Automated versus non-automated weaning for reducing the duration of mechanical ventilation in critically ill adults & children (Review)

Background Automated closed loop systems may improve adaptation of mechanical support for a patient's ventilatory needs and facilitate systematic and early recognition of their ability to breathe spontaneously and the potential for discontinuation of ventilation. This review was originally published in 2013 with an update published in 2014. Objectives The primary objective for this review was to compare the total duration of weaning from mechanical ventilation, defined as the time from study randomization to successful extubation (as defined by study authors), for critically ill ventilated patients managed with an automated weaning system versus no automated weaning system (usual care). Secondary objectives for this review were to determine differences in the duration of ventilation, intensive care unit (ICU) and hospital lengths of stay (LOS), mortality, and adverse events related to early or delayed extubation with the use of automated weaning systems compared to weaning in the absence of an automated weaning system. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8); MEDLINE (OvidSP) (1948 to September 2013); EMBASE (OvidSP) (1980 to September 2013); CINAHL (EBSCOhost) (1982 to September 2013); and the Latin American and Caribbean Health Sciences Literature (LILACS). Relevant published reviews were sought using the Database of Abstracts of Reviews of Effects (DARE) and the Health Technology Assessment Database (HTA Database). We also searched the Web of Science Proceedings; conference proceedings; trial registration websites; and reference lists of relevant articles. The original search was run in August 2011, with database auto-alerts up to August 2012. Selection criteria We included randomized controlled trials comparing automated closed loop ventilator applications to non-automated weaning strategies including non-protocolized usual care and protocolized weaning in patients over four weeks of age receiving invasive mechanical ventilation in an ICU. Data collection and analysis Two authors independently extracted study data and assessed risk of bias. We combined data in forest plots using random-effects modelling. Subgroup and sensitivity analyses were conducted according to a priori criteria. Main results We included 21 trials (19 adult, two paediatric) totaling 1676 participants (1628 adults, 48 children) in this updated review. Pooled data from 16 eligible trials reporting weaning duration indicated that automated closed loop systems reduced the geometric mean duration of weaning by 30% (95% confidence interval (CI) 13% to 45%), however heterogeneity was substantial (I2 = 87%, P < 0.00001). Reduced weaning duration was found with mixed or medical ICU populations (42%, 95% CI 10% to 63%) and Smartcare/PS™ (28%, 95% CI 7% to 49%) but not in surgical populations or using other systems. Automated closed loop systems reduced the duration of ventilation (10%, 95% CI 3% to 16%) and ICU LOS (8%, 95% CI 0% to 15%). There was no strong evidence of an effect on mortality rates, hospital LOS, reintubation rates, self-extubation and use of non-invasive ventilation following extubation. Prolonged mechanical ventilation > 21 days and tracheostomy were reduced in favour of automated systems (relative risk (RR) 0.51, 95% CI 0.27 to 0.95 and RR 0.67, 95% CI 0.50 to 0.90 respectively). Overall the quality of the evidence was high with the majority of trials rated as low risk. Authors' conclusions Automated closed loop systems may result in reduced duration of weaning, ventilation and ICU stay. Reductions are more likely to occur in mixed or medical ICU populations. Due to the lack of, or limited, evidence on automated systems other than Smartcare/PS™ and Adaptive Support Ventilation no conclusions can be drawn regarding their influence on these outcomes. Due to substantial heterogeneity in trials there is a need for an adequately powered, high quality, multi-centre randomized controlled trial in adults that excludes 'simple to wean' patients. There is a pressing need for further technological development and research in the paediatric population.

The reaction path of CO and Fe2O3 in a chemical-looping combustion system

The reaction mechanism of CO and Fe₂O₃ in a chemical-looping combustion (CLC) was studied based on density functional theory (DFT) at B3LYP level in this paper. The structures of all reactants, intermediate, transition structures and products of this reaction had been optimized and characterized. The reaction path was validated by means of the intrinsic reaction coordinate (IRC) approach. The result showed that the reaction was divided into two steps, the adsorbed CO molecule on Fe ₂O₃ surface formed a medium state with one broken Fe-O bond in step1, and in step2, O atom broken here oxidized a subsequent CO molecule in the fuel reactor. Thus, Fe₂O₃ molecule transport O from air to oxide CO continually in the CLC process. The activation energy and rate coefficients of the two steps were also obtained.

More nonlocality with less entanglement in a tripartite atom-optomechanical system

Quantum effects in hybrid atomic optomechanics in a system comprising a cloud of atoms and a mobile mirror mediated by a single-mode cavity are studied. Tripartite non-locality is observed in the atom-light-mirror system, as demonstrated by the violation of the Mermin-Klyshko (MK) inequality. It has been shown [C. Genes, et al., PRA 77, 050307 (R) (2008)] that tripartite entanglement is optimized when the cavity is resonant with the anti-Stokes sideband of the driving laser and the atomic frequency matches the Stokes one. However, we show that this is not the case for the nonlocality. The MK function achieves minima when the atoms are resonant with both the Stokes and anti-Stokes sidebands, and unexpectedly, we find violation of the MK inequality only in a parameter region where entanglement is far from being maximum. A negative relation exists between nonlocality and entanglement with consideration of the possibility of bipartite nonlocality in the violation of the MK inequality. We also study the non-classicality of the mirror by post-selected measurements, e.g. Geiger-like detection, on the cavity and/or the atoms. We show that with feasible parameters Geiger-like detection on the atoms can effectively induce mechanical non-classicality.

Squeezing of mechanical motion via qubit-assisted control

We propose a feedback control mechanism for the squeezing of the phononic mode of a mechanical oscillator. We show how, under appropriate working conditions, a simple adiabatic approach is able to induce mechanical squeezing. We then go beyond the limitations of such a working point and demonstrate the stationary squeezing induced by using repeated measurements and reinitialization of the state of a two-level system ancilla coupled to the oscillator. Our nonadaptive feedback loop offers interesting possibilities for quantum state engineering and steering in open-system scenarios.

A comparison of the effectiveness of TiO2 photocatalysis and UVA photolysis for the destruction of three pathogenic micro-organisms

TiO₂ photocatalysis has demonstrated efficacy as a treatment process for water contaminated with chemical pollutants. When exposed to UVA light TiO₂ also demonstrates an effective bactericidal activity. The mechanism of this process has been reported to involve attack by valence band generated hydroxyl radicals. In this study when three common bacterial pathogens, Escherichia coli, Salmonella enterica serovar Enteritidis and Pseudomonas aeruginosa, were exposed to TiO₂ and UVA light a substantial decrease in bacterial numbers was observed. Control experiments in which all three pathogens were exposed to UVA light only resulted in a similar reduction in bacterial numbers. Moreover, exposure to UVA light alone resulted in the production of a smaller than average colony phenotype among the surviving bacteria, for all three pathogens examined, a finding which was not observed following treatment with UVA and TiO₂. Small slow growing colonies have been described for several pathogenic bacteria and are referred to as small colony variants. Several studies have demonstrated an association between small colony variants and persistent, recurrent and antibiotic resistant infections. We propose that the production of small colony variants of pathogenic bacteria following UVA treatment of drinking water may represent a health hazard. As these small colony variants were not observed with the UVA/TiO₂ system this potential hazard is not a risk when using this technology. It would also appear that the bactericidal mechanism is different with the UVA/TiO₂ process compared to when UVA light is used alone.

Optimisation of a two-liquid component pre-filled acrylic bone cement system: A design of experiments approach to optimise cement final properties

The initial composition of acrylic bone cement along with the mixing and delivery technique used can influence its final properties and therefore its clinical success in vivo. The polymerisation of acrylic bone cement is complex with a number of processes happening simultaneously. Acrylic bone cement mixing and delivery systems have undergone several design changes in their advancement, although the cement constituents themselves have remained unchanged since they were first used. This study was conducted to determine the factors that had the greatest effect on the final properties of acrylic bone cement using a pre-filled bone cement mixing and delivery system. A design of experiments (DoE) approach was used to determine the impact of the factors associated with this mixing and delivery method on the final properties of the cement produced. The DoE illustrated that all factors present within this study had a significant impact on the final properties of the cement. An optimum cement composition was hypothesised and tested. This optimum recipe produced cement with final mechanical and thermal properties within the clinical guidelines and stated by ISO 5833 (International Standard Organisation (ISO), International standard 5833: implants for surgery—acrylic resin cements, 2002), however the low setting times observed would not be clinically viable and could result in complications during the surgical technique. As a result further development would be required to improve the setting time of the cement in order for it to be deemed suitable for use in total joint replacement surgery.

Investigation into the potential of using micro gas turbines in plug-in hybrid electric vehicles

The transport sector is considered to be one of the most dependent sectors on fossil fuels. Meeting ecological, social and economic demands throughout the sector has got increasingly important in recent times. A passenger vehicle with a more environmentally friendly propulsion system is the hybrid electric vehicle. Combining an internal combustion engine and an electric motor offers the potential to reduce carbon dioxide emissions. The overall objective of this research is to provide an appraisal of the use of a micro gas turbine as the range extender in a plug-in hybrid electric vehicle. In this application, the gas turbine can always operate at its most efficient operating point as its only requirement is to recharge the battery. For this reason, it is highly suitable for this purpose. Gas turbines offer many benefits over traditional internal combustion engines which are traditionally used in this application. They offer a high power-to-weight ratio, multi-fuel capability and relatively low emission levels due to continuous combustion.

The implausibility of ‘usual care’ in an open system: sedation and weaning practices in Paediatric Intensive Care Units (PICUs) in the United Kingdom (UK).

Background
The power of the randomised controlled trial depends upon its capacity to operate in a closed system whereby the intervention is the only causal force acting upon the experimental group and absent in the control group, permitting a valid assessment of intervention efficacy. Conversely, clinical arenas are open systems where factors relating to context, resources, interpretation and actions of individuals will affect implementation and effectiveness of interventions. Consequently, the comparator (usual care) can be difficult to define and variable in multi-centre trials. Hence outcomes cannot be understood without considering usual care and factors that may affect implementation and impact on the intervention.

Methods
Using a fieldwork approach, we describe PICU context, ‘usual’ practice in sedation and weaning from mechanical ventilation, and factors affecting implementation prior to designing a trial involving a sedation and ventilation weaning intervention. We collected data from 23 UK PICUs between June and November 2014 using observation, individual and multi-disciplinary group interviews with staff.

Results
Pain and sedation practices were broadly similar in terms of drug usage and assessment tools. Sedation protocols linking assessment to appropriate titration of sedatives and sedation holds were rarely used (9 % and 4 % of PICUs respectively). Ventilator weaning was primarily a medical-led process with 39 % of PICUs engaging senior nurses in the process: weaning protocols were rarely used (9 % of PICUs). Weaning methods were variably based on clinician preference. No formal criteria or use of spontaneous breathing trials were used to test weaning readiness. Seventeen PICUs (74 %) had prior engagement in multi-centre trials, but limited research nurse availability. Barriers to previous trial implementation were intervention complexity, lack of belief in the evidence and inadequate training. Facilitating factors were senior staff buy-in and dedicated research nurse provision.

Conclusions
We examined and identified contextual and organisational factors that may impact on the implementation of our intervention. We found usual practice relating to sedation, analgesia and ventilator weaning broadly similar, yet distinctively different from our proposed intervention, providing assurance in our ability to evaluate intervention effects. The data will enable us to develop an implementation plan; considering these factors we can more fully understand their impact on study outcomes.

A facile system to evaluate in vitro drug release from dissolving microneedle arrays

The use of biological tissues in the in vitro assessments of dissolving (?) microneedle (MN) array mechanical strength and subsequent drug release profiles presents some fundamental difficulties, in part due to inherent variability of the biological tissues employed. As a result, these biological materials are not appropriate for routine used in industrial formulation development or quality control (QC) tests. In the present work a facile system using Parafilm M® (PF) to test drug permeation performance using dissolving MN arrays is proposed. Dissolving MN arrays containing 196 needles (600 μm needle height) were inserted into a single layer of PF and a hermetic “pouch” was created including the array inside. The resulting system was placed in a dissolution bath and the release of model molecules was evaluated. Different MN formulations were tested using this novel setup, releasing between 40 and 180 µg of their cargos after 6 hours. The proposed system is a more realistic approach for MN testing than the typical performance test described in the literature for conventional transdermal patches. Additionally, the use of PF membrane was tested either in the hermetic “pouch” and using Franz Cell methodology yielding comparable release curves. Microscopy was used in order to ascertain the insertion of the different MN arrays in the PF layer. The proposed system appears to be a good alternative to the use of Franz cells in order to compare different MN formulations. Given the increasing industrial interest in MN technology, the proposed system has potential as a standardised drug/active agent release test for quality control purposes.

Effect of poly ethylene glycol on the mechanical and thermal properties of bioactive Poly (ε–caprolactone) melt extrudates for pharmaceutical applications

This paper investigates the effects of polyethylene glycol (PEG), on the mechanical and thermal properties of nalidixic acid/ploy ε-caprolactone (NA)/PCL blends prepared by hot melt extrusion. The blends were characterized by tensile and flexural analysis, dynamic mechanical analysis, differential scanning calorimetry, thermogravimetric analysis and X-ray diffraction. Experimental data indicated that the addition of NA caused loss of the tensile strength and toughness of PCL. Thermal analysis of the PCL showed that on addition of the thermally unstable NA, thermal degradation occurred early and was autocatalytic. However, the NA did benefit from the heat shielding provided by the PCL matrix resulting in more thermally stable NA particles. Results show that loading PEG in the PCL had a detrimental effect on the tensile strength and toughness of the blends, reducing them by 20-40%. The partial miscibility of the PCL-PEG system, causes an increase in Tg. While increases in the crystallinity is attributed to the plasticisation effect of PEG and the nucleation effect of NA. The average crystal size increased by 8% upon PEG addition.

Preparation of new materials by heterogeneous modification of cellulose

O presente trabalho teve como principal objectivo estudar a modificação química heterogénea controlada de fibras de celulose com diferentes reagentes de modo a alterar as suas propriedades de superfície, em especial em termos da criação de um carácter hidrofóbico e lipofóbico, preservando, sempre que possível, as suas propriedades mecânicas e, consequentemente, abrindo novas perspectivas de aplicação. O desenvolvimento do trabalho envolveu três abordagens principais, envolvendo, em cada caso, o estudo de diferentes condições reaccionais. Na primeira abordagem foram utilizados como reagentes de modificação compostos perfluorados, nomeadamente o anidrido trifluoroacético (TFAA), o cloreto de 2,3,4,5,6-pentafluorobenzoílo (PFBz) e o cloreto de 3,3,3- trifluoropropanoílo (TFP), para promover a acilação heterogénea da superfície das fibras. A segunda estratégia usada consistiu na preparação de híbridos de celulose do tipo orgânico-inorgânico classe-II, através da modificação das fibras de celulose com o (3-isocianatopropil)trietoxissilano (ICPTEOS), um reagente organossilano bifuncional. A ligação às fibras de celulose foi efectuada através das funções isocianato e, posteriormente, os grupos etoxissilano foram sujeitos a tratamentos de hidrólise ácida, como tal ou na presença de outros siloxanos, nomeadamente o tetraetoxissilano (TEOS) e o 1H,1H,2H,2Hperfluorodeciltrietoxissilano (PFDTEOS). Finalmente, a última abordagem foi baseada na modificação das fibras com triclorometilssilano (TCMS), através de uma reacção gás-sólido, que dispensou assim o uso de solventes orgânicos. A ocorrência de modificação química foi em cada caso confirmada por Espectroscopia de Infravermelho com Transformada de Fourier e Reflectância Total Atenuada (FTIR-ATR), Análise Elementar (EA) e determinação de ângulos de contacto. Adicionalmente, e dependendo de cada caso específico, diversas outras técnicas foram empregues na caracterização aprofundada dos materiais preparados, nomeadamente Ressonância Magnética Nuclear CPMAS no Estado Sólido (RMN), Espectroscopia de Difracção de Raios-X (XRD), Análise Termogravimétrica (TGA), Espectrometria de Massa de Iões Secundários com Análise de Tempo de Vôo (ToF-SIMS), Espectroscopia Fotoelectrónica de Raios-X (XPS) e Microscopia Electrónica de Varrimento (SEM). Relativamente à acilação das fibras de celulose com reagentes perfluorados, o sucesso da reacção foi comprovado por FTIR-ATR, EA, XPS e ToF-SIMS. Neste contexto, obtiveram-se fibras modificadas possuindo graus de substituição (DS) compreendidos entre 0.006 e 0.39. Verificou-se por XRD que, em geral, mesmo para os valores de DS mais elevados, a cristalinidade das fibras não foi afectada, indicando que a modificação foi limitada às camadas mais superficiais das mesmas ou a regiões amorfas das suas camadas mais internas. Adicionalmente, observou-se por ToF-SIMS que a distribuição dos grupos perfluorados à superfície das fibras foi, de facto, bastante heterogénea. Todos os derivados de celulose perfluorados apresentaram elevada hidrofobicidade e lipofobicidade, tendo-se atingido ângulos de contacto com água e diiodometano de 126º e 104º, respectivamente. Um aspecto interessante relativo a estes materiais é que a elevada omnifobicidade foi observada mesmo para valores de DS muito reduzidos, não se mostrando significativamente afectada pelo aumento dos mesmos. Em consonância, verificou-se por XPS que a cobertura da superfície das fibras de celulose com grupos perfluorados aumentou apenas ligeiramente com o aumento do DS, apontando para a esterificação de camadas mais internas das fibras, associada, neste caso, predominantemente aos seus domínios amorfos. No que diz respeito à estabilidade hidrolítica destes derivados, obtiveram-se dois tipos distintos de comportamento. Por um lado, as fibras de celulose trifluoroacetiladas são facilmente hidrolisáveis em meio neutro, e, por outro, as fibras pentafluorobenzoiladas e trifluoropropanoiladas mostram-se bastante resistentes face a condições de hidrólise em meio neutro e ácido (pH 4), podendo, contudo, ser facilmente hidrolisadas em meio alcalino (pH 9 e 12, para derivados do PFBz e do TFP, respectivamente). Na segunda abordagem verificou-se a ocorrência de reacção por FTIR-ATR e EA. Em geral, a modificação química com ICPTEOS ocorre predominantemente nas zonas mais superficiais das fibras de celulose ou em regiões amorfas. Contudo, em condições reaccionais mais severas (maior quantidade de reagente e tempo de reacção), esta atingiu também regiões cristalinas, afectando, consequentemente, a estrutura cristalina das fibras, como verificado por XRD. Por RMN de 29Si observou-se que após reacção com o ICPTEOS já existiam indícios de alguma hidrólise dos grupos etoxissilano, e que a sua subsequente condensação parcial tinha levado à formação de uma película inorgânica em redor das fibras (verificado por SEM), constituída maioritariamente por estruturas lineares, com uma contribuição mais modesta de estruturas “diméricas” e outras mais ramificadas. Consequentemente, este revestimento inorgânico transformou as fibras de celulose em materiais híbridos com elevada hidrofobicidade (ângulos de contacto com água entre 103-129º). A hidrólise ácida dos restantes grupos etoxissilano, como tal ou na presença de TEOS, originou híbridos de celulose com elevada hidrofilicidade, sendo impossível medirem-se os ângulos de contacto com água dos produtos finais, devido à presença maioritária de grupos silanol (Si-OH) e ligações Si-O-Si à superfície, os quais contribuíram para o consequente aumento de energia de superfície. No entanto, quando a hidrólise foi realizada na presença de PFDTEOS, obtiveram-se materiais híbridos com elevada hidrofobicidade e lipofobicidade (ângulos de contacto com água e diiodometano de 140º e 134º, respectivamente), devido à combinação da presença de grupos perfluorados e micro- e nano-rugosidades na superfície das fibras de celulose, conforme confirmado por SEM. Finalmente, a última abordagem permitiu preparar materiais derivados de celulose altamente hidrofóbicos e lipofóbicos (ângulos de contacto com água e diiodometano de 136º e 109º, respectivamente) por um processo simples, envolvendo tempos de tratamento tão curtos como 0.5 min. Este comportamento omnifóbico foi gerado pelo efeito sinergético entre a diminuição de energia de superfície das fibras, devido à presença de grupos metilo dos resíduos de TCMS ligados a estas, e a condensação dos resíduos de TCMS na forma de micro- e nano-partículas inorgânicas, que levou à criação de um revestimento rugoso à superfície das fibras, conforme observado por RMN de 29Si e SEM, respectivamente. A pré-humidificação das fibras de celulose demonstrou desempenhar um importante papel de “acelerador” dos processos de hidrólise e condensação das moléculas de TCMS. Nestas condições, o tempo de tratamento foi um dos parâmetros mais relevantes, pois para tempos de tratamento muito curtos (0.5 min) os materiais resultantes não apresentaram quaisquer diferenças a nível de propriedades físico-químicas em relação ao substrato de partida (a humidade em excesso consumiu todo o TCMS antes que este conseguisse reagir com os grupos hidroxilo das fibras de celulose), possuindo, por exemplo, valores de ângulos de contacto com água idênticos. Para tempos de tratamento mais longos, como 30 min, os materiais finais apresentaram a maior quantidade de componentes inorgânicos, tal como verificado por EA e TGA. Assim, o controlo da humidade das fibras é imperativo para se poder moldar as propriedades finais dos produtos. Esta última abordagem é particularmente promissora uma vez que tem como base um sistema simples e “verde” que pode ser facilmente implementado. Em conclusão, este trabalho permitiu demonstrar que a modificação química heterogénea controlada das fibras de celulose representa uma iniciativa promissora para a preparação de novos materiais obtidos a partir de recursos renováveis, com propriedades interessantes e passíveis de ser potencialmente aplicados em diferentes áreas. Para além do mais, as estratégias de modificação estudadas podem também ser precursoras de novos estudos que possam vir a ser desenvolvidos dentro do mesmo âmbito.

Multilayered micro/nanocrystalline CVD diamond coatings for biotribology

In the present work multilayered micro/nanocrystalline (MCD/NCD) diamond coatings were developed by Hot Filament Chemical Vapour Deposition (HFCVD). The aim was to minimize the surface roughness with a top NCD layer, to maximize adhesion onto the Si3N4 ceramic substrates with a starting MCD coating and to improve the mechanical resistance by the presence of MCD/NCD interfaces in these composite coatings. This set of features assures high wear resistance and low friction coefficients which, combined to diamond biocompatibility, set this material as ideal for biotribological applications. The deposition parameters of MCD were optimized using the Taguchi method, and two varieties of NCD were used: NCD-1, grown in a methane rich gas phase, and NCD-2 where a third gas, Argon, was added to the gas mixture. The best combination of surface pre-treatments in the Si3N4 substrates is obtained by polishing the substrates with a 15 μm diamond slurry, further dry etching with CF4 plasma for 10 minutes and final ultrasonic seeding in a diamond powder suspension in ethanol for 1 hour. The interfaces of the multilayered CVD diamond films were characterized with high detail using HRTEM, STEM-EDX and EELS. The results show that at the transition from MCD to NCD a thin precursor graphitic film is formed. On the contrary, the transition of the NCD to MCD grade is free of carbon structures other than diamond, as a result of the richer atomic hydrogen content and of the higher substrate temperature for MCD deposition. At those transitions, WC nanoparticles were found due to contamination from the filament, being also present at the first interface of the MCD layer with the silicon nitride substrate. In order to study the adhesion and mechanical resistance of the diamond coatings, indentation and particle jet blasting tests were conducted, as well as tribological experiments with homologous pairs. Indentation tests proved the superior behaviour of the multilayered coatings that attained a load of 800 N without delamination, when compared to the mono and bilayered ones. The multilayered diamond coatings also reveal the best solid particle erosion resistance, due to the MCD/NCD interfaces that act as crack deflectors. These results were confirmed by an analytical model on the stress field distribution based on the von Mises criterion. Regarding the tribological testing under dry sliding, multilayered coatings also exhibit the highest critical load values (200N for Multilayers with NCD-2). Low friction coefficient values in the range μ=0.02- 0.09 and wear coefficient values in the order of ~10-7 mm3 N-1 m-1 were obtained for the ball and flat specimens indicating a mild wear regime. Under lubrication with physiological fluids (HBSS e FBS), lower wear coefficient values ~10-9-10-8 mm3 N-1 m-1) were achieved, governed by the initial surface roughness and the effective contact pressure.

Higher order model for analysis of magneto-electro-elastic plates

In this paper is presented an higher-order model for static and free vibration analyses of magneto-electro-elastic plates, wich allows the analysis of thin and thick plates, which allows the analysis of thin and thick plates. The finite element model is a single layer triangular plate/shell element with 24 degrees of fredom for the generalized mechanical displacements. Two degrees on freedom are introduced per each element layer, one corresponding to the electrical potential and the other for magnetic potential. Solutions are obtained for different laminations of the magneto-electro-elastic plate, as well as for the purely elastic plate as a special case.