An evaluation of remifentanil-sevoflurane response surface models in patients emerging from anesthesia: model improvement using effect-site sevoflurane concentrations.

INTRODUCTION: We previously reported models that characterized the synergistic interaction between remifentanil and sevoflurane in blunting responses to verbal and painful stimuli. This preliminary study evaluated the ability of these models to predict a return of responsiveness during emergence from anesthesia and a response to tibial pressure when patients required analgesics in the recovery room. We hypothesized that model predictions would be consistent with observed responses. We also hypothesized that under non-steady-state conditions, accounting for the lag time between sevoflurane effect-site concentration (Ce) and end-tidal (ET) concentration would improve predictions. METHODS: Twenty patients received a sevoflurane, remifentanil, and fentanyl anesthetic. Two model predictions of responsiveness were recorded at emergence: an ET-based and a Ce-based prediction. Similarly, 2 predictions of a response to noxious stimuli were recorded when patients first required analgesics in the recovery room. Model predictions were compared with observations with graphical and temporal analyses. RESULTS: While patients were anesthetized, model predictions indicated a high likelihood that patients would be unresponsive (> or = 99%). However, after termination of the anesthetic, models exhibited a wide range of predictions at emergence (1%-97%). Although wide, the Ce-based predictions of responsiveness were better distributed over a percentage ranking of observations than the ET-based predictions. For the ET-based model, 45% of the patients awoke within 2 min of the 50% model predicted probability of unresponsiveness and 65% awoke within 4 min. For the Ce-based model, 45% of the patients awoke within 1 min of the 50% model predicted probability of unresponsiveness and 85% awoke within 3.2 min. Predictions of a response to a painful stimulus in the recovery room were similar for the Ce- and ET-based models. DISCUSSION: Results confirmed, in part, our study hypothesis; accounting for the lag time between Ce and ET sevoflurane concentrations improved model predictions of responsiveness but had no effect on predicting a response to a noxious stimulus in the recovery room. These models may be useful in predicting events of clinical interest but large-scale evaluations with numerous patients are needed to better characterize model performance.

Muscle Logic: New Knowledge Resource for Anatomy Enables Comprehensive Searches of the Literature on the Feeding Muscles of Mammals.

BACKGROUND: In recent years large bibliographic databases have made much of the published literature of biology available for searches. However, the capabilities of the search engines integrated into these databases for text-based bibliographic searches are limited. To enable searches that deliver the results expected by comparative anatomists, an underlying logical structure known as an ontology is required. DEVELOPMENT AND TESTING OF THE ONTOLOGY: Here we present the Mammalian Feeding Muscle Ontology (MFMO), a multi-species ontology focused on anatomical structures that participate in feeding and other oral/pharyngeal behaviors. A unique feature of the MFMO is that a simple, computable, definition of each muscle, which includes its attachments and innervation, is true across mammals. This construction mirrors the logical foundation of comparative anatomy and permits searches using language familiar to biologists. Further, it provides a template for muscles that will be useful in extending any anatomy ontology. The MFMO is developed to support the Feeding Experiments End-User Database Project (FEED, https://feedexp.org/), a publicly-available, online repository for physiological data collected from in vivo studies of feeding (e.g., mastication, biting, swallowing) in mammals. Currently the MFMO is integrated into FEED and also into two literature-specific implementations of Textpresso, a text-mining system that facilitates powerful searches of a corpus of scientific publications. We evaluate the MFMO by asking questions that test the ability of the ontology to return appropriate answers (competency questions). We compare the results of queries of the MFMO to results from similar searches in PubMed and Google Scholar. RESULTS AND SIGNIFICANCE: Our tests demonstrate that the MFMO is competent to answer queries formed in the common language of comparative anatomy, but PubMed and Google Scholar are not. Overall, our results show that by incorporating anatomical ontologies into searches, an expanded and anatomically comprehensive set of results can be obtained. The broader scientific and publishing communities should consider taking up the challenge of semantically enabled search capabilities.

Similar prevalence and magnitude of auditory-evoked and visually evoked activity in the frontal eye fields: implications for multisensory motor control.

Saccadic eye movements can be elicited by more than one type of sensory stimulus. This implies substantial transformations of signals originating in different sense organs as they reach a common motor output pathway. In this study, we compared the prevalence and magnitude of auditory- and visually evoked activity in a structure implicated in oculomotor processing, the primate frontal eye fields (FEF). We recorded from 324 single neurons while 2 monkeys performed delayed saccades to visual or auditory targets. We found that 64% of FEF neurons were active on presentation of auditory targets and 87% were active during auditory-guided saccades, compared with 75 and 84% for visual targets and saccades. As saccade onset approached, the average level of population activity in the FEF became indistinguishable on visual and auditory trials. FEF activity was better correlated with the movement vector than with the target location for both modalities. In summary, the large proportion of auditory-responsive neurons in the FEF, the similarity between visual and auditory activity levels at the time of the saccade, and the strong correlation between the activity and the saccade vector suggest that auditory signals undergo tailoring to match roughly the strength of visual signals present in the FEF, facilitating accessing of a common motor output pathway.

Do You Want to Hear the Bad News? The Value of Diagnostic Tests for Alzheimer's Disease.

OBJECTIVE: The diagnosis of Alzheimer's disease (AD) remains difficult. Lack of diagnostic certainty or possible distress related to a positive result from diagnostic testing could limit the application of new testing technologies. The objective of this paper is to quantify respondents' preferences for obtaining AD diagnostic tests and to estimate the perceived value of AD test information. METHODS: Discrete-choice experiment and contingent-valuation questions were administered to respondents in Germany and the United Kingdom. Choice data were analyzed by using random-parameters logit. A probit model characterized respondents who were not willing to take a test. RESULTS: Most respondents indicated a positive value for AD diagnostic test information. Respondents who indicated an interest in testing preferred brain imaging without the use of radioactive markers. German respondents had relatively lower money-equivalent values for test features compared with respondents in the United Kingdom. CONCLUSIONS: Respondents preferred less invasive diagnostic procedures and tests with higher accuracy and expressed a willingness to pay up to €700 to receive a less invasive test with the highest accuracy.

Diagnosis of tuberculosis: update of interferon gamma release tests in clinical practice

info:eu-repo/semantics/nonPublished

Seroprotection against tetanus in patients attending an emergency department in Belgium and evaluation of a bedside immunotest.

BACKGROUND: In most emergency departments, tetanus prophylaxis currently relies on vaccination history. Bedside evaluation of tetanus immunity may improve this process. OBJECTIVES: (i) To determine the seroprevalence of tetanus immunity; (ii) to evaluate the accuracy of vaccination history in assessing tetanus immunity; (iii) to identify factors predictive of seroprotection and incorrect history. METHOD: In a prospective observational study, tetanus immunity was assessed in 784 adults using Tétanos Quick Stick (TQS). A questionnaire was completed to obtain vaccination and general histories. Immunity assessed by TQS and by vaccination history were compared with anti-tetanus antibody levels measured by the enzyme-linked immunosorbent assay (seroprotection threshold >0.15 IU/ml). RESULTS: Overall, 64.2% of patients were protected according to TQS results. Four independent predictors of seroprotection were identified: young age, birthplace in Belgium, male sex and occupational medicine consultation. TQS performance was good: kappa=0.71, sensitivity 85.3%, specificity 87.2%, positive predictive value 92.1% and negative predictive value 77.2%. Seven hundred and sixty-two participants responded to the vaccination history: 23.4% said they were protected, 22.1% that they were not and 54.5% did not know. History performance was poor: kappa=0.27, sensitivity 60.3%, specificity 73.3%, positive predictive value 81.8% and negative predictive value 45.8%. Compared with history, TQS offered a significantly better sensitivity, negative and positive predictive values, but specificity was similar. No predictor of an incorrect history was identified. CONCLUSION: Lack of protective immunity against tetanus is frequent but poorly evaluated by history taking. Several demographic characteristics are good predictors of seroprotection. TQS could be a valuable tool in selected patients to improve tetanus prophylaxis in the emergency department.

Finite element modelling of crack detection tests

Four non-destructive tests for determining the length of fatigue cracks within the solder joints of a 2512 surface mount resistor are investigated. The sensitivity of the tests is obtained using finite element analysis with some experimental validation. Three of the tests are mechanically based and one is thermally based. The mechanical tests all operate by applying different loads to the PCB and monitoring the strain response at the top of the resistor. The thermal test operates by applying a heat source underneath the PCB, and monitoring the temperature response at the top of the resistor. From the modelling work done, two of these tests have shown to be sensitive to cracks. Some experimental results are presented but further work is required to fully validate the simulation results.

Assessing the performance of crack detection tests for solder joints

This paper presents both modelling and experimental test data to characterise the performance of four non-destructive tests. The focus is on determining the presence and rough magnitude of thermal fatigue cracks within the solder joints for a surface mount resistor on a strip of FR4 PCB. The tests all operate by applying mechanical loads to the PCB and monitoring the strain response at the top of the resistor. The modelling results show that of the four tests investigated, three are sensitive to the presence of a crack in the joint and its magnitude. Hence these tests show promise in being able to detect cracking caused by accelerated testing. The experimental data supports these results although more validation is required.

Comparative wetting behavior of Sn-0.7Cu and Sn-0.7Cu-0.3Ni solders on Cu and Ni substrates

Electronic packaging industries are now in great challenge to find a suitable lead-free solder as an interconnection material to replace the conventional SnPb solders. Many solders such as SnCu, SnAg, SnAgCu, SnZn, SnBi have already been proposed as the replacement but none of them has reached the physical and metallurgical properties similar to the SnPb solder. However, wetting is one of the basic problems that make the lead-free solder inferior as compared to the SnPb solder. Therefore, alloying with the help of third, fourth or fifth element is the researchers' interest to improve the wetting behavior of lead-free solders. This paper describes the comparative wetting behavior of Sn-0.7Cu and Sn-0.7Cu-0.3Ni solders on Cu and Ni substrates. Wetting balance tests were performed to assess the wetting behaviors. Three different commercial fluxes namely no-clean (NC), non-activated (R) and water soluble organic acid (WS)fluxes were used to assess the wettability for three solder bath temperatures. It was found that Sn0.7Cu-03Ni solder exhibits better wettability on Cu substrate for NC and WS fluxes whereas reverse results were found for R-type flux. In the case of Ni substrate, Sn-0.7Cu-0.3Ni solder showed better wetting behavior compared to the well-known Sn-0.7Cu solder. Among the three fluxes, R-type flux showed the worst performance. Very large contact angles were documented for both solders with this flux. Higher solder bath temperature lowered the contact angles, increased the wetting forces and enhanced the wettability. Computer modeling of wetting balance test revealed that both the wetting force and meniscus height are inversely proportional to the contact angles. Modeling results also reveal that increase in solder bath depths and radiuses do not affect significantly on the wetting behavior.

Study of the rheological behaviour of Sn-Ag-Cu solder pastes and their correlation with printing performance

Solder paste plays an important role in the electronic assembly process by providing electrical, mechanical and thermal bonding between the components and the substrate. The rheological characterisation of pastes is an important step in the design and development of new paste formulations. With the ever increasing trend of miniaturisation of electronic products, the study of the rheological properties of solder pastes is becoming an integral part in the R&D of new paste formulations and in the quality monitoring and control during paste manufacture and electronic assembly process. This research work outlines some of the novel techniques which can be successfully used to investigate the rheology of leadfree solder pastes. The report also presents the results of the correlation of rheological properties with solder paste printing performance. Four different solder paste samples (namely paste P1, P2, P3 and P4) with different flux vehicle systems and particle size distributions were investigated in the study. As expected, all the paste samples showed shear thinning behaviour. Although the samples displayed similar flow behaviour at high shear rates, differences were observed at low shear rates. In the stencil printing trials, round deposits showed better results than rectangular deposits in terms of paste heights and aperture filling. Our results demonstrate a good correlation between higher paste viscosity and good printing performance. The results of the oscillatory and thixotropy tests were also successfully correlated to the printing behaviour of solder paste.

Modelling dosator filling and discharge of powder

Dosators and other dosing mechanisms operating on generally similar principles are very widely used in the pharmaceutical industry for capsule filling, and for dosing products that are delivered to the customer in powder form such as inhalers. This is a trend that is set to increase. However a significant problem for this technology is being able to predict how accurately and reliably, new drug formulations will be dosed from these machines prior to manufacture. This paper presents a review of the literature relating to powder dosators which considers mathematical models for predicting dosator performance, the effects of the dosator geometry and machine settings on the accuracy of the dose weight. An overview of a model based on classical powder mechanics theory that has been developed at The University of Greenwich is presented. The model uses inputs from a range of powder characterisation tests including, wall friction, bulk density, stress ratio and permeability. To validate the model it is anticipated that it will be trialled for a range of powders alongside a single shot dosator test rig.