thus their performance properties are unknown. By conducting water tunnel testing using scale models of cetacean flippers derived via computed tomography (CT) scans, as well as computational fluid dynamic (CFD) simulations, we present a baseline work to describe the hydrodynamic properties of several cetacean flippers. We found that flippers of similar planform shape had similar hydrodynamic performance properties. Furthermore, one group of flippers of planform shape similar to modern swept wings was found to have lift coefficients that increased with angle of attack nonlinearly, which was caused by the onset of vortex-dominated lift. Drag coefficient versus angle of attack curves were found to be less dependent on planform shape. Our work represents a step towards the understanding of the association between performance, ecology, morphology and fluid mechanics based on the three-dimensional geometry of cetacean flippers.