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Related Concept Videos

Applications of Stress01:04

Applications of Stress

643
Consider a structure made of a boom and a rod designed to support a load. These two components are connected by a pin and stabilized by brackets and pins. The boom and the rod are detached from their supports to assess the different stresses imposed on this structure, and a free-body diagram is drawn. Then, all the forces applied, including the load acting on the structure, are identified. The reaction forces exerted on both the boom and the rod are computed using the equilibrium equations.
The...
643
Stress Concentrations01:24

Stress Concentrations

632
Stress concentration is when stress intensifies near discontinuities such as holes or abrupt cross-sectional changes in a structural member. This localized stress can often surpass the average stress within the member. The stress distribution in flat bars, either with a circular hole or varying widths connected by fillets, can be determined experimentally using a photoelastic method. The results are based on ratios of geometric parameters like the ratio of the hole's radius to the smaller...
632
Stress Concentrations01:13

Stress Concentrations

602
The concept of stress concentration is crucial for understanding how materials respond under bending stresses, particularly when there are irregularities or discontinuities in the material's geometry. Normally, stress in a symmetric member subjected to pure bending is assumed to be uniformly distributed across the entire cross-section. However, this assumption does not hold when there are variations in the cross-sectional geometry or the presence of notches and holes.
The stress...
602
Physiological Foundation of Stress01:24

Physiological Foundation of Stress

576
Stress triggers a coordinated physiological response involving the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. This dual activation ensures that the body is prepared for both immediate and prolonged stress management. The process begins with the perception of a stressor. This initial phase activates the SNS, leading to the rapid release of adrenaline (epinephrine) from the adrenal glands.
Role of the Sympathetic Nervous System
Adrenaline triggers the...
576
Stress: General Loading Conditions01:15

Stress: General Loading Conditions

529
To grasp the intricacy of real-world conditions where multiple loads are applied simultaneously to a structure, one might visualize a section passing through a specific point within a body, aligned parallel to the xy plane. This section is subjected to various forces, including original loads, normal forces, and shearing forces.
The shearing force, possessing potential directionality within the plane of the section, is simplified into two component forces running parallel to the x and y axes....
529

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Assessment of Stress Effects on Cognitive Flexibility using an Operant Strategy Shifting Paradigm
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A Bayesian re-analysis of the STRESS trial.

Kevin D Hill1, Jake Koerner2, Hwanhee Hong2

  • 1Duke University Pediatric and Congenital Heart Center, Durham, NC; Duke Clinical Research Institute, Durham, NC.

American Heart Journal
|September 27, 2025
PubMed
Summary
This summary is machine-generated.

Bayesian analysis of the STRESS trial suggests prophylactic methylprednisolone significantly reduces adverse outcomes in infants undergoing heart surgery. This re-analysis indicates a high probability of benefit, expanding on initial findings.

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Pharmacology

Background:

  • Prophylactic steroids are commonly used to mitigate systemic inflammatory responses during infant heart surgery involving cardiopulmonary bypass.
  • The original STRESS trial found no significant difference in outcomes between methylprednisolone and placebo, though secondary analyses suggested potential benefits.
  • Bayesian analytics were employed to re-evaluate the STRESS trial data for a more nuanced understanding of methylprednisolone's effects.

Purpose of the Study:

  • To re-analyze the STRESS trial data using Bayesian methods to assess the probability of benefit from methylprednisolone.
  • To investigate potential benefits of methylprednisolone beyond the primary endpoint of the original STRESS trial.
  • To explore the impact of varying prior beliefs on the probability of methylprednisolone efficacy.

Main Methods:

  • A covariate-adjusted proportional odds model was used with the STRESS trial's composite endpoint (death, transplant, major complication, length of stay).
  • Markov Chain Monte Carlo simulations were performed to determine the probability of benefit (OR < 1) versus harm (OR > 1).
  • Sensitivity analyses explored various prior beliefs (pessimistic, neutral, optimistic) and prior strengths, alongside a secondary analysis using priors from previous steroid trials.

Main Results:

  • The posterior probability of benefit from methylprednisolone was 92%, with an 8% probability of harm.
  • Methylprednisolone was associated with an absolute risk difference of -2% for composite death or major complication.
  • Nine sensitivity analyses consistently showed a higher probability of benefit than harm, with 8 demonstrating >80% probability of benefit and ≥1% absolute risk reduction.

Conclusions:

  • Bayesian re-analysis indicates a high probability that perioperative methylprednisolone reduces the risk of death or major complications in infants undergoing cardiopulmonary bypass.
  • This in-depth analysis provides stronger evidence for methylprednisolone's efficacy compared to the initial STRESS trial findings.
  • The findings support the use of methylprednisolone as a prophylactic measure in this patient population.