Evaluation of lung and chest wall mechanics during anaesthesia using the PEEP-step method.

Science.gov (United States)

Persson, P; Stenqvist, O; Lundin, S

2018-04-01

Postoperative pulmonary complications are common. Between patients there are differences in lung and chest wall mechanics. Individualised mechanical ventilation based on measurement of transpulmonary pressures would be a step forward. A previously described method evaluates lung and chest wall mechanics from a change of ΔPEEP and calculation of change in end-expiratory lung volume (ΔEELV). The aim of the present study was to validate this PEEP-step method (PSM) during general anaesthesia by comparing it with the conventional method using oesophageal pressure (PES) measurements. In 24 lung healthy subjects (BMI 18.5-32), three different sizes of PEEP steps were performed during general anaesthesia and ΔEELVs were calculated. Transpulmonary driving pressure (ΔPL) for a tidal volume equal to each ΔEELV was measured using PES measurements and compared to ΔPEEP with limits of agreement and intraclass correlation coefficients (ICC). ΔPL calculated with both methods was compared with a Bland-Altman plot. Mean differences between ΔPEEP and ΔPL were mechanical properties among the lung healthy patients stresses the need for individualised ventilator settings based on measurements of lung and chest wall mechanics. The agreement between ΔPLs measured by the two methods during general anaesthesia suggests the use of the non-invasive PSM in this patient population. NCT 02830516. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

English for lawyers / Liina Soobik ; [preface: Peep Pruks

Index Scriptorium Estoniae

Soobik, Liina, 1955-

2001-01-01

Kasutatud tekstide autorid: Peep Pruks, Merit-Ene Ilja, Ilona Nurmela, Kristi Raba, Andreas Kangur, Raul Narits, Peeter Roosma, Kalle Merusk, Maret Altnurme, Jaan Ginter, Aare Tark, Norman Aas, Lasse Lehis, Hannes Veinla, Jaan Sootak, Eerik Kergandberg, Paul Varul, Jaanus Ots, Urve Liin, Irene Kull, Merle Muda, Gaabriel Tavits, Andres Vutt, Kadri Siibak, Ellen Ridaste, Heiki Pisuke, Andrus Siibak

Lugejate valik : Peep Vain on parim / Marko Liibak

Index Scriptorium Estoniae

Liibak, Marko

2007-01-01

Aripaev.ee ja ajaleht Äripäev korraldasid lugejate seas küsitluse, mille käigus valiti Eesti parimaks koolitajaks Vain & Partnerite omanik ning koolituskonsultant Peep Vain. Teisele kohale tuli koolitaja, juhtimiskonsultant ja nõustaja ning Tallinn Ülikooli kliinilise psühholoogia professor Mare Pork. Järgnesid Ülo Vihma, Indrek Saul, Tiit Valm, Mihkel Pärjamäe ning Alexander Kotchubei

Voyeuristi alla finestra: Peeping Tom, dalla leggenda al cinema

Directory of Open Access Journals (Sweden)

Laura Staiano

2015-01-01

Full Text Available This essay deals with voyeuristic attitudes and ʹscopic powerʹ, i.e. the power to gaze at forbidden things and people without being seen. Indeed, its object par excellence coincides with female nakedness, while its subject is an invisible masculinity, which takes delight in looking. The paper is based on a study of the Anglo-Saxon legend of Lady Godiva and it is strictly connected with the subject of my dissertation in progress – metaphorical and physical blindness in 18th century French literature (since several voyeurs got blind because of their instincts and desires. Lady Godiva’s voyeur, called Peeping Tom, is struck blind for having looked out of his window and seen the noblewoman riding naked. This legend has inspired many artists in different fields, and nowadays its heroine is very famous and venerated. In particular, this essay focuses on the relation between this legend and compulsive looking (or scopophilia in two renowned films, Rear Window by Alfred Hitchcock, and Peeping Tom by Michael Powell.

Effect of PEEP and inhaled nitric oxide on pulmonary gas exchange during gaseous and partial liquid ventilation with small volumes of perfluorocarbon.

Science.gov (United States)

Max, M; Kuhlen, R; Falter, F; Reyle-Hahn, M; Dembinski, R; Rossaint, R

2000-04-01

Partial liquid ventilation, positive end-expiratory pressure (PEEP) and inhaled nitric oxide (NO) can improve ventilation/perfusion mismatch in acute lung injury (ALI). The aim of the present study was to compare gas exchange and hemodynamics in experimental ALI during gaseous and partial liquid ventilation at two different levels of PEEP, with and without the inhalation of nitric oxide. Seven pigs (24+/-2 kg BW) were surfactant-depleted by repeated lung lavage with saline. Gas exchange and hemodynamic parameters were assessed in all animals during gaseous and subsequent partial liquid ventilation at two levels of PEEP (5 and 15 cmH2O) and intermittent inhalation of 10 ppm NO. Arterial oxygenation increased significantly with a simultaneous decrease in cardiac output when PEEP 15 cmH2O was applied during gaseous and partial liquid ventilation. All other hemodynamic parameters revealed no relevant changes. Inhalation of NO and instillation of perfluorocarbon had no additive effects on pulmonary gas exchange when compared to PEEP 15 cmH2O alone. In experimental lung injury, improvements in gas exchange are most distinct during mechanical ventilation with PEEP 15 cmH2O without significantly impairing hemodynamics. Partial liquid ventilation and inhaled NO did not cause an additive increase of PaO2.

Enhancing the Automatic Generation of Hints with Expert Seeding

Science.gov (United States)

Stamper, John; Barnes, Tiffany; Croy, Marvin

2011-01-01

The Hint Factory is an implementation of our novel method to automatically generate hints using past student data for a logic tutor. One disadvantage of the Hint Factory is the time needed to gather enough data on new problems in order to provide hints. In this paper we describe the use of expert sample solutions to "seed" the hint generation…

FCT (functional computed tomography) evaluation of the lung volumes at different PEEP (positive-end expiratory pressure) ventilation pattern, in mechanical ventilated patients

International Nuclear Information System (INIS)

Papi, M.G.; Di Segni, R.; Mazzetti, G.; Staffa, F.; Conforto, F.; Calimici, R.; Salvi, A.; Matteucci, G.

2007-01-01

Purpose To evaluate with FCT (functional computed tomography) total lung volume and fractional lung volumes at different PEEP (positive end expiratory pressure) values in acute mechanically ventilated patients. Methods Nine ICU (intensive care unity) patients (1 lung pneumonia, 2 polytrauma, 2 sepsis, 3 brain surgery, 1 pulmonary embolism); mean age 48 ± 15 years, 6 male, 3 female; GE 16 MDCT scan was performed with acquisition from apex to diaphragma in seven seca at different PEEP values. Raw CT data were analysed by an advantage workstation to obtain volume density masks and histograms of both lungs and each lung and these density ranges were applied: - 1000 - 950 hyper-ventilated lung, -900 - 650 well aerated lung, -950 - 500 all aerated lung, -500 + 200 lung tissue. Total and fractional lung volumes, Hounsfield unit (HU) were calculated and compared at different PEEP values (0, 5, 10, 15 cm H 2 O). In four patients lung volumes were compared between the more and the less involved lung at increased PEEP. Statistic analysis: comparison means-medians tests. Results Data calculated at five PEEP showed unexpected decrease of total lung volume and increase of lung density (HU); proportionally no significant improvement of oxigenation. (orig.)

FCT (functional computed tomography) evaluation of the lung volumes at different PEEP (positive-end expiratory pressure) ventilation pattern, in mechanical ventilated patients

Energy Technology Data Exchange (ETDEWEB)

Papi, M.G.; Di Segni, R.; Mazzetti, G.; Staffa, F. [Dept. of Radiology, S. Giovanni HS, Rome (Italy); Conforto, F.; Calimici, R.; Salvi, A. [Dept. of Anesthesiology, S. Giovanni HS, Rome (Italy); Matteucci, G. [Dept. of Pneumology, S. Giovanni HS, Rome (Italy)

2007-06-15

Purpose To evaluate with FCT (functional computed tomography) total lung volume and fractional lung volumes at different PEEP (positive end expiratory pressure) values in acute mechanically ventilated patients. Methods Nine ICU (intensive care unity) patients (1 lung pneumonia, 2 polytrauma, 2 sepsis, 3 brain surgery, 1 pulmonary embolism); mean age 48 {+-} 15 years, 6 male, 3 female; GE 16 MDCT scan was performed with acquisition from apex to diaphragma in seven seca at different PEEP values. Raw CT data were analysed by an advantage workstation to obtain volume density masks and histograms of both lungs and each lung and these density ranges were applied: - 1000 - 950 = hyper-ventilated lung, -900 - 650 well aerated lung, -950 - 500 all aerated lung, -500 + 200 lung tissue. Total and fractional lung volumes, Hounsfield unit (HU) were calculated and compared at different PEEP values (0, 5, 10, 15 cm H{sub 2}O). In four patients lung volumes were compared between the more and the less involved lung at increased PEEP. Statistic analysis: comparison means-medians tests. Results Data calculated at five PEEP showed unexpected decrease of total lung volume and increase of lung density (HU); proportionally no significant improvement of oxigenation. (orig.)

Increased anxiety-related behaviour in Hint1 knockout mice.

Science.gov (United States)

Varadarajulu, Jeeva; Lebar, Maria; Krishnamoorthy, Gurumoorthy; Habelt, Sonja; Lu, Jia; Bernard Weinstein, I; Li, Haiyang; Holsboer, Florian; Turck, Christoph W; Touma, Chadi

2011-07-07

Several reports have implicated a role for the histidine triad nucleotide-binding protein-1 (Hint1) in psychiatric disorders. We have studied the emotional behaviour of male Hint1 knockout (Hint1 KO) mice in a battery of tests and performed biochemical analyses on brain tissue. The behavioural analysis revealed that Hint1 KO mice exhibit an increased emotionality phenotype compared to wildtype (WT) mice, while no significant differences in locomotion or general exploratory activity were noted. In the elevated plus-maze (EPM) test, the Hint1 KO animals entered the open arms of the apparatus less often than WT littermates. Similarly, in the dark-light box test, Hint1 KO mice spent less time in the lit compartment and the number of entries were reduced, which further confirmed an increased anxiety-related behaviour. Moreover, the Hint1 KO animals showed significantly more struggling and less floating behaviour in the forced swim test (FST), indicating an increased emotional arousal in aversive situations. Hint1 is known as a protein kinase C (PKC) interacting protein. Western blot analysis showed that PKCγ expression was elevated in Hint1 KO compared to WT mice. Interestingly, PKCγ mRNA levels of the two groups did not show a significant difference, implying a post-transcriptional PKCγ regulation. In addition, PKC enzymatic activity was increased in Hint1 KO compared to WT mice. In summary, our results indicate a role for Hint1 and PKCγ in modulating anxiety-related and stress-coping behaviour in mice. Copyright © 2011 Elsevier B.V. All rights reserved.

Financial model calibration using consistency hints.

Science.gov (United States)

Abu-Mostafa, Y S

2001-01-01

We introduce a technique for forcing the calibration of a financial model to produce valid parameters. The technique is based on learning from hints. It converts simple curve fitting into genuine calibration, where broad conclusions can be inferred from parameter values. The technique augments the error function of curve fitting with consistency hint error functions based on the Kullback-Leibler distance. We introduce an efficient EM-type optimization algorithm tailored to this technique. We also introduce other consistency hints, and balance their weights using canonical errors. We calibrate the correlated multifactor Vasicek model of interest rates, and apply it successfully to Japanese Yen swaps market and US dollar yield market.

Bussijuhtide kindrali rasked päevad / Peep Peterson ; interv. Tanel Raig

Index Scriptorium Estoniae

Peterson, Peep, 1975-

2007-01-01

Eesti Transpordi- ja Teetöötajate Ametiühingu esimees Peep Peterson vastab bussijuhtide ja tööandjate vahelisi lahkhelisid, ametiühinguliikumist ning kokkuleppe sõlmimist puudutavatele küsimustele. Kommenteerivad: Villem Tori. Streikija iseloomuga raske vastane; Henn Pärn. Peterson saavutas maksimumide maksimumi; Harri Taliga. Ametiühingu liidritel erinevad arusaamad. Lisa: Fakte eluloost

Active Learning Using Hint Information.

Science.gov (United States)

Li, Chun-Liang; Ferng, Chun-Sung; Lin, Hsuan-Tien

2015-08-01

The abundance of real-world data and limited labeling budget calls for active learning, an important learning paradigm for reducing human labeling efforts. Many recently developed active learning algorithms consider both uncertainty and representativeness when making querying decisions. However, exploiting representativeness with uncertainty concurrently usually requires tackling sophisticated and challenging learning tasks, such as clustering. In this letter, we propose a new active learning framework, called hinted sampling, which takes both uncertainty and representativeness into account in a simpler way. We design a novel active learning algorithm within the hinted sampling framework with an extended support vector machine. Experimental results validate that the novel active learning algorithm can result in a better and more stable performance than that achieved by state-of-the-art algorithms. We also show that the hinted sampling framework allows improving another active learning algorithm designed from the transductive support vector machine.

Hants Hint - kõigi ihaldatud kaalukeel / Hants Hint ; interv. Erik Gamzejev

Index Scriptorium Estoniae

Hint, Hants

2002-01-01

Ilmunud ka: Severnoje Poberezhje : Laupäev 26. okt. lk. 3. Res Publica Ida-Viru piirkonna juht Hants Hint: me oleme põhimõtteliselt valmis kõigi poliitiliste jõududega koostööd tegema. Autor: Res Publica

Raudna põhikooli spordihoone Heimtalis = Raudna School Sports Facility in Heimtali / Peep Jänes

Index Scriptorium Estoniae

Jänes, Peep, 1936-

2009-01-01

2008. a. valminud spordihoonest, mille autor on Peep Jänes, projekteerija GS-Dis, sisekujundajad Signe ja Gildardas Stokas. Spordihoone rajati 1860. a. ehitatud mõisa ringtalli välismüüri sisealale ja restaureeriti ajalooline ringmüür

Eating Hints: Before, During, and After Cancer Treatment

Science.gov (United States)

... Publications Reports Eating Hints: Before, during, and after Cancer Treatment Eating Hints is for people who are having or are about to have cancer treatment. Family and friends may also want to read ...

Astrophysical hints of axion-like particles

Science.gov (United States)

Roncadelli, M.; Galanti, G.; Tavecchio, F.; Bonnoli, G.

2015-01-01

After reviewing three astrophysical hints of the existence of axion-like particles (ALPs), we describe in more detail a new similar hint involving flat spectrum radio quasars (FSRQs). Detection of FSRQs above about 20GeV pose a challenge to very-high-energy (VHE) astrophysics, because at those energies the ultraviolet emission from their broad line region should prevent photons produced by the central engine to leave the source. Although a few astrophysical explanations have been put forward, they are totally ad hoc. We show that a natural explanation instead arises within the conventional models of FSRQs provided that photon-ALP oscillations occur inside the source. Our analysis takes the FSRQ PKR 1222+206 as an example, and it looks tantalizing that basically the same choice of the free model parameters adopted in this case is consistent with those that provide the other three hints of the existence of ALPs.

Monitoring of intratidal lung mechanics: a Graphical User Interface for a model-based decision support system for PEEP-titration in mechanical ventilation.

Science.gov (United States)

Buehler, S; Lozano-Zahonero, S; Schumann, S; Guttmann, J

2014-12-01

In mechanical ventilation, a careful setting of the ventilation parameters in accordance with the current individual state of the lung is crucial to minimize ventilator induced lung injury. Positive end-expiratory pressure (PEEP) has to be set to prevent collapse of the alveoli, however at the same time overdistension should be avoided. Classic approaches of analyzing static respiratory system mechanics fail in particular if lung injury already prevails. A new approach of analyzing dynamic respiratory system mechanics to set PEEP uses the intratidal, volume-dependent compliance which is believed to stay relatively constant during one breath only if neither atelectasis nor overdistension occurs. To test the success of this dynamic approach systematically at bedside or in an animal study, automation of the computing steps is necessary. A decision support system for optimizing PEEP in form of a Graphical User Interface (GUI) was targeted. Respiratory system mechanics were analyzed using the gliding SLICE method. The resulting shapes of the intratidal compliance-volume curve were classified into one of six categories, each associated with a PEEP-suggestion. The GUI should include a graphical representation of the results as well as a quality check to judge the reliability of the suggestion. The implementation of a user-friendly GUI was successfully realized. The agreement between modelled and measured pressure data [expressed as root-mean-square (RMS)] tested during the implementation phase with real respiratory data from two patient studies was below 0.2 mbar for data taken in volume controlled mode and below 0.4 mbar for data taken in pressure controlled mode except for two cases with RMS rational decision-making model for PEEP-titration.

Effect of patient position and PEEP on hepatic, portal and central venous pressures during liver resection.

Science.gov (United States)

Sand, L; Rizell, M; Houltz, E; Karlsen, K; Wiklund, J; Odenstedt Hergès, H; Stenqvist, O; Lundin, S

2011-10-01

It has been suggested that blood loss during liver resection may be reduced if central venous pressure (CVP) is kept at a low level. This can be achieved by changing patient position but it is not known how position changes affect portal (PVP) and hepatic (HVP) venous pressures. The aim of the study was to assess if changes in body position result in clinically significant changes in these pressures. We studied 10 patients undergoing liver resection. Mean arterial pressure (MAP) and CVP were measured using fluid-filled catheters, PVP and HVP with tip manometers. Measurements were performed in the horizontal, head up and head down tilt position with two positive end expiratory pressure (PEEP) levels. A 10° head down tilt at PEEP 5 cm H(2) O significantly increased CVP (11 ± 3 to 15 ± 3 mmHg) and MAP (72 ± 8 to 76 ± 8 mmHg) while head up tilt at PEEP 5 cm H(2) O decreased CVP (11 ± 3 to 6 ± 4 mmHg) and MAP (72 ± 8 to 63 ± 7 mmHg) with minimal changes in transhepatic venous pressures. Increasing PEEP from 5 to 10 resulted in small increases, around 1 mmHg in CVP, PVP and HVP. There was no significant correlation between changes in CVP vs. PVP and HVP during head up tilt and only a weak correlation between CVP and HVP by head down tilt. Changes of body position resulted in marked changes in CVP but not in HVPs. Head down or head up tilt to reduce venous pressures in the liver may therefore not be effective measures to reduce blood loss during liver surgery. 2011 The Authors Acta Anaesthesiologica Scandinavica, 2011 The Acta Anaesthesiologica Scandinavica Foundation.

"THE EVALUATION OF THE POSSIBLE EFFECT OF POSITIVE END EXPIRATORY PRESSURE (PEEP ON PHARMACOKINETICS OF PHENYTOIN IN PATIENTS WITH ACUTE BRAIN INJURY UNDER MECHANICAL VENTILATION."

Directory of Open Access Journals (Sweden)

"Elham Hadidi

2005-04-01

Full Text Available Positive ventilation has shown to have an influence on pharmacokinetic and disposition of some drugs.Beacause phenytoin with a narrow therapautic range, is the most commonly used drug for prophylaxis and treatment of early seizures after acute brain injuries, in the present study the effect of short term PEEP (5-10 cm H2O for at least 8 hours on phenytoin serum concentration and pharmacokinetic parameters such as Vmax and clearance in brain injured patients under mechanical ventilation was examined. Ten patients with moderate to severe acute brain injury who were placed on mechanical ventilation with an initial PEEP level of 0-5 cm H2O were included in the study. Patients received phenytoin loading dose of 15 mg/kg followed by a maintenance daily dose of 3-7 mg/kg initiated within 12 hours of loading dose. Sampels were taken on two different occasions before and after PEEP elevation. Total phenytoin serum concentrations were determined by HPLC method. A time invarient Michaelis-Menten pharmacokinetic model was used to calculate Vmax and clearance for each patient.Derrived variables were calculated as follows: Vmax, 3.5-6.8 and 3.7-8.2 mg/kg/day; Clearance, 0.1-0.7 and 0.1-1.2 l/kg/day (before and after PEEP elevation, respectively. Our data have shown a wide range of variability (2.6-32.5 mg/l in phenytoin serum concentrations. There were no statistically significant differences in the measured total concentrations (p=0.721 and calculated Vmax and clearance (p=0.285before and after PEEP elevation. Administration of fluid and inotropic agents, limitation in application of higher levels of PEEP and drug interactions, shall be considered as possible explanations for these findings.

Ventilation area measured with eit in order to optimize peep settings in mechanically ventilated patients

NARCIS (Netherlands)

Blankman, P; Groot Jebbink, E; Preis, C; Bikker, I.; Gommers, D.

2012-01-01

INTRODUCTION. Electrical Impedance Tomography (EIT) is a non-invasive imaging technique, which can be used to visualize ventilation. Ventilation will be measured by impedance changes due to ventilation. OBJECTIVES. The aim of this study was to optimize PEEP settings based on the ventilation area of

Efecto del incremento de la PEEP en la actividad muscular respiratoria evaluado con electromiografía de superficie en individuos sanos bajo ventilación espontánea

Directory of Open Access Journals (Sweden)

Hernández-Valdivieso, Alher Mauricio

2016-07-01

Full Text Available Introduction: In a mechanically ventilated patient with increased airway resistance, the expiratory time span is insufficient to exhale all the inspired volume. In order to maintain oxygenation and to reduce the workload of respiratory muscles, it is common to apply an extrinsic positive end-expiratory pressure (PEEP that reduces tissue collapsibility, counterbalancing the increased resistance. Several studies have shown the usefulness of surface electromyography (sEMG to quantify the work of breathing (WOB, particularly in patients with obstructive diseases. Objective: To assess the effect of incremental PEEP in the respiratory muscle activity through sEMG in healthy volunteers noninvasively ventilated. Methods: Study of muscle activity in 10 healthy male volunteers, noninvasively ventilated for 20 minutes. The extrinsic PEEP was applied from 0 to 5 cm H2O in steps of 1 cm H2O at 30 seconds intervals. Results: The bio-potentials of diaphragm and sternocleidomastoid muscles revealed different breathing patterns in response to incremental PEEP: 1 increase in the workload of both muscles during inspiration and expiration; 2 increase in the workload of only one muscle; 3 a remarkable increase in muscle activity only in expiration. Conclusion: In noninvasively ventilated volunteers, sEMG quantitatively relates the PEEP level with changes in sternocleidomastoid and diaphragm activity.

HINTS Puerto Rico: Final Report

Science.gov (United States)

This final report describes HINTS implementation in Puerto Rico. The report addresses sampling; staffing, training and management of data collection; calling protocol; findings from the CATI Operations, and sample weights.

An analytical model of the HINT performance metric

Energy Technology Data Exchange (ETDEWEB)

Snell, Q.O.; Gustafson, J.L. [Scalable Computing Lab., Ames, IA (United States)

1996-10-01

The HINT benchmark was developed to provide a broad-spectrum metric for computers and to measure performance over the full range of memory sizes and time scales. We have extended our understanding of why HINT performance curves look the way they do and can now predict the curves using an analytical model based on simple hardware specifications as input parameters. Conversely, by fitting the experimental curves with the analytical model, hardware specifications such as memory performance can be inferred to provide insight into the nature of a given computer system.

Rasked vestlused. Kuidas ma talle seda ütlen / Irene Metsis, Sami Seppänen, Peep Sooman ; intervjueerinud Heli Lehtsaar

Index Scriptorium Estoniae

Metsis, Irene

2009-01-01

Skanska EMV administratsioonijuhi Irene Metsise, AS-i Elisa Eesti tegevdirektori Sami Seppäneni ja Pindi Kinnisvara juhatuse liikme Peep Soomani soovitused negatiivse sõnumi edastamiseks töötajale. Vt. samas: 4 nõuannet juhile, kuidas end keeruliseks vestluseks ette valmistada

HinT proteins and their putative interaction partners in Mollicutes and Chlamydiaceae

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Hegemann Johannes H

2005-05-01

Full Text Available Background HinT proteins are found in prokaryotes and eukaryotes and belong to the superfamily of HIT proteins, which are characterized by an histidine-triad sequence motif. While the eukaryotic variants hydrolyze AMP derivates and modulate transcription, the function of prokaryotic HinT proteins is less clearly defined. In Mycoplasma hominis, HinT is concomitantly expressed with the proteins P60 and P80, two domains of a surface exposed membrane complex, and in addition interacts with the P80 moiety. Results An cluster of hitABL genes, similar to that of M. hominis was found in M. pulmonis, M. mycoides subspecies mycoides SC, M. mobile and Mesoplasma florum. RT-PCR analyses provided evidence that the P80, P60 and HinT homologues of M. pulmonis were polycistronically organized, suggesting a genetic and physical interaction between the proteins encoded by these genes in these species. While the hit loci of M. pneumoniae and M. genitalium encoded, in addition to HinT, a protein with several transmembrane segments, the hit locus of Ureaplasma parvum encoded a pore-forming protein, UU270, a P60 homologue, UU271, HinT, UU272, and a membrane protein of unknown function, UU273. Although a full-length mRNA spanning the four genes was not detected, amplification of all intergenic regions from the center of UU270 to the end of UU273 by RT-PCR may be indicative of a common, but unstable mRNA. In Chlamydiaceae the hit gene is flanked upstream by a gene predicted to encode a metal dependent hydrolase and downstream by a gene putatively encoding a protein with ARM-repeats, which are known to be involved in protein-protein interactions. In RT-PCR analyses of C. pneumoniae, regions comprising only two genes, Cp265/Cp266 and Cp266/Cp267 were able to be amplified. In contrast to this in vivo interaction analysis using the yeast two-hybrid system and in vitro immune co-precipitation revealed an interaction between Cp267, which contains the ARM repeats, Cp265, the

Understanding Attention to Adaptive Hints in Educational Games: An Eye-Tracking Study

Science.gov (United States)

Conati, Cristina; Jaques, Natasha; Muir, Mary

2013-01-01

This paper presents a user study that investigates the factors affecting student attention to user-adaptive hints during interaction with an educational computer game. The study focuses on Prime Climb, an educational game designed to provide individualized support for learning number factorization skills in the form of textual hints based on a…

Hint2, the mitochondrial nucleoside 5'-phosphoramidate hydrolase; properties of the homogeneous protein from sheep (Ovis aries) liver.

Science.gov (United States)

Bretes, Ewa; Wojdyła-Mamoń, Anna M; Kowalska, Joanna; Jemielity, Jacek; Kaczmarek, Renata; Baraniak, Janina; Guranowski, Andrzej

2013-01-01

Adenosine 5'-phosphoramidate (NH2-pA) is a rare natural nucleotide and its biochemistry and biological functions are poorly recognized. All organisms have proteins that may be involved in the catabolism of NH2-pA. They are members of the HIT protein family and catalyze hydrolytic splitting of NH2-pA to 5'-AMP and ammonia. At least five HIT proteins have been identified in mammals; however, the enzymatic and molecular properties of only Fhit and Hint1 have been comprehensively studied. Our study focuses on the Hint2 protein purified by a simple procedure to homogeneity from sheep liver mitochondrial fraction (OaHint2). Hint1 protein was also prepared from sheep liver (OaHint1) and the molecular and kinetic properties of the two proteins compared. Both function as homodimers and behave as nucleoside 5'-phosphoramidate hydrolases. The molecular mass of the OaHint2 monomer is 16 kDa and that of the OaHint1 monomer 14.9 kDa. Among potential substrates studied, NH2-pA appeared to be the best; the Km and kcat values estimated for this compound are 6.6 μM and 68.3 s⁻¹, and 1.5 μM and 11.0 s⁻¹ per natively functioning dimer of OaHint2 and OaHint1, respectively. Studies of the rates of hydrolysis of different NH2-pA derivatives show that Hint2 is more specific towards compounds with a P-N bond than Hint1. The thermostability of these two proteins is also compared.

Observational Hints of a Pre--Inflationary Scale?

CERN Document Server

Gruppuso, A.

2015-09-28

We argue that the lack of power exhibited by cosmic microwave background (CMB) anisotropies at large angular scales might be linked to the onset of inflation. We highlight observational features and theoretical hints that support this view, and present a preliminary estimate of the physical scale that would underlie the phenomenon.

A two-Higgs-doublet model facing experimental hints

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Crivellin Andreas

2016-01-01

Full Text Available Physics beyond the Standard Model has so far eluded our experimental probes. Nevertheless, a number of interesting anomalies have accumulated that can be taken as hints towards new physics: BaBar, Belle, and LHCb have found deviations of approximately 3:8σ in B → Dτν and B → D*τν; the anomalous magnetic moment of the muon differs by about 3σ from the theoretic prediction; the branching ratio for τ → μνν is about 2σ above the Standard Model expectation; and CMS and ATLAS found hints for a non-zero decay rate of h → μτ at 2.6σ. Here we consider these processes within a lepton-specific two-Higgs doublet model with additional non-standard Yukawa couplings and show how (and which of these excesses can be accommodated.

Gaze-based hints during child-robot gameplay

NARCIS (Netherlands)

Mwangi, E.; Barakova, Emilia I.; Diaz, M.L.Z.; Mallofre, A.C.; Rauterberg, G.W.M.; Kheddar, A.; Yoshida, E.; Sam Ge, S.; Suzuki, K.; Cabibihan, J.J.; Eyssel, F.; He, H.

2017-01-01

This paper presents a study that examines whether gaze hints provided by a robot tutor influences the behavior of children in a card matching game. In this regard, we conducted a within-subjects experiment, in which children played a card game “Memory” in the presence of a robot tutor in two

Mida arvate ideest, et kõrgkoole võiks juhtida ülikoolivälistest inimestest koosnev nõukogu? / Jaak Aaviksoo, Maris Mälzer, Peeter Kreitzberg, Peep Sürje

Index Scriptorium Estoniae

2010-01-01

Küsimusele vastavad Tartu Ülikooli eelmine rektor Jaak Aaviksoo, Eesti Üliõpilaskondade Liidu esimees Maris Mälzer, Riigikogu kultuurikomisjoni esimees Peeter Kreitzberg ja Tallinna Tehnikaülikooli rektor Peep Sürje

Anti-depressant and anxiolytic like behaviors in PKCI/HINT1 knockout mice associated with elevated plasma corticosterone level

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Wang Jia

2009-11-01

Full Text Available Abstract Background Protein kinase C interacting protein (PKCI/HINT1 is a small protein belonging to the histidine triad (HIT family proteins. Its brain immunoreactivity is located in neurons and neuronal processes. PKCI/HINT1 gene knockout (KO mice display hyper-locomotion in response to D-amphetamine which is considered a positive symptom of schizophrenia in animal models. Postmortem studies identified PKCI/HINT1 as a candidate molecule for schizophrenia and bipolar disorder. We investigated the hypothesis that the PKCI/HINT1 gene may play an important role in regulating mood function in the CNS. We submitted PKCI/HINT1 KO mice and their wild type (WT littermates to behavioral tests used to study anti-depressant, anxiety like behaviors, and goal-oriented behavior. Additionally, as many mood disorders coincide with modifications of hypothalamic-pituitary-adrenal (HPA axis function, we assessed the HPA activity through measurement of plasma corticosterone levels. Results Compared to the WT controls, KO mice exhibited less immobility in the forced swim (FST and the tail suspension (TST tests. Activity in the TST tended to be attenuated by acute treatment with valproate at 300 mg/kg in KO mice. The PKCI/HINT1 KO mice presented less thigmotaxis in the Morris water maze and spent progressively more time in the lit compartment in the light/dark test. In a place navigation task, KO mice exhibited enhanced acquisition and retention. Furthermore, the afternoon basal plasma corticosterone level in PKCI/HINT1 KO mice was significantly higher than in the WT. Conclusion PKCI/HINT1 KO mice displayed a phenotype of behavioral and endocrine features which indicate changes of mood function, including anxiolytic-like and anti-depressant like behaviors, in conjunction with an elevated corticosterone level in plasma. These results suggest that the PKCI/HINT 1 gene could be important for the mood regulation function in the CNS.

Kas omakeelsel haridusel ja teadusel on tulevikku? / Kirsti Siitonen, Jolanta Zabarskaite, Josep Soler-Carbonell, Rainer Enrique Hamel ; intervjueerinud Peep Nemvalts ; tõlkinud Doris Kareva, Aili Künstler

Index Scriptorium Estoniae

2011-01-01

TLÜ teaduskeelekeskus korraldas koos TLÜ eesti keele ja kultuuri instituudiga 29. ja 30. augustil rahvusvahelise konverentsi "Rahvuskeeled teaduses ja kõrghariduses". Sel teemal vastavad TLÜ teaduskeelekeskuse juhataja Peep Nemvaltsi küsimustele konverentsi rahvusvahelised esinejad

Theory of mind in a first-episode psychosis population using the Hinting Task.

Science.gov (United States)

Lindgren, Maija; Torniainen-Holm, Minna; Heiskanen, Inkeri; Voutilainen, Greta; Pulkkinen, Ulla; Mehtälä, Tuukka; Jokela, Markus; Kieseppä, Tuula; Suvisaari, Jaana; Therman, Sebastian

2018-05-01

Deficiencies in theory of mind (ToM) are common in psychosis and may largely explain impaired social functioning. Currently, it is unclear whether impairments in ToM are explained by the more general cognitive deficits related to psychosis or whether ToM is impaired in psychosis independently of other cognitive deficits. This study examined ToM using the Hinting Task in young adults (n = 66) with first-episode psychosis and matched controls (n = 62). The participants were administered a broad neuropsychological assessment. Participants with psychosis performed worse than controls on the Hinting Task. However, 75% of the variance between the groups was explained by general cognitive deficits, especially impaired processing speed and episodic memory. Hinting Task performance of the best functioning patient group did not differ from that of the control group. When the psychosis group was divided according to diagnosis, the Hinting Task difference between individuals with schizophrenia and controls remained significant even when general cognitive performance was controlled for, suggesting specific verbal ToM deficits in schizophrenia. In contrast, those with other psychotic disorders did not differ from controls. Our results suggest that ToM deficits can be seen in early phases of psychotic disorders, schizophrenia in particular, and are partly independent of other cognitive functions. Copyright © 2018 Elsevier B.V. All rights reserved.

Uus töölpeinguseadus : nagu Soomes lama ajal? Ei, veel karmim / Maret Maripuu, Tarmo Kriis, Peep Peterson ; interv. Külli-Riin Tigasson

Index Scriptorium Estoniae

Maripuu, Maret, 1974-

2008-01-01

Uue töölepingu seaduse eelnõust. Vestlusringis on sotsiaalminister Maret Maripuu, Eesti tööandjate keskliidu juhataja Tarmo Kriis ja transpordi ametiühingu juhatuse esimees Peep Peterson. Lisatud: mida eelnõu muudab? ; ametiühingute keskliidu juhi Harri Taliga kommentaar: dzhungliseaduste tagasitulek? ; Helmes ASi nõukogu esimehe Jaan Pillesaare kommentaar: praegune seadus on tobe

Between preservation and transformation. First considerations about the recovery of the peep districts in Parma

Directory of Open Access Journals (Sweden)

Luca Gullì

2012-10-01

Full Text Available The regeneration policy of the PEEP districts, can contribute to the enrichment of the theoretical framework formulated for the protection of the heritage of the Modern Movement. In 2011, the Municipality of Parma, showing a new awareness in relation to assets until now rarely considered, devices a specific field of study within its structural urbanistic plan. In the absence of a regulatory framework of reference, it is crucial to build up the appropriate frameworks of knowledge directed to operational decisions. This can be done by specifically dedicated archives to which to entrust with the definition of a body of rules of urban planning and housing tailored to the particularities of these settlements and to the real questions of transformation that can arise in them.

Pigeons (Columba livia) know when they will need hints: prospective metacognition for reference memory?

Science.gov (United States)

Iwasaki, Sumie; Watanabe, Sota; Fujita, Kazuo

2018-03-01

Despite their impressive cognitive abilities, avian species have shown less evidence for metacognition than mammals. We suspect that commonly used tasks such as matching to sample might be too demanding to allow metacognitive processing within birds' working memory. Here, we examined whether pigeons could control their behavior as a function of knowledge levels on a three-item sequence learning task, a reference memory task supposedly requiring fewer working memory resources. The experiment used two types of lists differing in familiarity. One was familiar to the pigeons through repeated exposure, whereas the other was novel in every new session. In test sessions, pigeons could choose between a trial with a hint specifying the next item to peck and one with no hint. However, successful responses in trials with a hint resulted in lowered rates of primary reinforcement: .60 in the first test and .75 in the second. Results showed that two of four pigeons chose the trial with a hint significantly more often before receiving a novel list than the familiar list in the four sessions of the first test, and three did so in the second test. Impressively, one bird showed robust evidence in the very first sessions in both tests. These results suggest that pigeons may monitor their long-term knowledge states and thereby control their environment before starting to solve a task.

HINTS outperforms ABCD2 to screen for stroke in acute continuous vertigo and dizziness.

Science.gov (United States)

Newman-Toker, David E; Kerber, Kevin A; Hsieh, Yu-Hsiang; Pula, John H; Omron, Rodney; Saber Tehrani, Ali S; Mantokoudis, Georgios; Hanley, Daniel F; Zee, David S; Kattah, Jorge C

2013-10-01

Dizziness and vertigo account for about 4 million emergency department (ED) visits annually in the United States, and some 160,000 to 240,000 (4% to 6%) have cerebrovascular causes. Stroke diagnosis in ED patients with vertigo/dizziness is challenging because the majority have no obvious focal neurologic signs at initial presentation. The authors sought to compare the accuracy of two previously published approaches purported to be useful in bedside screening for possible stroke in dizziness: a clinical decision rule (head impulse, nystagmus type, test of skew [HINTS]) and a risk stratification rule (age, blood pressure, clinical features, duration of symptoms, diabetes [ABCD2]). This was a cross-sectional study of high-risk patients (more than one stroke risk factor) with acute vestibular syndrome (AVS; acute, persistent vertigo or dizziness with nystagmus, plus nausea or vomiting, head motion intolerance, and new gait unsteadiness) at a single academic center. All underwent neurootologic examination, neuroimaging (97.4% by magnetic resonance imaging [MRI]), and follow-up. ABCD2 risk scores (0-7 points), using the recommended cutoff of ≥4 for stroke, were compared to a three-component eye movement battery (HINTS). Sensitivity, specificity, and positive and negative likelihood ratios (LR+, LR-) were assessed for stroke and other central causes, and the results were stratified by age. False-negative initial neuroimaging was also assessed. A total of 190 adult AVS patients were assessed (1999-2012). Median age was 60.5 years (range = 18 to 92 years; interquartile range [IQR] = 52.0 to 70.0 years); 60.5% were men. Final diagnoses were vestibular neuritis (34.7%), posterior fossa stroke (59.5% [105 infarctions, eight hemorrhages]), and other central causes (5.8%). Median ABCD2 was 4.0 (range = 2 to 7; IQR = 3.0 to 4.0). ABCD2 ≥ 4 for stroke had sensitivity of 61.1%, specificity of 62.3%, LR+ of 1.62, and LR- of 0.62; sensitivity was lower for those

Stoic Behavior Hypothesis in Hint Seeking and Development of Reversi Learning Environment as Work Bench for Investigation

Science.gov (United States)

Miwa, Kazuhisa; Kojima, Kazuaki; Terai, Hitoshi

2014-01-01

Tutoring systems provide students with various types of on-demand and context-sensitive hints. Students are required to consciously adapt their help-seeking behavior, proactively seek help in some situations, and solve problems independently without supports in other situations. We define the latter behavior as stoic behavior in hint seeking. In…

Res Publicas käärib mäss / Hants Hint

Index Scriptorium Estoniae

Hint, Hants

2002-01-01

Res Publica eestseisuse liige ja Ida-Viru piirkonna esimees Hants Hint vastab küsimustele Res Publica ja Keskerakonna võimuliidu moodustamisega tekkinud skandaali, Res Publica esimehe Juhan Partsiga kohtumise kohta. Vt. samas: "Korbi toetajaid ootab hukkamõist"

New physics hints in B decays and collider outlook

Indian Academy of Sciences (India)

There are currently two hints for new physics involving CP violation in → transitions: ≡ - / ≠ 0, and difference in direct CP asymmetry Δ A K π ≡ A K + π 0 − A K + π ≠ 0 . We explore the two scenarious with a large and unique new CP phase in ← tansitions. Motivated by ≠ 0, we update on the ...

[Peripheral vertigo versus central vertigo. Application of the HINTS protocol].

Science.gov (United States)

Batuecas-Caletrío, Ángel; Yáñez-González, Raquel; Sánchez-Blanco, Carmen; González-Sánchez, Enrique; Benito, José; Gómez, José Carlos; Santa Cruz-Ruiz, Santiago

2014-10-16

One of the most important dilemmas concerning vertigo in emergency departments is its differential diagnosis. There are highly sensitive warning signs in the examination that can put us on the path towards finding ourselves before a case of central vertigo. To determine how effective the application of the HINTS protocol is in the diagnosis of cerebrovascular accidents that mimics peripheral vertigo. We conducted a descriptive observation-based study on patients admitted to hospital with a diagnosis of acute vestibular syndrome in the emergency department. All the patients were monitored on a day-to-day basis until their symptoms improved, with information about nystagmus, the oculocephalic manoeuvre and the skew test. The results from the magnetic resonance imaging study were compared with the alteration of any of those three signs during the time the patient was hospitalised. Altogether 91 patients were examined, with a mean age of 55.8 years. A cerebrovascular accident was observed in eight cases. Of these (mean age: 71 years), in seven of them there were alterations in some of the HINTS signs, and in one case the study was normal (sensitivity: 0.88; specificity: 0.96). All of them had some vascular risk factor. Faced with a patient who visits the emergency department with an acute vestibular syndrome, a suitably directed examination is essential to be able to establish the differential diagnosis between peripheral and central pathology, since some cerebrovascular accidents can present with the appearance of acute vertigo. Applying a protocol like HINTS makes it possible to suspect the central pathology with a high degree of sensitivity and specificity.

Experimental hint for gravitational CP violation

Energy Technology Data Exchange (ETDEWEB)

Gharibyan, Vahagn [Deutsches Elektronen-Synchrotron, Hamburg (Germany). MDI Group

2016-01-15

An equality of particle and antiparticle gravitational interactions holds in general relativity and is supported by indirect observations. Gravity dependence on rotation or spin direction is experimentally constrained only at low energies. Here a method based on high energy Compton scattering is developed to measure the gravitational interaction of accelerated charged particles. Within that formalism the Compton spectra measured at HERA rule out the positron's anti-gravity and hint for a gravitational CP violation around 13 GeV energies, at a maximal level of 1.3±0.2% for the charge and 0.68±0.09% for the space parity. A stronger gravitational coupling to left helicity electrons relative to right helicity positrons is detected.

Experimental hint for gravitational CP violation

International Nuclear Information System (INIS)

Gharibyan, Vahagn

2016-01-01

An equality of particle and antiparticle gravitational interactions holds in general relativity and is supported by indirect observations. Gravity dependence on rotation or spin direction is experimentally constrained only at low energies. Here a method based on high energy Compton scattering is developed to measure the gravitational interaction of accelerated charged particles. Within that formalism the Compton spectra measured at HERA rule out the positron's anti-gravity and hint for a gravitational CP violation around 13 GeV energies, at a maximal level of 1.3±0.2% for the charge and 0.68±0.09% for the space parity. A stronger gravitational coupling to left helicity electrons relative to right helicity positrons is detected.

Employing UMLS for generating hints in a tutoring system for medical problem-based learning.

Science.gov (United States)

Kazi, Hameedullah; Haddawy, Peter; Suebnukarn, Siriwan

2012-06-01

While problem-based learning has become widely popular for imparting clinical reasoning skills, the dynamics of medical PBL require close attention to a small group of students, placing a burden on medical faculty, whose time is over taxed. Intelligent tutoring systems (ITSs) offer an attractive means to increase the amount of facilitated PBL training the students receive. But typical intelligent tutoring system architectures make use of a domain model that provides a limited set of approved solutions to problems presented to students. Student solutions that do not match the approved ones, but are otherwise partially correct, receive little acknowledgement as feedback, stifling broader reasoning. Allowing students to creatively explore the space of possible solutions is exactly one of the attractive features of PBL. This paper provides an alternative to the traditional ITS architecture by using a hint generation strategy that leverages a domain ontology to provide effective feedback. The concept hierarchy and co-occurrence between concepts in the domain ontology are drawn upon to ascertain partial correctness of a solution and guide student reasoning towards a correct solution. We describe the strategy incorporated in METEOR, a tutoring system for medical PBL, wherein the widely available UMLS is deployed and represented as the domain ontology. Evaluation of expert agreement with system generated hints on a 5-point likert scale resulted in an average score of 4.44 (Spearman's ρ=0.80, p<0.01). Hints containing partial correctness feedback scored significantly higher than those without it (Mann Whitney, p<0.001). Hints produced by a human expert received an average score of 4.2 (Spearman's ρ=0.80, p<0.01). Copyright © 2012 Elsevier Inc. All rights reserved.

Complexity hints for economic policy

CERN Document Server

Salzano, Massimo

2007-01-01

This volume extends the complexity approach to economics. This complexity approach is not a completely new way of doing economics, and that it is a replacement for existing economics, but rather the integration of some new analytic and computational techniques into economists’ bag of tools. It provides some alternative pattern generators, which can supplement existing approaches by providing an alternative way of finding patterns than be obtained by the traditional scientific approach. On this new kind of policy hints can be obtained. The reason why the complexity approach is taking hold now in economics is because the computing technology has advanced. This advance allows consideration of analytical systems that could not previously be considered by economists. Consideration of these systems suggested that the results of the "control-based" models might not extend easily to more complicated systems, and that we now have a method—piggybacking computer assisted analysis onto analytic methods—to start gen...

The Diagnostic Accuracy of Truncal Ataxia and HINTS as Cardinal Signs for Acute Vestibular Syndrome

Directory of Open Access Journals (Sweden)

Sergio Carmona

2016-08-01

Full Text Available The head impulse, nystagmus type, test of skew (HINTS protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS. The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests and negative MRI, and the rest with Stroke: 32 in the PICA territory (positive HINTS findings, positive MRI and 10 in the AICA territory (variable findings and grade 3 Ataxia, positive MRI. Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture.When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38, 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient's age. Grade 2-3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2-3 Ataxia had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate.

Can children take advantage of nao gaze-based hints during gameplay?

NARCIS (Netherlands)

Mwangi, E.N.; Diaz, M.; Barakova, E.I.; Catala, A.; Rauterberg, G.W.M.

2017-01-01

This paper presents a study that analyzes the effects of robots' gaze hints on children's performance in a card-matching game. We conducted a within-subjects study, in which children played a card matching game "Memory" in the presence of a robot tutor in two sessions. In one session, the robot gave

HINT computation of LHD equilibrium with zero rotational transform surface

International Nuclear Information System (INIS)

Kanno, Ryutaro; Toi, Kazuo; Watanabe, Kiyomasa; Hayashi, Takaya; Miura, Hideaki; Nakajima, Noriyoshi; Okamoto Masao

2004-01-01

A Large Helical Device equilibrium having a zero rotational transform surface is studied by using the three dimensional MHD equilibrium code, HINT. We find existence of the equilibrium but with formation of the two or three n=0 islands composing a homoclinic-type structure near the center, where n is a toroidal mode number. The LHD equilibrium maintains the structure, when the equilibrium beta increases. (author)

Health Information National Trends Survey in American Sign Language (HINTS-ASL): Protocol for the Cultural Adaptation and Linguistic Validation of a National Survey.

Science.gov (United States)

Kushalnagar, Poorna; Harris, Raychelle; Paludneviciene, Raylene; Hoglind, TraciAnn

2017-09-13

The Health Information National Trends Survey (HINTS) collects nationally representative data about the American's public use of health-related information. This survey is available in English and Spanish, but not in American Sign Language (ASL). Thus, the exclusion of ASL users from these national health information survey studies has led to a significant gap in knowledge of Internet usage for health information access in this underserved and understudied population. The objectives of this study are (1) to culturally adapt and linguistically translate the HINTS items to ASL (HINTS-ASL); and (2) to gather information about deaf people's health information seeking behaviors across technology-mediated platforms. We modified the standard procedures developed at the US National Center for Health Statistics Cognitive Survey Laboratory to culturally adapt and translate HINTS items to ASL. Cognitive interviews were conducted to assess clarity and delivery of these HINTS-ASL items. Final ASL video items were uploaded to a protected online survey website. The HINTS-ASL online survey has been administered to over 1350 deaf adults (ages 18 to 90 and up) who use ASL. Data collection is ongoing and includes deaf adult signers across the United States. Some items from HINTS item bank required cultural adaptation for use with deaf people who use accessible services or technology. A separate item bank for deaf-related experiences was created, reflecting deaf-specific technology such as sharing health-related ASL videos through social network sites and using video remote interpreting services in health settings. After data collection is complete, we will conduct a series of analyses on deaf people's health information seeking behaviors across technology-mediated platforms. HINTS-ASL is an accessible health information national trends survey, which includes a culturally appropriate set of items that are relevant to the experiences of deaf people who use ASL. The final HINTS

Interaction Networks: Generating High Level Hints Based on Network Community Clustering

Science.gov (United States)

Eagle, Michael; Johnson, Matthew; Barnes, Tiffany

2012-01-01

We introduce a novel data structure, the Interaction Network, for representing interaction-data from open problem solving environment tutors. We show how using network community detecting techniques are used to identify sub-goals in problems in a logic tutor. We then use those community structures to generate high level hints between sub-goals.…

PsHint1, associated with the G-protein α subunit PsGPA1, is required for the chemotaxis and pathogenicity of Phytophthora sojae.

Science.gov (United States)

Zhang, Xin; Zhai, Chunhua; Hua, Chenlei; Qiu, Min; Hao, Yujuan; Nie, Pingping; Ye, Wenwu; Wang, Yuanchao

2016-02-01

Zoospore chemotaxis to soybean isoflavones is essential in the early stages of infection by the oomycete pathogen Phytophthora sojae. Previously, we have identified a G-protein α subunit encoded by PsGPA1 which regulates the chemotaxis and pathogenicity of P. sojae. In the present study, we used affinity purification to identify PsGPA1-interacting proteins, including PsHint1, a histidine triad (HIT) domain-containing protein orthologous to human HIT nucleotide-binding protein 1 (HINT1). PsHint1 interacted with both the guanosine triphosphate (GTP)- and guanosine diphosphate (GDP)-bound forms of PsGPA1. An analysis of the gene-silenced transformants revealed that PsHint1 was involved in the chemotropic response of zoospores to the isoflavone daidzein. During interaction with a susceptible soybean cultivar, PsHint1-silenced transformants displayed significantly reduced infectious hyphal extension and caused a strong cell death in plants. In addition, the transformants displayed defective cyst germination, forming abnormal germ tubes that were highly branched and exhibited apical swelling. These results suggest that PsHint1 not only regulates chemotaxis by interacting with PsGPA1, but also participates in a Gα-independent pathway involved in the pathogenicity of P. sojae. © 2015 BSPP AND JOHN WILEY & SONS LTD.

"THE EVALUATION OF THE POSSIBLE EFFECT OF POSITIVE END EXPIRATORY PRESSURE (PEEP) ON PHARMACOKINETICS OF PHENYTOIN IN PATIENTS WITH ACUTE BRAIN INJURY UNDER MECHANICAL VENTILATION."

OpenAIRE

"Elham Hadidi; Mojtaba Mojtahedzadeh; Mohammad Reza Rouini; Behzad Eftekhar; Mohammad Abdollahi; Atabak Najafi; Mohammad R. Khajavi; Saeed Rezaee; Reza Ghaffari; Minoo Afshar"

2005-01-01

Positive ventilation has shown to have an influence on pharmacokinetic and disposition of some drugs.Beacause phenytoin with a narrow therapautic range, is the most commonly used drug for prophylaxis and treatment of early seizures after acute brain injuries, in the present study the effect of short term PEEP (5-10 cm H2O for at least 8 hours) on phenytoin serum concentration and pharmacokinetic parameters such as Vmax and clearance in brain injured patients under mechanical ventilation was e...

Pedagogical Agent Gestures to Improve Learner Comprehension of Abstract Concepts in Hints

Science.gov (United States)

Martins, Igor; de Morais, Felipe; Schaab, Bruno; Jaques, Patricia

2016-01-01

In most Intelligent Tutoring Systems, the help messages (hints) are not very clear for students as they are only presented textually and have little connection with the task elements. This can lead to students' undesired behaviors, like gaming the system, associated with low performance. In this paper, the authors aim at evaluating if the gestures…

HINT-KB: The human interactome knowledge base

KAUST Repository

Theofilatos, Konstantinos A.

2012-01-01

Proteins and their interactions are considered to play a significant role in many cellular processes. The identification of Protein-Protein interactions (PPIs) in human is an open research area. Many Databases, which contain information about experimentally and computationally detected human PPIs as well as their corresponding annotation data, have been developed. However, these databases contain many false positive interactions, are partial and only a few of them incorporate data from various sources. To overcome these limitations, we have developed HINT-KB (http://150.140.142.24:84/Default.aspx) which is a knowledge base that integrates data from various sources, provides a user-friendly interface for their retrieval, estimates a set of features of interest and computes a confidence score for every candidate protein interaction using a modern computational hybrid methodology. © 2012 IFIP International Federation for Information Processing.

Altered Light Conditions Contribute to Abnormalities in Emotion and Cognition Through HINT1 Dysfunction in C57BL/6 Mice

Directory of Open Access Journals (Sweden)

Yuan Zhou

2018-06-01

Full Text Available In recent years, the environmental impact of artificial light at night has been a rapidly growing global problem, affecting 99% of the population in the US and Europe, and 62% of the world population. The present study utilized a mouse model exposed to long-term artificial light and light deprivation to explore the impact of these conditions on emotion and cognition. Based on the potential links between histidine triad nucleotide binding protein 1 (HINT1 and mood disorders, we also examined the expression of HINT1 and related apoptosis factors in the suprachiasmatic nucleus (SCN, prefrontal cortex (PFC, nucleus accumbens (NAc and hippocampus (Hip. Mice exposed to constant light (CL exhibited depressive- and anxiety-like behaviors, as well as impaired spatial memory, as demonstrated by an increased immobility time in the tail suspension and forced swimming tests, less entries and time spent in the open arms of elevated plus-maze, and less platform site crossings and time spent in the target quadrant in the Morris water maze (MWM. The effects of constant darkness (CD partially coincided with long-term illumination, except that mice in the CD group failed to show anxiety-like behaviors. Furthermore, HINT1 was upregulated in four encephalic regions, indicating that HINT1 may be involved in mood disorders and cognitive impairments due to altered light exposure. The apoptosis-related proteins, BAX and BCL-2, showed the opposite expression pattern, reflecting an activated apoptotic pathway. These findings suggest that exposure to CL and/or darkness can induce significant changes in affective and cognitive responses, possibly through HINT1-induced activation of apoptotic pathways.

Data-Driven Hint Generation in Vast Solution Spaces: A Self-Improving Python Programming Tutor

Science.gov (United States)

Rivers, Kelly; Koedinger, Kenneth R.

2017-01-01

To provide personalized help to students who are working on code-writing problems, we introduce a data-driven tutoring system, ITAP (Intelligent Teaching Assistant for Programming). ITAP uses state abstraction, path construction, and state reification to automatically generate personalized hints for students, even when given states that have not…

NOAA People Empowered Products (PeEP): Combining social media with scientific models to provide eye-witness confirmed products

Science.gov (United States)

Codrescu, S.; Green, J. C.; Redmon, R. J.; Minor, K.; Denig, W. F.; Kihn, E. A.

2013-12-01

NOAA products and alerts rely on combinations of models and data to provide the public with information regarding space and terrestrial weather phenomena and hazards. This operational paradigm, while effective, neglects an abundant free source of measurements: millions of eyewitnesses viewing weather events. We demonstrate the capabilities of a prototype People Empowered Product (PeEP) that combines the OVATION prime auroral model running at the NOAA National Geophysical Data Center with Twitter reports of observable aurora. We introduce an algorithm for scoring Tweets based on keywords to improve the signal to noise of this dynamic data source. We use the location of the aurora derived from this new database of crowd sourced observations to validate the OVATION model for use in auroral forecasting. The combined product displays the model aurora in real time with markers showing the location and text of tweets from people actually observing the aurora. We discuss how the application might be extended to other space weather products such as radiation related satellite anomalies.

Development and Validation of a Novel Generic Health-related Quality of Life Instrument With 20 Items (HINT-20

Directory of Open Access Journals (Sweden)

Min-Woo Jo

2017-01-01

Full Text Available Objectives Few attempts have been made to develop a generic health-related quality of life (HRQoL instrument and to examine its validity and reliability in Korea. We aimed to do this in our present study. Methods After a literature review of existing generic HRQoL instruments, a focus group discussion, in-depth interviews, and expert consultations, we selected 30 tentative items for a new HRQoL measure. These items were evaluated by assessing their ceiling effects, difficulty, and redundancy in the first survey. To validate the HRQoL instrument that was developed, known-groups validity and convergent/discriminant validity were evaluated and its test-retest reliability was examined in the second survey. Results Of the 30 items originally assessed for the HRQoL instrument, four were excluded due to high ceiling effects and six were removed due to redundancy. We ultimately developed a HRQoL instrument with a reduced number of 20 items, known as the Health-related Quality of Life Instrument with 20 items (HINT-20, incorporating physical, mental, social, and positive health dimensions. The results of the HINT-20 for known-groups validity were poorer in women, the elderly, and those with a low income. For convergent/discriminant validity, the correlation coefficients of items (except vitality in the physical health dimension with the physical component summary of the Short Form 36 version 2 (SF-36v2 were generally higher than the correlations of those items with the mental component summary of the SF-36v2, and vice versa. Regarding test-retest reliability, the intraclass correlation coefficient of the total HINT-20 score was 0.813 (p<0.001. Conclusions A novel generic HRQoL instrument, the HINT-20, was developed for the Korean general population and showed acceptable validity and reliability.

Efeitos da compressão torácica manual versus a manobra de PEEP-ZEEP na complacência do sistema respiratório e na oxigenação de pacientes submetidos à ventilação mecânica invasiva Effects of manual rib-cage compression versus PEEP-ZEEP maneuver on respiratory system compliance and oxygenation in patients receiving mechanical ventilation

Directory of Open Access Journals (Sweden)

Flavio Renato Antunes dos Santos

2009-06-01

Full Text Available OBJETIVOS: Os pacientes com incapacidade de desempenhar suas funções ventilatórias podem ser submetidos à ventilação mecânica invasiva. A fisioterapia respiratória atua no tratamento destes pacientes com a finalidade de melhorar sua função pulmonar. O objetivo do estudo foi avaliar os efeitos da compressão torácica manual versus a manobra de pressão expiratória final positiva-pressão expiratória final zero (PEEP-ZEEP na complacência do sistema respiratório e na oxigenação de pacientes em ventilação mecânica invasiva. MÉTODOS: Foi realizado um estudo bicêntrico, prospectivo, randomizado e crossover, incluindo pacientes em ventilação mecânica invasiva em modo controlado por um período superior a 48 horas. Os protocolos de fisioterapia respiratória foram realizados de forma aleatória, com intervalo de 24 horas entre eles. Dados da complacência do sistema respiratório e da oxigenação foram coletados antes da aplicação dos protocolos e 30 minutos após a aplicação dos mesmos. RESULTADOS: Doze pacientes completaram o estudo. Na análise intragrupo, em ambas as técnicas houve aumento estatisticamente significativo do volume corrente (p=0,002, da complacência estática (p=0,002 e complacência dinâmica (p=0,002. Com relação à oxigenação, no grupo compressão torácica manual, a saturação periférica de oxigênio aumentou com diferença significativa (p=0,011. CONCLUSÕES: A compressão torácica manual e a manobra de PEEP-ZEEP têm efeitos clínicos positivos e não diferem entre si. Em relação à oxigenação encontramos um comportamento favorável da saturação periférica de oxigênio no grupo compressão torácica manual.OBJECTIVES: Patients unable to perform breathing functions may be submitted to invasive mechanical ventilation. Chest physiotherapy acts directly on the treatment of these patients for the purpose of improving their lung function. The objective of this study was to evaluate the

Hemodynamic responses to external counterbalancing of auto-positive end-expiratory pressure in mechanically ventilated patients with chronic obstructive pulmonary disease.

Science.gov (United States)

Baigorri, F; de Monte, A; Blanch, L; Fernández, R; Vallés, J; Mestre, J; Saura, P; Artigas, A

1994-11-01

To study the effect of positive end-expiratory pressure (PEEP) on right ventricular hemodynamics and ejection fraction in patients with chronic obstructive pulmonary disease and positive alveolar pressure throughout expiration by dynamic hyperinflation (auto-PEEP). Open, prospective, controlled trial. General intensive care unit of a community hospital. Ten patients sedated and paralyzed with an acute exacerbation of chronic obstructive pulmonary disease undergoing mechanical ventilation. Insertion of a pulmonary artery catheter modified with a rapid response thermistor and a radial arterial catheter. PEEP was then increased from 0 (PEEP 0) to auto-PEEP level (PEEP = auto-PEEP) and 5 cm H2O above that (PEEP = auto-PEEP +5). At each level of PEEP, airway pressures, flow and volume, hemodynamic variables (including right ventricular ejection fraction by thermodilution technique), and blood gas analyses were recorded. The mean auto-PEEP was 6.6 +/- 2.8 cm H2O and the total PEEP reached was 12.2 +/- 2.4 cm H2O. The degree of lung inflation induced by PEEP averaged 145 +/- 87 mL with PEEP = auto-PEEP and 495 +/- 133 mL with PEEP = auto-PEEP + 5. The PEEP = auto-PEEP caused a right ventricular end-diastolic pressure increase, but there was no other significant hemodynamic change. With PEEP = auto-PEEP + 5, there was a significant increase in intravascular pressures; this amount of PEEP reduced cardiac output (from 4.40 +/- 1.38 L/min at PEEP 0 to 4.13 +/- 1.48 L/min; p 10% in only five cases and this group of patients had significantly lower right ventricular volumes than the group with less cardiac output variation (right ventricular end-diastolic volume: 64 +/- 9 vs. 96 +/- 26 mL/m2; right ventricular end-systolic volume: 38 +/- 6 vs. 65 +/- 21 mL/m2; p < .05) without significant difference in the other variables that were measured. Neither right ventricular ejection fraction nor right ventricle volumes changed as PEEP increased, but there were marked interpatient

The relationship between high-frequency pure-tone hearing loss, hearing in noise test (HINT) thresholds, and the articulation index.

Science.gov (United States)

Vermiglio, Andrew J; Soli, Sigfrid D; Freed, Daniel J; Fisher, Laurel M

2012-01-01

Speech recognition in noise testing has been conducted at least since the 1940s (Dickson et al, 1946). The ability to recognize speech in noise is a distinct function of the auditory system (Plomp, 1978). According to Kochkin (2002), difficulty recognizing speech in noise is the primary complaint of hearing aid users. However, speech recognition in noise testing has not found widespread use in the field of audiology (Mueller, 2003; Strom, 2003; Tannenbaum and Rosenfeld, 1996). The audiogram has been used as the "gold standard" for hearing ability. However, the audiogram is a poor indicator of speech recognition in noise ability. This study investigates the relationship between pure-tone thresholds, the articulation index, and the ability to recognize speech in quiet and in noise. Pure-tone thresholds were measured for audiometric frequencies 250-6000 Hz. Pure-tone threshold groups were created. These included a normal threshold group and slight, mild, severe, and profound high-frequency pure-tone threshold groups. Speech recognition thresholds in quiet and in noise were obtained using the Hearing in Noise Test (HINT) (Nilsson et al, 1994; Vermiglio, 2008). The articulation index was determined by using Pavlovic's method with pure-tone thresholds (Pavlovic, 1989, 1991). Two hundred seventy-eight participants were tested. All participants were native speakers of American English. Sixty-three of the original participants were removed in order to create groups of participants with normal low-frequency pure-tone thresholds and relatively symmetrical high-frequency pure-tone threshold groups. The final set of 215 participants had a mean age of 33 yr with a range of 17-59 yr. Pure-tone threshold data were collected using the Hughson-Weslake procedure. Speech recognition data were collected using a Windows-based HINT software system. Statistical analyses were conducted using descriptive, correlational, and multivariate analysis of covariance (MANCOVA) statistics. The

Hint of a Z' boson from the CERN LEP II data

International Nuclear Information System (INIS)

Gulov, A. V.; Skalozub, V. V.

2007-01-01

The many-parametric fits of the LEP2 data on e + e - →e + e - , μ + μ - , τ + τ - processes are performed with the goal to estimate the signals of the Abelian Z ' boson. Four independent parameters must be fitted, if the derived already low-energy relations between the Z ' couplings to the standard model fermions are taken into consideration. No signals are found when the complete LEP2 data set for these processes is treated. In the fit of the backward bins, the hint at the 1.3σ confidence level is detected. The Z ' couplings to the vector and axial-vector lepton currents are constrained. The comparisons with the one-parameter fits and with the corresponding LEP1 experiments are fulfilled

Axion-like particles: possible hints and constraints from the high-energy Universe

International Nuclear Information System (INIS)

Brun, Pierre

2013-01-01

The high-energy Universe is potentially a great laboratory for searching new light bosons such as axion-like particles (ALPs). Cosmic sources are indeed the scene of violent phenomena that involve strong magnetic field and/or very long baselines, where the effects of the mixing of photons with ALPs could lead to observable effects. Two examples are archetypal of this fact, that are the Universe opacity to gamma-rays and the imprints of astrophysical magnetic turbulence in the energy spectra of high-energy sources. In the first case, hints for the existence of ALPs can be proposed whereas the second one is used to put constraints on the ALP mass and coupling to photons

Hints for clarification of influencing factors in case of occupational liver diseases

Energy Technology Data Exchange (ETDEWEB)

Zober, A; Raithel, H; Valentin, H

1981-05-01

Clarification of influencing factors is of great importance in suspected occupational liver diseases. Hints are given on the basis of the author's own experience and after critical evaluation of the relevant literature. Most important are: 1) Establishment of a comprehensive working anamnesis with special regard to specific features of the job, exposure patterns, and all working materials; 2) assessment of the hepatotoxic potential of the suspected working material according to the present state of knowledge in working medicine and toxicology; 3) objectification and quantification of the suspected noxious substances at the place of work by means of air analysis and analysis of the biological matter; 4) differential diagnosis in view of possible competitive influencing factors.

New physics hints in Β decays and collider outlook

International Nuclear Information System (INIS)

Hou, George W.S.

2006-01-01

There are currently two hints for new physics involving CP violation in b →s transitions: ΔS ≡ S f - S J/ ψK ≠ 0, and difference in direct CP asymmetry ΔA Kπ ≡ A K + π 0 - A K + π - ≠0. We explore the two scenarios with a large and unique new CP phase in b s transitions. Motivated by ΔS ≠ 0, we update on the right-handed strange beauty squark sb 1R at TeV scale. Motivated by ΔA Kπ ≠ 0, we explore sequential fourth generation t and b quarks. Both scenarios can survive constraints such as SM level b→sγ, sll and Β s mixing, and predict sizable CP violation in Β s mixing. The fourth generation picture predicts sizable K L → π 0 νν. Direct search for sb R , b' and t' at hadronic colliders, such as Tevatron Run II and LHC, can complement further CP violation studies at these machines, as well as at the future Super Β factory. (author)

Hint of nonstandard Mikheyev-Smirnov-Wolfenstein dynamics in solar neutrino conversion

Science.gov (United States)

Palazzo, Antonio

2011-05-01

Motivated by the recent low-threshold measurements of the solar B8 neutrino spectrum performed by Borexino, Super-Kamiokande and the Sudbury Neutrino Observatory—all now monitoring the transition regime between low-energy (vacuumlike) and high-energy (matter-dominated) flavor conversions—we consider the role of subdominant dynamical terms induced by new flavor-changing interactions. We find that the presence of such perturbations with strength ˜10-1GF is now favored, offering a better description of the anomalous behavior suggested by the new results, whose spectrum shows no sign of the typical low-energy upturn predicted by the standard Mikheyev-Smirnov-Wolfenstein (MSW) mechanism. Our findings, if interpreted in a 2-flavor scheme, provide a hint of such new interactions at the ˜2σ level, which is rather robust with respect to 3-flavor effects possibly induced by nonzero θ13.

ALGUNAS PAUTAS PARA LA ESCRITURA DE ARTÍCULOS CIENTÍFICOS SOME HINTS FOR WRITING SCIENTIFIC PAPERS

Directory of Open Access Journals (Sweden)

Carlos M Zapata

2008-06-01

Full Text Available El objetivo de este artículo es presentar, a aquellos investigadores neófitos, una serie de pautas que faciliten los procesos de escritura y publicación de manuscritos en revistas científicas de corriente principal. En la comunidad científica, una investigación sólo se completa cuando los resultados se socializan a través de artículos en revistas arbitradas que garanticen la originalidad, importancia y validez científica de los hallazgos reportados. Consecuentemente, es necesario que los investigadores desarrollen destrezas y habilidades en la escritura científica. Sin embargo, el proceso de preparación de un manuscrito, desde su fase inicial hasta su publicación final, suele ser largo y difícil, debido a algunos factores clave que tienen influencia sobre su calidad. Este artículo, suministra lineamientos generales sobre la preparación de manuscritos y entrega, también, pautas alrededor de las buenas prácticas de escritura de artículos con miras a facilitar la revisión por parte de los árbitros. En este sentido, este trabajo constituye aporte para quienes se inician en la difusión de la investigación científica.The objective of this paper is to present, to those neophyte researchers, a set of hints that facilitate manuscript writing and publishing processes needed for high class scientific journals. In the scientific community, a research would only be completed when the results are shared through papers in peer-reviewed journals that guarantees the originality, importance and scientific validation of reported contributions. Consequently, researchers have the necessity to develop skills and abilities in scientific writing. However, the manuscript preparation process from the initial phase to the final publication is usually slow and difficult, due to some key factors having influence over its quality. In this paper, we present general guidelines about manuscript preparation and we give some hints about good scientific

Hint of nonstandard Mikheyev-Smirnov-Wolfenstein dynamics in solar neutrino conversion

International Nuclear Information System (INIS)

Palazzo, Antonio

2011-01-01

Motivated by the recent low-threshold measurements of the solar 8 B neutrino spectrum performed by Borexino, Super-Kamiokande and the Sudbury Neutrino Observatory--all now monitoring the transition regime between low-energy (vacuumlike) and high-energy (matter-dominated) flavor conversions--we consider the role of subdominant dynamical terms induced by new flavor-changing interactions. We find that the presence of such perturbations with strength ∼10 -1 G F is now favored, offering a better description of the anomalous behavior suggested by the new results, whose spectrum shows no sign of the typical low-energy upturn predicted by the standard Mikheyev-Smirnov-Wolfenstein (MSW) mechanism. Our findings, if interpreted in a 2-flavor scheme, provide a hint of such new interactions at the ∼2σ level, which is rather robust with respect to 3-flavor effects possibly induced by nonzero θ 13 .

Seven Hints for Primordial Black Hole Dark Matter arXiv

CERN Document Server

Clesse, Sebastien

Seven observations point towards the existence of primordial black holes (PBH), constituting the whole or an important fraction of the dark matter in the Universe: the mass and spin of black holes detected by Advanced LIGO/VIRGO, the detection of micro-lensing events of distant quasars and stars in M31, the non-detection of ultra-faint dwarf satellite galaxies with radius below 15 parsecs, evidences for core galactic dark matter profiles, the correlation between X-ray and infrared cosmic backgrounds, and the existence of super-massive black holes very early in the Universe's history. Some of these hints are newly identified and they are all intriguingly compatible with the re-constructed broad PBH mass distribution from LIGO events, peaking on PBH mass $m_{\\rm PBH} \\approx 3 M_\\odot$ and passing all other constraints on PBH abundances. PBH dark matter also provides a new mechanism to explain the mass-to-light ratios of dwarf galaxies, including the recent detection of a diffuse galaxy not dominated by dark ma...

Clinical assessment of auto-positive end-expiratory pressure by diaphragmatic electrical activity during pressure support and neurally adjusted ventilatory assist.

Science.gov (United States)

Bellani, Giacomo; Coppadoro, Andrea; Patroniti, Nicolò; Turella, Marta; Arrigoni Marocco, Stefano; Grasselli, Giacomo; Mauri, Tommaso; Pesenti, Antonio

2014-09-01

Auto-positive end-expiratory pressure (auto-PEEP) may substantially increase the inspiratory effort during assisted mechanical ventilation. Purpose of this study was to assess whether the electrical activity of the diaphragm (EAdi) signal can be reliably used to estimate auto-PEEP in patients undergoing pressure support ventilation and neurally adjusted ventilatory assist (NAVA) and whether NAVA was beneficial in comparison with pressure support ventilation in patients affected by auto-PEEP. In 10 patients with a clinical suspicion of auto-PEEP, the authors simultaneously recorded EAdi, airway, esophageal pressure, and flow during pressure support and NAVA, whereas external PEEP was increased from 2 to 14 cm H2O. Tracings were analyzed to measure apparent "dynamic" auto-PEEP (decrease in esophageal pressure to generate inspiratory flow), auto-EAdi (EAdi value at the onset of inspiratory flow), and IDEAdi (inspiratory delay between the onset of EAdi and the inspiratory flow). The pressure necessary to overcome auto-PEEP, auto-EAdi, and IDEAdi was significantly lower in NAVA as compared with pressure support ventilation, decreased with increase in external PEEP, although the effect of external PEEP was less pronounced in NAVA. Both auto-EAdi and IDEAdi were tightly correlated with auto-PEEP (r = 0.94 and r = 0.75, respectively). In the presence of auto-PEEP at lower external PEEP levels, NAVA was characterized by a characteristic shape of the airway pressure. In patients with auto-PEEP, NAVA, compared with pressure support ventilation, led to a decrease in the pressure necessary to overcome auto-PEEP, which could be reliably monitored by the electrical activity of the diaphragm before inspiratory flow onset (auto-EAdi).

Particle Swarm Optimization algorithms for geophysical inversion, practical hints

Science.gov (United States)

Garcia Gonzalo, E.; Fernandez Martinez, J.; Fernandez Alvarez, J.; Kuzma, H.; Menendez Perez, C.

2008-12-01

PSO is a stochastic optimization technique that has been successfully used in many different engineering fields. PSO algorithm can be physically interpreted as a stochastic damped mass-spring system (Fernandez Martinez and Garcia Gonzalo 2008). Based on this analogy we present a whole family of PSO algorithms and their respective first order and second order stability regions. Their performance is also checked using synthetic functions (Rosenbrock and Griewank) showing a degree of ill-posedness similar to that found in many geophysical inverse problems. Finally, we present the application of these algorithms to the analysis of a Vertical Electrical Sounding inverse problem associated to a seawater intrusion in a coastal aquifer in South Spain. We analyze the role of PSO parameters (inertia, local and global accelerations and discretization step), both in convergence curves and in the a posteriori sampling of the depth of an intrusion. Comparison is made with binary genetic algorithms and simulated annealing. As result of this analysis, practical hints are given to select the correct algorithm and to tune the corresponding PSO parameters. Fernandez Martinez, J.L., Garcia Gonzalo, E., 2008a. The generalized PSO: a new door to PSO evolution. Journal of Artificial Evolution and Applications. DOI:10.1155/2008/861275.

Effects of positive end-expiratory pressure titration and recruitment maneuver on lung inflammation and hyperinflation in experimental acid aspiration-induced lung injury.

Science.gov (United States)

Ambrosio, Aline M; Luo, Rubin; Fantoni, Denise T; Gutierres, Claudia; Lu, Qin; Gu, Wen-Jie; Otsuki, Denise A; Malbouisson, Luiz M S; Auler, Jose O C; Rouby, Jean-Jacques

2012-12-01

In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological inflammation and hyperinflation in pigs with acid aspiration-induced lung injury. Forty-seven pigs were randomly allocated in seven groups: (1) controls spontaneously breathing; (2) without lung injury, PEEP 5 cm H2O; (3) without lung injury, PEEP titration; (4) without lung injury, PEEP titration + recruitment maneuver; (5) with lung injury, PEEP 5 cm H2O; (6) with lung injury, PEEP titration; and (7) with lung injury, PEEP titration + recruitment maneuver. Acute lung injury was induced by intratracheal instillation of hydrochloric acid. PEEP titration was performed by incremental and decremental PEEP from 5 to 20 cm H2O for optimizing arterial oxygenation. Three recruitment maneuvers (pressure of 40 cm H2O maintained for 20 s) were applied to the assigned groups at each PEEP level. Proportion of lung inflammation, hemorrhage, edema, and alveolar wall disruption were recorded on each histological field. Mean alveolar area was measured in the aerated lung regions. Acid aspiration increased mean alveolar area and produced alveolar wall disruption, lung edema, alveolar hemorrhage, and lung inflammation. PEEP titration significantly improved arterial oxygenation but simultaneously increased lung inflammation in juxta-diaphragmatic lung regions. Recruitment maneuver during PEEP titration did not induce additional increase in lung inflammation and alveolar hyperinflation. In a porcine model of acid aspiration-induced lung injury, PEEP titration aimed at optimizing arterial oxygenation, substantially increased lung inflammation. Recruitment maneuvers further improved arterial oxygenation without additional effects on inflammation and hyperinflation.

Alveolar Tidal recruitment/derecruitment and Overdistension During Four Levels of End-Expiratory Pressure with Protective Tidal Volume During Anesthesia in a Murine Lung-Healthy Model.

Science.gov (United States)

Soares, Joao Henrique Neves; Carvalho, Alysson Roncally; Bergamini, Bruno Curty; Gress, Maria Alice Kuster; Jandre, Frederico Caetano; Zin, Walter Araujo; Giannella-Neto, Antonio

2018-06-01

We compared respiratory mechanics between the positive end-expiratory pressure of minimal respiratory system elastance (PEEP minErs ) and three levels of PEEP during low-tidal-volume (6 mL/kg) ventilation in rats. Twenty-four rats were anesthetized, paralyzed, and mechanically ventilated. Airway pressure (P aw ), flow (F), and volume (V) were fitted by a linear single compartment model (LSCM) P aw (t) = E rs  × V(t) + R rs  × F(t) + PEEP or a volume- and flow-dependent SCM (VFDSCM) P aw (t) = (E 1  + E 2  × V(t)) × V(t) + (K 1  + K 2  × |F(t)|) × F(t) + PEEP, where E rs and R rs are respiratory system elastance and resistance, respectively; E 1 and E 2 × V are volume-independent and volume-dependent E rs , respectively; and K 1 and K 2  × F are flow-independent and flow-dependent R rs , respectively. Animals were ventilated for 1 h at PEEP 0 cmH 2 O (ZEEP); PEEP minErs ; 2 cmH 2 O above PEEP minErs (PEEP minErs+2 ); or 4 cmH 2 O above PEEP minErs (PEEP minErs+4 ). Alveolar tidal recruitment/derecruitment and overdistension were assessed by the index %E 2  = 100 × [(E 2  × V T )/(E 1  + |E 2 | × V T )], and alveolar stability by the slope of E rs (t). %E 2 varied between 0 and 30% at PEEP minErs in most respiratory cycles. Alveolar Tidal recruitment/derecruitment (%E 2   30) were predominant in the absence of PEEP and in PEEP levels higher than PEEP minErs , respectively. The slope of E rs (t) was different from zero in all groups besides PEEP minErs+4 . PEEP minErs presented the best compromise between alveolar tidal recruitment/derecruitment and overdistension, during 1 h of low-V T mechanical ventilation.

Setting individualized positive end-expiratory pressure level with a positive end-expiratory pressure decrement trial after a recruitment maneuver improves oxygenation and lung mechanics during one-lung ventilation.

Science.gov (United States)

Ferrando, Carlos; Mugarra, Ana; Gutierrez, Andrea; Carbonell, Jose Antonio; García, Marisa; Soro, Marina; Tusman, Gerardo; Belda, Francisco Javier

2014-03-01

We investigated whether individualized positive end-expiratory pressure (PEEP) improves oxygenation, ventilation, and lung mechanics during one-lung ventilation compared with standardized PEEP. Thirty patients undergoing thoracic surgery were randomly allocated to the study or control group. Both groups received an alveolar recruitment maneuver at the beginning and end of one-lung ventilation. After the alveolar recruitment maneuver, the control group had their lungs ventilated with a 5 cm·H2O PEEP, while the study group had their lungs ventilated with an individualized PEEP level determined by a PEEP decrement trial. Arterial blood samples, lung mechanics, and volumetric capnography were recorded at multiple timepoints throughout the procedure. The individualized PEEP values in study group were higher than the standardized PEEP values (10 ± 2 vs 5 cm·H2O; P decrement trial than with a standardized 5 cm·H2O of PEEP.

Neonatal Pneumothorax Pressures Surpass Higher Threshold in Lung Recruitment Maneuvers: An In Vivo Interventional Study.

Science.gov (United States)

González-Pizarro, Patricio; García-Fernández, Javier; Canfrán, Susana; Gilsanz, Fernando

2016-02-01

Causing pneumothorax is one of the main concerns of lung recruitment maneuvers in pediatric patients, especially newborns. Therefore, these maneuvers are not performed routinely during anesthesia. Our objective was to determine the pressures that cause pneumothorax in healthy newborns by a prospective experimental study of 10 newborn piglets (pneumothorax. Animals under anesthesia and bilateral chest tube catheterization were randomly allocated to 2 groups: one with PEEP and fixed inspiratory driving pressure of 15 cm H2O (PEEP group) and the second one with PEEP = 0 cm H2O and non-fixed inspiratory driving pressure (zero PEEP group). In both groups, the ventilation mode was pressure-controlled, and PIP was raised at 2-min intervals, with steps of 5 cm H2O until air leak was observed through the chest tubes. The PEEP group raised PIP through 5-cm H2O PEEP increments, and the zero PEEP group raised PIP through 5-cm H2O inspiratory driving pressure increments. Pneumothorax was observed with a PIP of 90.5 ± 15.7 cm H2O with no statistically significant differences between the PEEP group (92 ± 14.8 cm H2O) and the zero PEEP group (89 ± 18.2 cm H2O). The zero PEEP group had hypotension, with a PIP of 35 cm H2O; the PEEP group had hypotension, with a PIP of 60 cm H2O (P = .01). The zero PEEP group presented bradycardia, with PIP of 40 cm H2O; the PEEP group presented bradycardia, with PIP of 70 cm H2O (P = .002). Performing recruitment maneuvers in newborns without lung disease is a safe procedure in terms of pneumothorax. Pneumothorax does not seem to occur in the clinically relevant PIPs of pneumothorax PIP in poorly compliant lungs. Copyright © 2016 by Daedalus Enterprises.

Positive end expiratory pressure during one-lung ventilation: Selecting ideal patients and ventilator settings with the aim of improving arterial oxygenation

Directory of Open Access Journals (Sweden)

Hoftman Nir

2011-01-01

Full Text Available The efficacy of positive end-expiratory pressure (PEEP in treating intraoperative hypoxemia during one-lung ventilation (OLV remains in question given conflicting results of prior studies. This study aims to (1 evaluate the efficacy of PEEP during OLV, (2 assess the utility of preoperative predictors of response to PEEP, and (3 explore optimal intraoperative settings that would maximize the effects of PEEP on oxygenation. Forty-one thoracic surgery patients from a single tertiary care university center were prospectively enrolled in this observational study. After induction of general anesthesia, a double-lumen endotracheal tube was fiberoptically positioned and OLV initiated. Intraoperatively, PEEP = 5 and 10 cmH 2 O were sequentially applied to the ventilated lung during OLV. Arterial oxygenation, cardiovascular performance parameters, and proposed perioperative variables that could predict or enhance response to PEEP were analysed. T-test and c2 tests were utilized for continuous and categorical variables, respectively. Multivariate analyses were carried out using a classification tree model of binary recursive partitioning. PEEP improved arterial oxygenation by ≥20% in 29% of patients (n = 12 and failed to do so in 71% (n = 29; however, no cardiovascular impact was noted. Among the proposed clinical predictors, only intraoperative tidal volume per kilogram differed significantly between responders to PEEP and non-responders (mean 6.6 vs. 5.7 ml/kg, P = 0.013; no preoperative variable predicted response to PEEP. A multivariate analysis did not yield a clinically significant model for predicting PEEP responsiveness. PEEP improved oxygenation in a subset of patients; larger, although still protective tidal volumes favored a positive response to PEEP. No preoperative variables, however, could be identified as reliable predictors for PEEP responders.

Respiratory effects of low versus high tidal volume with or without positive end-expiratory pressure in anesthetized dogs with healthy lungs.

Science.gov (United States)

De Monte, Valentina; Bufalari, Antonello; Grasso, Salvatore; Ferrulli, Fabienne; Crovace, Alberto Maria; Lacitignola, Luca; Staffieri, Francesco

2018-05-01

OBJECTIVE To evaluate the impact of 2 tidal volumes (T V s) with or without positive end-expiratory pressure (PEEP) on lung mechanics, aeration, and gas exchange in healthy anesthetized dogs. ANIMALS 40 mixed-breed dogs with healthy lungs. PROCEDURES Anesthetized dogs were randomly assigned to 4 groups (n = 10/group) with different ventilatory settings: T V of 8 mL/kg and PEEP of 0 cm H 2 O (low T V group), T V of 8 mL/kg and PEEP of 5 cm H 2 O (low T V plus PEEP group), T V of 15 mL/kg and PEEP of 0 cm H 2 O (high T V group), or T V of 15 mL/kg and PEEP of 5 cm H 2 O (high T V plus PEEP group). Expired CO 2 and respiratory rate were titrated on the basis of a predetermined stepwise protocol. Gas exchange, respiratory mechanics, and pulmonary aeration were evaluated by means of CT 30 minutes after starting mechanical ventilation at the assigned setting. RESULTS Partial pressures of arterial and expired CO 2 were higher in the low T V and low T V plus PEEP groups than in the high T V and high T V plus PEEP groups. Peak and plateau airway pressures were higher in the PEEP group than in the other groups. Static lung compliance was higher in the high T V plus PEEP group than in the low T V group. Relative percentages of atelectatic and poorly aerated lung were lower in the high T V plus PEEP group than in the other groups. Oxygenation was similar among groups. CONCLUSIONS AND CLINICAL RELEVANCE Differences in T V and PEEP application during mechanical ventilation may affect respiratory function in anesthetized dogs with healthy lungs. Ventilation with a T V of 15 mL/kg and PEEP of 5 cm H 2 O significantly improved lung compliance and reduced the amount of atelectatic and poorly aerated lung.

Modelling magnetic islands in the H-1NF heliac with the hint code

International Nuclear Information System (INIS)

Lloyd, S.S.; Gardner, H.J.

1999-01-01

Full text: Recent progress in the theoretical modelling of the effects of plasma pressure on the growth and change in geometry of magnetic islands in the H-1NF Heliac will be reviewed. The HINT magnetohydrodynamic equilibrium code, which has become a standard workhorse in the stellarator community for problems of this type, has been modified to incorporate an interpolation algorithm which significantly accelerates its convergence. This has enabled the critical evaluation of earlier results, and of some conventional wisdom. In many ways the treatment of magnetic islands in low shear fusion reactors, such as H-1NF, is an ideal case study in computational science - the devil is in the details and the devil is important: the existence or otherwise of island self-healing at reactor pressures could significantly affect the design of future experiments. (author)

Impact of Different Ventilation Strategies on Driving Pressure, Mechanical Power, and Biological Markers During Open Abdominal Surgery in Rats.

Science.gov (United States)

Maia, Lígia de A; Samary, Cynthia S; Oliveira, Milena V; Santos, Cintia L; Huhle, Robert; Capelozzi, Vera L; Morales, Marcelo M; Schultz, Marcus J; Abreu, Marcelo G; Pelosi, Paolo; Silva, Pedro L; Rocco, Patricia Rieken Macedo

2017-10-01

Intraoperative mechanical ventilation may yield lung injury. To date, there is no consensus regarding the best ventilator strategy for abdominal surgery. We aimed to investigate the impact of the mechanical ventilation strategies used in 2 recent trials (Intraoperative Protective Ventilation [IMPROVE] trial and Protective Ventilation using High versus Low PEEP [PROVHILO] trial) on driving pressure (ΔPRS), mechanical power, and lung damage in a model of open abdominal surgery. Thirty-five Wistar rats were used, of which 28 were anesthetized, and a laparotomy was performed with standardized bowel manipulation. Postoperatively, animals (n = 7/group) were randomly assigned to 4 hours of ventilation with: (1) tidal volume (VT) = 7 mL/kg and positive end-expiratory pressure (PEEP) = 1 cm H2O without recruitment maneuvers (RMs) (low VT/low PEEP/RM-), mimicking the low-VT/low-PEEP strategy of PROVHILO; (2) VT = 7 mL/kg and PEEP = 3 cm H2O with RMs before laparotomy and hourly thereafter (low VT/moderate PEEP/4 RM+), mimicking the protective ventilation strategy of IMPROVE; (3) VT = 7 mL/kg and PEEP = 6 cm H2O with RMs only before laparotomy (low VT/high PEEP/1 RM+), mimicking the strategy used after intubation and before extubation in PROVHILO; or (4) VT = 14 mL/kg and PEEP = 1 cm H2O without RMs (high VT/low PEEP/RM-), mimicking conventional ventilation used in IMPROVE. Seven rats were not tracheotomized, operated, or mechanically ventilated, and constituted the healthy nonoperated and nonventilated controls. Low VT/moderate PEEP/4 RM+ and low VT/high PEEP/1 RM+, compared to low VT/low PEEP/RM- and high VT/low PEEP/RM-, resulted in lower ΔPRS (7.1 ± 0.8 and 10.2 ± 2.1 cm H2O vs 13.9 ± 0.9 and 16.9 ± 0.8 cm H2O, respectively; Pmechanical power (63 ± 7 and 79 ± 20 J/min vs 110 ± 10 and 120 ± 20 J/min, respectively; P = .007). Low VT/high PEEP/1 RM+ was associated with less alveolar collapse than low VT/low PEEP/RM- (P = .03). E-cadherin expression was higher in

OPTIMUM LEVEL OF POSITIVE END-EXPIRATORY PRESSURE IN ACUTE RESPIRATORY DISTRESS SYNDROME CAUSED BY INFLUENZA A(H1NI)PDM09: BALANCE BETWEEN MAXIMAL END-EXPIRATORY VOLUME AND MINIMAL ALVEOLAR OVERDISTENSION.

Science.gov (United States)

Yaroshetskiym A I; Protsenko, D N; Boytsov, P V; Chentsov, V B; Nistratov, S L; Kudlyakov, O N; Solov'ev, V V; Banova, Zh I; Shkuratova, N V; Rezenov, N A; Gel'fand, B R

2016-11-01

to determine optimum level ofpositive end-expiratory pressure (PEEP) according to balance between maxi- mal end-expiratory lung volume (EEL V)(more than predicted) and minimal decrease in exhaled carbon dioxide volume (VCO) and then to develop the algorithm of gas exchange correction based on prognostic values of EEL K; alveolar recruitability, PA/FiO2, static compliance (C,,,) and VCO2. 27 mechanically ventilatedpatients with acute respiratory distress syndrome (ARDS) caused by influenza A (HINJ)pdm09 in Moscow Municipal Clinics ICU's from January to March 2016 were included in the trial. At the beginning of the study patients had the following characteristic: duration offlu symptoms 5 (3-10) days, p.0/FiO2 120 (70-50) mmHg. SOFA 7 (5-9), body mass index 30.1 (26.4-33.8) kg/m², static compliance of respiratory system 35 (30-40) ml/mbar: Under sedation and paralysis we measured EELV, C VCO and end-tidal carbon dioxide concentration (EtCO) (for CO₂ measurements we fixed short-term values after 2 min after PEEP level change) at PEEP 8, 11,13,15,18, 20 mbar consequently, and incase of good recruitability, at 22 and 24 mbar. After analyses of obtained data we determined PEEP value in which increase in EELV was maximal (more than predicted) and depression of VCO₂ was less than 20%, change in mean blood pressure and heart rate were both less than 20% (measured at PEEP 8 mbar). After that we set thus determined level of PEEP and didn't change it for 5 days. Comparision of predicted and measured EELV revealed two typical points of alveloar recruiment: the first at PEEP 11-15 mbar, the second at PEEP 20-22 mbar. EELV measured at PEEP 18 mbar appeared to be higher than predicted at PEEP 8 mbar by 400 ml (approx.), which was the sign of alveolar recruitment-1536 (1020-1845) ml vs 1955 (1360-2320) ml, p=0,001, Friedman test). we didn't found significant changes of VCO₂ when increased PEEP in the range from 8 to 15 mbar (p>0.05, Friedman test). PEEP increase from 15 to

Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients

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Federico Franchi

2013-01-01

Full Text Available Purpose. The effects of mechanical ventilation (MV on speckle tracking echocardiography- (STE-derived variables are not elucidated. The aim of the study was to evaluate the effects of positive end-expiratory pressure (PEEP ventilation on 4-chamber longitudinal strain (LS analysis by STE. Methods. We studied 20 patients admitted to a mixed intensive care unit who required intubation for MV and PEEP titration due to hypoxia. STE was performed at three times: (T1 PEEP = 5 cmH2O; (T2 PEEP = 10 cmH2O; and (T3 PEEP = 15 cmH2O. STE analysis was performed offline using a dedicated software (XStrain MyLab 70 Xvision, Esaote. Results. Left peak atrial-longitudinal strain (LS was significantly reduced from T1 to T2 and from T2 to T3 (. Right peak atrial-LS and right ventricular-LS showed a significant reduction only at T3 (. Left ventricular-LS did not change significantly during titration of PEEP. Cardiac chambers’ volumes showed a significant reduction at higher levels of PEEP (. Conclusions. We demonstrated for the first time that incremental PEEP affects myocardial strain values obtained with STE in intubated critically ill patients. Whenever performing STE in mechanically ventilated patients, care must be taken when PEEP is higher than 10 cmH2O to avoid misinterpreting data and making erroneous decisions.

Experimental intra-abdominal hypertension influences airway pressure limits for lung protective mechanical ventilation.

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Cortes-Puentes, Gustavo A; Cortes-Puentes, Luis A; Adams, Alexander B; Anderson, Christopher P; Marini, John J; Dries, David J

2013-06-01

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) may complicate monitoring of pulmonary mechanics owing to their impact on the respiratory system. However, recommendations for mechanical ventilation of patients with IAH/ACS and the interpretation of thoracoabdominal interactions remain unclear. Our study aimed to characterize the influence of elevated intra-abdominal pressure (IAP) and positive end-expiratory pressure (PEEP) on airway plateau pressure (PPLAT) and bladder pressure (PBLAD). Nine deeply anesthetized swine were mechanically ventilated via tracheostomy: volume-controlled mode at tidal volume (VT) of 10 mL/kg, frequency of 15, inspiratory-expiratory ratio of 1:2, and PEEP of 1 and 10 cm H2O (PEEP1 and PEEP10, respectively). A tracheostomy tube was placed in the peritoneal cavity, and IAP levels of 5, 10, 15, 20, and 25 mm Hg were applied, using a continuous positive airway pressure system. At each IAP level, PBLAD and airway pressure measurements were performed during both PEEP1 and PEEP10. PBLAD increased as experimental IAP rose (y = 0.83x + 0.5; R = 0.98; p < 0.001 at PEEP1). Minimal underestimation of IAP by PBLAD was observed (-2.5 ± 0.8 mm Hg at an IAP of 10-25 mm Hg). Applying PEEP10 did not significantly affect the correlation between experimental IAP and PBLAD. Approximately 50% of the PBLAD (in cm H2O) was reflected by changes in PPLAT, regardless of the PEEP level applied. Increasing IAP did not influence hemodynamics at any level of IAP generated. With minimal underestimation, PBLAD measurements closely correlated with experimentally regulated IAP, independent of the PEEP level applied. For each PEEP level applied, a constant proportion (approximately 50%) of measured PBLAD (in cm H2O) was reflected in PPLAT. A higher safety threshold for PPLAT should be considered in the setting of IAH/ACS as the clinician considers changes in VT. A strategy of reducing VT to cap PPLAT at widely recommended values may not be

Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol for a randomized controlled trial.

Science.gov (United States)

Bluth, T; Teichmann, R; Kiss, T; Bobek, I; Canet, J; Cinnella, G; De Baerdemaeker, L; Gregoretti, C; Hedenstierna, G; Hemmes, S N; Hiesmayr, M; Hollmann, M W; Jaber, S; Laffey, J G; Licker, M J; Markstaller, K; Matot, I; Müller, G; Mills, G H; Mulier, J P; Putensen, C; Rossaint, R; Schmitt, J; Senturk, M; Serpa Neto, A; Severgnini, P; Sprung, J; Vidal Melo, M F; Wrigge, H; Schultz, M J; Pelosi, P; Gama de Abreu, M

2017-04-28

Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multicenter, two-arm, international randomized controlled trial. In total, 2013 obese patients with body mass index ≥35 kg/m 2 scheduled for at least 2 h of surgery under general anesthesia and at intermediate to high risk for PPCs will be included. Patients are ventilated intraoperatively with a low tidal volume of 7 ml/kg (predicted body weight) and randomly assigned to PEEP of 12 cmH 2 O with lung recruitment maneuvers (high PEEP) or PEEP of 4 cmH 2 O without recruitment maneuvers (low PEEP). The occurrence of PPCs will be recorded as collapsed composite of single adverse pulmonary events and represents the primary endpoint. To our knowledge, the PROBESE trial is the first multicenter, international randomized controlled trial to compare the effects of two different levels of intraoperative PEEP during protective low tidal volume ventilation on PPCs in obese patients. The results of the PROBESE trial will support anesthesiologists in their decision to choose a certain PEEP level during general anesthesia for surgery in obese patients in an attempt to prevent PPCs. ClinicalTrials.gov identifier: NCT02148692. Registered on 23 May 2014; last updated 7 June 2016.

Cardiac output estimation using pulmonary mechanics in mechanically ventilated patients

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Hann Christopher E

2010-11-01

Full Text Available Abstract The application of positive end expiratory pressure (PEEP in mechanically ventilated (MV patients with acute respiratory distress syndrome (ARDS decreases cardiac output (CO. Accurate measurement of CO is highly invasive and is not ideal for all MV critically ill patients. However, the link between the PEEP used in MV, and CO provides an opportunity to assess CO via MV therapy and other existing measurements, creating a CO measure without further invasiveness. This paper examines combining models of diffusion resistance and lung mechanics, to help predict CO changes due to PEEP. The CO estimator uses an initial measurement of pulmonary shunt, and estimations of shunt changes due to PEEP to predict CO at different levels of PEEP. Inputs to the cardiac model are the PV loops from the ventilator, as well as the oxygen saturation values using known respiratory inspired oxygen content. The outputs are estimates of pulmonary shunt and CO changes due to changes in applied PEEP. Data from two published studies are used to assess and initially validate this model. The model shows the effect on oxygenation due to decreased CO and decreased shunt, resulting from increased PEEP. It concludes that there is a trade off on oxygenation parameters. More clinically importantly, the model also examines how the rate of CO drop with increased PEEP can be used as a method to determine optimal PEEP, which may be used to optimise MV therapy with respect to the gas exchange achieved, as well as accounting for the impact on the cardiovascular system and its management.

Intratidal recruitment/derecruitment persists at low and moderate positive end-expiratory pressure in paediatric patients.

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Wirth, Steffen; Artner, Lisa; Broß, Tobias; Lozano-Zahonero, Sara; Spaeth, Johannes; Schumann, Stefan

2016-12-01

In paediatric patients positive end-expiratory pressure (PEEP) is traditionally set lower than in adults. We investigated whether moderately higher PEEP improves respiratory mechanics and regional ventilation. Therefore, 40 children were mechanically ventilated with PEEP 2 and 5cmH 2 O. Volume-dependent compliance profiles were analysed as a measure of intratidal recruitment/derecruitment. Regional ventilation was assessed using electrical impedance tomography. Mean compliance was 17.9±9.9mLcmH 2 O -1 (PEEP 2cmH 2 O), and 19.0±10.9mLcmH 2 O -1 (PEEP 5 cmH 2 O, pventilation. In conclusion, mechanically ventilated paediatric patients undergo intratidal recruitment/derecruitment which occurs more prominently in younger than in older children. A PEEP of 5cmH 2 O does not fully prevent intratidal recruitment/derecruitment but homogenizes regional ventilation in comparison to 2cmH 2 O. Copyright © 2016 Elsevier B.V. All rights reserved.

HEALTH INFO SANTÉ – REMINDER ANNUAL DEDUCTIBLE AND REIMBURSEMENT CLAIMS HINTS FOR USE

CERN Multimedia

CHIS Board

2000-01-01

Information from the CHIS Board and the Human Resources Division:Annual deductible and reimbursement claims: hints for useOne should bear in mind that the annual deductible is an amount (currently CHF 100) charged automatically by the Administrator of the scheme for every adult aged 18 and above. This is what happens: The amount is deducted annually for all medical services received over a calendar year.It is triggered by the date of the treatment and neither by the date of the bill nor that of the reimbursement claim.In other words, if you receive medical treatment in December for the first time in a given year, the CHF 100 will be deducted from the claim for that treatment. So, except for urgent cases, it would be better to wait till the following month, thus avoiding one annual deductible.It is also worth remembering that the cost of processing our reimbursement claims - and there were 54, 000 in 1999 - is part of the cost of our insurance.Help keep administrative costs down: do not submit reimbursement cl...

Influence of tidal volume on ventilation inhomogeneity assessed by electrical impedance tomography during controlled mechanical ventilation

International Nuclear Information System (INIS)

Becher, T; Kott, M; Schädler, D; Vogt, B; Meinel, T; Weiler, N; Frerichs, I

2015-01-01

The global inhomogeneity (GI) index is a parameter of ventilation inhomogeneity that can be calculated from images of tidal ventilation distribution obtained by electrical impedance tomography (EIT). It has been suggested that the GI index may be useful for individual adjustment of positive end-expiratory pressure (PEEP) and for guidance of ventilator therapy. The aim of the present work was to assess the influence of tidal volume (V_T) on the GI index values. EIT data from 9 patients with acute respiratory distress syndrome ventilated with a low and a high V_T of 5   ±   1 (mean  ±  SD) and 9   ±   1 ml kg"−"1 predicted body weight at a high and a low level of PEEP (PEEP_h_i_g_h, PEEP_l_o_w) were analyzed. PEEP_h_i_g_h and PEEP_l_o_w were set 2 cmH_2O above and 5 cmH_2O below the lower inflection point of a quasi-static pressure volume loop, respectively. The lower inflection point was identified at 8.1   ±   1.4 (mean  ±  SD) cmH_2O, resulting in a PEEP_h_i_g_h of 10.1   ±   1.4 and a PEEP_l_o_w of 3.1   ±   1.4 cmH_2O. At PEEP_h_i_g_h, we found no significant trend in GI index with low V_T when compared to high V_T (0.49   ±   0.15 versus 0.44   ±   0.09, p = 0.13). At PEEP_l_o_w, we found a significantly higher GI index with low V_T compared to high V_T (0.66   ±   0.19 versus 0.59   ±   0.17, p = 0.01). When comparing the PEEP levels, we found a significantly lower GI index at PEEP_h_i_g_h both for high and low V_T. We conclude that high V_T may lead to a lower GI index, especially at low PEEP settings. This should be taken into account when using the GI index for individual adjustment of ventilator settings. (paper)

Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation.

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Shojaee, Majid; Sabzghabaei, Anita; Alimohammadi, Hossein; Derakhshanfar, Hojjat; Amini, Afshin; Esmailzadeh, Bahareh

2017-01-01

Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. In this quasi-experimental study, patients under mechanical ventilation were evaluated with the aim of assessing the effect of PEEP change on CVP. Non-trauma patients, over 18 years of age, who were under mechanical ventilation and had stable hemodynamics, with inserted CV line were entered. After gathering demographic data, patients underwent 0, 5, and 10 cmH 2 O PEEPs and the respective CVPs of the mentioned points were recorded. The relationship of CVP and PEEP in different cut points were measured using SPSS 21.0 statistical software. 60 patients with the mean age of 73.95 ± 11.58 years were evaluated (68.3% male). The most frequent cause of ICU admission was sepsis with 45.0%. 5 cmH 2 O increase in PEEP led to 2.47 ± 1.53 mean difference in CVP level. If the PEEP baseline is 0 at the time of 5 cmH 2 O increase, it leads to a higher raise in CVP compared to when the baseline is 5 cmH 2 O (2.47 ± 1.53 vs. 1.57 ± 1.07; p = 0.039). The relationship between CVP and 5 cmH 2 O (p = 0.279), and 10 cmH 2 O (p = 0.292) PEEP changes were not dependent on the baseline level of CVP. The findings of this study revealed the direct relationship between PEEP and CVP. Approximately, a 5 cmH 2 O increase in PEEP will be associated with about 2.5 cmH 2 O raise in CVP. When applying a 5 cmH 2 O PEEP increase, if the baseline PEEP is 0, it leads to a significantly higher raise in CVP compared to when it is 5 cmH 2 O (2.5 vs. 1.6). It seems that sex, history of cardiac failure, baseline CVP level, and hypertension do not have a significant effect in this regard.

Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation

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Majid Shojaee

2016-12-01

Full Text Available Introduction: Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. Methods: In this quasi-experimental study, patients under mechanical ventilation were evaluated with the aim of assessing the effect of PEEP change on CVP. Non-trauma patients, over 18 years of age, who were under mechanical ventilation and had stable hemodynamics, with inserted CV line were entered. After gathering demographic data, patients underwent 0, 5, and 10 cmH2O PEEPs and the respective CVPs of the mentioned points were recorded. The relationship of CVP and PEEP in different cut points were measured using SPSS 21.0 statistical software. Results: 60 patients with the mean age of 73.95 ± 11.58 years were evaluated (68.3% male. The most frequent cause of ICU admission was sepsis with 45.0%. 5 cmH2O increase in PEEP led to 2.47 ± 1.53 mean difference in CVP level. If the PEEP baseline is 0 at the time of 5 cmH2O increase, it leads to a higher raise in CVP compared to when the baseline is 5 cmH2O (2.47 ± 1.53 vs. 1.57 ± 1.07; p = 0.039. The relationship between CVP and 5 cmH2O (p = 0.279, and 10 cmH2O (p = 0.292 PEEP changes were not dependent on the baseline level of CVP. Conclusion: The findings of this study revealed the direct relationship between PEEP and CVP. Approximately, a 5 cmH2O increase in PEEP will be associated with about 2.5 cmH2O raise in CVP. When applying a 5 cmH2O PEEP increase, if the baseline PEEP is 0, it leads to a significantly higher raise in CVP compared to when it is 5 cmH2O (2.5 vs. 1.6. It seems that sex, history of cardiac failure, baseline CVP level, and hypertension do not have a significant effect in this regard.

Influence of posture and positive end-tidal expiratory pressure (PEEP) on clearance of Tc99m-DTPA from the lungs

International Nuclear Information System (INIS)

Mason, G.R.; Maublant, J.; Sietsema, K.; Effros, R.M.; Mena, I.

1984-01-01

The clearance of Tc99m-DTPA aerosols from the lung has been used to detect and quantitate alterations in the permeability of the pulmonary epithelium. Clearance of the radionuclide is accelerated by both chronic and acute injuries to the lung and by smoking. Several laboratories have reported that Tc99m-DTPA clearance from upper lobes exceeded that from lower lobes in upright subjects. To investigate this phenomenon further the authors studied subjects with simultaneous anterior and posterior cameras in upright and supine positions. In the upright position, clearance from both the anterior and posterior upper regions of interest (ROI's) exceeded the lower regions (-1.64 +- .42 S.D. vs. -0.75 +- .41, anterior, p < .05, n=6), -1.04 +- .23 vs. -0.50 +- .36, posterior. All units = %/min. This difference was not observed in the supine subjects. Clearance from the anterior chest exceeded that from the posterior chest in the supine subjects (-1.28 +- .45 vs. -0.05 +- 1.08) and a small increase in radio-activity was observed in at least one ROI of 5 of 6 subjects from the posterior camera. An increase in activity is likely to be secondary to labeling of blood pool, which would have greatest affect where pulmonary blood volume is largest. Computer processing of the entire lung without observer bias in ROI placement showed similar effects of posture over non-peripheral ROI's. Five subjects breathed on PEEP to cause airspace distention, causing clearance to double. Both dependency and airspace distention appear to influence clearance of aerosolized DTPA, the latter may occur by stretching of epithelial pores

Combined Effects of Ventilation Mode and Positive End-Expiratory Pressure on Mechanics, Gas Exchange and the Epithelium in Mice with Acute Lung Injury

Science.gov (United States)

Thammanomai, Apiradee; Hamakawa, Hiroshi; Bartolák-Suki, Erzsébet; Suki, Béla

2013-01-01

The accepted protocol to ventilate patients with acute lung injury is to use low tidal volume (VT) in combination with recruitment maneuvers or positive end-expiratory pressure (PEEP). However, an important aspect of mechanical ventilation has not been considered: the combined effects of PEEP and ventilation modes on the integrity of the epithelium. Additionally, it is implicitly assumed that the best PEEP-VT combination also protects the epithelium. We aimed to investigate the effects of ventilation mode and PEEP on respiratory mechanics, peak airway pressures and gas exchange as well as on lung surfactant and epithelial cell integrity in mice with acute lung injury. HCl-injured mice were ventilated at PEEPs of 3 and 6 cmH2O with conventional ventilation (CV), CV with intermittent large breaths (CVLB) to promote recruitment, and a new mode, variable ventilation, optimized for mice (VVN). Mechanics and gas exchange were measured during ventilation and surfactant protein (SP)-B, proSP-B and E-cadherin levels were determined from lavage and lung homogenate. PEEP had a significant effect on mechanics, gas exchange and the epithelium. The higher PEEP reduced lung collapse and improved mechanics and gas exchange but it also down regulated surfactant release and production and increased epithelial cell injury. While CVLB was better than CV, VVN outperformed CVLB in recruitment, reduced epithelial injury and, via a dynamic mechanotransduction, it also triggered increased release and production of surfactant. For long-term outcome, selection of optimal PEEP and ventilation mode may be based on balancing lung physiology with epithelial injury. PMID:23326543

The human interactome knowledge base (hint-kb): An integrative human protein interaction database enriched with predicted protein–protein interaction scores using a novel hybrid technique

KAUST Repository

Theofilatos, Konstantinos A.

2013-07-12

Proteins are the functional components of many cellular processes and the identification of their physical protein–protein interactions (PPIs) is an area of mature academic research. Various databases have been developed containing information about experimentally and computationally detected human PPIs as well as their corresponding annotation data. However, these databases contain many false positive interactions, are partial and only a few of them incorporate data from various sources. To overcome these limitations, we have developed HINT-KB (http://biotools.ceid.upatras.gr/hint-kb/), a knowledge base that integrates data from various sources, provides a user-friendly interface for their retrieval, cal-culatesasetoffeaturesofinterest and computesaconfidence score for every candidate protein interaction. This confidence score is essential for filtering the false positive interactions which are present in existing databases, predicting new protein interactions and measuring the frequency of each true protein interaction. For this reason, a novel machine learning hybrid methodology, called (Evolutionary Kalman Mathematical Modelling—EvoKalMaModel), was used to achieve an accurate and interpretable scoring methodology. The experimental results indicated that the proposed scoring scheme outperforms existing computational methods for the prediction of PPIs.

Relationship of end-expiratory pressure, lung volume, and /sup 99m/Tc-DTPA clearance

International Nuclear Information System (INIS)

Cooper, J.A.; van der Zee, H.; Line, B.R.; Malik, A.B.

1987-01-01

We investigated the dose-response effect of positive end-expiratory pressure (PEEP) and increased lung volume on the pulmonary clearance rate of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA). Clearance of lung radioactivity was expressed as percent decrease per minute. Base-line clearance was measured while anesthetized sheep (n = 20) were ventilated with 0 cmH 2 O end-expiratory pressure. Clearance was remeasured during ventilation at 2.5, 5, 10, 15, or 20 cmH 2 O PEEP. Further studies showed stepwise increases in functional residual capacity (FRC) (P less than 0.05) measured at 0, 2.5, 5, 10, 15, and 20 cmH 2 O PEEP. At 2.5 cmH 2 O PEEP, the clearance rate was not different from that at base line (P less than 0.05), although FRC was increased from base line. Clearance rate increased progressively with increasing PEEP at 5, 10, and 15 cmH 2 O (P less than 0.05). Between 15 and 20 cmH 2 O PEEP, clearance rate was again unchanged, despite an increase in FRC. The pulmonary clearance of aerosolized /sup 99m/Tc-DTPA shows a sigmoidal response to increasing FRC and PEEP, having both threshold and maximal effects. This relationship is most consistent with the hypothesis that alveolar epithelial permeability is increased by lung inflation

Respiratory System Mechanics During Low Versus High Positive End-Expiratory Pressure in Open Abdominal Surgery: A Substudy of PROVHILO Randomized Controlled Trial.

Science.gov (United States)

D'Antini, Davide; Huhle, Robert; Herrmann, Jacob; Sulemanji, Demet S; Oto, Jun; Raimondo, Pasquale; Mirabella, Lucia; Hemmes, Sabrine N T; Schultz, Marcus J; Pelosi, Paolo; Kaczka, David W; Vidal Melo, Marcos Francisco; Gama de Abreu, Marcelo; Cinnella, Gilda

2018-01-01

In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications when compared to low PEEP (0-2 cm H2O) approach without recruitment breaths. However, effects of intraoperative PEEP on lung compliance remain poorly understood. We hypothesized that higher PEEP leads to a dominance of intratidal overdistension, whereas lower PEEP results in intratidal recruitment/derecruitment (R/D). To test our hypothesis, we used the volume-dependent elastance index %E2, a respiratory parameter that allows for noninvasive and radiation-free assessment of dominant overdistension and intratidal R/D. We compared the incidence of intratidal R/D, linear expansion, and overdistension by means of %E2 in a subset of the PROVHILO cohort. In 36 patients from 2 participating centers of the PROVHILO trial, we calculated respiratory system elastance (E), resistance (R), and %E2, a surrogate parameter for intratidal overdistension (%E2 > 30%) and R/D (%E2 mechanical ventilation with protective tidal volumes in patients undergoing open abdominal surgery, lung recruitment followed by PEEP of 12 cm H2O decreased the incidence of intratidal R/D and did not worsen overdistension, when compared to PEEP ≤2 cm H2O.

Variation of poorly ventilated lung units (silent spaces) measured by electrical impedance tomography to dynamically assess recruitment.

Science.gov (United States)

Spadaro, Savino; Mauri, Tommaso; Böhm, Stephan H; Scaramuzzo, Gaetano; Turrini, Cecilia; Waldmann, Andreas D; Ragazzi, Riccardo; Pesenti, Antonio; Volta, Carlo Alberto

2018-01-31

Assessing alveolar recruitment at different positive end-expiratory pressure (PEEP) levels is a major clinical and research interest because protective ventilation implies opening the lung without inducing overdistention. The pressure-volume (P-V) curve is a validated method of assessing recruitment but reflects global characteristics, and changes at the regional level may remain undetected. The aim of the present study was to compare, in intubated patients with acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS), lung recruitment measured by P-V curve analysis, with dynamic changes in poorly ventilated units of the dorsal lung (dependent silent spaces [DSSs]) assessed by electrical impedance tomography (EIT). We hypothesized that DSSs might represent a dynamic bedside measure of recruitment. We carried out a prospective interventional study of 14 patients with AHRF and ARDS admitted to the intensive care unit undergoing mechanical ventilation. Each patient underwent an incremental/decremental PEEP trial that included five consecutive phases: PEEP 5 and 10 cmH 2 O, recruitment maneuver + PEEP 15 cmH 2 O, then PEEP 10 and 5 cmH 2 O again. We measured, at the end of each phase, recruitment from previous PEEP using the P-V curve method, and changes in DSS were continuously monitored by EIT. PEEP changes induced alveolar recruitment as assessed by the P-V curve method and changes in the amount of DSS (p Recruited volume measured by the P-V curves significantly correlated with the change in DSS (r s  = 0.734, p recruitment measured using the P-V curve technique. EIT might provide useful information to titrate personalized PEEP. ClinicalTrials.gov, NCT02907840 . Registered on 20 September 2016.

Application of dead space fraction to titrate optimal positive end-expiratory pressure in an ARDS swine model.

Science.gov (United States)

Bian, Weishuai; Chen, Wei; Chao, Yangong; Wang, Lan; Li, Liming; Guan, Jian; Zang, Xuefeng; Zhen, Jie; Sheng, Bo; Zhu, Xi

2017-04-01

This study aimed to apply the dead space fraction [ratio of dead space to tidal volume (VD/VT)] to titrate the optimal positive end-expiratory pressure (PEEP) in a swine model of acute respiratory distress syndrome (ARDS). Twelve swine models of ARDS were constructed. A lung recruitment maneuver was then conducted and the PEEP was set at 20 cm H 2 O. The PEEP was reduced by 2 cm H 2 O every 10 min until 0 cm H 2 O was reached, and VD/VT was measured after each decrement step. VD/VT was measured using single-breath analysis of CO 2 , and calculated from arterial CO 2 partial pressure (PaCO 2 ) and mixed expired CO 2 (PeCO 2 ) using the following formula: VD/VT = (PaCO 2 - PeCO 2 )/PaCO 2 . The optimal PEEP was identified by the lowest VD/VT method. Respiration and hemodynamic parameters were recorded during the periods of pre-injury and injury, and at 4 and 2 cm H 2 O below and above the optimal PEEP (Po). The optimal PEEP in this study was found to be 13.25±1.36 cm H 2 O. During the Po period, VD/VT decreased to a lower value (0.44±0.08) compared with that during the injury period (0.68±0.10) (P<0.05), while the intrapulmonary shunt fraction reached its lowest value. In addition, a significant change of dynamic tidal respiratory compliance and oxygenation index was induced by PEEP titration. These results indicate that minimal VD/VT can be used for PEEP titration in ARDS.

Positive end-expiratory pressure improves gas exchange and pulmonary mechanics during partial liquid ventilation.

Science.gov (United States)

Kirmse, M; Fujino, Y; Hess, D; Kacmarek, R M

1998-11-01

Partial liquid ventilation (PLV) with perflubron (PFB) has been proposed as an adjunct to the current therapies for the acute respiratory distress syndrome (ARDS). Because PFB has been also referred to as "liquid PEEP," distributing to the most gravity-dependent regions of the lung, less attention has been paid to the amount of applied positive end-expiratory pressure (PEEP). We hypothesized that higher PEEP levels than currently applied are needed to optimize gas exchange, and that the lower inflection point (LIP) of the pressure-volume curve could be used to estimate the amount of PEEP needed when the lung is filled with PFB. Lung injury was induced in 23 sheep by repeated lung lavage with warmed saline until the PaO2/FIO2 ratio fell below 150. Five sheep were used to investigate the change of the LIP when the lung was filled with PFB in increments of 5 ml/kg/body weight to a total of 30 ml/kg/body weight. To evaluate the impact of PEEP set at LIP +1 cm H2O we randomized an additional 15 sheep to three groups with different doses (7.5 ml, 15 ml, 30 ml/kg/body weight) of PFB. In random order a PEEP of 5 cm H2O or PEEP at LIP +1 cm H2O was applied. The LIP decreased with incremental filling of PFB to a minimum at 10 ml (p PFB shifts the LIP to the left, and that setting PEEP at LIP +1 cm H2O improves gas exchange at moderate to high doses of PFB.

Open lung approach versus standard protective strategies: Effects on driving pressure and ventilatory efficiency during anesthesia - A pilot, randomized controlled trial.

Science.gov (United States)

Ferrando, Carlos; Suarez-Sipmann, Fernando; Tusman, Gerardo; León, Irene; Romero, Esther; Gracia, Estefania; Mugarra, Ana; Arocas, Blanca; Pozo, Natividad; Soro, Marina; Belda, Francisco J

2017-01-01

Low tidal volume (VT) during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM) can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia. Consecutive patients scheduled for major abdominal surgery were submitted to low-VT ventilation (6 ml·kg-1) and standard PEEP of 5 cmH2O (pre-RM, n = 36). After 30 min estabilization all patients received a RM and were randomly allocated to either continue with the same PEEP (RM-5 group, n = 18) or to an individualized open-lung PEEP (OL-PEEP) (Open Lung Approach, OLA group, n = 18) defined as the level resulting in maximal Cdyn during a decremental PEEP trial. We compared the effects on driving pressure and lung efficiency measured by volumetric capnography. OL-PEEP was found at 8±2 cmH2O. 36 patients were included in the final analysis. When compared with pre-RM, OLA resulted in a 22% increase in compliance and a 28% decrease in driving pressure when compared to pre-RM. These parameters did not improve in the RM-5. The trend of the DP was significantly different between the OLA and RM-5 groups (p = 0.002). VDalv/VTalv was significantly lower in the OLA group after the RM (p = 0.035). Lung recruitment applied during low-VT ventilation improves driving pressure and lung efficiency only when applied as an open-lung strategy with an individualized PEEP in patients without lung diseases undergoing major abdominal surgery. ClinicalTrials.gov NCT02798133.

Open lung approach versus standard protective strategies: Effects on driving pressure and ventilatory efficiency during anesthesia - A pilot, randomized controlled trial.

Directory of Open Access Journals (Sweden)

Carlos Ferrando

Full Text Available Low tidal volume (VT during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia.Consecutive patients scheduled for major abdominal surgery were submitted to low-VT ventilation (6 ml·kg-1 and standard PEEP of 5 cmH2O (pre-RM, n = 36. After 30 min estabilization all patients received a RM and were randomly allocated to either continue with the same PEEP (RM-5 group, n = 18 or to an individualized open-lung PEEP (OL-PEEP (Open Lung Approach, OLA group, n = 18 defined as the level resulting in maximal Cdyn during a decremental PEEP trial. We compared the effects on driving pressure and lung efficiency measured by volumetric capnography.OL-PEEP was found at 8±2 cmH2O. 36 patients were included in the final analysis. When compared with pre-RM, OLA resulted in a 22% increase in compliance and a 28% decrease in driving pressure when compared to pre-RM. These parameters did not improve in the RM-5. The trend of the DP was significantly different between the OLA and RM-5 groups (p = 0.002. VDalv/VTalv was significantly lower in the OLA group after the RM (p = 0.035.Lung recruitment applied during low-VT ventilation improves driving pressure and lung efficiency only when applied as an open-lung strategy with an individualized PEEP in patients without lung diseases undergoing major abdominal surgery.ClinicalTrials.gov NCT02798133.

Potential hazard of the Neopuff T-piece resuscitator in the absence of flow limitation.

LENUS (Irish Health Repository)

Hawkes, C P

2012-01-31

OBJECTIVE: (1) To assess peak inspiratory pressure (PIP), positive end expiratory pressure (PEEP) and maximum pressure relief (P(max)) at different rates of gas flow, when the Neopuff had been set to function at 5 l\\/min. (2) To assess maximum PIP and PEEP at a flow rate of 10 l\\/min with a simulated air leak of 50%. DESIGN: 5 Neopuffs were set to a PIP of 20, PEEP of 5 and P(max) of 30 cm H(2)O at a gas flow of 5 l\\/min. PIP, PEEP and P(max) were recorded at flow rates of 10, 15 l\\/min and maximum flow. Maximum achievable pressures at 10 l\\/min gas flow, with a 50% air leak, were measured. RESULTS: At gas flow of 15 l\\/min, mean PEEP increased to 20 (95% CI 20 to 21), PIP to 28 (95% CI 28 to 29) and the P(max) to 40 cm H(2)O (95% CI 38 to 42). At maximum flow (85 l\\/min) a PEEP of 71 (95% CI 51 to 91) and PIP of 92 cm H(2)O (95% CI 69 to 115) were generated. At 10 l\\/min flow, with an air leak of 50%, the maximum PEEP and PIP were 21 (95% CI 19 to 23) and 69 cm H(2)O (95% CI 66 to 71). CONCLUSIONS: The maximum pressure relief valve is overridden by increasing the rate of gas flow and potentially harmful PIP and PEEP can be generated. Even in the presence of a 50% gas leak, more than adequate pressures can be provided at 10 l\\/min gas flow. We recommend the limitation of gas flow to a rate of 10 l\\/min as an added safety mechanism for this device.

Tidal Volume Delivery and Endotracheal Tube Leak during Cardiopulmonary Resuscitation in Intubated Newborn Piglets with Hypoxic Cardiac Arrest Exposed to Different Modes of Ventilatory Support.

Science.gov (United States)

Mendler, Marc R; Weber, Claudia; Hassan, Mohammad A; Huang, Li; Mayer, Benjamin; Hummler, Helmut D

2017-01-01

There are few data available on the interaction of inflations, chest compressions (CC), and delivery of tidal volumes in newborn infants undergoing resuscitation in the presence of endotracheal tube (ET) leaks. To determine the effects of different respiratory support strategies along with CC on changes in tidal volume and ET leaks in hypoxic newborn piglets with cardiac arrest. Asphyxiated newborn piglets, intubated with weight-adapted uncuffed ET, were randomized into three groups and resuscitated according to ILCOR 2010 guidelines: (1) T-piece resuscitator (TPR) group = peak inspiratory pressure (PIP)/positive end-expiratory pressure (PEEP) 25/5 cm H2O, rate 30/min, inflations interposed between CC (3:1 ratio); (2) self- inflating bag (SIB) group = PIP 25 cm H2O without PEEP, rate 30/min, inflations interposed between CC (3:1 ratio), and (3) ventilator group = PIP/PEEP of 25/5 cm H2O, rate 30/min. CC were applied with a rate of 120/min without synchrony to inflations. We observed a significant increase of leak (average increase 11.4%) when CC was added to respiratory support (p = 0.0001). Expired tidal volume was larger in the SIB group than in the two other modes which both applied PEEP. However, tidal volumes caused by CC only were larger in the two groups with PEEP than in the SIB group (without PEEP). There is interaction between lung inflations and CC affecting leak and delivery of tidal volume, which may be influenced by the mode/device used for respiratory support. Leak is larger in the presence of PEEP. However, CC cause additional tidal volume which is larger in the presence of PEEP. © 2016 S. Karger AG, Basel.

Prediction of high airway pressure using a non-linear autoregressive model of pulmonary mechanics.

Science.gov (United States)

Langdon, Ruby; Docherty, Paul D; Schranz, Christoph; Chase, J Geoffrey

2017-11-02

For mechanically ventilated patients with acute respiratory distress syndrome (ARDS), suboptimal PEEP levels can cause ventilator induced lung injury (VILI). In particular, high PEEP and high peak inspiratory pressures (PIP) can cause over distension of alveoli that is associated with VILI. However, PEEP must also be sufficient to maintain recruitment in ARDS lungs. A lung model that accurately and precisely predicts the outcome of an increase in PEEP may allow dangerous high PIP to be avoided, and reduce the incidence of VILI. Sixteen pressure-flow data sets were collected from nine mechanically ventilated ARDs patients that underwent one or more recruitment manoeuvres. A nonlinear autoregressive (NARX) model was identified on one or more adjacent PEEP steps, and extrapolated to predict PIP at 2, 4, and 6 cmH 2 O PEEP horizons. The analysis considered whether the predicted and measured PIP exceeded a threshold of 40 cmH 2 O. A direct comparison of the method was made using the first order model of pulmonary mechanics (FOM(I)). Additionally, a further, more clinically appropriate method for the FOM was tested, in which the FOM was trained on a single PEEP prior to prediction (FOM(II)). The NARX model exhibited very high sensitivity (> 0.96) in all cases, and a high specificity (> 0.88). While both FOM methods had a high specificity (> 0.96), the sensitivity was much lower, with a mean of 0.68 for FOM(I), and 0.82 for FOM(II). Clinically, false negatives are more harmful than false positives, as a high PIP may result in distension and VILI. Thus, the NARX model may be more effective than the FOM in allowing clinicians to reduce the risk of applying a PEEP that results in dangerously high airway pressures.

W7-X vacuum and finite-β magnetic field structure resolved with the HINT 3D equilibrium code

International Nuclear Information System (INIS)

Hayashi, T.; Merkel, P.; Nuehrenberg, J.; Schwenn, U.

1994-01-01

The 3D equilibrium code HINT allows the direct investigation of finite-β effects on sizes and phases of islands in genuinely 3D configurations like the W7-X stellarator planned by the Max-Planck-Institut fuer Plasmaphysik in Germany. The code does not require the existence of nested flux surfaces. This, in contrast to the inverse formulation used in the VMEC code, leads to a considerably more complex computational goal. The HINT code combines some crucial features reducing the numerical problems and the computational effort to such an extent as to allow computation of 3D equilibria at finite-β with magnetic islands. The code is based on a two-step procedure: Starting from a given B and an initial pressure, the iteration technique for the pressure advancement is differencing in an artificial time with an explicit 4th order scheme, or - alternatively for resolving the island topology - field lines starting from all gridpoints are followed long enough to allow pressure equalization along these. B.∇p 0, for fixed B. In a second step, p is kept fixed and B is advanced with an artificial time for solving ∇p - jxB = 0 under the constraint of vanishing toroidal current J. The differential equations are discretized in space with 4th order difference approximations on an Eulerian grid spanned by a rectangular box whose toroidal rotation law follows the W7-X geometry. The two sub-iteration steps are repeated until the force balance is satisfied to an appropriate accuracy. The boundaries (where the boundary conditions are prescribed) are far enough away from the last closed magnetic surface, thus guaranteeing the motion of the plasma column not being constrained by the boundary conditions. Due to the stellarator symmetry in the toroidal direction only half of an equilibrium period is computed, using modified periodic boundary conditions guaranteeing the 4th order of the spatial discretization. (author) 5 refs., 4 figs

Mechanical ventilation with lower tidal volumes and positive end-expiratory pressure prevents pulmonary inflammation in patients without preexisting lung injury.

Science.gov (United States)

Wolthuis, Esther K; Choi, Goda; Dessing, Mark C; Bresser, Paul; Lutter, Rene; Dzoljic, Misa; van der Poll, Tom; Vroom, Margreeth B; Hollmann, Markus; Schultz, Marcus J

2008-01-01

Mechanical ventilation with high tidal volumes aggravates lung injury in patients with acute lung injury or acute respiratory distress syndrome. The authors sought to determine the effects of short-term mechanical ventilation on local inflammatory responses in patients without preexisting lung injury. Patients scheduled to undergo an elective surgical procedure (lasting > or = 5 h) were randomly assigned to mechanical ventilation with either higher tidal volumes of 12 ml/kg ideal body weight and no positive end-expiratory pressure (PEEP) or lower tidal volumes of 6 ml/kg and 10 cm H2O PEEP. After induction of anesthesia and 5 h thereafter, bronchoalveolar lavage fluid and/or blood was investigated for polymorphonuclear cell influx, changes in levels of inflammatory markers, and nucleosomes. Mechanical ventilation with lower tidal volumes and PEEP (n = 21) attenuated the increase of pulmonary levels of interleukin (IL)-8, myeloperoxidase, and elastase as seen with higher tidal volumes and no PEEP (n = 19). Only for myeloperoxidase, a difference was found between the two ventilation strategies after 5 h of mechanical ventilation (P volumes and PEEP may limit pulmonary inflammation in mechanically ventilated patients without preexisting lung injury. The specific contribution of both lower tidal volumes and PEEP on the protective effects of the lung should be further investigated.

AUTOSOMAL RECESSIVE PERIPHERAL NEUROPATHY WITH NEUROMYOTONIA (ARAN-NM: DESCRIPTION OF A CLINICAL CASE CONFIRMED BY A MUTATION IN THE HINT1 GENE

Directory of Open Access Journals (Sweden)

Olga A. Klochkova

2017-01-01

Full Text Available Autosomal recessive  peripheral neuropathy with neuromyotonia  (ARAN-NM  is a relatively newly described  disease associated  with mutations  in the HINT1 gene.  It accounts  for a significant  part of the poorly  differentiated  forms  of axonal polyneuropathies.  We present the first in Russia description of the genetically confirmed case of ARAN-NM in a boy aged 14 years and 11 months without the hereditary-tainted anamnesis. On presentation,  the patient experienced  progressive  distal muscular weakness, asymmetric foot deformity,  gait disorders  and minimal manifestations  of neuromyotonia  (stiffness  in the fingers.  During examination,  we detected an increase in the level of creatine phosphokinase up to 635 U/l, a disturbance of conduction of motor and, to a lesser extent, sensory fibers  of  the  peripheral  nerves  (according  to  the  stimulation  electromyography,  EMG,  denervation-reinnervation  changes,  single positive acute waves, fibrillation potentials, complex repeated discharge (according to the data of needle EMG. In the study of exome, a homozygous mutation c.110G>C, p.R37P was determined in exon 01 of the HINT1 gene, which confirmed the presence of ARAN-NM. A molecular-genetic  examination of the patient's immediate relatives was carried out. The described case is compared with literature data. An overview of currently available information on ARAN-NM is provided. Diagnostic criteria of the disease are presented.

Protective versus Conventional Ventilation for Surgery: A Systematic Review and Individual Patient Data Meta-analysis.

Science.gov (United States)

Serpa Neto, Ary; Hemmes, Sabrine N T; Barbas, Carmen S V; Beiderlinden, Martin; Biehl, Michelle; Binnekade, Jan M; Canet, Jaume; Fernandez-Bustamante, Ana; Futier, Emmanuel; Gajic, Ognjen; Hedenstierna, Göran; Hollmann, Markus W; Jaber, Samir; Kozian, Alf; Licker, Marc; Lin, Wen-Qian; Maslow, Andrew D; Memtsoudis, Stavros G; Reis Miranda, Dinis; Moine, Pierre; Ng, Thomas; Paparella, Domenico; Putensen, Christian; Ranieri, Marco; Scavonetto, Federica; Schilling, Thomas; Schmid, Werner; Selmo, Gabriele; Severgnini, Paolo; Sprung, Juraj; Sundar, Sugantha; Talmor, Daniel; Treschan, Tanja; Unzueta, Carmen; Weingarten, Toby N; Wolthuis, Esther K; Wrigge, Hermann; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J

2015-07-01

Recent studies show that intraoperative mechanical ventilation using low tidal volumes (VT) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between VT size and positive end-expiratory pressure (PEEP) level and occurrence of PPC. Randomized controlled trials comparing protective ventilation (low VT with or without high levels of PEEP) and conventional ventilation (high VT with low PEEP) in patients undergoing general surgery. The primary outcome was development of PPC. Predefined prognostic factors were tested using multivariate logistic regression. Fifteen randomized controlled trials were included (2,127 patients). There were 97 cases of PPC in 1,118 patients (8.7%) assigned to protective ventilation and 148 cases in 1,009 patients (14.7%) assigned to conventional ventilation (adjusted relative risk, 0.64; 95% CI, 0.46 to 0.88; P ventilation with low VT and high PEEP levels and 63 cases in 525 patients (12%) assigned to ventilation with low VT and low PEEP levels (adjusted relative risk, 0.93; 95% CI, 0.64 to 1.37; P = 0.72). A dose-response relationship was found between the appearance of PPC and VT size (R2 = 0.39) but not between the appearance of PPC and PEEP level (R2 = 0.08). These data support the beneficial effects of ventilation with use of low VT in patients undergoing surgery. Further trials are necessary to define the role of intraoperative higher PEEP to prevent PPC during nonopen abdominal surgery.

Hints on cost- and energy saving during lime-sand brick production; Hinweise zur Kosten- und Energieeinsparung bei der Kalksandstein-Produktion

Energy Technology Data Exchange (ETDEWEB)

Eden, W.

2001-05-01

The publication contains hints for reduction of energy consumption and cost in lime-sand brick production. The information was compiled by Bundesverband Kalksandsteinindustrie e.V. and was derived from technical discussions of the master seminars on production technology of the years 1995 - 2000, consultations form member organizations, or from other sources. [German] Diese Arbeit ist eine Zusammenstellung von Hinweisen zur Reduzierung des Energieverbrauchs und der Kostensenkung bei der KS-Produktion und soll eine Hilfestellung bei entsprechenden Rationalisierungsmassnahmen in den Mitgliedsunternehmen sein. Die hier aufgefuehrten Hinweise und Anregungen entstammen den Fachdiskussionen der Meisterseminare zur Produktionstechnik aus den Jahren 1995 bis 2000, Beratungsgespraechen fuer Mitgliedsunternehmen oder wurden dem Bundesverband Kalksandsteinindustrie eV freundlicherweise fuer die Gemeinschaftsarbeit zur Verfuegung gestellt. (orig.)

Prevention of pectus excavatum for children with spinal muscular atrophy type 1.

Science.gov (United States)

Bach, John R; Bianchi, Carlo

2003-10-01

To demonstrate the elimination of pectus excavatum and promotion of more normal lung growth and chest wall development by the use of high-span positive inspiratory pressure plus positive end-expiratory pressure (PIP+PEEP), patients with spinal muscular atrophy type 1 with paradoxical breathing were placed on high-span PIP+PEEP when sleeping from the point of diagnosis of spinal muscular atrophy. Although the appearance of pectus excavatum is ubiquitous in untreated infants with spinal muscular atrophy type 1, after institution of high-span PIP+PEEP, pectus resolves and lungs and chest walls grow more normally. High-span PIP+PEEP is indicated for all infants diagnosed with spinal muscular atrophy who demonstrate paradoxical breathing for the purpose of promoting more normal lung and chest development.

Sustained Aeration of Infant Lungs (SAIL) trial: study protocol for a randomized controlled trial.

Science.gov (United States)

Foglia, Elizabeth E; Owen, Louise S; Thio, Marta; Ratcliffe, Sarah J; Lista, Gianluca; Te Pas, Arjan; Hummler, Helmut; Nadkarni, Vinay; Ades, Anne; Posencheg, Michael; Keszler, Martin; Davis, Peter; Kirpalani, Haresh

2015-03-15

Extremely preterm infants require assistance recruiting the lung to establish a functional residual capacity after birth. Sustained inflation (SI) combined with positive end expiratory pressure (PEEP) may be a superior method of aerating the lung compared with intermittent positive pressure ventilation (IPPV) with PEEP in extremely preterm infants. The Sustained Aeration of Infant Lungs (SAIL) trial was designed to study this question. This multisite prospective randomized controlled unblinded trial will recruit 600 infants of 23 to 26 weeks gestational age who require respiratory support at birth. Infants in both arms will be treated with PEEP 5 to 7 cm H2O throughout the resuscitation. The study intervention consists of performing an initial SI (20 cm H20 for 15 seconds) followed by a second SI (25 cm H2O for 15 seconds), and then PEEP with or without IPPV, as needed. The control group will be treated with initial IPPV with PEEP. The primary outcome is the combined endpoint of bronchopulmonary dysplasia or death at 36 weeks post-menstrual age. www.clinicaltrials.gov , Trial identifier NCT02139800 , Registered 13 May 2014.

Pulmonary lesion induced by low and high positive end-expiratory pressure levels during protective ventilation in experimental acute lung injury.

Science.gov (United States)

Pássaro, Caroline P; Silva, Pedro L; Rzezinski, Andréia F; Abrantes, Simone; Santiago, Viviane R; Nardelli, Liliane; Santos, Raquel S; Barbosa, Carolina M L; Morales, Marcelo M; Zin, Walter A; Amato, Marcelo B P; Capelozzi, Vera L; Pelosi, Paolo; Rocco, Patricia R M

2009-03-01

To investigate the effects of low and high levels of positive end-expiratory pressure (PEEP), without recruitment maneuvers, during lung protective ventilation in an experimental model of acute lung injury (ALI). Prospective, randomized, and controlled experimental study. University research laboratory. Wistar rats were randomly assigned to control (C) [saline (0.1 mL), intraperitoneally] and ALI [paraquat (15 mg/kg), intraperitoneally] groups. After 24 hours, each group was further randomized into four groups (six rats each) at different PEEP levels = 1.5, 3, 4.5, or 6 cm H2O and ventilated with a constant tidal volume (6 mL/kg) and open thorax. Lung mechanics [static elastance (Est, L) and viscoelastic pressure (DeltaP2, L)] and arterial blood gases were measured before (Pre) and at the end of 1-hour mechanical ventilation (Post). Pulmonary histology (light and electron microscopy) and type III procollagen (PCIII) messenger RNA (mRNA) expression were measured after 1 hour of mechanical ventilation. In ALI group, low and high PEEP levels induced a greater percentage of increase in Est, L (44% and 50%) and DeltaP2, L (56% and 36%) in Post values related to Pre. Low PEEP yielded alveolar collapse whereas high PEEP caused overdistension and atelectasis, with both levels worsening oxygenation and increasing PCIII mRNA expression. In the present nonrecruited ALI model, protective mechanical ventilation with lower and higher PEEP levels than required for better oxygenation increased Est, L and DeltaP2, L, the amount of atelectasis, and PCIII mRNA expression. PEEP selection titrated for a minimum elastance and maximum oxygenation may prevent lung injury while deviation from these settings may be harmful.

Differing responses in right and left ventricular filling, loading and volumes during positive end-expiratory pressure

International Nuclear Information System (INIS)

Schulman, D.S.; Biondi, J.W.; Matthay, R.A.; Zaret, B.L.; Soufer, R.

1989-01-01

Using a combined hemodynamic and radionuclide technique, 20 patients with varied ventricular function were evaluated during positive end-expiratory pressure (PEEP) application. Left ventricular (LV) and right ventricular (RV) ejection fractions and cardiac output were measured, and ventricular volumes were derived. Seven patients (group 1) who had an increase in LV end-diastolic volume with PEEP and 13 patients (group 2) who had the more typical response, a decrease in LV end-diastolic volume with PEEP, were identified. Compared with group 2, group 1 patients had a higher incidence of coronary artery disease (5 of 7 vs 1 of 13, p less than 0.005) and lower cardiac output (3.9 +/- 1.6 vs 9.1 +/- 3.2 liters/min, p less than 0.005), LV ejection fraction (27 +/- 13 vs 51 +/- 21%, p less than 0.05), RV ejection fraction (15 +/- 6 vs 32 +/- 8%, p less than 0.005) and peak filling rate (1.32 +/- 0.43 vs 3.51 +/- 1.70 end-diastolic volumes/s, p less than 0.05). LV and RV volumes increased and peak filling rate decreased with PEEP in group 1, whereas in group 2 LV volume decreased and RV volume and peak filling rate remained unchanged. Using stepwise regression analysis, the change in LV volume with PEEP was related directly to baseline systemic vascular resistance and inversely to baseline blood pressure. Similarly, the change in peak filling rate with PEEP was inversely related to the change in RV end-diastolic volume. Thus, the hemodynamic response to PEEP is heterogeneous and may be related to LV ischemia

Comparison of lung protective ventilation strategies in a rabbit model of acute lung injury.

Science.gov (United States)

Rotta, A T; Gunnarsson, B; Fuhrman, B P; Hernan, L J; Steinhorn, D M

2001-11-01

To determine the impact of different protective and nonprotective mechanical ventilation strategies on the degree of pulmonary inflammation, oxidative damage, and hemodynamic stability in a saline lavage model of acute lung injury. A prospective, randomized, controlled, in vivo animal laboratory study. Animal research facility of a health sciences university. Forty-six New Zealand White rabbits. Mature rabbits were instrumented with a tracheostomy and vascular catheters. Lavage-injured rabbits were randomized to receive conventional ventilation with either a) low peak end-expiratory pressure (PEEP; tidal volume of 10 mL/kg, PEEP of 2 cm H2O); b) high PEEP (tidal volume of 10 mL/kg, PEEP of 10 cm H2O); c) low tidal volume with PEEP above Pflex (open lung strategy, tidal volume of 6 mL/kg, PEEP set 2 cm H2O > Pflex); or d) high-frequency oscillatory ventilation. Animals were ventilated for 4 hrs. Lung lavage fluid and tissue samples were obtained immediately after animals were killed. Lung lavage fluid was assayed for measurements of total protein, elastase activity, tumor necrosis factor-alpha, and malondialdehyde. Lung tissue homogenates were assayed for measurements of myeloperoxidase activity and malondialdehyde. The need for inotropic support was recorded. Animals that received a lung protective strategy (open lung or high-frequency oscillatory ventilation) exhibited more favorable oxygenation and lung mechanics compared with the low PEEP and high PEEP groups. Animals ventilated by a lung protective strategy also showed attenuation of inflammation (reduced tracheal fluid protein, tracheal fluid elastase, tracheal fluid tumor necrosis factor-alpha, and pulmonary leukostasis). Animals treated with high-frequency oscillatory ventilation had attenuated oxidative injury to the lung and greater hemodynamic stability compared with the other experimental groups. Both lung protective strategies were associated with improved oxygenation, attenuated inflammation, and

Injurious mechanical ventilation in the normal lung causes a progressive pathologic change in dynamic alveolar mechanics.

Science.gov (United States)

Pavone, Lucio A; Albert, Scott; Carney, David; Gatto, Louis A; Halter, Jeffrey M; Nieman, Gary F

2007-01-01

Acute respiratory distress syndrome causes a heterogeneous lung injury, and without protective mechanical ventilation a secondary ventilator-induced lung injury can occur. To ventilate noncompliant lung regions, high inflation pressures are required to 'pop open' the injured alveoli. The temporal impact, however, of these elevated pressures on normal alveolar mechanics (that is, the dynamic change in alveolar size and shape during ventilation) is unknown. In the present study we found that ventilating the normal lung with high peak pressure (45 cmH(2)0) and low positive end-expiratory pressure (PEEP of 3 cmH(2)O) did not initially result in altered alveolar mechanics, but alveolar instability developed over time. Anesthetized rats underwent tracheostomy, were placed on pressure control ventilation, and underwent sternotomy. Rats were then assigned to one of three ventilation strategies: control group (n = 3, P control = 14 cmH(2)O, PEEP = 3 cmH(2)O), high pressure/low PEEP group (n = 6, P control = 45 cmH(2)O, PEEP = 3 cmH(2)O), and high pressure/high PEEP group (n = 5, P control = 45 cmH(2)O, PEEP = 10 cmH(2)O). In vivo microscopic footage of subpleural alveolar stability (that is, recruitment/derecruitment) was taken at baseline and than every 15 minutes for 90 minutes following ventilator adjustments. Alveolar recruitment/derecruitment was determined by measuring the area of individual alveoli at peak inspiration (I) and end expiration (E) by computer image analysis. Alveolar recruitment/derecruitment was quantified by the percentage change in alveolar area during tidal ventilation (%I - E Delta). Alveoli were stable in the control group for the entire experiment (low %I - E Delta). Alveoli in the high pressure/low PEEP group were initially stable (low %I - E Delta), but with time alveolar recruitment/derecruitment developed. The development of alveolar instability in the high pressure/low PEEP group was associated with histologic lung injury. A large change in

Positive end-expiratory pressure increases pulmonary clearance of inhaled 99mTc-DTPA in nonsmokers but not in healthy smokers

International Nuclear Information System (INIS)

Nolop, K.B.; Braude, S.; Royston, D.; Maxwell, D.L.; Hughes, J.M.B.

1987-01-01

Positive end-expiratory pressure (PEEP) is widely used in the treatment of severe pulmonary oedema, although its effects on the clearance of water and small solutes from alveolus to blood are not well characterized. We studied the effect of the application of 10 cmH 2 O of PEEP on the flux of inhaled 99 mTc-diethylene-triamine-penta-acetic acid (DTPA) from lung to blood in six healthy smoking and six nonsmoking subjects. The rate of flux was corrected for possible changes in pulmonary blood volume during PEEP by use of an intravenous injection of 99m Tc-DTPA. The baseline clearance rate (K,%.min -1 ) for nonsmokers was 1.48±0.12 (mean±SE) and increased to 2.40±0.29 during PEEP (p<0.05). In contrast, the mean clearance rate for smokers was 3.26±0.82 at baseline and 3.03±0.82 during PEEP (p=NS). The application of positive end-expiratory pressure appears to increase alveolar solute flux in nonsmokers but not in smokers, suggesting that the pathway for solute clearance in smokers is governed by different rate-limiting steps to those of nonsmokers

Salt Lake Cityst Torinoni / Olev Remsu

Index Scriptorium Estoniae

Remsu, Olev, 1947-

2006-01-01

Dokumentaalfilm Eesti suusameeskonna valmistumisest Torino olümpiamängudeks "Tiim" : idee autorid Peep Puks, Hans Roosipuu : režissöör Peep Puks : F-Seitse 2006. Esilinastus toimus 26. mail Otepääl, ETVs 31. mail

Evaluation of lung recruitment maneuvers in acute respiratory distress syndrome using computer simulation.

Science.gov (United States)

Das, Anup; Cole, Oana; Chikhani, Marc; Wang, Wenfei; Ali, Tayyba; Haque, Mainul; Bates, Declan G; Hardman, Jonathan G

2015-01-12

Direct comparison of the relative efficacy of different recruitment maneuvers (RMs) for patients with acute respiratory distress syndrome (ARDS) via clinical trials is difficult, due to the heterogeneity of patient populations and disease states, as well as a variety of practical issues. There is also significant uncertainty regarding the minimum values of positive end-expiratory pressure (PEEP) required to ensure maintenance of effective lung recruitment using RMs. We used patient-specific computational simulation to analyze how three different RMs act to improve physiological responses, and investigate how different levels of PEEP contribute to maintaining effective lung recruitment. We conducted experiments on five 'virtual' ARDS patients using a computational simulator that reproduces static and dynamic features of a multivariable clinical dataset on the responses of individual ARDS patients to a range of ventilator inputs. Three recruitment maneuvers (sustained inflation (SI), maximal recruitment strategy (MRS) followed by a titrated PEEP, and prolonged recruitment maneuver (PRM)) were implemented and evaluated for a range of different pressure settings. All maneuvers demonstrated improvements in gas exchange, but the extent and duration of improvement varied significantly, as did the observed mechanism of operation. Maintaining adequate post-RM levels of PEEP was seen to be crucial in avoiding cliff-edge type re-collapse of alveolar units for all maneuvers. For all five patients, the MRS exhibited the most prolonged improvement in oxygenation, and we found that a PEEP setting of 35 cm H2O with a fixed driving pressure of 15 cm H2O (above PEEP) was sufficient to achieve 95% recruitment. Subsequently, we found that PEEP titrated to a value of 16 cm H2O was able to maintain 95% recruitment in all five patients. There appears to be significant scope for reducing the peak levels of PEEP originally specified in the MRS and hence to avoid exposing the lung to

Pharmacologic Interventions to Improve Splanchnic Oxygenation During Ventilation with Positive End-Expiratory Pressure

NARCIS (Netherlands)

Fournell, A.; Scheeren, T. W. L.; Picker, O.; Schwarte, L. A.; Wolf, M; Bucher, HU; Rudin, M; VanHuffel, S; Wolf, U; Bruley, DF; Harrison, DK

2012-01-01

Mechanical ventilation with positive end-expiratory pressure (PEEP) is an indispensable tool in the management of respiratory failure to preserve or improve lung function and systemic oxygenation. However, PEEP per se may also, as has been shown in experimental animals, impair regional

Ma olen Turist, ma elan siin / Mait Väljas

Index Scriptorium Estoniae

Väljas, Mait

2006-01-01

Endise valuutapoe, praeguse klubi "Parlament" lammutamisplaanist Tallinnas Tartu mnt. 17. Arhitektid Peep Jänes ja Henno Sepmann, sisearhitekt Toivo Gans, sisekujundaja Aulo Padar. Ehitamisel osalesid ka soome arhitektid Kalle-Heiki Narinen ja Tapio Hänninen. Kommentaar Peep Jäneselt ja Aulo Padarilt

Low tidal volume and high positive end-expiratory pressure mechanical ventilation results in increased inflammation and ventilator-associated lung injury in normal lungs.

Science.gov (United States)

Hong, Caron M; Xu, Da-Zhong; Lu, Qi; Cheng, Yunhui; Pisarenko, Vadim; Doucet, Danielle; Brown, Margaret; Aisner, Seena; Zhang, Chunxiang; Deitch, Edwin A; Delphin, Ellise

2010-06-01

Protective mechanical ventilation with low tidal volume (Vt) and low plateau pressure reduces mortality and decreases the length of mechanical ventilation in patients with acute respiratory distress syndrome. Mechanical ventilation that will protect normal lungs during major surgical procedures of long duration may improve postoperative outcomes. We performed an animal study comparing 3 ventilation strategies used in the operating room in normal lungs. We compared the effects on pulmonary mechanics, inflammatory mediators, and lung tissue injury. Female pigs were randomized into 3 groups. Group H-Vt/3 (n = 6) was ventilated with a Vt of 15 mL/kg predicted body weight (PBW)/positive end-expiratory pressure (PEEP) of 3 cm H(2)O, group L-Vt/3 (n = 6) with a Vt of 6 mL/kg PBW/PEEP of 3 cm H(2)O, and group L-Vt/10 (n = 6) with a Vt of 6 mL/kg PBW/PEEP of 10 cm H(2)O, for 8 hours. Hemodynamics, airway mechanics, arterial blood gases, and inflammatory markers were monitored. Bronchoalveolar lavage (BAL) was analyzed for inflammatory markers and protein concentration. The right lower lobe was assayed for mRNA of specific cytokines. The right lower lobe and right upper lobe were evaluated histologically. In contrast to groups H-Vt/3 and L-Vt/3, group L-Vt/10 exhibited a 6-fold increase in inflammatory mediators in BAL (P ventilation with high PEEP resulted in increased production of inflammatory markers. Low PEEP resulted in lower levels of inflammatory markers. High Vt/low PEEP resulted in less histologic lung injury.

A Case of Shunting Postoperative Patent Foramen Ovale Under Mechanical Ventilation Controlled by Different Ventilator Settings.

Science.gov (United States)

Pragliola, Claudio; Di Michele, Sara; Galzerano, Domenico

2017-06-07

A 56-year old male with ischemic heart disease and an unremarkable preoperative echocardiogram underwent surgical coronary revascularization. An intraoperative post pump trans-esophageal echocardiogram (TOE) performed while the patient was being ventilated at a positive end expiratory pressure (PEEP) of 8 cm H 2 O demonstrated a right to left interatrial shunt across a patent foramen ovale (PFO). Whereas oxygen saturation was normal, a reduction of the PEEP to 3 cm H 2 O led to the complete resolution of the shunt with no change in arterial blood gases. Attempts to increase the PEEP level above 3 mmHg resulted in recurrence of the interatrial shunt. The remaining of the TEE was unremarkable. Mechanical ventilation, particularly with PEEP, causes an increase in intrathoracic pressure. The resulting rise in right atrial pressure, mostly during inspiration, may unveil and pop open an unrecognized PFO, thus provoking a right to left shunt across a seemingly intact interatrial septum. This phenomenon increases the risk of paradoxical embolism and can lead to hypoxemia. The immediate management would be to adjust the ventilatory settings to a lower PEEP level. A routine search for a PFO should be performed in ventilated patients who undergo a TEE.

A case of shunting postoperative patent foramen ovale under mechanical ventilation controlled by different ventilator settings

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Claudio Pragliola

2017-08-01

Full Text Available A 56-year old male with ischemic heart disease and an unremarkable preoperative echocardiogram underwent surgical coronary revascularization. An intraoperative post pump trans-esophageal echocardiogram (TOE performed while the patient was being ventilated at a positive end expiratory pressure (PEEP of 8 cm H2O demonstrated a right to left interatrial shunt across a patent foramen ovale (PFO. Whereas oxygen saturation was normal, a reduction of the PEEP to 3 cm H2O led to the complete resolution of the shunt with no change in arterial blood gases. Attempts to increase the PEEP level above 3 mmHg resulted in recurrence of the interatrial shunt. The remaining of the TEE was unremarkable. Mechanical ventilation, particularly with PEEP, causes an increase in intrathoracic pressure. The resulting rise in right atrial pressure, mostly during inspiration, may unveil and pop open an unrecognized PFO, thus provoking a right to left shunt across a seemingly intact interatrial septum. This phenomenon increases the risk of paradoxical embolism and can lead to hypoxemia. The immediate management would be to adjust the ventilatory settings to a lower PEEP level. A routine search for a PFO should be performed in ventilated patients who undergo a TEE.

A Recruiting Maneuver Algorithm in Patients with Early Acute Respiratory Distress Syndrome

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D. I. Levikov

2011-01-01

Full Text Available Objective: to evaluate the efficiency of a recruiting maneuver (RM and adjustment of positive end-expiratory pressure (PEEP in patients with early acute respiratory distress syndrome (ARDS. Subjects and methods. The study enrolled 16 patients (14 men and 2 women aged 46 to 78 years (range 62±5.6 years with ARDS of various genesis. RM was made, by stepwisely increasing PEEP and inspiratory pressure under the control of dynamic lung compliance and hemodynamic parameters. The values of blood gas composition and hemodynamics were determined during the study. Results. RM caused an increase in oxygenation index (OI from 153.5±48.3 to 348.5±53.2 mm Hg. Oxygenation values returned to the baseline levels 30—40 min after the PEEP was set at the closure point of +2 cm H2O. If the set PEEP was 8—10 cm H2O higher than the objective, the effect of RM was retained for as long as 24 hours. When RM was performed using the maximum pressure of 50—60 cm H2O, the cardiac index (CI was lower in all the patients and 30—50% of the baseline values were achieved in all cases, which required the optimization of cardiotonic therapy. The time of this pronounced reduction in cardiac output with RM was not longer than 5 min. After RM, during mechanical ventilation with 18—26 cm H2O PEEP, the CI did not practically differ from the baseline values (3.31±0.41 and 3.37±0.36 l/min/m2, respectively, though the dopamine dose required to maintain normal hemodynamics was somewhat higher (7.5±2.3 and 6.3±2.6 ^g/kg/min. Conclusion. Analysis of the given cases suggests that RM is highly effective in patients at the early stages of acute lung injury. The duration of RM effects may depend on the set PEEP level in individual cases. Setting PEEP at a level of +2—4 cm H2O fails to prevent repeated alveolar derecruitment in a number of patients. In these cases, it is expedient to individually adjust PEEP levels, by taking into account the long-term changes in OI and Cdyn. In

Keskkond / Peep Pobbul

Index Scriptorium Estoniae

Pobbul, Peep

2004-01-01

Ilmunud ka: 2003 : annual report : [Eesti Raudtee]. - Tallinn, 2004, lk. 40-41; 2003 : godovoi ottshjot : [Eesti Raudtee]. - Tallinn, 2004, lk. 40-41. AS-i Eesti Raudtee keskkonna-alastest projektidest

The Peep Show

Science.gov (United States)

Gamble, David L.

2010-01-01

Three years ago, the author and Linda Arbuckle (University of Florida ceramic professor and internationally known majolica clay artist) were on the phone discussing how electric kilns just don't have any artistic design flair to them. The round kiln has basic properties that allow it to function properly, but its looks are far from exciting. They…

The effects of intraoperative lung protective ventilation with positive end-expiratory pressure on blood loss during hepatic resection surgery: A secondary analysis of data from a published randomised control trial (IMPROVE).

Science.gov (United States)

Neuschwander, Arthur; Futier, Emmanuel; Jaber, Samir; Pereira, Bruno; Eurin, Mathilde; Marret, Emmanuel; Szymkewicz, Olga; Beaussier, Marc; Paugam-Burtz, Catherine

2016-04-01

During high-risk abdominal surgery the use of a multi-faceted lung protective ventilation strategy composed of low tidal volumes, positive end-expiratory pressure (PEEP) and recruitment manoeuvres, has been shown to improve clinical outcomes. It has been speculated, however, that mechanical ventilation using PEEP might increase intraoperative bleeding during liver resection. To study the impact of mechanical ventilation with PEEP on bleeding during hepatectomy. Post-hoc analysis of a randomised controlled trial. Seven French university teaching hospitals from January 2011 to August 2012. Patients scheduled for liver resection surgery. In the Intraoperative Protective Ventilation trial, patients scheduled for major abdominal surgery were randomly assigned to mechanical ventilation using low tidal volume, PEEP between 6 and 8  cmH2O and recruitment manoeuvres (lung protective ventilation strategy) or higher tidal volume, zero PEEP and no recruitment manoeuvres (non-protective ventilation strategy). The primary endpoint was intraoperative blood loss volume. A total of 79 (19.8%) patients underwent liver resections (41 in the lung protective and 38 in the non-protective group). The median (interquartile range) amount of intraoperative blood loss was 500 (200 to 800)  ml and 275 (125 to 800)  ml in the non-protective and lung protective ventilation groups, respectively (P = 0.47). Fourteen (35.0%) and eight (21.5%) patients were transfused in the non-protective and lung protective groups, respectively (P = 0.17), without a statistically significant difference in the median (interquartile range) number of red blood cells units transfused [2.5 (2 to 4) units and 3 (2 to 6) units in the two groups, respectively; P = 0.54]. During hepatic surgery, mechanical ventilation using PEEP within a multi-faceted lung protective strategy was not associated with increased bleeding compared with non-protective ventilation using zero PEEP. The current study was not

Do we deliver the pressures we intend to when using a T-piece resuscitator?

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Evelien Roegholt

Full Text Available BACKGROUND: A T-piece resuscitator (TPR uses a built-in manometer to set the inflation pressures, but we are not informed what pressures are actually delivered distally. Aim of this study was to measure the proximal and distal pressures under different gas conditions when using a TPR. METHODOLOGY/FINDINGS: A test lung was ventilated using a TPR (PIP 25 cmH₂O, PEEP 5 cmH₂O with a gas flow rate of 8 L/min. A Pressure delivered by six different TPRs was tested. To test variability 20 participants were asked to set PEEP and PIP pressures to 25/5 cmH₂O. B PIP and PEEP were measured proximal and distal of the TPR when using standard tubing or heated tubing with or without a humidifier. In experiment A mean (SD proximal PIP and PEEP of the TPRs were respectively 20.3 (0.3 cmH₂O (19.9-20.6 cmH₂O and 4.9 (0.1 cmH₂O. When 20 participants set pressures; PIP 26.7 (0.5 cm H₂O and PEEP 5.9 (0.44 cmH2O were measured. Experiment B showed that the decrease of PIP between proximal and distal pressures was not clinically significant. However there was a significant decrease of PEEP using the standard tubing (5.1 (0.1 cmH₂O proximally versus 4.8 (0.2 cmH₂O distally; p<0.001 compared to, when using a humidifier with associated tubing and the humidifier turned on, 5.1 (0.1 proximally versus 3.9 (0.2 cmH₂O distally; (p<0.001. CONCLUSION/SIGNIFICANCE: The accuracy of the built-in manometer of a TPR is acceptable. Most pressures set proximally are comparable to the actual pressures delivered distally. However, when using tubing associated with the humidifier PEEP decreases distally by 1.1-1.2 cmH₂O and users should anticipate on this.

Nonassociative learning promotes respiratory entrainment to mechanical ventilation.

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Shawna M MacDonald

Full Text Available BACKGROUND: Patient-ventilator synchrony is a major concern in critical care and is influenced by phasic lung-volume feedback control of the respiratory rhythm. Routine clinical application of positive end-expiratory pressure (PEEP introduces a tonic input which, if unopposed, might disrupt respiratory-ventilator entrainment through sustained activation of the vagally-mediated Hering-Breuer reflex. We suggest that this potential adverse effect may be averted by two differentiator forms of nonassociative learning (habituation and desensitization of the Hering-Breuer reflex via pontomedullary pathways. METHODOLOGY/PRINCIPAL FINDINGS: We tested these hypotheses in 17 urethane-anesthetized adult Sprague-Dawley rats under controlled mechanical ventilation. Without PEEP, phrenic discharge was entrained 1:1 to the ventilator rhythm. Application of PEEP momentarily dampened the entrainment to higher ratios but this effect was gradually adapted by nonassociative learning. Bilateral electrolytic lesions of the pneumotaxic center weakened the adaptation to PEEP, whereas sustained stimulation of the pneumotaxic center weakened the entrainment independent of PEEP. In all cases, entrainment was abolished after vagotomy. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate an important functional role for pneumotaxic desensitization and extra-pontine habituation of the Hering-Breuer reflex elicited by lung inflation: acting as buffers or high-pass filters against tonic vagal volume input, these differentiator forms of nonassociative learning help to restore respiratory-ventilator entrainment in the face of PEEP. Such central sites-specific habituation and desensitization of the Hering-Breuer reflex provide a useful experimental model of nonassociative learning in mammals that is of particular significance in understanding respiratory rhythmogenesis and coupled-oscillator entrainment mechanisms, and in the clinical management of mechanical ventilation in

Patient-provider discussion of online health information: results from the 2007 Health Information National Trends Survey (HINTS).

Science.gov (United States)

Chung, Jae Eun

2013-01-01

Increasing numbers of people have turned to the Internet for health information. Little has been done beyond speculation to empirically investigate patients' discussion of online health information with health care professionals (HCPs) and patients' perception of HCPs' reactions to such discussion. The author analyzed data from the 2007 Health Information National Trends Survey (HINTS) to identify the characteristics of patients (a) who search for health information on the Internet, (b) who discuss the information found on the Internet with HCPs, and (c) who positively assess HCPs' reaction to the online information. Findings show that men were more likely than were women to have a conversation on online information with HCPs. It is unfortunate that patients who had trouble understanding or trusting online health information were no more likely to ask questions to or seek guidance from HCPs. Reactions of HCPs to online information were perceived as particularly negative by certain groups of patients, such as those who experienced poor health and those who had more concerns about the quality of their searched information. Results are discussed for their implications for patient empowerment and patient-HCP relationships.

Low pulmonary artery flush perfusion pressure combined with high positive end-expiratory pressure reduces oedema formation in isolated porcine lungs

International Nuclear Information System (INIS)

Schumann, Stefan; Schließmann, Stephan J; Wagner, Giskard; Goebel, Ulrich; Priebe, Hans-Joachim; Guttmann, Josef; Kirschbaum, Andreas

2010-01-01

Flush perfusion of the pulmonary artery with organ protection solution is a standard procedure before lung explantation. However, rapid flush perfusion may cause pulmonary oedema which is deleterious in the lung transplantation setting. In this study we tested the hypotheses that high pulmonary perfusion pressure contributes to the development of pulmonary oedema and positive end-expiratory pressure (PEEP) counteracts oedema formation. We expected oedema formation to increase weight and decrease compliance of the lungs on the basis of a decrease in alveolar volume as fluid replaces alveolar air spaces. The pulmonary artery of 28 isolated porcine lungs was perfused with a low-potassium dextrane solution at low (mean 27 mmHg) or high (mean 40 mmHg) pulmonary artery pressure (PAP) during mechanical ventilation at low (4 cmH 2 O) or high (8 cmH 2 O) PEEP, respectively. Following perfusion and storage, relative increases in lung weight were smaller (p < 0.05) during perfusion at low PAP (62 ± 32% and 42 ± 26%, respectively) compared to perfusion at high PAP (133 ± 54% and 87 ± 30%, respectively). Compared to all other PAP–PEEP combinations, increases in lung weight were smallest (44 ± 9% and 27 ± 12%, respectively), nonlinear intratidal lung compliance was largest (46% and 17% respectively, both p < 0.05) and lung histology showed least infiltration of mononuclear cells in the alveolar septa, and least alveolar destruction during the combination of low perfusion pressure and high PEEP. The findings suggest that oedema formation during pulmonary artery flush perfusion in isolated and ventilated lungs can be reduced by choosing low perfusion pressure and high PEEP. PAP–PEEP titration to minimize pulmonary oedema should be based on lung mechanics and PAP monitoring

[A comparison of leak compensation in six acute care ventilators during non-invasive ventilation].

Science.gov (United States)

Hu, X S; Wang, Y; Wang, Z T; Yan, P; Zhang, X G; Zhao, S F; Xie, F; Gu, H J; Xie, L X

2017-02-12

Objective: To compare the ability of leak compensation in 6 medical ventilators during non-invasive ventilation. Methods: Six medical ventilators were selected, including 3 non-invasive ventilators (V60, Flexo and Stellar150), and 3 invasive ventilators(Avea, Servo I and BellaVist). Using a lung simulator, the ability of leak compensation was evaluated during triggering and cycling in 2 respiratory mechanics conditions (high airway resistance condition and high elastance resistance condition), and each condition was performed under 2 PEEP levels (4, and 8 cmH(2)O, 1 mmHg=0.098 kPa) at 4 air leak level conditions (L0: 2-3 L/min, L1: 8-10 L/min, L2: 22-27 L/min, L3: 35-40 L/min). Results: In the high elastance resistance condition (L2, L3)with different leak levels, the number of auto-triggering and miss-triggering of the non-invasive ventilator Flexo was significantly less than those of the others (L2: 1, 1; L3: 1.67, 1.33, P ventilators ( P ventilators (1, 0.67, 0, P ventilators in both high airway resistance and high elastance resistance conditions with L0 and L1 leak levels and PEEP levels [ARDS, PEEP=4: (109.8±1.8) ms, (112.0±0.6) ms; ARDS, PEEP=8: (103.1±0.7) ms, (109.7±0.7) ms; COPD, PEEP=4: (207.3±1.1) ms, (220.8±1.1) ms; COPD, PEEP=8: (195.6±6.7) ms, (200.0±1.2) ms , P ventilators could be synchronized, among which V60, Stellar150 and Flexo presented a good performance features in specific conditions.

Within-breath arterial PO2 oscillations in an experimental model of acute respiratory distress syndrome.

Science.gov (United States)

Williams, E M; Viale, J P; Hamilton, R M; McPeak, H; Sutton, L; Hahn, C E

2000-09-01

Tidal ventilation causes within-breath oscillations in alveolar oxygen concentration, with an amplitude which depends on the prevailing ventilator settings. These alveolar oxygen oscillations are transmitted to arterial oxygen tension, PaO2, but with an amplitude which now depends upon the magnitude of venous admixture or true shunt, QS/QT. We investigated the effect of positive end-expiratory pressure (PEEP) on the amplitude of the PaO2 oscillations, using an atelectasis model of shunt. Blood PaO2 was measured on-line with an intravascular PaO2 sensor, which had a 2-4 s response time (10-90%). The magnitude of the time-varying PaO2 oscillation was titrated against applied PEEP while tidal volume, respiratory rate and inspired oxygen concentration were kept constant. The amplitude of the PaO2 oscillation, delta PaO2, and the mean PaO2 value varied with the level of PEEP applied. At zero PEEP, both the amplitude and the mean were at their lowest values. As PEEP was increased to 1.5 kPa, both delta PaO2 and the mean PaO2 increased to a maximum. Thereafter, the mean PaO2 increased but delta PaO2 decreased. Clear oscillations of PaO2 were seen even at the lowest mean PaO2, 9.5 kPa. Conventional respiratory models of venous admixture predict that these PaO2 oscillations will be reduced by the steep part of the oxyhaemoglobin dissociation curve if a constant pulmonary shunt exists throughout the whole respiratory cycle. The facts that the PaO2 oscillations occurred at all mean PaO2 values and that their amplitude increased with increasing PEEP suggest that QS/QT, in the atelectasis model, varies between end-expiration and end-inspiration, having a much lower value during inspiration than during expiration.

Männik ohverdas Aaviksoo

Index Scriptorium Estoniae

2003-01-01

Eesti Telekomi nõukogu otsusest vabastada ametist EMT juhatuse esimees Peep Aaviksoo, uuest kandidaadist Valdo Kalmust ning EMT ja Elioni võimalikust ühinemisest. Diagramm: EMT turuosa libiseb Tele2-le. Vt. samas: EMT lahkuva juhi Peep Aaviksoo avalik kiri. Kommenteerivad Sami Seppänen, Üllar Jaaksoo, Monika Salu, Jaak Aaviksoo, Toomas Tamsar

Positive end-expiratory pressure improves survival in a rodent model of cardiopulmonary resuscitation using high-dose epinephrine.

LENUS (Irish Health Repository)

McCaul, Conán

2009-10-01

Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pulmonary vascular resistance, and potentially improve cardiac output, its use during CPR would increase survival.

Profiling and quantitative evaluation of three Nickel-Coated magnetic matrices for purification of recombinant proteins: lelpful hints for the optimized nanomagnetisable matrix preparation

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Zarei Saeed

2011-08-01

Full Text Available Abstract Background Several materials are available in the market that work on the principle of protein magnetic fishing by their histidine (His tags. Little information is available on their performance and it is often quoted that greatly improved purification of histidine-tagged proteins from crude extracts could be achieved. While some commercial magnetic matrices could be used successfully for purification of several His-tagged proteins, there are some which have been proved to operate just for a few extent of His-tagged proteins. Here, we address quantitative evaluation of three commercially available Nickel nanomagnetic beads for purification of two His-tagged proteins expressed in Escherichia coli and present helpful hints for optimized purification of such proteins and preparation of nanomagnetisable matrices. Results Marked differences in the performance of nanomagnetic matrices, principally on the basis of their specific binding capacity, recovery profile, the amount of imidazole needed for protein elution and the extent of target protein loss and purity were obtained. Based on the aforesaid criteria, one of these materials featured the best purification results (SiMAG/N-NTA/Nickel for both proteins at the concentration of 4 mg/ml, while the other two (SiMAC-Nickel and SiMAG/CS-NTA/Nickel did not work well with respect to specific binding capacity and recovery profile. Conclusions Taken together, functionality of different types of nanomagnetic matrices vary considerably. This variability may not only be dependent upon the structure and surface chemistry of the matrix which in turn determine the affinity of interaction, but, is also influenced to a lesser extent by the physical properties of the protein itself. Although the results of the present study may not be fully applied for all nanomagnetic matrices, but provide a framework which could be used to profiling and quantitative evaluation of other magnetisable matrices and also

Bench performance of ventilators during simulated paediatric ventilation.

Science.gov (United States)

Park, M A J; Freebairn, R C; Gomersall, C D

2013-05-01

This study compares the accuracy and capabilities of various ventilators using a paediatric acute respiratory distress syndrome lung model. Various compliance settings and respiratory rate settings were used. The study was done in three parts: tidal volume and FiO2 accuracy; pressure control accuracy and positive end-expiratory pressure (PEEP) accuracy. The parameters set on the ventilator were compared with either or both of the measured parameters by the test lung and the ventilator. The results revealed that none of the ventilators could consistently deliver tidal volumes within 1 ml/kg of the set tidal volume, and the discrepancy between the delivered volume and the volume measured by the ventilator varied greatly. The target tidal volume was 8 ml/kg, but delivered tidal volumes ranged from 3.6-11.4 ml/kg and the volumes measured by the ventilator ranged from 4.1-20.6 ml/kg. All the ventilators maintained pressure within 20% of the set pressure, except one ventilator which delivered pressures of up to 27% higher than the set pressure. Two ventilators maintained PEEP within 10% of the prescribed PEEP. The majority of the readings were also within 10%. However, three ventilators delivered, at times, PEEPs over 20% higher. In conclusion, as lung compliance decreases, especially in paediatric patients, some ventilators perform better than others. This study highlights situations where ventilators may not be able to deliver, nor adequately measure, set tidal volumes, pressure, PEEP or FiO2.

Effects of positive end-expiratory pressure on intraoperative core temperature in patients undergoing posterior spine surgery: prospective randomised trial.

Science.gov (United States)

Seo, Hyungseok; Do Son, Je; Lee, Hyung-Chul; Oh, Hyung-Min; Jung, Chul-Woo; Park, Hee-Pyoung

2018-03-01

Objective Positive end-expiratory pressure (PEEP) causes carotid baroreceptor unloading, which leads to thermoregulatory peripheral vasoconstriction. However, the effects of PEEP on intraoperative thermoregulation in the prone position remain unknown. Methods Thirty-seven patients undergoing spine surgery in the prone position were assigned at random to receive either 10 cmH 2 O PEEP (Group P) or no PEEP (Group Z). The primary endpoint was core temperature 180 minutes after intubation. Secondary endpoints were delta core temperature (difference in core temperature between 180 minutes and immediately after tracheal intubation), incidence of intraoperative hypothermia (core temperature of peripheral vasoconstriction-related data. Results The median [interquartile range] core temperature 180 minutes after intubation was 36.1°C [35.9°C-36.2°C] and 36.0°C [35.9°C-36.4°C] in Groups Z and P, respectively. The delta core temperature and incidences of intraoperative hypothermia and peripheral vasoconstriction were not significantly different between the two groups. The peripheral vasoconstriction threshold (36.2°C±0.5°C vs. 36.7°C±0.6°C) was lower and the onset of peripheral vasoconstriction (66 [60-129] vs. 38 [28-70] minutes) was slower in Group Z than in Group P. Conclusions Intraoperative PEEP did not reduce the core temperature decrease in the prone position, although it resulted in an earlier onset and higher threshold of peripheral vasoconstriction.

Effects of a preemptive alveolar recruitment strategy on arterial oxygenation during one-lung ventilation with different tidal volumes in patients with normal pulmonary function test.

Science.gov (United States)

Jung, Jong Dal; Kim, Sang Hun; Yu, Byung Sik; Kim, Hye Ji

2014-08-01

Hypoxemia during one-lung ventilation (OLV) remains a major concern. The present study compared the effect of alveolar recruitment strategy (ARS) on arterial oxygenation during OLV at varying tidal volumes (Vt) with or without positive end-expiratory pressure (PEEP). In total, 120 patients undergoing wedge resection by video assisted thoracostomy were randomized into four groups comprising 30 patients each: those administered a 10 ml/kg tidal volume with or without preemptive ARS (Group H and Group H-ARS, respectively) and those administered a 6 ml/kg tidal volume and a 8 cmH2O PEEP with or without preemptive ARS (Group L and Group L-ARS, respectively). ARS was performed using pressure-controlled ventilation with a 40 cmH2O plateau airway pressure and a 15 cmH2O PEEP for at least 10 breaths until OLV began. Preemptive ARS significantly improved the PaO2/FiO2 ratio compared to the groups that did not receive ARS (P volume combined with 8 cmH2O PEEP after preemptive ARS may reduce the risk of pulmonary injury caused by high tidal volume during one-lung ventilation in patients with normal pulmonary function.

Spatial distribution of sequential ventilation during mechanical ventilation of the uninjured lung: an argument for cyclical airway collapse and expansion

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Altemeier William A

2010-05-01

Full Text Available Abstract Background Ventilator-induced lung injury (VILI is a recognized complication of mechanical ventilation. Although the specific mechanism by which mechanical ventilation causes lung injury remains an active area of study, the application of positive end expiratory pressure (PEEP reduces its severity. We have previously reported that VILI is spatially heterogeneous with the most severe injury in the dorsal-caudal lung. This regional injury heterogeneity was abolished by the application of PEEP = 8 cm H2O. We hypothesized that the spatial distribution of lung injury correlates with areas in which cyclical airway collapse and recruitment occurs. Methods To test this hypothesis, rabbits were mechanically ventilated in the supine posture, and regional ventilation distribution was measured under four conditions: tidal volumes (VT of 6 and 12 ml/kg with PEEP levels of 0 and 8 cm H2O. Results We found that relative ventilation was sequentially redistributed towards dorsal-caudal lung with increasing tidal volume. This sequential ventilation redistribution was abolished with the addition of PEEP. Conclusions These results suggest that cyclical airway collapse and recruitment is regionally heterogeneous and spatially correlated with areas most susceptible to VILI.

Effects of respiratory rate, plateau pressure, and positive end-expiratory pressure on PaO2 oscillations after saline lavage.

Science.gov (United States)

Baumgardner, James E; Markstaller, Klaus; Pfeiffer, Birgit; Doebrich, Marcus; Otto, Cynthia M

2002-12-15

One of the proposed mechanisms of ventilator-associated lung injury is cyclic recruitment of atelectasis. Collapse of dependent lung regions with every breath should lead to large oscillations in PaO2 as shunt varies throughout the respiratory cycle. We placed a fluorescence-quenching PO2 probe in the brachiocephalic artery of six anesthetized rabbits after saline lavage. Using pressure-controlled ventilation with oxygen, ventilator settings were varied in random order over three levels of positive end-expiratory pressure (PEEP), respiratory rate (RR), and plateau pressure minus PEEP (Delta). Dependence of the amplitude of PaO2 oscillations on PEEP, RR, and Delta was modeled by multiple linear regression. Before lavage, arterial PO2 oscillations varied from 3 to 22 mm Hg. After lavage, arterial PO2 oscillations varied from 5 to 439 mm Hg. Response surfaces showed markedly nonlinear dependence of amplitude on PEEP, RR, and Delta. The large PaO2 oscillations observed provide evidence for cyclic recruitment in this model of lung injury. The important effect of RR on the magnitude of PaO2 oscillations suggests that the static behavior of atelectasis cannot be accurately extrapolated to predict dynamic behavior at realistic breathing frequencies.

Setting ventilation parameters guided by electrical impedance tomography in an animal trial of acute respiratory distress syndrome

Science.gov (United States)

Czaplik, Michael; Biener, Ingeborg; Leonhardt, Steffen; Rossaint, Rolf

2014-03-01

Since mechanical ventilation can cause harm to lung tissue it should be as protective as possible. Whereas numerous options exist to set ventilator parameters, an adequate monitoring is lacking up to date. The Electrical Impedance Tomography (EIT) provides a non-invasive visualization of ventilation which is relatively easy to apply and commercially available. Although there are a number of published measures and parameters derived from EIT, it is not clear how to use EIT to improve clinical outcome of e.g. patients suffering from acute respiratory distress syndrome (ARDS), a severe disease with a high mortality rate. On the one hand, parameters should be easy to obtain, on the other hand clinical algorithms should consider them to optimize ventilator settings. The so called Global inhomogeneity (GI) index bases on the fact that ARDS is characterized by an inhomogeneous injury pattern. By applying positive endexpiratory pressures (PEEP), homogeneity should be attained. In this study, ARDS was induced by a double hit procedure in six pigs. They were randomly assigned to either the EIT or the control group. Whereas in the control group the ARDS network table was used to set the PEEP according to the current inspiratory oxygen fraction, in the EIT group the GI index was calculated during a decremental PEEP trial. PEEP was kept when GI index was lowest. Interestingly, PEEP was significantly higher in the EIT group. Additionally, two of these animals died ahead of the schedule. Obviously, not only homogeneity of ventilation distribution matters but also limitation of over-distension.

Cardiac effects of positive pressure ventilation in ARDS assessed by NT-proBNP, Troponin T and Troponin I

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Yasser Sadek Nassar

2013-01-01

Although the increase in cardiac markers are insignificant, yet they point to the potentially harmful role played by high PEEP, low PH and low PaO2/FiO2 ratio on the heart. Currently, no clinically relevant conclusion can be drawn apart from the recommendation to attempt to lower PEEP and shorten the duration of positive pressure ventilation, even in patients with structurally normal hearts.

Perturbed Lepton-Specific Two-Higgs-Doublet Model Facing Experimental Hints for Physics beyond the Standard Model.

Science.gov (United States)

Crivellin, Andreas; Heeck, Julian; Stoffer, Peter

2016-02-26

BABAR, Belle, and LHCb Collaborations report evidence for new physics in B→Dτν and B→D^{*}τν of approximately 3.8σ. There is also the long lasting discrepancy of about 3σ in the anomalous magnetic moment of the muon, and the branching ratio for τ→μνν is 1.8σ (2.4σ) above the standard model expectation using the HFAG (PDG) values. Furthermore, CMS Collaboration finds hints for a nonzero decay rate of h→μτ. Interestingly, all these observations can be explained by introducing new scalars. In this Letter we consider these processes within a lepton-specific two-Higgs doublet model (i.e., of type X) with additional nonstandard Yukawa couplings. It is found that one can accommodate τ→μνν with modified Higgs-τ couplings. The anomalous magnetic moment of the muon can be explained if the additional neutral CP-even Higgs boson H is light (below 100 GeV). Also R(D) and R(D^{*}) can be easily explained by additional t-c-Higgs couplings. Combining these t-c couplings with a light H the decay rate for t→Hc can be in a testable range for the LHC. Effects in h→μτ are also possible, but in this case a simultaneous explanation of the anomalous magnetic moment of the muon is difficult due to the unavoidable τ→μγ decay.

The MOST - Monitor for Oxygenation of Surface and Tissue.

Science.gov (United States)

1995-10-01

anesthesia Effectiveness of COR Bio-feedback for peripheral vasodilation Relationship of CPAP and PEEP to atelectasis Waveforms Diagnosis of irregularities...deliberate hypoxia in premature infants Servo-controlled saturation, prematures Converse 02 in home 02 therapy Determine optimal PEEP and CPAP Monitor...Kusakawa I, Ohata J, Kawano T, Honma Y. Use of Pulse Oximetry In Neonatal Anesthe- sia. J Perinatology. 1987:7;343-5. Nishimura S, Tomita Y, Horiuchi T

[Alveolar ventilation and recruitment under lung protective ventilation].

Science.gov (United States)

Putensen, Christian; Muders, Thomas; Kreyer, Stefan; Wrigge, Hermann

2008-11-01

Goal of mechanical ventilation is to improve gas exchange and reduce work of breathing without contributing to further lung injury. Besides providing adequate EELV and thereby arterial oxygenation PEEP in addition to a reduction in tidal volume is required to prevent cyclic alveolar collapse and tidal recruitment and hence protective mechanical ventilation. Currently, there is no consensus if and if yes at which price alveolar recruitment with high airway pressures should be intended ("open up the lung"), or if it is more important to reduce the mechanical stress and strain to the lungs as much as possible ("keep the lung closed"). Potential of alveolar recruitment differs from patient to patient but also between lung regions. Potential for recruitment depends probably more on regional lung mechanics - especially on lung elastance - than on the underlying disease. Based on available data neither high PEEP nor other methods used for alveolar recruitment could demonstrate a survival benefit in patients with ARDS. These results may support an individualized titration of PEEP or other manoeuvres used for recruitment taking into consideration the regional effects. Bedside imaging techniques allowing titration of PEEP or other manoeuvres to prevent end-expiratory alveolar collapse (tidal recruitment) and inspiratory overinflation may be a promising development.

Effects of positive end expiratory pressure administration during non-invasive ventilation in patients affected by amyotrophic lateral sclerosis: A randomized crossover study.

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Crescimanno, Grazia; Greco, Francesca; Arrisicato, Salvo; Morana, Noemi; Marrone, Oreste

2016-10-01

No studies have evaluated the impact of different settings of non-invasive ventilation (NIV) in patients affected by amyotrophic lateral sclerosis (ALS). We explored consequences of positive end-expiratory pressure (PEEP) application on effectiveness of ventilation, sleep architecture and heart rate variability (HRV) in patients with ALS naïve to ventilatory treatment. In two consecutive nights, 25 patients received in random order 0 or 4 cm H2 0 of PEEP during nocturnal NIV administration (Idea Ultra ResMed) with the same level of total positive inspiratory pressure. Polysomnographies were performed to evaluate sleep and NIV quality, as well as HRV. HRV was analyzed on 4-h periods and on 5-min segments of stable NREM sleep. We did not observe differences in gas exchanges during NIV with and without PEEP. Conversely, during PEEP application increases in leaks (41.4 ± 29.3% vs 31.0 ± 25.7%, P = 0.0007) and in autotriggerings (4.2 (IQR 1.3-10.0) vs 0.9 (IQR 0.0-3.0) events/h, P NIV was associated with worse NIV and sleep quality and with higher sympathetic activity. © 2016 Asian Pacific Society of Respirology.

Obesity does not influence the onset and offset of sevoflurane effect as measured by the hysteresis between sevoflurane concentration and bispectral index.

Science.gov (United States)

Cortínez, Luis I; Gambús, Pedro; Trocóniz, Iñaki F; Echevarría, Ghislaine; Muñoz, Hernán R

2011-07-01

The onset and offset of action of anesthetic gases might be delayed by respiratory changes and gas exchange alterations present in obese patients. In this study, we assessed the influence of obesity on the hysteresis between sevoflurane and its effect as measured by the bispectral index (BIS). Because the use of positive end-expiratory pressure (PEEP) in obese patients has improved gas exchange, we also assessed the influence of PEEP on hysteresis. Fifteen obese and 15 normal-weight patients, ASA physical status I and II, 20 to 50 years old, scheduled to undergo general anesthesia for elective laparoscopic surgery, were prospectively studied. Anesthesia was induced with propofol and maintained with sevoflurane and fentanyl. At the end of surgery and after stable BIS values of 60 to 65, the inspired concentration of sevoflurane was increased to 5 vol% for 5 minutes or until BIS was rate constant was not influenced by body mass index or PEEP (P > 0.05). Neither obesity nor PEEP showed any influence on the PK/PD descriptors. Our results do not support the hypothesis that obesity prolongs induction or recovery times when sevoflurane, a poorly soluble anesthetic, is used to maintain anesthesia from 90 to 120 minutes.

Barbarid, plastiliinijänes, Miriam ja Frank Muller / Annika Koppel

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Koppel, Annika

2003-01-01

Nukufilm näitab 4 uut filmi : "Barbarid" (stsenaristid Andrus Kivirähk ja Hardi Volmer, režissöör H. Volmer), "Porgand" (stsenarist Peep Pedmanson, režissöör Pärtel Tall), "Miriami jõulupäkapikk" (stsenaristid Leelo Tungal ja Peep Pedmanson, režissöör Mait Laas), "Kuuvaatleja" (reklaamitreiler Frank Mulleri kellafirmale ; stsenarist, režissöör, kunstnik Mati Kütt)

Avaliação da função pulmonar de recém-nascidos com síndrome do desconforto respiratório em diferentes pressões finais expiratórias positivas Assessment of pulmonary function of preterm newborn infants with respiratory distress syndrome at different positive end expiratory pressure levels

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Luiz C.T. Consolo

2002-09-01

Full Text Available RESUMO\tABSTRACT \t Objetivo: verificar as alterações da função pulmonar: complacência dinâmica (Cdyn, volume corrente inspiratório (V Tinsp, pressão arterial de dióxido de carbono (PaCO2, em recém-nascidos pré-termo com síndrome do desconforto respiratório. Pacientes e Métodos: estudo de caso controle, incluindo 11 pré-termos com idade gestacional Objective: to verify the alterations of pulmonary function in preterm newborn infants with respiratory distress syndrome (RDS. The parameters analyzed were Dynamic Compliance (Cdyn, Inspiratory Tidal Volume (TVinsp, partial arterial pressure of carbon dioxide (PaCO2. Methods: eleven preterm newborn infants, with gestational age < 35 weeks, and birth weight < 2.500 g, were include in a control case study. All infants presented RDS and were treated with 120 mg/Kg of porcine surfactant. The initial positive end expiratory pressure (PEEP was 3 cm H2O. A pneumotachograph with a graphical monitor was used to assess the pulmonary function. After each increase in the PEEP (4 and 6 cm H2O, there was an interval of 20 minutes before measuring the arterial data of pulmonary function and arterial gases. Results: there were three males and eight females (1:2,7 among the infants with RDS. The mean gestational age was 30.78. 2.05 weeks, ranging from 26 to 34 weeks. The increase in the PEEP from 3 to 6 cm H2O caused significant decrease in the TVinsp (6.46 ±3.43 to 4.20 ±2.35, P=0.0262. With the increase in the PEEP from 4 to 6 cm H2O, there was also a decrease in the TVinsp (5.98.± 3.33 to 4.20.± 2.35, (P=0.0044. Regarding the Cdyn, when there was an increase in the PEEP from 3 to 6 cm H2O, the reduction was statistically significant (0.58.± 0.27 to 0.46± 0.25, P=0.0408 and from 4 to 6 cm H2O, the reduction in the Cdyn was also important (0.77± 0.27 to 0.46± 0.25, (P=0.0164. Increases in the PEEP from 4 to 6 cm H2O caused increases in the PaCO2 (52.81± 15.49 to 64.90± 12.69, (P= 0,0141. A

Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis.

Science.gov (United States)

Guo, Lei; Wang, Weiwei; Zhao, Nana; Guo, Libo; Chi, Chunjie; Hou, Wei; Wu, Anqi; Tong, Hongshuang; Wang, Yue; Wang, Changsong; Li, Enyou

2016-07-22

It has been shown that the application of a lung-protective mechanical ventilation strategy can improve the prognosis of patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). However, the optimal mechanical ventilation strategy for intensive care unit (ICU) patients without ALI or ARDS is uncertain. Therefore, we performed a network meta-analysis to identify the optimal mechanical ventilation strategy for these patients. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, EMBASE, MEDLINE, CINAHL, and Web of Science for studies published up to July 2015 in which pulmonary compliance or the partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FIO2) ratio was assessed in ICU patients without ALI or ARDS, who received mechanical ventilation via different strategies. The data for study characteristics, methods, and outcomes were extracted. We assessed the studies for eligibility, extracted the data, pooled the data, and used a Bayesian fixed-effects model to combine direct comparisons with indirect evidence. Seventeen randomized controlled trials including a total of 575 patients who received one of six ventilation strategies were included for network meta-analysis. Among ICU patients without ALI or ARDS, strategy C (lower tidal volume (VT) + higher positive end-expiratory pressure (PEEP)) resulted in the highest PaO2/FIO2 ratio; strategy B (higher VT + lower PEEP) was associated with the highest pulmonary compliance; strategy A (lower VT + lower PEEP) was associated with a shorter length of ICU stay; and strategy D (lower VT + zero end-expiratory pressure (ZEEP)) was associated with the lowest PaO2/FiO2 ratio and pulmonary compliance. For ICU patients without ALI or ARDS, strategy C (lower VT + higher PEEP) was associated with the highest PaO2/FiO2 ratio. Strategy B (higher VT + lower PEEP) was superior to the other strategies in improving pulmonary

Investigation of continuous effect modifiers in a meta-analysis on higher versus lower PEEP in patients requiring mechanical ventilation--protocol of the ICEM study.

Science.gov (United States)

Kasenda, Benjamin; Sauerbrei, Willi; Royston, Patrick; Briel, Matthias

2014-05-20

Categorizing an inherently continuous predictor in prognostic analyses raises several critical methodological issues: dependence of the statistical significance on the number and position of the chosen cut-point(s), loss of statistical power, and faulty interpretation of the results if a non-linear association is incorrectly assumed to be linear. This also applies to a therapeutic context where investigators of randomized clinical trials (RCTs) are interested in interactions between treatment assignment and one or more continuous predictors. Our goal is to apply the multivariable fractional polynomial interaction (MFPI) approach to investigate interactions between continuous patient baseline variables and the allocated treatment in an individual patient data meta-analysis of three RCTs (N = 2,299) from the intensive care field. For each study, MFPI will provide a continuous treatment effect function. Functions from each of the three studies will be averaged by a novel meta-analysis approach for functions. We will plot treatment effect functions separately for each study and also the averaged function. The averaged function with a related confidence interval will provide a suitable basis to assess whether a continuous patient characteristic modifies the treatment comparison and may be relevant for clinical decision-making. The compared interventions will be a higher or lower positive end-expiratory pressure (PEEP) ventilation strategy in patients requiring mechanical ventilation. The continuous baseline variables body mass index, PaO2/FiO2, respiratory compliance, and oxygenation index will be the investigated potential effect modifiers. Clinical outcomes for this analysis will be in-hospital mortality, time to death, time to unassisted breathing, and pneumothorax. This project will be the first meta-analysis to combine continuous treatment effect functions derived by the MFPI procedure separately in each of several RCTs. Such an approach requires individual

Effects of positive end-expiratory pressure on renal function.

Science.gov (United States)

Järnberg, P O; de Villota, E D; Eklund, J; Granberg, P O

1978-01-01

The effects were studied positive end-expiratory pressure (PEEP) on renal function in eight patients with acute respiratory failure, requiring mechanical ventilation. On application of PEEP + 10 cm H2O, central venous pressure increased, systolic blood pressure decreased, urine flow and PAH-clearance were reduced, while inulin clearance remained stable. There was a marked increase in fractional sodium reabsorption and a concurrent decrease in fractional osmolal excretion. Fractional free-water clearance and the ratio UOsm/POsm did change.

Positional effects on distribution of ventilation in chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Shim, C.; Chun, K.J.; Williams, M.H. Jr.; Blaufox, M.D.

1986-01-01

Ventilation is distributed predominantly to the dependent lung in normal persons in the decubitus position. We evaluated the distribution of ventilation in four patients with mild-to-moderate chronic obstructive pulmonary disease using 81mKr gas. Patients were tested in the sitting and right and left decubitus positions with and without the application of positive end expiratory pressure (PEEP). In contrast to findings in controls, ventilation was predominantly distributed to the nondependent lung in patients in the decubitus position. Mean ventilation in the right lung decreased from 51% of the total in the sitting position to 31% in the right decubitus position; it increased with the application of 10 cm PEEP. Reduced ventilation in the dependent lung most likely is caused by closure of the airways after a decrease in volume. Application of PEEP resulted in increased lung volume and preferential distribution of ventilation to the dependent lung

Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: a meta-analysis of individual patient data.

Science.gov (United States)

Neto, Ary Serpa; Hemmes, Sabrine N T; Barbas, Carmen S V; Beiderlinden, Martin; Fernandez-Bustamante, Ana; Futier, Emmanuel; Gajic, Ognjen; El-Tahan, Mohamed R; Ghamdi, Abdulmohsin A Al; Günay, Ersin; Jaber, Samir; Kokulu, Serdar; Kozian, Alf; Licker, Marc; Lin, Wen-Qian; Maslow, Andrew D; Memtsoudis, Stavros G; Reis Miranda, Dinis; Moine, Pierre; Ng, Thomas; Paparella, Domenico; Ranieri, V Marco; Scavonetto, Federica; Schilling, Thomas; Selmo, Gabriele; Severgnini, Paolo; Sprung, Juraj; Sundar, Sugantha; Talmor, Daniel; Treschan, Tanja; Unzueta, Carmen; Weingarten, Toby N; Wolthuis, Esther K; Wrigge, Hermann; Amato, Marcelo B P; Costa, Eduardo L V; de Abreu, Marcelo Gama; Pelosi, Paolo; Schultz, Marcus J

2016-04-01

Protective mechanical ventilation strategies using low tidal volume or high levels of positive end-expiratory pressure (PEEP) improve outcomes for patients who have had surgery. The role of the driving pressure, which is the difference between the plateau pressure and the level of positive end-expiratory pressure is not known. We investigated the association of tidal volume, the level of PEEP, and driving pressure during intraoperative ventilation with the development of postoperative pulmonary complications. We did a meta-analysis of individual patient data from randomised controlled trials of protective ventilation during general anesthaesia for surgery published up to July 30, 2015. The main outcome was development of postoperative pulmonary complications (postoperative lung injury, pulmonary infection, or barotrauma). We included data from 17 randomised controlled trials, including 2250 patients. Multivariate analysis suggested that driving pressure was associated with the development of postoperative pulmonary complications (odds ratio [OR] for one unit increase of driving pressure 1·16, 95% CI 1·13-1·19; pprotective ventilation on development of pulmonary complications (p=0·027). In two studies that compared low with high PEEP during low tidal volume ventilation, an increase in the level of PEEP that resulted in an increase in driving pressure was associated with more postoperative pulmonary complications (OR 3·11, 95% CI 1·39-6·96; p=0·006). In patients having surgery, intraoperative high driving pressure and changes in the level of PEEP that result in an increase of driving pressure are associated with more postoperative pulmonary complications. However, a randomised controlled trial comparing ventilation based on driving pressure with usual care is needed to confirm these findings. None. Copyright © 2016 Elsevier Ltd. All rights reserved.

Higgs hints

Energy Technology Data Exchange (ETDEWEB)

Anon.

1991-10-15

As well as dominating the news at the recent Joint International Lepton-Photon Symposium and Europhysics Conference on High Energy Physics in Geneva, results from the four big experiments - Aleph , Delphi, L3 and Opal - at CERN's big LEP electron-positron collider had far-reaching implications.

Hint from the interfamily mass hierarchy: Two vectorlike families in the TeV range

Science.gov (United States)

Babu, K. S.; Pati, Jogesh C.; Stremnitzer, Hanns

1995-03-01

Two vectorlike familes QL,R=(U, D, N, E)L,R and Q'L,R=(U', D', N', E')L,R with masses of order 1 TeV, one of which is a doublet of SU(2)L and the other a doublet of SU(2)R, have been predicted to exist, together with the three observed chiral families, in the context of a viable and economical SUSY preon model. The model itself possesses many attractive features which include explanations of the origins of (i) diverse mass scales, (ii) family replication, (iii) protection of the masses of the composite quarks and leptons compared to their compositeness scales, and (iv) interfamily mass hierarchy. The existence of the two vectorlike familes, a prediction of the model, turns out to be crucial especially for an explanation of the interfamily mass hierarchy (IFMH). Given the simplicity of the explanation, the observed IFMH in turn appears to us to be a strong hint in favor of the existence of the two vectorlike families. This paper is devoted to a detailed study of the expected masses, mixings and decay modes of the fermions belonging to the two vectorlike families, in the context of the SUSY preon model, with the inclusion of the renormalization effects due to the standard model gauge interactions. Including QCQ renormalization effects, the masses of the vectorlike quarks are expected to lie in the range of 500 GeV to about 2.5 TeV, while those of the vectorlike leptons are expected to be in the range of 200 GeV to 1 TeV. Their mass pattern and decay modes exhibit certain distinguishing features and characteristic signals. For example, when the CERN LHC and, possibly a future version of the SSC are built, pair production of the vectorlike quarks would lead to systems such as (bb¯+4Z+W+W-) and (bb¯+2Z+W+W-), while an e-e+ linear collider (NLC) of suitable energy can produce appreciably a single neutral heavy lepton N together, with ντ, followed by the decay of N into (Z+ντ)-->(e-e+)+ντ. This last signal may conceivably materialize even at CERN LEP 200 if N is

Weimar, Euroopa kultuuripealinn / Peep Pillak

Index Scriptorium Estoniae

Pillak, Peep, 1957-

1999-01-01

1999. a. Euroopa kultuuripealinnast Weimarist. Linna minevikust, Weimaris elanud suurmehi, juubelitest, mida tähistatakse 1999. a. 1552. a. asus Weimarisse Lucas Cranach, isa alustatut jätkas Lucas Cranach noorem. 1919. a. alustas Walter Gropiuse juhtimisel Weimaris tegevust Bauhaus, kus aastatel 1922-1925 töötasid ka Wassily Kandinsky, Paul Klee

Pommisatelliit Eesti kohal / Peep Pedmanson

Index Scriptorium Estoniae

Pedmanson, Peep, 1963-

1997-01-01

Discovery Channel Europe presenteeris Pirital toimunud telemessil videofilmi "Profid. Pommirühm" ("Professionals : Bomb Squad"), stsenarist, režissöör ja operaator Rein Kotov : Inglismaa - Eesti - Taani 1997

Tarbekunstist ja kunstitarbest / Peep Ilmet

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Ilmet, Peep, pseud., 1948-

2010-01-01

4. rahvusvahelisest köitekunsti näitusest "Scripta manent" Eesti Tarbekunsti- ja Disainimuuseumis, näituse arengust, eesti köitekunstist, autori soovitused eesti köitekunsti rikastamiseks. Raamatu sisu kaitse ja ligipääsetavuse nõudest

Kutsekeskkooli õpilaste koosseisust / Peep Leppik

Index Scriptorium Estoniae

Leppik, Peep

2001-01-01

Helme Kutsekeskkoolis 1985-1988, 1991-1992.a. läbi viidud uuringutest, milles määrati õpilaste IQ, käitumine, õppetöös edasijõudmine. Võrdluseks teisi Eesti koolide õpilaste seas läbi viidud intelligentsusuuringuid (Juhan Tork, 1939 ; Eda Heinla, 1988-1990 ; Juha Sõerd, 1973 ; A.Sukamägi, K.Tamm, 1994)

Physiologic effects of alveolar recruitment and inspiratory pauses during moderately-high-frequency ventilation delivered by a conventional ventilator in a severe lung injury model.

Directory of Open Access Journals (Sweden)

Ricardo Luiz Cordioli

Full Text Available To investigate whether performing alveolar recruitment or adding inspiratory pauses could promote physiologic benefits (VT during moderately-high-frequency positive pressure ventilation (MHFPPV delivered by a conventional ventilator in a porcine model of severe acute respiratory distress syndrome (ARDS.Prospective experimental laboratory study with eight pigs. Induction of acute lung injury with sequential pulmonary lavages and injurious ventilation was initially performed. Then, animals were ventilated on a conventional mechanical ventilator with a respiratory rate (RR = 60 breaths/minute and PEEP titrated according to ARDS Network table. The first two steps consisted of a randomized order of inspiratory pauses of 10 and 30% of inspiratory time. In final step, we removed the inspiratory pause and titrated PEEP, after lung recruitment, with the aid of electrical impedance tomography. At each step, PaCO2 was allowed to stabilize between 57-63 mmHg for 30 minutes.The step with RR of 60 after lung recruitment had the highest PEEP when compared with all other steps (17 [16,19] vs 14 [10, 17]cmH2O, but had lower driving pressures (13 [13,11] vs 16 [14, 17]cmH2O, higher P/F ratios (212 [191,243] vs 141 [105, 184] mmHg, lower shunt (23 [20, 23] vs 32 [27, 49]%, lower dead space ventilation (10 [0, 15] vs 30 [20, 37]%, and a more homogeneous alveolar ventilation distribution. There were no detrimental effects in terms of lung mechanics, hemodynamics, or gas exchange. Neither the addition of inspiratory pauses or the alveolar recruitment maneuver followed by decremental PEEP titration resulted in further reductions in VT.During MHFPPV set with RR of 60 bpm delivered by a conventional ventilator in severe ARDS swine model, neither the inspiratory pauses or PEEP titration after recruitment maneuver allowed reduction of VT significantly, however the last strategy decreased driving pressures and improved both shunt and dead space.

T-piece resuscitators: how do they compare?

Science.gov (United States)

Hinder, Murray; McEwan, Alistair; Drevhammer, Thomas; Donaldson, Snorri; Tracy, Mark Brian

2018-05-04

The T-piece resuscitator (TPR) has seen increased use as a primary resuscitation device with newborns. Traditional TPR design uses a high resistance expiratory valve to produce positive end expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) at resuscitation. A new TPR device that uses a dual flow ratio valve (fluidic flip) to produce PEEP/CPAP is now available (rPAP). We aimed to compare the measured ventilation performance of different TPR devices in a controlled bench test study. Single operator provided positive pressure ventilation to an incremental testlung compliance (Crs) model (0.5-5 mL/cmH 2 O) with five different brands of TPR device (Atom, Neopuff, rPAP, GE Panda warmer and Draeger Resuscitaire). At recommended peak inflation pressure (PIP) 20 cmH 2 O, PEEP of 5 cmH 2 O and rate of 60 inflations per minute. 1864 inflations were analysed. Four of the five devices tested demonstrated inadvertent elevations in mean PEEP (5.5-10.3 cmH 2 O, p<0.001) from set value as Crs was increased, while one device (rPAP) remained at the set value. Measured PIP exceeded the set value in two infant warmer devices (GE and Draeger) with inbuilt TPR at Crs of 0.5 (24.5 and 23.5 cmH 2 O, p<0.001). Significant differences were seen in tidal volumes across devices particularly at higher Crs (p<0.001). Results show important variation in delivered ventilation from set values due to inherent TPR device design characteristics with a range of lung compliances expected at birth. Device-generated inadvertent PEEP and overdelivery of PIP may be clinically deleterious for term and preterm newborns or infants with larger Crs during resuscitation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Dr. Heinz von zur Mühlen - teenekas Tallinna ajaloo uurija / Peep Pillak ; foto: Peep Pillak

Index Scriptorium Estoniae

Pillak, Peep

2003-01-01

ülevaade üheks paremaks Eesti ja Liivimaa, eriti aga Tallinna keskaja asjatundjaks peetava baltisakslasest ajaloolase eluteest ja teaduslikest uurimustöödest, mille eest pälvis 11. sept. 2002 Tallinna teenetemärgi

High tidal volume ventilation in infant mice.

Science.gov (United States)

Cannizzaro, Vincenzo; Zosky, Graeme R; Hantos, Zoltán; Turner, Debra J; Sly, Peter D

2008-06-30

Infant mice were ventilated with either high tidal volume (V(T)) with zero end-expiratory pressure (HVZ), high V(T) with positive end-expiratory pressure (PEEP) (HVP), or low V(T) with PEEP. Thoracic gas volume (TGV) was determined plethysmographically and low-frequency forced oscillations were used to measure the input impedance of the respiratory system. Inflammatory cells, total protein, and cytokines in bronchoalveolar lavage fluid (BALF) and interleukin-6 (IL-6) in serum were measured as markers of pulmonary and systemic inflammatory response, respectively. Coefficients of tissue damping and tissue elastance increased in all ventilated mice, with the largest rise seen in the HVZ group where TGV rapidly decreased. BALF protein levels increased in the HVP group, whereas serum IL-6 rose in the HVZ group. PEEP keeps the lungs open, but provides high volumes to the entire lungs and induces lung injury. Compared to studies in adult and non-neonatal rodents, infant mice demonstrate a different response to similar ventilation strategies underscoring the need for age-specific animal models.

Design and Construction of a Microcontroller-Based Ventilator Synchronized with Pulse Oximeter.

Science.gov (United States)

Gölcük, Adem; Işık, Hakan; Güler, İnan

2016-07-01

This study aims to introduce a novel device with which mechanical ventilator and pulse oximeter work in synchronization. Serial communication technique was used to enable communication between the pulse oximeter and the ventilator. The SpO2 value and the pulse rate read on the pulse oximeter were transmitted to the mechanical ventilator through transmitter (Tx) and receiver (Rx) lines. The fuzzy-logic-based software developed for the mechanical ventilator interprets these values and calculates the percentage of oxygen (FiO2) and Positive End-Expiratory Pressure (PEEP) to be delivered to the patient. The fuzzy-logic-based software was developed to check the changing medical states of patients and to produce new results (FiO2 ve PEEP) according to each new state. FiO2 and PEEP values delivered from the ventilator to the patient can be calculated in this way without requiring any arterial blood gas analysis. Our experiments and the feedbacks from physicians show that this device makes it possible to obtain more successful results when compared to the current practices.

Battery life of portable home ventilators: effects of ventilator settings.

Science.gov (United States)

Falaize, Line; Leroux, Karl; Prigent, Hélène; Louis, Bruno; Khirani, Sonia; Orlikowski, David; Fauroux, Brigitte; Lofaso, Frédéric

2014-07-01

The battery life (BL) of portable home ventilator batteries is reported by manufacturers. The aim of this study was to evaluate the effects of ventilator mode, breathing frequency, PEEP, and leaks on the BL of 5 commercially available portable ventilators. The effects of the ventilator mode (volume controlled-continuous mandatory ventilation [VC-CMV] vs pressure support ventilation [PSV]), PEEP 5 cm H2O, breathing frequency (10, 15, and 20 breaths/min), and leaks during both volume-targeted ventilation and PSV on the BL of 5 ventilators (Elisée 150, Monnal T50, PB560, Vivo 50, and Trilogy 100) were evaluated. Each ventilator was ventilated with a test lung at a tidal volume of 700 ml and an inspiratory time of 1.2 s in the absence of leaks. Switching from PSV to VC-CMV or the addition of PEEP did not significantly change ventilator BL. The increase in breathing frequency from 10 to 20 breaths/min decreased the BL by 18 ± 11% (P = .005). Leaks were associated with an increase in BL during the VC-CMV mode (18 ± 20%, P = .04) but a decrease in BL during the PSV mode (-13 ± 15%, P = .04). The BL of home ventilators depends on the ventilator settings. BL is not affected by the ventilator mode (VC-CMV or PSV) or the addition of PEEP. BL decreases with an increase in breathing frequency and during leaks with a PSV mode, whereas leaks increase the duration of ventilator BL during VC-CMV. Copyright © 2014 by Daedalus Enterprises.

Postural lung recruitment assessed by lung ultrasound in mechanically ventilated children.

Science.gov (United States)

Tusman, Gerardo; Acosta, Cecilia M; Böhm, Stephan H; Waldmann, Andreas D; Ferrando, Carlos; Marquez, Manuel Perez; Sipmann, Fernando Suarez

2017-10-13

Atelectasis is a common finding in mechanically ventilated children with healthy lungs. This lung collapse cannot be overcome using standard levels of positive end-expiratory pressure (PEEP) and thus for only individualized lung recruitment maneuvers lead to satisfactory therapeutic results. In this short communication, we demonstrate by lung ultrasound images (LUS) the effect of a postural recruitment maneuver (P-RM, i.e., a ventilatory strategy aimed at reaerating atelectasis by changing body position under constant ventilation). Data was collected in the operating room of the Hospital Privado de Comunidad, Mar del Plata, Argentina. Three anesthetized children undergoing mechanical ventilation at constant settings were sequentially subjected to the following two maneuvers: (1) PEEP trial in the supine position PEEP was increased to 10 cmH 2 O for 3 min and then decreased to back to baseline. (2) P-RM patient position was changed from supine to the left and then to the right lateral position for 90 s each before returning to supine. The total P-RM procedure took approximately 3 min. LUS in the supine position showed similar atelectasis before and after the PEEP trial. Contrarily, atelectasis disappeared in the non-dependent lung when patients were placed in the lateral positions. Both lungs remained atelectasis free even after returning to the supine position. We provide LUS images that illustrate the concept and effects of postural recruitment in children. This maneuver has the advantage of achieving recruitment effects without the need to elevate airways pressures.

Different Techniques of Respiratory Support Do Not Significantly Affect Gas Exchange during Cardiopulmonary Resuscitation in a Newborn Piglet Model.

Science.gov (United States)

Mendler, Marc R; Maurer, Miriam; Hassan, Mohammad A; Huang, Li; Waitz, Markus; Mayer, Benjamin; Hummler, Helmut D

2015-01-01

There are no evidence-based recommendations on the use of different techniques of respiratory support and chest compressions (CC) during neonatal cardiopulmonary resuscitation (CPR). We studied the short-term effects of different ventilatory support strategies along with CC representing clinical practice on gas exchange [arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2)], hemodynamics and cerebral oxygenation. We hypothesized that in newborn piglets with cardiac arrest, use of a T-piece resuscitator (TPR) providing positive end-expiratory pressure (PEEP) improves gas exchange as measured by SaO2 during CPR as compared to using a self-inflating bag (SIB) without PEEP. Furthermore, we explored the effects of a mechanical ventilator without synchrony to CC. Thirty newborn piglets with asystole were randomized into three groups and resuscitated for 20 min [fraction of inspired oxygen (FiO2) = 0.21 for 10 min and 1.0 thereafter]. Group 1 received ventilation using a TPR [peak inspiratory pressure (PIP)/PEEP of 20/5 cm H2O, rate 30/min] with inflations interposed between CC (3:1 ratio). Group 2 received ventilation using a SIB (PIP of 20 cm H2O without PEEP, rate 30/min) with inflations interposed between CC (3:1 ratio). Group 3 received ventilation using a mechanical ventilator (PIP/PEEP of 20/5 cm H2O, rate 30/min). CC were applied with a rate of 120/min without synchrony to inflations. We found no significant differences in SaO2 between the three groups. However, there was a trend toward a higher SaO2 [TPR: 28.0% (22.3-40.0); SIB: 23.7% (13.4-52.3); ventilator: 44.1% (39.2-54.3); median (interquartile range)] and a lower PaCO2 [TPR: 95.6 mm Hg (82.1-113.6); SIB: 100.8 mm Hg (83.0-108.0); ventilator: 74.1 mm Hg (68.5-83.1); median (interquartile range)] in the mechanical ventilator group. We found no significant effect on gas exchange using different respiratory support strategies

Respiratory mechanics in infants with severe bronchiolitis on controlled mechanical ventilation.

Science.gov (United States)

Cruces, Pablo; González-Dambrauskas, Sebastián; Quilodrán, Julio; Valenzuela, Jorge; Martínez, Javier; Rivero, Natalia; Arias, Pablo; Díaz, Franco

2017-10-06

Analysis of respiratory mechanics during mechanical ventilation (MV) is able to estimate resistive, elastic and inertial components of the working pressure of the respiratory system. Our aim was to discriminate the components of the working pressure of the respiratory system in infants on MV with severe bronchiolitis admitted to two PICU's. Infants younger than 1 year old with acute respiratory failure caused by severe bronchiolitis underwent neuromuscular blockade, tracheal intubation and volume controlled MV. Shortly after intubation studies of pulmonary mechanics were performed using inspiratory and expiratory breath hold. The maximum inspiratory and expiratory flow (QI and QE) as well as peak inspiratory (PIP), plateau (PPL) and total expiratory pressures (tPEEP) were measured. Inspiratory and expiratory resistances (RawI and RawE) and Time Constants (K TI and K TE ) were calculated. We included 16 patients, of median age 2.5 (1-5.8) months. Bronchiolitis due to respiratory syncytial virus was the main etiology (93.8%) and 31.3% had comorbidities. Measured respiratory pressures were PIP 29 (26-31), PPL 24 (20-26), tPEEP 9 [8-11] cmH2O. Elastic component of the working pressure was significantly higher than resistive and both higher than threshold (tPEEP - PEEP) (P mechanics of infants with severe bronchiolitis receiving MV shows that the elastic component of the working pressure of the respiratory system is the most important. The elastic and resistive components in conjunction with flow profile are characteristic of restrictive diseases. A better understanding of lung mechanics in this group of patients may lead to change the traditional ventilatory approach to severe bronchiolitis.

Multifaceted bench comparative evaluation of latest intensive care unit ventilators.

Science.gov (United States)

Garnier, M; Quesnel, C; Fulgencio, J-P; Degrain, M; Carteaux, G; Bonnet, F; Similowski, T; Demoule, A

2015-07-01

Independent bench studies using specific ventilation scenarios allow testing of the performance of ventilators in conditions similar to clinical settings. The aims of this study were to determine the accuracy of the latest generation ventilators to deliver chosen parameters in various typical conditions and to provide clinicians with a comprehensive report on their performance. Thirteen modern intensive care unit ventilators were evaluated on the ASL5000 test lung with and without leakage for: (i) accuracy to deliver exact tidal volume (VT) and PEEP in assist-control ventilation (ACV); (ii) performance of trigger and pressurization in pressure support ventilation (PSV); and (iii) quality of non-invasive ventilation algorithms. In ACV, only six ventilators delivered an accurate VT and nine an accurate PEEP. Eleven devices failed to compensate VT and four the PEEP in leakage conditions. Inspiratory delays differed significantly among ventilators in invasive PSV (range 75-149 ms, P=0.03) and non-invasive PSV (range 78-165 ms, Pventilation algorithms efficiently prevented the decrease in pressurization capacities and PEEP levels induced by leaks in, respectively, 10 and 12 out of the 13 ventilators. We observed real heterogeneity of performance amongst the latest generation of intensive care unit ventilators. Although non-invasive ventilation algorithms appear to maintain adequate pressurization efficiently in the case of leakage, basic functions, such as delivered VT in ACV and pressurization in PSV, are often less reliable than the values displayed by the device suggest. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Estimation of lung volume and pulmonary blood volume from radioisotopic images

International Nuclear Information System (INIS)

Kanazawa, Minoru

1989-01-01

Lung volume and pulmonary blood volume in man were estimated from the radioisotopic image using single photon emission computed tomography (SPECT). Six healthy volunteers were studied in a supine position with normal and altered lung volumes by applying continuous negative body-surface pressure (CNP) and by positive end-expiratory pressure (PEEP). 99m Tc labeled human serum albumin was administered as an aerosol to image the lungs. The CNP caused the diaphragm to be lowered and it increased the mean lung tissue volume obtained by SPECT from 3.09±0.49 l for baseline to 3.67±0.62 l for 10 cmH 2 O (p 2 O (p 2 O), respectively. The PEEP also increased the lung tissue volume to 3.68±0.68 l for 10 cmH 2 O as compared with the baseline (p 2 O PEEP. The lung tissue volume obtained by SPECT showed a positive correlation with functional residual capacity measured by the He dilution method (r=0.91, p 99m Tc-labeled red blood cells. The L/H ratio decreased after either the CNP or PEEP, suggesting a decrease in the blood volume per unit lung volume. However, it was suggested that the total pulmonary blood volume increased slightly either on the CNP (+7.4% for 10 cmH 2 O, p 2 O,p<0.05) when we extrapolated the L/H ratio to the whole lungs by multiplying the lung tissue volume obtained by SPECT. We concluded that SPECT could offer access to the estimation of lung volume and pulmonary blood volume in vivo. (author)

Influencia del reclutamiento alveolar sobre los efectos del surfactante exógeno Influence of pulmonary recruitment on exogenous surfactant effects

Directory of Open Access Journals (Sweden)

Néstor R. Herrera

2006-02-01

Full Text Available Se investigaron los efectos producidos por una maniobra de insuflación sostenida previa a la administración de surfactante exógeno y los producidos por diferentes patrones ventilatorios sobre la respuesta al mismo. Se estudiaron 20 ratas albinas adultas a las que se les produjo una injuria pulmonar por repetidos lavados con solución fisiológica. Se evaluó el pH, PaO2, PaCO2, la presión arterial sistólica, la compliance toracopulmonar y la histología. Los animales se dividieron en 2 grupos según se les hubiera aplicado o no insuflación sostenida para evaluar el efecto inmediato de la misma. Posteriormente los grupos citados fueron subdivididos en función de la capacidad residual funcional (CRF aplicada, quedando conformados 4 grupos experimentales. El grupo 1 recibió previo al surfactante una insuflación sostenida de 30 cm H2O durante 15 segundos y se ventiló posteriormente con presión al final de la espiración (PEEP de10 cm H2O. El grupo 2, no recibió insuflación sostenida y se ventiló con PEEP 10 cm H2O. El grupo 3, recibió insuflación sostenida y se ventiló con PEEP 4 cm H2O y el grupo 4, sin insuflación sostenida se ventiló con PEEP 4 cm H2O. Los efectos inmediatos del surfactante no fueron modificados por la aplicación previa de insuflación sostenida. Se verificó durante el transcurso de la experiencia un aumento de la PaO2 asociada al aumento de la capacidad residual funcional (Grupo1 p=0.0001; Grupo2 p= 0.0001, e independiente de la insuflación sostenida. El uso de insuflación sostenida previo a la administración de surfactante sumado a la ventilación con capacidad residual funcional alta se asoció con infiltración de polimorfonucleares debajo del epitelio bronquiolar (p = 0.008. Nuestros resultados no avalan el uso de insuflación sostenida previo a la administración de surfactante exógeno.An experimental modelwas devised to study the effects of a sustained insufflation maneuver on the immediate

Hints for Diagnosis

DEFF Research Database (Denmark)

Poulsen, Lars K

2015-01-01

/or caretakers. Based on this, a provisional decision to pursue a food allergy diagnosis may be made after carefully considering other possible reasons for an adverse reaction to a food: aversion, infection, intoxication, or an underlying metabolic disease. To respond to the next question, the anamnesis...

IFLA 39. aastakongress Baltimaades / Peep Moorast

Index Scriptorium Estoniae

Moorast, Peep

2002-01-01

Rahvusvaheline maastikuarhitektide föderatsiooni IFLA 39. kongress deviisiga "Muutused maastikus" Baltimaades 7.-13. X 2002. Kongressi peakorterist Riias korraldati väljasõite Lätisse, Eestisse ja Leetu. Eesti Põllumajandusülikoolis sümpoosionil esinesid Eestist Tiina Tammet ja Peeter Vassiljev. Eestile esitati kutse astuda IFLA liikmeks

Mälestustahvel Oslo valitsusele / Peep Pillak

Index Scriptorium Estoniae

Pillak, Peep, 1957-

2016-01-01

Otsustati tähistada Oslos asuv hoone, kus 1953. aastal nimetati ametiise Eesti Vabariigi valitsus eksiilis. Sõjajärgsetel aastatel organiseerusid eestlased Rootsis. Kuna Rootsis oli pagulaste poliitiline tegevus keelatud, siis toimus eksiilvalitsuse ametisse määramine Oslos. Kui 20. augustil 1991 taastati iseseisev Eesti riik, siis tunnustas seda ka Eesti Vabariigi valitsus eksiilis. Vabariigi valitsus eksiilis lõpetas oma tegevuse 7. oktoobril 1992. aastal. 2. oktoobril 2015 toimunud mälestustahvli avamisest

Andmekaitseõigusest andmekaitseasutuse pilguga / Peep Viljar

Index Scriptorium Estoniae

Peep, Viljar, 1970-

2018-01-01

Euroopa Liidu ja USA andmekaitseõiguse alusvalikute võrdlus, selgitatakse, millele keskendudb Eesti Andmekaitse Inspektsioon oma töös, andmekaitse üldmääruse trahvide regulatsioonist ja sellega seotud probleemidest Eestis

Privacy : Plug the Internet Peep Hole

OpenAIRE

Denebo, Petra; Linder, Anna-Katrine

2001-01-01

The Internet is a relatively new technology that has developed explosively during the last 10 years. The Internet-technology has been accepted rapidly by users, but the legal and ethical aspects have not been updated at the same rapid rate. Trust in electronic services or products is founded on knowledge and an understanding of what happens during a session and of the effects that might occur. Within electronically based services there are obvious risks for invisible and undesired results suc...

Mitogen-activated protein kinase phosphatase-1 modulates regional effects of injurious mechanical ventilation in rodent lungs.

Science.gov (United States)

Park, Moo Suk; He, Qianbin; Edwards, Michael G; Sergew, Amen; Riches, David W H; Albert, Richard K; Douglas, Ivor S

2012-07-01

Mechanical ventilation induces heterogeneous lung injury by mitogen-activated protein kinase (MAPK) and nuclear factor-κB. Mechanisms regulating regional injury and protective effects of prone positioning are unclear. To determine the key regulators of the lung regional protective effects of prone positioning in rodent lungs exposed to injurious ventilation. Adult rats were ventilated with high (18 ml/kg, positive end-expiratory pressure [PEEP] 0) or low Vt (6 ml/kg; PEEP 3 cm H(2)O; 3 h) in supine or prone position. Dorsal-caudal lung mRNA was analyzed by microarray and MAPK phosphatases (MKP)-1 quantitative polymerase chain reaction. MKP-1(-/-) or wild-type mice were ventilated with very high (24 ml/kg; PEEP 0) or low Vt (6-7 ml/kg; PEEP 3 cm H(2)O). The MKP-1 regulator PG490-88 (MRx-108; 0.75 mg/kg) or phosphate-buffered saline was administered preventilation. Injury was assessed by lung mechanics, bronchioalveolar lavage cell counts, protein content, and lung injury scoring. Immunoblotting for MKP-1, and IκBα and cytokine ELISAs were performed on lung lysates. Prone positioning was protective against injurious ventilation in rats. Expression profiling demonstrated MKP-1 20-fold higher in rats ventilated prone rather than supine and regional reduction in p38 and c-jun N-terminal kinase activation. MKP-1(-/-) mice experienced amplified injury. PG490-88 improved static lung compliance and injury scores, reduced bronchioalveolar lavage cell counts and cytokine levels, and induced MKP-1 and IκBα. Injurious ventilation induces MAPK in an MKP-1-dependent fashion. Prone positioning is protective and induces MKP-1. PG490-88 induced MKP-1 and was protective against high Vt in a nuclear factor-κB-dependent manner. MKP-1 is a potential target for modulating regional effects of injurious ventilation.

Clearance of 99mTc-labeled albumin from lungs in anesthetized guinea pigs

International Nuclear Information System (INIS)

Connelly, J.C.; Peterson, B.T.

1993-01-01

Gamma imaging was used to measure the rate of clearance of aerosolized 99m Tc-human serum albumin (HSA) from the lungs of control guinea pigs and guinea pigs that received increased lung inflation or lung injury. Anesthetized guinea pigs were ventilated for 6 min with an aerosol of HSA and the radioactivity in the chest was monitored for 2 h with a gamma camera to determine whether the clearance rate would be a reliable assessment of lung epithelial permeability. Increased lung volumes were effected by application of 5 or 7 cm H 2 O positive end-expired pressure (5-PEEP and 7-PEEP, respectively). Lung injury was induced either by intravenous oleic acid (OA, 27-73 μl/kg) or inhalation of nitrogen dioxide (NO 2 , 80-100 ppm) for 2 h. Postmortem extravascular lung water volume (EVLW) provided an assessment of the degree of lung injury. Tracer clearance rates in animals receiving 5 or 7 cm H 2 O PEEP were not significantly different from controls (K = 0.15 ± 0.05 and 0.24 ± 0.10 vs 0.12 ± 0.03%/min, respectively, p > .05). Animals exposed to NO 2 had faster tracer clearance rates (K = 0.33 ± 0.21%/min, p 2 -exposed guinea pigs correlated well with injury as assessed by EVLW (r = .93, p 2 O PEEP (K = 0.58 ± 0.41%/min, EVLW = 8.1 ± 0.8 mL/g dry lung tissue, p < .05), but there was no correlation between these parameters in this injury model. It is concluded that imaging of the disappearance of radiolabeled HSA in the guinea pig can be a useful index of lung epithelial permeability, but this technique is limited to certain models of lung injury. 33 refs

Efeitos de diferentes volumes correntes e da pressão expiratória final positiva sobre a troca gasosa na fístula broncopleural experimental Effects of different tidal volumes and positive end expiratory pressure on gas exchange in experimental bronchopleural fistula

Directory of Open Access Journals (Sweden)

Maria Gabriela Cavicchia Toneloto

2008-09-01

Full Text Available OBJETIVO: O presente estudo foi desenhado para identificar o efeito da pressão expiratória final positiva (PEEP e o volume corrente pulmonar ideal para ventilar animais com fístula broncopleural produzida cirurgicamente, com o intuito de reduzir a vazão da fístula sem afetar a troca gasosa. MÉTODOS: Avaliação hemodinâmica e respiratória da troca gasosa foi obtida em cinco porcos jovens, saudáveis, da linhagem Large White, ventilados mecanicamente no modo ventilatório volume controlado com FiO2 de 0.4 e relação inspiração:expiração em torno de 1:2, com freqüência respiratória mantida em 22 cpm. A fístula broncopleural foi produzida pela ressecção da língula. Um sistema de drenagem a selo d'água foi instalado e o tórax foi hermeticamente fechado. A troca gasosa e o débito da fístula broncopleural foram medidos com animais ventilados sequencialmente com volumes correntes de 4 ml/kg, 7 ml/kg e 10 ml/Kg alternando zero de pressão expiratória final positiva (ZEEP e PEEP de 10 cmH2O, sempre na mesma ordem. RESULTADOS: Esses dados são atribuídos à ventilação alveolar reduzida e às anormalidades da ventilação/perfusão que foram atenuadas com volumes correntes mais altos. PEEP aumentou o vazamento de ar pela fístula, mesmo com baixos volumes, de 2.0 ± 2,8mL para 31 ± 20,7mL (p= 0,006 e diminuiu a ventilação alveolar em todos os volumes correntes. A ventilação alveolar melhorou com altos volumes correntes, mas aumentou o débito da fístula (4 ml/kg - 2,0 ± 2,8mL e 10 mL/kg - 80,2 ± 43,9mL; p=0,001. Baixos volumes correntes resultaram em hipercapnia (ZEEP - 83,7± 6,9 mmHg e com PEEP 10 -93 ± 10,1mmHg e diminuição significativa da saturação de oxigênio arterial, em torno de 84%. CONCLUSÃO: O volume corrente de 7 ml/kg com ZEEP foi considerado o melhor volume corrente, visto que, apesar da hipercapnia moderada, a saturação de oxigênio arterial é sustentada em torno de 90%. A ventilação alveolar

Aaviksoo võistleb Donald Trumpiga

Index Scriptorium Estoniae

2007-01-01

Peep Aaviksoole ja tema äripartneritele kuuluv IPC Investment tegeleb Rumeenias lisaks kinnisvarainvesteeringutele ka ehitusmaterjalide tootmisega. USA kinnisvaramagnaat Donald Trump on otsustanud riiki investeerida miljard eurot

Evaluation of right and left ventricular function during adult respiratory distress syndrom using radionuclide angiocardiography conventional and tomographic approaches

International Nuclear Information System (INIS)

Devaux, J.Y.; Dhainaut, J.F.; Roucayrol, J.C.; Brunol, J.

1982-01-01

Despite numerous experimental and clinical studies, the cardiovascular effects of mechanical ventilation with positive-end-expiratory pressure (PEEP) are unclear. Specially, the constant fall in cardiac output is not well undestood. The purpose of this study was to investigate the effects of PEEP on right and left ventricular systolic and diastolic performance before and after volume expansion using angioscintigraphy with red blood cells, in vitro labelled with 99m Tc, a reliable, non invasive method to assess right and left ventricular dimensions and global and segmental contractility. First results in patients with adult respiratory distress syndrom (ARDS) confirm the capabilities of such a method for evaluation of regional wall motion in both ventricles

[Lung protective ventilation. Ventilatory modes and ventilator parameters].

Science.gov (United States)

Schädler, Dirk; Weiler, Norbert

2008-06-01

Mechanical ventilation has a considerable potential for injuring the lung tissue. Therefore, attention has to be paid to the proper choice of ventilatory mode and settings to secure lung-protective ventilation whenever possible. Such ventilator strategy should account for low tidal volume ventilation (6 ml/kg PBW), limited plateau pressure (30 to 35 cm H2O) and positive end-expiratory pressure (PEEP). It is unclear whether pressure controlled or volume controlled ventilation with square flow profile is beneficial. The adjustment of inspiration and expiration time should consider the actual breathing mechanics and anticipate the generation of intrinsic PEEP. Ventilatory modes with the possibility of supporting spontaneous breathing should be used as soon as possible.

Rationale and study design of PROVHILO - a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery.

Science.gov (United States)

Hemmes, Sabrine N T; Severgnini, Paolo; Jaber, Samir; Canet, Jaume; Wrigge, Hermann; Hiesmayr, Michael; Tschernko, Edda M; Hollmann, Markus W; Binnekade, Jan M; Hedenstierna, Göran; Putensen, Christian; de Abreu, Marcelo Gama; Pelosi, Paolo; Schultz, Marcus J

2011-05-06

Post-operative pulmonary complications add to the morbidity and mortality of surgical patients, in particular after general anesthesia >2 hours for abdominal surgery. Whether a protective mechanical ventilation strategy with higher levels of positive end-expiratory pressure (PEEP) and repeated recruitment maneuvers; the "open lung strategy", protects against post-operative pulmonary complications is uncertain. The present study aims at comparing a protective mechanical ventilation strategy with a conventional mechanical ventilation strategy during general anesthesia for abdominal non-laparoscopic surgery. The PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure ("PROVHILO") trial is a worldwide investigator-initiated multicenter randomized controlled two-arm study. Nine hundred patients scheduled for non-laparoscopic abdominal surgery at high or intermediate risk for post-operative pulmonary complications are randomized to mechanical ventilation with the level of PEEP at 12 cmH(2)O with recruitment maneuvers (the lung-protective strategy) or mechanical ventilation with the level of PEEP at maximum 2 cmH(2)O without recruitment maneuvers (the conventional strategy). The primary endpoint is any post-operative pulmonary complication. The PROVHILO trial is the first randomized controlled trial powered to investigate whether an open lung mechanical ventilation strategy in short-term mechanical ventilation prevents against postoperative pulmonary complications. ISRCTN: ISRCTN70332574.

Ventilation therapy for patients suffering from obstructive lung diseases.

Science.gov (United States)

Jungblut, Sven A; Heidelmann, Lena M; Westerfeld, Andreas; Frickmann, Hagen; Körber, Mareike K; Zautner, Andreas E

2014-01-01

Severe bronchial obstruction due to one of the major pulmonary diseases: asthma, COPD, or emphysema often requires mechanical ventilation support. Otherwise, patients are at risk of severe hypooxygenation with consecutive overloading and dilatation of the right cardiac ventricle with subsequent failure. This review focuses on how to manage a calculated ventilation therapy of patients suffering from bronchial obstruction and relevant patents. Options and pitfalls of invasive and non-invasive ventilation in the intensive care setting regarding clinical improvement and final outcome are discussed. The non-invasive ventilation is very efficient in treating acute or chronic respiratory failure in COPD patients and is capable of shortening the duration of hospitalization. Further non-invasive ventilation can successfully support the weaning after a long-lasting ventilation therapy and improve the prognosis of COPD patients. "Permissive hypercapnia" is unequivocally established in invasive ventilation therapy of severe bronchial obstruction in situations of limited ventilation. When intrinsic positive end-expiratory pressure (PEEP) and elevated airways resistance are present PEEP may be useful although external-PEEP application relieves over-inflation only in selected patients with airway obstruction during controlled mechanical ventilation. Upper limit of airways peak pressure used in "protective ventilation" of adult respiratory distress syndrome (ARDS) patients can be exceeded under certain circumstances.

Low Tidal Volume versus Non-Volume-Limited Strategies for Patients with Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis.

Science.gov (United States)

Walkey, Allan J; Goligher, Ewan C; Del Sorbo, Lorenzo; Hodgson, Carol L; Adhikari, Neill K J; Wunsch, Hannah; Meade, Maureen O; Uleryk, Elizabeth; Hess, Dean; Talmor, Daniel S; Thompson, B Taylor; Brower, Roy G; Fan, Eddy

2017-10-01

Trials investigating use of lower tidal volumes and inspiratory pressures for patients with acute respiratory distress syndrome (ARDS) have shown mixed results. To compare clinical outcomes of mechanical ventilation strategies that limit tidal volumes and inspiratory pressures (LTV) to strategies with tidal volumes of 10 to 15 ml/kg among patients with ARDS. This is a systematic review and meta-analysis of clinical trials investigating LTV mechanical ventilation strategies. We used random effects models to evaluate the effect of LTV on 28-day mortality, organ failure, ventilator-free days, barotrauma, oxygenation, and ventilation. Our primary analysis excluded trials for which the LTV strategy was combined with the additional strategy of higher positive end-expiratory pressure (PEEP), but these trials were included in a stratified sensitivity analysis. We performed metaregression of tidal volume gradient achieved between intervention and control groups on mortality effect estimates. We used Grading of Recommendations Assessment, Development, and Evaluation methodology to determine the quality of evidence. Seven randomized trials involving 1,481 patients met eligibility criteria for this review. Mortality was not significantly lower for patients receiving an LTV strategy (33.6%) as compared with control strategies (40.4%) (relative risk [RR], 0.87; 95% confidence interval [CI], 0.70-1.08; heterogeneity statistic I 2  = 46%), nor did an LTV strategy significantly decrease barotrauma or ventilator-free days when compared with a lower PEEP strategy. Quality of evidence for clinical outcomes was downgraded for imprecision. Metaregression showed a significant inverse association between larger tidal volume gradient between LTV and control groups and log odds ratios for mortality (β, -0.1587; P = 0.0022). Sensitivity analysis including trials that protocolized an LTV/high PEEP cointervention showed lower mortality associated with LTV (nine trials and 1

[Clinical research of using optimal compliance to determine positive end-expiratory pressure].

Science.gov (United States)

Xu, Lei; Feng, Quan-sheng; Lian, Fu; Shao, Xin-hua; Li, Zhi-bo; Wang, Zhi-yong; Li, Jun

2012-07-01

To observe the availability and security of optimal compliance strategy to titrate the optimal positive end-expiratory pressure (PEEP), compared with quasi-static pressure-volume curve (P-V curve) traced by low-flow method. Fourteen patients received mechanical ventilation with acute respiratory distress syndrome (ARDS) admitted in intensive care unit (ICU) of Tianjin Third Central Hospital from November 2009 to December 2010 were divided into two groups(n = 7). The quasi-static P-V curve method and the optimal compliance titration were used to set the optimal PEEP respectively, repeated 3 times in a row. The optimal PEEP and the consistency of repeated experiments were compared between groups. The hemodynamic parameters, oxygenation index (OI), lung compliance (C), cytokines and pulmonary surfactant-associated protein D (SP-D) concentration in plasma before and 2, 4, and 6 hours after the experiment were observed in each group. (1) There were no significant differences in gender, age and severity of disease between two groups. (2)The optimal PEEP [cm H(2)O, 1 cm H(2)O=0.098 kPa] had no significant difference between quasi-static P-V curve method group and the optimal compliance titration group (11.53 ± 2.07 vs. 10.57 ± 0.87, P>0.05). The consistency of repeated experiments in quasi-static P-V curve method group was poor, the slope of the quasi-static P-V curve in repeated experiments showed downward tendency. The optimal PEEP was increasing in each measure. There was significant difference between the first and the third time (10.00 ± 1.58 vs. 12.80 ± 1.92, P vs. 93.71 ± 5.38, temperature: 38.05 ± 0.73 vs. 36.99 ± 1.02, IL-6: 144.84 ± 23.89 vs. 94.73 ± 5.91, TNF-α: 151.46 ± 46.00 vs. 89.86 ± 13.13, SP-D: 33.65 ± 8.66 vs. 16.63 ± 5.61, MAP: 85.47 ± 9.24 vs. 102.43 ± 8.38, CCI: 3.00 ± 0.48 vs. 3.81 ± 0.81, OI: 62.00 ± 21.45 vs. 103.40 ± 37.27, C: 32.10 ± 2.92 vs. 49.57 ± 7.18, all P safety and usability.

Evaluation of the Efficiency of Alveolar Opening in Cardiosurgical Patients with Low Left Ventricular Ejection Fraction

Directory of Open Access Journals (Sweden)

Yu. G Zorina

2009-01-01

Full Text Available Objective: to determine the optimum alveolar opening parameters for the improvement of postoperative pulmonary oxygenizing function in patients with a left ventricular ejection fraction (LVEF of less or more than 40% after aortocoronary bypass surgery (ACBS. Subjects and methods. Twenty patients with a LVEF of less than 40% after ACBS and with postoperative pulmonary oxygenizing dysfunction (PaO2/FiO2 less than 250 (Group 1 were examined. A control group consisted of 20 patients with a LVEF of more than 40% (Group 2. Gas exchange, respiration biomechanics, and central hemodynamic (CH parameters were monitored (a Vigilance monitor (Edvard LifeScience. Alveolar mobilization was carried out on Drager Evita-2 apparatuses in the BIPAP mode, by taking into account the previous artificial ventilation (AV parameters. The low pressure phase corresponded to the positive end-expiratory pressure (PEEP with volume AV, the high pressure phase was Pplato; the duration of both phases — that of inspiration and expiration (the high pressure phase was inspiration time; the low pressure phase was expiration time. Then the values of Pplato and PEEP were simultaneously increased by 2 cm H2O with a duration of 10 breathing cycles, by continuously monitoring Vt and SaO2 over this interval. By continuously monitoring Vt, a stepwise increase in PEEP and Pplato was continued until there was a Vt reduction or a negative impact of AV on CH. All alveoli were considered to be open when the maximum Vt and SaO2 were achieved. Conclusion. In Group 1 patients with Pinsp of 27—30 cm H2O, PEEP of 10—12 cm H2O, there are increases in PaO2/FiO2 and Cst. In Group 2, the increase of PaO2/FiO2 and Cst is observed with Pinsp of 30—35 cm H2O and PEEP 12—14 cm H2O. With these AV indices, there is an allowable hemodynamic reduction that results in no negative consequences and development of cardiovascular events. After switching to AV in an individually chosen mode, all

Smartphone Ownership Among US Adult Cigarette Smokers: 2014 Health Information National Trends Survey (HINTS) Data.

Science.gov (United States)

Heffner, Jaimee L; Mull, Kristin E

2017-08-31

Despite increasing interest in smartphone apps as a platform for delivery of tobacco cessation interventions, no previous studies have evaluated the prevalence and characteristics of smokers who can access smartphone-delivered interventions. To guide treatment development in this new platform and to evaluate disparities in access to smartphone-delivered interventions, we examined associations of smartphone ownership with demographics, tobacco use and thoughts about quitting, other health behaviors, physical and mental health, health care access, and Internet and technology utilization using a nationally representative sample of US adult smokers. Data were from the National Cancer Institute's 2014 Health Information National Trends Survey 4 (HINTS 4), Cycle 4. This mailed survey targeted noninstitutionalized individuals aged 18 years or older using two-stage stratified random sampling. For this analysis, we restricted the sample to current smokers with complete data on smartphone ownership (n=479). Nearly two-thirds (weighted percent=63.8%, 248/479) of smokers reported owning a smartphone. Those who were younger (P<.001), employed (P=.002), never married (P=.002), and had higher education (P=.002) and income (P<.001) had the highest rates of ownership. Smartphone owners did not differ from nonowners on frequency of smoking, recent quit attempts, or future plans to quit smoking, although they reported greater belief in the benefits of quitting (P=.04). Despite being equally likely to be overweight or obese, smartphone owners reported greater fruit and vegetable consumption (P=.03) and were more likely to report past-year efforts to increase exercise (P=.001) and to lose weight (P=.02). No differences in health care access and utilization were found. Smartphone owners reported better physical and mental health in several domains and higher access to and utilization of technology and the Internet, including for health reasons. Smartphone ownership among smokers mirrors

Verba volant, scripta manent / Milvi Tedremaa

Index Scriptorium Estoniae

Tedremaa, Milvi, 1937-2012

1999-01-01

Rets. rmt.: Meie õppisime raamatukogundust Tartu Ülikoolis / koost. Maare Kümnik, Kaja Noodla. Tartu, 1998. Vastukaja: Peep, Laine. Mitte ainult Milvi Tedremaale // Raamatukogu (1999) nr. 4, lk. 44

Vastuolud annavad märku muutuste vajadusest / Marit Pukk

Index Scriptorium Estoniae

Pukk, Marit

2002-01-01

Kiiresti areneva firma struktuur vajab muutmist. Kommenteerivad gasellettevõtete juhid Argo Schneider (OÜ Albion Reisid), Peep Nork (AS Euro Truck Trade Center), Riinu Värk (AS Meditsiinigrupp) ja Tiit Elenurm

Takistusriba avalikule teabele / Ivar Tallo

Index Scriptorium Estoniae

Tallo, Ivar, 1964-

2004-01-01

Autori arvates on riiklike registrite poolt jagatava teabe eest tasu võtmine avaliku teabe seadusega vastuolus ega vasta kaasaegsetele infotehnoloogilistele lahendustele. Vastuseks vt.Viljar Peep. Registritest 6.aug. Postimees lk. 10

Põldsamm : 3G lepingu kaotus pole maailma lõpp / Toivo Tänavsuu

Index Scriptorium Estoniae

Tänavsuu, Toivo

2006-01-01

Kolmanda põlvkonna mobiiltelefonivõrgu neljanda sagedusloa väljaandmise avaliku konkursi võitis Venemaa äriühingutele Alkominvest ja Praim kuuluv OÜ Crosson Capital. Bravocomi juhi Peep Põldsammi arvamus

Tallinna Sakala keskuse projekt kütab kirgi / Aivo Vahemets

Index Scriptorium Estoniae

Vahemets, Aivo

2004-01-01

Raine Karbi projekteeritud hoone ümberehituse projekt telliti Inglismaalt büroost Burrow&Cave, OÜ Arhitektuuriagentuuri projektist loobuti. Eesti Arhitektide Liidu esinaise Margit Mutso ja arhitektuurinõukogu esimehe Peep Aaviksoo kommentaar

Titanic või turist? / Karin Paulus

Index Scriptorium Estoniae

Paulus, Karin, 1975-

2006-01-01

Tallinnas Tartu maanteel asuva endise Turisti poe (arhitektid Peep Jänes, Henno Sepmann) asemele tahavad hoone omanikud ehitada kõrghoone nimega Titanic. Hoone ajutine võtmine muinsuskaitse alla on põhjustanud kohtuvaidluse

Prima Vista toob pargiraamatukogu

Index Scriptorium Estoniae

2005-01-01

5. ja 6. mail 2005 toimub teine Tartu kirjandusfestival "Prima Vista". Avatakse pargiraamatukogu, kus esinevad 5. mail Jürgen Rooste, Merca, Aapo Ilves, Peep Ilmet, Marko Martinson, Jüri Kaldmaa, Jaan Pehk

Meeleavaldajad rõhutavad Bonnis kliimaleppe olulisust / Merit Kopli

Index Scriptorium Estoniae

Kopli, Merit, 1969-

2001-01-01

Bonnis peetaval kliimakonverentsil pole seni kasvuhoonegaaside vähendmist sätestava Kyoto lepingu osas edu saavutatud. Eesti Rohelise Liikumise koordinaator Peep Mardiste meeleavaldusest Bonnis. Eesti keskkonnaministeeriumi ametnik Andres Kratonits Bonni kliimakonverentsist

Rationale and study design of PROVHILO - a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery

Directory of Open Access Journals (Sweden)

Hedenstierna Göran

2011-05-01

Full Text Available Abstract Background Post-operative pulmonary complications add to the morbidity and mortality of surgical patients, in particular after general anesthesia >2 hours for abdominal surgery. Whether a protective mechanical ventilation strategy with higher levels of positive end-expiratory pressure (PEEP and repeated recruitment maneuvers; the "open lung strategy", protects against post-operative pulmonary complications is uncertain. The present study aims at comparing a protective mechanical ventilation strategy with a conventional mechanical ventilation strategy during general anesthesia for abdominal non-laparoscopic surgery. Methods The PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure ("PROVHILO" trial is a worldwide investigator-initiated multicenter randomized controlled two-arm study. Nine hundred patients scheduled for non-laparoscopic abdominal surgery at high or intermediate risk for post-operative pulmonary complications are randomized to mechanical ventilation with the level of PEEP at 12 cmH2O with recruitment maneuvers (the lung-protective strategy or mechanical ventilation with the level of PEEP at maximum 2 cmH2O without recruitment maneuvers (the conventional strategy. The primary endpoint is any post-operative pulmonary complication. Discussion The PROVHILO trial is the first randomized controlled trial powered to investigate whether an open lung mechanical ventilation strategy in short-term mechanical ventilation prevents against postoperative pulmonary complications. Trial registration ISRCTN: ISRCTN70332574

Norma majandustulemuste ootused käivad üksteisele vastu / Gea Velthut-Sokka

Index Scriptorium Estoniae

Velthut-Sokka, Gea, 1977-

2004-01-01

LHV ja Hansapanga analüütikud ennustavad Normale suurenenud kasumit ja aktsiahinna tõusu, Suprema ennustab nii käibe kui ka kasumi vähenemist. Kommenteerib Norma tegevdirektor Peep Siimon. Diagramm

Ajakirjanikud ajasid metsas hundijälgi / Liisi Seil

Index Scriptorium Estoniae

Seil, Liisi, 1971-

2003-01-01

Hundiuurija Marko Kübarsepp viis teabepäevast "Elu koos hundiga" osalejad Soomaa metsadesse hundijälgi otsima. Kiskja kohta jagasid veel teavet Tõnu Traks, Ilmar Rootsi, Peep Männil ja Jaak Volmer

compliance of the respiratory system as a predictor for successful

African Journals Online (AJOL)

clinical, ventilatory and blood gas criteria were studied. ... pressure (PIP) and positive end-expiratory pressure (PEEP) represented ... criteria for extubation, we found that bedside measurement of total ... position in neutral head-neck posture.

A importância da pressão pleural na avaliação da mecânica respiratória La importancia de la presión pleural en la evaluación de la mecánica respiratoria Importance of pleural pressure for the evaluation of respiratory mechanics

Directory of Open Access Journals (Sweden)

Cláudia Regina Fernandes

2006-06-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Para a partição das medidas de mecânica do sistema respiratório em seus componentes pulmão e parede torácica, faz-se necessário o conhecimento da pressão pleural. A finalidade desta revisão foi discutir sobre medidas alternativas à obtenção da pressão pleural para o cálculo da mecânica pulmonar, relatar as peculiaridades do método do balão esofágico para obtenção indireta da pressão pleural, as particularidades da obtenção da medida da pressão esofágica em pacientes sedados ou anestesiados, discorrer sobre a medida direta da pressão pleural e sua correlação com a pressão esofágica, assim como relatar sobre o reflexo da PEEP nas pressões pleural e esofágica. CONTEÚDO: A variação da pressão intra-esofágica reflete a variação da pressão intrapleural, podendo ser usada como medida alternativa à pressão pleural direta, no estudo da mecânica dos componentes pulmão e parede do sistema respiratório. A medida da pressão esofágica pode ser realizada por meio de um delicado balão posicionado no interior do esôfago. O método e a técnica foram observados e validados em seres humanos e animais em diferentes condições e posturas corporais. O emprego da PEEP em pacientes sob ventilação controlada mecânica está consolidado; no entanto, existem controvérsias da correlação próxima entre a pressão esofágica e a pressão pleural em pacientes ventilados com PEEP, o que pode resultar em erros de cálculo de mecânica respiratória considerando a pressão esofágica. CONCLUSÕES: O método do balão esofágico é o mais utilizado para a obtenção da medida indireta da pressão pleural. Em pacientes sedados ou anestesiados sem alterações significativas da complacência respiratória, a variação da pressão esofágica corresponde à variação da pressão pleural quando a PEEP é aplicada.JUSTIFICATIVA Y OBJETIVOS: Para la partición de las medidas de mecánica del sistema

Lung Transcriptomics during Protective Ventilatory Support in Sepsis-Induced Acute Lung Injury.

Directory of Open Access Journals (Sweden)

Marialbert Acosta-Herrera

Full Text Available Acute lung injury (ALI is a severe inflammatory process of the lung. The only proven life-saving support is mechanical ventilation (MV using low tidal volumes (LVT plus moderate to high levels of positive end-expiratory pressure (PEEP. However, it is currently unknown how they exert the protective effects. To identify the molecular mechanisms modulated by protective MV, this study reports transcriptomic analyses based on microarray and microRNA sequencing in lung tissues from a clinically relevant animal model of sepsis-induced ALI. Sepsis was induced by cecal ligation and puncture (CLP in male Sprague-Dawley rats. At 24 hours post-CLP, septic animals were randomized to three ventilatory strategies: spontaneous breathing, LVT (6 ml/kg plus 10 cmH2O PEEP and high tidal volume (HVT, 20 ml/kg plus 2 cmH2O PEEP. Healthy, non-septic, non-ventilated animals served as controls. After 4 hours of ventilation, lung samples were obtained for histological examination and gene expression analysis using microarray and microRNA sequencing. Validations were assessed using parallel analyses on existing publicly available genome-wide association study findings and transcriptomic human data. The catalogue of deregulated processes differed among experimental groups. The 'response to microorganisms' was the most prominent biological process in septic, non-ventilated and in HVT animals. Unexpectedly, the 'neuron projection morphogenesis' process was one of the most significantly deregulated in LVT. Further support for the key role of the latter process was obtained by microRNA studies, as four species targeting many of its genes (Mir-27a, Mir-103, Mir-17-5p and Mir-130a were found deregulated. Additional analyses revealed 'VEGF signaling' as a central underlying response mechanism to all the septic groups (spontaneously breathing or mechanically ventilated. Based on this data, we conclude that a co-deregulation of 'VEGF signaling' along with 'neuron projection

Lung Transcriptomics during Protective Ventilatory Support in Sepsis-Induced Acute Lung Injury

Science.gov (United States)

Acosta-Herrera, Marialbert; Lorenzo-Diaz, Fabian; Pino-Yanes, Maria; Corrales, Almudena; Valladares, Francisco; Klassert, Tilman E.; Valladares, Basilio; Slevogt, Hortense; Ma, Shwu-Fan

2015-01-01

Acute lung injury (ALI) is a severe inflammatory process of the lung. The only proven life-saving support is mechanical ventilation (MV) using low tidal volumes (LVT) plus moderate to high levels of positive end-expiratory pressure (PEEP). However, it is currently unknown how they exert the protective effects. To identify the molecular mechanisms modulated by protective MV, this study reports transcriptomic analyses based on microarray and microRNA sequencing in lung tissues from a clinically relevant animal model of sepsis-induced ALI. Sepsis was induced by cecal ligation and puncture (CLP) in male Sprague-Dawley rats. At 24 hours post-CLP, septic animals were randomized to three ventilatory strategies: spontaneous breathing, LVT (6 ml/kg) plus 10 cmH2O PEEP and high tidal volume (HVT, 20 ml/kg) plus 2 cmH2O PEEP. Healthy, non-septic, non-ventilated animals served as controls. After 4 hours of ventilation, lung samples were obtained for histological examination and gene expression analysis using microarray and microRNA sequencing. Validations were assessed using parallel analyses on existing publicly available genome-wide association study findings and transcriptomic human data. The catalogue of deregulated processes differed among experimental groups. The ‘response to microorganisms’ was the most prominent biological process in septic, non-ventilated and in HVT animals. Unexpectedly, the ‘neuron projection morphogenesis’ process was one of the most significantly deregulated in LVT. Further support for the key role of the latter process was obtained by microRNA studies, as four species targeting many of its genes (Mir-27a, Mir-103, Mir-17-5p and Mir-130a) were found deregulated. Additional analyses revealed 'VEGF signaling' as a central underlying response mechanism to all the septic groups (spontaneously breathing or mechanically ventilated). Based on this data, we conclude that a co-deregulation of 'VEGF signaling' along with 'neuron projection

Performance of ventilators compatible with magnetic resonance imaging: a bench study.

Science.gov (United States)

Chikata, Yusuke; Okuda, Nao; Izawa, Masayo; Onodera, Mutsuo; Nishimura, Masaji

2015-03-01

Magnetic resonance imaging (MRI) is indispensable for diagnosing brain and spinal cord abnormalities. Magnetic components cannot be used during MRI procedures; therefore, patient support equipment must use MRI-compatible materials. However, little is known of the performance of MRI-compatible ventilators. At commonly used settings, we tested the delivered tidal volume (V(T)), F(IO2), PEEP, and operation of the high-inspiratory-pressure-relief valves of 4 portable MRI-compatible ventilators (Pneupac VR1, ParaPAC 200DMRI, CAREvent MRI, iVent201) and one ICU ventilator (Servo-i). Each ventilator was set in volume control/continuous mandatory ventilation mode. Breathing frequency and V(T) were tested at 10 breaths/min and 300, 500, and 700 mL, respectively. The Pneupac VR1 has fixed V(T) and frequency combinations, so it was tested at V(T) = 300 mL and 20 breaths/min, V(T) = 500 mL and 12 breaths/min, and V(T) = 800 mL and 10 breaths/min. F(IO2) was 0.6 and 1.0. At the air-mix setting, F(IO2) was fixed at 0.5 with the Pneupac VR1, 0.45 with the ParaPAC 200DMRI, and 0.6 with the CAREvent MRI. PEEP was set at 5 and 10 cm H2O, and pressure relief was set at 30 and 40 cm H2O. V(T) error varied widely among ventilators (-28.1 to 25.5%). As V(T) increased, error decreased with the Pneupac VR1, ParaPAC 200DMRI, and CAREvent MRI (P ventilators (-29.2 to 42.5%). Only the Servo-i maintained V(T), F(IO2), and PEEP at set levels. The pressure-relief valves worked in all ventilators. None of the MRI-compatible ventilators maintained V(T), F(IO2), and PEEP at set levels. Vital signs of patients with unstable respiratory mechanics should be monitored during transport and MRI. Copyright © 2015 by Daedalus Enterprises.

"Oravad" tõmbavad Eesti Energia börsileminekule piduri peale / Raimo Poom

Index Scriptorium Estoniae

Poom, Raimo

2010-01-01

Riigikogu Reformierakonna fraktsiooni kohtumisest Eesti Energia juhi Sandor Liive ning majandus- ja kommunikatsiooniministeeriumi esindajatega. Fraktsiooni esimees Peep Aru räägib küsimustest, mis on seotud Eesti Energia börsilemineku kavaga

Kas eesti keelt kummitab sõnavaravaegus? / Virve Liivanõmm

Index Scriptorium Estoniae

Liivanõmm, Virve

2009-01-01

Terminoloogiakonverentsist "Eestikeelne ülikool" Tartus ning Eesti teaduskeele konverentsist Tallinna Ülikoolis. Konverentsidel võtsid sõna Peeter Päll, Mats Estonius, Peeter Saari, Igor Gräzin, Peep Nemvalts, Krista Kerge, Toomas Silk

Samaja bolshaja stroiploshtshadka v Estonii / Konstantin Morenko

Index Scriptorium Estoniae

Morenko, Konstantin

2004-01-01

Tallinna linnavalitsus korraldas ümarlaua linna rannaalade hetkeseisu ja arenguvõimaluste hindamiseks, mille töös osalesid ka Euroopa tuntud linnaplaneerimise konsultandid. Arvamust avaldavad Peep Aaviksoo, Lutz Schleich, Giorgio Risicaris ja Stefan Boltz

Väljaspool iseennast / Aita Kivi

Index Scriptorium Estoniae

Kivi, Aita, 1954-

2000-01-01

Sisu : Jaan Kaplinski. Silm. Hektor; John Grisham. Aguliadvokaat; Kerttu Rakke. Kalevipoeg; luulekogu "Armastuse valgus", koost. Peep Ilmet; James Woodall. John Lennon ja Yoko Ono; Donald Braider. El Greco eraelu; Åke Edwardson. Tants ingliga

Vene kriis kukutas Norma juhid / Raul Ranne

Index Scriptorium Estoniae

Ranne, Raul

1998-01-01

AS Norma vallandas ettevõtte tegevjuhi Peep Aaviksoo, sest ei olnud rahul ettevõtte tegevusega Venemaal. Tabelid: Norma aktsia on kukkunud, Norma kuukasum miinuses. Ilmunud ka: Delovõje Vedomosti, 9. sept. 1998, lk. 10

40 aastat uurivat õpetajat / Raivo Juurak

Index Scriptorium Estoniae

Juurak, Raivo, 1949-

2001-01-01

ÜPUI asutamisest, minevikust ja ka tulevikust. Vestlusringis on Ühiskondliku Pedagoogika Uurimise Instituudi asutajad ja eestvedajad - Helme kutsekooli õpetaja Peep Leppik, TÜ kasvatusteaduste dotsent Inger Kraav, TPÜ emeriitprofessor Inge Unt, TPÜ dotsent Viivi Maanso

Bravocom süüdistab Tele2 ja EMT-d alatus konkurentsivõitluses / Kristiina Viiron

Index Scriptorium Estoniae

Viiron, Kristiina, 1971-

2007-01-01

Kallines Tele2 ja EMT võrgust Bravocomi mobiilinumbritele helistamise minutihind. Bravocomi juhatuse esimees Peep Põldsamm peab nii kalli hinna - 4.50 minut - kehtestamist konkurentsivõitluseks. Tabelid: Hinnavõrdlus. Lisa: Tele2 ja EMT kommentaarid

Eesti animafilmid võitsid Raumas

Index Scriptorium Estoniae

pPIK mare 2010

1999-01-01

VI Sinise Mere filmifestivalil Raumas jagasid A-sarjas esikohta Mait Laasi "Päevavalgus" ja Peep Pedmansoni "Just Märried", teiseks jäi Märt Sildvee "Guardian Angel" ja kolmandaks Riho Undi - Hardi Volmeri "Primavera"

Kunstigaleriist pART on võimalik tellida näitust tutvustavaid loenguid / Ülle Lätte

Index Scriptorium Estoniae

Lätte, Ülle, 1955-

2008-01-01

Kunstigalerii pART näitusel "Nad rõõmustavad meid" eksponeeritakse Põltsamaalt pärit kunstnike Tiit Pääsukese, Peeter Alliku, Toivo Raidmetsa, Viive Väljaotsa, Mare Tralla, Ave Nahkuri, Peep Pedmansoni loomingut

Midagi enamat kui hea film / Peep Pedmanson

Index Scriptorium Estoniae

Pedmanson, Peep

2006-01-01

Mängufilm "Libahundi needus" : stsenaristid Margus Kasterpalu, Ilmar Raag ja Rainer Sarnet : režissöör Rainer Sarnet : osades Katariina Lauk, Rene Reinumägi : Shop of Dreams - Eesti Televisioon 2005

Poliitikauuringud ja õiguspoliitika kujundamine Eestis / Peep Pruks

Index Scriptorium Estoniae

Pruks, Peep, 1963-

2000-01-01

Poliitikauuringutest lääneriikides (USA-s) ning Ida- ja Kesk-Euroopa üleminekuühiskondades. Mõttekeskustest (think tank), Eesti poliitikauuringute keskusest PRAXIS ning projektidest "Avaliku sektori ja kolmanda sektori õigusloome alane koostöö" ja "Eesti kriminaalmenetluse optimeerimine"

Eesti mood esitles end Stockholmis / Peep Sooman

Index Scriptorium Estoniae

Sooman, Peep, 1978-

1999-01-01

Eesti moepäevadel Stockholmis esitleti moeshow'l üle 80 rõivakollektsiooni, osalesid: Baltika, Klementi, Sangar, Zik-Zak (Ivo Nikkolo), Katrin Kuldma Moemaja, Arne Studio, Hipo, Uljas & Tütred, Virulane, Althea.

Production of Energy Efficient Preform Structures (PEEPS)

Energy Technology Data Exchange (ETDEWEB)

Dr. John A. Baumann

2012-06-08

Due to its low density, good structural characteristics, excellent fabrication properties, and attractive appearance, aluminum metal and its alloys continue to be widely utilized. The transportation industry continues to be the largest consumer of aluminum products, with aerospace as the principal driver for this use. Boeing has long been the largest single company consumer of heat-treated aluminum in the U.S. The extensive use of aluminum to build aircraft and launch vehicles has been sustained, despite the growing reliance on more structurally efficient carbon fiber reinforced composite materials. The trend in the aerospace industry over the past several decades has been to rely extensively on large, complex, thin-walled, monolithic machined structural components, which are fabricated from heavy billets and thick plate using high speed machining. The use of these high buy-to-fly ratio starting product forms, while currently cost effective, is energy inefficient, with a high environmental impact. The widespread implementation of Solid State Joining (SSJ) technologies, to produce lower buy-to-fly ratio starting forms, tailored to each specific application, offers the potential for a more sustainable manufacturing strategy, which would consume less energy, require less material, and reduce material and manufacturing costs. One objective of this project was to project the energy benefits of using SSJ techniques to produce high-performance aluminum structures if implemented in the production of the world fleet of commercial aircraft. A further objective was to produce an energy consumption prediction model, capable of calculating the total energy consumption, solid waste burden, acidification potential, and CO2 burden in producing a starting product form - whether by conventional or SSJ processes - and machining that to a final part configuration. The model needed to be capable of computing and comparing, on an individual part/geometry basis, multiple possible manufacturing pathways, to identify the best balance of energy consumption and environmental impact. This model has been created and populated with energy consumption data for individual SSJ processes and process platforms. Technology feasibility cases studies were executed, to validate the model, and confirm the ability to create lower buy-to-fly ratio performs and machine these to final configuration aircraft components. This model can now be used as a tool to select manufacturing pathways that offer significant energy savings and, when coupled with a cost model, drive implementation of the SSJ processes.

Nukufilm lasi käiku pooletunnise 3D-seiklusfilmi / Tiit Tuumalu

Index Scriptorium Estoniae

Tuumalu, Tiit, 1971-

2009-01-01

Stuudios Nukufilm algasid pooletunnise 3D-nukufilmi "Lisa Limone ja Maroc Orange'i tormakas armulugu" võtted. Filmi režissöör on Mait Laas, stsenaristid Kati Kovacs ja Peep Pedmanson, produtsent Arvo Nuut

Avati mälestuskivi Heinrich Marga sünnikohas / Peep Pillak ; fotod: Peep Pillak ja Valitsuse Kommunikatsioonibüroo

Index Scriptorium Estoniae

Pillak, Peep

2008-01-01

1. oktoobril avati mälestuskivi Eesti Vabariigi valitsuse eksiilis peaministri presidendi ülesannetes Heinrich Marga sünnikohas Põlvamaal Kõlleste (Krootuse) vallas Ihamaru külas Otsa talu juures

Performance of the New Turbine Mid-Level Critical Care Ventilators.

Science.gov (United States)

Delgado, Carlos; Romero, Jose E; Puig, Jaume; Izquierdo, Ana; Ferrando, Carlos; Belda, F Javier; Soro, Marina

2017-01-01

During recent years, ventilators using turbines as flow-generating systems have become increasingly more relevant. This bench study was designed to compare triggering and pressurization of 7 turbine mid-level ICU ventilators. We used a dual-chamber lung model to test 7 mid-level ICU ventilators in pressure support mode with levels of 10, 15, and 20 cm H 2 O with 2 PEEP levels of 5 cm H 2 O and the minimum level allowed by the ventilator. A ventilator was connected to the master chamber to simulate 2 different effort levels. Pressure drop, trigger delay time, time to minimum pressure, and pressure time products (PTP) during trigger and the first 300 and 500 ms were analyzed. In the trigger evaluation, the Savina had the highest delay time, whereas the C2, the V60, and the Trilogy had the lowest pressure drops and PTP values in both effort levels. In pressurization capacity assessment using ideal PTP300 and PTP500 percentages, the C2 and the V680 had the best results, and the Carina and the Savina had lower values, with no differences between both effort levels. Differences between PEEP levels did not seem to be relevant. Pressure support mode for tested ventilators worked properly, but pressurization capacity and trigger function performance were clearly superior in the newest machines. The use of PEEP did not modify the results. Copyright © 2017 by Daedalus Enterprises.

Neopuff T-piece resuscitator mask ventilation: Does mask leak vary with different peak inspiratory pressures in a manikin model?

Science.gov (United States)

Maheshwari, Rajesh; Tracy, Mark; Hinder, Murray; Wright, Audrey

2017-08-01

The aim of this study was to compare mask leak with three different peak inspiratory pressure (PIP) settings during T-piece resuscitator (TPR; Neopuff) mask ventilation on a neonatal manikin model. Participants were neonatal unit staff members. They were instructed to provide mask ventilation with a TPR with three PIP settings (20, 30, 40 cm H 2 O) chosen in a random order. Each episode was for 2 min with 2-min rest period. Flow rate and positive end-expiratory pressure (PEEP) were kept constant. Airway pressure, inspiratory and expiratory tidal volumes, mask leak, respiratory rate and inspiratory time were recorded. Repeated measures analysis of variance was used for statistical analysis. A total of 12 749 inflations delivered by 40 participants were analysed. There were no statistically significant differences (P > 0.05) in the mask leak with the three PIP settings. No statistically significant differences were seen in respiratory rate and inspiratory time with the three PIP settings. There was a significant rise in PEEP as the PIP increased. Failure to achieve the desired PIP was observed especially at the higher settings. In a neonatal manikin model, the mask leak does not vary as a function of the PIP when the flow rate is constant. With a fixed rate and inspiratory time, there seems to be a rise in PEEP with increasing PIP. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Predicting the lung compliance of mechanically ventilated patients via statistical modeling

International Nuclear Information System (INIS)

Ganzert, Steven; Kramer, Stefan; Guttmann, Josef

2012-01-01

To avoid ventilator associated lung injury (VALI) during mechanical ventilation, the ventilator is adjusted with reference to the volume distensibility or ‘compliance’ of the lung. For lung-protective ventilation, the lung should be inflated at its maximum compliance, i.e. when during inspiration a maximal intrapulmonary volume change is achieved by a minimal change of pressure. To accomplish this, one of the main parameters is the adjusted positive end-expiratory pressure (PEEP). As changing the ventilator settings usually produces an effect on patient's lung mechanics with a considerable time delay, the prediction of the compliance change associated with a planned change of PEEP could assist the physician at the bedside. This study introduces a machine learning approach to predict the nonlinear lung compliance for the individual patient by Gaussian processes, a probabilistic modeling technique. Experiments are based on time series data obtained from patients suffering from acute respiratory distress syndrome (ARDS). With a high hit ratio of up to 93%, the learned models could predict whether an increase/decrease of PEEP would lead to an increase/decrease of the compliance. However, the prediction of the complete pressure–volume relation for an individual patient has to be improved. We conclude that the approach is well suitable for the given problem domain but that an individualized feature selection should be applied for a precise prediction of individual pressure–volume curves. (paper)

Assessment of regional ventilation distribution: comparison of vibration response imaging (VRI) with electrical impedance tomography (EIT).

Science.gov (United States)

Shi, Chang; Boehme, Stefan; Bentley, Alexander H; Hartmann, Erik K; Klein, Klaus U; Bodenstein, Marc; Baumgardner, James E; David, Matthias; Ullrich, Roman; Markstaller, Klaus

2014-01-01

Vibration response imaging (VRI) is a bedside technology to monitor ventilation by detecting lung sound vibrations. It is currently unknown whether VRI is able to accurately monitor the local distribution of ventilation within the lungs. We therefore compared VRI to electrical impedance tomography (EIT), an established technique used for the assessment of regional ventilation. Simultaneous EIT and VRI measurements were performed in the healthy and injured lungs (ALI; induced by saline lavage) at different PEEP levels (0, 5, 10, 15 mbar) in nine piglets. Vibration energy amplitude (VEA) by VRI, and amplitudes of relative impedance changes (rel.ΔZ) by EIT, were evaluated in seven regions of interest (ROIs). To assess the distribution of tidal volume (VT) by VRI and EIT, absolute values were normalized to the VT obtained by simultaneous spirometry measurements. Redistribution of ventilation by ALI and PEEP was detected by VRI and EIT. The linear correlation between pooled VT by VEA and rel.ΔZ was R(2) = 0.96. Bland-Altman analysis showed a bias of -1.07±24.71 ml and limits of agreement of -49.05 to +47.36 ml. Within the different ROIs, correlations of VT-distribution by EIT and VRI ranged between R(2) values of 0.29 and 0.96. ALI and PEEP did not alter the agreement of VT between VRI and EIT. Measurements of regional ventilation distribution by VRI are comparable to those obtained by EIT.

Sihtasutus Eesti Rahvuskultuuri Fond...

Index Scriptorium Estoniae

2002-01-01

15. oktoobrini võetakse vastu 2003. a. stipendiumide ja kultuuriprojektide finantseerimise taotlusi. Esimest korda jagatakse stipendiume Peep Keskküla (toetatakse Eesti kunstielu arengut), Renate Jõesaare (stipendium eesti rahvusest isikule, kes on tegev kujutava kunsti alal) jt. fondidest

Urmas Sõõrumaa rentis peoks terve linnahalli / Kirsti Vainküla

Index Scriptorium Estoniae

Vainküla, Kirsti, 1972-

2006-01-01

Peol esilinastub mängufilm "Hundi agoonia", mis valminud tellimustööna : režissöör Asko Kase, produtsent Artur Talvik, stsenarist Peep Pedmanson : RUUT Pictures 2006. Lisaks sõnum "Miljonäri äriimpeerium"

Who named it in anaesthesia?

African Journals Online (AJOL)

Few words existed before 1846 and majority naturally came after. A peep is made .... He had discovered many elements, such as potassium, sodium, barium .... Jokichi Takamine (1854–1922), a Japanese scientist, were trying to isolate and ...

Partial liquid ventilation improves lung function in ventilation-induced lung injury

NARCIS (Netherlands)

G.F. Vazquez de Anda; R.A. Lachmann; S.J.C. Verbrugge (Serge); D.A.M.P.J. Gommers (Diederik); J.J. Haitsma (Jack); B.F. Lachmann (Burkhard)

2001-01-01

textabstractDisturbances in lung function and lung mechanics are present after ventilation with high peak inspiratory pressures (PIP) and low levels of positive end-expiratory pressure (PEEP). Therefore, the authors investigated whether partial liquid ventilation can re-establish

Virmaliste valge kuma / Piret Veigel

Index Scriptorium Estoniae

Veigel, Piret, 1961-

2004-01-01

Kirsi ja Marko Ekströmi valge modernne ridaelamukorter (73 mø) Helsingis. Köögimööbel valmistati Eesti firmas Idema, projekti autor Peep Savason. Idemas tehti ka tualettruumi sisustus. K. Ekströmi kommentaarid. 13 ill

Oistrahhi-festival võtab vastu belgia muusikuid / Toivo Traks

Index Scriptorium Estoniae

Traks, Toivo

2006-01-01

Belgia rahvuspühale pühendatud kontsertidest: fagotimängija Pierre Dubuisson'i esinemisest 21. juulil Pärnu raekoja saalis ja belgia bass-baritoni Lione Lhote ning Peep Lassmanni kontserdist 21. juulil Eliisabeti kirikus, Vanbrugh Quarteti kontserdist Tallinnas

Atonen ja Aaviksoo tegid eile esimese 3G kõne / Viktoria Korpan

Index Scriptorium Estoniae

Korpan, Viktoria, 1976-

2003-01-01

Majandusminister Meelis Atonen ja Eesti Mobiiltelefoni juht Peep Aaviksoo pidasid EMT tehnoloogiakeskuses esimese ametliku kõne 3G testvõrgus. Lisaks tavakõnele videokõnet ja kiiret andmesidet võimaldav teenus jõuab kommertskasutusse orienteeruvalt aastal 2005, lubas Aaviksoo

Lilleküla jalgpallistaadion = Lilleküla Football Stadium / Haldo Oravas

Index Scriptorium Estoniae

Oravas, Haldo, 1960-

2001-01-01

Arhitekt, projekti ja detailplaneeringu (AS Eesti Projekt, 1999) autor Haldo Oravas. Projekteerijad: ETP Grupp, projektijuht Aare Uusalu, arhitekt Peep Urb. Sisekujundaja Sirje Pohl. Projekt 2000-2001. 8 ill.: V korruse ja asendiplaan, tribüüni lõige, vaated

Andres Ellamaa : suurperede seostamine asotsiaalsusega mõjub koletislikult / Andres Ellamaa ; interv. Indrek Veiserik

Index Scriptorium Estoniae

Ellamaa, Andres, 1944-

2008-01-01

Vestlus doktor Andres Ellamaaga suurperede toetamisest, kunstlikust viljastamisest. Lisaks: Kuidas kommenteerite dr. Andres Ellamaa 2. juuni Postimehes ilmunud artikli järel tekkinud diskussiooni avalikkuses ja meedias? Kommenteerivad Tallinna Arstide Liidu juhatuse liige Peeter Mardna ja Jõgeva haigla juhataja Peep Põdder

Lung-protective ventilation in intensive care unit and operation room : Tidal volume size, level of positive end-expiratory pressure and driving pressure

NARCIS (Netherlands)

Serpa Neto, A.

2017-01-01

Several investigations have shown independent associations between three ventilator settings – tidal volume size, positive end–expiratory pressure (PEEP) and driving pressure – and outcomes in patients with the acute respiratory distress syndrome (ARDS). There is an increasing notion that similar

Masin ei küsi kõrgemat palka / Teeli Remmelg

Index Scriptorium Estoniae

Remmelg, Teeli

2007-01-01

Ettevõtjad näevad tööjõupuuduse nappuse lahendusena uute masinate ostmist ja töödistsipliini parandamist. Kommenteerib Ott Licht. Küsimusele vastavad Peep Siimon, Jaanus Vihand, Viktor Valkiainen, Erkki Pärtin, Peeter Mõrd ja Triin Kaasik

Köitekunstist pärikarva / Maarja Undusk

Index Scriptorium Estoniae

Undusk, Maarja

2000-01-01

Rahvusvahelisest köitekunsti ja kalligraafianäirusest "Scripta manent II" Tallinna Kunstihoones. Miks valiti tekstiautoreiks J. Kaplinski ja D. Kareva. Peeter Brambati ja Peep Laansalu videofilmis näidatakse köiteid ka seestpoolt. Filmi muusika - Peeter Vähi

Eramu Suurupis = A House in Suurupi / Tiina Mang

Index Scriptorium Estoniae

Mang, Tiina

2002-01-01

2002. a. valminud eramu projekteeris Arhitektibüroo Emil Urbel. Arhitektid Emil Urbel ja Indrek Erm, sisearhitekt Tiina Mang, konstruktor Peep Rosenberg. Projekt 2000-2001. 7 ill.: I korruse plaan, sise- ja välisvaated.Emil Urbel (arhitektibüroo).

Maardu ja Jõelähtme maa alla võib tulla elektrijaam / Erik Müürsepp

Index Scriptorium Estoniae

Müürsepp, Erik

2009-01-01

OÜ Maardu Graniidikaevandus taotleb graniidikaevanduse luba, ettevõtte juhi Peep Siitami väitel oleks kaeveõõnte hilisem kasutamine pump-hüdroakumulatsioonijaama asukohana parim võimalus kuni 1000 megavati võimsuse ulatuses tuulikuparkide töö ühtlustamiseks

Raudna põhikooli spordihoone Heimtalis = Sports facility at Raudna Basic School in Heimtali / Margit Mutso

Index Scriptorium Estoniae

Mutso, Margit, 1966-

2009-01-01

Heimtali mõisa ringtalli müüride vahele rajatud spordihoonest, žürii hinnang ehitisele, mille arhitekt Peep Jänes pälvis arhitektuuri sihtkapitali aastapreemia 2008. Muinsuskaitse eritingimused koostas Anu Kulbach, sisearhitektid Signe ja Gildardas Stokas, peaprojekteerija K & H

[The influence of positive end-expiratory pressure on cerebral blood flow and cerebrovascular autoregulation in patients with acute respiratory distress syndrome].

Science.gov (United States)

Yang, Chunli; Chen, Zhi; Lu, Yuanhua; He, Huiwei; Zeng, Weihua

2014-05-01

To explore the influence of different positive end-expiratory pressure (PEEP) levels on cerebral blood flow (CBF) and cerebrovascular autoregulation in patients with acute respiratory distress syndrome(ARDS). A prospective study was conducted. Moderate or severe ARDS patients admitted to Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2013 to October 1st, 2013 were enrolled. The changes in hemodynamics, respiratory mechanics and gas exchange under different levels of PEEP were observed. CBF velocity of middle cerebral artery (MCA) was measured using transcranial Doppler (TCD), and breath-holding index (BHI) was also calculated. 35 patients with ARDS were included. The oxygenation index (OI), peak inspiratory pressure (PIP), plat pressure (Pplat) and central venous pressure (CVP) were markedly elevated (OI: 324.7±117.2 mmHg vs. 173.4±95.8 mmHg, t=5.913, P=0.000; PIP: 34.7±9.1 cmH2O vs. 26.1±7.9 cmH2O,t=4.222, P=0.000; Pplat: 30.5±8.4 cmH2O vs. 22.2±7.1 cmH2O, t=4.465, P=0.000; CVP: 12.1±3.5 mmHg vs. 8.8±2.2 mmHg, t=4.723, P=0.000) when PEEP was increased from (6.4±1.0) cmH2O to (14.5±2.0) cmH2O (1 cmH2O=0.098 kPa). But no significant difference in the heart rate (85.5±19.1 beats/min vs. 82.7±17.3 beats/min, t=0.643, P=0.523), mean arterial pressure (73.5±12.4 mmHg vs. 76.4±15.1 mmHg, t=0.878, P=0.383) and CBF velocity of MCA [peak systolic flow velocity (Vmax): 91.26±17.57 cm/s vs. 96.64±18.71 cm/s, t=1.240, P=0.219; diastolic flow velocity (Vmin): 31.54±7.71 cm/s vs. 33.87±8.53 cm/s, t=1.199, P=0.235; mean velocity (Vmean): 51.19±12.05 cm/s vs. 54.27±13.36 cm/s, t=1.013, P=0.315] was found. 18 patients with BHI<0.1 at baseline demonstrated that cerebral vasomotor reactivity was poor. BHI was slightly decreased with increase in PEEP (0.78±0.16 vs. 0.86±0.19, t=1.905, P=0.061). Some of moderate or severe ARDS patients without central nervous system disease have independent of preexisting cerebral

Fluorescent supramolecular micelles for imaging-guided cancer therapy

Science.gov (United States)

Sun, Mengmeng; Yin, Wenyan; Dong, Xinghua; Yang, Wantai; Zhao, Yuliang; Yin, Meizhen

2016-02-01

A novel smart fluorescent drug delivery system composed of a perylene diimide (PDI) core and block copolymer poly(d,l-lactide)-b-poly(ethyl ethylene phosphate) is developed and named as PDI-star-(PLA-b-PEEP)8. The biodegradable PDI-star-(PLA-b-PEEP)8 is a unimolecular micelle and can self-assemble into supramolecular micelles, called as fluorescent supramolecular micelles (FSMs), in aqueous media. An insoluble drug camptothecin (CPT) can be effectively loaded into the FSMs and exhibits pH-responsive release. Moreover, the FSMs with good biocompatibility can also be employed as a remarkable fluorescent probe for cell labelling because the maximum emission of PDI is beneficial for bio-imaging. The flow cytometry and confocal laser scanning microscopy analysis demonstrate that the micelles are easily endocytosed by cancer cells. In vitro and in vivo tumor growth-inhibitory studies reveal a better therapeutic effect of FSMs after CPT encapsulation when compared with the free CPT drug. The multifunctional FSM nanomedicine platform as a nanovehicle has great potential for fluorescence imaging-guided cancer therapy.A novel smart fluorescent drug delivery system composed of a perylene diimide (PDI) core and block copolymer poly(d,l-lactide)-b-poly(ethyl ethylene phosphate) is developed and named as PDI-star-(PLA-b-PEEP)8. The biodegradable PDI-star-(PLA-b-PEEP)8 is a unimolecular micelle and can self-assemble into supramolecular micelles, called as fluorescent supramolecular micelles (FSMs), in aqueous media. An insoluble drug camptothecin (CPT) can be effectively loaded into the FSMs and exhibits pH-responsive release. Moreover, the FSMs with good biocompatibility can also be employed as a remarkable fluorescent probe for cell labelling because the maximum emission of PDI is beneficial for bio-imaging. The flow cytometry and confocal laser scanning microscopy analysis demonstrate that the micelles are easily endocytosed by cancer cells. In vitro and in vivo tumor growth

Respiratory System Mechanics During Low Versus High Positive End-Expiratory Pressure in Open Abdominal Surgery: A Substudy of PROVHILO Randomized Controlled Trial

NARCIS (Netherlands)

D'Antini, Davide; Huhle, Robert; Herrmann, Jacob; Sulemanji, Demet S.; Oto, Jun; Raimondo, Pasquale; Mirabella, Lucia; Hemmes, Sabrine N. T.; Schultz, Marcus J.; Pelosi, Paolo; Kaczka, David W.; Vidal Melo, Marcos Francisco; Gama de Abreu, Marcelo; Cinnella, Gilda

2018-01-01

In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications

Eesti seep saab hoo sisse / Maria Ulfsak

Index Scriptorium Estoniae

Ulfsak, Maria, 1981-

2003-01-01

Kanal 2s algab uus kodumaine komöödiasari "Õpetajate tuba", mille käsikiri on Peep Pedmansonilt, lavastus Ivo Eensalult, näitlejad on Ita Ever, Eino Baskin, Madis Milling, Henrik Normann, Maria Klenskaja, Margus Tabor jt., tootjafirmaks "Ruut"

Associations between positive end-expiratory pressure and outcome of patients without ARDS at onset of ventilation: a systematic review and meta-analysis of randomized controlled trials

NARCIS (Netherlands)

Serpa Neto, Ary; Filho, Roberto Rabello; Cherpanath, Thomas; Determann, Rogier; Dongelmans, Dave A.; Paulus, Frederique; Tuinman, Pieter Roel; Pelosi, Paolo; de Abreu, Marcelo Gama; Schultz, Marcus J.

2016-01-01

The aim of this investigation was to compare ventilation at different levels of positive end-expiratory pressure (PEEP) with regard to clinical important outcomes of intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) at onset of ventilation. Meta-analysis of

Õpetatud Eesti Selts 1988-1991 : [Ülevaade koosolekutest] / Tiit Rosenberg, Maris Pruuli

Index Scriptorium Estoniae

Rosenberg, Tiit, 1946-

1995-01-01

Lisa: Õpetatud Eesti Seltsi taasasutamise ürik : [26 apr. 1988]. Allakirjutanute hulgas Paul Ariste, Eduard Laugaste, Leo Metsar, Aino Põldmäe, Harald Peep, Juhan Peegel, Imbi Pelkonen, Heno Sarv, Arne Merilai, Margus Kasterpalu, Heli Laanekask, Eva Aaver, Paul Hagu, Hando Runnel

Kutseõpetaja - ideaalid ja reaalsus / Ülo Tikk

Index Scriptorium Estoniae

Tikk, Ülo

2003-01-01

Kutseõpetajate koolituse üle vahetavad mõtteid TPÜ töö- ja kutseõpetuse osakonna professor Ants Tarraste, Tallinna Ehituskooli direktor Kaljo-Ilmar Tiitso, Paide Kutsekeskkooli direktori kt. Mare Veermaa, Valga Kutseõppekeskuse õpetaja Peep Leppik ja Tartu abilinnapea Vladimir ?okman

Austraallased huvituvad ETV toodangust / Karin Leemet

Index Scriptorium Estoniae

Leemet, Karin

2000-01-01

ETV saadet "Simson Seakülast" näidatakse peagi Austraalia telekanalil The Special Broadcasting Service. 1995. a. valminud kunstisaade on eesti skulptorist Aivar Simsonist, saate autorid Mariina Mälk, Peeter Brambat, operaator Peep Laansalu. Mari Sobolev A. Simsoni töödest

Application of the Novel Ventilation Mode FLow-Controlled EXpiration (FLEX): A Crossover Proof-of-Principle Study in Lung-Healthy Patients.

Science.gov (United States)

Wirth, Steffen; Springer, Sebastian; Spaeth, Johannes; Borgmann, Silke; Goebel, Ulrich; Schumann, Stefan

2017-10-01

Traditionally, mechanical ventilation is achieved via active lung inflation during inspiration and passive lung emptying during expiration. By contrast, the novel FLEX (FLow-controlled EXpiration) ventilator mode actively decreases the rate of lung emptying. We investigated whether FLEX can be used during intraoperative mechanical ventilation of lung-healthy patients. In 30 adult patients scheduled for neurosurgical procedures, we studied respiratory system mechanics, regional ventilation, oxygenation, and hemodynamics during ventilation with and without FLEX at positive end-expiratory pressure (PEEP) of 5 and 7 cm H2O. The FLEX system was integrated into the expiratory limb and modified the expiratory flow profile by continuously changing expiratory resistance according to a computer-controlled algorithm. Mean airway pressure increased with PEEP by 1.9 cm H2O and with FLEX by 1 cm H2O (all P ventilated during general anesthesia. FLEX improves the homogeneous distribution of ventilation in the lungs.

Common-path Fourier domain optical coherence tomography of irradiated human skin and ventilated isolated rabbit lungs

Science.gov (United States)

Popp, A.; Wendel, M.; Knels, L.; Knuschke, P.; Mehner, M.; Koch, T.; Boller, D.; Koch, P.; Koch, E.

2005-08-01

A compact common path Fourier domain optical coherence tomography (FD-OCT) system based on a broadband superluminescence diode is used for biomedical imaging. The epidermal thickening of human skin after exposure to ultraviolet radiation is measured to proof the feasibility of FD-OCT for future substitution of invasive biopsies in a long term study on natural UV skin protection. The FD-OCT system is also used for imaging lung parenchyma. FD-OCT images of a formalin fixated lung show the same alveolar structure as scanning electron microscopy images. In the ventilated and blood-free perfused isolated rabbit lung FD-OCT is used for real-time cross-sectional image capture of alveolar mechanics throughout tidal ventilation. The alveolar mechanics changing from alternating recruitment-derecruitment at zero positive end-expiratory pressure (PEEP) to persistent recruitment after applying a PEEP of 5 cm H2O is observed in the OCT images.

Kaks kaptenit / Krister Kivi

Index Scriptorium Estoniae

Kivi, Krister, 1975-

2007-01-01

Väliseestlased Mart ja Peter Hint on teinud silmapaistvat karjääri Ameerika Lennunduses. Mart Hint töötab Boening 767 kaptenina lennukompaniis Delta, Peter Hint töötab lennukompaniis American Airlines

Reliability of transpulmonary pressure-time curve profile to identify tidal recruitment/hyperinflation in experimental unilateral pleural effusion.

Science.gov (United States)

Formenti, P; Umbrello, M; Graf, J; Adams, A B; Dries, D J; Marini, J J

2017-08-01

The stress index (SI) is a parameter that characterizes the shape of the airway pressure-time profile (P/t). It indicates the slope progression of the curve, reflecting both lung and chest wall properties. The presence of pleural effusion alters the mechanical properties of the respiratory system decreasing transpulmonary pressure (Ptp). We investigated whether the SI computed using Ptp tracing would provide reliable insight into tidal recruitment/overdistention during the tidal cycle in the presence of unilateral effusion. Unilateral pleural effusion was simulated in anesthetized, mechanically ventilated pigs. Respiratory system mechanics and thoracic computed tomography (CT) were studied to assess P/t curve shape and changes in global lung aeration. SI derived from airway pressure (Paw) was compared with that calculated by Ptp under the same conditions. These results were themselves compared with quantitative CT analysis as a gold standard for tidal recruitment/hyperinflation. Despite marked changes in tidal recruitment, mean values of SI computed either from Paw or Ptp were remarkably insensitive to variations of PEEP or condition. After the instillation of effusion, SI indicates a preponderant over-distension effect, not detected by CT. After the increment in PEEP level, the extent of CT-determined tidal recruitment suggest a huge recruitment effect of PEEP as reflected by lung compliance. Both SI in this case were unaffected. We showed that the ability of SI to predict tidal recruitment and overdistension was significantly reduced in a model of altered chest wall-lung relationship, even if the parameter was computed from the Ptp curve profile.

Intratidal Overdistention and Derecruitment in the Injured Lung: A Simulation Study.

Science.gov (United States)

Amini, Reza; Herrmann, Jacob; Kaczka, David W

2017-03-01

Ventilated patients with the acute respiratory distress syndrome (ARDS) are predisposed to cyclic parenchymal overdistention and derecruitment, which may worsen existing injury. We hypothesized that intratidal variations in global mechanics, as assessed at the airway opening, would reflect such distributed processes. We developed a computational lung model for determining local instantaneous pressure distributions and mechanical impedances continuously during a breath. Based on these distributions and previous literature, we simulated the within-breath variability of airway segment dimensions, parenchymal viscoelasticity, and acinar recruitment in an injured canine lung for tidal volumes( V T ) of 10, 15, and 20 mL·kg -1 and positive end-expiratory pressures (PEEP) of 5, 10, and 15 cm H 2 O. Acini were allowed to transition between recruited and derecruited states when exposed to stochastically determined critical opening and closing pressures, respectively. For conditions of low V T and low PEEP, we observed small intratidal variations in global resistance and elastance, with a small number of cyclically recruited acini. However, with higher V T and PEEP, larger variations in resistance and elastance were observed, and the majority of acini remained open throughout the breath. Changes in intratidal resistance, elastance, and impedance followed well-defined parabolic trajectories with tracheal pressure, achieving minima near 12 to 16 cm H 2 O. Intratidal variations in lung mechanics may allow for optimization of ventilator settings in patients with ARDS, by balancing lung recruitment against parenchymal overdistention. Titration of airway pressures based on variations in intratidal mechanics may mitigate processes associated with injurious ventilation.

Methodology for the Model-based Small Area Estimates of Cancer-Related Knowledge - Small Area Estimates

Science.gov (United States)

The HINTS is designed to produce reliable estimates at the national and regional levels. GIS maps using HINTS data have been used to provide a visual representation of possible geographic relationships in HINTS cancer-related variables.

Lung-protective perioperative mechanical ventilation

NARCIS (Netherlands)

Hemmes, S.N.T.

2015-01-01

Intraoperative ventilation has the potential to cause lung injury and possibly increase risk of pulmonary complications after surgery. Use of large tidal volumes could cause overdistension of lung tissue, which can be aggravated by too high levels of positive end-expiratory pressure (PEEP). Too low

Millise mängufilmi tellis Sõõrumaa Falcki peoks / Andris Feldmanis

Index Scriptorium Estoniae

Feldmanis, Andris, 1982-

2006-01-01

Mängufilm või pseudodokumentaalfilm "Hundi agoonia", mis valminud ärimees Urmas Sõõrumaa tellimustööna turvafirma Falck 15-ks sünnipäevaks : režissöör Asko Kase, produtsent Artur Talvik, stsenarist Peep Pedmanson : RUUT Pictures 2006

Mis on "Sõrmuste isanda" edu saladus?

Index Scriptorium Estoniae

2002-01-01

Toimetuse küsimusele vastavad Ilmar Raag ja Peep Pedmanson. Küsimuse all on Peter Jacksoni esimene film J.R.R. Tolkieni triloogia "Sõrmuste isand" alusel - "Sõrmuse vennaskond", "The Lord of the Rings : The Fellowship of the Ring" : Uus-Meremaa, Ameerika Ühendriigid 2001

Effects of Inhaled Fenoterol and Positive End-Expiratory Pressure on the Respiratory Mechanics of Patients with Chronic Obstructive Pulmonary Disease

Directory of Open Access Journals (Sweden)

Claude Guerin

2005-01-01

Full Text Available BACKGROUND: During acute ventilatory failure in patients with chronic obstructive pulmonary disease (COPD, applying external positive end-expiratory pressure (PEEPe will reopen small airways and, thus, may enhance peripheral deposition as well as the physiological effects of inhaled beta-2 agonists.

32 CFR Appendix D to Part 154 - Reporting of Nonderogatory Cases

Science.gov (United States)

2010-07-01

... travel, education, visits, correspondence, relatives, or contact with persons from or living in a foreign..., window-peeping, and similar situations from whatever source. Unlisted full-time employment or education; full-time education or employment that cannot be verified by any reference or record source or that...

Early Phonological Development: Creating an Assessment Test

Science.gov (United States)

Stoel-Gammon, Carol; Williams, A. Lynn

2013-01-01

This paper describes a new protocol for assessing the phonological systems of two-year-olds with typical development and older children with delays in vocabulary acquisition. The test (Profiles of Early Expressive Phonological Skills ("PEEPS"), Williams & Stoel-Gammon, in preparation) differs from currently available assessments in…

Eestil odava tööjõu eelis kadunud / Liis Kängsepp

Index Scriptorium Estoniae

Kängsepp, Liis, 1981-

2005-01-01

Database Central Europe'i tehtud tööjõu maksumuse uuringu järgi on tööjõukulu Eestis tunduvalt suurem kui Lätis, Leedus ning mitmes Ida-Euroopa riigis. Diagrammid. Kommenteerivad: Peep Siimon, Taavi Veskimägi, Jaak Leimann ja Ilmar Petersen

The value of laparoscopic classifications in decision on definitive ...

African Journals Online (AJOL)

The value of laparoscopic classifications in decision on definitive surgery in patients ... was to present our clinical experience with the laparoscopic approach in patients ... in 10 cases in whom cord structures were seen entering the internal inguinal ring. ... Four canalicular testes (peeping) were treated with open orchiopexy.

Eesti funktsionalismi näitus Jyväskyläs / Karin Hallas-Murula

Index Scriptorium Estoniae

Hallas-Murula, Karin, 1957-

2002-01-01

6. VIII-15. IX Alvar Aalto muuseumis Eesti Arhitekuurimuuseumi näitus "Funktsionalism Eestis". Eksponeeritakse 1930. aastate originaalprojekte, digitaliseeritud ajaloolisi fotosid ning makette. Näituse ja kataloogi on koostanud Karin Hallas-Murula, näituse kujundanud Peeter Mauer, kataloogi kujundanud Jaanus Tamme ja Jaak Peep (Tank)

Õpetaja, kus asub Kennedy neem? / Marii Karell

Index Scriptorium Estoniae

Karell, Marii, 1980-

2003-01-01

Kanal 2s algab uus kodumaine komöödiaseriaal "Õpetajate tuba", mille käsikiri on Peep Pedmansonilt, lavastaja Ivo Eensalu, kes artiklis meenutab oma kooliaegu. Lisaks sõnumid "Eino Baskin sokutas õpetaja istumise alla siili" ja "Madis Milling - rohkem kõnemees kui tangensite tagaajaja"

Kuus uut Eesti filmi korraga ekraanil / Tarmo Teder

Index Scriptorium Estoniae

Teder, Tarmo

1998-01-01

21. mail esilinastuvad kinos Sõprus 'Just märried', rezh. Peep Pedmanson; 'Päevavalgus', rezh. Mait Laas; 'Primavera', rezh. Riho Unt ja Hardi Volmer; 'Vares ja hiired', rezh. Priit Tender ja Mikk Rand; 'Bermuda', rezh. Ülo Pikkov; 'Tom ja Fluffy', rezh. Janno Põldma ja Heiki Ernits

Lung-Protective Ventilation Strategies for Relief from Ventilator-Associated Lung Injury in Patients Undergoing Craniotomy: A Bicenter Randomized, Parallel, and Controlled Trial

Directory of Open Access Journals (Sweden)

Chaoliang Tang

2017-01-01

Full Text Available Current evidence indicates that conventional mechanical ventilation often leads to lung inflammatory response and oxidative stress, while lung-protective ventilation (LPV minimizes the risk of ventilator-associated lung injury (VALI. This study evaluated the effects of LPV on relief of pulmonary injury, inflammatory response, and oxidative stress among patients undergoing craniotomy. Sixty patients undergoing craniotomy received either conventional mechanical (12 mL/kg tidal volume [VT] and 0 cm H2O positive end-expiratory pressure [PEEP]; CV group or protective lung (6 mL/kg VT and 10 cm H2O PEEP; PV group ventilation. Hemodynamic variables, lung function indexes, and inflammatory and oxidative stress markers were assessed. The PV group exhibited greater dynamic lung compliance and lower respiratory index than the CV group during surgery (P0.05. Patients receiving LPV during craniotomy exhibited low perioperative inflammatory response, oxidative stress, and VALI.

Comparison between conventional and protective one-lung ventilation for ventilator-assisted thoracic surgery.

Science.gov (United States)

Ahn, H J; Kim, J A; Yang, M; Shim, W S; Park, K J; Lee, J J

2012-09-01

Recent papers suggest protective ventilation (PV) as a primary ventilation strategy during one-lung ventilation (OLV) to reduce postoperative pulmonary morbidity. However, data regarding the advantage of the PV strategy in patients with normal preoperative pulmonary function are inconsistent, especially in the case of minimally invasive thoracic surgery. Therefore we compared conventional OLV (VT 10 ml/kg, FiO2 1.0, zero PEEP) to protective OLV (VT 6 ml/kg, FiO2 0.5, PEEP 5 cmH2O) in patients with normal preoperative pulmonary function tests undergoing video-assisted thoracic surgery. Oxygenation, respiratory mechanics, plasma interleukin-6 and malondialdehyde levels were measured at baseline, 15 and 60 minutes after OLV and 15 minutes after restoration of two-lung ventilation. PaO2 and PaO2/FiO2 were higher in conventional OLV than in protective OLV (PProtective ventilation did not provide advantages over conventional ventilation for video-assisted thoracic surgery in this group of patients with normal lung function.

Anesthetic management of the SRS™ Endoscopic Stapling System for gastro-esophageal reflux disease.

Science.gov (United States)

Topuz, Ufuk; Umutoglu, Tarik; Bakan, Mefkur; Ozturk, Erdogan

2013-01-14

The SRS(TM) Endoscopic Stapling System (Medigus, Tel Aviv, Israel) is a new tool capable of creating a totally endoscopic fundoplication, combined with an endoscope, endoscopic ultrasound and a surgical stapler. SRS(TM) endoscopic stapling for gastro-esophageal reflux disease is a minimally invasive, outpatient procedure, which requires general anesthesia with positive-pressure ventilation. Keeping the patient on positive end-expiratory pressure (PEEP) may minimize the pressure gradient between the esophagus and the mediastinum, as well as help to prevent air from leaking around the screws and causing pneumomediastinum. In addition, in patients with hiatal hernia, higher PEEP levels may be required to increase intra-thoracic pressure and to force the stomach to slide into the abdomen for ease of endoscopy. We advise smoother emergence from anesthesia, taking precautions for retching, postoperative nausea and vomiting (PONV), while coughing and gagging during extubation and PONV may affect the success of the procedure. Total intravenous anesthesia with propofol and remifentanil seems to be a good choice for these reasons.

Eesti arhiivid Euroopa kontekstis / Lea Kõiv, Peep Pillak

Index Scriptorium Estoniae

Kõiv, Lea, 1961-

2013-01-01

2005. aastal toimus konverents "Eesti arhiivid Euroopa kontekstis". Selle konverentsil esitatud ettekannete baasil ilmunud kogumikust "Die Archive Estlands im Europäischen Kontxt/Estonian Archives in the European Context". Kogumikus sisalduvatest artiklitest

Kolm jääaegset triumfi / Peep Pedmanson

Index Scriptorium Estoniae

Pedmanson, Peep

2002-01-01

Tallinnas ja Tartus tuli ekraanile USA joonisfilm "Jääaeg" ("Ice Age"), mille dubleerimisse on režissöör Janno Põldma juhtimisel kaasatud parimad eesti näitlejad. Eriti Anu Lambi meisterlikkusest laisklooma dubleerimisel ning arvutianimatsiooni kõrgest tasemest

Schaulust und Horror Soziokulturelle - Perspektiven auf PEEPING TOM

Directory of Open Access Journals (Sweden)

Thomas Ballhausen

2010-09-01

Full Text Available Die Geschichte des Kinos und des Films ist mindestens ebenso sehr eine Geschichte des Schreckens (und der damit verbundenen Schaulust wie sie eine Geschichte des Dokumentarischen zu sein scheint. Es sind die außergewöhnlichen Körper und deren Bewegungen, die das Publikum zu allen Zeiten faszinierten, schockierten und zum Schauen und Sehen lockten. Besonders das Genre des Horrorfilms ist mit diesem zentralen Aspekt des Kinos besonders deutlich verbunden.

Parts pakub pensionilisa kinnisvara tagatisel / Kadri Bank

Index Scriptorium Estoniae

Bank, Kadri

2008-01-01

Ilmunud ka: Delovõje Vedomosti 30. jaan. lk. 4. Majandusminister Juhan Parts pakub välja ideed, mis võimaldaks pensionäril saada oma kinnisvara eest igakuist pensionilisa. Vt. samas: Skeem: Pensionilisa kinnisvara tagatisel; Vanurid koduga riskima ei tõtta. Kommenteerivad Valdek Mikkal, Triin Messimas ja Peep Sooman

"Siis sõi Sõõrumaa Punamütsikese ka ära..." / Jüri Muttika

Index Scriptorium Estoniae

Muttika, Jüri

2006-01-01

Mängufilm või pseudodokumentaalfilm "Hundi agoonia", mis valminud ärimees Urmas Sõõrumaa tellimustööna turvafirma Falck 15-ks sünnipäevaks : režissöör Asko Kase, produtsent Artur Talvik, stsenarist Peep Pedmanson : RUUT Pictures 2006. Lisaks tutvustus "Hundi agoonia"

Norma juht hämas Venemaa osas / Annika Matson

Index Scriptorium Estoniae

Matson, Annika, 1976-

2005-01-01

Norma juhatuse esimees Peep Siimon teatas osalise tööaja rakendamise vajadust 551 töötaja puhul ning põhjendab seda keerulise olukorraga Venemaal. Diagramm: Vene autoturg kasvab. Vt. samas: Eesti analüütikud osalise tööaja teadet ei pelga. Kommenteerib Valentin Jurkin

The effect of positive end-expiratory pressure on pulse pressure ...

African Journals Online (AJOL)

The effect of positive end-expiratory pressure on pulse pressure variation. FJ Smith, M Geyser, I Schreuder, PJ Becker. Abstract. Objectives: To determine the effect of different levels of positive end-expiratory pressure (PEEP) on pulse pressure variation (PPV). Design: An observational study. Setting: Operating theatres of a ...

Persistent puhnonary hypertension ofthe neonate in a developing ...

African Journals Online (AJOL)

the study period. Their clinical characteristics are dis- played in Tables IT and ITl. Comparison of the clinical, ventilatory and laboratory findings of the survivors v. the non-survivors .... Fio, = fractional concentration of inspired oxygen; PEEP = positive end expiratory ... had multi-organ failure and was assessed as having a.

Nonminimal hints for asymptotic safety

Science.gov (United States)

Eichhorn, Astrid; Lippoldt, Stefan; Skrinjar, Vedran

2018-01-01

In the asymptotic-safety scenario for gravity, nonzero interactions are present in the ultraviolet. This property should also percolate into the matter sector. Symmetry-based arguments suggest that nonminimal derivative interactions of scalars with curvature tensors should therefore be present in the ultraviolet regime. We perform a nonminimal test of the viability of the asymptotic-safety scenario by working in a truncation of the renormalization group flow, where we discover the existence of an interacting fixed point for a corresponding nonminimal coupling. The back-coupling of such nonminimal interactions could in turn destroy the asymptotically safe fixed point in the gravity sector. As a key finding, we observe nontrivial indications of stability of the fixed-point properties under the impact of nonminimal derivative interactions, further strengthening the case for asymptotic safety in gravity-matter systems.

[A comparative study between inflation and deflation pressure-volume curve in determining the optimal positive end-expiratory pressure].

Science.gov (United States)

Gang, Li; Sun, Xiao-yi; Xu, Jin-quan; Zhang, Xin-li; Kou, Lu-xin; Jiang, Zhi-hong; Zhang, Lei

2012-02-01

To determine the optimal positive end-expiratory pressure (PEEP) according to inflation and deflation pressure-volume curve (P-V curve) in patients with acute respiratory distress syndrome (ARDS). ARDS models were reproduced in 20 dogs, and they were randomly divided into two groups. In both groups, Levenberg-Marquardt iterative algorithm was employed using software to explore parameters fitting with Boltzmann formula, by which the real inflection point of pressure (Pinf d) in deflation limb or lower inflection point pressure (PLip) in inflation limb on P-V curve were defined. For the control group (inflation curve) P-V curve of PLip + 2 cm H(2)O [1 cm H(2)O = 0.098 kPa] was applied as the best PEEP value. In the experimental group (deflation curve) the Pinf d was taken as the best PEEP value. The heart rate (HR), blood pressure (BP), fingertip pulse oxygen saturation [SpO(2)], static lung compliance (Cst), arterial partial pressure of oxygen [PaO(2)] and arterial partial pressure of carbon dioxide [PaCO(2)] were monitored at 0, 2, 6, 12, 24 and 48 hours. Oxygenation index increased significantly both in control and experimental groups. In experimental group, oxygenation index (mm Hg, 1 mm Hg = 0.133 kPa) of 12, 24 and 48 hours was respectively significantly higher than that of the control group (12 hours: 177.63 ± 8.94 vs. 165.60 ± 8.90, 24 hours: 194.19 ± 10.67 vs. 168.70 ± 10.60, 48 hours: 203.15 ± 13.21 vs. 171.26 ± 9.21, all P deflation P-V curve was better than that of inflation curve.

Feasibility of Protective Ventilation During Elective Supratentorial Neurosurgery: A Randomized, Crossover, Clinical Trial.

Science.gov (United States)

Ruggieri, Francesco; Beretta, Luigi; Corno, Laura; Testa, Valentina; Martino, Enrico A; Gemma, Marco

2017-06-30

Traditional ventilation approaches, providing high tidal volumes (Vt), produce excessive alveolar distention and lung injury. Protective ventilation, employing lower Vt and positive end-expiratory pressure (PEEP), is an attractive alternative also for neuroanesthesia, when prolonged mechanical ventilation is needed. Nevertheless, protective ventilation during intracranial surgery may exert dangerous effects on intracranial pressure (ICP). We tested the feasibility of a protective ventilation strategy in neurosurgery. Our monocentric, double-blind, 1:1 randomized, 2×2 crossover study aimed at studying the effect size and variability of ICP in patients undergoing elective supratentorial brain tumor removal and alternatively ventilated with Vt 9 mL/kg-PEEP 0 mm Hg and Vt 7 mL/kg-PEEP 5 mm Hg. Respiratory rate was adjusted to maintain comparable end-tidal carbon dioxide between ventilation modes. ICP was measured through a subdural catheter inserted before dural opening. Forty patients were enrolled; 8 (15%) were excluded after enrollment. ICP did not differ between traditional and protective ventilation (11.28±5.37, 11 [7 to 14.5] vs. 11.90±5.86, 11 [8 to 15] mm Hg; P=0.541). End-tidal carbon dioxide (28.91±2.28, 29 [28 to 30] vs. 28.00±2.17, 28 [27 to 29] mm Hg; Pprotective ventilation. Blood pressure, heart rate, and body temperature did not differ between ventilation modes. Dural tension was "acceptable for surgery" in all cases. ICP differences between ventilation modes were not affected by ICP values under traditional ventilation (coefficient=0.067; 95% confidence interval, -0.278 to 0.144; P=0.523). Protective ventilation is a feasible alternative to traditional ventilation during elective neurosurgery.

Human or monitor feedback to improve mask ventilation during simulated neonatal cardiopulmonary resuscitation.

Science.gov (United States)

Binder, Corinna; Schmölzer, Georg M; O'Reilly, Megan; Schwaberger, Bernhard; Urlesberger, Berndt; Pichler, Gerhard

2014-03-01

To investigate if external chest compressions (ECC) increase mask leak, and if human or technical feedback improves mask ventilation during simulated neonatal cardiopulmonary resuscitation (CPR). In this observational study, 32 participants delivered positive pressure ventilation (PPV) to a modified, leak-free manikin via facemask. Mask leak, tidal volume (VT), positive end expiratory pressure (PEEP) and respiratory rate (RR) were measured with a respiratory function monitor (RFM). Participants had to perform four studies. In the first study, participants performed PPV alone as baseline. Thereafter, three studies were performed in random order. In the PPV+ECC+manometer group, participants had to observe the manometer while the RFM was covered; in the PPV+ECC+RFM group, the RFM was used while the manometer was covered; and in the PPV+ECC+verbal feedback group, the RFM and manometer were covered while a team leader viewed the RFM and provided verbal feedback to the participants. Median (IQR) mask leak of all studies was 15% (5-47%). Comparing the studies, PPV+ECC+RFM and PPV+ECC+verbal feedback had significantly less mask leak than PPV+ECC+manometer. Mean (SD) VT of all studies was 9.5±3.5 mL. Comparing all studies, PPV+ECC+RFM had a significantly higher VT than PPV and PPV+ECC+manometer. As well, PPV+ECC+verbal feedback had a significantly higher VT than PPV. PEEP and RR were within our target, mean (SD) PEEP was 6±2 cmH2O and RR was 36±13/min. During simulated neonatal CPR, ECCs did not influence mask leak, and a RFM and verbal feedback were helpful methods to reduce mask leak and increase VT significantly.

evaluation of total annual costs of heat exchanger networks using

African Journals Online (AJOL)

This study presents pinch analysis of some heat exchanger networks (HENs) problems using Hint integration (HINT) software. Three examples reported to have been solved using different approaches by various researchers to obtain the least possible total annual cost (TAC) were solved using the Hint software. In this work ...

Collaboration and peer tutoring in chemistry laboratory education

NARCIS (Netherlands)

Ding, N.; Harskamp, E.G.

2011-01-01

The aim of this study is to examine the effectiveness of collaborative learning with hints and peer tutoring with hints, and individual learning with hints in chemistry laboratory education in a secondary school. A total of 96 eleventh graders participated in this study. The study has a randomized

Teater täis sära ja müstikat / Ell-Maaja Randküla

Index Scriptorium Estoniae

Randküla, Ell-Maaja, 1939-2016

2005-01-01

Tallinnas Pärnu mnt. 5 asuva Eesti Draamateatri renoveerimine. Sisekujundus: Mari Kurismaa, Stuudio Kurismaa. Arhitektuurne lahendus: AB Kolde Grupp ( arhitektid Peep Jänes, Indrek Suigusaar). Ehitus: AS Estconde E. Mari Kurismaast, tema tähtsamad loomingulised saavutused maalikunstnikuna ja sisearhitektina. M. Kurismaa kommentaarid. Ill.: plaan, 10 värv. vaadet

Telesügis: uued omasaated ja õnnemängud / Erika Klaats

Index Scriptorium Estoniae

Klaats, Erika, 1954-

2010-01-01

ETV ekraanile jõudvatest draamasarjadest "Klass: elu pärast" ja "ENSV" ning Mati Talviku ajaloosarjast "Ajavaod". Kanal 2 ekraanile jõudvast draamasarjast "Pilvede all", dokumentaalsarjast "Eesti maffia", saatest "Tantsud tähtedega". TV 3 ekraanile jõudvast saatest "Eesti talent" ja komöödiasarjast "Kälimehed" (stsenarist Peep Pedmanson)

Läänemere filmiamatöörid Tallinnas

Index Scriptorium Estoniae

2002-01-01

5. ja 6. oktoobril peeti Tallinna Kinomajas 33. avatud Balti amatöörfilmide festival, mille žüriid juhtis Peep Puks. Ühe II auhinna sai Daniel Müntineni alias Dan Leadi animafilm "Punapäine päikeseloojang" ja ühe III auhinna Elen Lotmani tõsielufilm "Homo sapiens"

An experimental randomized study of six different ventilatory modes in a piglet model with normal lungs

DEFF Research Database (Denmark)

Nielsen, J B; Sjöstrand, U H; Henneberg, S W

1991-01-01

-controlled intermittent positive-pressure ventilation; and SV-20P denotes pressure-controlled intermittent positive-pressure ventilation. With all modes of ventilation a PEEP of 7.5 cm H2O was used. In the abbreviations used, the number denotes the ventilatory frequency in breaths per minute (bpm). HFV indicates that all...

Surfactant impairment after mechanical ventilation with large alveolar surface area changes and effects of positive end-expiratory pressure

NARCIS (Netherlands)

S.J.C. Verbrugge (Serge); S.H. Bohm; D.A.M.P.J. Gommers (Diederik); L.J.I. Zimmermann (Luc); B.F. Lachmann (Burkhard)

1998-01-01

textabstractWe have assessed the effects of overinflation on surfactant function and composition in rats undergoing ventilation for 20 min with 100% oxygen at a peak inspiratory pressure of 45 cm H2O, with or without PEEP 10 cm H2O (groups 45/10 and 45/0, respectively).

Tallinna ülikool ehitab uue Ursa maja / Mihkel Tamm

Index Scriptorium Estoniae

Tamm, Mihkel

2017-01-01

2018. a. veebruaris kavatseb Tallinna Ülikool hakata lammutama loodus- ja terviseteaduste õppehoonet ehk Ursa maja. Amortiseerunud hoone asemele ehitatakse uus, mille uksed loodetakse tudengitele avada 2019. aasta sügissemestriks. Selgitusi uue hoone kahta jagab TLÜ kantsler Peep Jonas ning kavandatava õueala kohta keskkonnakorralduse professor Helen Sooväli-Sepping

Adaptive filtering primer with Matlab

CERN Document Server

Poularikas, Alexander D

2006-01-01

INTRODUCTIONSignal ProcessingAn ExampleOutline of the TextDISCRETE-TIME SIGNAL PROCESSINGDiscrete Time SignalsTransform-Domain Representation of Discrete-Time SignalsThe Z-TransformDiscrete-Time SystemsProblemsHints-Solutions-SuggestionsRANDOM VARIABLES, SEQUENCES, AND STOCHASTIC PROCESSESRandom Signals and DistributionsAveragesStationary ProcessesSpecial Random Signals and Probability Density FunctionsWiener-Khinchin RelationsFiltering Random ProcessesSpecial Types of Random ProcessesNonparametric Spectra EstimationParametric Methods of power Spectral EstimationProblemsHints-Solutions-SuggestionsWIENER FILTERSThe Mean-Square ErrorThe FIR Wiener FilterThe Wiener SolutionWiener Filtering ExamplesProblemsHints-Solutions-SuggestionsEIGENVALUES OF RX - PROPERTIES OF THE ERROR SURFACEThe Eigenvalues of the Correlation MatrixGeometrical Properties of the Error SurfaceProblemsHints-Solutions-SuggestionsNEWTON AND STEEPEST-DESCENT METHODOne-Dimensional Gradient Search MethodSteepest-Descent AlgorithmProblemsHints-Sol...

NNS computing facility manual P-17 Neutron and Nuclear Science

International Nuclear Information System (INIS)

Hoeberling, M.; Nelson, R.O.

1993-11-01

This document describes basic policies and provides information and examples on using the computing resources provided by P-17, the Neutron and Nuclear Science (NNS) group. Information on user accounts, getting help, network access, electronic mail, disk drives, tape drives, printers, batch processing software, XSYS hints, PC networking hints, and Mac networking hints is given

Kriisiaasta - tasu tõusis 300 000krooni : Ülikoolid: rektorite sissetulek kasvab / Kadri Paas

Index Scriptorium Estoniae

Paas, Kadri, 1982-

2010-01-01

Eesti suuremate kõrgkoolide rektorite sissetulek on aastaid kerkinud, sõltumata sellest, kas majandus õitseb või langeb. Mullust edetabelit juhib Tallinna Tehnikaülikooli rektor Peep Sürje, kelle aastatasu kerkis 300 000 krooni võrra. Ka Tartu Ülikooli rektori Alar Karise ja Tallinna Ülikooli rektori Rein Raua palkadest

Director läks ja küsis / Indrek Randveer, Evelyn Karming, Priit Palk ... [jt.

Index Scriptorium Estoniae

2010-01-01

EMT teenindus- ja müügidirektor Indrek Randveer, Estraveli müügidirektor Evelyn Karming, ABC King/Nero/SHU/Suurtüki turundusjuht Anne-Liis Ostov, kohvik-restoran Crepp juhataja Priit Palk ja Sokos Hotel Viru kommunikatsioonijuht Peep Ehasalu vastavad küsimustele, mis puudutavad nende kogemusi keerukate ja absurdsete kliendikaebuste kohta

Teated

Index Scriptorium Estoniae

2008-01-01

Kontserdid TÜ aulas: Tartu Ülikooli kammerkoori kevadkontsert 16. märtsil, pianist Peep Lassmann 18. märtsil (kavas: Sumera "Pala aastast 1981", Liszt-Rossini "Stabat Mater", Liszt-Verdi "Rigoletto parafraas", Liszt "Tuisk" ja "Hispaania rapsoodia"), saksofonikvartett Sax-Est 19. märtsil, kontsert "Richard Ritsing - 105" 28. märtsil

3 Level Ventilation: the First Clinical Experience

Directory of Open Access Journals (Sweden)

P. Torok

2008-01-01

Full Text Available Considering the issues of artificial ventilation (AV in non-homogenous pathological lung processes (acute lung injury (ALI, acute respiratory distress syndrome (ARDS, pneumonia, etc., the authors applied the three-level lung ventilation to a group of 12 patients with non-homogenous lung injury. Three-level ventilation was defined as a type (modification of AV whose basic ventilation level was produced by the modes CMV, PCV or PS (ASB and add-on level, the so-called background ventilation was generated by two levels of PEEP. PEEP (constant and PEEPh (PEEP high with varying frequency and duration of transition between the individual levels of PEEP. Objective: to elucidate whether in cases of considerably non-homogenous gas distribution in acute pathological disorders, three-level ventilation (3LV can correct gas distribution into the so-called slow bronchoalveolar compartments, by decreasing the volume load of the so-called fast compartments and to improve lung gas exchange, by following the principles of safe ventilation. Results. 3LV was applied to 12 patients with severe non-homogenous lung injury/disorder (atypic pneumonia and ARDS/ALI and low-success PCV ventilation after recruitment manoeuvre (PaO2 (kPA /FiO2 = 5—6. There were pronounced positive changes in pulmonary gas exchange within 1—4 hours after initiation of 3LV at a fPCV of 26±4 breaths/min-1 and PEEPh at a fPEEPH of 7±2 breaths/min-1 with a minute ventilation of 12±4 l/min. 3LV reduced a intrapulmonary shunt fraction 50±5 to 30±5%, increased CO2 elimination, with PaCO2 falling to the values below 6±0.3 kPa, and PaO2 to 7.5±1.2 kPa, with FiO2 being decreased to 0.8—0.4. Lung recruitment also improved gas exchange: with PEEP=1.2±0.4 kPa, static tho-racopulmonary compliance (Cst elevated from 0.18±0.02 l/kPa to 0.3±0.02 l/kPa and then to 0.38±0.05 l/kPa. Airways resistance (Raw decreased by more than 30%. Improved lung aeration was also estimated as a manifestation of

Measurement of tidal volume using respiratory ultrasonic plethysmography in anaesthetized, mechanically ventilated horses.

Science.gov (United States)

Russold, Elena; Ambrisko, Tamas D; Schramel, Johannes P; Auer, Ulrike; Van Den Hoven, Rene; Moens, Yves P

2013-01-01

To compare tidal volume estimations obtained from Respiratory Ultrasonic Plethysmography (RUP) with simultaneous spirometric measurements in anaesthetized, mechanically ventilated horses. Prospective randomized experimental study. Five experimental horses. Five horses were anaesthetized twice (1 week apart) in random order in lateral and in dorsal recumbency. Nine ventilation modes (treatments) were scheduled in random order (each lasting 4 minutes) applying combinations of different tidal volumes (8, 10, 12 mL kg(-1)) and positive end-expiratory pressures (PEEP) (0, 10, 20 cm H(2)O). Baseline ventilation mode (tidal volume=15 mL kg(-1), PEEP=0 cm H(2)O) was applied for 4 minutes between all treatments. Spirometry and RUP data were downloaded to personal computers. Linear regression analyses (RUP versus spirometric tidal volume) were performed using different subsets of data. Additonally RUP was calibrated against spirometry using a regression equation for all RUP signal values (thoracic, abdominal and combined) with all data collectively and also by an individually determined best regression equation (highest R(2)) for each experiment (horse versus recumbency) separately. Agreement between methods was assessed with Bland-Altman analyses. The highest correlation of RUP and spirometric tidal volume (R(2)=0.81) was found with the combined RUP signal in horses in lateral recumbency and ventilated without PEEP. The bias ±2 SD was 0±2.66 L when RUP was calibrated for collective data, but decreased to 0±0.87 L when RUP was calibrated with individual data. A possible use of RUP for tidal volume measurement during IPPV needs individual calibration to obtain limits of agreement within ±20%. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

[Effect of transpulmonary pressure-directed mechanical ventilation on respiration in severe acute pancreatitis patient with intraabdominal hypertension].

Science.gov (United States)

Wu, Xiaoyan; Zheng, Ruiqiang; Lin, Hua; Zhuang, Zhiqing; Zhang, Min; Yan, Peixia

2015-10-20

To assess the effect of mehanical ventilation (MV) guided by transpulmonary pressure (Ptp) on respiratory mechanics and gas exchange in severe acute pancreatitis patient with intraabdominal hypertension. Twelve severe acute pancreatitis patient with intraabdominal hypertension and acute respiratory distress syndrome(ARDS) underwent mechanical ventilation were involved from Jan to Dec 2013. PEEP levels were set to achieve a Ptp of 0 to 10 cm of water at end expiration. We also limited tidal volume to keep Ptp at less than 25 cm of water at end inspiration. Respiratory mechanics and gas-exchange were measured. Plat pressure (Pplat) increased and the compliance of chest wall (Ccw) decreased when intraabdominal pressure (IAP) increased. Pplat correlated with IAP positively (r2=0.741 9, P0.05). Compared with baseline, after guiding MV with Ptp, the Level of PEEP (14.6±4.2) cmH2O vs (8.3±2.0) cmH2O, and Ptp-e (1.5±0.5) cmH2O vs (-2.3±1.4) cmH2O increased (P0.05). Ptp-e correlated with PEEP (r2=0.549, P0.05). Compared with baseline, lung compliance (CL) (48.1±10.3) cmH2O vs (25.7±6.4) cmH2O and oxygenation index (PaO2/FiO2) (235±48) mmHg vs (160±35) mmHg improved obviously (P0.05). Transpulmonary pressure-directed mechanical ventilation in ARDS secondary to severe acute pancreatitis patient with intraabdominal hypertension could not only recruit the collapsed alveoli, improve lung compliance, increase oxygenation index and decrease dead space ventilation but also monitor lung stress to avoid alveoli overinflation, which might be lung protective.

Pneumoperitoneum deteriorates intratidal respiratory system mechanics: an observational study in lung-healthy patients.

Science.gov (United States)

Wirth, Steffen; Biesemann, Andreas; Spaeth, Johannes; Schumann, Stefan

2017-02-01

Pneumoperitoneum during laparoscopic surgery leads to atelectasis and impairment of oxygenation. Positive end-expiratory pressure (PEEP) is supposed to counteract atelectasis. We hypothesized that the derecruiting effects of pneumoperitoneum would deteriorate the intratidal compliance profile in patients undergoing laparoscopic surgery. In 30 adult patients scheduled for surgery with pneumoperitoneum, respiratory variables were measured during mechanical ventilation. We calculated the dynamic compliance of the respiratory system (C RS ) and the intratidal volume-dependent C RS curve using the gliding-SLICE method. The C RS curve was then classified in terms of indicating intratidal recruitment/derecruitment (increasing profile) and overdistension (decreasing profile). During the surgical interventions, the PEEP level was maintained nearly constant at 7 cm H 2 O. Data are expressed as mean [confidence interval]. Baseline C RS was 60 [54-67] mL cm H 2 O -1 . Application of pneumoperitoneum decreased C RS to 40 [37-43] mL cm H 2 O -1 which partially recovered to 54 [50-59] mL cm H 2 O -1 (P < 0.001) after removal but remained below the value measured before pneumoperitoneum (P < 0.001). Baseline compliance profiles indicated intratidal recruitment/derecruitment in 48 % patients. After induction of pneumoperitoneum, intratidal recruitment/derecruitment was indicated in 93 % patients (P < 0.01), and after removal intratidal recruitment/derecruitment was indicated in 59 % patients. Compliance profiles showing overdistension were not observed. Analyses of the intratidal compliance profiles reveal that pneumoperitoneum during laparoscopic surgery causes intratidal recruitment/derecruitment which partly persists after its removal. The analysis of the intratidal volume-dependent C RS profiles could be used to guide intraoperative PEEP adjustments during elevated intraabdominal pressure.

Respiratory Management of Perioperative Obese Patients.

Science.gov (United States)

Imber, David Ae; Pirrone, Massimiliano; Zhang, Changsheng; Fisher, Daniel F; Kacmarek, Robert M; Berra, Lorenzo

2016-12-01

With a rising incidence of obesity in the United States, anesthesiologists are faced with a larger volume of obese patients coming to the operating room as well as obese patients with ever-larger body mass indices (BMIs). While there are many cardiovascular and endocrine issues that clinicians must take into account when caring for the obese patient, one of the most prominent concerns of the anesthesiologist in the perioperative setting should be the status of the lung. Because the pathophysiology of reduced lung volumes in the obese patient differs from that of the ARDS patient, the best approach to keeping the obese patient's lung open and adequately ventilated during mechanical ventilation is unique. Although strong evidence and research are lacking regarding how to best ventilate the obese surgical patient, we aim with this review to provide an assessment of the small amount of research that has been conducted and the pathophysiology we believe influences the apparent results. We will provide a basic overview of the anatomy and pathophysiology of the obese respiratory system and review studies concerning pre-, intra-, and postoperative respiratory care. Our focus in this review centers on the best approach to keeping the lung recruited through the prevention of compression atelectasis and the maintaining of physiological lung volumes. We recommend the use of PEEP via noninvasive ventilation (NIV) before induction and endotracheal intubation, the use of both PEEP and periodic recruitment maneuvers during mechanical ventilation, and the use of PEEP via NIV after extubation. It is our hope that by studying the underlying mechanisms that make ventilating obese patients so difficult, future research can be better tailored to address this increasingly important challenge to the field of anesthesia. Copyright © 2016 by Daedalus Enterprises.

Yli 100 syytä mennä Viroon / Terhi Pääskylä-Malmström

Index Scriptorium Estoniae

Pääskylä-Malmström, Terhi, 1979-

2015-01-01

Tutvustus: Did you know that there are over 100 exciting, quirky, unique and important reasons to visit Estonia! = Tiesitkö että on yli 100 jännittävää, outoa, ainutlaatuista ja tärkeää syytä tulla Viroon? / koostanud Jussi-Pekka Aukia, Peep Ehasalu. Tallinn : AS Sokotel, 2015

Suurfirmade 2008. aasta eelarved kinnitavad majanduse jahtumist / Mikk Salu

Index Scriptorium Estoniae

Salu, Mikk, 1975-

2008-01-01

Eesti suurettevõtete juhid räägivad, kuidas nad oma ettevõtte uue aasta eelarvet on planeerinud, kui palju on arvestanud palgakasvuks. Pindi Kinnisvara arvestab oma tulude 20-protsendilise langusega. Peep Sooman, Enn Saar, Vahur Roossaar, Tarmo Noop, Siim Kallast ja Meelis Milder vastavad küsimusele, millist palgatõusu nad prognoosivad 2008. aastal

Tallinna linn või aukude plombeerimine = City of Tallinn or filling of holes / Veljo Kaasik

Index Scriptorium Estoniae

Kaasik, Veljo

1999-01-01

"Eesti Päevalehes" ilmunud arhitektide viimase aja karakteersemate tööde hindamistabelist, selles olevast Nissani keskusest (Andres Siim, Hanno Kreis), Hansapanga hoonest ja Stockmanni kaubamajast (Peep Jänes). Tallinna arhitektuurist kui tervikust. Tallinnas on palju tühje krunte, rekonstrueerimist ootavaid linnaosi ja suuri üksikhooneid. Linn realiseerub läbi investorite majandusliku huvitatuse

Multifilm kui tõsine asi / Marko Mägi

Index Scriptorium Estoniae

Mägi, Marko

1998-01-01

Esilinastus 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Eesti animafilme igale maitsele / Sulev Teinemaa

Index Scriptorium Estoniae

Teinemaa, Sulev, 1947-

1998-01-01

Esilinastus 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Aimdusi tsivilisatsioonist / Tarmo Teder

Index Scriptorium Estoniae

Teder, Tarmo, 1958-

1998-01-01

Esilinastus 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Animaalselt ja humaanselt / Karlo Funk

Index Scriptorium Estoniae

Funk, Karlo, 1971-

1998-01-01

Esilinastus 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

The effect of lung deflation on the position of the pleura during subclavian vein cannulation in infants receiving mechanical ventilation: an ultrasound study.

Science.gov (United States)

Jang, Y-E; Lee, J-H; Park, Y-H; Byon, H-J; Kim, H-S; Kim, C-S; Kim, J-T

2013-10-01

We evaluated the effect of lung deflation on the relative position of the pleura compared with a reference line during supra- and infraclavicular approaches to the right subclavian vein. The reference line was drawn relative to the predicted pathway of the needle. The distances between the pleura and the reference line for supra- and infraclavicular approaches were measured during inspiration and expiration in 41 infants. Measurements were repeated with the application of 5 cmH2O positive end-expiratory pressure (PEEP) and in the Trendelenburg position. Lung deflation during the supraclavicular approach significantly decreased the volume of lung crossing the reference line by a median (IQR [range]) of 1.0 (0.6 to 1.3 [0.0 to 4.8]) mm, p deflation showed no change in the distance of the pleura from the reference line regardless of PEEP or patient position. We conclude that lung deflation moves the lung apex caudally and can reduce the potential risk of pneumothorax during a supraclavicular approach to the right subclavian vein in infants. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Effects of positive end-expiratory pressure on arthroscopic shoulder surgery under general anesthesia.

Science.gov (United States)

Ersoy, Ayşın; Çakırgöz, Mensure; Ervatan, Zekeriya; Kıran, Özlem; Türkmen, Aygen; Esenyel, Cem Zeki

2016-01-01

Our study is a prospective, randomized study on patients undergoing arthroscopic shoulder surgery in the beach-chair position to evaluate the effects of positive end-expiratory pressure (PEEP) on hemodynamic stability, providing a bloodless surgical field and surgical satisfaction. Fifty patients were divided into two groups. Group I (n=25) had zero end-expiratory pressure (ZEEP) administered under general anesthesia, and group II (n=25) had +5 PEEP administered. During surgery, intraarticular hemorrhage and surgical satisfaction were evaluated on a scale of 0-10. During surgery, at the 5th, 30th, 60th, and 90th minutes and at the end of surgery, heart rate, mean arterial pressure (MAP), and positive inspiratory pressure were recorded. At the end of the surgery, the amount of bleeding and duration of the operation were recorded. In group I, the duration of operation and amount of bleeding were found to be significantly greater than those in group II (pshoulder surgery in the beach-chair position reduces the amount of hemorrhage in the surgical field and thus increases surgical satisfaction without requiring the creation of controlled hypotension.

Летняя кухня - функционально и красиво / Тийна Кольк

Index Scriptorium Estoniae

Кольк, Тийна

2010-01-01

Valik arhitektuurikonkursile "Väike 2007-2009" esitatud väikeobjektidest. Korvamäe suveköök (Urmas Muru, Peeter Pere, Reet Viigipuu, Karl Õiger), Mähe puhkemaja väliköök (Emil Urbel, Indrek Erm), aiamaja Pelgulinnas (Madis Eek), Suurupi aiapaviljon (Peep Roosmann), Tabasalu vaskeramu grillikoht (Urmas Muru, Peeter Pere, Anna-Maria Erik, Ago Kuddu)

Grillipaviljon, väliköök, varjualune... / Tiina Kolk

Index Scriptorium Estoniae

Kolk, Tiina

2010-01-01

Tutvustatakse valikut arhitektuurikonkursile "Väike 2007-2009" esitatud õueobjektidest. Suurupi aiapaviljon (Peep Roosmann), aiamaja Pelgulinnas (Madis Eek), Mähe puhkemaja väliköök (Emil Urbel, Indrek Erm), Korvamäe suveköök (Urmas Muru, Peeter Pere, Reet Viigipuu, Karl Õiger), Tabasalu vaskeramu grillikoht (Urmas Muru, Peeter Pere, Anna-Maria Erik, Ago Kuddu)

Ilo Pariisi varjus / Kaia Sisask

Index Scriptorium Estoniae

Sisask, Kaia

2003-01-01

Portreefilm Pariisis giidina töötavast kirjanik Juhan Jaigi tütrest Ilo Jaik-Riedbergist "Ilo Pariisis" : stsenarist ja režissöör Peep Puks : operaatorid Arvo Vilu, Ago Ruus, Heli Arvo Vilu, Henn Liiva, Jüri Vaher : teksti loeb Anu Lamp : muusikaline kujundus Merike Vaino : filmi direktor Maie Kerma : Pro-Film 2002

Torontos peeti eesti dokfilmifestivali "Estdoc's" / Olev Remsu

Index Scriptorium Estoniae

Remsu, Olev, 1947-

2006-01-01

Toronto eesti dokumentaalfilmide festival "Estdoc's". Demonstreeriti filme: "Sinimäed" (Raimo Jõerand), "Tiim" (Peep Puks), "Mikk" (Rein Raamat, Peeter Brambat), "6 tundi" (Rein Kotov), "Erna retk" (Vaado Sarapuu), "Tõrjutud mälestused" (Imbi Paju), "Middendorfi jälgedes" (Riho Västrik), "Mehed unustatud armeest" (Indrek Treufeldt), "Nagu noor jumal" ja "Orjus Eestis" (mõlema autor Olev Remsu)

Afbrydelsens kronotopi i britisk litteratur, 1840-1870

DEFF Research Database (Denmark)

Damkjær, Maria

2017-01-01

-1866), combined with a new historicist reading of Victorian advice literature, this article argues that narrative marginalisation was paradoxically a viable strategy for showing an otherwise invisible temporality. In the background, peeping out whenever the plot interrupts, is an enduring and ongoing time......, mediated by unnamed and underrepresented servants, that gives the middle-class home temporal depth and realism....

Animatsiooni vastu ei saa ükski / Mikk Rand

Index Scriptorium Estoniae

Rand, Mikk, 1970-

1998-01-01

21.5. esilinastuvad kinos "Sõprus" 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Esilinastuvad eesti animafilmid

Index Scriptorium Estoniae

1998-01-01

21.5. esilinastuvad kinos "Sõprus" 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Kuus uut Eesti filmi korraga ekraanil / Tarmo Teder

Index Scriptorium Estoniae

Teder, Tarmo, 1958-

1998-01-01

21.5. esilinastuvad kinos "Sõprus" 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Ventilator-induced mediator release: role of PEEP and surfactant

OpenAIRE

Haitsma, Jack

2002-01-01

textabstractLung protective ventilation such as the ARDSnet low tidal volumes strategy can reduce mortality in ARDS patients. The lmowledge that an essential therapy such as mechanical ventilation on the intensive care influences patient outcome has given rise to the re-evaluation of current ventilation practices. This review addresses the current state of lung protective strategies and their physiological rationale. Latest knowledge on the instigation and progression of lung injury by mechan...

Loe raha, ole paindlik ning kuula klienti / Peep Ehasalu

Index Scriptorium Estoniae

Ehasalu, Peep, 1966-

2004-01-01

Eesti ettevõtete TOP 100 1. koht. Kolmandat aastat järjest edetabeli tippu jõudnud Tele2 edu rajaneb kolmel sambal. Lisad: Tele2 Eesti AS; Tele2 pürgib maruliselt kõrgustesse. Kommenteerivad Andrus Hiiepuu, Inna Kramer ja Agne Kivisaar.

Ettevaatust, bussid jäävad seisma! / Peep Peterson

Index Scriptorium Estoniae

Peterson, Peep, 1975-

2004-01-01

Ilmunud ka: Severnoje Poberezhje, 23. okt. 2004, lk. 2; Narva Postiljon, 23. okt. 2004, lk. 5; Narvskaja Gazeta, 23. okt. 2004, lk. 4; Sakala, 26. okt. 2004, lk. 2; Võrumaa Teataja, 26. okt. 2004, lk. 2; Vooremaa, 26. okt. 2004, lk. 2; Meie Maa, 26. okt. 2004, lk. 2; Harjumaa, 26. okt. 2004, lk. 2; Järva Teataja, 28. okt. 2004, lk. 2; Hiiu Leht, 29. okt. 2004, lk. 2; Pärnu Postimees, 29. okt. 2004, lk. 15; Linnaleht : Pärnu, 29. okt. 2004, lk. A4; Valgamaalane, 6. nov. 2004, lk. 2. Transpordi ametiühing andis autoettevõtete liidule üle nõudmise, milles taotleb kõigile bussijuhtidele lisatasudeta Eesti keskmist palka. Kokkuleppele tuleb jõuda enne 2005. aasta 1. jaanuari

Kuidas kirjutada eesti rahva vastupanust okupatsioonivõimudele? / Peep Varju

Index Scriptorium Estoniae

Varju, Peep

2009-01-01

Eestlaste vastupanust Teise maailmasõja ajal, ajalootõlgendusest taasiseseisvumise esimestel aastatel. Ettekanne Jüri Kuke mälestusele pühendatud Langenud Vabadusvõitlejate Päeva XIII aulakonverentsil Tartu Ülikoolis 28. märtsil 2009

Sõjakurjategijate ja nende ohvrite kohtlemisest Eesti Vabariigis / Peep Varju

Index Scriptorium Estoniae

Varju, Peep

2009-01-01

Autor kritiseerib 1949. aasta märtsiküüditamises kannatanute võimalusi õigusabile ja küüditajate üle kohtumõistmise venimist. Viited okupatsioonirežiimide poolt represseeritud isiku seadusele

Kolmepoolne koostöölepe Tehnikaülikooli, OÜ TTÜ Sport ja SEB Ühispanga vahel

Index Scriptorium Estoniae

2006-01-01

Tallinna Tehnikaülikool rektor Peep Sürje, Osaühing TTÜ Sport juhatuse esimees Andres Öpik ja AS SEB Eesti Ühispank juhatuse esimees Mart Altvee allkirjastasid kolmepoolse koostöölepingu, milles nähakse ette ühistegevused TTÜ üliõpilastele õppekavadega seotud äriplaanikonkursi korraldamisel, üliõpilaste sporditegevuse edasiarendamisel ning üliõpilastele osutatud pangateenuste parandamisel

Short outlines of books by Estonian authors : [annotations] / Rutt Hinrikus, Janika Kronberg

Index Scriptorium Estoniae

Hinrikus, Rutt, 1946-

1999-01-01

Ehin, Andres. Seljatas sada meest; Ilmet, Peep. Tuuldunud luule; Kaplinski, Jaan. Öölinnud. Öömõtted; Kender, Kaur. Iseseisvuspäev; Kesküla, Kalev. Vabariigi laulud; Luik, Viivi. Maa taevas; Nõu, Helga. Hundi silmas; Raun, Mait. Wake up; Remsu, Olev. Haapsalu tragöödia; Sauter, Peeter. Kogu moos; Undusk, Jaan. Maagiline müstiline keel; Vint, Toomas. Kunstnikuromaan

Eesti täispikad dokumentaalfilmid 2005. aastal / Marianne Kõrver

Index Scriptorium Estoniae

Kõrver, Marianne, 1980-

2006-01-01

Portreefilmid : Priit Pärnast "Pärnograafia" (Hardi Volmer), Ivar Heinmaast "Kutse" (Peep Puks), Veljo Tormisest "Tormise regi" (Sulev Keedus), Rein Tammikust "Teekond ruudulisel laudlinal" (Peeter Urbla), "Afanassi" (Liina Trishkina) ; probleemfilmid : "Parema elu nimel" (Märt Sildvee), "Piisa torn" (Arko Okk) ; sõjateemalised dokumentaalid : "Afganistani armid" (Ivar Heinmaa), "Hauka grupp" (Rene Vilbre), "Tõrjutud mälestused" (Imbi Paju) ; loodusfilm "Eesti kotkad" (Rein Maran)

Suur esilinastamine

Index Scriptorium Estoniae

1998-01-01

21.5. esilinastuvad kinos "Sõprus" 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer. Aut. : M.R

Mäss Norma pardal / Annika Matson, Katre Pilvinski

Index Scriptorium Estoniae

Matson, Annika, 1976-

2008-01-01

Norma väikeaktsionärid nõuavad Norma juhilt Peep Siimonilt suuremat dividendi ja et ettevõte ostaks neilt kuni kümnendiku aktsiaid tagasi turuhinnast ligi kaks korda kõrgema hinnaga. Diagramm: Norma dividendimaksed. Kommenteerib Sander Danil. Vt. ka Enn Tossi art. "Norma tegevus ajab väikeaktsionäri vihale" Äripäev 8. mai lk. 3

Väike luulekaleidoskoop. III / Jürgen Rooste

Index Scriptorium Estoniae

Rooste, Jürgen, 1979-

2009-01-01

Ülevaade järgmistest luuleraamatutest: Anmann, Aarne. Südametunnistuse mälestuseks. Tartu : A. Anmann, 2009 ; Ilmet, Peep. Meilmail. Tallinn : Varrak, 2009 ; Kasemaa, Andrus. Lagunemine. Tallinn : Eesti Keele Sihtasutus, 2009 ; Kuus, Anti ; Oll, Sulev. Öö mõte on kuus. Tallinn : Akta A. K., 2008 ; Meres, Triinu. Lagunemine. Tartu : Hermes, 2009 ; Tasuja, Triin. Provintsiluule. Tartu : Värske Rõhk, 2009

Practical Hints on Greek and Latin

Science.gov (United States)

Jopes, James

1978-01-01

A discussion of some of the difficulties and procedures in translating classical quotations occurring in a modern text. Some of the topics covered are: use of published translations, transliteration from ancient Greek, and non-classical idioms such as medieval and botanical Latin. (AMH)

[Modifying our "obesogenic" environment: which hints?].

Science.gov (United States)

Masciangelo, M L; Golay, A

2006-03-29

Overweight is nowadays a major problem of public health in Switzerland. Swiss people eat too much, too much fat, sugar and salt! Most efficient public health strategies are global and also apply to environmental modifications, an important determinant to change individual behaviours. Today, our environment is "obesogenic": unlimited access to food, food industry marketing, lifestyle changes. As global programmes for smoking cessation and cardiovascular diseases prevention, it is urgent to propose interventions taking into account all environmental factors which could support individuals in their efforts of changes.

Design Copyright: The Latest Judicial Hint

OpenAIRE

Scott Hemphill; Jeannie Suk

2013-01-01

The most intriguing aspect of the debate over fashion copyright is the occasion it presents for rethinking the expansive copyright law we currently have. C. Scott Hemphill (Columbia Law) & Jeannie Suk (Harvard Law)

Taso Mähar : galerii / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2003-01-01

Taso Mähari projekteeritud töödest. 1997. a. valminud restorani Exit sisekujundusest, mis pälvis Eesti Sisearhitektide Liidu aastapreemia. Metallist ja ühest tükist väljapainutatud toolist ja samas laadis tehtud diivanist aastast 1989, mis leidsid 1992. a. aastauudistena äramärkimist ajakirjas Abitare. T. Mähari kommentaarid. 3 värv. ill

Observational hints on the Big Bounce

International Nuclear Information System (INIS)

Mielczarek, Jakub; Kurek, Aleksandra; Szydłowski, Marek; Kamionka, Michał

2010-01-01

In this paper we study possible observational consequences of the bouncing cosmology. We consider a model where a phase of inflation is preceded by a cosmic bounce. While we consider in this paper only that the bounce is due to loop quantum gravity, most of the results presented here can be applied for different bouncing cosmologies. We concentrate on the scenario where the scalar field, as the result of contraction of the universe, is driven from the bottom of the potential well. The field is amplified, and finally the phase of the standard slow-roll inflation is realized. Such an evolution modifies the standard inflationary spectrum of perturbations by the additional oscillations and damping on the large scales. We extract the parameters of the model from the observations of the cosmic microwave background radiation. In particular, the value of inflaton mass is equal to m = (1.7±0.6)·10 13 GeV. In our considerations we base on the seven years of observations made by the WMAP satellite. We propose the new observational consistency check for the phase of slow-roll inflation. We investigate the conditions which have to be fulfilled to make the observations of the Big Bounce effects possible. We translate them to the requirements on the parameters of the model and then put the observational constraints on the model. Based on assumption usually made in loop quantum cosmology, the Barbero-Immirzi parameter was shown to be constrained by γ < 1100 from the cosmological observations. We have compared the Big Bounce model with the standard Big Bang scenario and showed that the present observational data is not informative enough to distinguish these models

Kerjav kunstnik / Anna Hints, Maria Rõhu

Index Scriptorium Estoniae

Hints, Anna, 1982-

2011-01-01

Tallinna Linnagaleriis oli 17.03.-10.04.2011 avatud Anna Hintsi ja Maria Rõhu näitus "Nälg". Autorid näituse taotlusest, raha taotlemisest, aktsioonist "Kerjav kunstnik", külastajate suhtumisest sellesse. Näituse aruanne

HINTS IN OMABE BASED SCULPTURE INSTALLATIONS ...

African Journals Online (AJOL)

ASOGWA IFEANYI

2017-02-02

Feb 2, 2017 ... to develop both new methods of inquiry and appropriate forms of ... sculpture, music, dance, poetry, movement, dialogue and painting. ... were feared and respected by everybody in the society, including women and children.

Masking Release for Igbo and English

OpenAIRE

Ebem, Deborah U.; Desloge, Joseph G.; Reed, Charlotte M.; Braida, Louis D.; Uguru, Joy O.

2013-01-01

In this research, we explored the effect of noise interruption rate on speech intelligibility. Specifically, we used the Hearing In Noise Test (HINT) procedure with the original HINT stimuli (English) and Igbo stimuli to assess speech reception ability in interrupted noise. For a given noise level, the HINT test provides an estimate of the signal-to-noise ratio (SNR) required for 50%-correct speech intelligibility. The SNR for 50%-correct intelligibility changes depending upon the interruptio...

Sense of Accomplishment Is Modulated by a Proper Level of Instruction and Represented in the Brain Reward System.

Science.gov (United States)

Nakai, Tomoya; Nakatani, Hironori; Hosoda, Chihiro; Nonaka, Yulri; Okanoya, Kazuo

2017-01-01

Problem-solving can be facilitated with instructions or hints, which provide information about given problems. The proper amount of instruction that should be provided for learners is controversial. Research shows that tasks with intermediate difficulty induce the largest sense of accomplishment (SA), leading to an intrinsic motivation for learning. To investigate the effect of instructions, we prepared three instruction levels (No hint, Indirect hint, and Direct hint) for the same insight-problem types. We hypothesized that indirect instructions impose intermediate difficulty for each individual, thereby inducing the greatest SA per person. Based on previous neuroimaging studies that showed involvement of the bilateral caudate in learning and motivation, we expected SA to be processed in this reward system. We recruited twenty-one participants, and investigated neural activations during problem solving by functional magnetic resonance imaging (fMRI). We confirmed that the Indirect hint, which imposed intermediate difficulty, induced the largest SA among the three instruction types. Using fMRI, we showed that activations in the bilateral caudate and anterior cingulate cortex (ACC) were significantly modulated by SA. In the bilateral caudate, the indirect hint induced the largest activation, while the ACC seemed to reflect the difference between correct and incorrect trials. Importantly, such activation pattern was independent of notations (number or letter). Our results indicate that SA is represented in the reward system, and that the Indirect instruction effectively induces such sensation.

Pitfalls and Rewards for Implementing Ocular Motor Testing in Acute Vestibular Syndrome: A Pilot Project.

Science.gov (United States)

Dumitrascu, Oana M; Torbati, Sam; Tighiouart, Mourad; Newman-Toker, David E; Song, Shlee S

2017-03-01

Isolated acute vestibular syndrome (iAVS) presentations to the emergency department (ED) pose management challenges, given the concerns for posterior circulation strokes. False-negative brain imaging may erroneously reassure clinicians, whereas HINTS-plus examination outperforms imaging to screen for strokes in iAVS. We studied the feasibility of implementing HINTS-plus testing in the ED, aiming to reduce neuroimaging in patients with iAVS. We launched an institutional Quality Improvement initiative, using DMAIC methodology. The outcome measures [proportion of iAVS subjects who had HINTS-plus examinations and underwent neuroimaging by computed tomography/magnetic resonance imaging (CT/MRI)] were compared before and after the established intervention. The intervention consisted of formal training for neurologists and emergency physicians on how to perform, document, and interpret HINTS-plus and implementation of novel iAVS management algorithm. Neuroimaging was not recommended if HINTS-plus suggested peripheral vestibular etiology. If a central process was suspected, brain MRI/MR angiogram was performed. Head CT was reserved only for thrombolytic time-window cases. In the first 2 months postimplementation, HINTS-plus testing performance by neurologists increased from 0% to 80% (P=0.007), and by ED providers from 0% to 9.09% (P=0.367). Head CT scans were reduced from 18.5% to 6.25%. Brain MRI use was reduced from 51.8% to 31.2%. About 60% of the iAVS subjects were discharged from the ED; none were readmitted or had another ED presentation in the ensuing 30 days. Implementation of HINTS-plus evaluation in the ED is valuable and feasible for neurologists, but challenging for emergency physicians. Future studies should determine the "dose-response" curve of educational interventions.

Lung-protective ventilation in abdominal surgery.

Science.gov (United States)

Futier, Emmanuel; Jaber, Samir

2014-08-01

To provide the most recent and relevant clinical evidence regarding the use of prophylactic lung-protective mechanical ventilation in abdominal surgery. Evidence is accumulating, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary complications in patients undergoing abdominal surgery. Nonprotective ventilator settings, especially high tidal volume (>10-12 ml/kg), very low level of positive end-expiratory pressure (PEEP, ventilator-associated lung injury in patients with healthy lungs. Stimulated by the previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung-protective mechanical ventilation. Recent data provide compelling evidence that prophylactic lung-protective mechanical ventilation using lower tidal volume (6-8 ml/kg of predicted body weight), moderate PEEP (6-8 cm H2O), and recruitment maneuvers is associated with improved functional or physiological and clinical postoperative outcome in patients undergoing abdominal surgery. The use of prophylactic lung-protective ventilation can help in improving the postoperative outcome.

Time course of lung inflammatory and fibrogenic responses during protective mechanical ventilation in healthy rats.

Science.gov (United States)

Krebs, Joerg; Pelosi, Paolo; Tsagogiorgas, Charalambos; Haas, Jenny; Yard, Benito; Rocco, Patricia R M; Luecke, Thomas

2011-09-15

This study aimed to assess pulmonary inflammatory and fibrogenic responses and their impact on lung mechanics and histology in healthy rats submitted to protective mechanical ventilation for different experimental periods. Eighteen Wistar rats were randomized to undergo open lung-mechanical ventilation (OL-MV) for 1, 6 or 12 h. Following a recruitment maneuver, a decremental PEEP trial was performed and PEEP set according to the minimal respiratory system static elastance. Respiratory system, lung, and chest-wall elastance and gas-exchange were maintained throughout the 12 h experimental period. Histological lung injury score remained low at 1 and 6 h, but was higher at 12 h due to overinflation. A moderate inflammatory response was observed with a distinct peak at 6h. Compared to unventilated controls, type I procollagen mRNA expression was decreased at 1 and 12h, while type III procollagen expression decreased throughout the 12h experimental period. In conclusion, OL-MV in healthy rats yielded overinflation after 6 h even though respiratory elastance and gas-exchange were preserved for up to 12 h. Copyright © 2011 Elsevier B.V. All rights reserved.

Performance of ICU ventilators during noninvasive ventilation with large leaks in a total face mask: a bench study.

Science.gov (United States)

Nakamura, Maria Aparecida Miyuki; Costa, Eduardo Leite Vieira; Carvalho, Carlos Roberto Ribeiro; Tucci, Mauro Roberto

2014-01-01

Discomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM. This was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization. Of the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly. The majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM.

Performance of ICU ventilators during noninvasive ventilation with large leaks in a total face mask: a bench study* **

Science.gov (United States)

Nakamura, Maria Aparecida Miyuki; Costa, Eduardo Leite Vieira; Carvalho, Carlos Roberto Ribeiro; Tucci, Mauro Roberto

2014-01-01

Objective: Discomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM. Methods: This was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization. Results: Of the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly. Conclusions: The majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM. PMID:25029653

Personalizing mechanical ventilation for acute respiratory distress syndrome

OpenAIRE

Berngard, S. Clark; Beitler, Jeremy R.; Malhotra, Atul

2016-01-01

Lung-protective ventilation with low tidal volumes remains the cornerstone for treating patient with acute respiratory distress syndrome (ARDS). Personalizing such an approach to each patient's unique physiology may improve outcomes further. Many factors should be considered when mechanically ventilating a critically ill patient with ARDS. Estimations of transpulmonary pressures as well as individual's hemodynamics and respiratory mechanics should influence PEEP decisions as well as response ...

Ground water in Delhi area, problems and prospects under fast urbanisation- a nuclear aided study

International Nuclear Information System (INIS)

Mookerjee, P.; Datta, P.S.; Chandrasekharan, H.; Tyagi, S.K.; Singh, R.V.

1994-01-01

The work presented in this paper constitutes a peep into the components of urbanization in the two decades which affected the quality and availability of ground water in the Delhi territory. The recharge studies conducted in Delhi villages employing oxygen 18 and tritium tagging have been described with a view to focus attention on the sustainability of the ground water potential. 1 fig., 1 tab

Seitse raamatut ühtmoodi loodusest, kuid kõik erinevad / Ulvar Käärt, Mari Klein

Index Scriptorium Estoniae

Käärt, Ulvar, 1982-

2009-01-01

Arvustus: Järva, Jaanus. Looduse aasta. Tallinn : Varrak, 2008; Järva, Jaanus. Raba : vaikuses ja varjus. Tallinn : Pegasus, 2008; Savisaar, Remo. Loodus kutsub. Tallinn : Varrak, 2008; Relve, Hendrik. Eesti looduse vägi. Tallinn : Koolibri, 2008; Tartes, Urmas, Põder, Jaak. Legendiloomad. Tallinn : Varrak, 2008; Eesti maastikud. Tallinn : Tänapäev, 2008; Veedla, Peep. Lindudega sõbraks / pildid joonistanud Triinu Ootsing. Tallinn : Berit Grupp, 2008

Nanotoxicity comparison of four amphiphilic polymeric micelles with similar hydrophilic or hydrophobic structure.

Science.gov (United States)

Zhao, Bo; Wang, Xue-Qing; Wang, Xiao-You; Zhang, Hua; Dai, Wen-Bing; Wang, Jun; Zhong, Zhen-Lin; Wu, Hou-Nan; Zhang, Qiang

2013-10-03

Nanocarriers represent an attractive means of drug delivery, but their biosafety must be established before their use in clinical research. Four kinds of amphiphilic polymeric (PEG-PG-PCL, PEEP-PCL, PEG-PCL and PEG-DSPE) micelles with similar hydrophilic or hydrophobic structure were prepared and their in vitro and in vivo safety were evaluated and compared. In vitro nanotoxicity evaluations included assessments of cell morphology, cell volume, inflammatory effects, cytotoxicity, apoptosis and membrane fluidity. An umbilical vein cell line (Eahy.926) and a kind of macrophages (J774.A1) were used as cell models considering that intravenous route is dominant for micelle delivery systems. In vivo analyses included complete blood count, lymphocyte subset analysis, detection of plasma inflammatory factors and histological observations of major organs after intravenous administration to KM mice. All the micelles enhanced inflammatory molecules in J774.A1 cells, likely resulting from the increased ROS levels. PEG-PG-PCL and PEEP-PCL micelles were found to increase the J774.A1 cell volume. This likely correlated with the size of PEG-PG-PCL micelles and the polyphosphoester structure in PEEP-PCL. PEG-DSPE micelles inhibited the growth of Eahy.926 cells via inducing apoptosis. This might relate to the structure of DSPE, which is a type of phospholipid and has good affinity with cell membrane. No evidence was found for cell membrane changes after treatment with these micelles for 24 h. In the in vivo study, during 8 days of 4 time injection, each of the four nanocarriers altered the hematic phase differently without changes in inflammatory factors or pathological changes in target organs. These results demonstrate that the micelles investigated exhibit diverse nanotoxicity correlated with their structures, their biosafety is different in different cell model, and there is no in vitro and in vivo correlation found. We believe that this study will certainly provide more

Modes of mechanical ventilation for the operating room.

Science.gov (United States)

Ball, Lorenzo; Dameri, Maddalena; Pelosi, Paolo

2015-09-01

Most patients undergoing surgical procedures need to be mechanically ventilated, because of the impact of several drugs administered at induction and during maintenance of general anaesthesia on respiratory function. Optimization of intraoperative mechanical ventilation can reduce the incidence of post-operative pulmonary complications and improve the patient's outcome. Preoxygenation at induction of general anaesthesia prolongs the time window for safe intubation, reducing the risk of hypoxia and overweighs the potential risk of reabsorption atelectasis. Non-invasive positive pressure ventilation delivered through different interfaces should be considered at the induction of anaesthesia morbidly obese patients. Anaesthesia ventilators are becoming increasingly sophisticated, integrating many functions that were once exclusive to intensive care. Modern anaesthesia machines provide high performances in delivering the desired volumes and pressures accurately and precisely, including assisted ventilation modes. Therefore, the physicians should be familiar with the potential and pitfalls of the most commonly used intraoperative ventilation modes: volume-controlled, pressure-controlled, dual-controlled and assisted ventilation. Although there is no clear evidence to support the advantage of any one of these ventilation modes over the others, protective mechanical ventilation with low tidal volume and low levels of positive end-expiratory pressure (PEEP) should be considered in patients undergoing surgery. The target tidal volume should be calculated based on the predicted or ideal body weight rather than on the actual body weight. To optimize ventilation monitoring, anaesthesia machines should include end-inspiratory and end-expiratory pause as well as flow-volume loop curves. The routine administration of high PEEP levels should be avoided, as this may lead to haemodynamic impairment and fluid overload. Higher PEEP might be considered during surgery longer than 3 h

Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study.

Science.gov (United States)

Ladha, Karim; Vidal Melo, Marcos F; McLean, Duncan J; Wanderer, Jonathan P; Grabitz, Stephanie D; Kurth, Tobias; Eikermann, Matthias

2015-07-14

To evaluate the effects of intraoperative protective ventilation on major postoperative respiratory complications and to define safe intraoperative mechanical ventilator settings that do not translate into an increased risk of postoperative respiratory complications. Hospital based registry study. Academic tertiary care hospital and two affiliated community hospitals in Massachusetts, United States. 69,265 consecutively enrolled patients over the age of 18 who underwent a non-cardiac surgical procedure between January 2007 and August 2014 and required general anesthesia with endotracheal intubation. Protective ventilation, defined as a median positive end expiratory pressure (PEEP) of 5 cmH2O or more, a median tidal volume of less than 10 mL/kg of predicted body weight, and a median plateau pressure of less than 30 cmH2O. Composite outcome of major respiratory complications, including pulmonary edema, respiratory failure, pneumonia, and re-intubation. Of the 69,265 enrolled patients 34,800 (50.2%) received protective ventilation and 34,465 (49.8%) received non-protective ventilation intraoperatively. Protective ventilation was associated with a decreased risk of postoperative respiratory complications in multivariable regression (adjusted odds ratio 0.90, 95% confidence interval 0.82 to 0.98, P=0.013). The results were similar in the propensity score matched cohort (odds ratio 0.89, 95% confidence interval 0.83 to 0.97, P=0.004). A PEEP of 5 cmH2O and median plateau pressures of 16 cmH2O or less were associated with the lowest risk of postoperative respiratory complications. Intraoperative protective ventilation was associated with a decreased risk of postoperative respiratory complications. A PEEP of 5 cmH2O and a plateau pressure of 16 cmH2O or less were identified as protective mechanical ventilator settings. These findings suggest that protective thresholds differ for intraoperative ventilation in patients with normal lungs compared with those used for patients

Evaluating the effects of protective ventilation on organ-specific cytokine production in porcine experimental postoperative sepsis.

Science.gov (United States)

Sperber, Jesper; Lipcsey, Miklós; Larsson, Anders; Larsson, Anders; Sjölin, Jan; Castegren, Markus

2015-05-10

Protective ventilation with lower tidal volume (VT) and higher positive end-expiratory pressure (PEEP) reduces the negative additive effects of mechanical ventilation during systemic inflammatory response syndrome. We hypothesised that protective ventilation during surgery would affect the organ-specific immune response in an experimental animal model of endotoxin-induced sepsis-like syndrome. 30 pigs were laparotomised for 2 hours (h), after which a continuous endotoxin infusion was started at 0.25 micrograms × kg(-1) × h(-1) for 5 h. Catheters were placed in the carotid artery, hepatic vein, portal vein and jugular bulb. Animals were randomised to two protective ventilation groups (n = 10 each): one group was ventilated with VT 6 mL × kg(-1) during the whole experiment while the other group was ventilated during the surgical phase with VT of 10 mL × kg(-1). In both groups PEEP was 5 cmH2O during surgery and increased to 10 cmH2O at the start of endotoxin infusion. A control group (n = 10) was ventilated with VT of 10 mL × kg(-1) and PEEP 5 cm H20 throughout the experiment. In four sample locations we a) simultaneously compared cytokine levels, b) studied the effect of protective ventilation initiated before and during endotoxemia and c) evaluated protective ventilation on organ-specific cytokine levels. TNF-alpha levels were highest in the hepatic vein, IL-6 levels highest in the artery and jugular bulb and IL-10 levels lowest in the artery. Protective ventilation initiated before and during endotoxemia did not differ in organ-specific cytokine levels. Protective ventilation led to lower levels of TNF-alpha in the hepatic vein compared with the control group, whereas no significant differences were seen in the artery, portal vein or jugular bulb. Variation between organs in cytokine output was observed during experimental sepsis. We see no implication from cytokine levels for initiating protective ventilation before endotoxemia. However, during endotoxemia

Application of mid-frequency ventilation in an animal model of lung injury: a pilot study.

Science.gov (United States)

Mireles-Cabodevila, Eduardo; Chatburn, Robert L; Thurman, Tracy L; Zabala, Luis M; Holt, Shirley J; Swearingen, Christopher J; Heulitt, Mark J

2014-11-01

Mid-frequency ventilation (MFV) is a mode of pressure control ventilation based on an optimal targeting scheme that maximizes alveolar ventilation and minimizes tidal volume (VT). This study was designed to compare the effects of conventional mechanical ventilation using a lung-protective strategy with MFV in a porcine model of lung injury. Our hypothesis was that MFV can maximize ventilation at higher frequencies without adverse consequences. We compared ventilation and hemodynamic outcomes between conventional ventilation and MFV. This was a prospective study of 6 live Yorkshire pigs (10 ± 0.5 kg). The animals were subjected to lung injury induced by saline lavage and injurious conventional mechanical ventilation. Baseline conventional pressure control continuous mandatory ventilation was applied with V(T) = 6 mL/kg and PEEP determined using a decremental PEEP trial. A manual decision support algorithm was used to implement MFV using the same conventional ventilator. We measured P(aCO2), P(aO2), end-tidal carbon dioxide, cardiac output, arterial and venous blood oxygen saturation, pulmonary and systemic vascular pressures, and lactic acid. The MFV algorithm produced the same minute ventilation as conventional ventilation but with lower V(T) (-1 ± 0.7 mL/kg) and higher frequency (32.1 ± 6.8 vs 55.7 ± 15.8 breaths/min, P ventilation and MFV for mean airway pressures (16.1 ± 1.3 vs 16.4 ± 2 cm H2O, P = .75) even when auto-PEEP was higher (0.6 ± 0.9 vs 2.4 ± 1.1 cm H2O, P = .02). There were no significant differences in any hemodynamic measurements, although heart rate was higher during MFV. In this pilot study, we demonstrate that MFV allows the use of higher breathing frequencies and lower V(T) than conventional ventilation to maximize alveolar ventilation. We describe the ventilatory or hemodynamic effects of MFV. We also demonstrate that the application of a decision support algorithm to manage MFV is feasible. Copyright © 2014 by Daedalus Enterprises.

Bench evaluation of 7 home-care ventilators.

Science.gov (United States)

Blakeman, Thomas C; Rodriquez, Dario; Hanseman, Dennis; Branson, Richard D

2011-11-01

Portable ventilators continue to decrease in size while increasing in performance. We bench-tested the triggering, battery duration, and tidal volume (V(T)) of 7 portable ventilators: LTV 1000, LTV 1200, Puritan Bennett 540, Trilogy, Vela, iVent 101, and HT50. We tested triggering with a modified dual-chamber test lung to simulate spontaneous breathing with weak, normal, and strong inspiratory effort. We measured battery duration by fully charging the battery and operating the ventilator with a V(T) of 500 mL, a respiratory rate of 20 breaths/min, and PEEP of 5 cm H(2)O until breath-delivery ceased. We tested V(T) accuracy with pediatric ventilation scenarios (V(T) 50 mL or 100 mL, respiratory rate 50 breaths/min, inspiratory time 0.3 s, and PEEP 5 cm H(2)O) and an adult ventilation scenario (V(T) 400 mL, respiratory rate 30 breaths/min, inspiratory time 0.5 s, and PEEP 5 cm H(2)O). We measured and analyzed airway pressure, volume, and flow signals. At the adult settings the measured V(T) range was 362-426 mL. On the pediatric settings the measured V(T) range was 51-182 mL at the set V(T) of 50 mL, and 90-141 mL at the set V(T) of 100 mL. The V(T) delivered by the Vela at both the 50 mL and 100 mL, and by the HT50 at 100 mL, did not meet the American Society for Testing and Materials standard for V(T) accuracy. Triggering response and battery duration ranged widely among the tested ventilators. There was wide variability in battery duration and triggering sensitivity. Five of the ventilators performed adequately in V(T) delivery across several settings. The combination of high respiratory rate and low V(T) presented problems for 2 of the ventilators.

Mechanical breath profile of airway pressure release ventilation: the effect on alveolar recruitment and microstrain in acute lung injury.

Science.gov (United States)

Kollisch-Singule, Michaela; Emr, Bryanna; Smith, Bradford; Roy, Shreyas; Jain, Sumeet; Satalin, Joshua; Snyder, Kathy; Andrews, Penny; Habashi, Nader; Bates, Jason; Marx, William; Nieman, Gary; Gatto, Louis A

2014-11-01

Improper mechanical ventilation settings can exacerbate acute lung injury by causing a secondary ventilator-induced lung injury. It is therefore important to establish the mechanism by which the ventilator induces lung injury to develop protective ventilation strategies. It has been postulated that the mechanism of ventilator-induced lung injury is the result of heterogeneous, elevated strain on the pulmonary parenchyma. Acute lung injury has been associated with increases in whole-lung macrostrain, which is correlated with increased pathology. However, the effect of mechanical ventilation on alveolar microstrain remains unknown. To examine whether the mechanical breath profile of airway pressure release ventilation (APRV), consisting of a prolonged pressure-time profile and brief expiratory release phase, reduces microstrain. In a randomized, nonblinded laboratory animal study, rats were randomized into a controlled mandatory ventilation group (n = 3) and an APRV group (n = 3). Lung injury was induced by polysorbate lavage. A thoracotomy was performed and an in vivo microscope was placed on the lungs to measure alveolar mechanics. In the controlled mandatory ventilation group, multiple levels of positive end-expiratory pressure (PEEP; 5, 10, 16, 20, and 24 cm H2O) were tested. In the APRV group, decreasing durations of expiratory release (time at low pressure [T(low)]) were tested. The T(low) was set to achieve ratios of termination of peak expiratory flow rate (T-PEFR) to peak expiratory flow rate (PEFR) of 10%, 25%, 50%, and 75% (the smaller this ratio is [ie, 10%], the more time the lung is exposed to low pressure during the release phase, which decreases end-expiratory lung volume and potentiates derecruitment). Alveolar perimeters were measured at peak inspiration and end expiration using digital image analysis, and strain was calculated by normalizing the change in alveolar perimeter length to the original length. Macrostrain was measured by volume

Gerd Kanter alistas keerulised tuuled ja tugevad vastased / Peep Pahv

Index Scriptorium Estoniae

Pahv, Peep, 1970-

2008-01-01

Vt. ka Postimees : na russkom jazõke 17. märts, lk. 13. Maailmameister Gerd Kanter võitis viiendat korda Euroopa talvised karikavõistlused. Mihkel Kukk viskas oda 78.41 ning täitis Pekingi olümpia B-normi

Tunni analüüs - mis see on? / Peep Leppik

Index Scriptorium Estoniae

Leppik, Peep

2001-01-01

Tunni analüüs, õppe-kasvatustöö eesmärgid. Tunni analüüs on hinnangu andmine protsessidele, mille kutsub esile õpetaja tegevus (või tegevusetus) tunnis. Tunni läbiviimise protsessi mõjutavad õpilaste koosseis klassis, erinevate õppevormide ja õppemeetodite kasutamine, kasutatud õppevõtete otstarbekus, erinevad metoodikad ja õppesüsteemid

Kuulus velotuur võib jõuda Eesti teedele / Peep Pahv

Index Scriptorium Estoniae

Pahv, Peep, 1970-

2007-01-01

Vt. ka Postimees : na russkom jazõke 29. nov., lk. 12. Maailma mainekaima velotuuri Tour de France korraldajad on pöördunud Eesti kultuuriministeeriumi poole ettepanekuga alustada 2018. aasta võidusõitu Tallinnast

Eesti nimekaim ilukirurg jagab enesekindlust / Peep Pree ; intevjueerinud Priit Pullerits

Index Scriptorium Estoniae

Pree, Peep, 1958-

2006-01-01

Vestlus Tartu esteetilise kirurgia erakliiniku Clinica juhatajaga tööst, vastutustundest, ebaõnnestumistest. Kommenteerivad Tartu linnapea Laine Jänes ja Tartu Ülikooli arstiteaduskonna emeriitprofessor Ennu Sepp

``Peeps,'' cream, heads, and food coloring in a vacuum jar

Science.gov (United States)

DePino, Andrew

2001-01-01

This note describes some methods of adding interest to the standard vacuum jar demonstrations. Marshmallow animals, shaving cream, doll heads, and food coloring add some spark to these demos. These new twists have been well received by the students.

"Scientific peep show": the human body in contemporary science museums.

Science.gov (United States)

Canadelli, Elena

2011-01-01

The essay focuses on the discourse about the human body developed by contemporary science museums with educational and instructive purposes directed at the general public. These museums aim mostly at mediating concepts such as health and prevention. The current scenario is linked with two examples of past museums: the popular anatomical museums which emerged during the 19th century and the health museums thrived between 1910 and 1940. On the museological path about the human body self-care we went from the emotionally involving anatomical Venuses to the inexpressive Transparent Man, from anatomical specimens of ill organs and deformed subjects to the mechanical and electronic models of the healthy body. Today the body is made transparent by the new medical diagnostics and by the latest discoveries of endoscopy. The way museums and science centers presently display the human body involves computers, 3D animation, digital technologies, hands-on models of large size human parts.

Kuusalus saab rattad alla autotreileritööstus / Peep Talimaa

Index Scriptorium Estoniae

Talimaa, Peep

2008-01-01

OÜ-le Trucks & Trailers kuuluvast Kuusalu treileritehasest. Lisa: Kuusalu treileritehase ajalugu ja eellugu; Autotreileri valmimine; Üldandmeid treilerite kohta; Kuusalu treileritehase ajalugu ja eellugu

Jahindus = Hunting / Jüri Tõnisson, Kaarel Roht, Peep Männil

Index Scriptorium Estoniae

Tõnisson, Jüri, 1946-

2007-01-01

Jahimeeste poolt loendatavate ulukite arvukus ja küttimine. Statistilised andmed 1985-2005. aasta jahihooajast. Põdra arvukus ja küttimine 1960-2005. Erinevate jahiulukite populatsioonide seisund Eesti metsades. Tabelid, diagrammid, graafikud

Jahindus = Hunting / Jüri Tõnisson, Kaarel Roht, Peep Männil

Index Scriptorium Estoniae

Tõnisson, Jüri, 1946-

2008-01-01

Jahimeeste poolt loendatavate ulukite arvukus ja küttimine. Statistilised andmed 1985-2006. aasta jahihooajast. Põdra arvukus ja küttimine 1960-2006. Erinevate jahiulukite populatsioonide seisund Eesti metsades. Tabelid, diagrammid, graafikud

Kes kaitseks Eesti ohvitsere NKVD-KGB laimu eest? / Peep Varju

Index Scriptorium Estoniae

Varju, Peep

2008-01-01

Autor polemiseerib Eesti Ekspressis ilmunud artiklitega Eesti endiste ohvitseride kohta, kus käsitletakse nende väidetavat koostööd KGBga. Vaatluse all on ohvitserid Ain Mere, Harald Nugiseks, Alfons Rebane ja Harald Riipalu

Žürii kommenteerib Kultuurkapitali arhitektuuripreemiaid 2008 / Marika Lõoke, Laila Põdra, Liina Jänes... [jt.

Index Scriptorium Estoniae

2009-01-01

Peapreemia: Markus Kaasik, Andres Ojari, Ilmar Valdur, Mihkel Tüür, Kalle Komissarov (Pärnu Keskraamatukogu hoone), tegevuspreemia: Maarja Kask, Ralf Lõoke, Neeme Külm, Ingrid Ruudi (projekt Gaasitoru 11. Veneetsia arhitektuuribiennaalil), aastapreemia: Maarja Kask, Ralf Lõoke, Karli Luik (Tartu Kesklinna Kooli juurdeehitus) ja Peep Jänes (Raudna Põhikooli spordihoone), sisearhitektuuri preemia: Tea Tammelaan, Malle Jürgenson, Krista Lepland, restaureerimispreemia: Mari Hammer, Tiiu Lõhmus, Helve Ilves, Villu Kadakas (Vanalinna Hariduskolleegiumi hoone)

Rahvusooperi Estonia teatrihoone publikuruumide restaureerimistöödest / Liivi Künnapu

Index Scriptorium Estoniae

Künnapu, Liivi, 1953-

2006-01-01

Arhitektuuriajalooline ülevaade. 2005. a. restaureerimistöödest: garderoob-vestibüülist, peatrepist, ringfuajeedest, teatri- ja Valgest saalist, keldrikorruse ruumidest. Muinsuskaitse eritingimused, järelevalve: Liivi Künnapu. Projekteerijad: Peep Jänes, Indrek Suigussaar, AB Kolde Grupp. Sisekujundus: Juta Lember, Aulo Padar. Teostus: Koger ja Partnerid, projektijuht Indrek Võeras. Laemaali (E. Okas, E. Kits, R. Sagrits) restaureerimine, uuringud: KAR-Grupp. Akustik: Linda Madalik. Bibliogr. lk. 25. 8 vaadet

Experiential Marketing Sebagai Suatu Strategi Dalam Menciptakan Customer Satisfaction Dan Repeat Buying Untuk Meningkatkan Kinerja Pemasaran

OpenAIRE

Indriani, Farida

2006-01-01

Experiential marketing represent the alternative from excellence competition had by company as asset able to improve the marketing performance. Experiential marketing had by company can assist the company to peep out the new idea in each planning compilation, peculiarly in compiling marketing strategy. That way also by improving experiential marketing strategy continously, company quickly can anticipate the change that happened around company through the strategy which application. And with ...

Network Security Risks of Online Social Networking in the Workplace

Science.gov (United States)

2013-11-01

Facebook explains pornographic shock spam, hints at browser vulnera- bility, nakedsecurity. URL – http://nakedsecurity.sophos.com/2011/11/16/ facebook...explains- pornographic -shock-spam-hints-at-browser-vul nerability/. 22 UNCLASSIFIED UNCLASSIFIED DSTO–GD–0772 44. Blatz, J. (2011) CSRF: attack and

Lastekirjandus vallutab uusi tippe : eesti lastekirjandus 2009 / Jaanus Vaiksoo

Index Scriptorium Estoniae

Vaiksoo, Jaanus, 1967-

2010-01-01

Ülevaade 2009. aasta eesti lastekirjandusest. Pikemalt käsitletakse järgmisi autoreid ja nende teoseid: Kadi Hinrikus "Kui emad olid väikesed", Kristiina Kass "Peeter ja mina", Mika Keränen "Varastatud oranž jalgratas", Andrus Kivirähk "Kaka ja kevad", Aino Pervik "Ühes väikses veidras linnas", Maarja Undusk "Päkapikk Ingo", Ilmar Tomusk "Vend Johannes", Indrek Koff "Enne kooli", Piret Raud "Härra Linnu lugu", Wimberg "Suur pidusöök", Artur Jurin "Puru kuningriigi lood II", Joonas Sildre "Maailma naba", kogumik "Uued eesti muinasjutud", Aino Pervik "Tirilinna lood", Aimeé Beekman "Päästekoer Walter", Eve Ernis "Karupoeg Nummi seiklused", Priit Aimla "Torisev vanatoi", Juhani Püttsepp "Väikese hundi lood" ja "Lauajupi Madonna", Epp Petrone "Siis, kui seened veel rääkisid", Heiki Vilep "Habemega nali", "Nõiutud linn", Leelo Tungal "Naljatilgad lähevad laulupeole", "Kama üks ja kama kaks", koos Peep Pedmansoniga Miriami lood"(esimene 3D-piltidega lasteraamat), Aidi Vallik "Pints ja Tutsik" 2. osa, Mare Müürsepp "Viis vaba kutsikat", Tiia Selli "Kass Kriibik", Aleksei Turovski "Kassipoeg Võilill", Kaider Vardja "Vana maja lugu", Merca "Mullivesi", Ülle Kütsen "Väike puu ja rändur kuu", Lehte Hainsalu "Mängiks midagi", Peep Veedla "Pöialpoiss"

Glutamine Attenuates Acute Lung Injury Caused by Acid Aspiration

Directory of Open Access Journals (Sweden)

Chih-Cheng Lai

2014-08-01

Full Text Available Inadequate ventilator settings may cause overwhelming inflammatory responses associated with ventilator-induced lung injury (VILI in patients with acute respiratory distress syndrome (ARDS. Here, we examined potential benefits of glutamine (GLN on a two-hit model for VILI after acid aspiration-induced lung injury in rats. Rats were intratracheally challenged with hydrochloric acid as a first hit to induce lung inflammation, then randomly received intravenous GLN or lactated Ringer’s solution (vehicle control thirty min before different ventilator strategies. Rats were then randomized to receive mechanical ventilation as a second hit with a high tidal volume (TV of 15 mL/kg and zero positive end-expiratory pressure (PEEP or a low TV of 6 mL/kg with PEEP of 5 cm H2O. We evaluated lung oxygenation, inflammation, mechanics, and histology. After ventilator use for 4 h, high TV resulted in greater lung injury physiologic and biologic indices. Compared with vehicle treated rats, GLN administration attenuated lung injury, with improved oxygenation and static compliance, and decreased respiratory elastance, lung edema, extended lung destruction (lung injury scores and lung histology, neutrophil recruitment in the lung, and cytokine production. Thus, GLN administration improved the physiologic and biologic profiles of this experimental model of VILI based on the two-hit theory.

Ernesto Achille Preatoni

Index Scriptorium Estoniae

2001-01-01

Äripäeva ajakirjanike Peeter Raidla, Sulev Olli, Peep Soomani ja Inno tähismaa artiklid Ernesto Preatoni tegevusest Eestis ja välismaal: Ühispanga hõivamine; Grandioossed plaanid; Sõprus Arco Varaga; Minek börsile ja naaberriikidesse; Kiire kõrvalpõige väikepankadesse; Oma panga loomine; Eesti kodaniku ajastu; Pro Kapitali kodusõda; Lõppvaatus ja Tallinna börsilt lahkumine; Pro Kapital tegutses; Võitlus eesti ajakirjandusega; Kaubanduskeskuse ja sinimajade tooja

El proyecto «escuela: espacio de paz» como elementos de mejora de la convivencia escolar

Directory of Open Access Journals (Sweden)

M.ª Ángeles DÍAZ LINARES

2010-11-01

Full Text Available En la tesis doctoral presentada se aborda el estudio llevado a cabo en centros públicos y concertados, de distintos niveles educativos no universitarios de la Comunidad Autónoma de Andalucía, con el fin de determinar si los Proyectos «escuela: espacio de Paz» (PeeP son instrumentos capaces de prevenir la violencia y mejorar la convivencia, en el marco del Proyecto educativo de los centros escolares.

HINT-KB: The human interactome knowledge base

KAUST Repository

Theofilatos, Konstantinos A.; Dimitrakopoulos, Christos M.; Kleftogiannis, Dimitrios A.; Moschopoulos, Charalampos N.; Papadimitriou, Stergios; Likothanassis, Spiridon D.; Mavroudi, Seferina P.

2012-01-01

Proteins and their interactions are considered to play a significant role in many cellular processes. The identification of Protein-Protein interactions (PPIs) in human is an open research area. Many Databases, which contain information about

Recommender System for Learning SQL Using Hints

Science.gov (United States)

Lavbic, Dejan; Matek, Tadej; Zrnec, Aljaž

2017-01-01

Today's software industry requires individuals who are proficient in as many programming languages as possible. Structured query language (SQL), as an adopted standard, is no exception, as it is the most widely used query language to retrieve and manipulate data. However, the process of learning SQL turns out to be challenging. The need for a…

Tunne bossanova plaadiümbriselt / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2004-01-01

Kahekorruseline eramu (285 m2), mille merepoolne sein on klaasist. Läbiv idee - silmside loodusega. Arhitekt ja sisearhitekt Tarmo Piirmets, tema kommentaar. Ill.: I ja II korruse plaan, 13 värv. vaadet

Nursing knowledge: hints from the placebo effect.

Science.gov (United States)

Zanotti, Renzo; Chiffi, Daniele

2017-07-01

Nursing knowledge stems from a dynamic interplay between population-based scientific knowledge (the general) and specific clinical cases (the particular). We compared the 'cascade model of knowledge translation', also known as 'classical biomedical model' in clinical practice (in which knowledge gained at population level may be applied directly to a specific clinical context), with an emergentist model of knowledge translation. The structure and dynamics of nursing knowledge are outlined, adopting the distinction between epistemic and non-epistemic values. Then, a (moderately) emergentist approach to nursing knowledge is proposed, based on the assumption of a two-way flow from the general to the particular and vice versa. The case of the 'placebo effect' is analysed as an example of emergentist knowledge. The placebo effect is usually considered difficult to be explained within the classical biomedical model, and we underscore its importance in shaping nursing knowledge. In fact, nurses are primarily responsible for administering placebo in the clinical setting and have an essential role in promoting the placebo effect and reducing the nocebo effect. The beliefs responsible for the placebo effect are as follows: (1) interactive, because they depend on the relationship between patients and health care professionals; (2) situated, because they occur in a given clinical context related to certain rituals; and (3) grounded on higher order beliefs concerning what an individual thinks about the beliefs of others. It is essential to know the clinical context and to understand other people's beliefs to make sense of the placebo effect. The placebo effect only works when the (higher order) beliefs of doctors, nurses and patients interact in a given setting. Finally, we argue for a close relationship between placebo effect and nursing knowledge. © 2016 John Wiley & Sons Ltd.

Election Year Hints at Shifts for Unions

Science.gov (United States)

Honawar, Vaishali; Keller, Bess

2008-01-01

The National Education Association is poised for a change in leadership this year as its president of six years, Reg Weaver, bumps up against term limits. Now, speculation is widespread that Edward J. McElroy, his counterpart at the American Federation of Teachers, might not seek re-election in July. The possible exit of Mr. McElroy--and the…

Unsupervised MDP Value Selection for Automating ITS Capabilities

Science.gov (United States)

Stamper, John; Barnes, Tiffany

2009-01-01

We seek to simplify the creation of intelligent tutors by using student data acquired from standard computer aided instruction (CAI) in conjunction with educational data mining methods to automatically generate adaptive hints. In our previous work, we have automatically generated hints for logic tutoring by constructing a Markov Decision Process…

Web-Based Quiz-Game-Like Formative Assessment: Development and Evaluation

Science.gov (United States)

Wang, Tzu-Hua

2008-01-01

This research aims to develop a multiple-choice Web-based quiz-game-like formative assessment system, named GAM-WATA. The unique design of "Ask-Hint Strategy" turns the Web-based formative assessment into an online quiz game. "Ask-Hint Strategy" is composed of "Prune Strategy" and "Call-in Strategy".…

Intracellular pH distribution as a cell health indicator in Saccharomyces cerevisiae

DEFF Research Database (Denmark)

Aabo, Thomas; Glückstad, Jesper; Siegumfeldt, Henrik

2011-01-01

.d.(pHint)) to describe the internal pH distributions. The cellular pH distributional response to external stress such as heat has not previously been determined. In this study, the intracellular pH (pHi) and the s.d.(pHint) of Saccharomyces cerevisiae cells exposed to supralethal temperatures were measured using...

A high-flow nasal cannula system with relatively low flow effectively washes out CO2 from the anatomical dead space in a sophisticated respiratory model made by a 3D printer.

Science.gov (United States)

Onodera, Yu; Akimoto, Ryo; Suzuki, Hiroto; Okada, Masayuki; Nakane, Masaki; Kawamae, Kaneyuki

2018-03-15

Although clinical studies of the high-flow nasal cannula (HFNC) and its effect on positive end-expiratory pressure (PEEP) have been done, the washout effect has not been well evaluated. Therefore, we made an experimental respiratory model to evaluate the respiratory physiological effect of HFNC. An airway model was made by a 3D printer using the craniocervical 3D-CT data of a healthy 32-year-old male. CO 2 was infused into four respiratory lung models (normal-lung, open- and closed-mouth models; restrictive- and obstructive-lung, open-mouth models) to maintain the partial pressure of end-tidal CO 2 (P ET CO 2 ) at 40 mmHg. HFNC flow was changed from 10 to 60 L/min. Capnograms were recorded at the upper pharynx, oral cavity, subglottic, and inlet sites of each lung model. With the normal-lung, open-mouth model, 10 L/min of HFNC flow decreased the subglottic P ET CO 2 to 30 mmHg. Increasing the HFNC flow did not further decrease the subglottic P ET CO 2 . With the normal-lung, closed-mouth model, HFNC flow of 40 L/min was required to decrease the P ET CO 2 at all sites. Subglottic P ET CO 2 reached 30 mmHg with an HFNC flow of 60 L/min. In the obstructive-lung, open-mouth model, P ET CO 2 at all sites had the same trend as in the normal-lung, open-mouth model. In the restrictive-lung, open-mouth model, 20 L/min of HFNC flow decreased the subglottic P ET CO 2 to 25 mmHg, and it did not decrease further. As HFNC flow was increased, PEEP up to 7 cmH 2 O was gradually generated in the open-mouth models and up to 17 cmH 2 O in the normal-lung, closed-mouth model. The washout effect of the HFNC was effective with relatively low flow in the open-mouth models. The closed-mouth model needed more flow to generate a washout effect. Therefore, HFNC flow should be considered based on the need for the washout effect or PEEP.

"Don't know" responses to risk perception measures: implications for underserved populations.

Science.gov (United States)

Waters, Erika A; Hay, Jennifer L; Orom, Heather; Kiviniemi, Marc T; Drake, Bettina F

2013-02-01

Risk perceptions are legitimate targets for behavioral interventions because they can motivate medical decisions and health behaviors. However, some survey respondents may not know (or may not indicate) their risk perceptions. The scope of "don't know" (DK) responding is unknown. Examine the prevalence and correlates of responding DK to items assessing perceived risk of colorectal cancer. Two nationally representative, population-based, cross-sectional surveys (2005 National Health Interview Survey [NHIS]; 2005 Health Information National Trends Survey [HINTS]), and one primary care clinic-based survey comprised of individuals from low-income communities. Analyses included 31,202 (NHIS), 1,937 (HINTS), and 769 (clinic) individuals. Five items assessed perceived risk of colorectal cancer. Four of the items differed in format and/or response scale: comparative risk (NHIS, HINTS); absolute risk (HINTS, clinic), and "likelihood" and "chance" response scales (clinic). Only the clinic-based survey included an explicit DK response option. "Don't know" responding was 6.9% (NHIS), 7.5% (HINTS-comparative), and 8.7% (HINTS-absolute). "Don't know" responding was 49.1% and 69.3% for the "chance" and "likely" response options (clinic). Correlates of DK responding were characteristics generally associated with disparities (e.g., low education), but the pattern of results varied among samples, question formats, and response scales. The surveys were developed independently and employed different methodologies and items. Consequently, the results were not directly comparable. There may be multiple explanations for differences in the magnitude and characteristics of DK responding. "Don't know" responding is more prevalent in populations affected by health disparities. Either not assessing or not analyzing DK responses could further disenfranchise these populations and negatively affect the validity of research and the efficacy of interventions seeking to eliminate health disparities.

Ventilator-driven xenon ventilation studies

International Nuclear Information System (INIS)

Chilcoat, R.T.; Thomas, F.D.; Gerson, J.I.

1984-01-01

A modification of a common commercial Xe-133 ventilation device is described for mechanically assisted ventilation imaging. The patient's standard ventilator serves as the power source controlling the ventilatory rate and volume during the xenon study, but the gases in the two systems are not intermixed. This avoids contamination of the ventilator with radioactive xenon. Supplemental oxygen and positive end-expiratory pressure (PEEP) are provided if needed. The system can be converted quickly for conventional studies with spontaneous respiration

Coherent Change Detection with COSMO SkyMed Data-experimental Results

OpenAIRE

A. Mishra; D. Chaudhuri; C. Bhattacharya; Y.S. Rao

2013-01-01

Change detection is a technique in which we try to find changes between two acquisitions. These acquisitions can be from different platforms and sensors. Acquisition from satellite using synthetic aperture radar (SAR) is of immense interest to military applications. Satellite has the ability to peep into the enemy territory while SAR has the capability of day and night operations, being an active sensor. Coherent change detection (CCD) can be used to detect minute changes between two images. ...

Kuidas ühiskondlikus leppes lubatud hea tuntavaks tehakse? / Jaak Aaviksoo, Jüri Tamm, Kaul Nurm...[jt.

Index Scriptorium Estoniae

2003-01-01

Küsimusele "missugune oleks nende panus ja plaan esimese aasta jooksul ühiskondlikus leppes fikseeritud eesmärkide saavutamiseks" vastavad Tartu Ülikooli rektor Jaak Aaviksoo, EOK asepresident Jüri Tamm, Eestimaa Talupidajate Keskliidu peadirektor Kaul Nurm, Eesti Kirikute Nõukogu täitevsekretär Eerik Jõks, Eesti Ühistegelise Liidu juhatuse esimees Urmas Laht, Eesti Väike- ja Keskettevõtjate Assotsiatsiooni juhataja Riina Danilson ning Reformierakonna pressinõunik Peep Lillemägi. Samas ka karikatuur

Eesti tipprallimehed koondusid ühise kaubamärgi alla / Peep Pahv

Index Scriptorium Estoniae

Pahv, Peep, 1970-

2008-01-01

WRC-sarjas osalevad Urmo Aava ja Kuldar Sikk, PWRC-sarjas startivad Martin Rauam ja Silver Kütt ning juunioride sarjas sõitvad Jaan Mölder ja kaardilugeja Frederic Miclotte on tänavusteks võistlusteks registreerinud võistkonna World Rally Team Estonia

Nuclear physics in India: a perspective and a peep into future

International Nuclear Information System (INIS)

Hans, H.S.

1986-01-01

Research in the field of nuclear physics in India began some 40 years ago. A brief account of the research activities in both experimental and theoretical nuclear physics is given. It is noted, that the research so far made and being conducted does not match the international standards. So far no new experimental or calculational techniques in accelerator technology has been developed in India. So also no new experiment based on an experimental or theoretical idea developed for the first time in India has been performed. Reasons for giving high priority to the development of nuclear physics as one of the most basic subjects of physics are discussed. Programmes for future must be formulated in such a way that the available funds are put to optimum use. For this purpose it is suggested that: (1) there should be a partnership between universities and the Department of Atomic Energy in setting up of the experimental facilities, (2) there should be corresponding change in the administrative procedures of the universities (3) collaborative programmes with foreign countries should be taken up with the aim of achieving self-sufficiency and to raise the level of research to that of international standards, (4) an attempt should be made to develop an Asian Centre of Nuclear Physics in India which should house a proton synchrotron and a high energy linear accelerator around which research activities in medium energy range can be developed, (5) the universities should be encouraged to develop strong theoretical nuclear physics centres, and (6) schools of theoretical nuclear physics around very good senior research scientists should be developed. (M.G.B.)

Peeping thread from a laparotomy scar: Misery of an old man

Directory of Open Access Journals (Sweden)

Ramesh Aggarwal

2012-01-01

Full Text Available Despite availability of modern methods of various surgical techniques for treating complicated patients, there are still some unreported incidents in day to day practice where simple surgical procedure ends up in unwanted complications. This may be attributed sometimes to the negligence of treating doctors and sometime to the patient himself. We present here one such case where unnecessary morbidity added to the patient after surgery.

Vabale turule pole alternatiivi / Johnny Munkhammar ; interv. Lillemägi, Peep

Index Scriptorium Estoniae

Munkhammar, Johnny

2008-01-01

Konverentsil Restart esinenud Rootsi majandusanalüütik ja kommentaator võrdleb praegust kriisi 1929. aasta omaga, tema arvates on tegu poliitikute möödalaskmistega, mitte turumajanduse läbikukkumistega. Nüüd oli vaja valitsuste sekkumist, kuid kaugemas perspektiivis pole valitsuste sekkumine turumehhanismide toimimisse õige

Johan Kõpu pärand on mitmekülgne / Peep Pillak

Index Scriptorium Estoniae

Pillak, Peep

2008-01-01

rets. rmt.: Rohtmets, Priit. Rektor Johan Kõpp / toimetaja Mart Orav; resümeede tõlge: saksa keelde Reet Bender, inglise keelde Saskia Kangro, vene keelde A & A Lingua; kujundus Kalle Toompere. Tallinn : Aasta Raamat, 2007. 144 lk.

Peeping through heart′s window: A case report of Fallots tetralogy

Directory of Open Access Journals (Sweden)

Bhowate R

2005-03-01

Full Text Available Tetralogy of Fallot is a congenital heart defect. A combination of four abnormalities in heart allow oxygen rich and oxygen-depleted blood to mix. The resulting low-oxygen blood then circulates through the body. A child with the condition tends to develop slowly, eat poorly and grow slowly and may experience "blue" spells on crying and dyspnea on exertion. A 12 year old child with this congenital heart defect and cleft palate with cleft lip is discussed. Details of the latest diagnostic and treatment procedures are also presented.

The Clinical Utilisation of Respiratory Elastance Software (CURE Soft): a bedside software for real-time respiratory mechanics monitoring and mechanical ventilation management.

Science.gov (United States)

Szlavecz, Akos; Chiew, Yeong Shiong; Redmond, Daniel; Beatson, Alex; Glassenbury, Daniel; Corbett, Simon; Major, Vincent; Pretty, Christopher; Shaw, Geoffrey M; Benyo, Balazs; Desaive, Thomas; Chase, J Geoffrey

2014-09-30

Real-time patient respiratory mechanics estimation can be used to guide mechanical ventilation settings, particularly, positive end-expiratory pressure (PEEP). This work presents a software, Clinical Utilisation of Respiratory Elastance (CURE Soft), using a time-varying respiratory elastance model to offer this ability to aid in mechanical ventilation treatment. CURE Soft is a desktop application developed in JAVA. It has two modes of operation, 1) Online real-time monitoring decision support and, 2) Offline for user education purposes, auditing, or reviewing patient care. The CURE Soft has been tested in mechanically ventilated patients with respiratory failure. The clinical protocol, software testing and use of the data were approved by the New Zealand Southern Regional Ethics Committee. Using CURE Soft, patient's respiratory mechanics response to treatment and clinical protocol were monitored. Results showed that the patient's respiratory elastance (Stiffness) changed with the use of muscle relaxants, and responded differently to ventilator settings. This information can be used to guide mechanical ventilation therapy and titrate optimal ventilator PEEP. CURE Soft enables real-time calculation of model-based respiratory mechanics for mechanically ventilated patients. Results showed that the system is able to provide detailed, previously unavailable information on patient-specific respiratory mechanics and response to therapy in real-time. The additional insight available to clinicians provides the potential for improved decision-making, and thus improved patient care and outcomes.

[USE OF PROTECTIVE LUNG VENTILATION REGIMEN IN CARDIAC SURGERY PATIENTS.

Science.gov (United States)

Pshenichniy, T A; Akselrod, B A; Titova, I V; Trekova, N A; Khrustaleva, M V

2017-09-01

In cardiac surgery, protective lung ventilation and/or preventive brdnchoscopy (PB) are able to decrease lung injury effects of cardiopulmonary bypass (CPB) and mechanical ventilation. define lung complication risks, evaluate the effect ofprotective lung ventilation (PLV) on lung functioning, and investigate the feasibility ofpreventive PB in higher pulmonary risk (PR) patients. 66 patients participated in prospective randomized research. Allocation was based on PR and intraoperative mechanical ventilation type. PLV includedfollowing parameters: PCK PIP - up to 20 cm H20, Vt - 6 ml/ kg of PBW, PEEP - 5-10 cm H20, IE ratio - 1:1.5-1:1, EtCO2 - 35-42 mm Hg, FiO2 - 45-60%, lung ventilation during CPB, alveolar recruitment. Four groups were formed: A - higher PR plus PLV- B - higher PR plus conventional LV (CLV), C - lower PR plus PLV- D - lower PR plus CLV PIP PEEP dynamic compliance, p/f ratio and intrapulmonary shunt (Qs/Qt) were recorded. Seventeen patients of group A underwent PB. Advanced dynamic compliance, higher p/f ratio and lower Qs/Qt were seen in group A, in comparison with group B (pProtective lung ventilation improves lung biomechanics and oxygenating function in higher risk patients and decreases intrapulmonary shunt fraction in higher and lower risk patients. Addictive preventive bronchoscopy can be successfully used in higher risk patients.

A novel mechanical lung model of pulmonary diseases to assist with teaching and training

Directory of Open Access Journals (Sweden)

Shaw Geoffrey M

2006-08-01

Full Text Available Abstract Background A design concept of low-cost, simple, fully mechanical model of a mechanically ventilated, passively breathing lung is developed. An example model is built to simulate a patient under mechanical ventilation with accurate volumes and compliances, while connected directly to a ventilator. Methods The lung is modelled with multiple units, represented by rubber bellows, with adjustable weights placed on bellows to simulate compartments of different superimposed pressure and compliance, as well as different levels of lung disease, such as Acute Respiratory Distress Syndrome (ARDS. The model was directly connected to a ventilator and the resulting pressure volume curves recorded. Results The model effectively captures the fundamental lung dynamics for a variety of conditions, and showed the effects of different ventilator settings. It was particularly effective at showing the impact of Positive End Expiratory Pressure (PEEP therapy on lung recruitment to improve oxygenation, a particulary difficult dynamic to capture. Conclusion Application of PEEP therapy is difficult to teach and demonstrate clearly. Therefore, the model provide opportunity to train, teach, and aid further understanding of lung mechanics and the treatment of lung diseases in critical care, such as ARDS and asthma. Finally, the model's pure mechanical nature and accurate lung volumes mean that all results are both clearly visible and thus intuitively simple to grasp.

Functional flexibility in wild bonobo vocal behaviour

Directory of Open Access Journals (Sweden)

Zanna Clay

2015-08-01

Full Text Available A shared principle in the evolution of language and the development of speech is the emergence of functional flexibility, the capacity of vocal signals to express a range of emotional states independently of context and biological function. Functional flexibility has recently been demonstrated in the vocalisations of pre-linguistic human infants, which has been contrasted to the functionally fixed vocal behaviour of non-human primates. Here, we revisited the presumed chasm in functional flexibility between human and non-human primate vocal behaviour, with a study on our closest living primate relatives, the bonobo (Pan paniscus. We found that wild bonobos use a specific call type (the “peep” across a range of contexts that cover the full valence range (positive-neutral-negative in much of their daily activities, including feeding, travel, rest, aggression, alarm, nesting and grooming. Peeps were produced in functionally flexible ways in some contexts, but not others. Crucially, calls did not vary acoustically between neutral and positive contexts, suggesting that recipients take pragmatic information into account to make inferences about call meaning. In comparison, peeps during negative contexts were acoustically distinct. Our data suggest that the capacity for functional flexibility has evolutionary roots that predate the evolution of human speech. We interpret this evidence as an example of an evolutionary early transition away from fixed vocal signalling towards functional flexibility.

A Quality Improvement Initiative to Reduce the Need for Mechanical Ventilation in Extremely Low Gestational Age Neonates.

Science.gov (United States)

Templin, Ludivine; Grosse, Camille; Andres, Virginie; Robert, Clotilde Des; Fayol, Laurence; Simeoni, Umberto; Boubred, Farid

2017-07-01

Objective  Limiting early intubation and mechanical ventilation in extremely low gestational age neonates (ELGAN) may decrease neonatal morbidity and mortality. The aim of our study was to demonstrate the feasibility, efficacy, and tolerability of a delivery room respiratory management protocol, including delayed umbilical cord clamping (DUCC) in combination with optimized nCPAP with high PEEP levels and less invasive surfactant administration (LISA). Study Design  This cohort quality improvement study analyzed the respiratory and neonatal outcomes of all consecutive infants born between 24 +0 and 26 +6 weeks' gestation before (period 1, n  = 40) and after (period 2, n  = 52) implementing the new protocol. Results  Compared with the period 1 infants, the period 2 infants had a lower rate of intubation in the delivery room (31 vs. 90%, p  = 0.001) and were less likely to need mechanical ventilation on day 3 (28 vs. 62%, p  = 0.002) and during the hospital stay (75 vs. 92.5%, p  < 0.05). The two groups did not differ in terms of mortality or neonatal morbidity. Conclusion  A delivery room respiratory management protocol based on DUCC, optimized nCPAP with high PEEP levels, and LISA procedure is both feasible and safe, and improved ELGAN respiratory outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effects of vertical positioning on gas exchange and lung volumes in acute respiratory distress syndrome.

Science.gov (United States)

Richard, Jean-Christophe M; Maggiore, Salvatore Maurizio; Mancebo, Jordi; Lemaire, François; Jonson, Bjorn; Brochard, Laurent

2006-10-01

Supine position may contribute to the loss of aerated lung volume in patients with acute respiratory distress syndrome (ARDS). We hypothesized that verticalization increases lung volume and improves gas exchange by reducing the pressure surrounding lung bases. Prospective observational physiological study in a medical ICU. In 16 patients with ARDS we measured arterial blood gases, pressure-volume curves of the respiratory system recorded from positive-end expiratory pressure (PEEP), and changes in lung volume in supine and vertical positions (trunk elevated at 45 degrees and legs down at 45 degrees ). Vertical positioning increased PaO(2) significantly from 94+/-33 to 142+/-49 mmHg, with an increase higher than 40% in 11 responders. The volume at 20 cmH(2)O measured on the PV curve from PEEP increased using the vertical position only in responders (233+/-146 vs. -8+/-9 1ml in nonresponders); this change was correlated to oxygenation change (rho=0.55). End-expiratory lung volume variation from supine to vertical and 1 h later back to supine, measured in 12 patients showed a significant increase during the 1-h upright period in responders (n=7) but not in nonresponders (n=5; 215+/-220 vs. 10+/-22 ml), suggesting a time-dependent recruitment. Vertical positioning is a simple technique that may improve oxygenation and lung recruitment in ARDS patients.

Personalizing mechanical ventilation for acute respiratory distress syndrome.

Science.gov (United States)

Berngard, S Clark; Beitler, Jeremy R; Malhotra, Atul

2016-03-01

Lung-protective ventilation with low tidal volumes remains the cornerstone for treating patient with acute respiratory distress syndrome (ARDS). Personalizing such an approach to each patient's unique physiology may improve outcomes further. Many factors should be considered when mechanically ventilating a critically ill patient with ARDS. Estimations of transpulmonary pressures as well as individual's hemodynamics and respiratory mechanics should influence PEEP decisions as well as response to therapy (recruitability). This summary will emphasize the potential role of personalized therapy in mechanical ventilation.

Maaülikooli uksed uutele tulijatele valla / Sirje Pärismaa

Index Scriptorium Estoniae

Pärismaa, Sirje, 1958-

2008-01-01

Oma õpingutest räägivad maaülikooli tudengid: Kadi Avi (majandusarvestus ja finantsjuhtimine III), Kaiti Pilk (maastikuarhitekt III), Mart Kelk (metsatööstuse magistrantuur I), Karin Ojamäe (rakendushüdrobioloogia III), Heidi Heitur (ökonoomika ja ettevõtlus I); Margus Paesalu (metsatööstus III), Kadri Kalle ( maastikukaitse ja -hoolduse magistrantuur I), Liisi Õunapuu (loodusvarade kasutamine ja kaitse III), Laura Niemelä (veterinaarmeditsiin IV) ja Peep Teppo (metsamajanduse magistrantuur II) ning õppeprorektor Jüri Lehtsaar

Light weakly interacting massive particles

Science.gov (United States)

Gelmini, Graciela B.

2017-08-01

Light weakly interacting massive particles (WIMPs) are dark matter particle candidates with weak scale interaction with the known particles, and mass in the GeV to tens of GeV range. Hints of light WIMPs have appeared in several dark matter searches in the last decade. The unprecedented possible coincidence into tantalizingly close regions of mass and cross section of four separate direct detection experimental hints and a potential indirect detection signal in gamma rays from the galactic center, aroused considerable interest in our field. Even if these hints did not so far result in a discovery, they have had a significant impact in our field. Here we review the evidence for and against light WIMPs as dark matter candidates and discuss future relevant experiments and observations.

Estratégias ventilatórias frente à hipoxemia em cirurgia cardíaca: validação de questionário para anestesiologistas no Brasil Estrategias ventilatorias frente a la hipoxemia en cirugía cardíaca: validación de cuestionario para anestesiólogos en Brasil Ventilatory strategies for hypoxemia during cardiac surgery: survey validation for anesthesiologists in Brazil

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Celso Augusto Martins Parra

2010-08-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A hipoxemia perioperatória ocorre frequentemente em cirurgia cardíaca e a atelectasia é sua principal causa. Além disso, podemos citar como causas circulação extracorpórea (CEC, dissecção de artérias torácicas internas, status clínico prévio do paciente, entre outras. O presente estudo elaborou um questionário anônimo para observar as estratégias ventilatórias frente à hipoxemia em cirurgia cardía ca adotadas por cinco mil anestesiologistas distribuídos no país. MÉTODO: Foram enviados questionários por e-mail a cinco mil anestesiologistas do Brasil. RESULTADOS: Dos questionários enviados, foram recebidas 81 respostas válidas. Dentre as respostas, 65 (80% anestesiologistas fazem uso da ventilação controlada a volume (VCV frente a 16 (20% que preferem ventilação controlada à pressão (PCV. O volume (Vt corrente utilizado é inferior a 10 mL.kg-1 para 46 (61% contra 29 (39% que adotam um Vt maior que 10 mL.kg-1. Quarenta e sete (58% usam PEEP e 17 (21% utilizam FiO2 acima de 60%. No caso de hipoxemia intraoperatória, 20,9% aumentam ou introduzem PEEP, 70,3% aumentam a FiO2, 19,7% realizam manobra de recrutamento alveolar, 13,5% aumentam o volume-corrente e 20,9% realizam checagem de falhas no aparelho de anestesia. As respostas foram enviadas de 15 estados. CONCLUSÕES: As condutas descritas nos questionários respondidos são compatíveis com a literatura internacional. Com ajuste no formato do questionário e na abordagem aos anestesiologistas, novos estudos poderão ser realizados.JUSTIFICATIVA Y OBJETIVOS: La hipoxemia perioperatoria ocurre frecuentemente en la cirugía cardíaca, y la atelectasia es su principal causa. Además, podemos citar como causas la circulación extracorpórea (CEC, disección de arterias torácicas internas, status clínico previo del paciente, entre otras. El presente estudio elaboró un cuestionario anónimo para observar las estrategias ventilatorias frente a

Food Safety and Quality Control: Hints from Proteomics

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Angelo D'Alessandro

2012-01-01

Full Text Available Over the last decade, proteomics has been successfully applied to the study of quality control in production processes of food (including meat, wine and beer, transgenic plants and milk and food safety (screening for food-derived pathogens. Indeed, food quality and safety and their influence on the health of end consumers have growingly become a founding principle in the international agenda of health organizations. The application of proteomics in food science was at first characterized by exploratory analyses of food of various origin (bovine, swine, chicken or lamb meat, but also transgenic food such as genetically modified maize, for example and beverages (beer, wine, in parallel to the genomic and transcriptomic approaches seeking determination of quantitative trait loci. In the last few years, technical improvements such as microbial biotyping strategies have growingly allowed proteomicists to address the safety issue as well. The newly introduced technical improvements (instrumentation characterized by higher sensitivity such as mass spectrometers have paved the way for the individuation of food-contaminating pathogens in a fast and efficient workflow which is mandatory in industrial food production chains.

An Impending geomagnetic transition? Hints from the past.

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Carlo eLAJ

2015-10-01

Full Text Available The rapid decrease of the geomagnetic field intensity in the last centuries has led to speculations that an attempt to a reversal or an excursion might be under way. Here we investigate this hypothesis by examining past records of geomagnetic field intensity obtained from sedimentary cores and from the study of cosmogenic nuclides. The selected records describe geomagnetic changes with an unprecedented temporal resolution between 20 and 75 kyr B.P. We find that some aspects of the present-day geomagnetic field have some similarities with those documented for the Laschamp excursion 41 kyr ago. Under the assumption that the dynamo processes for an eventual future reversal or excursion would be similar to those of the Laschamp excursion, we tentatively suggest that, whilst irreversible processes that will drive the geodynamo into a polarity change may have already started, a reversal or an excursion should not be expected before 500 to 1000 years.

An impending geomagnetic transition? Hints from the past

OpenAIRE

Laj, Carlo; Kissel, Catherine

2015-01-01

The rapid decrease of the geomagnetic field intensity in the last centuries has led to speculations that an attempt to a reversal or an excursion might be under way. Here we investigate this hypothesis by examining past records of geomagnetic field intensity obtained from sedimentary cores and from the study of cosmogenic nuclides. The selected records describe geomagnetic changes with an unprecedented temporal resolution between 20 and 75 kyr B.P. We find that some aspects of the present-day...

Brotze väljaande filoloogilisi probleeme / Mati Hint

Index Scriptorium Estoniae

Hint, Mati

2007-01-01

Rets. rmt. : Johann Christoph Brotze. Estonica. Koostanud / Herausgegeben von Ants Hein, Ivar Leimus, Raimo Pullat, Ants Viires. Projektijuht ja vastutav toimetaja : Raimo Pullat. tõlge eesti keelde: Tõnis Liibek, Ivar Leimus, tõlge saksa keelde: Aigi Heero, Ene Rõngelep. Kujundus: Andres Tali. Tallinn : Estopol OÜ, 2006. XXXVI, 619 lk. Teoses esinevaid keele- ja kohanimeprobleeme

Ageing collider throws up hint or dark matter

CERN Multimedia

Ananthaswamy, Anil

2008-01-01

"Never mind the Large Hadron Collider at CERN, its ageing predecessor may have discovered a new and unexpected kind of particle. The announcement last week from the Tevatron particle accelerator at Fermilab in Batavai, Illinois, provided some excitement amid the frustration of ongoing repairs to the LHC."

New planet hints at life in the stars

CERN Multimedia

Dalton, A W

2002-01-01

Astronomers have detected a distant planet 100 light years from Earth, circling Tau1 Gruis, its star, in the constellation of Grus (the crane). The planet, similar in appearance to Jupiter, is three times as far away from its star as the Earth is from the Sun and takes four years to revolve around the star, in a roughly circular orbit. Scientists believe this type of planetary orbit is the most promising for finding worlds that contain life (1 page).

Generation of Tutorial Dialogues: Discourse Strategies for Active Learning

Science.gov (United States)

1998-05-29

AND SUBTITLE Generation of Tutorial Dialogues: Discourse Strategies for active Learning AUTHORS Dr. Martha Evens 7. PERFORMING ORGANI2ATION NAME...time the student starts in on a new topic. Michael and Rovick constantly attempt to promote active learning . They regularly use hints and only resort...Controlling active learning : How tutors decide when to generate hints. Proceedings of FLAIRS 󈨣. Melbourne Beach, FL. 157-161. Hume, G., Michael

Avaliação da função pulmonar em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea Evaluación de la función pulmonar en pacientes sometidos a cirugía cardíaca con circulación extracorpórea Evaluation of pulmonary function in patients undergoing cardiac surgery with cardiopulmonary bypass

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Ricardo Antonio Guimarães Barbosa

2002-11-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: As complicações pulmonares permanecem como um grande problema no pós-operatório de cirurgia cardíaca com circulação extracorpórea (CEC. O objetivo do presente estudo foi avaliar as alterações da função pulmonar ocorridas em pacientes submetidos à cirurgia cardíaca de revascularização miocárdica, comparando-os àqueles submetidos à cirurgia cardíaca de troca valvar. MÉTODO: Quinze pacientes submetidos à revascularização (Grupo RM e 15 pacientes submetidos à troca valvar (Grupo TV foram avaliados através da relação entre a pressão arterial de oxigênio e sua fração inspirada (PaO2/FiO2, do gradiente alvéolo-arterial de oxigênio (GA-aO2, do shunt pulmonar, da PEEP de melhor complacência e da complacência estática, avaliados no pré-operatório, após a indução da anestesia, 1, 3 e 6 horas de pós-operatório e no 1º e 2º dias de pós-operatório. Os dados foram analisados através da análise de variância para medidas repetidas (p JUSTIFICATIVA Y OBJETIVOS: Las complicaciones pulmonares permanecen como un grande problema en el pós-operatorio de cirugía cardíaca con circulación extracorpórea (CEC. El objetivo de este actual estudio fue evaluar las alteraciones de la función pulmonar ocurridas en pacientes sometidos a cirugía cardíaca de revascularización miocárdica, comparándolos a aquellos sometidos a cirugía cardíaca de cambio valvar. MÉTODO: Quince pacientes sometidos a revascularización (Grupo RM y 15 pacientes sometidos a cambio valvar (Grupo TV fueron evaluados a través de la relación entre la presión arterial de oxígeno y su fracción inspirada (PaO2/FiO2, del gradiente alvéolo-arterial de oxígeno (GA-aO2, del shunt pulmonar, de la PEEP de mejor Complacencia y de la Complacencia Estática, evaluados en el pré-operatorio, después de la inducción de la anestesia, 1, 3 y 6 horas de pós-operatorio y en el 1º y 2º dias de pós-operatorio. Los datos fueron

Liberação de pressão de vias aéreas em pacientes pediátricos submetidos à cirurgia cardíaca Airway pressure release ventilation in post operative cardiac surgery in pediatric patients

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W. B. de Carvalho

2000-06-01

Full Text Available OBJETIVO: Comparar três modos de VPM, a ventilação mandatória intermitente com pressão expiratória positiva (VMI+PEEP, a VLPVA e a utilização de pressão positiva contínua em vias aéreas (CPAP em crianças no pós-operatório de cirurgia cardíaca com hipertensão pulmonar e lesão pulmonar leve ou moderada. MÉTODOS: Estudados 10 pacientes com monitorização respiratória (Bear Neonatal Volume Monitor-1®, em VPM com aparelho de fluxo contínuo, ciclado a tempo e limitado a pressão. As variáveis cardiocirculatórias analisadas foram a pressão venosa central (PVC, extração de oxigênio (ExtO2, freqüência cardíaca (FC, pressão arterial sistólica (PAS, pressão arterial média (PAM e a diferença artério-venosa de CO2 (D(A-VCO2. Utilizou-se o teste não-paramétrico de Friedman para comparar as variáveis aferidas nas três modalidades de ventilação e o teste de Wilcoxon para a comparação das variáveis obtidas em duas das modalidades. RESULTADOS: A pressão média de vias aéreas (PMVA apresentou um aumento significante durante a VLPVA em relação à VMI+PEEP (p=0,012. A pressão inspiratória positiva (PIP, o volume minuto e a relação da pressão arterial de O2 com a fração inspirada de O2 (PaO2/FiO2 não mostraram diferença estatística. Houve uma diminuição da freqüência respiratória (FR na VLPVA (p=0,004 e um aumento do volume corrente (VC (p=0,045 comparativamente aos outros dois modos de ventilação. A PVC foi a única variável cardiocirculatória que apresentou alteração mostrando ser maior (p=0,019 na VLPVA. CONCLUSÕES: Devido à metodologia empregada, houve um aumento significativo da PMVA na VLPVA, com conseqüente aumento do VC e manutenção das outras variáveis respiratórias e cardiocirculatórias quando comparados os três modos de VPM, indicando ser a VLPVA um método seguro e de fácil aplicação.OBJECTIVE: Comparison of three modes of MV: intermittent mandatory ventilation with

Effect of protective lung ventilation strategy combined with lung recruitment maneuver in patients with acute respiratory distress syndrome (ARDS

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Sheng Yu

2017-01-01

Full Text Available Objective: To evaluate the efficacy and safety of protective lung ventilation strategy combined with lung recruitment maneuver (RM in the treatment patients with acute respiratory distress syndrome (ARDS.Methods: Totally 74 patients with ARDS admitted to the Department of Intensive Care Unit, Changshu Second People's Hospital in Jiangsu Province between September 2010 and June 2013 were selected and randomly divided into lung recruitment group and non-lung recruitment group, and the initial ventilation solution for both groups was synchronized intermittent mandatory ventilation (SIMV. For RM, SIMV mode (pressure control and pressure support was adopted. Positive end expiratory pressure (PEEP was increased by 5 cm H2O every time and maintained for 40-50 s before entering the next increasing period, and the peak airway pressure was kept below 45 cm H2O. After PEEP reached the maximum value, it was gradually reduced by 5 cm H2O every time and finally maintained at 15 cm H2O for 10 min.Results: A total of 74 patients with mean age of (49.0±18.6 years old were enrolled, 36 patients were enrolled in lung recruitment maneuver (RM group and 38 patients were enrolled into non-lung recruitment maneuver (non-RM group. 44 were male and accounted for 59.5% of all the patients. For the indicators such as PEEP, pressure support (PS, plateau airway pressure (Pplat, peak airway pressure (Ppeak, vital capacity (VC and fraction of inspired oxygen (FiO2, no statistical differences in the indicators were found between the RM group and non-RM group on D1, D3 and D7 (P>0.05, except that only FiO2 of RM group on D7 was significantly lower than that of non-RM group (47.2±10.0 vs. (52.2±10.5, P0.05. 28-day mortality, ICU mortality and in-hospital mortality were 25% vs. 28.9%, 25% vs. 26.3% and 36.1% vs. 39.5% respectively between RM group and non-RM group (all P>0.05.Conclusion: Protective lung ventilation strategy combined with lung recruitment maneuver can improve

Comparative analysis of parameters of oxygenation, ventilation and acid-base status during intraoperative application of conventional and protective lung ventilation

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Videnović N.

2015-01-01

Full Text Available The aim of this study was to perform a comparative analysis applied conventional (traditional and protective mechanical lung ventilation in clinical conditions with regard to intraoperative parameters changes of oxygenation, ventilation and acid-base status. This was a prospective study that included 240 patients. All patients underwent the same elective surgery (classic cholecystectomy. Patients were divided into two groups of 120 patients, A and B. In group A during the operation had received conventional lung ventilation with tidal volume of 10-15 ml/kg body weight, respiratory rate 12/min. and a PEEP zero. In group B was applied protective lung ventilation with a tidal volume of 6-8 ml/kg body weight, respiratory rate 12/min. and a PEEP of 7 mbar. Monitoring of oxygenation included the monitoring SaO2 and PaO2. Monitoring of ventilation included the determination of the value of tidal volume and minute volume ventilation, peak inspiratory pressure (Ppeak, medium pressure in the airway (Paw.mean, PEEP, PaCO2 and EtCO2. Monitoring of acid-base status was performed via determination of the pH values of arterial blood. Monitoring was carried out in four intervals: T1 - 5-10 minutes after the establishment of the airway, T2 - after opening peritoneum, T3 - after removal of the gallbladder, T4 - after the closure of the abdominal wall. All monitoring results are presented as mean. The statistical significance of differences in mean values was tested by t - test mean values in the case of two independent samples. As a statistical significance test taken as standard values p <0.01 and p <0.001. Comparative analysis of the value of SaO2, PaO2, Ppeak did not reach statistical significance. Statistical significance there is in the analysis of values of tidal volume and Paw.mean (p <0.001. Analysis of PaCO2 and pH of arterial blood showed no statistical significance in the first interval measurements but did interval T2-T4 (p <0.001. Based on the

A Short Period of Ventilation without Perfusion Seems to Reduce Atelectasis without Harming the Lungs during Ex Vivo Lung Perfusion

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Sandra Lindstedt

2013-01-01

Full Text Available To evaluate the lung function of donors after circulatory deaths (DCDs, ex vivo lung perfusion (EVLP has been shown to be a valuable method. We present modified EVLP where lung atelectasis is removed, while the lung perfusion is temporarily shut down. Twelve pigs were randomized into two groups: modified EVLP and conventional EVLP. When the lungs had reached 37°C in the EVLP circuit, lung perfusion was temporarily shut down in the modified EVLP group, and positive end-expiratory pressure (PEEP was increased to 10 cm H2O for 10 minutes. In the conventional EVLP group, PEEP was increased to 10 cm H2O for 10 minutes with unchanged lung perfusion. In the modified EVLP group, the arterial oxygen partial pressure (PaO2 was 18.5 ± 7.0 kPa before and 64.5 ± 6.0 kPa after the maneuver (P<0.001. In the conventional EVLP group, the PaO2 was 16.8 ± 3.1 kPa and 46.8 ± 2.7 kPa after the maneuver (P<0.01; P<0.01. In the modified EVLP group, the pulmonary graft weight was unchanged, while in the conventional EVLP group, the pulmonary graft weight was significantly increased. Modified EVLP with normoventilation of the lungs without ongoing lung perfusion for 10 minutes may eliminate atelectasis almost completely without harming the lungs.

Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome.

Science.gov (United States)

Fanelli, Vito; Ranieri, Marco V; Mancebo, Jordi; Moerer, Onnen; Quintel, Michael; Morley, Scott; Moran, Indalecio; Parrilla, Francisco; Costamagna, Andrea; Gaudiosi, Marco; Combes, Alain

2016-02-10

Mechanical ventilation with a tidal volume (VT) of 6 mL/kg/predicted body weight (PBW), to maintain plateau pressure (Pplat) lower than 30 cmH2O, does not completely avoid the risk of ventilator induced lung injury (VILI). The aim of this study was to evaluate safety and feasibility of a ventilation strategy consisting of very low VT combined with extracorporeal carbon dioxide removal (ECCO2R). In fifteen patients with moderate ARDS, VT was reduced from baseline to 4 mL/kg PBW while PEEP was increased to target a plateau pressure--(Pplat) between 23 and 25 cmH2O. Low-flow ECCO2R was initiated when respiratory acidosis developed (pH 60 mmHg). Ventilation parameters (VT, respiratory rate, PEEP), respiratory compliance (CRS), driving pressure (DeltaP = VT/CRS), arterial blood gases, and ECCO2R system operational characteristics were collected during the period of ultra-protective ventilation. Patients were weaned from ECCO2R when PaO2/FiO2 was higher than 200 and could tolerate conventional ventilation settings. Complications, mortality at day 28, need for prone positioning and extracorporeal membrane oxygenation, and data on weaning from both MV and ECCO2R were also collected. During the 2 h run in phase, VT reduction from baseline (6.2 mL/kg PBW) to approximately 4 mL/kg PBW caused respiratory acidosis (pH protective mechanical ventilation strategy in patients with moderate ARDS.

Feasibility and safety of low-flow extracorporeal CO2 removal managed with a renal replacement platform to enhance lung-protective ventilation of patients with mild-to-moderate ARDS.

Science.gov (United States)

Schmidt, Matthieu; Jaber, Samir; Zogheib, Elie; Godet, Thomas; Capellier, Gilles; Combes, Alain

2018-05-10

Extracorporeal carbon-dioxide removal (ECCO 2 R) might allow ultraprotective mechanical ventilation with lower tidal volume (VT) (ventilator-induced lung injury. This study was undertaken to assess the feasibility and safety of ECCO 2 R managed with a renal replacement therapy (RRT) platform to enable very low tidal volume ventilation of patients with mild-to-moderate acute respiratory distress syndrome (ARDS). Twenty patients with mild (n = 8) or moderate (n = 12) ARDS were included. VT was gradually lowered from 6 to 5, 4.5, and 4 ml/kg, and PEEP adjusted to reach 23 ≤ P plat  ≤ 25 cmH 2 O. Standalone ECCO 2 R (no hemofilter associated with the RRT platform) was initiated when arterial PaCO 2 increased by > 20% from its initial value. Ventilation parameters (VT, respiratory rate, PEEP), respiratory system compliance, P plat and driving pressure, arterial blood gases, and ECCO 2 R-system operational characteristics were collected during at least 24 h of very low tidal volume ventilation. Complications, day-28 mortality, need for adjuvant therapies, and data on weaning off ECCO 2 R and mechanical ventilation were also recorded. While VT was reduced from 6 to 4 ml/kg and P plat kept ventilation with moderate increase in PaCO 2 in patients with mild-to-moderate ARDS. ClinicalTrials.gov, NCT02606240. Registered on 17 November 2015.

Implementation of a Goal-Directed Mechanical Ventilation Order Set Driven by Respiratory Therapists Improves Compliance With Best Practices for Mechanical Ventilation.

Science.gov (United States)

Radosevich, Misty A; Wanta, Brendan T; Meyer, Todd J; Weber, Verlin W; Brown, Daniel R; Smischney, Nathan J; Diedrich, Daniel A

2017-01-01

Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice. We evaluated 1302 patients undergoing invasive mechanical ventilation (1693 separate episodes of invasive mechanical ventilation) prior to and after institution of a standardized, goal-directed mechanical ventilation order set using a controlled before-and-after study design. Patient-specific goals for oxygenation partial pressure of oxygen in arterial blood (Pao 2 ), ARDS Network [Net] positive end-expiratory pressure [PEEP]/fraction of inspired oxygen [Fio 2 ] table use) and ventilation (pH, partial pressure of carbon dioxide) were selected by prescribers and implemented by RTs. Compliance with the new mechanical ventilation order set was high: 88.2% compliance versus 3.8% before implementation of the order set ( P mechanical ventilation, intensive care unit (ICU) length of stay, and in-hospital or ICU mortality. A standardized best practice mechanical ventilation order set can be implemented by a multidisciplinary team and is associated with improved compliance to written orders and adherence to the ARDSNet PEEP/Fio 2 table.

Massive aspiration past the tracheal tube cuff caused by closed tracheal suction system.

Science.gov (United States)

Dave, Mital H; Frotzler, Angela; Madjdpour, Caveh; Koepfer, Nelly; Weiss, Markus

2011-01-01

Aspiration past the tracheal tube cuff has been recognized to be a risk factor for the development of ventilator-associated pneumonia (VAP). This study investigated the effect of closed tracheal suctioning on aspiration of fluid past the tracheal tube cuff in an in vitro benchtop model. High-volume low pressure tube cuffs of 7.5 mm internal diameter (ID) were placed in a 22 mm ID artificial trachea connected to a test lung. Positive pressure ventilation (PPV) with 15 cm H₂O peak inspiratory pressure and 5 cm H₂O positive end-expiratory pressure (PEEP) was used. A closed tracheal suction system (CTSS) catheter (size 14Fr) was attached to the tracheal tube and suction was performed for 5, 10, 15, or 20 seconds under 200 or 300 cm H₂O suction pressures. Amount of fluid (mL) aspirated along the tube cuff and the airway pressure changes were recorded for each suction procedure. Fluid aspiration during different suction conditions was compared using Kruskal-Wallis and Mann-Whitney test (Bonferroni correction [α = .01]). During 10, 15, and 20 seconds suction, airway pressure consistently dropped down to -8 to -13 cm H₂O (P aspiration was never observed under PPV + PEEP but occurred always during suctioning. Aspiration along the tube cuff was higher with -300 cm H₂O than with -200 cm H₂O suction pressure (P aspiration of fluid occurs along the tracheal tube cuff during suction with the closed tracheal suction system. © SAGE Publications 2011.

Data-driven classification of ventilated lung tissues using electrical impedance tomography

International Nuclear Information System (INIS)

Gómez-Laberge, Camille; Hogan, Matthew J; Elke, Gunnar; Weiler, Norbert; Frerichs, Inéz; Adler, Andy

2011-01-01

Current methods for identifying ventilated lung regions utilizing electrical impedance tomography images rely on dividing the image into arbitrary regions of interest (ROI), manually delineating ROI, or forming ROI with pixels whose signal properties surpass an arbitrary threshold. In this paper, we propose a novel application of a data-driven classification method to identify ventilated lung ROI based on forming k clusters from pixels with correlated signals. A standard first-order model for lung mechanics is then applied to determine which ROI correspond to ventilated lung tissue. We applied the method in an experimental study of 16 mechanically ventilated swine in the supine position, which underwent changes in positive end-expiratory pressure (PEEP) and fraction of inspired oxygen (F I O 2 ). In each stage of the experimental protocol, the method performed best with k = 4 and consistently identified 3 lung tissue ROI and 1 boundary tissue ROI in 15 of the 16 subjects. When testing for changes from baseline in lung position, tidal volume, and respiratory system compliance, we found that PEEP displaced the ventilated lung region dorsally by 2 cm, decreased tidal volume by 1.3%, and increased the respiratory system compliance time constant by 0.3 s. F I O 2 decreased tidal volume by 0.7%. All effects were tested at p < 0.05 with n = 16. These findings suggest that the proposed ROI detection method is robust and sensitive to ventilation dynamics in the experimental setting

Toward improved surveillance: the impact of ventilator-associated complications on length of stay and antibiotic use in patients in intensive care units.

Science.gov (United States)

Hayashi, Yoshiro; Morisawa, Kenichiro; Klompas, Michael; Jones, Mark; Bandeshe, Hiran; Boots, Robert; Lipman, Jeffrey; Paterson, David L

2013-02-01

Hospitals and quality improvement agencies are vigorously focusing on reducing rates of hospital-acquired infection. Ventilator-associated pneumonia (VAP) is notoriously difficult to diagnose and surveillance is thwarted by the subjectivity of many components of the surveillance definition. Alternative surveillance strategies are needed. Ventilator-associated complications (VAC) is a simple, objective measure of respiratory deterioration. VAC is defined by increases in fraction of inspired oxygen (FiO(2)) by ≥ 15% or positive end-expiratory pressure (PEEP) by ≥ 2.5 cm H(2)O lasting ≥ 2 days after stable or decreasing FiO(2) or PEEP lasting ≥ 2 days. We retrospectively assessed patients on mechanical ventilation for ≥ 48 hours in our study intensive care unit (ICU) using electronic medical record data. We analyzed the association between VAC and clinical diagnoses, ICU length of stay, duration of mechanical ventilation, antibiotic use, and mortality. We assessed 153 patients with VAC and 390 without VAC. VAC events were associated with significantly increased ICU length of stay, duration of mechanical ventilation, and consumption of broad-spectrum antibiotics but not with longer hospital stays or ICU mortality. Surveillance for VAP is subjective and labor intensive. VAC is an objective measure which can be readily obtained from electronic records. It is associated with adverse outcomes and increased broad-spectrum antibiotic usage. VAC may be a useful surveillance tool. The utility of VAC prevention bundles merits assessment.

Reseach blog:

DEFF Research Database (Denmark)

Lieberoth, Andreas

2011-01-01

Ongoing research blog discussing Andreas' research in the psychology of applied games, as well as general musings on cognitive neuroscience, game-design, and more. Also contains hints and guides for students on writing psychology research-papers.......Ongoing research blog discussing Andreas' research in the psychology of applied games, as well as general musings on cognitive neuroscience, game-design, and more. Also contains hints and guides for students on writing psychology research-papers....

Universiteedi instituudid / Peep Nemvalts ; kommenteerivad Peeter Vihma, Hagi Šein, Andi Kivinukk

Index Scriptorium Estoniae

Nemvalts, Peep

2007-01-01

Tallinna ülikooli struktuuri muutustest ning terminite instituut, teaduskond ja osakond kasutusest, sisaldab sotsioloogia magistrandi, Rahvusvaheliste ja Sotsiaaluuringute Instituudi riigiteaduste osakonna assistendi Peeter Vihma, Balti Filmi- ja Meediakooli direktori Hagi Šeini, matemaatika-loodusteaduskonna dekaani Andi Kivinuki kommentaare

Performance and optimization of support vector machines in high-energy physics classification problems

Energy Technology Data Exchange (ETDEWEB)

Sahin, Mehmet Oezguer; Kruecker, Dirk; Melzer-Pellmann, Isabell [DESY, Hamburg (Germany)

2016-07-01

In this talk, the use of Support Vector Machines (SVM) is promoted for new-physics searches in high-energy physics. We developed an interface, called SVM HEP Interface (SVM-HINT), for a popular SVM library, LibSVM, and introduced a statistical-significance based hyper-parameter optimization algorithm for the new-physics searches. As example case study, a search for Supersymmetry at the Large Hadron Collider is given to demonstrate the capabilities of SVM using SVM-HINT.

Translations on USSR Military Affairs, Number 1328.

Science.gov (United States)

1978-02-02

of his age. This news came as no surprise to Mikhail Vasil’yevich, and he reported to the commander his readiness immediately to begin the transfer...for this period, in which regard he dropped a hint to the commander. 103 Major Labushev did not take the hint. Convinced that there was no mutual...District. It was directed thence to the garrison judge advocate, who sent Mikhail Vasil’yevich an encouraging letter. It declared that his unit

Üks vormiõpetus (I) : Vaimumõõgad / Henn Saari

Index Scriptorium Estoniae

Saari, Henn, 1924-1999

1998-01-01

Diskussioonist eesti nüüdiskeele võrmiõpetuse ning selle eelduseks oleva fooniasüsteemi üle uut õigekeelsussõnaraamatut ette valmistades. Vt. ka: Ehala, Martin. Eesti morfoloogia olemus // Keel ja Kirjandus, 1997, nr. 6 ; Hint, Mati. Eesti foneetika möödunud hiilgus ja möödumata viletsus // Keel ja Kirjandus, 1997, nr. 2 ; Ross, Kristiina. Eesti morfo(fono)loogia põnevamad probleemid : EKG contra Mati Hint // Keel ja Kirjandus, 1997, nr. 5

Towards high-density matter with relativistic heavy-ion collisions

International Nuclear Information System (INIS)

Nagamiya, Shoji.

1990-04-01

Recent progress in nucleus-nucleus collisions at BNL and CERN suggests a hint that the formation of high-density nuclear matter could be possible with relativistic heavy-ion beams. What is the maximum density that can be achieved by heavy-ion collisions? Are there data which show evidence or hints on the formation of high density matter? Why is the research of high-density interesting? How about the future possibilities on this subject? These points are discussed. (author)

From the standard model to dark matter

International Nuclear Information System (INIS)

Wilczek, F.

1995-01-01

The standard model of particle physics is marvelously successful. However, it is obviously not a complete or final theory. I shall argue here that the structure of the standard model gives some quite concrete, compelling hints regarding what lies beyond. Taking these hints seriously, one is led to predict the existence of new types of very weakly interacting matter, stable on cosmological time scales and produced with cosmologically interesting densities--that is, ''dark matter''. copyright 1995 American Institute of Physics

Avaliação das modalidades ventilatórias no período transoperatório por meio de questionário Evaluación de las modalidades ventilatorias en el período transoperatorio por medio de cuestionario Evaluation of transoperatory ventilation modalities by a questionnaire

Directory of Open Access Journals (Sweden)

Angel Soubhie

2010-08-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Os aparelhos de anestesia vêm possibilitando reduzir repercussões fisiológicas e problemas causados por ventilação mecânica. O objetivo deste estudo foi avaliar, retrospectivamente, os métodos e recursos de suporte ventilatório utilizados por um grupo de anestesiologistas em pacientes sem lesão pulmonar prévia no período intraoperatório. MÉTODO: Um questionário anônimo, com 27 questões objetivas, foi aplicado em um grupo composto por médicos anestesiologistas e em especialização que atuam em diferentes hospitais privados na cidade de São Paulo. Os questionários foram aplicados em um período de 15 dias. Observaram-se os padrões ventilatórios, a pressão positiva ao final da expiração (PEEP, o recrutamento alveolar e o cálculo do volume-corrente empregado com intubação traqueal. RESULTADOS: Os participantes foram predominantemente do sexo masculino, 40,5% com título superior em Anestesiologia (TSA, e a maioria concluiu a especialização há menos de 10 anos. A maior parte dos anestesiologistas faz uso de PEEP rotineiramente, entre 5 e 10 cmH2O. Fluxo de gases frescos acima de 1.000 mL.min-1 ainda é utilizado pela maior parte dos anestesiologistas. Manobras de recrutamento alveolar são realizadas por 80% dos entrevistados, logo após a intubação e antes da desintubação, sendo a estratégia mais comum a insuflação com 40 cmH2O por 15 segundos. Quanto às estratégias protetoras de ventilação, apenas 30% utilizam volume-corrente JUSTIFICATIVA Y OBJETIVOS: Los aparatos de anestesia han venido posibilitando la reducción de las repercusiones fisiológicas y de los problemas causados por la ventilación mecánica. El objetivo de este estudio fue evaluar de forma retrospectiva, los métodos y los recursos de ayuda ventilatoria utilizados por un grupo de anestesiólogos en pacientes sin lesión pulmonar previa en el período intraoperatorio. MÉTODO: Un cuestionario no identificado, con

Cool WISPs for stellar cooling excesses

Energy Technology Data Exchange (ETDEWEB)

Giannotti, Maurizio [Physical Sciences, Barry University, 11300 NE 2nd Avenue, Miami Shores, FL 33161 (United States); Irastorza, Igor; Redondo, Javier [Departamento de Física Teórica, Universidad de Zaragoza, Pedro Cerbuna 12, E-50009, Zaragoza, España (Spain); Ringwald, Andreas, E-mail: mgiannotti@barry.edu, E-mail: igor.irastorza@cern.ch, E-mail: jredondo@unizar.es, E-mail: andreas.ringwald@desy.de [Theory group, Deutsches Elektronen-Synchrotron DESY, Notkestraße 85, D-22607 Hamburg (Germany)

2016-05-01

Several stellar systems (white dwarfs, red giants, horizontal branch stars and possibly the neutron star in the supernova remnant Cassiopeia A) show a mild preference for a non-standard cooling mechanism when compared with theoretical models. This exotic cooling could be provided by Weakly Interacting Slim Particles (WISPs), produced in the hot cores and abandoning the star unimpeded, contributing directly to the energy loss. Taken individually, these excesses do not show a strong statistical weight. However, if one mechanism could consistently explain several of them, the hint could be significant. We analyze the hints in terms of neutrino anomalous magnetic moments, minicharged particles, hidden photons and axion-like particles (ALPs). Among them, the ALP or a massless HP represent the best solution. Interestingly, the hinted ALP parameter space is accessible to the next generation proposed ALP searches, such as ALPS II and IAXO and the massless HP requires a multi TeV energy scale of new physics that might be accessible at the LHC.

Cool WISPs for stellar cooling excesses

International Nuclear Information System (INIS)

Giannotti, Maurizio; Irastorza, Igor; Redondo, Javier; Ringwald, Andreas

2016-01-01

Several stellar systems (white dwarfs, red giants, horizontal branch stars and possibly the neutron star in the supernova remnant Cassiopeia A) show a mild preference for a non-standard cooling mechanism when compared with theoretical models. This exotic cooling could be provided by Weakly Interacting Slim Particles (WISPs), produced in the hot cores and abandoning the star unimpeded, contributing directly to the energy loss. Taken individually, these excesses do not show a strong statistical weight. However, if one mechanism could consistently explain several of them, the hint could be significant. We analyze the hints in terms of neutrino anomalous magnetic moments, minicharged particles, hidden photons and axion-like particles (ALPs). Among them, the ALP or a massless HP represent the best solution. Interestingly, the hinted ALP parameter space is accessible to the next generation proposed ALP searches, such as ALPS II and IAXO and the massless HP requires a multi TeV energy scale of new physics that might be accessible at the LHC.

Evaluation of a computerized system for mechanical ventilation of infants.

Science.gov (United States)

Tehrani, Fleur T; Abbasi, Soraya

2009-04-01

To evaluate a computerized system for mechanical ventilation of infants. FLEX is a computerized system that includes the features of a patented mode known as adaptive-support ventilation (ASV). In addition, it has many other features including adjustment of positive end-expiratory pressure (PEEP), fraction of inspired oxygen (F(IO2)), minute ventilation, and control of weaning. It is used as an open-loop decision support system or as a closed-loop technique. Blood gas and ventilation data were collected from 12 infants in the neonatal intensive care at baseline and at the next round of evaluation. This data were input to open-loop version of FLEX. The system recommendations were compared to clinical determinations. FLEX recommended values for ventilation were on the average within 25% and 16.5% of the measured values at baseline and at the next round of evaluation, respectively. For F(IO2) and PEEP, FLEX recommended values were in general agreement with the clinical settings. FLEX recommendations for weaning were the same as the clinical determinations 50% of the time at baseline and 55% of the time at the next round of evaluation. FLEX did not recommend weaning for infants with weak spontaneous breathing effort or those who showed signs of dyspnea. A computerized system for mechanical ventilation is evaluated for treatment of infants. The results of the study show that the system has good potential for use in neonatal ventilatory care. Further refinements can be made in the system for very low-birth-weight infants.

The effect of low level laser therapy on ventilator-induced lung injury in mice (Conference Presentation)

Science.gov (United States)

Szabari, Margit V.; Miller, Alyssa J.; Hariri, Lida P.; Hamblin, Michael R.; Musch, Guido; Stroh, Helene; Suter, Melissa J.

2016-03-01

Although mechanical ventilation (MV) is necessary to support gas exchange in critically ill patients, it can contribute to the development of lung injury and multiple organ dysfunction. It is known that high tidal volume (Vt) MV can cause ventilator-induced lung injury (VILI) in healthy lungs and increase the mortality of patients with Acute Respiratory Distress Syndrome. Low level laser therapy (LLLT) has demonstrated to have anti-inflammatory effects. We investigated whether LLLT could alleviate inflammation from injurious MV in mice. Adult mice were assigned to 2 groups: VILI+LLLT group (3 h of injurious MV: Vt=25-30 ml/kg, respiratory rate (RR)=50/min, positive end-expiratory pressure (PEEP)=0 cmH20, followed by 3 h of protective MV: Vt=9 ml/kg, RR=140/min, PEEP=2 cmH20) and VILI+no LLLT group. LLLT was applied during the first 30 min of the MV (810 nm LED system, 5 J/cm2, 1 cm above the chest). Respiratory impedance was measured in vivo with forced oscillation technique and lung mechanics were calculated by fitting the constant phase model. At the end of the MV, bronchoalveolar lavage (BAL) was performed and inflammatory cells counted. Lungs were removed en-bloc and fixed for histological evaluation. We hypothesize that LLLT can reduce lung injury and inflammation from VILI. This therapy could be translated into clinical practice, where it can potentially improve outcomes in patients requiring mechanical ventilation in the operating room or in the intensive care units.

Intraoperative mechanical ventilation: state of the art.

Science.gov (United States)

Ball, Lorenzo; Costantino, Federico; Orefice, Giulia; Chandrapatham, Karthikka; Pelosi, Paolo

2017-10-01

Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review was to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass. While anesthesia and mechanical ventilation are becoming increasingly safe practices, the contribution to surgical mortality attributable to postoperative lung injury is not negligible: for these reasons, the prevention of PPCs, including the use of protective mechanical ventilation is mandatory. Mechanical ventilation should be optimized providing an adequate respiratory support while minimizing unwanted negative effects. Due to the high number of surgical procedures performed daily, the impact on patients' health and healthcare costs can be relevant, even when new strategies result in an apparently small improvement of outcome. A protective intraoperative ventilation should include a low tidal volume of 6-8 mL/kg of predicted body weight, plateau pressures ideally below 16 cmH2O, the lowest possible driving pressure, moderate-low PEEP levels except in obese patients, laparoscopy and long surgical procedures that might benefit of a slightly higher PEEP. The work of the anesthesiologist should start with a careful preoperative visit to assess the risk, and a close postoperative monitoring.

A "g" beyond "Homo Sapiens"? Some Hints and Suggestions

Science.gov (United States)

Lee, James J.

2007-01-01

This article proposes that a complete account of cognitive evolution may have to accommodate a domain-general source of variance in mental abilities accounting for differences among primate taxa. Deaner, van Schaik, and Johnson [Deaner, R.O., van Schaik, C.P. and Johnson, V.E. (2006). Do some taxa have better domain-general cognition than others?…

Hints for electric-field compensation in multicell resonant structures

Energy Technology Data Exchange (ETDEWEB)

Fernandes, P; Parodi, R

1981-03-31

We propose a lumped-parameter equivalent circuit for a TM/sub 01/ multicell standing wave accelerating structure with full end cells. By the suggested model we can predict the amount of end cell frequency compensation needed to achieve field flatness in the highest mode of the structure.

Sünnitades "Ema ja tütart" / Anna Hints

Index Scriptorium Estoniae

Hints, Anna, 1982-

2010-01-01

Tartu sünnitusmajale Toomemäel, naise eluringile ja põlvkondade järjepidevusele pühendatud "Ema ja tütar" kui koha, heli, foto ja rituaalse tegevuse koostoimel sündinud autori tajuvõrgustikku dekodeeriv pärimusliku ja isikliku taustaga kunstitöö

Short views and hints on information, knowledge and scenarios

DEFF Research Database (Denmark)

Kristiansson, Michael

2011-01-01

This article discusses information and knowledge in relation to scenario planning (van der Heijden) and considers the type of information that is relied on/included as well as the nature of knowledge produced by the scenario planning sequence. In addition, the chief tools and processes drawn upon...

Mari Koger : seina sisse ehitatud akvaariumiga poissmehekodu / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2003-01-01

80-ruutmeetrine poissmehekorter Viimsi uues elamus. Elutoa ja vannitoa vahelises seinas paikneb kahelt poolt vaadeldav akvaarium. Magamistoa üks seintest on ehitatud vanadest tellistest. Sisearhitekt Mari Koger, tema kommentaarid. Ill.: plaan, 9 värv. vaadet

Tiina Mang : vanalinna korter muutus visuaalselt suuremaks / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2003-01-01

74-ruutmeetrine vanalinna korter, mõeldud kahele inimesele, kellest üks töötab kodus. Enamik mööblist on valmistatud eritellimusel. Sisearhitekt Tiina Mang, tema kommentaarid. Ill.: plaan, 3 värv. vaadet

200 more puzzling physics problems with hints and solutions

CERN Document Server

Gnädig, Péter; Vigh, Máté

2016-01-01

Like its predecessor, 200 Puzzling Physics Problems, this book is aimed at strengthening students' grasp of the laws of physics by applying them to situations that are practical, and to problems that yield more easily to intuitive insight than to brute-force methods and complex mathematics. The problems are chosen almost exclusively from classical, non-quantum physics, but are no easier for that. They are intriguingly posed in accessible non-technical language, and require readers to select an appropriate analysis framework and decide which branches of physics are involved. The general level of sophistication needed is that of the exceptional school student, the good undergraduate, or the competent graduate student; some physics professors may find some of the more difficult questions challenging. By contrast, the mathematical demands are relatively minimal, and seldom go beyond elementary calculus. This further book of physics problems is not only instructive and challenging, but also enjoyable.

Aet Piel : oluline sisekujunduselement on viltune sein / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2003-01-01

Poolkaares ehitatud korterelamus on Aet Pieli kujundatud korteris üks sein viltu. Esmapilgul häirivana mõjunud sein sai oluliseks sisekujunduselemendiks. Eritellimusel valmistatud mööbel on tammepuidust. A. Pieli kommentaarid. Ill.: plaan enne ja nüüd, 9 värv. vaadet

Remembering Multiple Passwords by Way of Minimal-Feedback Hints

DEFF Research Database (Denmark)

Hertzum, Morten

2004-01-01

Passwords are a prominent mechanism for user authentication but entail a conflict between ease of use and security in that passwords must be both easy to remember for the password holder and difficult to guess for everybody else. To support users in remembering their passwords minimal-feedback...

Using peer instruction with hints in introductory business statistics

NARCIS (Netherlands)

Ding, Ning; Xu, Xiaoyan

2014-01-01

Abstract:Purpose – Peer instruction has been widely adopted as an instructional method in higher education. However, due to students' different preconceptions, the authors argued that peer instruction is not a panacea in international business education when students' prior knowledge extensively

Taso Mähar : avatud vannitoaga vanalinna korter / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2003-01-01

Modernne korter (220 m2). Sisearhitekt Taso Mähar, tema kommentaarid. Kogu korteri ulatuses on sisekujundusmaterjalidena kasutatud väärispuitu, metalli, marmorit ja klaasi. T. Mähari projekteeritud on trepp ja piirded, kamin, baarilett ja õhukesed alumiiniumraamidel mattklaasidega uksed. Ill.: I ja II korruse plaan, 8 värv. vaadet

"To Improve upon Hints of Things": Illustrating Isaac Newton.

Science.gov (United States)

Schilt, Cornelis J

2016-01-01

When Isaac Newton died in 1727 he left a rich legacy in terms of draft manuscripts, encompassing a variety of topics: natural philosophy, mathematics, alchemy, theology, and chronology, as well as papers relating to his career at the Mint. One thing that immediately strikes us is the textuality of Newton's legacy: images are sparse. Regarding his scholarly endeavours we witness the same practice. Newton's extensive drafts on theology and chronology do not contain a single illustration or map. Today we have all of Newton's draft manuscripts as witnesses of his working methods, as well as access to a significant number of books from his own library. Drawing parallels between Newton's reading practices and his natural philosophical and scholarly work, this paper seeks to understand Newton's recondite writing and publishing politics.

New physics hints in B decays and collider outlook

Indian Academy of Sciences (India)

Less noticed is the difference in direct CPV (DCPV) asymmetries in B0 ... Our working picture is that squarks are relatively degenerate at some ... We stress that the new (and unique!) ..... [1] See http://mlm.home.cern.ch/mlm/FlavLHC.html.

DEMYSTIFYING QUANTUM MECHANICS: Will there be hints from LHC?

CERN Multimedia

CERN. Geneva

2007-01-01

All modern theories for particles, forces and even space-time itself, use the framework provided by quantum mechanics. The Standard Model is a quantized field theory. Even superstring theory is based on quantum mechanics. There is something odd about quantum mechanics: it brilliantly allows us to predict the outcome of experiments, yet it gives confusing statements about what really is going on inside particles and fields. Suppose we would be asking for a theory that allows us to describe what actually happens in less ambiguous terms, without destroying the magnificent successes of quantum mechanics, would this help us to answer some of the great mysteries of theoretical elementary particle physics?Organiser(s): L. Alvarez-Gaume / PH-THNote: * Tea & coffee will be served at 16:00.

Kas teie arvates tuleks Ülejõe pargid Emajõe vasakkaldal taashoonestada? / intervjueerinud Ivi Drikkit ja Jüri Saar

Index Scriptorium Estoniae

2011-01-01

Vastasid: Mati Tolmoff, Veljo Ipits, Toomas Savi, Verni Loodmaa, Väino Kull, Toomas Kapp, Triin Anette Kaasik, Kristjan Karis, Hele Everaus, Margot Fjuk, Janika Mölder, Hannes Astok, Jaak Adamsoo, Martin Parmas, Toivo Kabanen, Oleg Nesterenko, Tõnu Ints, Piret Uluots, Peep Peterson, Marju Lauristin, Jarno Laur, Arno Arukask, Ülo Veldre, Toomas Jürgenstein, Veera Sirg, Maie Pastik, Elmut Paavel, Avo Rosenvald, Toivo Maimets, Peeter Tulviste, Joel Luhamets, Jüri Kõre, Ants Kask, Enn Tarto, Tarmo Punger, Merle Jääger, Vladimir Šokman, Boris Habramov, Jevgenia Lindevaldt, Harri Jallajas, Natalja Trošina, Olev Raju, Nikolai Põdramägi

Mecânica pulmonar de pacientes em suporte ventilatório na unidade de terapia intensiva. Conceitos e monitorização Concepts and monitoring of pulmonary mechanic in patients under ventilatory support in intensive care unit

Directory of Open Access Journals (Sweden)

Eduardo Antonio Faustino

2007-06-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Em ventilação mecânica invasiva e não-invasiva, o conhecimento da fisiologia da mecânica respiratória, é imprescindível para tomada de decisões e no manuseio eficiente dos ventiladores modernos. A monitorização dos parâmetros da mecânica pulmonar é recomendada nos trabalhos de revisão e de pesquisas clínicas. O objetivo deste estudo foi rever os conceitos de mecânica pulmonar e os métodos utilizados para obtenção de medidas à beira do leito, enfatizando três parâmetros: resistência, complacência e PEEP intrínseca. MÉTODO: Foi realizada revisão bibliográfica através dos bancos de dados LILACS, MedLine e PubMed, no período de 1996 a 2006. RESULTADOS: Esta revisão abordou os parâmetros de resistência, complacência pulmonar e PEEP intrínseca como fundamentais na compreensão da insuficiência respiratória aguda e suporte ventilatório mecânico, principalmente na doença pulmonar obstrutiva crônica (DPOC e na síndrome da angústia respiratória aguda (SARA. CONCLUSÕES: A monitorização da mecânica pulmonar em pacientes sob ventilação mecânica em unidade de terapia intensiva (UTI pode fornecer dados relevantes e deve ser implementada de forma sistemática e racional.BACKGROUND AND OBJECTIVES: In mechanical ventilation, invasive and noninvasive, the knowledge of respiratory mechanic physiology is indispensable to take decisions and into the efficient management of modern ventilators. Monitoring of pulmonary mechanic parameters is been recommended from all the review works and clinical research. The objective of this study was review concepts of pulmonary mechanic and the methods used to obtain measures in the bed side, preparing a rational sequence to obtain this data. METHODS: It was obtained bibliographic review through data bank LILACS, MedLine and PubMed, from the last ten years. RESULTS: This review approaches parameters of resistance, pulmonary compliance and intrinsic PEEP

MHD equilibrium of heliotron J plasmas

International Nuclear Information System (INIS)

Suzuki, Yasuhiro; Nakamura, Yuji; Kondo, Katsumi; Nakajima, Noriyoshi; Hayashi, Takaya

2004-01-01

MHD equilibria of Heliotron J plasma are investigated by using HINT code. By assuming some profiles of the current density, effects of the net toroidal currents on the magnetohydrodynamics (MHD) equilibrium are investigated. If the rotational transform can be controlled by the currents, the generation of good flux surfaces is expected. In order to study equilibria with self-consistent bootstrap current, the boozer coordinates are constructed by converged HINT equilibrium as a preliminary study. Obtained spectra are compared with ones of VMEC code and both results are consistent. (author)

Kuues üritus tõi Roman Šebrlele maailmameistritiitli / Raigo Pajula, Peep Pahv

Index Scriptorium Estoniae

Pajula, Raigo, 1971-

2007-01-01

32-aastane tšehh Roman Šeberle on nüüd mitmevõistlejana triumfeerinud kõikidel tiitlivõistlustel. Jaapanis Osakas sai ta MMi kuldmedali. Esimest korda suurvõistlusel osalenud Andres Raja sai 16. koha

Politsei on tsiviilühiskonna lihased / Ignar Fjuk ; interv. Peep Lillemägi

Index Scriptorium Estoniae

Fjuk, Ignar, 1953-

2001-01-01

Ilmunud ka: Nädaline, 18. sept. 2001, lk. 6; Meie Maa, 18. sept. 2001, lk. 2; Virumaa Teataja, 20. sept. 2001, lk. 7; Valgamaalane, 20. sept. 2001, lk. 2; Vooremaa, 25. sept. 2001, lk. 2. Hinnang politseireformi sildi all toimunud koondamistele. Autor: Reformierakond. Parlamendisaadik

Rastotshitelstvo - glavnaja problema tsentristskoi upravõ / Remo Holsmer ; interv. Peep Lillemägi

Index Scriptorium Estoniae

Holsmer, Remo, 1980-

2008-01-01

Tallinna linnavolikogu Eesti Reformierakonna fraktsiooni esimehe hinnangul ajab Keskerakond Tallinnas riigi omale vastandlikku poliitikat, tähelepanu on suunatud vaid Lasnamäel ja Põhja-Tallinnas elavatele toetajatele. Reformierakonna fraktsioon on algatanud eelnõu lasteaedadele makstava nn. pearaha tõstmise kohta 2009. a. ja teinud ettepaneku vähendada maamaksu

Millised mõtted on peidus parimate töösturite peas? / Peep Talimaa

Index Scriptorium Estoniae

Talimaa, Peep

2008-01-01

Ettevõtluse Auhind 2008 parima tööstusettevõtte tiitli võitnud AS Favor edu põhjustest, tulevikuperspektiividest ja ootustest riigile. Vt. samas: Eesti parimad ettevõtted on ABB ja Tallink Grupp. Lisa: Konkursi "Ettevõtluse auhind 2008" laureaadid ja kandidaadid

Remo Holsmer: mees Kalevi pingi taga / Remo Holsmer ; interv. Peep Lillemägi

Index Scriptorium Estoniae

Holsmer, Remo, 1980-

2009-01-01

Reformierakonna Tallinna piirkonnajuht Remo Holsmer vastab küsimustele, mis puudutavad tema tööd Kalevi korvpalliklubi managerina, korvpalli taset Eestis, Kalevisse välismängijate leidmist, Tallinna Kalev-Tartu Rock vastasseisu ning suhteid Jaak Salumetsaga

Avati mälestuskivi Heinrich Marga sünnikohas / Peep Pillak ; Peeter Margna

Index Scriptorium Estoniae

Pillak, Peep, 1957-

2008-01-01

1. oktoobril 2008 avati mälestuskivi Heinrich Margale (1. oktoober 1911 - 2. august 2004) Põlvamaal Kõlleste vallas Ihamaru külas Otsa talus. Heinrich Mark õppis Tartu Ülikooli õigusteaduskonnas aastatel 1933-1938. Lisatud Peeter Margna sõnavõtt Heinrich Marga mälestuskivi avamisel

Transdermal granisetron for the prevention of nausea and vomiting following moderately or highly emetogenic chemotherapy in Chinese patients: a randomized, double-blind, phase III study.

Science.gov (United States)

Yang, Liu-Qing; Sun, Xin-Chen; Qin, Shu-Kui; Chen, Ying-Xia; Zhang, He-Long; Cheng, Ying; Chen, Zhen-Dong; Shi, Jian-Hua; Wu, Qiong; Bai, Yu-Xian; Han, Bao-Hui; Liu, Wei; Ouyang, Xue-Nong; Liu, Ji-Wei; Zhang, Zhi-Hui; Li, Yong-Qiang; Xu, Jian-Ming; Yu, Shi-Ying

2016-12-01

The granisetron transdermal delivery system (GTDS) has been demonstrated effectiveness in the control of chemotherapy-induced nausea and vomiting (CINV) in previous studies. This is the first phase III study to evaluate the efficacy and tolerability of GTDS in patients receiving moderately emetogenic chemotherapy (MEC) or highly emetogenic chemotherapy (HEC) in China. A total of 313 patients were randomized into the GTDS group (one transdermal granisetron patch, 7 days) or the oral granisetron group (granisetron oral 2 mg/day, ≥2 days). The primary endpoint was the percentage of patients achieving complete control (CC) from chemotherapy initiation until 24 h after final administration (PEEP). Chi-square test and Fisher's exact test were used for statistical analysis. Two hundred eighty-one patients were included in the per protocol analysis. During PEEP, CC was achieved by 67 (47.52%) patients in the GTDS group and 83 (59.29%) patients in the oral granisetron group. There was no statistical significance between the groups (P=0.0559). However, the difference of the CC percentage mainly occurred on the first day of chemotherapy between the groups. The CC was 70.13% on day 1 in the GTDS group, which was significantly lower than that of 91.03% in the oral granisetron group in the full analysis set. In the following days of chemotherapy, the CC was similar between the groups. In terms of cisplatin-contained regimen and female, there was statistical significance between the groups. Both treatments were well tolerated and safe. The most common adverse event was constipation. GTDS provided effective and well-tolerated control of CINV in Chinese patients, especially to non-cisplatin-contained regimen.

Antenatal and postnatal corticosteroid and resuscitation induced lung injury in preterm sheep

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Kallapur Suhas G

2009-12-01

Full Text Available Abstract Background Initiation of ventilation using high tidal volumes in preterm lambs causes lung injury and inflammation. Antenatal corticosteroids mature the lungs of preterm infants and postnatal corticosteroids are used to treat bronchopulmonary dysplasia. Objective To test if antenatal or postnatal corticosteroids would decrease resuscitation induced lung injury. Methods 129 d gestational age lambs (n = 5-8/gp; term = 150 d were operatively delivered and ventilated after exposure to either 1 no medication, 2 antenatal maternal IM Betamethasone 0.5 mg/kg 24 h prior to delivery, 3 0.5 mg/kg Dexamethasone IV at delivery or 4 Cortisol 2 mg/kg IV at delivery. Lambs then were ventilated with no PEEP and escalating tidal volumes (VT to 15 mL/kg for 15 min and then given surfactant. The lambs were ventilated with VT 8 mL/kg and PEEP 5 cmH20 for 2 h 45 min. Results High VT ventilation caused a deterioration of lung physiology, lung inflammation and injury. Antenatal betamethasone improved ventilation, decreased inflammatory cytokine mRNA expression and alveolar protein leak, but did not prevent neutrophil influx. Postnatal dexamethasone decreased pro-inflammatory cytokine expression, but had no beneficial effect on ventilation, and postnatal cortisol had no effect. Ventilation increased liver serum amyloid mRNA expression, which was unaffected by corticosteroids. Conclusions Antenatal betamethasone decreased lung injury without decreasing lung inflammatory cells or systemic acute phase responses. Postnatal dexamethasone or cortisol, at the doses tested, did not have important effects on lung function or injury, suggesting that corticosteroids given at birth will not decrease resuscitation mediated injury.

Evaluation of transport ventilators at mild simulated altitude: a bench study in a hypobaric chamber.

Science.gov (United States)

Boussen, Salah; Coulange, Mathieu; Fournier, Marc; Gainnier, Marc; Michelet, Pierre; Micoli, Christophe; Negrel, Lionel

2014-08-01

Previous studies on ventilators used for air transport showed significant effects of altitude, in particular with regard to accuracy of the tidal volume (VT) and breathing frequency. The aim of the study was to evaluate transport ventilators under hypobaric conditions. We conducted a bench study of 6 transport ventilators in a Comex hypobaric chamber to simulate mild altitude (1,500 m [4,920 feet] and 2,500 m [8,200 feet]). The ventilators were connected to a test lung to evaluate their accuracy: (1) to deliver a set VT under normal resistance and compliance conditions at F(IO2) = 0.6 and 1, (2) to establish a set PEEP (0, 5, 10, and 15 cm H2O), and (3) to establish a set inspiratory pressure in pressure controlled mode, (4) at a F(IO2) setting, and (5) and at a frequency setting. Four ventilators kept an average relative error in VT of ventilator was affected by the altitude only at F(IO2) = 1. The Osiris 3 ventilator had > 40% error even at 1,500 m. We found no change in frequency as a function of altitude for any ventilators studied. No clinically important differences were found between all altitudes with the PEEP or inspiratory pressure setting. Although F(IO2) was affected by altitude, the average error did not exceed 11%, and it is unclear whether this fact is an experimental artifact. We have shown that most of the new transport ventilators tested require no setting adjustment at moderate altitude and are as safe at altitude as at sea level under normal respiratory conditions. Older technologies still deliver more volume with altitude in volumetric mode.

Energetics of the protein-DNA-water interaction

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Marabotti Anna

2007-01-01

Full Text Available Abstract Background To understand the energetics of the interaction between protein and DNA we analyzed 39 crystallographically characterized complexes with the HINT (Hydropathic INTeractions computational model. HINT is an empirical free energy force field based on solvent partitioning of small molecules between water and 1-octanol. Our previous studies on protein-ligand complexes demonstrated that free energy predictions were significantly improved by taking into account the energetic contribution of water molecules that form at least one hydrogen bond with each interacting species. Results An initial correlation between the calculated HINT scores and the experimentally determined binding free energies in the protein-DNA system exhibited a relatively poor r2 of 0.21 and standard error of ± 1.71 kcal mol-1. However, the inclusion of 261 waters that bridge protein and DNA improved the HINT score-free energy correlation to an r2 of 0.56 and standard error of ± 1.28 kcal mol-1. Analysis of the water role and energy contributions indicate that 46% of the bridging waters act as linkers between amino acids and nucleotide bases at the protein-DNA interface, while the remaining 54% are largely involved in screening unfavorable electrostatic contacts. Conclusion This study quantifies the key energetic role of bridging waters in protein-DNA associations. In addition, the relevant role of hydrophobic interactions and entropy in driving protein-DNA association is indicated by analyses of interaction character showing that, together, the favorable polar and unfavorable polar/hydrophobic-polar interactions (i.e., desolvation mostly cancel.

Joint statement by the chairmen of the Standing Committee on Reactors and the Reactor Safety Commission on safety-related documents drawn up under the Franco-German Commission on Safety Questions for Nuclear Installations (DFK). August 29, 1986

International Nuclear Information System (INIS)

1986-01-01

The report contains: 1. The present situation regarding hints and recommendations in the safety declaration by the TUEV Baden on the subject of Cattenom nuclear power station in June 1982. 2. The present situation regarding hints and recommendations in the declaration by the TUEV Rhineland in February 1982 on the subject of radiological aspects and features of the Cattenom site for the nuclear power plant. 3. Answers to press allegations about the safety of Cattenom NPP: scram system, safety cooling system, heat sink for after-heat removal, emergency power supplies, load-follow operation, air crashes, susceptibility to failures. (orig./HP) [de

Imageology and clinical examination: Two sides of the same coin

Directory of Open Access Journals (Sweden)

Deepa Das

2011-01-01

Full Text Available The continuous and rapid transition of techniques from research lab into clinical practice has been the pattern of development in radiology and imaging, and this has put the concept of clinical imaging into a different perspective. From a passive role of pattern recognition, distinguishing a radiograph from normal to abnormal, the task of a radiologist today has been elevated to reporting a comprehensive clinical imaging assay, giving information at a level profound enough to be useful for scientists working in allied fields. A peep into the literature shows how radiological and clinical examination can be two sides of the same coin.

Impacto hemodinâmico de manobra de recrutamento alveolar em pacientes evoluindo com choque cardiogênico no pós-operatório imediato de revascularização do miocárdio Impacto hemodinámico de maniobra de reclutamiento alveolar en pacientes evolucionando con choque cardiogénico en el postoperatorio inmediato de revascularización del miocardio Hemodynamic impact of alveolar recruitment maneuver in patients evolving with cardiogenic shock in the immediate postoperative period of myocardial revascularization

Directory of Open Access Journals (Sweden)

Luiz Marcelo Sá Malbouisson

2008-04-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Manobras de recrutamento alveolar (MRA utilizando pressões de 40 cmH2O nas vias aéreas são efetivas em reverter as atelectasias após revascularização cirúrgica do miocárdio (RM, contudo não existem estudos avaliando o impacto hemodinâmico dessa manobra em pacientes que evoluíram com choque cardiogênico. O objetivo foi testar a tolerância hemodinâmica à MRA em pacientes evoluindo com choque cardiogênico após RM. MÉTODO: Após admissão na UTI e estabilização hemodinâmica, foram estudados dez pacientes hipoxêmicos e em choque cardiogênico após RM. Os ajustes ventilatórios foram volume corrente de 8 mL.kg-1, PEEP 5 cmH2O, FR de 12 ipm e FiO2 de 0,6. Pressão contínua de 40 cmH2O foi aplicada nas vias aéreas por 40 segundos em três ciclos. Entre os ciclos, os pacientes foram ventilados por 30 segundos e após o último ciclo a PEEP foi ajustada em 10 cmH2O. Foram obtidas medidas hemodinâmicas após 1, 10, 30 e 60 minutos da MRA e colhidas amostras sangüíneas arteriais e venosas para mensuração de lactato e gases sangüíneos 10 e 60 minutos após. Dados analisados por meio de ANOVA e teste de Friedman. Valor de p fixado em 0,05. RESULTADOS: A MRA aumentou a relação PaO2/FiO2 de 87 para 129,5 após 10 minutos e 120 após 60 minutos (p JUSTIFICATIVA Y OBJETIVOS: Maniobras de reclutamiento alveolar (MRA utilizando presiones de 40 cmH2O en las vías aéreas son efectivas en revertir las atelectasias después de la revascularización quirúrgica del miocardio (RM, sin embargo, no existen estudios que evalúen el impacto hemodinámico de esta maniobra en pacientes que evolucionaron con choque cardiogénico. El objetivo fue probar la tolerancia hemodinámica a la MRA en pacientes que evolucionan con choque cardiogénico después de la RM. MÉTODO: Después de la entrada en la UCI y de la estabilización hemodinámica, se estudiaron 10 pacientes hipoxémicos y en choque cardiogénico después de

Individualised perioperative open-lung approach versus standard protective ventilation in abdominal surgery (iPROVE): a randomised controlled trial.

Science.gov (United States)

Ferrando, Carlos; Soro, Marina; Unzueta, Carmen; Suarez-Sipmann, Fernando; Canet, Jaume; Librero, Julián; Pozo, Natividad; Peiró, Salvador; Llombart, Alicia; León, Irene; India, Inmaculada; Aldecoa, Cesar; Díaz-Cambronero, Oscar; Pestaña, David; Redondo, Francisco J; Garutti, Ignacio; Balust, Jaume; García, Jose I; Ibáñez, Maite; Granell, Manuel; Rodríguez, Aurelio; Gallego, Lucía; de la Matta, Manuel; Gonzalez, Rafael; Brunelli, Andrea; García, Javier; Rovira, Lucas; Barrios, Francisco; Torres, Vicente; Hernández, Samuel; Gracia, Estefanía; Giné, Marta; García, María; García, Nuria; Miguel, Lisset; Sánchez, Sergio; Piñeiro, Patricia; Pujol, Roger; García-Del-Valle, Santiago; Valdivia, José; Hernández, María J; Padrón, Oto; Colás, Ana; Puig, Jaume; Azparren, Gonzalo; Tusman, Gerardo; Villar, Jesús; Belda, Javier

2018-03-01

The effects of individualised perioperative lung-protective ventilation (based on the open-lung approach [OLA]) on postoperative complications is unknown. We aimed to investigate the effects of intraoperative and postoperative ventilatory management in patients scheduled for abdominal surgery, compared with standard protective ventilation. We did this prospective, multicentre, randomised controlled trial in 21 teaching hospitals in Spain. We enrolled patients who were aged 18 years or older, were scheduled to have abdominal surgery with an expected time of longer than 2 h, had intermediate-to-high-risk of developing postoperative pulmonary complications, and who had a body-mass index less than 35 kg/m 2 . Patients were randomly assigned (1:1:1:1) online to receive one of four lung-protective ventilation strategies using low tidal volume plus positive end-expiratory pressure (PEEP): open-lung approach (OLA)-iCPAP (individualised intraoperative ventilation [individualised PEEP after a lung recruitment manoeuvre] plus individualised postoperative continuous positive airway pressure [CPAP]), OLA-CPAP (intraoperative individualised ventilation plus postoperative CPAP), STD-CPAP (standard intraoperative ventilation plus postoperative CPAP), or STD-O 2 (standard intraoperative ventilation plus standard postoperative oxygen therapy). Patients were masked to treatment allocation. Investigators were not masked in the operating and postoperative rooms; after 24 h, data were given to a second investigator who was masked to allocations. The primary outcome was a composite of pulmonary and systemic complications during the first 7 postoperative days. We did the primary analysis using the modified intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT02158923. Between Jan 2, 2015, and May 18, 2016, we enrolled 1012 eligible patients. Data were available for 967 patients, whom we included in the final analysis. Risk of pulmonary and systemic

Using big-data to validate theories of rehabilitation in aphasia

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Swathi Kiran

2015-05-01

Full Text Available Introduction. While the evidence for efficacy of rehabilitation of language disorders is fairly robust and conclusive (Allen, et al., 2012; Brady, et al., 2012; Kelly, Brady, & Enderby, 2010; Cherney, et al., 2008, a major limitation identified by these reviews is that the sample size of patients in each of the interventions have been modest (5-20 patients. As technology moves our field forward, we can now collect and analyze larger sets of data to validate theories of rehabilitation. As a first step, we report data from a recently completed study examining the effectiveness of software platform (Constant Therapy to deliver, monitor and analyze treatment for individuals with aphasia (Des Roches et al., 2015. Methods. Fifty one individuals with language and cognitive deficits were administered standardized tests (Western Aphasia Battery, Boston Naming Test, Pyramids and Palm Trees, and Cognitive Linguistic Quick Test prior to initiation and following completion of therapy. Forty-two experimental patients used the iPad-based therapy once a week with the clinician and up to six days a week for home practice. Nine control patients practiced therapy on the iPad once per week with the clinician only. Thirty-eight therapy tasks were divided into language and cognitive activities that were developed (Des Roches et al., 2015, 28 of these tasks included buttons that revealed a hint to assist the patient answer the item. The assigned therapy tasks were tailored to that individual’s language and cognitive impairment profile based on an initial baseline assessment. Each task was practiced until accuracy on task reached 100% on multiple occasions at which point that task was replaced with the task at the next level of difficulty. The 51 patients each completed a 10 week program leading to total of 3327 therapy sessions across patients. Analysis and Results: Mixed regression models showed that both the experimental and control groups improved but

Learning To Learn: 15 Vocabulary Acquisition Activities. Tips and Hints.

Science.gov (United States)

Holden, William R.

1999-01-01

This article describes a variety of ways learners can help themselves remember new words, choosing the ones that best suit their learning styles. It is asserted that repeated exposure to new lexical items using a variety of means is the most consistent predictor of retention. The use of verbal, visual, tactile, textual, kinesthetic, and sonic…

HINT for Squint: A Computer Reliant Diagnostic Aid for Strabismus

OpenAIRE

Gieszl, Louis R.; Morris, Jacqueline; Guyton, David L.

1983-01-01

This paper provides an outline of methods used for the implementation of a computer reliant diagnostic aid in the medical specialty of Ophthalmology. Some problems have been associated with many previous diagnostic models. A careful review indicates that the most serious problems were:

IceCube events and decaying dark matter: hints and constraints

Science.gov (United States)

Esmaili, Arman; Kang, Sin Kyu; Dario Serpico, Pasquale

2014-12-01

In the light of the new IceCube data on the (yet unidentified) astrophysical neutrino flux in the PeV and sub-PeV range, we present an update on the status of decaying dark matter interpretation of the events. In particular, we develop further the angular distribution analysis and discuss the perspectives for diagnostics. By performing various statistical tests (maximum likelihood, Kolmogorov-Smirnov and Anderson-Darling tests) we conclude that currently the data show a mild preference (below the two sigma level) for the angular distribution expected from dark matter decay vs. the isotropic distribution foreseen for a conventional astrophysical flux of extragalactic origin. Also, we briefly develop some general considerations on heavy dark matter model building and on the compatibility of the expected energy spectrum of decay products with the IceCube data, as well as with existing bounds from gamma-rays. Alternatively, assuming that the IceCube data originate from conventional astrophysical sources, we derive bounds on both decaying and annihilating dark matter for various final states. The lower limits on heavy dark matter lifetime improve by up to an order of magnitude with respect to existing constraints, definitively making these events—even if astrophysical in origin—an important tool for astroparticle physics studies.

IceCube events and decaying dark matter: hints and constraints

International Nuclear Information System (INIS)

Esmaili, Arman; Kang, Sin Kyu; Serpico, Pasquale Dario

2014-01-01

In the light of the new IceCube data on the (yet unidentified) astrophysical neutrino flux in the PeV and sub-PeV range, we present an update on the status of decaying dark matter interpretation of the events. In particular, we develop further the angular distribution analysis and discuss the perspectives for diagnostics. By performing various statistical tests (maximum likelihood, Kolmogorov-Smirnov and Anderson-Darling tests) we conclude that currently the data show a mild preference (below the two sigma level) for the angular distribution expected from dark matter decay vs. the isotropic distribution foreseen for a conventional astrophysical flux of extragalactic origin. Also, we briefly develop some general considerations on heavy dark matter model building and on the compatibility of the expected energy spectrum of decay products with the IceCube data, as well as with existing bounds from gamma-rays. Alternatively, assuming that the IceCube data originate from conventional astrophysical sources, we derive bounds on both decaying and annihilating dark matter for various final states. The lower limits on heavy dark matter lifetime improve by up to an order of magnitude with respect to existing constraints, definitively making these events—even if astrophysical in origin—an important tool for astroparticle physics studies

Taso Mähar : maali ümber ehitatud maja / Gitte Hint

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Hint, Gitte

2003-01-01

220-ruutmeetrise ühekorde eramu sisekujundus. Arhitekt Emil Urbel. Sisearhitekt Taso Mähar, tema kommentaarid. Köögimööbel on T. Mähari projekteeritud. Elutoas mööblifirma T&T Mang pehme mööbel, seinal Lemming Nageli maal "Punane joon all - Burn Out". Ill.: plaan, 17 värv. vaadet

What Caused the Recession of 2008? Hints from Labor Productivity

OpenAIRE

Casey Mulligan

2009-01-01

A labor market tautology says that any change in labor usage can be decomposed into a movement along a marginal productivity schedule and a shift of the schedule. I calculate this decomposition for the recession of 2008, assuming an aggregate Cobb-Douglas marginal productivity schedule, and find that all of the decline in employment and hours since December 2007 is a movement along the schedule. This finding suggests that a reduction in labor supply and/or an increase in labor market distorti...

Phenomenological Hints from a Class of String Motivated Model Constructions

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Hans Peter Nilles

2015-01-01

Full Text Available We use string theory constructions towards the generalisation of the supersymmetric standard model of strong and electroweak interactions. Properties of the models depend crucially on the location of fields in extradimensional compact space. This allows us to extract some generic lessons for the phenomenological properties of the low energy effective action. Within this scheme we present a compelling model based on local grand unification and mirage mediation of supersymmetry breakdown. We analyse the properties of the specific model towards its possible tests at the LHC and the complementarity to direct dark matter searches.

Building Models to Predict Hint-or-Attempt Actions of Students

Science.gov (United States)

Castro, Francisco Enrique Vicente; Adjei, Seth; Colombo, Tyler; Heffernan, Neil

2015-01-01

A great deal of research in educational data mining is geared towards predicting student performance. Bayesian Knowledge Tracing, Performance Factors Analysis, and the different variations of these have been introduced and have had some success at predicting student knowledge. It is worth noting, however, that very little has been done to…

Riemannian geometry of Hamiltonian chaos: hints for a general theory.

Science.gov (United States)

Cerruti-Sola, Monica; Ciraolo, Guido; Franzosi, Roberto; Pettini, Marco

2008-10-01

We aim at assessing the validity limits of some simplifying hypotheses that, within a Riemmannian geometric framework, have provided an explanation of the origin of Hamiltonian chaos and have made it possible to develop a method of analytically computing the largest Lyapunov exponent of Hamiltonian systems with many degrees of freedom. Therefore, a numerical hypotheses testing has been performed for the Fermi-Pasta-Ulam beta model and for a chain of coupled rotators. These models, for which analytic computations of the largest Lyapunov exponents have been carried out in the mentioned Riemannian geometric framework, appear as paradigmatic examples to unveil the reason why the main hypothesis of quasi-isotropy of the mechanical manifolds sometimes breaks down. The breakdown is expected whenever the topology of the mechanical manifolds is nontrivial. This is an important step forward in view of developing a geometric theory of Hamiltonian chaos of general validity.

Kaire Kemp-Tishler : harmoonia moodsa ja vana vahel / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2003-01-01

Eramu sisekujundus. Sisearhitekt Kaire Kemp-Tishler, tema kommentaarid. Arhitekt Vahur Sova. Kamina sepised tegi Heigo Jelle. Trepihallis Tiit Pääsukese maal "Orasnzh". Ill.: I ja II korruse plaan, 14 värv. vaadet

Kaire Kemp-Tishler: "Igatsen luua midagi kole-ilusat" / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2003-01-01

Kaire Kemp-Tishler (sünd. 1964) kodu sisekujunduse projekteerimisest, tasakaalust sisearhitektuuris, oma kodust. Kaire Kemp-Tishlerist, tema tehtud tööde loetelu. 1998. aastast teeb K. Kemp-Tishler koostööd Ea Andlaga, kellega koos asutas 2001. a. OÜ sisearhitektuuribüroo ArtAku. Ill.: K. Kemp-Tishleri värv. portree

Hints about Dark, Light-Bending Matter in the Distant Universe

Science.gov (United States)

1997-07-01

New infrared observations of a gravitational lens About 20 cases of gravitationally lensed (GL) quasars are known. This special physical effect, also known as a cosmic mirage, occurs when the rays of light of a distant quasar on their way to us pass near a massive object, for instance a galaxy. As a result, two or more images of the same quasar will be seen near each other. This phenomenon is described in more detail in the Appendix. A new study by a group of three European astronomers, headed by Frederic Courbin ( Institut d'Astrophysique, Universite de Liege, Belgium, and Observatoire de Paris-Meudon, France) [1], has led to the discovery of the object responsible for the double images of a remote quasar in the gravitational lens HE 1104-1805 . The investigation is based on infrared observations at the ESO La Silla Observatory in Chile and the `lensing system' turns out to be a distant, massive galaxy. Nevertheless, the geometry of the object is unusual and an additional gravitational lens of `dark' (invisible) matter may possibly be involved. This gravitational lens is also particularly well suited for future cosmological studies that aim at the determination of the Hubble constant and the expansion rate of the Universe. A new and detailed study of gravitational lenses It is rare among the relatively few, confirmed cases of gravitational lensing in the distant Universe, that the distribution of matter in the lensing system is well known. However, it is exactly this information that is needed to derive cosmological parameters by means of photometric monitoring of the brightness of the individual images in a gravitational lens [2]. The three astronomers have therefore undertaken a detailed study of some previously known gravitational lenses (or good candidate objects) with the primary aim to detect and map the associated lensing matter (refered to as the gravitational deflector or lensing object ). This is observationally quite difficult and time-consuming since the huge masses responsible for the gravitational bending of light are almost always located at very large distances from us. Thus they are quite faint and can only be observed with large telescopes and state-of-the-art equipment. Moreover, the faint images of lensing objects are located between the much brighter quasar images they lens. This makes the discovery of a lensing object and the recording of its image a most challenging task. The advantage of infrared observations The image of a remote galaxy is usually very faint at visible wavelengths, but it is brighter in the infra-red part of the spectrum. This is because the wavelength of maximum intensity in the spectrum of a rapidly receding, distant galaxy (a composite of the spectra of the stars of which it consists) is redshifted from the visual into the infrared region of the spectrum. For instance, galaxies with redshifts around z = 1 [3] are best observed in the J -band near the near-infrared wavelength of 1.25 microns (about twice that of red light), while the images of galaxies with even higher redshifts and velocities are better recorded in the 2.2 micron K -band. The present search for gravitational deflectors is therefore conducted in the infrared spectral region, using the ESO/MPI 2.2-m telescope and the IR detector IRAC 2b . Such a survey has the further advantage of revealing, if present, additional lensed images of the quasars, that may be heavily obscured by intervening dust, for example by the dust contained in the lensing galaxy. A new and powerful image combination/deconvolution algorithm These investigations have always been difficult because of the small angular separations in such lensed objects, of the order of one arcsecond, or even less in many cases. This corresponds to the image-smearing (seeing) effects introduced by atmospheric turbulence under common ground-based observing conditions. Detailed observations of such objects are therefore normally best made from space-based observatories, like the Hubble Space Telescope (HST). However, an alternative method of obtaining high-resolution images is to combine numerous exposures of the same object in an optimised way; this allows to `eliminate' most of the image degradation caused by atmospheric effects. New and powerful software for this procedure has recently been developed at the Astrophysical Institute in Liege, cf. http://vela.astro.ulg.ac.be/imaproc. The new algorithm allows to treat (`deconvolve') simultaneously a large number of exposures - especially in the infrared - and yields high-resolution, combined images of the celestial objects on which precise brightness and positional measurements can be performed. Detection of the lensing galaxy in HE 1104-1805 During the present programme, the astronomers recently observed HE 1104-1805 , a gravitational lens with a doubly imaged quasar with a redshift of z = 2.316 that was discovered in 1993 at the La Silla Observatory. Observations in 1995, made in the I -waveband (0.9 micron) under poor seeing conditions, showed a very faint feature between the quasar images but the observations did not allow to ascertain the nature of this object. Caption to ESO PR Photo 21/97 [JPEG, 55k] New infrared images were obtained during the night of April 14-15, 1997. They were then processed with the new software and the resulting, detailed images with high-angular resolution, 0.27 arcsec, now show very clearly the lensing object, a remote, elliptical galaxy, between the quasar images. The image displayed in ESO Press Photo 21/97 was obtained in the near-infrared J-band, where the lensing galaxy in HE 1104-1805 is quite faint, but still well visible and measurable after `deconvolution'. The observed, infrared colour, i.e. the difference in brightness of its image in the J- and K-bands (the (J-K) index ), is compatible with that of a high-redshift elliptical galaxy, at a distance corresponding to a redshift somewhere between z = 1 and z = 1.8. The brightest of the two quasar images (`A'; the upper one in ESO PR Photo 21/97) shows absorption lines in its spectrum which have been redshifted at z = 1.66. Since the lensing galaxy is situated at a small angular distance from this component, it is quite likely that these spectral lines are produced by this galaxy. Thus, the gravitational deflector in HE 1104-1805 is most probably an elliptical galaxy at redshift z = 1.66. This corresponds to a recession velocity of about 200,000 km/sec and a distance that, depending on the adopted Hubble relation, is of the order of 6,000 - 9,000 million light-years. Since this galaxy is comparatively bright in the infrared, this may be checked in the near future by taking an infrared spectrum, for example with the future IR instrument of the ESO New Technology Telescope, SOFI, cf. ESO Press Photo 17/97. Continued studies of HE 1104-1805 This gravitational lens is known to show brightness variations with time. It is therefore a good candidate for continued photometric monitoring which may possibly yield a new and independent determination of the Hubble constant [2], as this was recently done for another gravitational lens, PG 1115+080 [4]. If the lensing galaxy is actually located at redshift z = 1.66, then the time delay expected for brightness variations of the two lensed quasar images is of the order of 3 to 4 years, depending on the model. This should be easily measurable. A `Dark Lens' in HE 1104-1805? The observed geometry of HE 1104-1805 is somewhat surprising, since current lens models predict that the position of the deflector, as seen in the sky, is closer to the fainter quasar image than to the brighter one; here the contrary is the case. This would suggest that the distribution of the lensing matter is more complex than that of a single elliptical galaxy. In addition, the brightness of the lensing galaxy in the K-band is somewhat too high for a normal one. This may indicate the presence of a more massive object, for example a cluster of galaxies. This may not be the case, though, since the present, very deep observations would have allowed the detection of any normal cluster of galaxies between us and the quasar whose light is being split by the lens. An interesting question is therefore: do we `see' the effects of a lens of dark matter in HE 1104-1805? Only future observations, for instance with the ESO Very Large Telescope (VLT) , will tell. Where to find additional information More details about the image deconvolution techniques used for this investigation is available at the WWW pages of the Liege group. Information about another gravitational-lens related discovery by astronomers at the Institut d'Astrophysique in Liege have been reported in ESO Press Release 04/96 (9 February 1996). Notes: [1] The group consists of Frederic Courbin (Institut d'Astrophysique, Universite de Liege, Belgium, and Observatoire de Paris-Meudon, France) and Pierre Magain (Institut d'Astrophysique, Universite de Liege, Belgium) and Chris Lidman (ESO). [2] The careful observation of similar, but time-shifted brightness variations of the individual images of a quasar in a gravitational lens may sometimes lead to a determination of the distance to the lensing object (normally a distant galaxy). This is because the measured time delay of such variations (from some months to several years), from the known speed of light, will provide a direct indication of the difference in the length of the two light paths, expressed in kilometres. If moreover the overall distribution of the matter that causes the lensing effect is known (from observations of the shape of the lens) and thus the relative geometry of the lensing system and the light paths, it is then possible to estimate the absolute size of the system. When this is compared with its angular size (as seen in the sky on direct images), the true distance to the lensing object can be found. Dividing this distance with the measured recession velocity (along the line-of-sight), finally gives an independent value of the expansion rate of the Universe, the famous Hubble constant . [3] In astronomy, the redshift denotes the fraction by which the lines in the spectrum of an object are shifted towards longer wavelengths. The observed redshift of a distant galaxy or quasar gives a direct estimate of the apparent recession velocity as caused by the universal expansion. Since the expansion rate increases with the distance, the velocity is itself a function (the Hubble relation) of the distance to the object. A redshift of z = 1 corresponds to a recession velocity of 180,000 km/sec; z = 2 to 214,300 km/sec, z = 3 to 233,300 km/sec, and z = 4 to 245,500 km/sec; the non-proportionality is a relativistic effect. [4] Detailed information about PG 1115+080 may be found in the scientific papers by Schechter et al. (1997, ApJ, 475, L85) and Courbin et al. (1997, SISSA preprint astro-ph/9705093, A&A Letters, in press). Appendix: What is a gravitational lens? The physical principle behind a gravitational lens (also known as a cosmic mirage ) has been known since 1916 as a consequence of Einstein's General Relativity Theory. The gravitational field of a massive object curves the local geometry of the Universe, so light rays passing close to the object are also curved (in the same way as a `straight line' on the surface of the Earth is necessarily curved because of the curvature of the Earth's surface). This effect was first observed by astronomers in 1919 during a total solar eclipse. Accurate positional measurements of stars seen in the dark sky near the eclipsed Sun indicated an apparent displacement in the direction opposite to the Sun, about as much as predicted by the theory. The effect was obviously due to the gravitational attraction of the stellar photons when they passed near the Sun on their way to us. This was a direct confirmation of a new phenomenon and represented a milestone in physics. In the 1930's, astronomer Fritz Zwicky (1898 - 1974), of Swiss nationality and working at the Mount Wilson Observatory in California, realised that the same effect may also happen far out in space where galaxies and large galaxy clusters may be sufficiently compact and massive to bend the light from even more distant objects. However, it was only five decades later, in 1979, that his ideas were observationally confirmed when the first example of a cosmic mirage was discovered. In this connection, it is of particular interest, that this gravitational lensing effect may not only result in double or multiple images of the same object, but also that the intensities of these images increase significantly, just as it is the case with an ordinary optical lens. Distant galaxies, galaxy clusters, etc. may thereby act as natural telescopes which allow us to observe objects that would otherwise have been too faint to be detected with currently available astronomical telescopes. How to obtain ESO Press Information ESO Press Information is made available on the World-Wide Web (URL: http://www.eso.org../). ESO Press Photos may be reproduced, if credit is given to the European Southern Observatory.

Mari Koger : "Arhitekte on palju. Tuleb leida õige" / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2003-01-01

Mari Koger (sünd. 1973) kodu kujundamisest, planeerimisest, valgustusest, värvidest, suhtlemisest kliendiga. Mari Kogerist, loetletud tema tehtud ühiskondlike ruumide sisekujundused aastast 2002. M. Koger töötab Boom.ee OÜ-s. Ill.: M. Kogeri värv. portree

Sanitation and recultivation of the Endlhausen landfill. Experience and hints

Energy Technology Data Exchange (ETDEWEB)

Hoerich, O; Rieger, W

1986-02-01

A landfill located in a former gravel pit was covered once 300,000 t of domestic refuse had been dumped. Drain pipes were laid for degassing the landfill. A clay layer was used to prevent surface water inroads. The article explains details and approaches. The cost are some DM 900,000 at an area of 3 ha. Grassing and planting will follow.

Observational hints of radial migration in disc galaxies from CALIFA

Science.gov (United States)

Ruiz-Lara, T.; Pérez, I.; Florido, E.; Sánchez-Blázquez, P.; Méndez-Abreu, J.; Sánchez-Menguiano, L.; Sánchez, S. F.; Lyubenova, M.; Falcón-Barroso, J.; van de Ven, G.; Marino, R. A.; de Lorenzo-Cáceres, A.; Catalán-Torrecilla, C.; Costantin, L.; Bland-Hawthorn, J.; Galbany, L.; García-Benito, R.; Husemann, B.; Kehrig, C.; Márquez, I.; Mast, D.; Walcher, C. J.; Zibetti, S.; Ziegler, B.; Califa Team

2017-07-01

Context. According to numerical simulations, stars are not always kept at their birth galactocentric distances but they have a tendency to migrate. The importance of this radial migration in shaping galactic light distributions is still unclear. However, if radial migration is indeed important, galaxies with different surface brightness (SB) profiles must display differences in their stellar population properties. Aims: We investigate the role of radial migration in the light distribution and radial stellar content by comparing the inner colour, age, and metallicity gradients for galaxies with different SB profiles. We define these inner parts, avoiding the bulge and bar regions and up to around three disc scale lengths (type I, pure exponential) or the break radius (type II, downbending; type III, upbending). Methods: We analysed 214 spiral galaxies from the CALIFA survey covering different SB profiles. We made use of GASP2D and SDSS data to characterise the light distribution and obtain colour profiles of these spiral galaxies. The stellar age and metallicity profiles were computed using a methodology based on full-spectrum fitting techniques (pPXF, GANDALF, and STECKMAP) to the Integral Field Spectroscopic CALIFA data. Results: The distributions of the colour, stellar age, and stellar metallicity gradients in the inner parts for galaxies displaying different SB profiles are unalike as suggested by Kolmogorov-Smirnov and Anderson-Darling tests. We find a trend in which type II galaxies show the steepest profiles of all, type III show the shallowest, and type I display an intermediate behaviour. Conclusions: These results are consistent with a scenario in which radial migration is more efficient for type III galaxies than for type I systems, where type II galaxies present the lowest radial migration efficiency. In such a scenario, radial migration mixes the stellar content, thereby flattening the radial stellar properties and shaping different SB profiles. However, in light of these results we cannot further quantify the importance of radial migration in shaping spiral galaxies, and other processes, such as recent star formation or satellite accretion, might play a role. Based on observations collected at the Centro Astronómico Hispano Alemán (CAHA) at Calar Alto, operated jointly by the Max-Planck Institut für Astronomie and the Instituto de Astrofísica de Andalucía (CSIC).Table 1 is only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/604/A4

Observational hints of radial migration in disc galaxies from CALIFA

NARCIS (Netherlands)

Ruiz-Lara, T.; Pérez, I.; Florido, E.; Sánchez-Blázquez, P.; Méndez-Abreu, J.; Sánchez-Menguiano, L.; Sánchez, S. F.; Lyubenova, M.; Falcón-Barroso, J.; van de Ven, G.; Marino, R. A.; de Lorenzo-Cáceres, A.; Catalán-Torrecilla, C.; Costantin, L.; Bland-Hawthorn, J.; Galbany, L.; García-Benito, R.; Husemann, B.; Kehrig, C.; Márquez, I.; Mast, D.; Walcher, C. J.; Zibetti, S.; Ziegler, B.

2017-01-01

Context. According to numerical simulations, stars are not always kept at their birth galactocentric distances but they have a tendency to migrate. The importance of this radial migration in shaping galactic light distributions is still unclear. However, if radial migration is indeed important,

3rd Circuit hints it may reconsider McNemar reasoning.

Science.gov (United States)

1997-10-17

The [name removed] v. The Disney Store ruling is under criticism and the 3rd U.S. Circuit Court of Appeals may reconsider its 1996 decision to not allow employees who receive disability benefits to sue under the Americans with Disabilities Act (ADA). A panel of 3rd Circuit judges, working on [name removed] v. American Sterilizer Co., asserts that the [name removed] decision should not be used to assume that an individual's ADA claims are barred because of prior representations of disability. [Name removed] is suing American Sterilizer under the retaliation provisions of the ADA. Other courts are criticizing the [name removed] decision, including the District of Columbia Court in [name removed] v. Washington Metropolitan Area Transit Authority. The [name removed] court assets that a statement made in the context of a disability application does not preclude an ADA claim brought by a worker for illegal discrimination because the ADA and the Social Security Act differ in their statutory intent. AIDS advocates state that the [name removed] decision places a plaintiff in the position of having to choose between asserting a legal right or maintaining an income. Alan Epstein, who represented [name removed], is pleased by the criticism but explains that [name removed], who died this summer, will not be vindicated.

Andro Kööp : villa, mis sai ajaloo / Gitte Hint

Index Scriptorium Estoniae

Hint, Gitte

2003-01-01

Saaremaal asuva arhitekt Ike Volkovi projekti järgi ehitatud villa sisekujundus. Sisearhitekt Andro Kööp, tema kommentaarid. A. Kööp on kavandanud ka vaibad. Suures osas on villa sisekujunduses kasutatud kataloogimööblit. Ill.: I ja II korruse plaan, 17 värv. vaadet

Bs Physics at LEP, SLD, and CDF Delta m_s and Delta Gamma_s

CERN Document Server

Boix, G

2001-01-01

The current status of the experimental knowledge of $\\Bs$ meson physics is reviewed. Results from LEP and CDF on the width difference $\\dgs$ are presented, the corresponding average is found to be in good agreement with the present theoretical estimation. The $\\Bs$ oscillations have not yet been resolved, despite the progress recently achieved by SLD and ALEPH. The world combination, including results from the LEP experiments, SLD and CDF, is presented, together with the expected and observed lower limit on the $\\Bs$ oscillation frequency. A tantalizing hint of an oscillation is observed around $\\dms\\sim17 \\psin$, near future results could increase the significance of this hint.

Prügiveo hind hakkab olenema inimesest endast / Peep Aaviksoo ; interv. Jaan Rõõmussaar

Index Scriptorium Estoniae

Aaviksoo, Peep, 1956-

2004-01-01

Ilmunud ka: Stolitsa, 5. nov. 2004, lk. 3. AS-i Tallinna Prügila taotles prügi ladestamishinna tõstmist, ettevõtlusameti hinna ja tarbijakaitse osakond pidas taotletavat hinda liiga kõrgeks. Tallinna abilinnapea vastab küsimustele prügimajanduse kota

Heterogeneity of O blood group in India: Peeping through the window of molecular biology

Directory of Open Access Journals (Sweden)

Harita Gogri

2018-01-01

Results And Discussion: Overall, ten different genotypes were identified. Three rare alleles, namely, O05, O11, and O26 were seen in the mixed group category. These results suggest that there is an internal heterogeneity in the mixed group while Dhodias and Parsis, the groups which were screened earlier, seem to be more homogenous groups. An important piece of information emerges out from this study, that is, O01O02 genotype is expressing some selective force in population groups screened in India as well as many other groups worldwide. Conclusion: In the future, molecular genotyping of the ABO blood group system among different ethnic and tribal Indian groups would help in generating data to fill up the gaps in the molecular ABO map of the world.