Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children

Background Guidelines and clinical practice for the prevention of complications associated with central venous catheters (CVC) around the world vary greatly. Most institutions recommend the use of heparin to prevent occlusion, however there is debate regarding the need for heparin and evidence to suggest 0.9% sodium chloride (normal saline) may be as effective. The use of heparin is not without risk, may be unnecessary and is also associated with increased cost. Objectives To assess the clinical effects (benefits and harms) of intermittent flushing of heparin versus normal saline to prevent occlusion in long term central venous catheters in infants and children. Search Methods The Cochrane Vascular Trials Search Co-ordinator searched the Specialised Register (last searched April 2015) and the Cochrane Register of Studies (Issue 3, 2015). We also searched the reference lists of retrieved trials. Selection criteria Randomised controlled trials that compared the efficacy of normal saline with heparin to prevent occlusion of long term CVCs in infants and children aged up to 18 years of age were included. We excluded temporary CVCs and peripherally inserted central catheters (PICC). Data Collection and Analysis Two review authors independently assessed trial inclusion criteria, trial quality and extracted data. Rate ratios were calculated for two outcome measures - occlusion of the CVC and central line-associated blood stream infection. Other outcome measures included duration of catheter placement, inability to withdraw blood from the catheter, use of urokinase or recombinant tissue plasminogen, incidence of removal or re-insertion of the catheter, or both, and other CVC-related complications such as dislocation of CVCs, other CVC site infections and thrombosis. Main Results Three trials with a total of 245 participants were included in this review. The three trials directly compared the use of normal saline and heparin, however, between studies, all used different protocols for the standard and experimental arms with different concentrations of heparin and different frequency of flushes reported. In addition, not all studies reported on all outcomes. The quality of the evidence ranged from low to very low because there was no blinding, heterogeneity and inconsistency between studies was high and the confidence intervals were wide. CVC occlusion was assessed in all three trials (243 participants). We were able to pool the results of two trials for the outcomes of CVC occlusion and CVC-associated blood stream infection. The estimated rate ratio for CVC occlusion per 1000 catheter days between the normal saline and heparin group was 0.75 (95% CI 0.10 to 5.51, two studies, 229 participants, very low quality evidence). The estimated rate ratio for CVC-associated blood stream infection was 1.48 (95% CI 0.24 to 9.37, two studies, 231 participants; low quality evidence). The duration of catheter placement was reported to be similar between the two study arms, in one study (203 participants). Authors' Conclusions The review found that there was not enough evidence to determine the effects of intermittent flushing of heparin versus normal saline to prevent occlusion in long term central venous catheters in infants and children. Ultimately, if this evidence were available, the development of evidenced-based clinical practice guidelines and consistency of practice would be facilitated.

Climate response to physiological forcing of carbon dioxide simulated by the coupled Community Atmosphere Model (CAM3.1) and Community Land Model (CLM3.0)

Increasing concentrations of atmospheric CO2 decrease stomatal conductance of plants and thus suppress canopy transpiration. The climate response to this CO2-physiological forcing is investigated using the Community Atmosphere Model version 3.1 coupled to Community Land Model version 3.0. In response to the physiological effect of doubling CO2, simulations show a decrease in canopy transpiration of 8%, a mean warming of 0.1K over the land surface, and negligible changes in the hydrological cycle. These climate responses are much smaller than what were found in previous modeling studies. This is largely a result of unrealistic partitioning of evapotranspiration in our model control simulation with a greatly underestimated contribution from canopy transpiration and overestimated contributions from canopy and soil evaporation. This study highlights the importance of a realistic simulation of the hydrological cycle, especially the individual components of evapotranspiration, in reducing the uncertainty in our estimation of climatic response to CO2-physiological forcing. Citation: Cao, L., G. Bala, K. Caldeira, R. Nemani, and G.Ban-Weiss (2009), Climate response to physiological forcing of carbon dioxide simulated by the coupled Community Atmosphere Model (CAM3.1) and Community Land Model (CLM3.0).

Bearing capacity factor N-c under phi=0 condition for piles in clays

Bearing capacity factor N-c for axially loaded piles in clays whose cohesion increases linearly with depth has been estimated numerically under undrained (phi=0) condition. The Study follows the lower bound limit analysis in conjunction With finite elements and linear programming. A new formulation is proposed for solving an axisymmetric geotechnical stability problem. The variation of N-c with embedment ratio is obtained for several rates of the increase of soil cohesion with depth; a special case is also examined when the pile base was placed on the stiff clay stratum overlaid by a soft clay layer. It was noticed that the magnitude of N-c reaches almost a constant value for embedment ratio greater than unity. The roughness of the pile base and shaft affects marginally the magnitudes of N-c. The results obtained from the present study are found to compare quite well with the different numerical solutions reported in the literature.

Cr3+ electron paramagnetic resonance study of Sn(1-x)CrxO(2) (0.00 <= x <= 0.10)

This paper reports on the liquid-helium-temperature (5 K) electron paramagnetic resonance (EPR) spectra of Cr3+ ions in the nanoparticles of SnO2 synthesized at 600 degrees C with concentrations of 0%, 0.1%, 0.5%, 1%, 1.5%, 2.0%, 2.5%, 3.0%, 5.0%, and 10%. Each spectrum may be simulated as overlap of spectra due to four magnetically inequivalent Cr3+ centers characterized by different values of the spin-Hamiltonian parameters. Three of these centers belong to Cr3+ ions in orthorhombic sites, situated near oxygen vacancies, characterized by very large zero-field splitting parameters D and E, presumably due to the presence of nanoparticles in the samples. The fourth EPR spectrum belongs to the Cr3+ ions situated at sites with tetragonal symmetry, substituting for the Sn4+ ion, characterized by a very small value of D. In addition, there appears a ferromagnetic resonance line due to oxygen defects for samples with Cr3+ concentrations of <= 2.5%. Further, in samples with Cr3+ concentrations of >2.5%, there appears an intense and wide EPR line due to the interactions among the Cr3+ ions in the clusters formed due to rather excessive doping; the intensity and width of this line increase with increasing concentration. The Cr3+ EPR spectra observed in these nanopowders very different from those in bulk SnO2 crystals.

Kuva tikkeinä kankaalla : Kokemuksia PE-design 6.0 -kirjontakuvion suunnitteluohjelman kahden automaattisen tekniikan käytettävyydestä

The aim of the thesis was to compare the correspondence of the outcome a computer assisted program appearance compared to the original image. The aspect of the study was directed to embroidery with household machines. The study was made from the usability point of view with Brother's PE-design 6.0 embroidery design programs two automatic techniques; multicoloured fragment design and multicoloured stitch surface design. The study's subject is very current because of the fast development of machine embroidery. The theory is based on history of household sewing machines, embroidery sewing machines, stitch types in household sewing machines, embroidery design programs as well as PE-design 6.0 embroidery design program's six automatic techniques. Additionally designing of embroidery designs were included: original image, digitizing, punching, applicable sewing threads as well as the connection between embroidery designs and materials used on embroidery. Correspondences of sewn appearances were examined with sewing experimental methods. 18 research samples of five original image were sewn with both techniques. Experiments were divided into four testing stages in design program. Every testing stage was followed by experimental sewing with Brother Super Galaxie 3100D embroidery machine. Experiments were reported into process files and forms made for the techniques. Research samples were analysed on images syntactic bases with sensory perception assessment. Original images and correspondence of the embroidery appearances were analysed with a form made of it. The form was divided into colour and shape assessment in five stage-similarity-scale. Based on this correspondence analysis it can be said that with both automatic techniques the best correspondence of colour and shape was achieved by changing the standard settings and using the makers own thread chart and edited original image. According to the testing made it is impossible to inform where the image editing possibilities of the images are sufficient or does the optimum correspondence need a separate program. When aiming at correspondence between appearances of two images the computer is unable to trace by itself the appearance of the original image. Processing a computer program assisted embroidery image human perception and personal decision making are unavoidable.

Oxygen desorption from high Tc YBa2Cu3O7−δ (δ = 0.05, 0.5)

From a temperature programmed desorption study employing a quadrupole mass spectrometer, the superconducting oxide YBa2Cu3O7−δ (δ = 0.05) showed two distinct oxygen desorption peaks, one below and one above 470°C. The activation energy of oxygen desorption of the superconducting oxide was 28 Kcals/mole and that of non-superconducting oxide (YBa2Cu3O6.5) was 54 Kcals/mole. No impurity peaks due to H2O, CO and CO2 from the bulk or adsorbed on surfaces could be observed when a well prepared superconducting oxide was heated up to 650°C.

Ce1-xRuxO2-delta (x=0.05, 0.10): A New High Oxygen Storage Material and Pt, Pd-Free Three-Way Catalyst

Nanocrystalline Ce1-xRuxO2-delta (x = 0.05 and 0.10) of 8-10 nm sizes have been synthesized by hydrothermal method using melamine as complexing agent. Compounds have been characterized by powder X-ray diffraction (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), and energy-dispersive X-ray analysis (EDX) and their structures have been refined by the Rietveld method.The compounds crystallize in fluorite structure and the composition is Ce1-xRuxO2-x/2 where Ru is in +4 state and Ce is in mixed-valence (+3, +4) state. Substitution of Ru4+ ion in CeO2 activated the lattice oxygen. Ce1-xRuxO2-x/2 reversibly releases 0.22[O] and 0.42[O] for x = 0.05 and 0.10, respectively, which is higher than the maximumpossible OSC of 0.22 [O] observed for Ce0.50Zr0.50O2. Utilization of Higher OSC of Ce1-xRuxO2-delta (x = 0.05 and 0.10) is also reflected in terms of low-temperature CO oxidation with these catalysts, both in the presence and absence of feed oxygen. The Ru4+ ion acts as an active center for reducing molecules (CO, hydrocarbon ``HC'') and oxide ion vacancy acts as an active center for O-2 and NO, leading to low-temperature NO conversion to N-2. Thus due to Ru4+ ion, Ce1-xRuxO2-delta is not just a high oxygen storage material but also shows high activity toward CO, hydrocarbon ``HC'' oxidation, and NO reduction by CO at low temperature with high N-2 selectivity for three-way catalysis.

BSDD-2.0: Biomolecules Segment Display Device - An updated web accessible computing resource

The existing internet computing resource, Biomolecules Segment Display Device (BSDD), has been updated with several additional useful features. An advanced option is provided to superpose the structural motifs obtained from a search on the Protein Data Bank (PDB) in order to see if the three-dimensional structures adopted by identical or similar sequence motifs are the same. Furthermore, the options to display structural aspects like inter- and intra-molecular interactions, ion-pairs, disulphide bonds, etc. have been provided.The updated resource is interfaced with an up-to-date copy of the public domain PDB as well as 25 and 90% non-redundant protein structures. Further, users can upload the three-dimensional atomic coordinates (PDB format) from the client machine. A free molecular graphics program, JMol, is interfaced with it to display the three-dimensional structures.

Valence states and magnetic properties of LaNi1-xMnxO3 (for 0≤x≤0.2 and x=0.5)

Single-phase LaNi1-xMnxO3 samples in the compositional range 00.05, but any motional enthalpy appears to remain small ( Delta Hm approximately=0). The x=0.1 sample exhibits ferrimagnetic spin glass behaviour below 40K, and the ferromagnetic interactions increase with manganese concentration. The oxide with x=0.50 is ferromagnetic with a well defined Curie temperature.

Crystallization Kinetics and Electrical Relaxation of BaO-0.5Li(2)O-4.5B(2)O(3) Glasses

Transparent glasses in the composition BaO-0.5Li(2)O-4.5B(2)O(3) (BLBO) were fabricated via the conventional melt-quenching technique. X-ray powder diffraction combined with differential scanning calorimetric (DSC) studies carried out on the as-quenched samples confirmed their amorphous and glassy nature, respectively. The crystallization behavior of these glasses has been studied by isothermal and nonisothermal methods using DSC. Crystallization kinetic parameters were evaluated from the Johnson-Mehl-Avrami equation. The value of the Avrami exponent (n) was found to be 3.6 +/- 0.1, suggesting that the process involves three-dimensional bulk crystallization. The average value of activation energy associated with the crystallization of BLBO glasses was 317 +/- 10 kJ/mol. Transparent glass-ceramics were fabricated by controlled heat-treatment of the as-quenched glasses at 845 K/40 min. The dielectric constants for BLBO glasses and glass-ceramics in the 100 Hz-10 MHz frequency range were measured as a function of the temperature (300-925 K). The electrical relaxation and dc conductivity characteristics were rationalized using electric modulus formalism. The imaginary part of the electric modulus spectra was modeled using an approximate solution of the Kohlrausch-Williams-Watts relation. The temperature-dependent behavior of stretched exponent (beta) was discussed for the as-quenched and heat-treated BLBO glasses.

LPG Gas-Sensing System With SnO2 Thin-Film Transducer and 0.7-mu m CMOS Signal Conditioning ASIC

The design and implementation of a complete gas sensor system for liquified petroleum gas (LPG) gas sensing are presented. The system consists of a SnO2 transducer, a lowcost heater, an application specific integrated circuit (ASIC) with front-end interface circuitry, and a microcontroller interface for data logging. The ASIC includes a relaxation-oscillator-based heater driver circuit that is capable of controlling the sensor operating temperature from 100degC to 425degC. The sensor readout circuit in the ASIC, which is based on the resistance to time conversion technique, has been designed to measure the gas sensor response over three orders of resistance change during its interaction with gases.

Isotope shifts and hyperfine structure in the 555.8-nm S-1(0) -> P-3(1) line of Yb

We apply our technique of using a Rb-stabilized ring-cavity resonator to measure the frequencies of various spectral components in the 555.8-nm 1S0-->3P1 line of Yb. We determine the isotope shifts with 60 kHz precision, which is an order-of-magnitude improvement over the best previous measurement on this line. There are two overlapping transitions, 171Yb(1/2-->3/2) and 173Yb(5/2-->3/2), which we resolve by applying a magnetic field. We thus obtain the hyperfine constants in the 3P1 state of the odd isotopes with a significantly improved precision. Knowledge of isotope shifts and hyperfine structure should prove useful for high-precision calculations in Yb necessary to interpret ongoing experiments testing parity and time-reversal symmetry violation in the laws of physics.