PEEP-ZEEP technique: cardiorespiratory repercussions in mechanically ventilated patients submitted to a coronary artery bypass graft surgery

Abstract Background The PEEP-ZEEP technique is previously described as a lung inflation through a positive pressure enhancement at the end of expiration (PEEP), followed by rapid lung deflation with an abrupt reduction in the PEEP to 0 cmH2O (ZEEP), associated to a manual bilateral thoracic compression. Aim To analyze PEEP-ZEEP technique's repercussions on the cardio-respiratory system in immediate postoperative artery graft bypass patients. Methods 15 patients submitted to a coronary artery bypass graft surgery (CABG) were enrolled prospectively, before, 10 minutes and 30 minutes after the technique. Patients were curarized, intubated, and mechanically ventilated. To perform PEEP-ZEEP technique, saline solution was instilled into their orotracheal tube than the patient was reconnected to the ventilator. Afterwards, the PEEP was increased to 15 cmH2O throughout 5 ventilatory cycles and than the PEEP was rapidly reduced to 0 cmH2O along with manual bilateral thoracic compression. At the end of the procedure, tracheal suction was accomplished. Results The inspiratory peak and plateau pressures increased during the procedure (p < 0.001) compared with other pressures during the assessment periods; however, they were within lung safe limits. The expiratory flow before the procedure were 33 ± 7.87 L/min, increasing significantly during the procedure to 60 ± 6.54 L/min (p < 0.001), diminishing to 35 ± 8.17 L/min at 10 minutes and to 36 ± 8.48 L/min at 30 minutes. Hemodynamic and oxygenation variables were not altered. Conclusion The PEEP-ZEEP technique seems to be safe, without alterations on hemodynamic variables, produces elevated expiratory flow and seems to be an alternative technique for the removal of bronchial secretions in patients submitted to a CABG.

Previous exposure to musical auditory stimulation immediately influences the cardiac autonomic responses to the postural change maneuver in women

Background Chronic exposure to musical auditory stimulation has been reported to improve cardiac autonomic regulation. However, it is not clear if music acutely influences it in response to autonomic tests. We evaluated the acute effects of music on heart rate variability (HRV) responses to the postural change maneuver (PCM) in women. Method We evaluated 12 healthy women between 18 and 28 years old and HRV was analyzed in the time (SDNN, RMSSD, NN50 and pNN50) and frequency (LF, HF and LF/HF ratio) domains. In the control protocol, the women remained at seated rest for 10 minutes and quickly stood up within three seconds and remained standing still for 15 minutes. In the music protocol, the women remained at seated rest for 10 minutes, were exposed to music for 10 minutes and quickly stood up within three seconds and remained standing still for 15 minutes. HRV was recorded at the following time: rest, music (music protocol) 0–5, 5–10 and 10–15 min during standing. Results In the control protocol the SDNN, RMSSD and pNN50 indexes were reduced at 10–15 minutes after the volunteers stood up, while the LF (nu) index was increased at the same moment compared to seated rest. In the protocol with music, the indexes were not different from control but the RMSSD, pNN50 and LF (nu) were different from the music period. Conclusion Musical auditory stimulation attenuates the cardiac autonomic responses to the PCM.

Experimental investigation into the effect of stress on dissolution and growth of very soluble brittle salts in aqueous solution

Das Studium der Auflösungs- und Wachstumsprozesse an Feststoff-Flüssigkeits-Grenzflächen unter nicht-hydrostatischen Beanspruchungen ist wesentlich für das Verständnis von Defor-mationsprozessen, die in der Erde ablaufen. Unter diesen genannten Prozessen gehört die Drucklösung zu den wichtigsten duktilen Deformationsprozessen, von der Diagenese bishin zur niedrig- bis mittelgradigen metamorphen Bedingungen. Bisher ist allerdings wenig darüber bekannt, welche mechanischen, physikalischen oder chemischen Potentialenergie-Gradienten die Drucklösung steuern. I.a. wird angenommen, daß die Drucklösung durch Un-terschiede kristallplastischer Verformungsenergien oder aber durch Unterschiede der Normal-beanspruchung an Korngrenzen gesteuert wird. Unterschiede der elastischen Verformungs-energien werden dabei allerdings als zu gering erachtet, um einen signifikanten Beitrag zu leisten. Aus diesem Grund werden sie als mögliche treibende Kräfte für die Drucklösung vernachlässigt. Andererseits haben neue experimentelle und theoretische Untersuchungen gezeigt, daß die elastische Verformung in der Tat einen starken Einfluß auf Lösungs- und Wachstumsmechanismen von Kristallen in einer Lösung haben kann. Da die in der Erdkruste vorherrschenden Deformationsmechanismen überwiegend im elastischen Verformungsbereich der Gesteine ablaufen, ist es sehr wichtig, das Verständnis für die Effekte, die die elastische Verformung verursacht, zu erweitern, und ihre Rolle während der Deformation durch Drucklösung zu definieren. Die vorliegende Arbeit beschäftigt sich mit Experimenten, bei denen der Effekt der mechanisch kompressiven Beanspruchung auf Lösungs- und Wachstumsprozesse von Einzelkristallen unterschiedlicher, sehr gut löslicher, elastisch/spröder Salze untersucht wurde. Diese Salze wurden als Analoga gesteinsbildender Minerale wie Quarz und Calcit ausgewählt. Der Einfluß von Stress auf die Ausbildung der Oberflächenmikrostrukturen in einer untersättigten Lösung wurde an Kaliumalaun untersucht.Lösungsrillen (20 – 40 µm breit, 10 – 40 µm tief und 20 – 80 µm Abstand) entwickelten sich in den Bereichen, in denen die Beanspruchung im Kristall am größten war. Sie verschwanden wieder, sobald der Kristall entlastet wurde. Diese Rillen entwickelten sich parallel zu niedrig indizierten kristallographischen Richtungen und sub-perpendikular zu den Trajektorien, die der maximalen, lokalen kompressiven Beanspruchung entsprachen. Die Größe der Lösungsrillen hing von der lokalen Oberflächenbeanspruchung, der Oberflächenenergie und dem Untersättigungsgrad der wässrigen Lösung ab. Die mikrostrukturelle Entwicklung der Kristalloberflächen stimmte gut mit den theoretischen Vorhersagen überein, die auf den Modellen von Heidug & Leroy (1994) und Leroy & Heidug (1994) basieren. Der Einfluß der Beanspruchung auf die Auflösungsrate wurde an Natriumchlorat-Einzelkristallen untersucht. Dabei wurde herausgefunden, daß sich gestresste Kristalle schneller lösen als Kristalle, auf die keine Beanspruchung einwirkt. Der experimentell beobachtete Anstieg der Auflösungsrate der gestressten Kristalle war ein bis zwei Größenordnungen höher als theoretisch erwartet. Die Auflösungsrate stieg linear mit dem Stress an, und der Anstieg war um so größer, je stärker die Lösung untersättigt war. Außerdem wurde der Effekt der Bean-spruchung auf das Kristallwachstum an Kaliumalaun- und Kaliumdihydrogenphosphat-Ein-zelkristallen untersucht. Die Wachstumsrate der Flächen {100} und {110} von Kalium-alaun war bei Beanspruchung stark reduziert. Für all diese Ergebnisse spielte die Oberflächenrauhigkeit der Kristalle eine Schlüsselrolle, indem sie eine nicht-homogene Stressverteilung auf der Kristalloberfläche verursachte. Die Resultate zeigen, daß die elastische Verformung eine signifikante Rolle während der Drucklösung spielen kann, und eine signifikante Deformation in der oberen Kruste verursachen kann, bei Beanspruchungen, die geringer sind, als gemeinhin angenommen wird. Somit folgt, daß die elastische Bean-spruchung berücksichtigt werden muß, wenn mikrophysikalische Deformationsmodelle entwickelt werden sollen.

Sistemi liquido cristallini complessi: simulazioni al calcolatore e studi ESR

The aim of this PhD thesis was to study at a microscopic level different liquid crystal (LC) systems, in order to determine their physical properties, resorting to two distinct methodologies, one involving computer simulations, and the other spectroscopic techniques, in particular electron spin resonance (ESR) spectroscopy. By means of the computer simulation approach we tried to demonstrate this tool effectiveness for calculating anisotropic static properties of a LC material, as well as for predicting its behaviour and features. This required the development and adoption of suitable molecular models based on a convenient intermolecular potentials reflecting the essential molecular features of the investigated system. In particular, concerning the simulation approach, we have set up models for discotic liquid crystal dimers and we have studied, by means of Monte Carlo simulations, their phase behaviour and self­-assembling properties, with respect to the simple monomer case. Each discotic dimer is described by two oblate Gay­Berne ellipsoids connected by a flexible spacer, modelled by a harmonic "spring" of three different lengths. In particular we investigated the effects of dimerization on the transition temperatures, as well as on the characteristics of molecular aggregation displayed and the relative orientational order. Moving to the experimental results, among the many experimental techniques that are typically employed to evaluate LC system distinctive features, ESR has proved to be a powerful tool in microscopic scale investigation of the properties, structure, order and dynamics of these materials. We have taken advantage of the high sensitivity of the ESR spin probe technique to investigate increasingly complex LC systems ranging from devices constituted by a polymer matrix in which LC molecules are confined in shape of nano- droplets, as well as biaxial liquid crystalline elastomers, and dimers whose monomeric units or lateral groups are constituted by rod-like mesogens (11BCB). Reflection-mode holographic-polymer dispersed liquid crystals (H-PDLCs) are devices in which LCs are confined into nanosized (50­-300 nm) droplets, arranged in layers which alternate with polymer layers, forming a diffraction grating. We have determined the configuration of the LC local director and we have derived a model of the nanodroplet organization inside the layers. Resorting also to additional information on the nanodroplet size and shape distribution provided by SEM images of the H-PDLC cross-section, the observed director configuration has been modeled as a bidimensional distribution of elongated nanodroplets whose long axis is, on the average, parallel to the layers and whose internal director configuration is a uniaxial quasi- monodomain aligned along the nanodroplet long axis. The results suggest that the molecular organization is dictated mainly by the confinement, explaining, at least in part, the need for switching voltages significantly higher and the observed faster turn-off times in H-PDLCs compared to standard PDLC devices. Liquid crystal elastomers consist in cross-linked polymers, in which mesogens represent the monomers constituting the main chain or the laterally attached side groups. They bring together three important aspects: orientational order in amorphous soft materials, responsive molecular shape and quenched topological constraints. In biaxial nematic liquid crystalline elastomers (BLCEs), two orthogonal directions, rather than the one of normal uniaxial nematic, can be controlled, greatly enhancing their potential value for applications as novel actuators. Two versions of a side-chain BLCEs were characterized: side­-on and end­-on. Many tests have been carried out on both types of LCE, the main features detected being the lack of a significant dynamical behaviour, together with a strong permanent alignment along the principal director, and the confirmation of the transition temperatures already determined by DSC measurements. The end­-on sample demonstrates a less hindered rotation of the side group mesogenic units and a greater freedom of alignment to the magnetic field, as already shown by previous NMR studies. Biaxial nematic ESR static spectra were also obtained on the basis of Molecular Dynamics generated biaxial configurations, to be compared to the experimentally determined ones, as a mean to establish a possible relation between biaxiality and the spectral features. This provides a concrete example of the advantages of combining the computer simulation and spectroscopic approaches. Finally, the dimer α,ω-bis(4'-cyanobiphenyl-4-yl)undecane (11BCB), synthesized in the "quest" for the biaxial nematic phase has been analysed. Its importance lies in the dimer significance as building blocks in the development of new materials to be employed in innovative technological applications, such as faster switching displays, resorting to the easier aligning ability of the secondary director in biaxial phases. A preliminary series of tests were performed revealing the population of mesogenic molecules as divided into two groups: one of elongated straightened conformers sharing a common director, and one of bent molecules, which display no order, being equally distributed in the three dimensions. Employing this model, the calculated values show a consistent trend, confirming at the same time the transition temperatures indicated by the DSC measurements, together with rotational diffusion tensor values that follow closely those of the constituting monomer 5CB.

Comparative genomic sequencing analysis of a region in human chromosome 11p15.3, mouse chromosome 7 and analysis of the novel STK33, Stk33 gene

The comparative genomic sequence analysis of a region in human chromosome 11p15.3 and its homologous segment in mouse chromosome 7 between ST5 and LMO1 genes has been performed. 158,201 bases were sequenced in the mouse and compared with the syntenic region in human, partially available in the public databases. The analysed region exhibits the typical eukaryotic genomic structure and compared with the close neighbouring regions, strikingly reflexes the mosaic pattern distribution of (G+C) and repeats content despites its relative short size. Within this region the novel gene STK33 was discovered (Stk33 in the mouse), that codes for a serine/threonine kinase. The finding of this gene constitutes an excellent example of the strength of the comparative sequencing approach. Poor gene-predictions in the mouse genomic sequence were corrected and improved by the comparison with the unordered data from the human genomic sequence publicly available. Phylogenetical analysis suggests that STK33 belongs to the calcium/calmodulin-dependent protein kinases group and seems to be a novelty in the chordate lineage. The gene, as a whole, seems to evolve under purifying selection whereas some regions appear to be under strong positive selection. Both human and mouse versions of serine/threonine kinase 33, consists of seventeen exons highly conserved in the coding regions, particularly in those coding for the core protein kinase domain. Also the exon/intron structure in the coding regions of the gene is conserved between human and mouse. The existence and functionality of the gene is supported by the presence of entries in the EST databases and was in vivo fully confirmed by isolating specific transcripts from human uterus total RNA and from several mouse tissues. Strong evidence for alternative splicing was found, which may result in tissue-specific starting points of transcription and in some extent, different protein N-termini. RT-PCR and hybridisation experiments suggest that STK33/Stk33 is differentially expressed in a few tissues and in relative low levels. STK33 has been shown to be reproducibly down-regulated in tumor tissues, particularly in ovarian tumors. RNA in-situ hybridisation experiments using mouse Stk33-specific probes showed expression in dividing cells from lung and germinal epithelium and possibly also in macrophages from kidney and lungs. Preliminary experimentation with antibodies designed in this work, performed in parallel to the preparation of this manuscript, seems to confirm this expression pattern. The fact that the chromosomal region 11p15 in which STK33 is located may be associated with several human diseases including tumor development, suggest further investigation is necessary to establish the role of STK33 in human health.

Weiterentwicklung einer Produktionsanlage und der Speicherungs- bzw. Transportkonzepte für hochpolarisiertes 3He

Der Bedarf an hyperpolarisiertem 3He in Medizin und physikalischer Grundlagenforschung ist in den letzten ca. 10-15 Jahren sowohl in Bezug auf die zu Verfügung stehende Menge, als auch auf den benötigten Grad der Kernspinpolarisation stetig gestiegen. Gleichzeitig mußten Lösungen für die polarisationserhaltende Speicherung und den Transport gefunden werden, die je nach Anwendung anzupassen waren. Als Ergebnis kann mit dieser Arbeit ein in sich geschlossenes Gesamtkonzept vorgestellt werden, daß sowohl die entsprechenden Mengen für klinische Anwendungen, als auch höchste Polarisation für physikalische Grundlagenfor-schung zur Verfügung stellen kann. Verschiedene unabhängige Polarimetriemethoden zeigten in sich konsistente Ergebnisse und konnten, neben ihrer eigenen Weiterentwicklung, zu einer verläßlichen Charakterisierung des neuen Systems und auch der Transportzellen und –boxen eingesetzt werden. Die Polarisation wird mittels „Metastabilem Optischen Pumpen“ bei einem Druck von 1 mbar erzeugt. Dabei werden ohne Gasfluß Werte von P = 84% erreicht. Im Flußbetrieb sinkt die erreichbare Polarisation auf P ≈ 77%. Das 3He kann dann weitgehend ohne Polarisationsver-luste auf mehrere bar komprimiert und zu den jeweiligen Experimenten transportiert werden. Durch konsequente Weiterentwicklung der vorgestellten Polarisationseinheit an fast allen Komponenten kann somit jetzt bei einem Fluß von 0,8 barl/h eine Polarisation von Pmax = 77% am Auslaß der Apparatur erreicht werden. Diese skaliert linear mit dem Fluß, sodaß bei 3 barl/h die Polarisation immer noch bei ca. 60% liegt. Dabei waren die im Rahmen dieser Arbeit durchgeführten Verbesserungen an den Lasern, der Optik, der Kompressionseinheit, dem Zwischenspeicher und der Gasreinigung wesentlich für das Erreichen dieser Polarisatio-nen. Neben dem Einsatz eines neuen Faserlasersystems ist die hohe Gasreinheit und die lang-lebige Kompressionseinheit ein Schlüssel für diese Leistungsfähigkeit. Seit Herbst 2001 er-zeugte das System bereits über 2000 barl hochpolarisiertes 3He und ermöglichte damit zahl-reiche interdisziplinäre Experimente und Untersuchungen. Durch Verbesserungen an als Prototypen bereits vorhandenen Transportboxen und durch weitgehende Unterdrückung der Wandrelaxation in den Transportgefäßen aufgrund neuer Erkenntnisse über deren Ursachen stellen auch polarisationserhaltende Transporte über große Strecken kein Problem mehr dar. In unbeschichteten 1 Liter Kolben aus Aluminosilikatglä-sern werden nun problemlos Speicherzeiten von T1 > 200h erreicht. Im Rahmen des europäi-schen Forschungsprojektes „Polarized Helium to Image the Lung“ wurden während 19 Liefe-rungen 70barl 3He nach Sheffield (UK) und bei 13 Transporten 100 barl nach Kopenhagen (DK) per Flugzeug transportiert. Zusammenfassend konnte gezeigt werden, daß die Problematik der Kernspinpolarisationser-zeugung von 3He, die Speicherung, der Transport und die Verwendung des polarisierten Ga-ses in klinischer Diagnostik und physikalischen Grundlagenexperimenten weitgehend gelöst ist und das Gesamtkonzept die Voraussetzungen für allgemeine Anwendungen auf diesen Gebieten geschaffen hat.

History of Restoration in Iran: Origins and Developments from 1900 to 1978

This thesis tends to study the origins and developments of the restoration in Iran from its very first moments till the Islamic revolution of 1978. The thesis is its first study of its kind. While almost all recent occidental ideologies regarding the thematic of restoration and conservation of historic monuments are translated and published in Iran, very little efforts have been done regarding the study of the origins of the formation of restoration in the country. The diversity of Iranian contexts, multiplicity of the intervening factors and other factors characterized a different background for the raise and developments of restoration in the country; in the thesis the influencing and characterizing factors in the formation and development of restoration in Iran will be defined and studied in detail with relative examples; due to the complexity of the Iranian context and in order to consider all influencing and characterizing factors the thesis, parallel to have formation and development of restoration, as the main scope of the research, the developments influencing factors will be confronted with necessary flashbacks to the main theme, when and where necessary. A great care will be given to the period of the activity of the restoration experts of IsMEO which is thesis will be called as the period of the introduction of the modern principles of restoration into Iranian context; the fundamental ideologies, practical and theoretical principles of IsMEO will be identified and studied in details; important case of studies of the restoration of IsMEO will be analyzed in details and the innovative aspect of the presence of Italian experts of IsMEO will be revealed.

The scintillating fiber focal plane detector for the use of Kaos as a double arm spectrometer

The upgrade of the Mainz Mikrotron (MAMI) electron accelerator facility in 2007 which raised the beam energy up to 1.5,GeV, gives the opportunity to study strangeness production channels through electromagnetic process. The Kaon Spectrometer (KAOS) managed by the A1 Collaboration, enables the efficient detection of the kaons associated with strangeness electroproduction. Used as a single arm spectrometer, it can be combined with the existing high-resolution spectrometers for exclusive measurements in the kinematic domain accessible to them.rnrnFor studying hypernuclear production in the ^A Z(e,e'K^+) _Lambda ^A(Z-1) reaction, the detection of electrons at very forward angles is needed. Therefore, the use of KAOS as a double-arm spectrometer for detection of kaons and the electrons at the same time is mandatory. Thus, the electron arm should be provided with a new detector package, with high counting rate capability and high granularity for a good spatial resolution. To this end, a new state-of-the-art scintillating fiber hodoscope has been developed as an electron detector.rnrnThe hodoscope is made of two planes with a total of 18432 scintillating double-clad fibers of 0.83 mm diameter. Each plane is formed by 72 modules. Each module is formed from a 60deg slanted multi-layer bundle, where 4 fibers of a tilted column are connected to a common read out. The read-out is made with 32 channels of linear array multianode photomultipliers. Signal processing makes use of newly developed double-threshold discriminators. The discriminated signal is sent in parallel to dead-time free time-to-digital modules and to logic modules for triggering purposes.rnrnTwo fiber modules were tested with a carbon beam at GSI, showing a time resolution of 220 ps (FWHM) and a position residual of 270 microm m (FWHM) with a detection efficiency epsilon>99%.rnrnThe characterization of the spectrometer arm has been achieved through simulations calculating the transfer matrix of track parameters from the fiber detector focal plane to the primary vertex. This transfer matrix has been calculated to first order using beam transport optics and has been checked by quasielastic scattering off a carbon target, where the full kinematics is determined by measuring the recoil proton momentum. The reconstruction accuracy for the emission parameters at the quasielastic vertex was found to be on the order of 0.3 % in first test realized.rnrnThe design, construction process, commissioning, testing and characterization of the fiber hodoscope are presented in this work which has been developed at the Institut für Kernphysik of the Johannes Gutenberg - Universität Mainz.

Patients with mild traumatic brain injury: immediate and long-term outcome compared to intra-cranial injuries on CT scan

BACKGROUND: Mild traumatic brain injury (MTBI) defined as Glasgow Coma Scale (GCS) 14 or 15 has shown contradictory short- and long-term outcomes. The objective of this study was to correlate intra-cranial injuries (ICI) on CT scan to neurocognitive tests at admission and to complaints after 1 year. METHODS: Two hundred and five patients with MTBI underwent a CT scan and were examined with neurocognitive tests. After 1 year complaints were assessed by phone interviews. RESULTS: The neurocognitive tests in 51% of the patients showed significant deficits; there was no difference for patients with GCS 14-15, nor was there a difference between patients with ICI to patients without. After 1 year patients with ICI had significantly more complaints than patients without ICI, the most frequent complaint was headache and memory deficits. CONCLUSIONS: No correlation was found between GCS or ICI and the neurocognitive tests upon admission. After 1 year, patients with ICI have significantly more complaints than patients without ICI. No cost savings resulted by doing immediate CT scan on all.

Histopathological alterations, EROD activity, CYP1A protein and biliary metabolites in gilthead seabream Sparus aurata exposed to benzo(a)pyrene

This study compared for seabream, Sparus aurata exposed to benzo(a)pyrene-B(a)P-, the response of molecular cytochrome P450 1A (CYP1A) and cellular histopathology biomarkers. Male gilthead seabream, Sparus aurata specimens were exposed for 20 days via water to a series of high B(a)P concentrations. CYP1A was assessed by measuring enzymatic activity (EROD) and CYP1A protein content, and cellular responses were evaluated by routine histopathological methods. In addition, biliary metabolites were measured in order to verify that B(a)P was absorbed and metabolised. Histological lesions, both in liver and gills, increased in parallel to B(a)P concentrations, with the majority of changes representing rather non-specific alterations. Hepatic EROD and CYP1A proteins data showed a concentration-dependent induction, while in the gills, EROD activity but not CYP1A proteins showed a non-monotonous dose response, with a maximum induction level at 200 microg B(a)P.L-1 and decreasing levels thereafter. The findings provide evidence that short-term, high dose exposure of fish can result in significant uptake and metabolism of the lipophilic B(a)P, and in pronounced pathological damage of absorptive epithelia and internal organs.

Radiological anatomy of the obturator nerve and its articular branches: basis to develop a method of radiofrequency denervation for hip joint pain

OBJECTIVE: A previous study of radiofrequency neurotomy of the articular branches of the obturator nerve for hip joint pain produced modest results. Based on an anatomical and radiological study, we sought to define a potentially more effective radiofrequency method. DESIGN: Ten cadavers were studied, four of them bilaterally. The obturator nerve and its articular branches were marked by wires. Their radiological relationship to the bone structures on fluoroscopy was imaged and analyzed. A magnetic resonance imaging (MRI) study was undertaken on 20 patients to determine the structures that would be encountered by the radiofrequency electrode during different possible percutaneous approaches. RESULTS: The articular branches of the obturator nerve vary in location over a wide area. The previously described method of denervating the hip joint did not take this variation into account. Moreover, it approached the nerves perpendicularly. Because optimal coagulation requires electrodes to lie parallel to the nerves, a perpendicular approach probably produced only a minimal lesion. In addition, MRI demonstrated that a perpendicular approach is likely to puncture femoral vessels. Vessel puncture can be avoided if an oblique pass is used. Such an approach minimizes the angle between the target nerves and the electrode, and increases the likelihood of the nerve being captured by the lesion made. Multiple lesions need to be made in order to accommodate the variability in location of the articular nerves. CONCLUSIONS: The method that we described has the potential to produce complete and reliable nerve coagulation. Moreover, it minimizes the risk of penetrating the great vessels. The efficacy of this approach should be tested in clinical trials.

Performance of vertebral cancellous bone augmented with compliant PMMA under dynamic loads

Increased fracture risk has been reported for the adjacent vertebral bodies after vertebroplasty. This increase has been partly attributed to the high Young's modulus of commonly used polymethylmethacrylate (PMMA). Therefore, a compliant bone cement of PMMA with a bulk modulus closer to the apparent modulus of cancellous bone has been produced. This compliant bone cement was achieved by introducing pores in the cement. Due to the reduced failure strength of that porous PMMA cement, cancellous bone augmented with such cement could deteriorate under dynamic loading. The aim of the present study was to assess the potential of acute failure, particle generation and mechanical properties of cancellous bone augmented with this compliant cement in comparison to regular cement. For this purpose, vertebral biopsies were augmented with porous- and regular PMMA bone cement, submitted to dynamic tests and compression to failure. Changes in Young's modulus and height due to dynamic loading were determined. Afterwards, yield strength and Young's modulus were determined by compressive tests to failure and compared to the individual composite materials. No failure occurred and no particle generation could be observed during dynamical testing for both groups. Height loss was significantly higher for the porous cement composite (0.53+/-0.21%) in comparison to the biopsies augmented with regular cement (0.16+/-0.1%). Young's modulus of biopsies augmented with porous PMMA was comparable to cancellous bone or porous cement alone (200-700 MPa). The yield strength of those biopsies (21.1+/-4.1 MPa) was around two times higher than for porous cement alone (11.6+/-3.3 MPa).

Corrugated wood composite panels for structural decking

High flexural strength and stiffness can be achieved by forming a thin panel into a wave shape perpendicular to the bending direction. The use of corrugated shapes to gain flexural strength and stiffness is common in metal and reinforced plastic products. However, there is no commercial production of corrugated wood composite panels. This research focuses on the application of corrugated shapes to wood strand composite panels. Beam theory, classical plate theory and finite element models were used to analyze the bending behavior of corrugated panels. The most promising shallow corrugated panel configuration was identified based on structural performance and compatibility with construction practices. The corrugation profile selected has a wavelength equal to 8”, a channel depth equal to ¾”, a sidewall angle equal to 45 degrees and a panel thickness equal to 3/8”. 16”x16” panels were produced using random mats and 3-layer aligned mats with surface flakes parallel to the channels. Strong axis and weak axis bending tests were conducted. The test results indicate that flake orientation has little effect on the strong axis bending stiffness. The 3/8” thick random mat corrugated panels exhibit bending stiffness (400,000 lbs-in2/ft) and bending strength (3,000 in-lbs/ft) higher than 23/32” or 3/4” thick APA Rated Sturd-I-Floor with a 24” o.c. span rating. Shear and bearing test results show that the corrugated panel can withstand more than 50 psf of uniform load at 48” joist spacings. Molding trials on 16”x16” panels provided data for full size panel production. Full size 4’x8’ shallow corrugated panels were produced with only minor changes to the current oriented strandboard manufacturing process. Panel testing was done to simulate floor loading during construction, without a top underlayment layer, and during occupancy, with an underlayment over the panel to form a composite deck. Flexural tests were performed in single-span and two-span bending with line loads applied at mid-span. The average strong axis bending stiffness and bending strength of the full size corrugated panels (without the underlayment) were over 400,000 lbs-in2/ft and 3,000 in-lbs/ft, respectively. The composite deck system, which consisted of an OSB sheathing (15/32” thick) nailed-glued (using 3d ringshank nails and AFG-01 subfloor adhesive) to the corrugated subfloor achieved about 60% of the full composite stiffness resulting in about 3 times the bending stiffness of the corrugated subfloor (1,250,000 lbs-in2/ft). Based on the LRFD design criteria, the corrugated composite floor system can carry 40 psf of unfactored uniform loads, limited by the L/480 deflection limit state, at 48” joist spacings. Four 10-ft long composite T-beam specimens were built and tested for the composite action and the load sharing between a 24” wide corrugated deck system and the supporting I-joist. The average bending stiffness of the composite T-beam was 1.6 times higher than the bending stiffness of the I-joist. A 8-ft x 12-ft mock up floor was built to evaluate construction procedures. The assembly of the composite floor system is relatively simple. The corrugated composite floor system might be able to offset the cheaper labor costs of the single-layer Sturd-IFloor through the material savings. However, no conclusive result can be drawn, in terms of the construction costs, at this point without an in depth cost analysis of the two systems. The shallow corrugated composite floor system might be a potential alternative to the Sturd-I-Floor in the near future because of the excellent flexural stiffness provided.

The Control of the Grain Size of ZInc.

The use of zinc as a structural metal has been militated against by two of its properties, namely, its low tensile strength and its susceptibility to grain growth. The importance of these factors can be appreciated when it is realized that the tensile strength of coarsely crystalline cast zinc is 4,000 pounds per square inch, while finely crystalline cast zinc has a tensile strength of 12,000 pounds per square inch.

The James Lind Library: explaining and illustrating the evolution of fair tests of medical treatments

The James Lind Library (www.jameslindlibrary.org) has been established to improve public and professional general knowledge about fair tests of treatments in healthcare and their history. Its foundation was laid ten years ago at the Royal College of Physicians of Edinburgh, and its administrative centre is in the College's Sibbald Library, one of the most important collections of historic medical manuscripts, papers and books in the world. The James Lind Library is a website that introduces visitors to the principles of fair tests of treatments, with a series of short, illustrated essays, which are currently available in English, Arabic, Chinese, French, Portuguese, Russian and Spanish. A 100-page book-- Testing Treatments--is now available free through the website, both in English and in Arabic and Spanish translations. To illustrate the evolution of ideas related to fair tests of treatments from 2000 BC to the present, the James Lind Library contains key passages and images from manuscripts, books and journal articles, many of them accompanied by commentaries, biographies, portraits and other relevant documents and images, including audio and video files. New material is being added to the website continuously, as relevant new records are identified and as methods for testing treatments evolve. A multinational, multilingual editorial team oversees the development of the website, which currently receives tens of thousands of visitors every month.