953 resultados para Respiration, Artificial [methods]
Resumo:
This study resulted in the development of a decision making tool for engineering consultancies looking to diversify into new markets. It reviewed existing decision tools used by contractor's entering new markets to develop a bespoke tool for engineering consultants to establish more rigor around the decision making process rather than rely purely on the intuition of company executives. The tool can be used for developing medium and long term company strategies or as a quick and efficient way to assess the viability of new market opportunities when they arise. A combination of Delphi and Analytical Hierarchy Process was selected as the basis of the decision theory.
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Successful anatomic fitting of a total artificial heart (TAH) is vital to achieve optimal pump hemodynamics after device implantation. Although many anatomic fitting studies have been completed in humans prior to clinical trials, few reports exist that detail the experience in animals for in vivo device evaluation. Optimal hemodynamics are crucial throughout the in vivo phase to direct design iterations and ultimately validate device performance prior to pivotal human trials. In vivo evaluation in a sheep model allows a realistically sized representation of a smaller patient, for which smaller third-generation TAHs have the potential to treat. Our study aimed to assess the anatomic fit of a single device rotary TAH in sheep prior to animal trials and to use the data to develop a threedimensional, computer-aided design (CAD)-operated anatomic fitting tool for future TAH development. Following excision of the native ventricles above the atrio-ventricular groove, a prototype TAH was inserted within the chest cavity of six sheep (28–40 kg).Adjustable rods representing inlet and outlet conduits were oriented toward the center of each atrial chamber and the great vessels, with conduit lengths and angles recorded for future analysis. A threedimensional, CAD-operated anatomic fitting tool was then developed, based on the results of this study, and used to determine the inflow and outflow conduit orientation of the TAH. The mean diameters of the sheep left atrium, right atrium, aorta, and pulmonary artery were 39, 33, 12, and 11 mm, respectively. The center-to-center distance and outer-edge-to-outer-edge distance between the atria, found to be 39 ± 9 mm and 72 ± 17 mm in this study, were identified as the most critical geometries for successful TAH connection. This geometric constraint restricts the maximum separation allowable between left and right inlet ports of a TAH to ensure successful alignment within the available atrial circumference.
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Aim To develop clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory. Background Numerous studies have reported that nurse-administered procedural sedation and analgesia is safe. However, the broad scope of existing guidelines for the administration and monitoring of patients who receive sedation during medical procedures without an anaesthetist presents means there is a lack of specific guidance regarding optimal nursing practices for the unique circumstances in which nurse-administered procedural sedation and analgesia is used in the cardiac catheterisation laboratory. Methods A sequential mixed methods design was utilised. Initial recommendations were produced from three studies conducted by the authors: an integrative review; a qualitative study; and a cross-sectional survey. The recommendations were revised in accordance with responses from a modified Delphi study. The first Delphi round was completed by nine senior cardiac catheterisation laboratory nurses. All but one of the draft recommendations met the pre-determined cut-off point for inclusion. There were a total of 59 responses to the second round. Consensus was reached on all recommendations. Implications for nursing The guidelines that were derived from the Delphi study offer twenty four recommendations within six domains of nursing practice: Pre-procedural assessment; Pre-procedural patient and family education; Pre-procedural patient comfort; Intra-procedural patient comfort; Intra-procedural patient assessment and monitoring; and Post-procedural patient assessment and monitoring. Conclusion These guidelines provide an important foundation towards the delivery of safe, consistent and evidence-based nursing care for the many patients who receive sedation in the cardiac catheterisation laboratory setting.
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The microstructure of an artificial grain boundary in an YBa2Cu3O7-δ (YBCO) thin film grown on a (100)(110), [001]-tilt yttria-stabilized-zirconia (YSZ) bicrystal substrate has been studied using transmission electron microscopy (TEM). The orientation relationship between the YBCO film and the YSZ substrate was [001]YBCO∥[001]YSZ and [110]YBCO∥[100]YSZ for each half of the bicrystal film. However, the exact boundary geometry of the bicrystal substrate was not transferred to the film. The substrate boundary was straight while the film boundary was wavy. In several cases there was bending of the lattice confined within a distance of a few basal-plane lattice spacings from the boundary plane and microfaceting. No intergranular secondary phase was observed but about 25% of the boundary was covered by c-axis-tilted YBCO grains and a-axis-oriented grains, both of which were typically adjacent to CuO grains or surrounded by a thin Cu-rich amorphous layer.
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The microstructure of artificial grain boundaries in YBa2Cu3O7-δ (YBCO) thin films grown on [001] tilt YZrO2 (YSZ) bicrystal substrates has been characterized using transmission electron microscopy and atomic force microscopy. Despite a relatively straight morphology of the substrate boundaries, the film boundaries were wavy. The waviness was a result of the combined effects of grooving at the substrate boundaries prior to the film deposition and an island-growth mechanism for YBCO on YSZ substrates. The dihedral angle of the groove walls varied with the misorientation angle and depended on the symmetry of the substrate boundary. The amplitudes of the film boundary waviness compared well with the widths of the grooves. In addition, the grooves induced local bending of the YBCO lattice planes and additional tilt components perpendicular to the c-axis close to the film boundaries. © 1995.
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Weak links were fabricated by pulsed laser deposition of YBa 2Cu3Ox thin films on Y-ZrO2 bicrystal substrates. They were formed by transferring the bicrystal boundary into the epitaxial film during the film growth. Their properties were determined by the misorientation angle ( theta ) between the two halves of the bicrystal. The transport properties of the weak links were studied as a function of theta and an exponential dependence of the weak link critical current density was observed for angles up to 45 degrees . Clear Josephson effects with good microwave and magnetic field response were observed.
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We have studied weak links and dc-SQUIDs made from pulsed laser deposited YBa2Cu3O7-δ thin films on Y-ZrO 2 bicrystal substrates. The transport properties of the weak links were studied as a function of the misorientation angle (θ) between the two halves of the bicrystal and an exponential dependence of the weak link critical current density was observed for angles up to 40°at 77 K. Josephson effects with clear microwave and magnetic field responses were observed. An optimum dc-SQUID performance at 77 K was obtained for θ=32°. At this temperature, we achieved a periodic magnetic field response with a modulation depth of 12 μV.
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Engineered grain boundary Josephson junctions in YBaCuO were formed on bicrystal Y-ZrO2 substrates. Laser deposited films were patterned into micron size microbridges. The authors obsd. a pronounced correlation between superconducting transport properties of grain boundary junctions and the misorientation angle θ between the two halves of the bicrystal. The crit. Josephson current Ic decreased about four orders of magnitude as θ was increased from 0 to 45 degrees. Clear microwave and magnetic field responses were obsd. at 77 K. At this temp., crit. current times normal resistance products, IcRn, of up to 1 mV were measured for low angle grain boundaries, and Shapiro steps were obsd. up to that voltage. DC SQUIDs were fabricated, and best performance at 77 K was obtained for θ = 32° with a 4-μm strip width. To utilize the higher IcRn value of a lower θ, submicron junctions have to be developed. [on SciFinder(R)]
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There has been considerable recent work on the development of energy conserving one-step methods that are not symplectic. Here we extend these ideas to stochastic Hamiltonian problems with additive noise and show that there are classes of Runge-Kutta methods that are very effective in preserving the expectation of the Hamiltonian, but care has to be taken in how the Wiener increments are sampled at each timestep. Some numerical simulations illustrate the performance of these methods.
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The pull-through/local dimpling failure strength of screwed connections is very important in the design of profiled steel cladding systems to help them resist storms and hurricanes. The current American and European provisions recommend four different test methods for the screwed connections in tension, but the accuracy of these methods in determining the connection strength is not known. It is unlikely that the four test methods are equivalent in all cases and thus it is necessary to reduce the number of methods recommended. This paper presents a review of these test methods based on some laboratory tests on crest- and valley-fixed claddings and then recommends alternative tests methods that reproduce the real behavior of the connections, including the bending and membrane deformations of the cladding around the screw fasteners and the tension load in the fastener.
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Trees are capable of portraying the semi-structured data which is common in web domain. Finding similarities between trees is mandatory for several applications that deal with semi-structured data. Existing similarity methods examine a pair of trees by comparing through nodes and paths of two trees, and find the similarity between them. However, these methods provide unfavorable results for unordered tree data and result in yielding NP-hard or MAX-SNP hard complexity. In this paper, we present a novel method that encodes a tree with an optimal traversing approach first, and then, utilizes it to model the tree with its equivalent matrix representation for finding similarity between unordered trees efficiently. Empirical analysis shows that the proposed method is able to achieve high accuracy even on the large data sets.
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Schweitzer et al. previously published a paper in the Australian and New Zealand Journal of Psychiatry which provided prevalence rates on suicidal ideation and behaviour among university students [1]. We wish to provide an update on extensions of our previously published work. In our previous publication we indicated the relatively high percentage of students who reported suicide-related behaviour over the past 12 months (6.6%). This figure is very similar to a more recent study undertaken in the UK where 6% of student respondents reported suicide attempts [2]. As a follow up, we investigated this finding further in studies undertaken in 1994 and 1997 by asking fresh samples of University of Queensland first-year undergraduates who responded positively to the question ‘I have made attempts to kill myself’ (in the past year), to provide additional data relating to the methods employed in their suicide attempts and the consequences following their suicide attempt in terms of level of injury and medical care received...
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Purpose to evaluate the effects of the wearer’s pupil size and spherical aberration on visual performance with centre-near, aspheric multifocal contact lenses (MFCLs). The advantage of binocular over monocular vision was also investigated. Methods Twelve young volunteers, with an average age of 27±5 years, participated in the study. LogMAR Visual Acuity (VA) was measured under cycloplegia for a range of defocus levels (from +3.0 to -3.0D, in 0.5D steps) with no correction and with three aspheric MFCLs (Air Optix Aqua Multifocal, Ciba Vision, Duluth, GA, US) with a centre-near design, providing correction for “Low”, “Med” and “High” near demands. Measurements were performed for all combinations of the following conditions: i) artificial pupils of 6mm and 3mm diameter, ii) binocular and monocular (dominant eye) vision. Depth-of-focus (DOF) was calculated from the VA vs. defocus curves. Ocular aberrations under cycloplegia were measured using iTrace. Results VA at -3.0D defocus (simulating near performance) was statistically higher for the 3mm than for the 6mm pupil (p=0.006), and for binocular rather than for monocular vision (p<0.001). Similarly, DOF was better for the 3mm pupil (p=0.002) and for binocular viewing conditions (p<0.001, ANOVA). Both VA at –3.0D defocus and DOF increased as the “addition” of the MFCL correction increased. Finally, with the centre-near MFCLs a linear correlation was found between VA at –3.0D defocus and the wearer’s ocular spherical aberration (R2=0.20 p<0.001 for 6mm data), with the eyes exhibiting the higher positive spherical aberration experiencing lower VAs. By contrast, no correlation was found between VA and spherical aberration at 0.00D defocus (distance vision). Conclusions Both near VA and depth-of-focus improve with these MFCLs, with the effects being more pronounced for small pupils and binocular than for monocular vision. Coupling of the wearer’s ocular spherical aberration with the aberration profiles provided by MFCLs affects their functionality.