Patient-ventilator asynchrony during noninvasive pressure support ventilation and neurally adjusted ventilatory assist in infants and children.

OBJECTIVES: To document the prevalence of asynchrony events during noninvasive ventilation in pressure support in infants and in children and to compare the results with neurally adjusted ventilatory assist. DESIGN: Prospective randomized cross-over study in children undergoing noninvasive ventilation. SETTING: The study was performed in a PICU. PATIENTS: From 4 weeks to 5 years. INTERVENTIONS: Two consecutive ventilation periods (pressure support and neurally adjusted ventilatory assist) were applied in random order. During pressure support (PS), three levels of expiratory trigger (ETS) setting were compared: initial ETS (PSinit), and ETS value decreased and increased by 15%. Of the three sessions, the period allowing for the lowest number of asynchrony events was defined as PSbest. Neurally adjusted ventilator assist level was adjusted to match the maximum airway pressure during PSinit. Positive end-expiratory pressure was the same during pressure support and neurally adjusted ventilator assist. Asynchrony events, trigger delay, and cycling-off delay were quantified for each period. RESULTS: Six infants and children were studied. Trigger delay was lower with neurally adjusted ventilator assist versus PSinit and PSbest (61 ms [56-79] vs 149 ms [134-180] and 146 ms [101-162]; p = 0.001 and 0.02, respectively). Inspiratory time in excess showed a trend to be shorter during pressure support versus neurally adjusted ventilator assist. Main asynchrony events during PSinit were autotriggering (4.8/min [1.7-12]), ineffective efforts (9.9/min [1.7-18]), and premature cycling (6.3/min [3.2-18.7]). Premature cycling (3.4/min [1.1-7.7]) was less frequent during PSbest versus PSinit (p = 0.059). The asynchrony index was significantly lower during PSbest versus PSinit (40% [28-65] vs 65.5% [42-76], p < 0.001). With neurally adjusted ventilator assist, all types of asynchronies except double triggering were reduced. The asynchrony index was lower with neurally adjusted ventilator assist (2.3% [0.7-5] vs PSinit and PSbest, p < 0.05 for both comparisons). CONCLUSION: Asynchrony events are frequent during noninvasive ventilation with pressure support in infants and in children despite adjusting the cycling-off criterion. Compared with pressure support, neurally adjusted ventilator assist allows improving patient-ventilator synchrony by reducing trigger delay and the number of asynchrony events. Further studies should determine the clinical impact of these findings.

Ilmavirtausten laskennallinen mallinnus

Diplomityössä tutkitaan kolmea erilaista virtausongelmaa CFD-mallinnuksella. Yhteistä näille ongelmille on virtaavana aineena oleva ilma. Lisäksi tapausten perinteinen mittaus on erittäin vaikeaa tai mahdotonta. Ensimmäinen tutkimusongelma on tarrapaperirainan kuivain, jonka tuotantomäärä halutaan nostaa kaksinkertaiseksi. Tämä vaatii kuivatustehon kaksinkertaistamista, koska rainan viipymäaika kuivausalueella puolittuu. Laskentayhtälöillä ja CFD-mallinnuksella tutkitaan puhallussuihkun nopeuden ja lämpötilan muutoksien vaikutusta rainan pinnan lämmön- ja massansiirtokertoimiin. Tuloksena saadaan varioitujen suureiden sekä massan- ja lämmönsiirtokertoimien välille riippuvuuskäyrät, joiden perusteella kuivain voidaan säätää parhaallamahdollisella tavalla. Toinen ongelma käsittelee suunnitteilla olevan kuparikonvertterin sekundaarihuuvan sieppausasteen optimointia. Ilman parannustoimenpiteitä käännetyn konvertterin päästöistä suurin osa karkaa ohi sekundaarihuuvan. Tilannetta tutkitaan konvertterissa syntyvän konvektiivisen nostevirtauksen eli päästöpluumin sekä erilaisten puhallussuihkuratkaisujen CFD-mallinnuksella. Tuloksena saadaan puhallussuihkuilla päästöpluumia poikkeuttava ilmaverho. Suurin osa nousevasta päästöpluumista indusoituu ilmaverhoon ja kulkeutuu poistokanavaan. Kolmas tutkittava kohde on suunnitteilla oleva kuparielektrolyysihalli, jossa ilmanvaihtoperiaatteena on luonnollinen ilmanvaihto ja mekaaninen happosumun keräysjärjestelmä. Ilmanvaihtosysteemin tehokkuus ja sisäilman virtaukset halutaan selvittää ennen hallin rakentamista. CFD-mallinnuksella ja laskentayhtälöillä tutkitaan lämpötila- ja virtauskentät sekä hallin läpi virtaava ilmamäärä ja ilmanvaihtoaste. Tulo- ja poistoilma-aukkojen mitoitukseen ja sijoitukseen liittyvät suunnitteluarvot varmennetaan sekä löydetään ilmanvaihdon ongelmakohdat. Ongelmakohtia tutkitaan ja niille esitetään parannusehdotukset.

Optimal Mechanical PulpingProcesses for Eucalyptus, Acacia and Birch

Tässä diplomityössä tutkittiin ja vertailtiin eukalyptuksen, akaasian ja koivun kemimekaanista kuiduttamista ja valkaisua. Yleensä näitä puulajeja käytetään sellun keittoon. Puulajit eroavat toisistaan kasvupaikan ja kuiturakenteen osalta. Eukalyptus ja akaasia ovat niin sanottuja trooppisia lehtipuita, kun taas koivu kasvaa pohjoisilla vyöhykkeillä. Koivulla on kookkaimmat kuidut ja akaasialla pienimmät kuidut. Myös näiden lajien putkilot eroavat toisistaan. Koivun putkilot ovat pitkiä ja kapeita, kun taas eukalyptuksen ja akaasian putkilot ovat lyhyitä ja leveitä. Prosessiksi valittiin kaksivaiheinen APMP-prosessi. Koeajot tehtiinKeskuslaboratorio Oy:ssä. Massoille asetettiin seuraavat tavoitteet: freeness 150-200 ml ja vaaleus 80 %ISO. Eukalyptukselle ja koivulle tehtiin kaksi erilaista impregnointisarjaa, mutta akaasialle vain yksi. Jauhatuksen viimeisessä vaiheessa kokeiltiin myös jauhinvalkaisua. Jauhatuksen energiankulutus oli korkea varsinkin eukalyptuksella ja akaasialla. Jotta energiankulutus saataisiin pienemmäksi, tulisi käyttää enemmän lipeää, mutta se johtaa alkalitummumiseen. Lopuksi massat valkaistiin laboratoriossa. Eukalyptus ja koivu pystyttiin valkaisemaan vaaleuteen 80 %ISO, mutta eukalyptuksen valkaisu vaati enemmän peroksidia kuin koivun valkaisu. Akaasian lähtövaaleus oli niin alhainen, ettei siinä päästy tavoitevaaleuteen. Eukalyptuksella on parempi valonsironta ja paremmat lujuusominaisuudet kuin koivulla. Kemimekaanista massaa voidaan käyttää hienopaperissa parantamassa jäykkyyttä, bulkkia ja valonsirontaa, mutta usein ongelmana on alhainen vaaleus ja huono vaaleuden pysyvyys. Kemimekaanista massaa voidaankäyttää missä tahansa mekaanisissa painopapereissa. Mekaanisissa painopapereissa kemimekaanisella lehtipuumassalla voidaan korvata mekaanista havupuumassaa. Akaasia on niin tummaa, ettei sitä voida käyttää korkeavaaleuksisiin papereihin. Eukalyptus ja koivu ovat vaaleampia ja helpompia valkaista kuin akaasia, mutta myös niillä on niin huono vaaleudenpysyvyys että käyttö hienopapereissa on rajoittunutta. Mekaanisille eukalyptus ja koivumassoille hienopaperia parempi käyttökohde on mekaaniset painopaperit, kuten MWC-paperi.

Real-time monitoring of protein conformational changes using a nano-mechanical sensor.

Proteins can switch between different conformations in response to stimuli, such as pH or temperature variations, or to the binding of ligands. Such plasticity and its kinetics can have a crucial functional role, and their characterization has taken center stage in protein research. As an example, Topoisomerases are particularly interesting enzymes capable of managing tangled and supercoiled double-stranded DNA, thus facilitating many physiological processes. In this work, we describe the use of a cantilever-based nanomotion sensor to characterize the dynamics of human topoisomerase II (Topo II) enzymes and their response to different kinds of ligands, such as ATP, which enhance the conformational dynamics. The sensitivity and time resolution of this sensor allow determining quantitatively the correlation between the ATP concentration and the rate of Topo II conformational changes. Furthermore, we show how to rationalize the experimental results in a comprehensive model that takes into account both the physics of the cantilever and the dynamics of the ATPase cycle of the enzyme, shedding light on the kinetics of the process. Finally, we study the effect of aclarubicin, an anticancer drug, demonstrating that it affects directly the Topo II molecule inhibiting its conformational changes. These results pave the way to a new way of studying the intrinsic dynamics of proteins and of protein complexes allowing new applications ranging from fundamental proteomics to drug discovery and development and possibly to clinical practice.

Principal components analysis for quality evaluation of cooled banana 'Nanicão' in different packing

This work aims determinate the evaluation of the quality of 'Nanicão' banana, submitted to two conditions of storage temperature and three different kinds of package, using the technique of the Analysis of Principal Components (ACP), as a basis for an Analysis of Variance. The fruits used were 'Nanicão' bananas, at ripening degree 3, that is, more green than yellow. The packages tested were: "Torito" wood boxes, load capacity: 18 kg; "½ box" wood boxes, load capacity: 13 kg; and cardboard boxes, load capacity: 18 kg. The temperatures assessed were: room temperature (control); and (13±1ºC), with humidity controlled to 90±2,5%. Fruits were discarded when a sensory analysis determined they had become unfit for consumption. Peel coloration, percentages of imperfection, fresh mass, total acidity, pH, total soluble solids and percentages of sucrose were assessed. A completely randomized design with a 2-factorial treatment structure (packing X temperature) was used. The obtained data were analyzed through a multivariate analysis known as Principal Components Analysis, using S-plus 4.2. The conclusion was that the best packages to preserve the fruit were the ½ box ones, which proves that it is necessary to reduce the number of fruits per package to allow better ventilation and decreases mechanical injuries and ensure quality for more time.

The Influence of Process Conditions on the Deresination Efficiency in Mechanical Pulp Washing

The aim of this thesis was to produce information for the estimation of the flow balance of wood resin in mechanical pulping and to demonstrate the possibilities for improving the efficiency of deresination in practice. It was observed that chemical changes in wood resin take place only during peroxide bleaching, a significant amount of water dispersed wood resin is retained in the pulp mat during dewatering and the amount of wood resin in the solid phase of the process filtrates is very small. On the basis of this information there exist three parameters related to behaviour of wood resin that determine the flow balance in the process: 1. The liberation of wood resin to the pulp water phase 2. Theretention of water dispersed wood resin in dewatering 3. The proportion of wood resin degraded in the peroxide bleaching The effect of different factors on these parameters was evaluated with the help of laboratory studies and a literature survey. Also, information related to the values of these parameters in existing processes was obtained in mill measurements. With the help of this information, it was possible to evaluate the deresination efficiency and the effect of different factors on this efficiency in a pulping plant that produced low-freeness mechanical pulp. This evaluation showed that the wood resin content of mechanical pulp can be significantly decreased if there exists, in the process, a peroxide bleaching and subsequent washing stage. In the case of an optimal process configuration, as high as a 85 percent deresination efficiency seems to be possible with a water usage level of 8 m3/o.d.t.

Studies on integrating kinematic design method with mechanical systems simulation techniques

Theultimate goal of any research in the mechanism/kinematic/design area may be called predictive design, ie the optimisation of mechanism proportions in the design stage without requiring extensive life and wear testing. This is an ambitious goal and can be realised through development and refinement of numerical (computational) technology in order to facilitate the design analysis and optimisation of complex mechanisms, mechanical components and systems. As a part of the systematic design methodology this thesis concentrates on kinematic synthesis (kinematic design and analysis) methods in the mechanism synthesis process. The main task of kinematic design is to find all possible solutions in the form of structural parameters to accomplish the desired requirements of motion. Main formulations of kinematic design can be broadly divided to exact synthesis and approximate synthesis formulations. The exact synthesis formulation is based in solving n linear or nonlinear equations in n variables and the solutions for the problem areget by adopting closed form classical or modern algebraic solution methods or using numerical solution methods based on the polynomial continuation or homotopy. The approximate synthesis formulations is based on minimising the approximation error by direct optimisation The main drawbacks of exact synthesis formulationare: (ia) limitations of number of design specifications and (iia) failure in handling design constraints- especially inequality constraints. The main drawbacks of approximate synthesis formulations are: (ib) it is difficult to choose a proper initial linkage and (iib) it is hard to find more than one solution. Recentformulations in solving the approximate synthesis problem adopts polynomial continuation providing several solutions, but it can not handle inequality const-raints. Based on the practical design needs the mixed exact-approximate position synthesis with two exact and an unlimited number of approximate positions has also been developed. The solutions space is presented as a ground pivot map but thepole between the exact positions cannot be selected as a ground pivot. In this thesis the exact synthesis problem of planar mechanism is solved by generating all possible solutions for the optimisation process ¿ including solutions in positive dimensional solution sets - within inequality constraints of structural parameters. Through the literature research it is first shown that the algebraic and numerical solution methods ¿ used in the research area of computational kinematics ¿ are capable of solving non-parametric algebraic systems of n equations inn variables and cannot handle the singularities associated with positive-dimensional solution sets. In this thesis the problem of positive-dimensional solutionsets is solved adopting the main principles from mathematical research area of algebraic geometry in solving parametric ( in the mathematical sense that all parameter values are considered ¿ including the degenerate cases ¿ for which the system is solvable ) algebraic systems of n equations and at least n+1 variables.Adopting the developed solution method in solving the dyadic equations in direct polynomial form in two- to three-precision-points it has been algebraically proved and numerically demonstrated that the map of the ground pivots is ambiguousand that the singularities associated with positive-dimensional solution sets can be solved. The positive-dimensional solution sets associated with the poles might contain physically meaningful solutions in the form of optimal defectfree mechanisms. Traditionally the mechanism optimisation of hydraulically driven boommechanisms is done at early state of the design process. This will result in optimal component design rather than optimal system level design. Modern mechanismoptimisation at system level demands integration of kinematic design methods with mechanical system simulation techniques. In this thesis a new kinematic design method for hydraulically driven boom mechanism is developed and integrated in mechanical system simulation techniques. The developed kinematic design method is based on the combinations of two-precision-point formulation and on optimisation ( with mathematical programming techniques or adopting optimisation methods based on probability and statistics ) of substructures using calculated criteria from the system level response of multidegree-of-freedom mechanisms. Eg. by adopting the mixed exact-approximate position synthesis in direct optimisation (using mathematical programming techniques) with two exact positions and an unlimitednumber of approximate positions the drawbacks of (ia)-(iib) has been cancelled.The design principles of the developed method are based on the design-tree -approach of the mechanical systems and the design method ¿ in principle ¿ is capable of capturing the interrelationship between kinematic and dynamic synthesis simultaneously when the developed kinematic design method is integrated with the mechanical system simulation techniques.

Effect of Mechanical and Geometric Mismatching on Fatigue and Damage of Welded Joints

The future of high technology welded constructions will be characterised by higher strength materials and improved weld quality with respect to fatigue resistance. The expected implementation of high quality high strength steel welds will require that more attention be given to the issues of crack initiation and mechanical mismatching. Experiments and finite element analyses were performed within the framework of continuum damage mechanics to investigate the effect of mismatching of welded joints on void nucleation and coalescence during monotonic loading. It was found that the damage of undermatched joints mainly occurred in the sandwich layer and the damageresistance of the joints decreases with the decrease of the sandwich layer width. The damage of over-matched joints mainly occurred in the base metal adjacent to the sandwich layer and the damage resistance of the joints increases with thedecrease of the sandwich layer width. The mechanisms of the initiation of the micro voids/cracks were found to be cracking of the inclusions or the embrittled second phase, and the debonding of the inclusions from the matrix. Experimental fatigue crack growth rate testing showed that the fatigue life of under-matched central crack panel specimens is longer than that of over-matched and even-matched specimens. Further investigation by the elastic-plastic finite element analysis indicated that fatigue crack closure, which originated from the inhomogeneousyielding adjacent to the crack tip, played an important role in the fatigue crack propagation. The applicability of the J integral concept to the mismatched specimens with crack extension under cyclic loading was assessed. The concept of fatigue class used by the International Institute of Welding was introduced in the parametric numerical analysis of several welded joints. The effect of weld geometry and load condition on fatigue strength of ferrite-pearlite steel joints was systematically evaluated based on linear elastic fracture mechanics. Joint types included lap joints, angle joints and butt joints. Various combinations of the tensile and bending loads were considered during the evaluation with the emphasis focused on the existence of both root and toe cracks. For a lap joint with asmall lack-of-penetration, a reasonably large weld leg and smaller flank angle were recommended for engineering practice in order to achieve higher fatigue strength. It was found that the fatigue strength of the angle joint depended strongly on the location and orientation of the preexisting crack-like welding defects, even if the joint was welded with full penetration. It is commonly believed that the double sided butt welds can have significantly higher fatigue strength than that of a single sided welds, but fatigue crack initiation and propagation can originate from the weld root if the welding procedure results in a partial penetration. It is clearly shown that the fatigue strength of the butt joint could be improved remarkably by ensuring full penetration. Nevertheless, increasing the fatigue strength of a butt joint by increasing the size of the weld is an uneconomical alternative.

Neuro-mechanical and metabolic adjustments to the repeated anaerobic sprint test in professional football players.

PURPOSE: This study aimed to determine the neuro-mechanical and metabolic adjustments in the lower limbs induced by the running anaerobic sprint test (the so-called RAST). METHODS: Eight professional football players performed 6 × 35 m sprints interspersed with 10 s of active recovery on artificial turf with their football shoes. Sprinting mechanics (plantar pressure insoles), root mean square activity of the vastus lateralis (VL), rectus femoris (RF), and biceps femoris (BF) muscles (surface electromyography, EMG) and VL muscle oxygenation (near-infrared spectroscopy) were monitored continuously. RESULTS: Sprint time, contact time and total stride duration increased from the first to the last repetition (+17.4, +20.0 and +16.6 %; all P < 0.05), while flight time and stride length remained constant. Stride frequency (-13.9 %; P < 0.001) and vertical stiffness decreased (-27.2 %; P < 0.001) across trials. Root mean square EMG activities of RF and BF (-18.7 and -18.1 %; P < 0.01 and 0.001, respectively), but not VL (-1.2 %; P > 0.05), decreased over sprint repetitions and were correlated with the increase in running time (r = -0.82 and -0.90; both P < 0.05). Together with a better maintenance of RF and BF muscles activation levels over sprint repetitions, players with a better repeated-sprint performance (lower cumulated times) also displayed faster muscle de- (during sprints) and re-oxygenation (during recovery) rates (r = -0.74 and -0.84; P < 0.05 and 0.01, respectively). CONCLUSION: The repeated anaerobic sprint test leads to substantial alterations in stride mechanics and leg-spring behaviour. Our results also strengthen the link between repeated-sprint ability and the change in neuromuscular activation as well as in muscle de- and re-oxygenation rates.

End-tidal carbon dioxide monitoring using a naso-buccal sensor is not appropriate to monitor capnia during non-invasive ventilation.

BACKGROUND: In acute respiratory failure, arterial blood gas analysis (ABG) is used to diagnose hypercapnia. Once non-invasive ventilation (NIV) is initiated, ABG should at least be repeated within 1 h to assess PaCO2 response to treatment in order to help detect NIV failure. The main aim of this study was to assess whether measuring end-tidal CO2 (EtCO2) with a dedicated naso-buccal sensor during NIV could predict PaCO2 variation and/or PaCO2 absolute values. The additional aim was to assess whether active or passive prolonged expiratory maneuvers could improve the agreement between expiratory CO2 and PaCO2. METHODS: This is a prospective study in adult patients suffering from acute hypercapnic respiratory failure (PaCO2 ≥ 45 mmHg) treated with NIV. EtCO2 and expiratory CO2 values during active and passive expiratory maneuvers were measured using a dedicated naso-buccal sensor and compared to concomitant PaCO2 values. The agreement between two consecutive values of EtCO2 (delta EtCO2) and two consecutive values of PaCO2 (delta PaCO2) and between PaCO2 and concomitant expiratory CO2 values was assessed using the Bland and Altman method adjusted for the effects of repeated measurements. RESULTS: Fifty-four datasets from a population of 11 patients (8 COPD and 3 non-COPD patients), were included in the analysis. PaCO2 values ranged from 39 to 80 mmHg, and EtCO2 from 12 to 68 mmHg. In the observed agreement between delta EtCO2 and deltaPaCO2, bias was -0.3 mmHg, and limits of agreement were -17.8 and 17.2 mmHg. In agreement between PaCO2 and EtCO2, bias was 14.7 mmHg, and limits of agreement were -6.6 and 36.1 mmHg. Adding active and passive expiration maneuvers did not improve PaCO2 prediction. CONCLUSIONS: During NIV delivered for acute hypercapnic respiratory failure, measuring EtCO2 using a dedicating naso-buccal sensor was inaccurate to predict both PaCO2 and PaCO2 variations over time. Active and passive expiration maneuvers did not improve PaCO2 prediction. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01489150.