143 resultados para Endotracheal tube


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Developing follicles and follicular cysts in the ovary are lined by granulosa cells. Approximately the size of histiocytes, non-neoplastic granulosa cells have scant granular to foamy cytoplasm and mildly atypical hyperchromatic nuclei, which may be mitotically active. 1 Displaced granulosa cells, derived from normal follicles and introduced into ovarian vascular channels, ovarian stroma and the fallopian tube, have been reported to cause diagnostic difficulty in histol- ogy, as they may mimic small cell carcinoma or other metastatic carcinomas. 2–4 The cells are thought to be displaced artefactually due to surgical trauma or during sectioning in the laboratory or during ovulation...

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This paper presents a nonlinear finite element (FE) model for the analysis of very high strength (VHS) steel hollow sections wrapped by high modulus carbon fibre rein forced polymer (CFRP) sheets. The bond strength of CFRP wrapped VHS circular steel hollow section under tension is investigated using the FE model. The three dimensional FE model by Nonlinear static analysis has been carried out by Strand 7 finite element software. The model is validated by the experimental data obtained from Fawzia et al [1]. A detail parametric study has been performed to examine the effect of number of CFRP layers, different diameters of VHS steel tube and different bond lengths of CFRP sheet. The analytical model developed by Fawzia et al. [1] has been used to determine the load carrying capacity of different diameters of CFRP strengthened VHS steel tube by using the capacity from each layer of CFRP sheet. The results from FE model have found in reasonable agreement with the analytical model developed by Fawzia et al [1]. This validation was necessary because the analytical model by Fawzia et al [1] was developed by using only one diameter of VHS steel tube and fixed (five) number of CFRP layers. It can be concluded that the developed analytical model is valid for CFRP strengthened VHS steel tubes with diameter range of 38mm to 100mm and CFRP layer range of 3 to 5 layers. Based on the results it can also be concluded that the effective bond length is consistent for different diameters of steel tubes and different layers of CFRP. Three layers of CFRP is considered most effective wrapping scheme due to the cost effectiveness. Finally the distribution of longitudinal and hoop stress has been determined by the finite element model for different diameters of CFRP strengthened VHS steel tube.

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Red blood cells (RBCs) exhibit different types of motions and deformations when the blood flows through capillaries. Interestingly, due to the complex three-dimensional structure of the RBC membrane, RBCs show three-dimensional motions and deformations in the blood flow. These motions and deformations of the RBCs highly depend on the stiffness of the RBC membrane and on the geometrical parameters of the capillary through which blood flows. However, capillaries always do not have uniform cross sections and some capillaries have stenosed segments, where cross sectional area suddenly reduces. Further, some diseases can alter the stiffness of the RBC membrane drastically. In this study, the deformation behaviour of a single three-dimensional RBC is examined, when it moves through a stenosed capillary. A three-dimensional spring network is used to model the RBC membrane. The RBC’s inside and outside fluids are discretized into a finite number of mass points and treated by smoothed particle hydrodynamics (SPH) method. The capillary is considered as a rigid tube with a stenosed section. The deformation index, mean velocity and total energy of the RBC are analysed when it flows through the stenosed capillary. Further, motion and deformation of the RBCs with different membrane stiffness (KB) are compared when they flow through the stenosed segment of the capillary. The simulation results demonstrate the RBCs are subjected to a larger deformation when they move through the stenosed part of the capillary and the RBCs with lower KBvalues easily pass through the stenosed segment of the capillary. Further, RBCs having higher KBvalues have a lower mean velocity and it leads to slow down the overall blood flow rate

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Steel hollow sections used in structures such as bridges, buildings and space structures involve different strengthening techniques according to their structural purpose and shape of the structural member. One such technique is external bonding of CFRP sheets to steel tubes. The performance of CFRP strengthening for steel structures has been proven under static loading while limited studies have been conducted on their behaviour under impact loading. In this study, a comprehensive numerical investigation is carried out to evaluate the response of CFRP strengthened steel tubes under dynamic axial impact loading. Impact force, axial deformation impact velocities are studied. The results of the numerical investigations are validated by experimental results. Based on the developed finite element (FE) model several output parameters are discussed. The results show that CFRP wrapping is an effective strengthening technique to increase the axial dynamic load bearing capacity by increasing the stiffness of the steel tube.

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Galvanic corrosion is a common phenomenon in Carbon Fibre Reinforced Polymer (CFRP) strengthened steel structures in wet environments and submerged conditions, which reduces durability by weakening the bond between the CFRP and steel substrate. CFRP materials have already been proven to have superior resistance to corrosion and chemical attacks but the adhesive and steel are generally affected by long-term exposure to moisture, especially in conjunction with salts resulting from deicing of ocean spray. This paper presents the results of a research program to improve the durability of CFRP strengthened steel circular hollow section (CHS) members by treating the steel surface with an epoxy based adhesion promoter and inserting Glass Fibre Reinforced Polymer (GFRP) as a galvanic corrosion barrier against simulated sea water. It also presents the effects of accelerated corrosion on the bond of CFRP strengthened hollow steel members. The program consisted of four CFRP strengthened steel beams and one unstrengthened steel beam. Two strengthened beams were used as control while the other two beams were exposed to a highly corrosive environment to induce accelerated corrosion. The corrosion rate was considered 10% which represents a moderate level of loss in the cross-sectional area of the steel tube throughout its intended service life. The beams were then loaded to failure under four-point bending. The research findings indicate that the accelerated corrosion adversely affected the ultimate strength of the conditioned beams and the embedded glass fibre enhanced the bond durability.

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In the general population it is evident that parent feeding practices can directly shape a child’s life long dietary intake. Young children undergoing childhood cancer treatment may experience feeding difficulties and limited food intake, due to the inherent side effects of their anti-cancer treatment. What is not clear is how these treatment side effects are influencing the parent–child feeding relationship during anti-cancer treatment. This retrospective qualitative study collected telephone based interview data from 38 parents of childhood cancer patients who had recently completed cancer treatment (child’s mean age: 6.98 years). Parents described a range of treatment side effects that impacted on their child’s ability to eat, often resulting in weight loss. Sixty-one percent of parents (n = 23) reported high levels of stress in regard to their child’s eating and weight loss during treatment. Parents reported stress, feelings of helplessness, and conflict and/or tension between parent and the child during feeding/eating interactions. Parents described using both positive and negative feeding practices, such as: pressuring their child to eat, threatening the insertion of a nasogastric feeding tube, encouraging the child to eat and providing home cooked meals in hospital. Results indicated that parent stress may lead to the use of coping strategies such as positive or negative feeding practices to entice their child to eat during cancer treatment. Future research is recommended to determine the implication of parent feeding practice on the long term diet quality and food preferences of childhood cancer survivors.

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An accurate and comprehensive pain assessment is crucial for adequate pain management in pre- and early verbal children during painful medical procedures. This study used an inductive approach to explore the processes involved in parental pain assessment and to develop a new model of Parental Assessment of Acute Child Pain. Participants were 19 parents of children aged under 3 years who had previously or were potentially about to experience an intravenous cannula or nasogastric tube insertion. Parental affect regulation, while witnessing their child in acute pain/distress, appeared to be critical to the processes involved in assessing their child’s pain.

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Introduction Hydrogels prepared from poly(ethylene glycol) (PEG) and maleimide-functionalized heparin provide a potential matrix for use in developing three dimensional (3D) models. We have previously demonstrated that these hydrogels support the cultivation of human umbilical vein endothelial cells (HUVECs) (1). We extend this body of work to study the ability to create an extracellular matrix (ECM)-like model to study breast and prostate cancer cell growth in 3D. Also, we investigate the ability to produce a tri-culture mimicking tumour angiogenesis with cancer spheroids, HUVECs and mesenchymal stem cells (MSC). Materials and Methods The breast cancer cell lines, MCF-7 and MDA-MB-231, and prostate cancer cell lines, LNCaP and PC3, were seeded into starPEG-heparin hydrogels and grown for 14 Days to analyse the effects of varying hydrogel stiffness on spheroid development. Resulting hydrogel constructs were analyzed via Alamar Blue assays, light microscopy, and immunofluorescence staining for cytokeratin 8/18, Ki67 and E-Cadherin. Cancer cell lines were then pre-grown in hydrogels for 5-7 days and then re-seeded into starPEG-heparin hydrogels functionalised with RGD, SDF-1, bFGF and VEGF as spheroids with HUVECs and MSC and grown for 14 days as a tri-culture in Endothelial Cell Growth Medium (ECGM; Promocell). Cell lines were also seeded as a single cell suspension into the functionalised tri-culture system. Cultures were fixed in 4% paraformaldehyde and analysed via immunostaining for Von Willebrand Factor and CD31, as well as the above mentioned markers, and observed using confocal microscopy. Results Cultures prepared in MMP-cleavable starPEG-heparin hydrogels display spheroid formation in contrast to adherent growth on tissue culture plastic. Small differences were visualised in cancer spheroid growth between different gel stiffness across the range of cell lines. Cancer cell lines were able to be co-cultivated with HUVECs and MSC. HUVEC tube formation and cancer line spheroid formation occured after 3-4 days. Interaction was visualised between tumours and HUVECs via confocal microscopy. Slightly increased interaction was seen between cancer tumours and micro-vascular tubes when seeded as single cells compared with the pre-formed spheroid approach. Further studies intend to utilise cytokine gradients to further optimise the ECM environment of in situ tumour angiogenesis. Discussion and Conclusions Our results confirm the suitability of hydrogels constructed from starPEG-heparin for HUVECs and MSC co-cultivation with cancer cell lines to study cell-cell and cell-matrix interactions in a 3D environment. This represents a step forward in the development of 3D culture models to study the pathomechanisms of breast and prostate cancer. References 1. Tsurkan MV, Chwalek K, Prokoph S, Zieris A, Levental KR, Freudenberg U, Werner C. Advanced Materials. 25, 2606-10, 2013. Disclosures The authors declare no conflicts of interest

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The primary purpose of this paper is to overview a selection of advanced water treatment technology systems that are suited for application in towns and settlements in remote and very remote regions of Australia and vulnerable and lagging rural regions in Sri Lanka. This recognises that sanitation and water treatment are inextricably linked and both are needed to reduce risks to environment and population health from contaminated water sources. For both Australia and Sri Lanka only a small fraction of the settlements in rural and remote regions are connected to water treatment facilities and town water supplies. In Australia’s remote/very remote regions raw water is drawn from underground sources and rainwater capture. Most settlements in rural Sri Lanka rely on rivers, reservoirs, wells, springs or carted water. Furthermore, Sri Lanka has more than 25,000 hand pumped tube wells which saved the communities during recent droughts. Decentralised water supply systems offer the opportunity to provide safe drinking water to these remote/very remote and rural regions where centralised systems are not feasible due to socio-cultural, economic, political, technological reasons. These systems reduce health risks from contaminated water supplies. In remote areas centralized systems fail due to low population density and less affordability. Globally, a new generation of advanced water treatment technologies are positioned to make a major impact on the provision of safe potable water in remote/very remote regions in Australia and rural regions in Sri Lanka. Some of these systems were developed for higher income countries. However, with careful selection and further research they can be tailored to match local socio-economic conditions and technical capacity. As such, they can equally be used to provide decentralised water supply in communities in developed and developing countries such as Australia and Sri Lanka.

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Switchgrass was treated by 1% (w/w) H₂SO₄in batch tube reactors at temperatures ranging from 140–220°C for up to 60 minutes. In this study, release patterns of glucose, 5-hydroxymethylfurfural (5-HMF), and levulinic acid from switchgrass cellulose were investigated through a mechanistic kinetic model. The predictions were consistent with the measured products of interest when new parameters reflecting the effects of reaction limitations, such as cellulose crystallinity, acid soluble lignin–glucose complex (ASL–glucose) and humins that cannot be quantitatively analyzed, were included. The new mechanistic kinetic model incorporating these parameters simulated the experimental data with R² above 0.97. Results showed that glucose yield was most sensitive to variations in the parameter regarding the cellulose crystallinity at low temperatures (140–180°C), while the impact of crystallinity on the glucose yield became imperceptible at elevated temperatures (200–220 °C). Parameters related to the undesired products (e.g. ASL–glucose and humins) were the most sensitive factors compared with rate constants and other additional parameters in impacting the levulinic acid yield at elevated temperatures (200–220°C), while their impacts were negligible at 140–180°C. These new findings provide a more rational explanation for the kinetic changes in dilute acid pretreatment performance and suggest that the influences of cellulose crystallinity and undesired products including ASL–glucose and humins play key roles in determining the generation of glucose, 5-HMF and levulinic acid from biomass-derived cellulose.

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The production mechanism of OH radicals in a pulsed DC plasma jet is studied by a two-dimensional (2-D) plasma jet model and a one-dimensional (1-D) discharge model. For the plasma jet in the open air, electron-impact dissociation of H2O, electron neutralization of H2O+, as well as dissociation of H2O by O(1D) are found to be the main reactions to generate the OH species. The contribution of the dissociation of H2O by electron is more than the others. The additions of N2, O2, air, and H2O into the working gas increase the OH density outside the tube slightly, which is attributed to more electrons produced by Penning ionization. On the other hand, the additions of O2 and H2O into the working gas increase the OH density inside the tube substantially, which is attributed to the increased O (1D) and H2O concentration, respectively. The gas flow will transport high density OH out of the tube during pulse off period. It is also shown that the plasma chemistry and reactivity can be effectively controlled by the pulse numbers. These results are supported by the laser induced fluorescence measurements and are relevant to several applications of atmospheric-pressure plasmas in health care, medicine, and materials processing.

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Purpose Malnutrition is a very common problem in oncology patients and is associated with many negative consequences including poorer prognosis, quality of life and survival. However, malnutrition in oncology patients is often overlooked although there is growing evidence showing that it can be prevented or reduced through nutrition intervention. This paper aims to provide an updated review on the effectiveness of different nutrition intervention approaches on nutrition status outcomes in oncology patients. Methods Randomised controlled trials (RCTs) published between 1994 and 2014 which examined the effects of nutrition intervention approaches—in particular, nutrition counselling (NC), oral nutrition supplements (ONS) and tube feeding (TF)—on nutrition status outcomes of oncology patients were identified and reviewed. Results Thirteen papers from 11 RCTs with a total of 1077 participants were included. The intervention approaches included NC (four studies), NC + ONS (five studies), ONS (three studies) and TF (three studies). The various results suggest that NC with or without ONS was associated with consistent improvements in several nutrition status outcomes. On the other hand, ONS and TF were associated with inconsistent improvements in few aspects of nutrition status outcomes. Conclusions The referral of oncology patients for NC is recommended given the strong evidence of its beneficial effects on the prevention and reduction of malnutrition. Other forms of nutrition support including ONS and TF may then be included if deemed suitable and necessary for the individual.

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Background: Many preterm neonates display difficulty establishing suck-feeding competence in the weeks following birth. Ineffective management of transitional feeding issues may cause patient complications, and can contribute to increased length of stay. Aims: Given that many neonatal nurseries appear to vary in their neonatal feeding management practices, the aim of this study was to investigate and document the routine level of support and intervention currently provided for preterm neonates with transitional feeding issues across the various level II (special care) nurseries (SCNs) in Queensland, Australia. Methods: A questionnaire was mailed to all Queensland SCNs in 2005 (n = 36). The questionnaire contained a series of closed-choice and short-answer questions designed to obtain information from each SCN regarding their current practices for managing transitional feeding issues in preterm neonates. Results were confirmed during a follow-up phone call. Results: Responses were obtained from 29 SCNs (80.6%). None of these nurseries reported having any formal, written policies regarding the management of transitional feeding issues in preterm neonates. Wide variations were reported in relation to the suck-feeding assessments and interventions used by staff within the various SCNs. Of the 29 nurseries, 4 (13.8%) reported using checklists or assessments to judge readiness for suck-feeds, and 5 (17.2%) reported using pulse oximetry to judge tolerance of suck-feeding attempts. Eighteen SCNs (62.1%) reported offering some form of active intervention to assist neonates with transitional feeding issues, with the most common intervention techniques reported being non-nutritive sucking during tube feeds, pre-feeding oral stimulation, and actively pacing suck-feeds. Twenty-two SCNs (75.4%) reported having access to a lactation consultant to assist mothers with breastfeeding issues. Conclusions: Differences were reported in the routine management of transitional feeding issues in preterm neonates across the various SCNs in Queensland. It is suggested that evidence based guidelines need to be developed, and that, in order to do this, further research studies are required to determine current best practice, as well as to answer remaining questions. © 2008 Elsevier Ireland Ltd. All rights reserved.

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The safety, effectiveness and capabilities of therapeutic upper fibreoptic endoscopy in children undergoing therapeutic endoscopic procedures (n = 443) was studied. Therapy for gastrointestinal bleeding formed the major group (injection sclerotherapy for varices, n = 197 procedures; thermocoagulation for haemorrhagic gastritis, n = 1; and photocoaulation for Dieulafoy's disease, n = 1). Sclerotherapy was 97% effective in controlling acute bleeding and 84% effective in obliterating varices with no serious complications or deaths. Oesophageal dilatations for surgical, caustic, congenital and peptic strictures and achalasia (n = 193) were performed with no oesophageal perforations or deaths. Foreign bodies were retrieved (n = 34) with no failures or complications. Percutaneous endoscopic gastrostomy was performed (n = 11) with one failure, proceeding to an unsuccessful surgical gastrostomy. Miscellaneous procedures included endoscopic transpyloric tube placement (n = 5) and endoscopic diathermy of pyloric web (n = 1). Therapeutic fibreoptic endoscopy is therefore concluded to be safe and effective in children, replacing rigid oesophagoscopy and some traditional surgical approaches.

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The aim of this study is to investigate the blood flow pattern in carotid bifurcation with a high degree of luminal stenosis, combining in vivo magnetic resonance imaging (MRI) and computational fluid dynamics (CFD). A newly developed two-equation transitional model was employed to evaluate wall shear stress (WSS) distribution and pressure drop across the stenosis, which are closely related to plaque vulnerability. A patient with an 80% left carotid stenosis was imaged using high resolution MRI, from which a patient-specific geometry was reconstructed and flow boundary conditions were acquired for CFD simulation. A transitional model was implemented to investigate the flow velocity and WSS distribution in the patient-specific model. The peak time-averaged WSS value of approximately 73Pa was predicted by the transitional flow model, and the regions of high WSS occurred at the throat of the stenosis. High oscillatory shear index values up to 0.50 were present in a helical flow pattern from the outer wall of the internal carotid artery immediately after the throat. This study shows the potential suitability of a transitional turbulent flow model in capturing the flow phenomena in severely stenosed carotid arteries using patient-specific MRI data and provides the basis for further investigation of the links between haemodynamic variables and plaque vulnerability. It may be useful in the future for risk assessment of patients with carotid disease.