Effect of manual hyperinflation on hemodynamics, gas exchange, and respiratory mechanics in ventilated patients

The authors investigated the effect of manual hyperinflation (MHI) with set parameters applied to patients on mechanical ventilation on hemodynamics, respiratory mechanics, and gas exchange. Sixteen critically ill patients post-septic shock, with acute lung injury, were studied. Heart rate, arterial pressure, and mean pulmonary artery pressure were recorded every minute. pulmonary artery occlusion pressure, cardiac output, arterial blood gases, and dynamic compliance (C-dyn) were recorded pre- and post-MHI. From this, systemic vascular resistance index (SVRI), cardiac index, oxygen delivery, and partial pressure of oxygen:fraction of inspired oxygen (PaO2:FiO(2)) ratio were calculated. There were significant increases in SVRI (P < 0.05) post-MHI and diastolic arterial pressure (P < 0.01)during MHI. C-dyn increased post-MHI (P < 0.01) and was sustained at 20 minutes post-MHI (P < 0.01). Subjects with an intrapulmonary cause of lung disease had a significant decrease (P = 0.02) in PaO2:FiO(2), and those with extrapulmonary causes of lung disease had a significant increase (P < 0.001) in PaO2:FiO(2) post-MHI. In critically ill patients, MHI resulted in an improvement in lung mechanics and an improvement in gas exchange in patients with lung disease due to extrapulmonary events and did not result in impairment of the cardiovascular system.

NAD-glycohydrolase production and speA and speC distribution in group A streptococcus (GAS) isolates do not correlate with severe GAS diseases in the Australian population

Streptococcus pyogenes isolates from a tropical region and a subtropical region of Australia with high and low incidences of severe streptococcal diseases, respectively, were analyzed for speA, speB, and speC gene distributions and NAD-glycohydrolase expression. No direct correlation of these characteristics with a propensity to cause invasive diseases was observed.

Effect of functional gain on satisfaction with medical rehabilitation after stroke

Objective: To examine the association between gain in motor and cognitive functional status with patient satisfaction 3-6 mo after rehabilitation discharge. Design: Patient satisfaction and changes in functional status were examined in 18,375 patients with stroke who received inpatient medical rehabilitation. Information was obtained from 144 hospitals and rehabilitation facilities contributing records to the Uniform Data System for Medical Rehabilitation and the National Follow-up Services. Results: Data analysis revealed significant (P < 0.05) differences in satisfaction responses based on whether information was collected from patient self-report or from a family member proxy, and the two subsets were analyzed separately. Logistic regression revealed the following significant predictors of satisfaction for data collected from stroke patients: cognitive and motor gain, rehospitalization, who the patient was living with at follow-up, age, and follow-up therapy. In the patient-reported data subset, compared with patients who showed improved cognitive or motor functional status, those with no change, respectively, had a 31% and 33% reduced risk of dissatisfaction. In addition, rehospitalized patients had a higher risk of dissatisfaction. For the proxy reported data subset, significant influences on satisfaction were health maintenance, rehospitalization, stroke type, ethnicity, cognitive FIM(TM) gain, length of stay, and follow-up therapy. Conclusions: Ratings of satisfaction with rehabilitation services were affected by change in functional status and whether the information was collected from patient rating or proxy response.

Online titrimetric and off-gas analysis for examining nitrification processes in wastewater treatment

The two steps of nitrification, namely the oxidation of ammonia to nitrite and nitrite to nitrate, often need to be considered separately in process studies. For a detailed examination, it is desirable to monitor the two-step sequence using online measurements. In this paper, the use of online titrimetric and off-gas analysis (TOGA) methods for the examination of the process is presented. Using the known reaction stoichiometry, combination of the measured signals (rates of hydrogen ion production, oxygen uptake and carbon dioxide transfer) allows the determination of the three key process rates, namely the ammonia consumption rate, the nitrite accumulation rate and the nitrate production rate. Individual reaction rates determined with the TOGA sensor under a number of operation conditions are presented. The rates calculated directly from the measured signals are compared with those obtained from offline liquid sample analysis. Statistical analysis confirms that the results from the two approaches match well. This result could not have been guaranteed using alternative online methods. As a case study, the influences of pH and dissolved oxygen (DO) on nitrite accumulation are tested using the proposed method. It is shown that nitrite accumulation decreased with increasing DO and pH. Possible reasons for these observations are discussed. (C) 2003 Elsevier Science Ltd. All rights reserved.

Prediction of genetic gain from selection indices for disease resistance in papaya hybrids

In order to select superior hybrids for the concentration of favorable alleles for resistance to papaya black spot, powdery mildew and phoma spot, 67 hybrids were evaluated in two seasons, in 2007, in a randomized block design with two replications. Genetic gains were estimated from the selection indices of Smith & Hazel, Pesek & Baker, Williams, Mulamba & Mock, with selection intensity of 22.39%, corresponding to 15 hybrids. The index of Mulamba & Mock showed gains more suitable for the five traits assessed when it was used the criterion of economic weight tentatively assigned. Together, severity of black spot on leaves and on fruits, characteristics considered most relevant to the selection of resistant materials, expressed percentage gain of -44.15%. In addition, there were gains for other characteristics, with negative predicted selective percentage gain. The results showed that the index of Mulamba & Mock is the most efficient procedure for simultaneous selection of papaya hybrid resistant to black spot, powdery mildew and phoma spot.

New Steel Alloys for the Design of Heat Recovery Steam Generator Components of Combined Cycle Gas Plants

Demand for power is growing every day, mainly due to emerging economies in countries such as China, Russia, India, and Brazil. During the last 50 years steam pressure and temperature in power plants have been continuously raised to improve thermal efficiency. Recent efforts to improve efficiency leads to the development of a new generation of heat recovery steam generator, where the Benson once-through technology is applied to improve the thermal efficiency. The main purpose of this paper is to analyze the mechanical behavior of a high pressure superheater manifold by applying finite element modeling and a finite element analysis with the objective of analyzing stress propagation, leading to the study of damage mechanism, e.g., uniaxial fatigue, uniaxial creep for life prediction. The objective of this paper is also to analyze the mechanical properties of the new high temperature resistant materials in the market such as 2Cr Bainitic steels (T/P23 and T/P24) and also the 9-12Cr Martensitic steels (T/P91, T/P92, E911, and P/T122). For this study the design rules for construction of power boilers to define the geometry of the HPSH manifold were applied.

ITO/SiOx/Si optical sensor with internal gain

A visible/near-infrared optical sensor based on an ITO/SiOx/n-Si structure with internal gain is presented. This surface-barrier structure was fabricated by a low-temperature processing technique. The interface properties and carder transport were investigated from dark current-voltage and capacitance-voltage characteristics. Examination of the multiplication properties was performed under different light excitation and reverse bias conditions. The spectral and pulse response characteristics are analysed. The current amplification mechanism is interpreted by the control of electron current by the space charge of photogenerated holes near the SiOx/Si interface. The optical sensor output characteristics and some possible device applications are presented.

An heuristic approach for optimal location of gas supply units in transportation system

The best places to locate the Gas Supply Units (GSUs) on a natural gas systems and their optimal allocation to loads are the key factors to organize an efficient upstream gas infrastructure. The number of GSUs and their optimal location in a gas network is a decision problem that can be formulated as a linear programming problem. Our emphasis is on the formulation and use of a suitable location model, reflecting real-world operations and constraints of a natural gas system. This paper presents a heuristic model, based on lagrangean approach, developed for finding the optimal GSUs location on a natural gas network, minimizing expenses and maximizing throughput and security of supply.The location model is applied to the Iberian high pressure natural gas network, a system modelised with 65 demand nodes. These nodes are linked by physical and virtual pipelines – road trucks with gas in liquefied form. The location model result shows the best places to locate, with the optimal demand allocation and the most economical gas transport mode: by pipeline or by road truck.

Natural Gas location design and operation

A major determinant of the level of effective natural gas supply is the ease to feed customers, minimizing system total costs. The aim of this work is the study of the right number of Gas Supply Units – GSUs - and their optimal location in a gas network. This paper suggests a GSU location heuristic, based on Lagrangean relaxation techniques. The heuristic is tested on the Iberian natural gas network, a system modelized with 65 demand nodes, linked by physical and virtual pipelines. Lagrangean heuristic results along with the allocation of loads to gas sources are presented, using a 2015 forecast gas demand scenario.

Optimal location of gas supply units in natural gas system network

Natural gas industry has been confronted with big challenges: great growth in demand, investments on new GSUs – gas supply units, and efficient technical system management. The right number of GSUs, their best location on networks and the optimal allocation to loads is a decision problem that can be formulated as a combinatorial programming problem, with the objective of minimizing system expenses. Our emphasis is on the formulation, interpretation and development of a solution algorithm that will analyze the trade-off between infrastructure investment expenditure and operating system costs. The location model was applied to a 12 node natural gas network, and its effectiveness was tested in five different operating scenarios.

Optimization model for medium term natural gas commitment

In this paper we study the optimal natural gas commitment for a known demand scenario. This study implies the best location of GSUs to supply all demands and the optimal allocation from sources to gas loads, through an appropriate transportation mode, in order to minimize total system costs. Our emphasis is on the formulation and use of a suitable optimization model, reflecting real-world operations and the constraints of natural gas systems. The mathematical model is based on a Lagrangean heuristic, using the Lagrangean relaxation, an efficient approach to solve the problem. Computational results are presented for Iberian and American natural gas systems, geographically organized in 65 and 88 load nodes, respectively. The location model results, supported by the computational application GasView, show the optimal location and allocation solution, system total costs and suggest a suitable gas transportation mode, presented in both numerical and graphic supports.

Natural gas system operation: lagrangean optimization techniques

To comply with natural gas demand growth patterns and Europe´s import dependency, the gas industry needs to organize an efficient upstream infrastructure. The best location of Gas Supply Units – GSUs and the alternative transportation mode – by phisical or virtual pipelines, are the key of a successful industry. In this work we study the optimal location of GSUs, as well as determining the most efficient allocation from gas loads to sources, selecting the best transportation mode, observing specific technical restrictions and minimizing system total costs. For the location of GSUs on system we use the P-median problem, for assigning gas demands nodes to source facilities we use the classical transportation problem. The developed model is an optimisation-based approach, based on a Lagrangean heuristic, using Lagrangean relaxation for P-median problems – Simple Lagrangean Heuristic. The solution of this heuristic can be improved by adding a local search procedure - the Lagrangean Reallocation Heuristic. These two heuristics, Simple Lagrangean and Lagrangean Reallocation, were tested on a realistic network - the primary Iberian natural gas network, organized with 65 nodes, connected by physical and virtual pipelines. Computational results are presented for both approaches, showing the location gas sources and allocation loads arrangement, system total costs and gas transportation mode.

Obesity and gestational weight gain: cesarean delivery and labor complications

OBJECTIVE: To assess the association between pre-gestational obesity and weight gain with cesarean delivery and labor complications. METHODS: A total of 4,486 women 20-28 weeks pregnant attending general prenatal care clinics of the national health system in Brazil from 1991 to 1995 were enrolled and followed up through birth. Body mass index categories based on prepregnancy weight and total weight gain were calculated. Associations between body mass index categories and labor complications were adjusted through logistic regression analysis. RESULTS: Obesity was present in 308 (6.9%) patients. Cesarean delivery was performed in 164 (53.2%) obese, 407 (43.1%) pre-obese, 1,045 (35.1%) normal weight and 64 (24.5%) underweight women. The relative risk for cesarean delivery in obese women was 1.8 (95% CI: 1.5-2.0) compared to normal weight women. Greater weight gain was particularly associated with cesarean among the obese (RR 4th vs 2nd weight gain quartile 2.2; 95% CI: 1.4-3.2). Increased weight at the beginning of pregnancy was associated with a significantly higher adjusted risk of meconium with vaginal delivery and perinatal death and infection in women submitted to cesarean section. Similarly, greater weight gain during pregnancy increased the risk for meconium and hemorrhage in women submitted to vaginal delivery and for prematurity with cesarean. CONCLUSIONS: Pre-gestational obesity and greater weight gain independently increase the risk of cesarean delivery, as well as of several adverse outcomes with vaginal delivery. These findings provide further evidence of the negative effects of prepregnancy obesity and greater gestational weight gain on pregnancy outcomes.

Analysis of six fungicides and one acaricide in still and fortified wines using solid-phase microextraction-gas chromatography/tandem mass spectrometry

A multiresidue gas chromatographic method for the determination of six fungicides (captan, chlorthalonil, folpet, iprodione, procymidone and vinclozolin) and one acaricide (dicofol) in still and fortified wines was developed. Solid-phase microextraction (SPME) was chosen for the extraction of the compounds from the studied matrices and tandem mass spectrometry (MS/MS) detection was used. The extraction consists in a solvent free and automated procedure and the detection is highly sensitive and selective. Good linearity was obtained with correlation coefficients of regression (R2) > 0.99 for all the compounds. Satisfactory results of repeatability and intermediate precision were obtained for most of the analytes (RSD < 20%). Recoveries from spiked wine ranged from 80.1% to 112.0%. Limits of quantification (LOQs) were considerably below the proposedmaximumresidue limits (MRLs) for these compounds in grapes and below the suggested limits for wine (MRLs/10), with the exception of captan.