Direct support and general support maintenance repair parts and special tools lists (including depot maintenance repair parts and special tools lists) : grader, road, motorized, DED, 13,000 lb pressure at blade, 12 foot blade, 6 wheels, 4 driving, 2 steerable, leaning front wheels, w/scarifier army model 440HA, NSN 3805-00-931-7881, army model 440HAROPS, NSN 3805-01-018-2866.

Includes index.

Intra-abdominal pressure response to multidirectional support-surface translation

A complex response of the trunk muscles occurs to restore equilibrium in response to movement of the support surface. Intra-abdominal pressure (IAP) is considered to contribute to control of the trunk. This study investigated the contribution of IAP to the postural response to multidirection support-surface translation. IAP was recorded with a thin-film pressure transducer inserted via the nose into the stomach and trunk motion was recorded with an optoelectronic system with markers over the spinous process of L1. A pattern of trunk movement was recorded in response to the support-surface translations that was consistent with a 'hip' strategy of postural control. The trunk moved in a manner appropriate to move the centre of gravity over the new base of support. IAP was increased with movement in each direction, but varied in timing and amplitude between translation directions. In general, the IAP was greater with translations in the sagittal plane compared to the frontal plane and was initiated earlier for translations in the backward direction. These data indicate that IAP contributes to the postural response associated with support-surface translation and suggest that this is consistent with stiffening the spine. (C) 2003 Elsevier B.V. All rights reserved.

Reduced inspiratory muscle endurance following successful weaning from prolonged mechanical ventilation

Study objectives: Respiratory muscle weakness and decreased endurance have been demonstrated following mechanical ventilation. However, its relationship to the duration of mechanical ventilation is not known. The aim of this study was to assess respiratory muscle endurance and its relationship to the duration of mechanical ventilation. Design: Prospective study. Setting: Tertiary teaching hospital ICU. Patients: Twenty subjects were recruited for the study who had received mechanical ventilation for a 48 h and had been discharged from the ICU. Measurements: FEV1 FVC, and maximal inspiratory pressure (Pimax) at functional residual capacity were recorded. The Pimax attained following resisted inspiration at 30% of the initial Pimax for 2 min was recorded, and the fatigue resistance index (FRI) [Pimax final/Pimax initial] was calculated. The duration of ICU length of stay (ICULOS), duration of mechanical ventilation (MVD), duration of weaning (WD), and Charlson comorbidities score (CCS) were also recorded. Relationships between fatigue and other parameters were analyzed using the Spearman correlations (p). Results: Subjects were admitted to the ICU for a mean duration of 7.7 days (SD, 3.7 days) and required mechanical ventilation for a mean duration of 4.6 days (SD, 2.5 days). The mean FRI was 0.88 (SD, 0.13), indicating a 12% fall in Pimax, and was negatively correlated with MVD (r = -0.65; p = 0.007). No correlations were found between the FRI and FEV1, FVC, ICULOS, WD, or CCS. Conclusions: Patients who had received mechanical ventilation for > 48 h have reduced inspiratory muscle endurance that worsens with the duration of mechanical ventilation and is present following successful weaning. These data suggest that patients needing prolonged mechanical ventilation are at risk of respiratory muscle fatigue and may benefit from respiratory muscle training.

Assessing longwall support-roof interaction from shield leg pressure data

A concept has been developed where characteristic load cycles of longwall shields can describe most of the interaction between a longwall support and the roof. A characteristic load cycle is the change in support pressure with time from setting the support against the roof to the next release and movement of the support. The concept has been validated through the back-analysis of more than 500 000 individual load cycles in five longwall panels at four mines and seven geotechnical domains. The validation process depended upon the development of new software capable of both handling the large quantity of data emanating from a modern longwall and accurately delineating load cycles. Existing software was found not to be capable of delineating load cycles to a sufficient accuracy. Load-cycle analysis can now be used quantitatively to assess the adequacy of support capacity and the appropriateness of set pressure for the conditions under which a longwall is being operated. When linked to a description of geotechnical conditions, this has allowed the development of a database for support selection for greenfield sites. For existing sites, the load-cycle characteristic concept allows for a diagnosis of strata-support problem areas, enabling changes to be made to set pressure and mining strategies to manage better, or avoid, strata control problems. With further development of the software, there is the prospect of developing a system that is able to respond to changes in strata-support interaction in real time.

Characterization of patients undergoing noninvasive ventilation admitted in unit intermediate care

Non-invasive ventilation (NIV) is the application of a ventilatory support without resorting to invasive methods. Today it’s considered a credible therapeutic option, with enough scientiic evidence to support its application in various situations and clinical settings related to the treatment of acute respiratory disease, as well as chronic respiratory disease. Objectives: Characterize patients undergoing NIV admitted in Unit Intermediate Care (ICU) in the period from October 1st 2015 to June 30th 2016. Methods: Prospective study conducted in ICU between October 2015 and June 2016. In this study were included all patients hospitalized in this unit (ICU) and in that time period a sample of 57 participants was obtained. As data collection instruments we used a questionnaire for sociodemographic and clinical data and the Braden scale. Results: Participants were mostly male 38 (66.7%), the average age 69.5 ± 11.3 years, ranging between 43 and 92 years. They weighed on average 76.6 kg (52 and 150), with an average body mass index of 28.5 kg/m2 (20 to 58.5). With skin intact 28 (49.1%) with abnormal perfusion 12 (21.1%), with altered sensitivity 11 (19.3%) and a high risk of ulcer on the scale of Braden 37 (65%). The admission diagnosis was respiratory failure 33 (57.3%) and had different backgrounds. We used reused mask 53 (93.0%), the average time of NIV was 7.1 days (1-28), 4.8 days of hospitalization (1-18) and an average of 7.8 IPAP pressure. 11 (19.3%) of the participants developed face ulcer pressure.Conclusions: The NIV is used in patients with advanced age, obesity, respiratory failure and high risk of face ulcer development.

L'activité tonique diaphragmatique chez les enfants avec et sans support respiratoire

Introduction : Les nourrissons, vu la grande compliance de leur cage thoracique, doivent maintenir activement leur volume pulmonaire de fin d’expiration (VPFE). Ceci se fait par interruption précoce de l’expiration, et par le freinage expiratoire au niveau laryngé et par la persistance de la contraction des muscles inspiratoires. Chez les nourrissons ventilés mécaniquement, notre équipe a montré que le diaphragme est activé jusqu’à la fin de l’expiration (activité tonique). Il n’est pas clair si cette activité tonique diaphragmatique compense pour l’absence de freinage laryngé liée à l’intubation endotrachéale. Objectif : Notre objectif est de déterminer si l’activité tonique diaphragmatique persiste après l’extubation chez les nourrissons et si elle peut être observée chez les enfants plus âgés. Méthode : Ceci est une étude observationnelle longitudinale prospective de patients âgés de 1 semaine à 18 ans admis aux soins intensifs pédiatriques (SIP), ventilés mécaniquement pour >24 heures et avec consentement parental. L’activité électrique du diaphragme (AEdi) a été enregistrée à l’aide d’une sonde nasogastrique spécifique à 4 moments durant le séjour aux SIP : en phase aigüe, pré et post-extubation et au congé. L’AEdi a été analysée de façon semi-automatique. L’AEdi tonique a été définie comme l’AEdi durant le dernier quartile de l’expiration. Résultats : 55 patients avec un âge médian de 10 mois (écart interquartile: 1-48) ont été étudiés. Chez les nourrissons (<1an, n=28), l’AEdi tonique en pourcentage de l’activité inspiratoire était de 48% (30-56) en phase aigüe, 38% (25-44) pré-extubation, 28% (17-42) post-extubation et 33% (22-43) au congé des SIP (p<0.05, ANOVA, avec différence significative entre enregistrements 1 et 3-4). Aucun changement significatif n’a été observé pré et post-extubation. L’AEdi tonique chez les patients plus âgés (>1an, n=27) était négligeable en phases de respiration normale (0.6mcv). Par contre, une AEdi tonique significative (>1mcv et >10%) a été observée à au moins un moment durant le séjour de 10 (37%) patients. La bronchiolite est le seul facteur indépendant associé à l’activité tonique diaphragmatique. Conclusion : Chez les nourrissons, l’AEdi tonique persiste après l’extubation et elle peut être réactivée dans certaines situations pathologiques chez les enfants plus âgés. Elle semble être un indicateur de l’effort du patient pour maintenir son VPFE. D’autres études devraient être menées afin de déterminer si la surveillance de l’AEdi tonique pourrait faciliter la détection de situations de ventilation inappropriée.

L'activité tonique diaphragmatique chez les enfants avec et sans support respiratoire

Introduction : Les nourrissons, vu la grande compliance de leur cage thoracique, doivent maintenir activement leur volume pulmonaire de fin d’expiration (VPFE). Ceci se fait par interruption précoce de l’expiration, et par le freinage expiratoire au niveau laryngé et par la persistance de la contraction des muscles inspiratoires. Chez les nourrissons ventilés mécaniquement, notre équipe a montré que le diaphragme est activé jusqu’à la fin de l’expiration (activité tonique). Il n’est pas clair si cette activité tonique diaphragmatique compense pour l’absence de freinage laryngé liée à l’intubation endotrachéale. Objectif : Notre objectif est de déterminer si l’activité tonique diaphragmatique persiste après l’extubation chez les nourrissons et si elle peut être observée chez les enfants plus âgés. Méthode : Ceci est une étude observationnelle longitudinale prospective de patients âgés de 1 semaine à 18 ans admis aux soins intensifs pédiatriques (SIP), ventilés mécaniquement pour >24 heures et avec consentement parental. L’activité électrique du diaphragme (AEdi) a été enregistrée à l’aide d’une sonde nasogastrique spécifique à 4 moments durant le séjour aux SIP : en phase aigüe, pré et post-extubation et au congé. L’AEdi a été analysée de façon semi-automatique. L’AEdi tonique a été définie comme l’AEdi durant le dernier quartile de l’expiration. Résultats : 55 patients avec un âge médian de 10 mois (écart interquartile: 1-48) ont été étudiés. Chez les nourrissons (<1an, n=28), l’AEdi tonique en pourcentage de l’activité inspiratoire était de 48% (30-56) en phase aigüe, 38% (25-44) pré-extubation, 28% (17-42) post-extubation et 33% (22-43) au congé des SIP (p<0.05, ANOVA, avec différence significative entre enregistrements 1 et 3-4). Aucun changement significatif n’a été observé pré et post-extubation. L’AEdi tonique chez les patients plus âgés (>1an, n=27) était négligeable en phases de respiration normale (0.6mcv). Par contre, une AEdi tonique significative (>1mcv et >10%) a été observée à au moins un moment durant le séjour de 10 (37%) patients. La bronchiolite est le seul facteur indépendant associé à l’activité tonique diaphragmatique. Conclusion : Chez les nourrissons, l’AEdi tonique persiste après l’extubation et elle peut être réactivée dans certaines situations pathologiques chez les enfants plus âgés. Elle semble être un indicateur de l’effort du patient pour maintenir son VPFE. D’autres études devraient être menées afin de déterminer si la surveillance de l’AEdi tonique pourrait faciliter la détection de situations de ventilation inappropriée.

Experimental analysis of the aerodynamic and mixing performance of a ventilation device

Numerous types of acute respiratory failure are routinely treated using non-invasive ventilatory support (NIV). Its efficacy is well documented: NIV lowers intubation and death rates in various respiratory disorders. It can be delivered by means of face masks or head helmets. Currently the scientific community’s interest about NIV helmets is mostly focused on optimising the mixing between CO2 and clean air and on improving patient comfort. To this end, fluid dynamic analysis plays a particularly important role and a two- pronged approach is frequently employed. While on one hand numerical simulations provide information about the entire flow field and different geometries, they exhibit require huge temporal and computational resources. Experiments on the other hand help to validate simulations and provide results with a much smaller time investment and thus remain at the core of research in fluid dynamics. The aim of this thesis work was to develop a flow bench and to utilise it for the analysis of NIV helmets. A flow test bench and an instrumented mannequin were successfully designed, produced and put into use. Experiments were performed to characterise the helmet interface in terms of pressure drop and flow rate drop over different inlet flow rates and outlet pressure set points. Velocity measurements by means of Particle Image Velocimetry were performed. Pressure drop and flow rate characteristics from experiments were contrasted with CFD data and sufficient agreement was observed between both numerical and experimental results. PIV studies permitted qualitative and quantitative comparisons with numerical simulation data and offered a clear picture of the internal flow behaviour, aiding the identification of coherent flow features.

A Comparison of Bimatoprost 0.03% Versus the Fixed-Combination of Latanotoprost 0.005% and Timolol 0.5% in Adult Patients With Elevated Intraocular Pressure: An Eight-Week, Randomized, Open-Label Trial

Introduction and Purpose: Bimatoprost and the fixed combination of latanoprost with timolol maleate are 2 medications widely used to treat glaucoma and ocular hypertension (OHT). The aim of the study is to compare the efficacy of these 2 drugs in reducing intraocular pressure (IOP) after 8 weeks of treatment in patients with primary open angle glaucoma (POAG) or OHT. Methods: In this randomized, open-label trial, 44 patients with POAG or OHT were allocated to receive either bimatoprost (1 drop QD) or latanoprost/timolol (1 drop QD). Primary outcome was the mean diurnal IOP measurement at the 8th week, calculated as the mean IOP measurements taken at 8:00 AM, 10: 00 AM, and 12: 00 PM Secondary outcomes included the baseline change in IOP measured 3 times a day, after the water-drinking test (performed after the last IOP measurement), and the assessment of side effects of each therapy. Results: The mean IOP levels of latanoprost/timolol (13.83, SD = 2.54) was significantly lower than of bimatoprost (16.16, SD = 3.28; P < 0.0001) at week 8. Also, the change in mean IOP values was significantly higher in the latanoprost/timolol group at 10:00 AM (P = 0.013) and 12:00 PM (P = 0.01), but not at 8: 00 AM (P = ns). During the water-drinking test, there was no signifi cant difference in IOP increase (absolute and percentage) between groups; however, there was a signifi cant decrease in mean heart rate in the latanoprost/timolol group. Finally, no signifi cant changes in blood pressure and lung spirometry were observed in either groups. Conclusions: The fixed combination of latanoprost/timolol was significantly superior to bimatoprost alone in reducing IOP in patients with POAG or OHT. Further studies with large sample sizes should be taken to support the superior efficacy of latanoprost/timolol, as well as to better assess its profile of side effects.

Comparative Study of the Changes in Partial Pressure of Plasma Carbon Dioxide During Carbon Dioxide Insufflation into the Intraperitoneal and Preperitoneal Spaces

Background: We aimed to compare plasma concentrations of carbon dioxide (CO(2)) in dogs that underwent intra- and preperitoneal CO(2) insufflation. Materials and Methods: Thirty dogs were studied. Ten formed a control group, 10 underwent intraperitoneal CO(2) insufflation, and 10 underwent preperitoneal CO(2) insufflation. General anesthesia with controlled ventilation was standardized for all dogs. After stabilizing the anesthesia, blood samples were collected at predetermined times and were sent for immediate gasometric analysis. Analysis of variance was used for comparing variables. Results: The plasma CO(2) concentration in the intraperitoneal insufflation group increased significantly more than in the preperitoneal insufflation group and was significantly greater than in the control group (P < 0.05). The pH values in the intraperitoneal group were lower than in the preperitoneal group (P < 0.05). Conclusion: The data from this study suggest that a greater plasma concentration of CO(2) is achieved by insufflation at constant pressure into the intraperitoneal space than into the preperitoneal space.

Determination of particle concentration in the breathing zone for four different types of office ventilation systems

Many factors affect the airflow patterns, thermal comfort, contaminant removal efficiency and indoor air quality at individual workstations in office buildings. In this study, four ventilation systems were used in a test chamber designed to represent an area of a typical office building floor and reproduce the real characteristics of a modern office space. Measurements of particle concentration and thermal parameters (temperature and velocity) were carried out for each of the following types of ventilation systems: (a) conventional air distribution system with ceiling supply and return; (b) conventional air distribution system with ceiling supply and return near the floor; (c) underfloor air distribution system; and (d) split system. The measurements aimed to analyse the particle removal efficiency in the breathing zone and the impact of particle concentration on an individual at the workstation. The efficiency of the ventilation system was analysed by measuring particle size and concentration, ventilation effectiveness and the indoor/outdoor ratio. Each ventilation system showed different airflow patterns and the efficiency of each ventilation system in the removal of the particles in the breathing zone showed no correlation with particle size and the various methods of analyses used. (C) 2008 Elsevier Ltd. All rights reserved.

Numerical modeling of ductile crack extension in high pressure pipelines with longitudinal flaws

This study examines the applicability of a micromechanics approach based upon the computational cell methodology incorporating the Gurson-Tvergaard (GT) model and the CTOA criterion to describe ductile crack extension of longitudinal crack-like defects in high pressure pipeline steels. A central focus is to gain additional insight into the effectiveness and limitations of both approaches to describe crack growth response and to predict the burst pressure for the tested cracked pipes. A verification study conducted on burst testing of large-diameter, precracked pipe specimens with varying crack depth to thickness ratio (a/t) shows the potential predictive capability of the cell approach even though both the CT model and the CTOA criterion appear to depend on defect geometry. Overall, the results presented here lend additional support for further developments in the cell methodology as a valid engineering tool for integrity assessments of pipelines with axial defects. (C) 2011 Elsevier Ltd. All rights reserved,

Positive end expiratory pressure during resuscitation of premature lambs rapidly improves blood gases without adversely affecting arterial pressure

Positive end expiratory pressure (PEEP) is important for neonatal ventilation but is not considered in guidelines for resuscitation. Our aim was to investigate the effects of PEEP on cardiorespiratory parameters during resuscitation of very premature lambs delivered by hysterotomy at similar to125 d gestation (term similar to147 d). Before delivery, they were intubated and lung fluid was drained. Immediately after delivery, they were ventilated with a Drager Babylog plus ventilator in volume guarantee mode with a tidal volume of 5 mL/kg. Lambs were randomized to receive 0, 4, 8, or 12 cm H2O of PEEP. They were ventilated for a 15-min resuscitation period followed by 2 h of stabilization at the same PEEP. Tidal volume, peak inspiratory pressure, PEEP, arterial pressure, oxygen saturation, and blood gases were measured regularly, and respiratory system compliance and alveolar/ arterial oxygen differences were calculated. Lambs that received 12 cm H2O of PEEP died from pneumothoraces; all others survived without pneumothoraces. Oxygenation was significantly improved by 8 and 12 cm H2O of PEEP compared with 0 and 4 cm H2O of PEEP. Lambs with 0 PEEP did not oxygenate adequately. The compliance of the respiratory system was significantly higher at 4 and 8 cm H2O of PEEP than at 0 PEEP. There were no significant differences in partial pressure of carbon dioxide in arterial blood between groups. Arterial pressure was highest with 8 cm H2O of PEEP, and there was no cardiorespiratory compromise at any level of PEEP. Applying PEEP during resuscitation of very premature infants might be advantageous and merits further investigation.