Principles of pressure transducer function and sources of error in clinical use

The invasive measurement of physiological pressures is a common requirement in anaesthesia and intensive care medicine. From arterial blood pressure to intracranial pressure, these calculated variables give a swift graphical and numerical representation of a patient's current physiological status. This allows us to respond rapidly to conditions outside our preferred parameters and to carefully titrate treatment to target effects. These systems are, however, not infallible. An understanding of the principles of their function will promote appropriate use and an ability to recognize and react to sources of error. This article aims to furnish the reader with this level of understanding in order to inform their academic and clinical practice.     

Optimal pole assignment into specified regions and its application to rotating mechanical systems

This paper considers a pole assignment problem to cluster all poles of a closed-loop system into some specified regions by introducing the complex state for systems having an isotropic property and by using the Riccati equation. The algebraic relations for the distribution of the eigenvalues of a complex matrix are used in order to cluster the poles into specified regions, which guarantees the relative stability margin, e.g. uniform damping or uniform damping ratio. The proposed scheme is essentially a combination of the pole assignment approach and linear quadratic design, taking the advantages of both. A block modal control method—an extension of recursive pole assignment—is also developed for the vibration control of rotating systems by clustering the forward and backward modes in order. Vibration control simulations with an isotropic rotor—bearing system, a magnetic bearing system and a rotating circular disc are treated in order to demonstrate the advantages of the proposed method.     

Damping characteristics of bone‐to‐implant interface; A clinical study with the Periotest® device.

The Periotest® device was used to evaluate the damping characteristics of different bone‐to‐implant interfaces of Brånemark implants. Implant and abutment lengths were found to have a significant influence on Periotest value (PTV). There was no statistical difference between PTVs of implants located in the anterior and posterior areas of the same jaw at abutment connection. No differences were found between PTVs of standard and self‐tapping implants. PTVs at abutment connection were highly influenced by the bone quality. The contact with two corticals, one at each extremity of the implant, was of a greater influence in the maxillary than in the mandibular jaw, indicating a firmer anchorage between the bicortical implants and the surrounding bone. A proaressive decrease of PTVs over time was observed, significant up to 5 years of loading.     

In-vivo evaluation of random donor platelet concentrates from pooled buffy coats

 Random-donor platelet concentrates (PC) prepared from pooled buffy coats have recently been described as an alternative method for platelet preparation. We evaluated such PCs in the clinical setting compared with a standard PC from platelet apheresis. PCs were prepared either from pools of buffy coats (BC-PC) or from single donors (SD-PC) with the cell separator CS-3000 plus. PCs were stored for up to 5 days before transfusion. We compared fresh PC (day 1) with stored (day 2–3) and long-stored PC (day 4–5). For analysis, platelet increment in the recipient was determined immediately and 16–22 h (mean 20 h) after transfusion, corrected for total body area and transfused platelets (CCI). A total of 316 PCs were administered to 36 thrombocytopenic patients suffering from various hematological disorders. Patients with detectable HLA or platelet-specific antibodies or splenomegaly were excluded from the study. Mean platelet content of the PC was 262×10⁹ for BC-PC and 251×10⁹ for SD-PC. The 20-h CCI after transfusion of fresh PC was slightly higher with BC-PC than with SD-PC (14.5 versus 11.9;p=0.19), but values did not differ significantly between the two types of PC on any day of storage. For BC-PC, 20-h CCI decreased with further storage by 30% (10.2;p=0.02). For SD-PC a decrease by 9% was not significant. In conclusion, platelet concentrates prepared from pools of buffy coats showed excellent transfusion results when administered fresh, but storage decreased the CCI by 30%. No significant difference from PCs from plateletpheresis was observed on any day of storage. Both types of platelet concentrates were capable of sufficient platelet increment even when stored for up to 5 days. Received: 28 December 1995 / Accepted: 14 May 1996     

大型养路机械低温维修超长无缝线路对轨道的影响

运用轨道的有限单元模型,采用荷载增量法,计算了低温条件下大型养路机械维修超长无缝线路对钢轨应力和锁定轨温的影响。计算结果表明,大型机械在一次性起道时会对钢轨产生较大的应力,建议一次性起道量不超过40mm。     

Does time of CCI measurement affect the evaluation of platelet transfusion effectiveness?

The measurement of corrected count increment at 1-h post-transfusion (CCI-1 h) of platelet concentrate (PC) transfusion is recommended, but in the revised Japanese Guideline (2017) it was changed to “after 10-min to 1-h”, following the revision of the guidelines from Western countries. Here, we aimed to investigate on the feasibility to apply the CCI measured at 10-min or 30-min post-transfusion as the surrogate of CCI-1 h. Peripheral blood was collected at 10-min, 30-min and 1-h post-transfusion of PC and the effectiveness of the transfusion was analyzed based on the CCI. In the period from December 2017 to February 2020, 8 patients, who received multiple PC transfusion (total 208) at our institution, were analyzed. We performed the univariate analyses to examine the relationship between CCI value and the categorical variables, p-value <0.1 was obtained for gender (p = 2.91 × 10^?19), fever after transfusion (p = 0.0163). The qualitative variables, namely measurement time (p = 0.0553), also showed p-value <0.1. Using these factors as covariates in the mixed effect model, we found that the measurement time (p = 0.0007) had a significant effect on the CCI value when looking at fixed effects. Although there is a tendency for decreased CCI values with time progression, the slope of the change in the mixed model was -0.00307, indicating that the CCI difference among the 3 measurements was small. Here we provide evidence that CCI measured at 10-min and 30-min post-transfusion give results comparable to those measured at 1-h post-transfusion, under the Japanese practice of platelet transfusion, which relies on 100 % single-donor apheresis PC, and ABO-identical whenever possible.     

Embedded NiTi Wires for Improved Dynamic Thermomechanical Performance of Silicone Elastomers

The extraordinary properties of shape memory NiTi alloy are combined with the inherent viscoelastic behavior of a silicon elastomer. NiTi wires are incorporated in a silicon elastomer matrix. Benefits include features as electrical/thermal conductivity, reinforcement along with enhanced damping performance and flexibility. To gain more insight of this composite, a comprehensive dynamic thermomechanical analysis is performed and the temperature- as well as frequency-dependent storage modulus and the mechanical loss factor are obtained. The analyses are realized for the composite and single components. Moreover, the models to express the examined properties and their temperature along with the frequency dependencies are also presented.     

Cross-match-compatible platelets improve corrected count increments in patients who are refractory to randomly selected platelets

Background

Cross-match-compatible platelets are used for the management of thrombocytopenic patients who are refractory to transfusions of randomly selected platelets. Data supporting the effectiveness of platelets that are compatible according to cross-matching with a modified antigen capture enzyme-linked immunosorbent assay (MAC-ELISA or MACE) are limited. This study aimed to determine the effectiveness of cross-match-compatible platelets in an unselected group of refractory patients.

Materials and methods

One hundred ABO compatible single donor platelet transfusions given to 31 refractory patients were studied. Patients were defined to be refractory if their 24-hour corrected count increment (CCI) was <5×10⁹/L following two consecutive platelet transfusions. Platelets were cross-matched by MACE and the CCI was determined to monitor the effectiveness of platelet transfusions.

Results

The clinical sensitivity, specificity, positive predictive value and negative predictive value of the MACE-cross-matched platelets for post-transfusion CCI were 88%, 54.6%, 39.3% and 93.2%, respectively. The difference between adequate and inadequate post-transfusion 24-hour CCI for MACE cross-matched-compatible vs incompatible single donor platelet transfusions was statistically significant (p=0.000). The 24-hour CCI (mean±SD) was significantly higher for cross-match-compatible platelets (9,250±026.6) than for incompatible ones (6,757.94±2,656.5) (p<0.0001). Most of the incompatible cross-matches (73.2%) were due to anti-HLA antibodies, alone (55.3% of cases) or together with anti-platelet glycoprotein antibodies (17.9%).

Discussion

The clinical sensitivity and negative predictive value of platelet cross-matching by MACE were high in this study and such tests may, therefore, be used to select compatible platelets for refractory patients. A high negative predictive value demonstrates the greater chance of an adequate response with cross-matched-compatible platelets.     

Meso-scale turbulence in living fluids

Turbulence is ubiquitous, from oceanic currents to small-scale biological and quantum systems. Self-sustained turbulent motion in microbial suspensions presents an intriguing example of collective dynamical behavior among the simplest forms of life and is important for fluid mixing and molecular transport on the microscale. The mathematical characterization of turbulence phenomena in active nonequilibrium fluids proves even more difficult than for conventional liquids or gases. It is not known which features of turbulent phases in living matter are universal or system-specific or which generalizations of the Navier-Stokes equations are able to describe them adequately. Here, we combine experiments, particle simulations, and continuum theory to identify the statistical properties of self-sustained meso-scale turbulence in active systems. To study how dimensionality and boundary conditions affect collective bacterial dynamics, we measured energy spectra and structure functions in dense Bacillus subtilis suspensions in quasi-2D and 3D geometries. Our experimental results for the bacterial flow statistics agree well with predictions from a minimal model for self-propelled rods, suggesting that at high concentrations the collective motion of the bacteria is dominated by short-range interactions. To provide a basis for future theoretical studies, we propose a minimal continuum model for incompressible bacterial flow. A detailed numerical analysis of the 2D case shows that this theory can reproduce many of the experimentally observed features of self-sustained active turbulence.     

Approximal caries increment in adolescents after a visual aid in combination with a comprehensive open discussion

Abstract

Objective. To achieve greater motivation for behavioural changes; educating, motivating and supporting the patient's ability to change lifestyle factors related to the caries disease are important tasks in the prevention of the disease. The aim of this study was to evaluate whether a visual aid (Visual Caries Dialogue, VCD) in combination with a comprehensive open discussion has a beneficial effect on approximal caries development among a population of young adolescents. Materials and methods. The study subjects were randomized to either an intervention group (n = 118), where VCD was conducted, or a control group (n = 112) receiving traditional oral healthcare information, at the annual dental health examination. The number of caries lesions reaching through the entire enamel (D2) and dentin caries reaching through the enamel into the dentin (D3) were recorded from bitewing radiographs each year, from 2001–2004. Differences between the study groups regarding at least two new approximal surfaces with caries (D2–D3) were tested using logistic regression. Results. The caries increment was lower in the intervention group compared to the control group. During the 3-year follow-up, 18 (15.3%) patients in the intervention group and 40 (35.7%) patients in the control group demonstrated a DS-approximal increment of at least two surfaces with a risk ratio of 2.34 (95% CI = 1.43–3.83). Conclusion. Visual Caries Dialogue in combination with a comprehensive open discussion reduced approximal caries increment among young individuals. The method provides an innovative simple and low-cost way of delivering information to patients and guides busy dental healthcare personnel in the approach.