Pore-Scale Hydrodynamics in a Progressively Bioclogged Three-Dimensional Porous Medium: 3-D Particle Tracking Experiments and Stochastic Transport Modeling.

Biofilms are ubiquitous bacterial communities that grow in various porous media including soils, trickling, and sand filters. In these environments, they play a central role in services ranging from degradation of pollutants to water purification. Biofilms dynamically change the pore structure of the medium through selective clogging of pores, a process known as bioclogging. This affects how solutes are transported and spread through the porous matrix, but the temporal changes to transport behavior during bioclogging are not well understood. To address this uncertainty, we experimentally study the hydrodynamic changes of a transparent 3-D porous medium as it experiences progressive bioclogging. Statistical analyses of the system's hydrodynamics at four time points of bioclogging (0, 24, 36, and 48 h in the exponential growth phase) reveal exponential increases in both average and variance of the flow velocity, as well as its correlation length. Measurements for spreading, as mean-squared displacements, are found to be non-Fickian and more intensely superdiffusive with progressive bioclogging, indicating the formation of preferential flow pathways and stagnation zones. A gamma distribution describes well the Lagrangian velocity distributions and provides parameters that quantify changes to the flow, which evolves from a parallel pore arrangement under unclogged conditions, toward a more serial arrangement with increasing clogging. Exponentially evolving hydrodynamic metrics agree with an exponential bacterial growth phase and are used to parameterize a correlated continuous time random walk model with a stochastic velocity relaxation. The model accurately reproduces transport observations and can be used to resolve transport behavior at intermediate time points within the exponential growth phase considered.

Intermittent Lagrangian velocities and accelerations in three-dimensional porous medium flow.

Intermittency of Lagrangian velocity and acceleration is a key to understanding transport in complex systems ranging from fluid turbulence to flow in porous media. High-resolution optical particle tracking in a three-dimensional (3D) porous medium provides detailed 3D information on Lagrangian velocities and accelerations. We find sharp transitions close to pore throats, and low flow variability in the pore bodies, which gives rise to stretched exponential Lagrangian velocity and acceleration distributions characterized by a sharp peak at low velocity, superlinear evolution of particle dispersion, and double-peak behavior in the propagators. The velocity distribution is quantified in terms of pore geometry and flow connectivity, which forms the basis for a continuous-time random-walk model that sheds light on the observed Lagrangian flow and transport behaviors.

Natural micro-scale heterogeneity induced solute and nanoparticle retardation in fractured crystalline rock.

We studied tracer (Tritiated Water (HTO); Tritium replaces one of the stable hydrogen atoms in the H(2)O molecule) and nanoparticle (quantum dots (QD)) transport by means of column migration experiments and comparison to 3D CFD modeling. Concerning the modeling approach, a natural single fracture was scanned using micro computed tomography (µCT) serving as direct input for the model generation. The 3D simulation does not incorporate any chemical processes besides the molecular diffusion coefficient solely reflecting the impact of fracture heterogeneity on mass (solute and nanoparticles) transport. Complex fluid velocity distributions (flow channeling and flowpath heterogeneity) evolve as direct function of fracture geometry. Both experimental and simulated solute and colloidal breakthrough curves show heavy tailing (non-Fickian transport behavior), respectively. Regarding the type of quantum dots and geochemical conditions prevailing (Grimsel ground water chemistry, QD and diorite surface charge, respectively and porosity of the Äspö diorite drill core) experimental breakthrough of the quantum dots always arrives faster than the solute tracer in line with the modeling results. Besides retardation processes like sorption, filtration, straining or matrix diffusion, the results show that natural 3D fracture heterogeneity represents an important additional retardation mechanism for solutes and colloidal phases. This is clearly verified by the numerical simulations, where the 3D real natural fracture geometry and the resulting complex flow velocity distribution is the only possible process causing solute/nanoparticle retardation. Differences between the experimental results and the simulations are discussed with respect to uncertainties in the µCT measurements and experimental and simulation boundary conditions, respectively.

Numerical studies of the transport behavior of a passive solute in a two-dimensional incompressible random flow field.

We study the transport behavior of a passive scalar in a two-dimensional (2D) time-independent Gaussian random velocity field by efficient and highly accurate numerical simulations. The model under consideration has been used in order to gain basic understanding of transport processes in incompressible flow through heterogeneous porous media. The velocity field is derived from the linearized solution of the Darcy equation with a Gauss-distributed log-hydraulic conductivity. The transport of a passive scalar is studied by a high precision random-walk method, which allows for a systematic nonperturbative study of the ensemble and effective dispersion coefficients. The conclusive numerical results validate the range of applicability of the perturbation theory and the consistency of nonperturbative approaches to the transport problem in a random medium. Furthermore, we observe closed streamlines in incompressible 2D Gaussian random fields, which restricts the direct applicability of the simulation method for transport in heterogeneous porous media, and questions the results of similar studies that do not observe this phenomenon.

The successful implementation of pharmaceutical practice guidelines. Analysis of associated outcomes and cost savings. SWiPE Group. Systematic Withdrawal of Perioperative Expenses.

BACKGROUND: Although approximately 2,000 medical practice guidelines have been proposed, few have been successfully implemented and sustained. We hypothesized that we could develop and institute practice guidelines to promote more appropriate use of costly anesthetics, to generate and sustain widespread compliance from a large physician group, and to decrease costs without adversely affecting clinical outcomes. METHODS: A prospective before and after comparison study was performed at a tertiary care medical center. Clinical outcomes data and times indicative of perioperative patient flow were collected on the first of two sets of patients 1 month before discussion of practice guidelines. Practice guidelines were developed by the physicians and their associated care team for the intraoperative use of anesthetic drugs. A drug distribution process was developed to aid compliance. Clinical outcomes data and times indicative of perioperative patient flow were collected on the second set of patients 1 month after institution of practice guidelines. Hospital drug costs and adherence to guidelines were noted throughout the study period and for each of the following 9 months by querying the database of an automated anesthesia record keeper. RESULTS: A total of 1,744 patients were studied. Drug costs decreased from 56 dollars per case to 32 dollars per case as a result of adherence to practice guidelines. Perioperative patient flow was minimally affected. Time (mean +/- SD) from end of surgery to arrival in the post-anesthesia care unit (PACU) increased from 11 +/- 7 min before the authors instituted practice guidelines to 14 +/- 8 min after practice guidelines (P < 0.0001). Admission of inpatients to the PACU receiving monitored anesthesia care increased from 6.5 to 12.9% (P < 0.02). Perioperative patient flow and clinical outcomes were not otherwise adversely affected. Compliance and cost savings have been sustained. CONCLUSIONS: This study is an example of a successful physician-directed program to promote more appropriate utilization of health care resources. Cost savings were obtained without any substantial changes in clinical outcomes. Institution of similar practice guidelines should result in pharmaceutical savings in the range of 50% at tertiary care centers around the country, with a slightly smaller degree of savings expected at institutions with more ambulatory surgery.

A comparison of amrinone with sodium nitroprusside for control of hemodynamics during infrarenal abdominal aortic surgery.

OBJECTIVES: The control of hemodynamic changes during surgical resection of abdominal aortic aneurysms (AAA) remains a challenge to anesthesiologists. In the past, hypertensive episodes have been treated with sodium nitroprusside (SNP). However, amrinone may provide some benefits when compared with SNP because of its positive inotropic and vasodilatory properties. Therefore, the purpose of this study was to compare amrinone with SNP for hemodynamic control during AAA surgery. DESIGN: This study was a prospective, randomized investigation. SETTING: This study was performed at a single university hospital. PARTICIPANTS: This study included 20 patients undergoing AAA resection. INTERVENTIONS: After institutional review board approval, participants were randomized to receive either SNP (group N = 10) or amrinone (group A = 10). Both agents were started 10 minutes before aortic cross-clamping and discontinued 10 minutes before unclamping. Anesthesia was induced with thiopental or etomidate and maintained with oxygen, nitrous oxide, isoflurane, fentanyl, and vecuronium. Hemodynamic measurements included heart rate, systolic and diastolic blood pressure, cardiac output, systolic and diastolic pulmonary artery pressure, pulmonary capillary wedge pressure, central venous pressure, mixed venous oxygen saturation, electrocardiogram, and ST-T wave trend analysis. MEASUREMENTS AND MAIN RESULTS: Demographic and clinical characteristics for the two groups were similar. Mixed venous oxygen saturation was significantly lower (p < 0.05) in group N immediately after unclamping. There were no differences between groups for the other measurements studied. There were no episodes of myocardial ischemia in either group. CONCLUSIONS: This study demonstrates that amrinone provides equivalent hemodynamic control to SNP during abdominal aortic aneurysm surgery because it allows moderate reductions in blood pressure without affecting other hemodynamic measurements. Further studies are needed to assess whether patients with poor preoperative left ventricular function would benefit from amrinone management during AAA resection.