National Data Sources on the Care and Outcomes of Patients with Community Acquired Pneumonia

Despite improved understanding and treatment of community acquired pneumonia (CAP), variations in clinical practice and patient outcomes still exists, resulting in excess healthcare dollars spent and decreased patient satisfaction. The use of treatment and outcomes research data can help providers improve their methods and standardize techniques to control costs and provide the best care for their patients. To better understand the utility and capabilities of this research, this article will compare several administrative and clinical databases. Two, data sources in particular, the EPI-Q Inc. CAP-Compare database and the University HealthSystem Consortium's (UHC) CAP Benchmarking Program contain clinical and utilization data specific to CAP. In addition there are several government and non-government sponsored data sources that include administrative data on many diagnosis including CAP. These include: Healthcare Benchmarking Systems International's EXPLORE database, the Center for Healthcare Industry Performance Studies database, the National Center for Health Statistics'--National Hospital Discharge Survey, and the Medicare Provider Analysis and Review data files.     

Experimental Tests and Numerical Simulations on the Ballistic Impact Response of a Highly Inhomogeneous Aluminium Foam

A sandwich structure is a composite material consisting of thin skins encapsulating a cellular core. Such structures have proven to be excellent energy absorbents and are frequently found in various types of protection. Even so, few studies exist in the open literature on the response of the core material itself under extreme loadings such as blast and impact. Since a blast load is usually accompanied by numerous fragments, it is important to understand and be able to predict the ballistic impact resistance of the often highly inhomogeneous cellular core materials in design. In this study, the ballistic impact response of an aluminium foam with a complex cell structure has been investigated both experimentally and numerically. First, an extensive material test program involving compression tests on cubic specimens loaded in the thickness direction of the foam was carried out to reveal the mechanical properties of the material. In addition, several of the specimens were scanned before testing using X-ray Micro Computed Tomography (XRMCT) to map the multi-scale topology and morphology of the material. These data were later analysed to extract density-variation plots in many different material orientations. Second, ballistic impact tests were conducted using a gas gun where rigid spheres were launched towards aluminium foam plates, and the ballistic limit velocity and curve of the foam material were established. Finally, numerical simulations of both the material tests and the ballistic impact tests were carried out using LS-DYNA and different modelling approaches based on the XRMCT data. It will be shown that, independent of the modelling strategy applied, good agreement between the experimental impact tests and the numerical predictions can be obtained. However, XRMCT data are important if the final goal is to numerically optimise and improve the behaviour of inhomogeneous foams with respect to energy absorption, thermal isolation, or similar properties.     

Pseudo-aneurysm of mitral aortic intervalvular fibrosa: Two case reports

The fibrous body between the mitral and aortic valve, known as mitral-aortic intervalvular fibrosa (MAIVF) is prone to infection and injury resulting in pseudo-aneurysm formation. Because of its relative rarity, we are far from making any conclusion regarding the natural history and appropriate therapeutic strategy for this condition. We report two cases of this condition with two different and rare etiologies with strikingly different natural courses, providing insight into the natural course and timing of surgery in this rare entity.