This systematic review aims to review clinical studies on the use of ketamine infusion for patients with treatment-resistant complex regional pain syndrome (CRPS).The following systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021228470). Studies for the systematic review were identified through three databases: PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Cochrane Reviews. Inclusion criteria for studies consisted of randomized clinical trials or cohort studies that conducted trials on the use of ketamine infusion for pain relief in patients with CRPS. Exclusion criteria for studies included any studies that were systematic reviews, meta-analyses, case reports, literature reviews, or animal studies. In the included studies, the primary outcome of interest was the post-drug administration pain score.In this systematic review, 14 studies met the inclusion criteria and were reviewed. In these studies, the dosage of ketamine infusion used ranged from 0.15 mg/kg to 7 mg/kg with the primary indication being the treatment of CRPS. In 13 of the studies, ketamine infusion resulted in a decrease in pain scores and relief of symptoms.Patients who received ketamine infusion for treatment-resistant CRPS self-reported adequate pain relief with treatment. This suggests that ketamine infusion may be a useful form of treatment for patients with no significant pain relief with other conservative measures. Future large-scale studies, including randomized double-blind placebo-controlled trials on the use of ketamine infusion for CRPS, must be conducted in a large-scale population to further assess the effectiveness of ketamine infusion in these populations.

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Collaboration is described on assessment of computational fluid dynamics (CFD) predictions for surface combatant model 5415 at static drift β = 0 deg and 20 deg using recent tomographic particle image velocimetry (TPIV) experiments. Assessment includes N-version verification and validation to determine the confidence intervals for CFD solutions/codes, and vortex onset, progression, instability, and turbulent kinetic energy (TKE) budget analysis. The increase in β shows the following trends. Forces and moment increase quadratically/cubically, and become unsteady due to shear layer, Karman and flapping instabilities on the bow. Wave elevation becomes asymmetric; its amplitude increases, but the total wave elevation angle remains same. The vortex strength and TKE increase by about two orders of magnitude, and for large β, the primary vortices exhibit helical mode instability similar to those for delta wings. Forces and moment for both β and wave elevation for β = 0 deg are compared within 4% of the data, and are validated at 7% interval. Wave elevation for β = 20 deg, and vortex core location and velocities for both β are compared within 9% of the data, and are validated at 12% interval. The vortex strength and TKE predictions show large 70% errors and equally large scatter and are not validated. Thus, both errors and scatter need reduction. TKE budgets show transport of turbulence into the separation bubble similar to canonical cases, but pressure transport is dominant for ship flows. Improved CFD predictions require better grids and/or turbulence models. Investigations of solution-adaptive mesh refinement for better grid design and hybrid Reynolds-averaged Navier-Stokes/large eddy simulation models for improved turbulent flow predictions are highest priority.

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The seakeeping ability of ships is one of the aspects that needs to be assessed during the design phase of ships. Traditionally, potential flow calculations and model tests are employed to investigate whether the ship performs according to specified criteria. With the increase of computational power nowadays, advanced computational tools such as Computational Fluid Dynamics (CFD) become within reach of application during the assessment of ship designs. In the present paper, a detailed validation study of several computational methods for ship dynamics is presented. These methods range from low-fidelity system-based methods, to potential flow methods, to high-fidelity CFD tools. The ability of the methods to predict motions in calm water as well as in waves is investigated. In calm water, the roll decay behavior of a fully appended self-propelled free running 5415M model is investigated first. Subsequently, forced roll motions simulated by oscillating the rudders or stabilizer fins are studied. Lastly, the paper discusses comparisons between experiments and simulations in waves with varying levels of complexity, i.e. regular head waves, regular beam waves and bi-chromatic waves. The predictions for all methods are validated with an extensive experimental data set for ship motions and loads on appendages such as rudders, fins and bilge keels. Comparisons between the different methods and with the experiments are made for the relevant motions and the high fidelity CFD results are used to explain some of the complex physics. The course keeping and seakeeping of the model, the reduction rate of the roll motion, the effectiveness of the fin stabilizers as roll reduction device and the interaction of the roll motion with other motions are investigated as well. The paper shows that only high-fidelity CFD is able to accurately predict all the relevant physics during roll decay, forced oscillation and sailing in waves.